An Evaluation of Comparability between NEISS and ICD-9-CM Injury Coding

PubMed Central

Thompson, Meghan C.; Wheeler, Krista K.; Shi, Junxin; Smith, Gary A.; Xiang, Huiyun

2014-01-01

Objective To evaluate the National Electronic Injury Surveillance System’s (NEISS) comparability with a data source that uses ICD-9-CM coding. Methods A sample of NEISS cases from a children’s hospital in 2008 was selected, and cases were linked with their original medical record. Medical records were reviewed and an ICD-9-CM code was assigned to each case. Cases in the NEISS sample that were non-injuries by ICD-9-CM standards were identified. A bridging matrix between the NEISS and ICD-9-CM injury coding systems, by type of injury classification, was proposed and evaluated. Results Of the 2,890 cases reviewed, 13.32% (n = 385) were non-injuries according to the ICD-9-CM diagnosis. Using the proposed matrix, the comparability of the NEISS with ICD-9-CM coding was favorable among injury cases (κ = 0.87, 95% CI: 0.85–0.88). The distribution of injury types among the entire sample was similar for the two systems, with percentage differences ≥1% for only open wounds or amputation, poisoning, and other or unspecified injury types. Conclusions There is potential for conducting comparable injury research using NEISS and ICD-9-CM data. Due to the inclusion of some non-injuries in the NEISS and some differences in type of injury definitions between NEISS and ICD-9-CM coding, best practice for studies using NEISS data obtained from the CPSC should include manual review of case narratives. Use of the standardized injury and injury type definitions presented in this study will facilitate more accurate comparisons in injury research. PMID:24658100

Open-access programs for injury categorization using ICD-9 or ICD-10.

PubMed

Clark, David E; Black, Adam W; Skavdahl, David H; Hallagan, Lee D

2018-04-09

The article introduces Programs for Injury Categorization, using the International Classification of Diseases (ICD) and R statistical software (ICDPIC-R). Starting with ICD-8, methods have been described to map injury diagnosis codes to severity scores, especially the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). ICDPIC was originally developed for this purpose using Stata, and ICDPIC-R is an open-access update that accepts both ICD-9 and ICD-10 codes. Data were obtained from the National Trauma Data Bank (NTDB), Admission Year 2015. ICDPIC-R derives CDC injury mechanism categories and an approximate ISS ("RISS") from either ICD-9 or ICD-10 codes. For ICD-9-coded cases, RISS is derived similar to the Stata package (with some improvements reflecting user feedback). For ICD-10-coded cases, RISS may be calculated in several ways: The "GEM" methods convert ICD-10 to ICD-9 (using General Equivalence Mapping tables from CMS) and then calculate ISS with options similar to the Stata package; a "ROCmax" method calculates RISS directly from ICD-10 codes, based on diagnosis-specific mortality in the NTDB, maximizing the C-statistic for predicting NTDB mortality while attempting to minimize the difference between RISS and ISS submitted by NTDB registrars (ISSAIS). Findings were validated using data from the National Inpatient Survey (NIS, 2015). NTDB contained 917,865 cases, of which 86,878 had valid ICD-10 injury codes. For a random 100,000 ICD-9-coded cases in NTDB, RISS using the GEM methods was nearly identical to ISS calculated by the Stata version, which has been previously validated. For ICD-10-coded cases in NTDB, categorized ISS using any version of RISS was similar to ISSAIS; for both NTDB and NIS cases, increasing ISS was associated with increasing mortality. Prediction of NTDB mortality was associated with C-statistics of 0.81 for ISSAIS, 0.75 for RISS using the GEM methods, and 0.85 for RISS using the ROCmax method; prediction of NIS mortality

[Inappropriate ICD therapies: All problems solved with MADIT-RIT?].

PubMed

Kolb, Christof

2015-06-01

The MADIT-RIT study represents a major trial in implantable cardioverter-defibrillator (ICD) therapy that was recently published. It highlights that different programming strategies (high rate cut-off or delayed therapy versus conventional) reduce inappropriate ICD therapies, leave syncope rates unaltered and can improve patient's survival. The study should motivate cardiologist and electrophysiologists to reconsider their individual programming strategies. However, as the study represents largely patients with ischemic or dilated cardiomyopathy for primary prevention of sudden cardiac death supplied with a dual chamber or cardiac resynchronisation therapy ICD, the results may not easily be transferable to other entities or other device types. Despite the success of the MADIT-RIT study efforts still need to be taken to further optimise device algorithms to avert inappropriate therapies. Optimised ICD therapy also includes the avoidance of unnecessary ICD shocks as well as the treatment of all aspects of the underlying cardiac disease.

Glypican-3 mRNA expression level in Wilms tumor: correlation with histological type, stage, and outcome.

PubMed

Wari, Md Nahidul; Vallonthaiel, Archana George; Ahmed, Aijaz; Saxena, Deepali; Iyer, Venkateswaran K; Mathur, Sandeep R; Agarwala, Sandeep; Bakhshi, Sameer; Srinivas, V; Chattopadhyaya, P; Sharma, Arundhati; Gupta, S Datta; Dinda, Amit

2017-06-01

To correlate expression of Glypican-3 in Wilms tumor with histopathology, stage, and outcome. Glypican-3 mRNA expression by real-time PCR on tumor and normal germline samples from 75 fresh nephrectomies for Wilms tumor with fold change after normalization against GAPDH was compared. Survival analysis for event-free and overall survival (EFS, OS) with 2-year follow-up for Glypican-3 overexpression (>1.5 times) and clinicopathological parameters was performed. Glypican-3 was overexpressed in 37/75 (49.3%). It was overexpressed in 77% (10/13) cases with blastema predominance or anaplastic histology, as compared to 44% of other histologies (27/62) (p = 0.03). OS was 73 and 93%, respectively (p = 0.016), for those with and without GPC-3 overexpression. EFS was not significantly different with Glypican-3 overexpression (p = 0.11). All 5 deaths among blastema predominant tumors and 4/5 deaths among triphasic tumors had overexpressed Glypican-3. Most deaths in Stage IV, Stage III, and Stage I + II (5/7, 3/3, 1/1) had GPC-3 overexpression. On multivariate analysis, only histology and stage were found to have independent prognostic value. Glypican-3 overexpression in Wilms tumor correlates with poor OS on univariate analysis. However, only histology and stage have independent prognostic value. Glypican-3 levels may help to stratify intermediate outcome histology (triphasic) and Stage III Wilms tumors.

Validation of the Combined Comorbidity Index of Charlson and Elixhauser to Predict 30-Day Mortality Across ICD-9 and ICD-10.

PubMed

Simard, Marc; Sirois, Caroline; Candas, Bernard

2018-05-01

To validate and compare performance of an International Classification of Diseases, tenth revision (ICD-10) version of a combined comorbidity index merging conditions of Charlson and Elixhauser measures against individual measures in the prediction of 30-day mortality. To select a weight derivation method providing optimal performance across ICD-9 and ICD-10 coding systems. Using 2 adult population-based cohorts of patients with hospital admissions in ICD-9 (2005, n=337,367) and ICD-10 (2011, n=348,820), we validated a combined comorbidity index by predicting 30-day mortality with logistic regression. To appreciate performance of the Combined index and both individual measures, factors impacting indices performance such as population characteristics and weight derivation methods were accounted for. We applied 3 scoring methods (Van Walraven, Schneeweiss, and Charlson) and determined which provides best predictive values. Combined index [c-statistics: 0.853 (95% confidence interval: CI, 0.848-0.856)] performed better than original Charlson [0.841 (95% CI, 0.835-0.844)] or Elixhauser [0.841 (95% CI, 0.837-0.844)] measures on ICD-10 cohort. All weight derivation methods provided close high discrimination results for the Combined index (Van Walraven: 0.852, Schneeweiss: 0.851, Charlson: 0.849). Results were consistent across both coding systems. The Combined index remains valid with both ICD-9 and ICD-10 coding systems and the 3 weight derivation methods evaluated provided consistent high performance across those coding systems.

Implementation of ICD-10 in Canada: how has it impacted coded hospital discharge data?

PubMed Central

2012-01-01

Background The purpose of this study was to assess whether or not the change in coding classification had an impact on diagnosis and comorbidity coding in hospital discharge data across Canadian provinces. Methods This study examined eight years (fiscal years 1998 to 2005) of hospital records from the Hospital Person-Oriented Information database (HPOI) derived from the Canadian national Discharge Abstract Database. The average number of coded diagnoses per hospital visit was examined from 1998 to 2005 for provinces that switched from International Classifications of Disease 9th version (ICD-9-CM) to ICD-10-CA during this period. The average numbers of type 2 and 3 diagnoses were also described. The prevalence of the Charlson comorbidities and distribution of the Charlson score one year before and one year after ICD-10 implementation for each of the 9 provinces was examined. The prevalence of at least one of the seventeen Charlson comorbidities one year before and one year after ICD-10 implementation were described by hospital characteristics (teaching/non-teaching, urban/rural, volume of patients). Results Nine Canadian provinces switched from ICD-9-CM to ICD-I0-CA over a 6 year period starting in 2001. The average number of diagnoses coded per hospital visit for all code types over the study period was 2.58. After implementation of ICD-10-CA a decrease in the number of diagnoses coded was found in four provinces whereas the number of diagnoses coded in the other five provinces remained similar. The prevalence of at least one of the seventeen Charlson conditions remained relatively stable after ICD-10 was implemented, as did the distribution of the Charlson score. When stratified by hospital characteristics, the prevalence of at least one Charlson condition decreased after ICD-10-CA implementation, particularly for low volume hospitals. Conclusion In conclusion, implementation of ICD-10-CA in Canadian provinces did not substantially change coding practices, but

Controlling n-type doping in MoO 3

DOE PAGES

Peelaers, H.; Chabinyc, M. L.; Van de Walle, C. G.

2017-02-27

Here, we study the electronic properties of native defects and intentional dopant impurities in MoO 3, a widely used transparent conductor. Using first-principles hybrid functional calculations, we show that electron polarons can be self-trapped, but they can also bind to defects; thus, they play an important role in understanding the properties of doped MoO 3. Our calculations show that oxygen vacancies can cause unintentional n-type doping in MoO 3. Mo vacancies are unlikely to form. Tc and Re impurities on the Mo site and halogens (F, Cl, and Br) on the O site all act as shallow donors but trapmore » electron polarons. Fe, Ru, and Os impurities are amphoteric and will compensate n-type MoO 3. Mn dopants are also amphoteric, and they show interesting magnetic properties. These results support the design of doping approaches that optimally exploit functionality.« less

The Italian subcutaneous implantable cardioverter-defibrillator survey: S-ICD, why not?

PubMed

Botto, Giovanni Luca; Forleo, Giovanni B; Capucci, Alessandro; Solimene, Francesco; Vado, Antonello; Bertero, Giovanni; Palmisano, Pietro; Pisanò, Ennio; Rapacciuolo, Antonio; Infusino, Tommaso; Vicentini, Alessandro; Viscusi, Miguel; Ferrari, Paola; Talarico, Antonello; Russo, Giovanni; Boriani, Giuseppe; Padeletti, Luigi; Lovecchio, Mariolina; Valsecchi, Sergio; D'Onofrio, Antonio

2017-11-01

A recommendation for a subcutaneous-implantable cardioverter-defibrillator (S-ICD) has been added to recent European Society of Cardiology Guidelines. However, the S-ICD is not ideally suitable for patients who need pacing. The aim of this survey was to analyse the current practice of ICD implantation and to evaluate the actual suitability of S-ICD. The survey 'S-ICD Why Not?' was an independent initiative taken by the Italian Heart Rhythm Society (AIAC). Clinical characteristics, selection criteria, and factors guiding the choice of ICD type were collected in consecutive patients who underwent ICD implantation in 33 Italian centres from September to December 2015. A cardiac resynchronization therapy (CRT) device was implanted in 39% (369 of 947) of patients undergoing de novo ICD implantation. An S-ICD was implanted in 12% of patients with no CRT indication (62 of 510 with available data). S-ICD patients were younger than patients who received transvenous ICD, more often had channelopathies, and more frequently received their device for secondary prevention of sudden death. More frequently, the clinical reason for preferring a transvenous ICD over an S-ICD was the need for pacing (45%) or for antitachycardia pacing (36%). Nonetheless, only 7% of patients fulfilled conditions for recommending permanent pacing, and 4% of patients had a history of monomorphic ventricular tachycardia that might have been treatable with antitachycardia pacing. The vast majority of patients needing ICD therapy are suitable candidates for S-ICD implantation. Nevertheless, it currently seems to be preferentially adopted for secondary prevention of sudden death in young patients with channelopathies. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

New Methodology for an Expert-Designed Map From International Classification of Diseases (ICD) to Abbreviated Injury Scale (AIS) 3+ Severity Injury.

PubMed

Zonfrillo, Mark R; Weaver, Ashley A; Gillich, Patrick J; Price, Janet P; Stitzel, Joel D

2015-01-01

There has been a longstanding desire for a map to convert International Classification of Diseases (ICD) injury codes to Abbreviated Injury Scale (AIS) codes to reflect the severity of those diagnoses. The Association for the Advancement of Automotive Medicine (AAAM) was tasked by European Union representatives to create a categorical map classifying diagnoses codes as serious injury (Abbreviated Injury Scale [AIS] 3+), minor/moderate injury (AIS 1/2), or indeterminate. This study's objective was to map injury-related ICD-9-CM (clinical modification) and ICD-10-CM codes to these severity categories. Approximately 19,000 ICD codes were mapped, including injuries from the following categories: amputations, blood vessel injury, burns, crushing injury, dislocations/sprains/strains, foreign body, fractures, internal organ, nerve/spinal cord injury, intracranial, laceration, open wounds, and superficial injury/contusion. Two parallel activities were completed to create the maps: (1) An in-person expert panel and (2) an electronic survey. The panel consisted of expert users of AIS and ICD from North America, the United Kingdom, and Australia. The panel met in person for 5 days, with follow-up virtual meetings to create and revise the maps. Additional qualitative data were documented to resolve potential discrepancies in mapping. The electronic survey was completed by 95 injury coding professionals from North America, Spain, Australia, and New Zealand over 12 weeks. ICD-to-AIS maps were created for: ICD-9-CM and ICD-10-CM. Both maps indicated whether the corresponding AIS 2005/Update 2008 severity score for each ICD code was AIS 3+, 1/2, or indeterminable. Though some ICD codes could be mapped to multiple AIS codes, the maximum severity of all potentially mapped injuries determined the final severity categorization. The in-person panel consisted of 13 experts, with 11 Certified AIS specialists (CAISS) with a median of 8 years and an average of 15 years of coding experience

Chiari malformation Type I surgery in pediatric patients. Part 1: validation of an ICD-9-CM code search algorithm.

PubMed

Ladner, Travis R; Greenberg, Jacob K; Guerrero, Nicole; Olsen, Margaret A; Shannon, Chevis N; Yarbrough, Chester K; Piccirillo, Jay F; Anderson, Richard C E; Feldstein, Neil A; Wellons, John C; Smyth, Matthew D; Park, Tae Sung; Limbrick, David D

2016-05-01

OBJECTIVE Administrative billing data may facilitate large-scale assessments of treatment outcomes for pediatric Chiari malformation Type I (CM-I). Validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code algorithms for identifying CM-I surgery are critical prerequisites for such studies but are currently only available for adults. The objective of this study was to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing CM-I decompression surgery. METHODS The authors retrospectively analyzed the validity of two ICD-9-CM code algorithms for identifying pediatric CM-I decompression surgery performed at 3 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-I), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression or laminectomy). Algorithm 2 restricted this group to the subset of patients with a primary discharge diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. RESULTS Among 625 first-time admissions identified by Algorithm 1, the overall PPV for CM-I decompression was 92%. Among the 581 admissions identified by Algorithm 2, the PPV was 97%. The PPV for Algorithm 1 was lower in one center (84%) compared with the other centers (93%-94%), whereas the PPV of Algorithm 2 remained high (96%-98%) across all subgroups. The sensitivity of Algorithms 1 (91%) and 2 (89%) was very good and remained so across subgroups (82%-97%). CONCLUSIONS An ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent PPV and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. These results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.

Correlation of E-cadherin expression with differentiation grade and histological type in breast carcinoma.

PubMed Central

Gamallo, C.; Palacios, J.; Suarez, A.; Pizarro, A.; Navarro, P.; Quintanilla, M.; Cano, A.

1993-01-01

Recently, a correlation has been suggested between a loss of E-cadherin (E-CD) and increased invasiveness of neoplastic cells. In this study, E-CD expression in breast cancer was investigated using an affinity-purified antibody (ECCD-2) in an immunoenzymatic (avidin-biotin-alkaline phosphatase) test. Intensity and extension of E-CD immunoreactivity were evaluated in 61 breast carcinomas and correlated with their histological type and grade, nodal involvement, and hormonal receptor status. Histological types were infiltrating ductal carcinoma of no special type (n = 54) and infiltrating lobular carcinoma (n = 7). All infiltrating ductal carcinomas of no special type except two grade 3 carcinomas showed positive immunoreactivity that was variable among different cases. Grade 1 breast carcinomas (n = 10) showed greater immunoreactivity than grade 2 (n = 25) and grade 3 (n = 19) carcinomas. E-CD immunoreactivity correlated positively with the degree of tubular formation and inversely with the mitoses number. None of the infiltrating lobular carcinomas expressed E-CD in their infiltrating cells, whereas they showed only weak immunostains in areas of atypical lobular hyperplasia and lobular carcinoma in situ. These results indicate that E-CD expression correlates with histological type and grade in breast carcinomas. Images Figure 1 Figure 2 Figure 3 PMID:7682767

Phase formation and UV luminescence of Gd{sup 3+} doped perovskite-type YScO{sub 3}

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shimizu, Yuhei; Ueda, Kazushige, E-mail: kueda@che.kyutech.ac.jp

Synthesis of pure and Gd{sup 3+}doped perovskite-type YScO{sub 3} was attempted by a polymerized complex (PC) method and solid state reaction (SSR) method. Crystalline phases and UV luminescence of samples were examined with varying heating temperatures. The perovskite-type single phase was not simply formed in the SSR method, as reported in some literatures, and two cubic C-type phases of starting oxide materials remained forming slightly mixed solid solutions. UV luminescence of Gd{sup 3+} doped samples increased with an increase in heating temperatures and volume of the perovskite-type phase. In contrast, a non-crystalline precursor was crystallized to a single C-type phasemore » at 800 °C in the PC method forming a completely mixed solid solution. Then, the phase of perovskite-type YScO{sub 3} formed at 1200 °C and its single phase was obtained at 1400 °C. It was revealed that high homogeneousness of cations was essential to generate the single perovskite-phase of YScO{sub 3}. Because Gd{sup 3+} ions were also dissolved into the single C-type phase in Gd{sup 3+} doped samples, intense UV luminescence was observed above 800 °C in both C-type phase and perovskite-type phase. - Graphical abstract: A pure perovskite-type YScO{sub 3} phase was successfully synthesized by a polymerized complex (PC) method. The perovskite-type YScO{sub 3} was generated through a solid solution of C-type (Y{sub 0.5}Sc{sub 0.5}){sub 2}O{sub 3} with drastic change of morphology. The PC method enabled a preparation of the single phase of the perovskite-type YScO{sub 3} at lower temperature and in shorter heating time. Gd{sup 3+} doped perovskite-type YScO{sub 3} was found to show a strong sharp UV emission at 314 nm. - Highlights: • Pure YScO{sub 3} phase was successfully synthesized by polymerized complex (PC) method. • Pure perovskite-type YScO{sub 3} phase was generated from pure C-type (Y{sub 0.5}Sc{sub 0.5}){sub 2}O{sub 3} one. • YScO{sub 3} was obtained at lower

[Cause-of-death statistics and ICD, quo vadis?

PubMed

Eckert, Olaf; Vogel, Ulrich

2018-07-01

The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study.

PubMed

Weems, Shelley; Heller, Pamela; Fenton, Susan H

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: 1. Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity. 2. Coder training and type of record (inpatient versus outpatient) affect coding productivity. 3. Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity.

[Impact of attachment style, social support and the number of implantable cardioverter defibrillator (ICD) discharges on psychological strain of ICD patients].

PubMed

Simson, Udo; Perings, Christian; Plaskuda, Ariane; Schäfer, Ralf; Brehm, Michael; Bader, Doris; Tress, Wolfgang; Franz, Matthias

2006-12-01

OBJECTIVE It is well known fact, that the life of ICD patients is often affected by anxiety and depression. The number of ICD discharges is only a contributing factor explaining the variance of anxiety and depression. There have to be other factors that have more influence on the physical strain of ICD patients. In this study we examined the impact of attachment style and social support in addition to the number of ICD discharges. METHODS 119 out-patients at an out-patient ICD unit were examined consecutively with the following self report scales: (1) the State-Trait-Anxiety Inventory (STAI), (2) the Beck Depression Inventory (BDI), (3) a short form of a social support questionnaire (F-SOZU), (4) the Bielefeld Partnership Expectations Questionnaire (BFPE) and (5) a specifically designed questionnaire for the assessment of sociodemografic data. To determine the frequency and timing of the ICD discharges we analysed the ICD data. RESULTS 38 % of the ICD patients reported enhanced anxiety levels and 37 % reported enhanced depression levels. Only 38 % of the ICD patients received discharges at all. Elevated levels of anxiety and depression were found in patients who showed insecure attachment styles, low social support, long-term treatment in hospital and a higher number of ICD discharges. To explain the variance of anxiety we found social support, attachment style, and the number of ICD storms to be contributing factors. To explain the variance of depression we found social support and time spent in hospital in the previous year to be contributing factors. CONCLUSIONS Almost half of the ICD patients suffer considerably from anxiety and/or depression. These patients have to be identified and treated psychotherapeutically. Patients who show insecure attachment styles, receive low social support, undergo long-term treatment in hospital and receive a higher number of discharges, especially so called ICD storms, bear the highest risk to develop psychological strain

Effects of voluntary running exercise on bone histology in type 2 diabetic rats.

PubMed

Takamine, Yuri; Ichinoseki-Sekine, Noriko; Tsuzuki, Takamasa; Yoshihara, Toshinori; Naito, Hisashi

2018-01-01

The incidence of obesity in children and adolescents, which may lead to type 2 diabetes, is increasing. Exercise is recommended to prevent and improve diabetes. However, little is known about the bone marrow environment at the onset of diabetes in the young, and it is unclear whether exercise training is useful for maintaining bone homeostasis, such as mechanical and histological properties. Thus, this study clarified the histological properties of bone and whether exercise contributes to maintaining bone homeostasis at the onset of type 2 diabetes in rats. Four-week-old male Otsuka Long-Evans Tokushima Fatty (OLETF; n = 21) rats as a diabetic model and Long-Evans Tokushima Otsuka (LETO; n = 18) rats as a control were assigned randomly to four groups: the OLETF sedentary group (O-Sed; n = 11), OLETF exercise group (O-Ex; n = 10), LETO sedentary group (L-Sed; n = 9), and LETO exercise group (L-Ex; n = 9). All rats in the exercise group were allowed free access to a steel running wheel for 20 weeks (5-25 weeks of age). In the glucose tolerance test, blood glucose level was higher in the O-Sed group than that in the L-Sed and L-Ex groups, and was markedly suppressed by the voluntary running exercise of O-Ex rats. The energy to fracture and the two-dimensional bone volume at 25 weeks of age did not differ significantly among the groups, though the maximum breaking force and stiffness were lower in OLETF rats. However, bone marrow fat volume was greater in O-Sed than that in L-Sed and L-Ex rats, and was markedly suppressed by wheel running in the O-Ex rats. Our results indicate that exercise has beneficial effects not only for preventing diabetes but also on normal bone remodeling at an early age.

Association of Single vs. Dual Chamber ICDs with Mortality, Readmissions and Complications among Patients Receiving an ICD for Primary Prevention

PubMed Central

Peterson, Pamela N; Varosy, Paul D; Heidenreich, Paul A; Wang, Yongfei; Dewland, Thomas A; Curtis, Jeptha P; Go, Alan S; Greenlee, Robert T; Magid, David J; Normand, Sharon-Lise T; Masoudi, Frederick A

2013-01-01

Importance Randomized trials of implantable cardioverter defibrillators (ICDs) for primary prevention predominantly employed single chamber devices. In clinical practice, patients often receive dual chamber ICDs, even without clear indications for pacing. The outcomes of dual versus single chamber devices are uncertain. Objective Compare outcomes of single and dual chamber ICDs for primary prevention of sudden cardiac death. Design, Setting, and Participants Retrospective cohort study. Admissions in the National Cardiovascular Data Registry’s (NCDR®) ICD Registry™ from 2006–2009 that could be linked to CMS fee for service Medicare claims data were identified. Patients were included if they received an ICD for primary prevention and did not have a documented indication for pacing. Main Outcome Measures Adjusted risks of 1-year mortality, all-cause readmission, HF readmission and device-related complications within 90 days were estimated with propensity-score matching based on patient, clinician and hospital factors. Results Among 32,034 patients, 38% (n=12,246) received a single chamber device and 62% (n=19,788) received a dual chamber device. In a propensity-matched cohort, rates of complications were lower for single chamber devices (3.5% vs. 4.7%; p<0.001; risk difference −1.20; 95% CI −1.72, −0.69), but device type was not significantly associated with mortality or hospitalization outcomes (unadjusted rate 9.9% vs. 9.8%; HR 0.99, 95% CI 0.91–1.07; p=0.792 for 1-year mortality; unadjusted rate 43.9% vs. 44.8%; HR 1.00, 95% CI 0.97–1.04; p=0.821 for 1-year all-cause hospitalization; unadjusted rate 14.7% vs. 15.4%; HR 1.05, 95% CI 0.99–1.12; p=0.189 for 1-year HF hospitalization). Conclusions and Relevance Among patients receiving an ICD for primary prevention without indications for pacing, the use of a dual chamber device compared with a single chamber device was associated with a higher risk of device-related complications but not with

Far-Infrared Emission of Intracluster Dust (ICD)

NASA Astrophysics Data System (ADS)

Arimoto, N.; Takagi, T.; Hanami, H.

2000-12-01

In the young universe, clusters of galaxies could be bright FIR-Submm sources due to the dust emissions from young ellipticals. The intracluster dust (ICD) could also contribute to the FIR-Submm emissions considerably, but the ICD is fragile in the ambient hot ICM. Therefore, a chance to detect the ICD emission would be much smaller than the dust emissions from galaxies. Dust emissions from elliptical galaxies (EROs) in the young Coma cluster at a distance of z=2-3 would be easily detected by a future mission of H2L2 satellite, thus the FIR-Submm survey would become a powerful tool for searching high-z clusters.

Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ).

PubMed

Karatzias, Thanos; Shevlin, Mark; Fyvie, Claire; Hyland, Philip; Efthymiadou, Erifili; Wilson, Danielle; Roberts, Neil; Bisson, Jonathan I; Brewin, Chris R; Cloitre, Marylene

2017-01-01

The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses following exposure to traumatic events; Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). We set out to explore whether the newly developed ICD-11 Trauma Questionnaire (ICD-TQ) can distinguish between classes of individuals according to the PTSD and CPTSD symptom profiles as per ICD-11 proposals based on latent class analysis. We also hypothesized that the CPTSD class would report more frequent and a greater number of different types of childhood trauma as well as higher levels of functional impairment. Methods Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland (N=193). Participants completed the ICD-TQ as well as measures of life events and functioning. Overall, results indicate that using the newly developed ICD-TQ, two subgroups of treatment-seeking individuals could be empirically distinguished based on different patterns of symptom endorsement; a small group high in PTSD symptoms only and a larger group high in CPTSD symptoms. In addition, CPTSD was more strongly associated with more frequent and a greater accumulation of different types of childhood traumatic experiences and poorer functional impairment. Sample predominantly consisted of people who had experienced childhood psychological trauma or been multiply traumatised in childhood and adulthood. CPTSD is highly prevalent in treatment seeking populations who have been multiply traumatised in childhood and adulthood and appropriate interventions should now be developed to aid recovery from this debilitating condition. Copyright © 2016 Elsevier B.V. All rights reserved.

Accuracy of lung cancer ICD-9-CM codes in Umbria, Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study

PubMed Central

Montedori, Alessandro; Bidoli, Ettore; Serraino, Diego; Fusco, Mario; Giovannini, Gianni; Casucci, Paola; Franchini, David; Granata, Annalisa; Ciullo, Valerio; Vitale, Maria Francesca; Gobbato, Michele; Chiari, Rita; Cozzolino, Francesco; Orso, Massimiliano; Orlandi, Walter

2018-01-01

Objectives To assess the accuracy of International Classification of Diseases 9th Revision–Clinical Modification (ICD-9-CM) codes in identifying subjects with lung cancer. Design A cross-sectional diagnostic accuracy study comparing ICD-9-CM 162.x code (index test) in primary position with medical chart (reference standard). Case ascertainment was based on the presence of a primary nodular lesion in the lung and cytological or histological documentation of cancer from a primary or metastatic site. Setting Three operative units: administrative databases from Umbria Region (890 000 residents), ASL Napoli 3 Sud (NA) (1 170 000 residents) and Friuli Venezia Giulia (FVG) Region (1 227 000 residents). Participants Incident subjects with lung cancer (n=386) diagnosed in primary position between 2012 and 2014 and a population of non-cases (n=280). Outcome measures Sensitivity, specificity and positive predictive value (PPV) for 162.x code. Results 130 cases and 94 non-cases were randomly selected from each database and the corresponding medical charts were reviewed. Most of the diagnoses for lung cancer were performed in medical departments. True positive rates were high for all the three units. Sensitivity was 99% (95% CI 95% to 100%) for Umbria, 97% (95% CI 91% to 100%) for NA, and 99% (95% CI 95% to 100%) for FVG. The false positive rates were 24%, 37% and 23% for Umbria, NA and FVG, respectively. PPVs were 79% (73% to 83%)%) for Umbria, 58% (53% to 63%)%) for NA and 79% (73% to 84%)%) for FVG. Conclusions Case ascertainment for lung cancer based on imaging or endoscopy associated with histological examination yielded an excellent sensitivity in all the three administrative databases. PPV was moderate for Umbria and FVG but lower for NA. PMID:29773701

Familial association of specific histologic types of ovarian malignancy with other malignancies.

PubMed

Lorenzo Bermejo, Justo; Rawal, Rajesh; Hemminki, Kari

2004-04-01

Population-based data on the familial association of specific histologic types of ovarian malignancy with other malignancies are limited. Such data may help to elucidate etiologic differences among histologic types of ovarian malignancy. The nationwide Swedish Family-Cancer Database, which includes 10.3 million individuals and 20,974 ovarian carcinomas, was used to calculate standardized incidence ratios and 95% confidence intervals for age- and histology-specific ovarian malignancies in women whose parents or siblings were affected with malignancies at the most common disease sites. Ovarian malignancy was found to be associated with ovarian, laryngeal, breast, endometrial, liver, and colon carcinoma, as well as myeloma; epithelial ovarian malignancy was found to be associated with ovarian, endometrial, and skin malignancies and with melanoma and myeloma; papillary serous cystadenocarcinoma was found to be associated with ovarian and skin malignancies and with myeloma; and endometrioid carcinoma was found to be associated with endometrial, ovarian, and prostate malignancies and with melanoma. For younger women (ages 40-45 years) whose mothers were affected with endometrial malignancies, the risk of developing endometrioid carcinoma was slightly greater than the risk of developing papillary serous cystadenocarcinoma. Specific types of ovarian malignancy may be associated with specific familial disease sites, with such associations depending on age at diagnosis; the strength of the observed associations varied according to histology. Associations were found between endometrioid carcinoma and endometrial malignancy and between serous carcinoma and Hodgkin disease. Copyright 2004 American Cancer Society.

Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples

PubMed Central

Hansen, Maj; Hyland, Philip; Armour, Cherie; Shevlin, Mark; Elklit, Ask

2015-01-01

Background In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptom profile of posttraumatic stress disorder (PTSD) was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11) that includes just six symptoms. Objectives and method The objectives of the current study are: 1) to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746) using confirmatory factor analysis; 2) to assess the concurrent validity of the ICD-11 model of PTSD; and 3) to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria. Results The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria. Conclusions The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria. PMID:26450830

Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples.

PubMed

Hansen, Maj; Hyland, Philip; Armour, Cherie; Shevlin, Mark; Elklit, Ask

2015-01-01

In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptom profile of posttraumatic stress disorder (PTSD) was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11) that includes just six symptoms. The objectives of the current study are: 1) to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746) using confirmatory factor analysis; 2) to assess the concurrent validity of the ICD-11 model of PTSD; and 3) to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria. The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria. The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria.

On the feasibility of p-type Ga2O3

NASA Astrophysics Data System (ADS)

Kyrtsos, Alexandros; Matsubara, Masahiko; Bellotti, Enrico

2018-01-01

We investigate the various cation substitutional dopants in Ga2O3 for the possibility of p-type conductivity using density functional theory. Our calculations include both standard density functional theory and hybrid functional calculations. We demonstrate that all the investigated dopants result in deep acceptor levels, not able to contribute to the p-type conductivity of Ga2O3. In light of these results, we compare our findings with other wide bandgap oxides and reexamine previous experiments on zinc doping in Ga2O3.

MW-assisted synthesis of SVO for ICD primary batteries

NASA Astrophysics Data System (ADS)

Beninati, Sabina; Fantuzzi, Matteo; Mastragostino, Marina; Soavi, Francesca

An Ag 2V 4O 11 (SVO) cathode material prepared by microwave (MW)-assisted solid-state synthesis (MW-SVO) was developed for lithium primary batteries for implantable cardioverter/defibrillators (ICDs). This paper presents the results of physical-chemical and electrochemical characterizations of MW-SVO as well as those of SVO prepared by conventional thermal route (T-SVO). A specific effect of MWs which accelerates the synthesis reaction and contributes to yield a material of different morphology and degree of crystallinity compared with those of T-SVO was observed. The results of pulsed electrochemical tests carried out at 37 °C in operative conditions of ICDs on Li/MW-SVO batteries with cathode mass loading sized for practical use are also reported. These tests demonstrated that MW-SVO can be used for high performing lithium primary battery delivering in few seconds the specific energy values required by ICD application.

Phase formation and UV luminescence of Gd3+ doped perovskite-type YScO3

NASA Astrophysics Data System (ADS)

Shimizu, Yuhei; Ueda, Kazushige

2016-10-01

Synthesis of pure and Gd3+doped perovskite-type YScO3 was attempted by a polymerized complex (PC) method and solid state reaction (SSR) method. Crystalline phases and UV luminescence of samples were examined with varying heating temperatures. The perovskite-type single phase was not simply formed in the SSR method, as reported in some literatures, and two cubic C-type phases of starting oxide materials remained forming slightly mixed solid solutions. UV luminescence of Gd3+ doped samples increased with an increase in heating temperatures and volume of the perovskite-type phase. In contrast, a non-crystalline precursor was crystallized to a single C-type phase at 800 °C in the PC method forming a completely mixed solid solution. Then, the phase of perovskite-type YScO3 formed at 1200 °C and its single phase was obtained at 1400 °C. It was revealed that high homogeneousness of cations was essential to generate the single perovskite-phase of YScO3. Because Gd3+ ions were also dissolved into the single C-type phase in Gd3+ doped samples, intense UV luminescence was observed above 800 °C in both C-type phase and perovskite-type phase.

Work-relatedness of lung cancer by smoking and histologic type in Korea.

PubMed

Lee, Young-Il; Lee, Sang-Gil; Kang, Dong-Mug; Kim, Jong-Eun; Kim, Young-Ki; Leem, Jong-Han; Kim, Hwan-Cheol

2014-01-01

This study investigated the distribution of causative agents related to occupational lung cancer, their relationships with work, and associations between work-relatedness and the histologic type of lung cancer. We used data from the occupational surveillance system in Korea in 2013. In addition, data from 1,404 participants diagnosed with lung cancer were collected through interviews. We included the patients' longest-held job in the analysis. Work-relatedness was categorized as "definite," "probable," "possible," "suspicious," "none," or "undetermined." Among the subjects, 69.3% were men and 30.7% were women. Regarding smoking status, current smokers were the most prevalent (35.5%), followed by non-smokers (32.3%), ex-smokers (32.2%). Regarding the causative agents of lung cancer, asbestos (1.0%) and crystalline silica (0.9%) were the most common in definite work-related cases, while non-arsenical insecticide (2.8%) was the most common in probable cases followed by diesel engine exhaust (1.9%) and asbestos (1.0%). Regarding histologic type, adenocarcinoma was the most common (41.7%), followed by squamous cell carcinoma (21.2%). Among current smokers, squamous cell carcinoma was the most common among definite and probable cases (13.4%), while non-small cell lung cancer was the least common (7.1%). Among non-smokers, squamous cell carcinoma was the most common (21.4%), while the least common was adenocarcinoma (1.6%). Approximately, 9.5% of all lung cancer cases in Korea are occupational-related lung cancer. Well-known substances associated with lung cancer, such as crystalline silica, asbestos, and diesel engine exhaust, are of particular concern. However, the histologic types of lung cancer related to smoking were inconsistent with previous studies when work-relatedness was taken into account. Future studies are required to clarify the incidence of occupational lung cancer in agricultural workers exposed to non-arsenical insecticides and the associations between

Development of an expert based ICD-9-CM and ICD-10-CM map to AIS 2005 update 2008.

PubMed

Loftis, Kathryn L; Price, Janet P; Gillich, Patrick J; Cookman, Kathy J; Brammer, Amy L; St Germain, Trish; Barnes, Jo; Graymire, Vickie; Nayduch, Donna A; Read-Allsopp, Christine; Baus, Katherine; Stanley, Patsye A; Brennan, Maureen

2016-09-01

This article describes how maps were developed from the clinical modifications of the 9th and 10th revisions of the International Classification of Diseases (ICD) to the Abbreviated Injury Scale 2005 Update 2008 (AIS08). The development of the mapping methodology is described, with discussion of the major assumptions used in the process to map ICD codes to AIS severities. There were many intricacies to developing the maps, because the 2 coding systems, ICD and AIS, were developed for different purposes and contain unique classification structures to meet these purposes. Experts in ICD and AIS analyzed the rules and coding guidelines of both injury coding schemes to develop rules for mapping ICD injury codes to the AIS08. This involved subject-matter expertise, detailed knowledge of anatomy, and an in-depth understanding of injury terms and definitions as applied in both taxonomies. The official ICD-9-CM and ICD-10-CM versions (injury sections) were mapped to the AIS08 codes and severities, following the rules outlined in each coding manual. The panel of experts was composed of coders certified in ICD and/or AIS from around the world. In the process of developing the map from ICD to AIS, the experts created rules to address issues with the differences in coding guidelines between the 2 schemas and assure a consistent approach to all codes. Over 19,000 ICD codes were analyzed and maps were generated for each code to AIS08 chapters, AIS08 severities, and Injury Severity Score (ISS) body regions. After completion of the maps, 14,101 (74%) of the eligible 19,012 injury-related ICD-9-CM and ICD-10-CM codes were assigned valid AIS08 severity scores between 1 and 6. The remaining 4,911 codes were assigned an AIS08 of 9 (unknown) or were determined to be nonmappable because the ICD description lacked sufficient qualifying information for determining severity according to AIS rules. There were also 15,214 (80%) ICD codes mapped to AIS08 chapter and ISS body region, which

Recent progress in oxide thermoelectric materials: p-type Ca3Co4O9 and n-type SrTiO3(-).

PubMed

Ohta, Hiromichi; Sugiura, Kenji; Koumoto, Kunihito

2008-10-06

Thermoelectric energy conversion technology to convert waste heat into electricity has received much attention. In addition, metal oxides have recently been considered as thermoelectric power generation materials that can operate at high temperatures on the basis of their potential advantages over heavy metallic alloys in chemical and thermal robustness. We have fabricated high-quality epitaxial films composed of oxide thermoelectric materials that are suitable for clarifying the intrinsic "real" properties. This review focuses on the thermoelectric properties of two representative oxide epitaxial films, p-type Ca 3Co 4O 9 and n-type SrTiO 3, which exhibit the best thermoelectric figures of merit, ZT (= S (2)sigma Tkappa (-1), S = Seebeck coefficient, sigma = electrical conductivity, kappa = thermal conductivity, and T = absolute temperature) among oxide thermoelectric materials reported to date. In addition, we introduce the recently discovered giant S of two-dimensional electrons confined within a unit cell layer thickness ( approximately 0.4 nm) of SrTiO 3.

Radiation and Smoking Effects on Lung Cancer Incidence by Histological Types Among Atomic Bomb Survivors

PubMed Central

Egawa, Hiromi; Furukawa, Kyoji; Preston, Dale; Funamoto, Sachiyo; Yonehara, Shuji; Matsuo, Takeshi; Tokuoka, Shoji; Suyama, Akihiko; Ozasa, Kotaro; Kodama, Kazunori; Mabuchi, Kiyohiko

2014-01-01

While the risk of lung cancer associated separately with smoking and radiation exposure has been widely reported, it is not clear how smoking and radiation together contribute to the risk of specific lung cancer histological types. With individual smoking histories and radiation dose estimates, we characterized the joint effects of radiation and smoking on type-specific lung cancer rates among the Life Span Study cohort of Japanese atomic bomb survivors. Among 105,404 cohort subjects followed between 1958 and 1999, 1,803 first primary lung cancer incident cases were diagnosed and classified by histological type. Poisson regression methods were used to estimate excess relative risks under several interaction models. Adenocarcinoma (636 cases), squamous-cell carcinoma (330) and small-cell carcinoma (194) made up 90% of the cases with known histology. Both smoking and radiation exposure significantly increased the risk of each major lung cancer histological type. Smoking-associated excess relative risks were significantly larger for small-cell and squamous-cell carcinomas than for adenocarcinoma. The gender-averaged excess relative risks per 1 Gy of radiation (for never-smokers at age 70 after radiation exposure at age 30) were estimated as 1.49 (95% confidence interval 0.1–4.6) for small-cell carcinoma, 0.75 (0.3–1.3) for adenocarcinoma, and 0.27 (0–1.5) for squamous-cell carcinoma. Under a model allowing radiation effects to vary with levels of smoking, the nature of the joint effect of smoking and radiation showed a similar pattern for different histological types in which the radiation-associated excess relative risk tended to be larger for moderate smokers than for heavy smokers. However, in contrast to analyses of all lung cancers as a group, such complicated interactions did not describe the data significantly better than either simple additive or multiplicative interaction models for any of the type-specific analyses. PMID:22862780

ICD-10 classification in Danish child and adolescent psychiatry--have diagnoses changed after the introduction of ICD-10?

PubMed

Møller, Lene Ruge; Sørensen, Merete Juul; Thomsen, Per Hove

2007-01-01

The aim was to test this in a nationwide register study of diagnoses used in child and adolescents psychiatry in Denmark. A larger number of different diagnoses were expected to be applied after the introduction of the 10th version of the International Classification of Diseases (ICD-10). Reflecting the time trend, we particularly expected an increase in the number of neuropsychiatric diagnoses. From the Danish Psychiatric Central Register data were drawn on clinical discharge diagnoses. All patients aged 0-15 years examined at psychiatric hospitals from 1995-2002 were included; 22,469 children and adolescents with a first contact were registered. The most frequent discharge diagnoses were pervasive development disorders (PDD; 11.9%), adjustment disorders (10.6%), conduct disorder (9.5%), emotional and anxiety disorders (7.6%), hyperkinetic disorders (7.3%), and specific developmental disorders (7.3%). We found a significant increase in the number of neuropsychiatric and affective diagnoses and a significant decrease in the number of adjustment, conduct and anxiety diagnoses during the study period. Of the 22,469 diagnoses, 45% were only partly specified according to ICD-10. Thirty-four per cent had diagnoses unspecified on the four-character level (Fxx.9) and 11% had Z-diagnoses. A larger number of different diagnoses and an increase in the use of neuropsychiatric diagnoses were seen after the introduction of ICD-10. Many diagnoses were only partly specified; consequently, a more detailed specification of the ICD-10 is still required.

ICD-10 procedure codes produce transition challenges

PubMed Central

Boyd, Andrew D.; Li, Jianrong ‘John’; Kenost, Colleen; Zaim, Samir Rachid; Krive, Jacob; Mittal, Manish; Satava, Richard A.; Burton, Michael; Smith, Jacob; Lussier, Yves A.

2018-01-01

The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: “identity”(I), “class-to-subclass”(C2S), “subclass-toclass”(S2C), “convoluted(C)”, and “no mapping”(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.http://www.lussiergroup.org/transition-to-ICD10PCS PMID:29888037

ICD-10 procedure codes produce transition challenges.

PubMed

Boyd, Andrew D; Li, Jianrong 'John'; Kenost, Colleen; Zaim, Samir Rachid; Krive, Jacob; Mittal, Manish; Satava, Richard A; Burton, Michael; Smith, Jacob; Lussier, Yves A

2018-01-01

The transition of procedure coding from ICD-9-CM-Vol-3 to ICD-10-PCS has generated problems for the medical community at large resulting from the lack of clarity required to integrate two non-congruent coding systems. We hypothesized that quantifying these issues with network topology analyses offers a better understanding of the issues, and therefore we developed solutions (online tools) to empower hospital administrators and researchers to address these challenges. Five topologies were identified: "identity"(I), "class-to-subclass"(C2S), "subclass-toclass"(S2C), "convoluted(C)", and "no mapping"(NM). The procedure codes in the 2010 Illinois Medicaid dataset (3,290 patients, 116 institutions) were categorized as C=55%, C2S=40%, I=3%, NM=2%, and S2C=1%. Majority of the problematic and ambiguous mappings (convoluted) pertained to operations in ophthalmology cardiology, urology, gyneco-obstetrics, and dermatology. Finally, the algorithms were expanded into a user-friendly tool to identify problematic topologies and specify lists of procedural codes utilized by medical professionals and researchers for mitigating error-prone translations, simplifying research, and improving quality.http://www.lussiergroup.org/transition-to-ICD10PCS.

3D prostate histology image reconstruction: Quantifying the impact of tissue deformation and histology section location

PubMed Central

Gibson, Eli; Gaed, Mena; Gómez, José A.; Moussa, Madeleine; Pautler, Stephen; Chin, Joseph L.; Crukley, Cathie; Bauman, Glenn S.; Fenster, Aaron; Ward, Aaron D.

2013-01-01

Background: Guidelines for localizing prostate cancer on imaging are ideally informed by registered post-prostatectomy histology. 3D histology reconstruction methods can support this by reintroducing 3D spatial information lost during histology processing. The need to register small, high-grade foci drives a need for high accuracy. Accurate 3D reconstruction method design is impacted by the answers to the following central questions of this work. (1) How does prostate tissue deform during histology processing? (2) What spatial misalignment of the tissue sections is induced by microtome cutting? (3) How does the choice of reconstruction model affect histology reconstruction accuracy? Materials and Methods: Histology, paraffin block face and magnetic resonance images were acquired for 18 whole mid-gland tissue slices from six prostates. 7-15 homologous landmarks were identified on each image. Tissue deformation due to histology processing was characterized using the target registration error (TRE) after landmark-based registration under four deformation models (rigid, similarity, affine and thin-plate-spline [TPS]). The misalignment of histology sections from the front faces of tissue slices was quantified using manually identified landmarks. The impact of reconstruction models on the TRE after landmark-based reconstruction was measured under eight reconstruction models comprising one of four deformation models with and without constraining histology images to the tissue slice front faces. Results: Isotropic scaling improved the mean TRE by 0.8-1.0 mm (all results reported as 95% confidence intervals), while skew or TPS deformation improved the mean TRE by <0.1 mm. The mean misalignment was 1.1-1.9° (angle) and 0.9-1.3 mm (depth). Using isotropic scaling, the front face constraint raised the mean TRE by 0.6-0.8 mm. Conclusions: For sub-millimeter accuracy, 3D reconstruction models should not constrain histology images to the tissue slice front faces and should be

Three-dimensional histology: tools and application to quantitative assessment of cell-type distribution in rabbit heart

PubMed Central

Burton, Rebecca A.B.; Lee, Peter; Casero, Ramón; Garny, Alan; Siedlecka, Urszula; Schneider, Jürgen E.; Kohl, Peter; Grau, Vicente

2014-01-01

Aims Cardiac histo-anatomical organization is a major determinant of function. Changes in tissue structure are a relevant factor in normal and disease development, and form targets of therapeutic interventions. The purpose of this study was to test tools aimed to allow quantitative assessment of cell-type distribution from large histology and magnetic resonance imaging- (MRI) based datasets. Methods and results Rabbit heart fixation during cardioplegic arrest and MRI were followed by serial sectioning of the whole heart and light-microscopic imaging of trichrome-stained tissue. Segmentation techniques developed specifically for this project were applied to segment myocardial tissue in the MRI and histology datasets. In addition, histology slices were segmented into myocytes, connective tissue, and undefined. A bounding surface, containing the whole heart, was established for both MRI and histology. Volumes contained in the bounding surface (called ‘anatomical volume’), as well as that identified as containing any of the above tissue categories (called ‘morphological volume’), were calculated. The anatomical volume was 7.8 cm3 in MRI, and this reduced to 4.9 cm3 after histological processing, representing an ‘anatomical’ shrinkage by 37.2%. The morphological volume decreased by 48% between MRI and histology, highlighting the presence of additional tissue-level shrinkage (e.g. an increase in interstitial cleft space). The ratio of pixels classified as containing myocytes to pixels identified as non-myocytes was roughly 6:1 (61.6 vs. 9.8%; the remaining fraction of 28.6% was ‘undefined’). Conclusion Qualitative and quantitative differentiation between myocytes and connective tissue, using state-of-the-art high-resolution serial histology techniques, allows identification of cell-type distribution in whole-heart datasets. Comparison with MRI illustrates a pronounced reduction in anatomical and morphological volumes during histology processing. PMID

US lung cancer trends by histologic type.

PubMed

Lewis, Denise Riedel; Check, David P; Caporaso, Neil E; Travis, William D; Devesa, Susan S

2014-09-15

Lung cancer incidence rates overall are declining in the United States. This study investigated the trends by histologic type and demographic characteristics. Surveillance, Epidemiology, and End Results (SEER) program rates of microscopically confirmed lung cancer overall and squamous cell, small cell, adenocarcinoma, large cell, other, and unspecified carcinomas among US whites and blacks diagnosed from 1977 to 2010 and white non-Hispanics, Asian/Pacific Islanders, and white Hispanics diagnosed from 1992 to 2010 were analyzed by sex and age. Squamous and small cell carcinoma rates declined since the 1990s, although less rapidly among females than males. Adenocarcinoma rates decreased among males and only through 2005, after which they then rose during 2006 to 2010 among every racial/ethnic/sex group; rates for unspecified type declined. Male/female rate ratios declined among whites and blacks more than among other groups. Recent rates among young females were higher than among males for adenocarcinoma among all racial/ethnic groups and for other specified carcinomas among whites. US lung cancer trends vary by sex, histologic type, racial/ethnic group, and age, reflecting historical cigarette smoking rates, duration, cessation, cigarette composition, and exposure to other carcinogens. Substantial excesses among males have diminished and higher rates of adenocarcinoma among young females have emerged as rates among males declined more rapidly. The recognition of EGFR mutation and ALK rearrangements that occur primarily in adenocarcinomas are the primary basis for the molecular revolution that has transformed lung cancer diagnosis and treatment over the past decade, and these changes have affected recent type-specific trends. © 2014 American Cancer Society.

Clinical implications of the proposed ICD-11 PTSD diagnostic criteria.

PubMed

Barbano, Anna C; van der Mei, Willem F; Bryant, Richard A; Delahanty, Douglas L; deRoon-Cassini, Terri A; Matsuoka, Yutaka J; Olff, Miranda; Qi, Wei; Ratanatharathorn, Andrew; Schnyder, Ulrich; Seedat, Soraya; Kessler, Ronald C; Koenen, Karestan C; Shalev, Arieh Y

2018-05-14

Projected changes to post-traumatic stress disorder (PTSD) diagnostic criteria in the upcoming International Classification of Diseases (ICD)-11 may affect the prevalence and severity of identified cases. This study examined differences in rates, severity, and overlap of diagnoses using ICD-10 and ICD-11 PTSD diagnostic criteria during consecutive assessments of recent survivors of traumatic events. The study sample comprised 3863 survivors of traumatic events, evaluated in 11 longitudinal studies of PTSD. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale (CAPS) to derive ICD-10 and ICD-11 diagnoses at different time intervals between trauma occurrence and 15 months. The ICD-11 criteria identified fewer cases than the ICD-10 across assessment intervals (range -47.09% to -57.14%). Over 97% of ICD-11 PTSD cases met concurrent ICD-10 PTSD criteria. PTSD symptom severity of individuals identified by the ICD-11 criteria (CAPS total scores) was 31.38-36.49% higher than those identified by ICD-10 criteria alone. The latter, however, had CAPS scores indicative of moderate PTSD. ICD-11 was associated with similar or higher rates of comorbid mood and anxiety disorders. Individuals identified by either ICD-10 or ICD-11 shortly after traumatic events had similar longitudinal course. This study indicates that significantly fewer individuals would be diagnosed with PTSD using the proposed ICD-11 criteria. Though ICD-11 criteria identify more severe cases, those meeting ICD-10 but not ICD-11 criteria remain in the moderate range of PTSD symptoms. Use of ICD-11 criteria will have critical implications for case identification in clinical practice, national reporting, and research.

Leveraging the NLM map from SNOMED CT to ICD-10-CM to facilitate adoption of ICD-10-CM.

PubMed

Cartagena, F Phil; Schaeffer, Molly; Rifai, Dorothy; Doroshenko, Victoria; Goldberg, Howard S

2015-05-01

Develop and test web services to retrieve and identify the most precise ICD-10-CM code(s) for a given clinical encounter. Facilitate creation of user interfaces that 1) provide an initial shortlist of candidate codes, ideally visible on a single screen; and 2) enable code refinement. To satisfy our high-level use cases, the analysis and design process involved reviewing available maps and crosswalks, designing the rule adjudication framework, determining necessary metadata, retrieving related codes, and iteratively improving the code refinement algorithm. The Partners ICD-10-CM Search and Mapping Services (PI-10 Services) are SOAP web services written using Microsoft's.NET 4.0 Framework, Windows Communications Framework, and SQL Server 2012. The services cover 96% of the Partners problem list subset of SNOMED CT codes that map to ICD-10-CM codes and can return up to 76% of the 69,823 billable ICD-10-CM codes prior to creation of custom mapping rules. We consider ways to increase 1) the coverage ratio of the Partners problem list subset of SNOMED CT codes and 2) the upper bound of returnable ICD-10-CM codes by creating custom mapping rules. Future work will investigate the utility of the transitive closure of SNOMED CT codes and other methods to assist in custom rule creation and, ultimately, to provide more complete coverage of ICD-10-CM codes. ICD-10-CM will be easier for clinicians to manage if applications display short lists of candidate codes from which clinicians can subsequently select a code for further refinement. The PI-10 Services support ICD-10 migration by implementing this paradigm and enabling users to consistently and accurately find the best ICD-10-CM code(s) without translation from ICD-9-CM. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Results of ENHANCED Implantable Cardioverter Defibrillator Programming to Reduce Therapies and Improve Quality of Life (from the ENHANCED-ICD Study).

PubMed

Mastenbroek, Mirjam H; Pedersen, Susanne S; van der Tweel, Ingeborg; Doevendans, Pieter A; Meine, Mathias

2016-02-15

Novel implantable cardioverter defibrillator (ICD) discrimination algorithms and programming strategies have significantly reduced the incidence of inappropriate shocks, but there are still gains to be made with respect to reducing appropriate but unnecessary antitachycardia pacing (ATP) and shocks. We examined whether programming a number of intervals to detect (NID) of 60/80 for ventricular tachyarrhythmia (VT)/ventricular fibrillation (VF) detection was safe and the impact of this strategy on (1) adverse events related to ICD shocks and syncopal events; (2) ATPs/shocks; and (3) patient-reported outcomes. The "ENHANCED Implantable Cardioverter Defibrillator programming to reduce therapies and improve quality of life" study (ENHANCED-ICD study) was a prospective, safety-monitoring study enrolling 60 primary and secondary prevention patients at the University Medical Center Utrecht. Patients implanted with any type of ICD with SmartShock technology and aged 18 to 80 years were eligible to participate. In all patients, a prolonged NID 60/80 was programmed. The cycle length for VT/fast VT/VF was 360/330/240 ms, respectively. Programming a NID 60/80 proved safe for ICD patients. Because of the new programming strategy, unnecessary ICD therapy was prevented in 10% of ENHANCED-ICD patients during a median follow-up period of 1.3 years. With respect to patient-reported outcomes, levels of distress were highest and perceived health status lowest at the time of implantation, which both gradually improved during follow-up. In conclusion, the ENHANCED-ICD study demonstrates that programming a NID 60/80 for VT/VF detection is safe for ICD patients and does not negatively impact their quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.

PubMed

Doernberg, Ellen; Hollander, Eric

2016-08-01

Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide.

An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings: factor analysis and comparisons to ICD-10 and DSM-IV.

PubMed

Haravuori, Henna; Kiviruusu, Olli; Suomalainen, Laura; Marttunen, Mauri

2016-05-12

The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4%) PTSD cases, the two-factor ICD-11 identified 56 (24.6%) cases and the DSM-IV identified 43 (18.9%) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3%) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases

Statistical Report of Central Nervous System Tumors Histologically Diagnosed in the Sichuan Province of China from 2008 to 2013: A West China Glioma Center Report.

PubMed

Wang, Xiang; Chen, Jin-Xiu; Zhou, Qiao; Liu, Yan-Hui; Mao, Qing; You, Chao; Chen, Ni; Xiong, Li; Duan, Jie; Liu, Liang

2016-12-01

Sichuan is a province in the west of China with a population of 81.4 million. This is the first statistical report of central nervous system (CNS) tumors surgically treated and histologically diagnosed in a large Chinese population. All the patient data were obtained from 86 medical facilities, which covered the Sichuan province population. Data from patients who underwent surgery between 2008 and 2013 and corresponding histology samples were re-reviewed in the major pathology centers. All the CNS tumors were categorized according to International Classification of Diseases (ICD)-10 and ICD-O-3 classifications and reviewed manually. The tumor distribution was analyzed and stratified by gender, age, race, and tumor sites. Tumors in some ethnic minorities, such as the Tibetan people, also were analyzed. The final analytic dataset included 35,496 records. The top four histologic tumors were meningioma (28.51 %), pituitary adenoma (15.00 %), nerve sheath (13.77 %), and glioblastoma (11.82 %). There was a dramatically high incidence of malignant tumor in males. The median age at diagnosis ranged from 13 years (pineal region tumors) to 56 years (metastatic brain tumors). Most of the tumors in the insular lobe or cerebellum were low grade, whereas those in the thalamus or basal ganglia were likely to be high grade. The incidence of malignant tumors or high-grade gliomas in the Tibetans was significantly lower than in the Chinese Han population. This report is a preliminary statistical analysis of brain and spinal tumors in a large Chinese population and may serve as a useful resource for clinicians, researchers, and patients' families.

Generator replacement is associated with an increased rate of ICD lead alerts.

PubMed

Lovelock, Joshua D; Cruz, Cesar; Hoskins, Michael H; Jones, Paul; El-Chami, Mikhael F; Lloyd, Michael S; Leon, Angel; DeLurgio, David B; Langberg, Jonathan J

2014-10-01

Lead malfunction is an important cause of morbidity and mortality in patients with an implantable cardioverter-defibrillator (ICD). We have shown that the failure of recalled high-voltage leads significantly increases after ICD generator replacement. However, generator replacement has not been recognized as a predictor of lead failure in general. The purpose of this study is to assess the effect of ICD generator exchange on the rate of ICD lead alerts. A time-dependent Cox proportional hazards model was used to analyze a database of remotely monitored ICDs. The model assessed the impact of generator exchange on the rate of lead alerts after ICD generator replacement. The analysis included 60,219 patients followed for 37 ± 19 months. The 5-year lead survival was 99.3% (95% confidence interval 99.2%-99.4%). Of 60,219 patients, 7458 patients (12.9%) underwent ICD generator exchange without lead replacement. After generator replacement, the rate of lead alerts was more than 5-fold higher than in controls with leads of the same age without generator replacement (hazard ratio 5.19; 95% confidence interval 3.45-7.84). A large number of lead alerted within 3 months of generator replacement. Lead alerts were more common in patients with single- vs dual-chamber ICDs and in younger patients. Sex was not associated with lead alerts. Routine generator replacement is associated with a 5-fold higher risk of lead alert compared to age-matched leads without generator replacement. This suggests the need for intense surveillance after generator replacement and the development of techniques to minimize the risk of lead damage during generator replacement. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Differentiation of osteophyte types in osteoarthritis - proposal of a histological classification.

PubMed

Junker, Susann; Krumbholz, Grit; Frommer, Klaus W; Rehart, Stefan; Steinmeyer, Jürgen; Rickert, Markus; Schett, Georg; Müller-Ladner, Ulf; Neumann, Elena

2016-01-01

Osteoarthritis is not only characterized by cartilage degradation but also involves subchondral bone remodeling and osteophyte formation. Osteophytes are fibrocartilage-capped bony outgrowths originating from the periosteum. The pathophysiology of osteophyte formation is not completely understood. Yet, different research approaches are under way. Therefore, a histological osteophyte classification to achieve comparable results in osteophyte research was established for application to basic science research questions. The osteophytes were collected from knee joints of osteoarthritis patients (n=10, 94 osteophytes in total) after joint replacement surgery. Their size and origin in the respective joint were photo-documented. To develop an osteophyte classification, serial tissue sections were evaluated using histological (hematoxylin and eosin, Masson's trichrome, toluidine blue) and immunohistochemical staining (collagen type II). Based on the histological and immunohistochemical evaluation, osteophytes were categorized into four different types depending on the degree of ossification and the percentage of mesenchymal connective tissue. Size and localization of osteophytes were independent from the histological stages. This histological classification system of osteoarthritis osteophytes provides a helpful tool for analyzing and monitoring osteophyte development and for characterizing osteophyte types within a single human joint and may therefore contribute to achieve comparable results when analyzing histological findings in osteophytes. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study

PubMed Central

Weems, Shelley; Heller, Pamela; Fenton, Susan H.

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity.Coder training and type of record (inpatient versus outpatient) affect coding productivity.Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity. PMID:26396553

[Sudden cardiac death in the youth. Is the new subcutaneous implantable cardioverter defibrillator S-ICD an alternative solution?].

PubMed

Roche, N-C; Stefuriac, M; Dumitrescu, N; Charbonnel, A; Godreuil, C; Bonnevie, L

2015-02-01

Implantable cardioverter defibrillator (ICD) is well-recognized therapy to prevent sudden cardiac death. Classic ICD need the use of permanent endocavitary leads, which may cause serious troubles (lead dislodgement, ventricular perforation, lead infections, etc.). The subcutaneous implantable cardioverter defibrillator (S-ICD) is a new device provided by only a subcutaneous lead. It has been developed for the last five years and it is becoming at present a real alternative to classic ICD. We report a clinical case of a 34 y.o. woman who presented a sudden cardiac death and who benefited the implantation of this new technology. This paper deals with the potential indications, usefulness benefits, and problems of the S-ICD. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Greater Prevalence of Proposed ICD-11 Alcohol and Cannabis Dependence Compared to ICD-10, DSM-IV, and DSM-5 in Treated Adolescents.

PubMed

Chung, Tammy; Cornelius, Jack; Clark, Duncan; Martin, Christopher

2017-09-01

Proposed International Classification of Diseases, 11th edition (ICD-11), criteria for substance use disorder (SUD) radically simplify the algorithm used to diagnose substance dependence. Major differences in case identification across DSM and ICD impact determinations of treatment need and conceptualizations of substance dependence. This study compared the draft algorithm for ICD-11 SUD against DSM-IV, DSM-5, and ICD-10, for alcohol and cannabis. Adolescents (n = 339, ages 14 to 18) admitted to intensive outpatient addictions treatment completed, as part of a research study, a Structured Clinical Interview for DSM SUDs adapted for use with adolescents and which has been used to assess DSM and ICD SUD diagnoses. Analyses examined prevalence across classification systems, diagnostic concordance, and sources of diagnostic disagreement. Prevalence of any past-year proposed ICD-11 alcohol or cannabis use disorder was significantly lower compared to DSM-IV and DSM-5 (ps < 0.01). However, prevalence of proposed ICD-11 alcohol and cannabis dependence diagnoses was significantly higher compared to DSM-IV, DSM-5, and ICD-10 (ps < 0.01). ICD-11 and DSM-5 SUD diagnoses showed only moderate concordance. For both alcohol and cannabis, youth typically met criteria for an ICD-11 dependence diagnosis by reporting tolerance and much time spent using or recovering from the substance, rather than symptoms indicating impaired control over use. The proposed ICD-11 dependence algorithm appears to "overdiagnose" dependence on alcohol and cannabis relative to DSM-IV and ICD-10 dependence, and DSM-5 moderate/severe use disorder, generating potential "false-positive" cases of dependence. Among youth who met criteria for proposed ICD-11 dependence, few reported impaired control over substance use, highlighting ongoing issues in the conceptualization and diagnosis of SUD. Copyright © 2017 by the Research Society on Alcoholism.

A self-report measure for the ICD-11 dimensional trait model proposal: The personality inventory for ICD-11.

PubMed

Oltmanns, Joshua R; Widiger, Thomas A

2018-02-01

Proposed for the 11th edition of the World Health Organization's International Classification of Diseases (ICD-11) is a dimensional trait model for the classification of personality disorder (Tyrer, Reed, & Crawford, 2015). The ICD-11 proposal consists of 5 broad domains: negative affective, detachment, dissocial, disinhibition, and anankastic (Mulder, Horwood, Tyrer, Carter, & Joyce, 2016). Several field trials have examined this proposal, yet none has included a direct measure of the trait model. The purpose of the current study was to develop and provide initial validation for the Personality Inventory for ICD-11 (PiCD), a self-report measure of this proposed 5-domain maladaptive trait model. Item selection and scale construction proceeded through 3 initial data collections assessing potential item performance. Two subsequent studies were conducted for scale validation. In Study 1, the PiCD was evaluated in a sample of 259 MTurk participants (who were or had been receiving mental health treatment) with respect to 2 measures of general personality structure: The Eysenck Personality Questionnaire-Revised and the 5-Dimensional Personality Test. In Study 2, the PiCD was evaluated in an additional sample of 285 participants with respect to 2 measures of maladaptive personality traits: The Personality Inventory for DSM-5 and the Computerized Adaptive Test for Personality Disorders. Study 3 provides an item-level exploratory structural equation model with the combined samples from Studies 1 and 2. The results are discussed with respect to the validity of the measure and the potential benefits for future research in having a direct, self-report measure of the ICD-11 trait proposal. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

PubMed Central

2012-01-01

Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases), to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6%) cases were benign, including mastopathy (fibrocystic disease) in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9%) cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC) being significantly more frequent (49.5%) than papillotubular growing type (Papi-tub) (P < 0.0001), solid-tubular growing type (P = 0.0001) and ductal carcinoma in situ (DCIS) (P = 0.0001). Among 458 indeterminate cases, 54/139 (38.8%) were histologically benign (mastopathy, 30.0%; fibroadenoma, 27.8%; papilloma, 26.0%) and 73/139 (52.5%) were malignant, with SIDC being the most frequent malignant tumor (37.0%). Among 52 false-negative cases, SIDC was significantly more frequent (42.3%) than DCIS (P = 0.0049) and Papi-tub (P = 0.001). There were three false-positive cases, with one each of fibroadenoma, epidermal cyst and papilloma. Conclusions The inadequate, indeterminate, false-negative and false-positive cases showed similar histological types, notably SIDC for malignant tumors, and mastopathy

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel.

PubMed

Kuester, Annika; Köhler, Kai; Ehring, Thomas; Knaevelsrud, Christine; Kober, Louisa; Krüger-Gottschalk, Antje; Schäfer, Ingo; Schellong, Julia; Wesemann, Ulrich; Rau, Heinrich

2017-01-01

Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives: This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p  < .001). Provisional PTSD prevalence was significantly increased under ICD-11 proposal compared to ICD-10 (30%) which was mainly due to the deletion of the time criterion. Agreement between ICD-10 and the proposed ICD-11 was low ( p  = .014). Conclusion: This study provides preliminary evidence for a satisfactory concordance between provisional PTSD prevalence based on the diagnostic criteria for PTSD that are defined using DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel

PubMed Central

Kuester, Annika; Köhler, Kai; Ehring, Thomas; Knaevelsrud, Christine; Kober, Louisa; Krüger-Gottschalk, Antje; Schäfer, Ingo; Schellong, Julia; Wesemann, Ulrich; Rau, Heinrich

2017-01-01

ABSTRACT Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives:This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p < .001). Provisional PTSD prevalence was significantly increased under ICD-11 proposal compared to ICD-10 (30%) which was mainly due to the deletion of the time criterion. Agreement between ICD-10 and the proposed ICD-11 was low (p = .014). Conclusion: This study provides preliminary evidence for a satisfactory concordance between provisional PTSD prevalence based on the diagnostic criteria for PTSD that are defined using DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD

Spinel, YbFe2O4, and Yb2Fe3O7 types of structure for compounds in the In2O3 and Sc2O3-A2O3-BO systems (A: Fe, Ga, or Al; B: Mg, Mn, Fe, Ni, Cu, or Zn) at temperatures over 1000C

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kimizuka, N.; Mohri, T.

In the Sc2O3-Ga2O3-CuO, Sc2O3-Ga2O3-ZnO, and Sc2O3-Al2O3-CuO systems, ScGaCuO4, ScGaZnO4, and ScAlCuO4 with the YbFe2O4-type structure and Sc2Ga2CuO7 with the Yb2Fe3O7-type structure were obtained. In the In2O3-A2O3-BO systems (A: Fe, Ga, or Al; B: Mg, Mn, Fe, Ni, or Zn), InGaFeO4, InGaNiO4, and InFeT MgO4 with the spinel structure, InGaZnO4, InGaMgO4, and InAl-CuO4 with the YbFe2O4-type structure, and In2Ga2MnO7 and In2Ga2ZnO7 with the Yb2Fe3O7-type structure were obtained. InGaMnO4 and InFe2O4 had both the YbFe2O4-type and spinel-type structures. The revised classification for the crystal structures of AB2O4 compounds is presented, based upon the coordination numbers of constituent A and B cations. 5more » references, 2 tables.« less

Live Virtual Constructive (LVC): Interface Control Document (ICD) for the LVC Gateway. [Flight Test 3

NASA Technical Reports Server (NTRS)

Jovic, Srba

2015-01-01

This Interface Control Document (ICD) documents and tracks the necessary information required for the Live Virtual and Constructive (LVC) systems components as well as protocols for communicating with them in order to achieve all research objectives captured by the experiment requirements. The purpose of this ICD is to clearly communicate all inputs and outputs from the subsystem components.

Template-etching route to construct uniform rattle-type Fe3O4@SiO2 hollow microspheres as drug carrier.

PubMed

Cheng, Lin; Liu, Yuanyuan; Zou, Bingfang; Yu, Yong; Ruan, Weimin; Wang, Yongqiang

2017-06-01

Template-etching strategy was put forward to synthesize rattle-type magnetic silica (Fe 3 O 4 @SiO 2 ) hollow microspheres in a controlled way. During the experiment, monodisperse Fe 2 O 3 microspheres were fabricated as physical template to generate uniform Fe 2 O 3 @SiO 2 with controlled shell thicknesses through sol-gel method, and the subsequent Fe 2 O 3 template etching process created variable space between Fe 2 O 3 core and SiO 2 shell, and the final calcination process transformed rattle-type Fe 2 O 3 @SiO 2 hollow microspheres into corresponding Fe 3 O 4 @SiO 2 product in hydrogen/nitrogen atmosphere. Compared with traditional physical template, here template-etching synthesis of rattle-type hollow microspheres saved the insertion of middle shells and their removal, which simplified the synthesis process with controllable core size and shell thickness. The rattle-type Fe 3 O 4 @SiO 2 hollow microspheres as drug carrier show efficient doxorubicin (DOX) loading, and the release rate of DOX loaded the rattle-type Fe 3 O 4 @SiO 2 hollow microspheres exhibit a surprising shell-thickness-dependent and a pH responsive drug release features. Additionally, MTT assays in HeLa cells demonstrated that the Fe 3 O 4 @SiO 2 nanocarriers were non-toxic even at the concentration of 250µgmL -1 for 48h. Thus, our results revealed that the Fe 3 O 4 @SiO 2 -DOX could play an important role in the development of intracellular delivery nanodevices for cancer therapy. Copyright © 2017. Published by Elsevier B.V.

Measuring diagnoses: ICD code accuracy.

PubMed

O'Malley, Kimberly J; Cook, Karon F; Price, Matt D; Wildes, Kimberly Raiford; Hurdle, John F; Ashton, Carol M

2005-10-01

To examine potential sources of errors at each step of the described inpatient International Classification of Diseases (ICD) coding process. The use of disease codes from the ICD has expanded from classifying morbidity and mortality information for statistical purposes to diverse sets of applications in research, health care policy, and health care finance. By describing a brief history of ICD coding, detailing the process for assigning codes, identifying where errors can be introduced into the process, and reviewing methods for examining code accuracy, we help code users more systematically evaluate code accuracy for their particular applications. We summarize the inpatient ICD diagnostic coding process from patient admission to diagnostic code assignment. We examine potential sources of errors at each step and offer code users a tool for systematically evaluating code accuracy. Main error sources along the "patient trajectory" include amount and quality of information at admission, communication among patients and providers, the clinician's knowledge and experience with the illness, and the clinician's attention to detail. Main error sources along the "paper trail" include variance in the electronic and written records, coder training and experience, facility quality-control efforts, and unintentional and intentional coder errors, such as misspecification, unbundling, and upcoding. By clearly specifying the code assignment process and heightening their awareness of potential error sources, code users can better evaluate the applicability and limitations of codes for their particular situations. ICD codes can then be used in the most appropriate ways.

[Restrictions for ICD patients in daily life].

PubMed

Köbe, Julia; Gradaus, Rainer; Zumhagen, Sven; Böcker, Dirk

2005-11-01

Patients with an implantable cardioverter defibrillator (ICD) may experience loss of consciousness. Electromagnetic interference (EMI) may trigger undesired or inhibit necessary therapy in patients with an ICD. Therefore, questions about personal or professional activities for ICD patients arise. Restricting driving or other personal activities has adverse effects on the patient's quality of life. The national Societies of Cardiology provide recommendations for ICD patients concerning driving of motor vehicles. Patients with an ICD that is implanted prophylactically do not have to refrain from driving after recovery from the implantation procedure. Patients with arrhythmias are classified into different groups depending on the risk of recurrence of tachycardias and symptoms. Commercial driving is not allowed for patients with an ICD in Germany except for those with a prophylactic indication without a history of arrhythmias. Those patients may drive small cars but no trucks or busses. Guidelines for medical fitness in commercial or military flying are regulated by the Joint Aviation Authorities (JAA) and ventricular tachycardias are a contraindication for both. Fortunately, loss of consciousness is not dangerous in most jobs. Strong sources of EMI can occur at special workplaces. Patients have to be advised and tested individually concerning their risk for EMI at their employment site before returning safely. Modern life exposes to an increasing amount of EMI. Intact household devices usually do not interfere with ICDs. Mobile phones may interfere with implanted devices. Interaction can be minimized by special precautions like maintaining a distance of minimum 10 cm between mobile phone and ICD. Electronic surveillance systems work differently and have the potential to interact with devices. Patients should be advised to pass those systems with avoiding longer exposure. The presence of an ICD is presently a contraindication for undergoing magnetic resonance imaging

Nonzero Berry phase in quantum oscillations from giant Rashba-type spin splitting in LaTiO3/SrTiO3 heterostructures.

PubMed

Veit, M J; Arras, R; Ramshaw, B J; Pentcheva, R; Suzuki, Y

2018-04-13

The manipulation of the spin degrees of freedom in a solid has been of fundamental and technological interest recently for developing high-speed, low-power computational devices. There has been much work focused on developing highly spin-polarized materials and understanding their behavior when incorporated into so-called spintronic devices. These devices usually require spin splitting with magnetic fields. However, there is another promising strategy to achieve spin splitting using spatial symmetry breaking without the use of a magnetic field, known as Rashba-type splitting. Here we report evidence for a giant Rashba-type splitting at the interface of LaTiO 3 and SrTiO 3 . Analysis of the magnetotransport reveals anisotropic magnetoresistance, weak anti-localization and quantum oscillation behavior consistent with a large Rashba-type splitting. It is surprising to find a large Rashba-type splitting in 3d transition metal oxide-based systems such as the LaTiO 3 /SrTiO 3 interface, but it is promising for the development of a new kind of oxide-based spintronics.

Design of n - and p -type oxide thermoelectrics in LaNiO3/SrTiO3(001 ) superlattices exploiting interface polarity

NASA Astrophysics Data System (ADS)

Geisler, Benjamin; Blanca-Romero, Ariadna; Pentcheva, Rossitza

2017-03-01

We investigate the structural, electronic, transport, and thermoelectric properties of LaNiO3/SrTiO3(001 ) superlattices containing either exclusively n - or p -type interfaces or coupled interfaces of opposite polarity by using density functional theory calculations with an on-site Coulomb repulsion term. The results show that significant octahedral tilts are induced in the SrTiO3 part of the superlattice. Moreover, the La-Sr distances and Ni-O out-of-plane bond lengths at the interfaces exhibit a distinct variation by about 7 % with the sign of the electrostatic doping. In contrast to the much studied LaAlO3/SrTiO3 system, the charge mismatch at the interfaces is exclusively accommodated within the LaNiO3 layers, whereas the interface polarity leads to a band offset and to the formation of an electric field within the coupled superlattice. Features of the electronic structure indicate an orbital-selective quantization of quantum well states. The potential- and confinement-induced multiband splitting results in complex cylindrical Fermi surfaces with a tendency towards nesting that depends on the interface polarity. The analysis of the thermoelectric response reveals a particularly large positive Seebeck coefficient (135 μ V /K) and a high figure of merit (0.35) for room-temperature cross-plane transport in the p -type superlattice that is attributed to the participation of the SrTiO3 valence band. Superlattices with either n - or p -type interfaces show cross-plane Seebeck coefficients of opposite sign and thus emerge as a platform to construct an oxide-based thermoelectric generator with structurally and electronically compatible n - and p -type oxide thermoelectrics.

Measuring Diagnoses: ICD Code Accuracy

PubMed Central

O'Malley, Kimberly J; Cook, Karon F; Price, Matt D; Wildes, Kimberly Raiford; Hurdle, John F; Ashton, Carol M

2005-01-01

Objective To examine potential sources of errors at each step of the described inpatient International Classification of Diseases (ICD) coding process. Data Sources/Study Setting The use of disease codes from the ICD has expanded from classifying morbidity and mortality information for statistical purposes to diverse sets of applications in research, health care policy, and health care finance. By describing a brief history of ICD coding, detailing the process for assigning codes, identifying where errors can be introduced into the process, and reviewing methods for examining code accuracy, we help code users more systematically evaluate code accuracy for their particular applications. Study Design/Methods We summarize the inpatient ICD diagnostic coding process from patient admission to diagnostic code assignment. We examine potential sources of errors at each step and offer code users a tool for systematically evaluating code accuracy. Principle Findings Main error sources along the “patient trajectory” include amount and quality of information at admission, communication among patients and providers, the clinician's knowledge and experience with the illness, and the clinician's attention to detail. Main error sources along the “paper trail” include variance in the electronic and written records, coder training and experience, facility quality-control efforts, and unintentional and intentional coder errors, such as misspecification, unbundling, and upcoding. Conclusions By clearly specifying the code assignment process and heightening their awareness of potential error sources, code users can better evaluate the applicability and limitations of codes for their particular situations. ICD codes can then be used in the most appropriate ways. PMID:16178999

The Tragedy of the Implementation of ICD-10-CM as ICD-10: Is the Cart Before the Horse or Is There a Tragic Paradox of Misinformation and Ignorance?

PubMed

Manchikanti, Laxmaiah; Kaye, Alan D; Singh, Vijay; Boswell, Mark V

2015-01-01

Information Management Association (AHIMA). The AHIMA has taken the lead with the AHA just behind, both with escalating profits and influence, essentially creating a statutory monopoly for their own benefit. Further, the ICD-10-CM coalition includes 3M which will boost its revenues and profits substantially with its implementation and Blue Cross Blue Shield which has its own agenda. Physician groups are not a party to these cooperating parties or coalitions, having only a peripheral involvement. ICD-10-CM creates numerous deficiencies with 500 codes that are more specific in ICD-9-CM than ICD-10-CM. The costs of an implementation are enormous, along with maintenance costs, productivity, and cash disruptions.

Shear wave elastography of breast cancer: Sensitivity according to histological type in a large cohort.

PubMed

Evans, Andrew; Sim, Yee Ting; Thomson, Kim; Jordan, Lee; Purdie, Colin; Vinnicombe, Sarah J

2016-04-01

To define the shear wave elastography (SWE) characteristics of breast cancer histological types by size in a large cohort. Consecutive patients with US visible masses underwent SWE. All those with confirmed invasive breast cancer were included in the study. Histologic type was ascertained from core biopsy and surgical resection specimens. For each type, mean and median values for Emean and Emax were ascertained. Commoner tumour types were further analysed by invasive size. The significance of differences was established using the Chi-square test. 1137 tumours constituted the study group. The proportion of tumours with Emean below 50 kPa was higher in tubular cancers (23%) compared to ductal carcinomas of no specific type (DNST) (6%) (p < 0.001). Emax below 80 kPa was seen in 34% of tubular cancers compared to 16% of DNST (p < 0.002). Emean and Emax for lobular, mucinous, papillary and metaplastic cancers were not different from those of DNST. There were no significant differences in Emean or Emax between tumour types once broken down according to invasive size. Most breast cancer histological types have similar SWE characteristics. The exception is tubular cancer which has significantly lower stiffness than other histologic types, accounted for largely by their small size. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of surgical margins according to the histological type of basal cell carcinoma.

PubMed

Godoy, Charles Antonio Pires de; Neta, Alice Lima de Oliveira; Leão, Sofia Silveira de Souza; Dantas, Raul Lima; Carvalho, Valeska Oliveira Fonseca; Silva, Samuel Freire da

2017-01-01

Basal cell carcinoma is the most common skin cancer in the world. The aim of this study was to evaluate the surgical margin of basal cell carcinoma and correlate this with its histologic subtype. A retrospective analysis of pathology laboratory records from 1990 to 2000 was performed and the following data was collected: age, sex, race, anatomical location, histological type, and state of the excision margins in 1,428 histopathological reports of basal cell carcinoma. Ages ranged from 6 to 99 years, with an average of 57. There was a slight predominance of lesions in white women patients, and the most common histological subtype was the nodular, followed by the superficial. The most common locations were in the head and neck, with highest prevalence appeared in the nose. Surgical margins revealed a lateral involvement of 20.14% and a deep involvement of 12.47%. The fibrosing basal cell carcinoma is the histological type that most often presented positive surgical margins.

ICD-9-CM and ICD-10-CM mapping of the AAST Emergency General Surgery disease severity grading systems: Conceptual approach, limitations, and recommendations for the future.

PubMed

Utter, Garth H; Miller, Preston R; Mowery, Nathan T; Tominaga, Gail T; Gunter, Oliver; Osler, Turner M; Ciesla, David J; Agarwal, Suresh K; Inaba, Kenji; Aboutanos, Michel B; Brown, Carlos V R; Ross, Steven E; Crandall, Marie L; Shafi, Shahid

2015-05-01

The American Association for the Surgery of Trauma (AAST) recently established a grading system for uniform reporting of anatomic severity of several emergency general surgery (EGS) diseases. There are five grades of severity for each disease, ranging from I (lowest severity) to V (highest severity). However, the grading process requires manual chart review. We sought to evaluate whether International Classification of Diseases, 9th and 10th Revisions, Clinical Modification (ICD-9-CM, ICD-10-CM) codes might allow estimation of AAST grades for EGS diseases. The Patient Assessment and Outcomes Committee of the AAST reviewed all available ICD-9-CM and ICD-10-CM diagnosis codes relevant to 16 EGS diseases with available AAST grades. We then matched grades for each EGS disease with one or more ICD codes. We used the Official Coding Guidelines for ICD-9-CM and ICD-10-CM and the American Hospital Association's "Coding Clinic for ICD-9-CM" for coding guidance. The ICD codes did not allow for matching all five AAST grades of severity for each of the 16 diseases. With ICD-9-CM, six diseases mapped into four categories of severity (instead of five), another six diseases into three categories of severity, and four diseases into only two categories of severity. With ICD-10-CM, five diseases mapped into four categories of severity, seven diseases into three categories, and four diseases into two categories. Two diseases mapped into discontinuous categories of grades (two in ICD-9-CM and one in ICD-10-CM). Although resolution is limited, ICD-9-CM and ICD-10-CM diagnosis codes might have some utility in roughly approximating the severity of the AAST grades in the absence of more precise information. These ICD mappings should be validated and refined before widespread use to characterize EGS disease severity. In the long-term, it may be desirable to develop alternatives to ICD-9-CM and ICD-10-CM codes for routine collection of disease severity characteristics.

Tilt engineering of exchange coupling at G-type SrMnO3/(La,Sr)MnO3 interfaces

NASA Astrophysics Data System (ADS)

Li, F.; Song, C.; Wang, Y. Y.; Cui, B.; Mao, H. J.; Peng, J. J.; Li, S. N.; Wang, G. Y.; Pan, F.

2015-11-01

With the recent realization of hybrid improper ferroelectricity and room-temperature multiferroic by tilt engineering, “functional” octahedral tilting has become a novel concept in multifunctional perovskite oxides, showing great potential for property manipulation and device design. However, the control of magnetism by octahedral tilting has remained a challenging issue. Here a qualitative and quantitative tilt engineering of exchange coupling, one of the magnetic properties, is demonstrated at compensated G-type antiferromagnetic/ferromagnetic (SrMnO3/La2/3Sr1/3MnO3) interfaces. According to interfacial Hamiltonian, exchange bias (EB) in this system originates from an in-plane antiphase rotation (a-) in G-type antiferromagnetic layer. Based on first-principles calculation, tilt patterns in SrMnO3 are artificially designed in experiment with different epitaxial strain and a much stronger EB is attained in the tensile heterostructure than the compressive counterpart. By controlling the magnitude of octahedral tilting, the manipulation of exchange coupling is even performed in a quantitative manner, as expected in the theoretical estimation. This work realized the combination of tilt engineering and exchange coupling, which might be significant for the development of multifunctional materials and antiferromagnetic spintronics.

The development, evolution, and modifications of ICD-10: challenges to the international comparability of morbidity data.

PubMed

Jetté, Nathalie; Quan, Hude; Hemmelgarn, Brenda; Drosler, Saskia; Maass, Christina; Moskal, Lori; Paoin, Wansa; Sundararajan, Vijaya; Gao, Song; Jakob, Robert; Ustün, Bedihran; Ghali, William A

2010-12-01

The United States is about to make a major nationwide transition from ICD-9-CM coding of hospital discharges to ICD-10-CM, a country-specific modification of the World Health Organization's ICD-10. As this transition occurs, the WHO is already in the midst of developing ICD-11. Given this context, we undertook this review to discuss: (1) the history of the International Classification of Diseases (a core information "building block" for health systems everywhere) from its introduction to the current era of ICD-11 development; (2) differences across country-specific ICD-10 clinical modifications and the challenges that these differences pose to the international comparability of morbidity data; (3) potential strategic approaches to achieving better international ICD-11 comparability. A literature review and stakeholder consultation was carried out. The various ICD-10 clinical modifications (ICD-10-AM [Australia], ICD-10-CA [Canada], ICD-10-GM [Germany], ICD-10-TM [Thailand], ICD-10-CM [United States]) were compared. These ICD-10 modifications differ in their number of codes, chapters, and subcategories. Specific conditions are present in some but not all of the modifications. ICD-11, with a similar structure to ICD-10, will function in an electronic health records environment and also provide disease descriptive characteristics (eg, causal properties, functional impact, and treatment). The threat to the comparability of international clinical morbidity is growing with the development of many country-specific ICD-10 versions. One solution to this threat is to develop a meta-database including all country-specific modifications to ensure more efficient use of people and resources, decrease omissions and errors but most importantly provide a platform for future ICD updates.

The genetic locus NRC-1 within chromosome 3p12 mediates tumor suppression in renal cell carcinoma independently of histological type, tumor microenvironment, and VHL mutation.

PubMed

Lovell, M; Lott, S T; Wong, P; El-Naggar, A; Tucker, S; Killary, A M

1999-05-01

Human chromosome 3p cytogenetic abnormalities and loss of heterozygosity have been observed at high frequency in the nonpapillary form of sporadic renal cell carcinoma (RCC). The von Hippel-Lindau (VHL) gene has been identified as a tumor suppressor gene for RCC at 3p25, and functional studies as well as molecular genetic and cytogenetic analyses have suggested as many as two or three additional regions of 3p that could harbor tumor suppressor genes for sporadic RCC. We have previously functionally defined a novel genetic locus nonpapillary renal carcinoma-1 (NRC-1) within chromosome 3p12, distinct from the VHL gene, that mediates tumor suppression and rapid cell death of RCC cells in vivo. We now report the suppression of tumorigenicity of RCC cells in vivo after the transfer of a defined centric 3p fragment into different histological types of RCC. Results document the functional involvement of NRC-1 in not only different cell types of RCC (i.e., clear cell, mixed granular cell/clear cell, and sarcomatoid types) but also in papillary RCC, a less frequent histological type of RCC for which chromosome 3p LOH and genetic aberrations have only rarely been observed. We also report that the tumor suppression observed in functional genetic screens was independent of the microenvironment of the tumor, further supporting a role for NRC-1 as a more general mediator of in vivo growth control. Furthermore, this report demonstrates the first functional evidence for a VHL-independent pathway to tumorigenesis in the kidney via the genetic locus NRC-1.

A new LiNbO{sub 3}-type polar oxide with closed-shell cations: ZnPbO{sub 3}

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, Runze, E-mail: yu.r.aa@m.titech.ac.jp, E-mail: mazuma@msl.titech.ac.jp; Hojo, Hajime; Azuma, Masaki, E-mail: yu.r.aa@m.titech.ac.jp, E-mail: mazuma@msl.titech.ac.jp

2015-09-07

A new lithium-niobate (LiNbO{sub 3})-type polar compound, namely, ZnPbO{sub 3} (a = 5.41605(7) Å and c = 14.33151(3) Å), with closed-shell ions only was synthesized under high pressure and high temperature (8 GPa and 1273 K). A point-charge-model calculation based on atomic positions refined by Rietveld analysis of synchrotron X-ray diffraction data gave an electrical ionic polarization of 77 μC/cm{sup 2} along the hexagonal c-axis. Detailed structural analysis indicated that the contribution of Pb{sup 4+} in ZnPbO{sub 3} to the polarization was almost twice as large as that of Sn{sup 4+} in ZnSnO{sub 3}. Transport measurement showed metallic behavior of ZnPbO{sub 3} from room temperature to lowmore » temperature despite the fact that both cations are closed-shell ions.« less

Substance use and addictive disorders in DSM-5 and ICD 10 and the draft ICD 11.

PubMed

Saunders, John B

2017-07-01

The present review compares and contrasts the diagnostic entities and taxonomy of substance use and addictive disorders in the beta draft of the Eleventh Revision of the International Classification of Diseases (ICD 11), which was released in November 2016, and the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which was published in mid-2013. Recently published papers relevant to these two classification systems are examined. New initiatives in diagnosis and assessment including the addictions neuroclinical assessment are noted. The draft ICD 11 retains substance dependence as the 'master diagnosis' in contrast to the broader and heterogeneous concept of substance use disorder in DSM-5 and there is empirical support for the coherence of substance dependence for alcohol, cannabis, and prescribed opioids. Both systems now include gambling disorder in the addictive disorders section, with it being transferred from the impulse control disorders section. The new diagnosis of Internet gaming disorder is included in DSM-5 as a condition for further study, and gaming disorder is grouped with the substance and gambling disorders in the draft ICD 11. Initiatives from the U.S. National Institutes of Health (NIH) are highlighting the importance of capturing the neurobiological phases of the addictive cycle in clinical diagnosis and assessment. Although most of the changes in the draft ICD 11 and DSM-5 are incremental, the contrast between DSM-5 substance use disorder and substance dependence in the draft ICD 11, and the inclusion of gambling disorder and gaming disorder will generate much discussion and research.

A 9-protein biomarker molecular signature for predicting histologic type in endometrial carcinoma by immunohistochemistry.

PubMed

Santacana, Maria; Maiques, Oscar; Valls, Joan; Gatius, Sònia; Abó, Ana Isabel; López-García, María Ángeles; Mota, Alba; Reventós, Jaume; Moreno-Bueno, Gema; Palacios, Jose; Bartosch, Carla; Dolcet, Xavier; Matias-Guiu, Xavier

2014-12-01

Histologic typing may be difficult in a subset of endometrial carcinoma (EC) cases. In these cases, interobserver agreement improves when immunohistochemistry (IHC) is used. A series of endometrioid type (EEC) grades 1, 2, and 3 and serous type (SC) were immunostained for p53, p16, estrogen receptor, PTEN, IMP2, IMP3, HER2, cyclin B2 and E1, HMGA2, FolR1, MSLN, Claudins 3 and 4, and NRF2. Nine biomarkers showed significant differences with thresholds in IHC value scale between both types (p53 ≥ 20, IMP2 ≥ 115, IMP3 ≥ 2, cyclin E1 ≥ 220, HMGA2 ≥ 30, FolR1 ≥ 50, p16 ≥ 170, nuclear PTEN ≥ 2 and estrogen receptor ≤ 50; P < .005). This combination led to increased discrimination when considering cases satisfying 0 to 5 conditions predicted as EEC and those satisfying 6 to 9 conditions predicted as SC. This signature correctly predicted all 48 EEC grade 1-2 cases and 18 SC cases, but 3 SC cases were wrongly predicted as EEC. Sensitivity was 86% (95% confidence interval [CI], 64%-97%), and specificity was 100% (95% CI, 89%-100%). The classifier correctly predicted all 28 EEC grade 3 cases but only identified the EEC and SC components in 4 of 9 mixed EEC-SC. An independent validation series (29 EEC grades 1-2, 28 EEC grade 3, and 31 SC) showed 100% sensitivity (95% CI, 84%-100%) and 83% specificity (95% CI, 64%-94%). We propose an internally and externally validated 9-protein biomarker signature to predict the histologic type of EC (EEC or SC) by IHC. The results also suggest that mixed EEC-SC is molecularly ambiguous. Copyright © 2014 Elsevier Inc. All rights reserved.

A scoping review of ICD-11 adjustment disorder research.

PubMed

Kazlauskas, Evaldas; Zelviene, Paulina; Lorenz, Louisa; Quero, Soledad; Maercker, Andreas

2017-01-01

Background : Adjustment disorder (AjD) is one of the most used mental disorder diagnoses among mental health professionals. Important revisions of the AjD definition in the 11th edition of the International Classification of Diseases (ICD-11) are proposed. AjD is included in a chapter of disorders specifically associated with stress in ICD-11. Objective : This paper aims to review recent developments in ICD-11 AjD research, and to discuss the available ICD-11 AjD diagnosis validation studies, AjD measures, treatment studies, and outline the future perspectives for AjD research and clinical practice. Methods : In total, 10 empirical studies of AjD ICD-11 were identified and included in this review. We searched for studies in Embase, PubMed, PsycINFO, Scopus, PILOTS, SocINDEX, and via additional search by contacting authors of published empirical studies and reference screening. Results : Review of the studies revealed a lack of validation studies of the ICD-11 AjD symptom structure. AjD validation study findings are ambiguous, and there is still little support for the proposed two symptom structure of AjD for the ICD-11. A self-report AjD measure 'Adjustment Disorder New Module' (ADNM) based on the ICD-11 definition has been developed and used in all 10 reviewed studies. Two self-help interventions have been developed for the ICD-11 AjD, and findings from these studies indicate that self-help low-intensity cognitive-behavioural interventions, delivered via bibliography or internet-based, might be effective treatment of AjD. Conclusions : The AjD definition in ICD-11 with a description of a new symptom profile facilitates AjD measurement and AjD-focused treatment developments. More studies and insights from clinical practice are needed to move the field of AjD research and practice forward.

Comparison of Photocatalytic Performance of Different Types of Graphene in Fe3O4/SnO2 Composites

NASA Astrophysics Data System (ADS)

Paramarta, Valentinus; Taufik, Ardiansyah; Saleh, Rosari

2017-03-01

We have reported the role of annealing temperature Fe3O4/SnO2 nanocomposites as a photocatalyst for remove methylene blue (MB) dye from aqueous solution. However, how to enhanced the degradation performance of Fe3O4/SnO2 nanocomposites is important to its photocatalytic application. Therefore, in this work Fe3O4/SnO2 nanocomposites was combined with two different types of graphene materials (NGP and grahene) to improve the photocatalytic performance for remove methylene blue (MB) dye. Fe3O4/SnO2/NGP and Fe3O4/SnO2/graphene have been successfully synthesized by co-precipitation method. The influence of two types graphene on Fe3O4/SnO2 nanocomposites properties were systematically investigated by means of X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy and Thermal gravimetric analysis (TGA). Degradation of methylene Blue (MB) in aqueous solution was studied in detail under photocatalytic process. Effect of catalyst dosage (0.1-0.4 g/L) and scavengers on dye degradation were carried out to check the efficiency of photocatalyst. The results indicated Fe3O4/SnO2/graphene displayed higher photocatalytic activity than other catalyst. The reusability tests have also been done to ensure the stability of the used photocatalyst.

Single-crystalline oxide films of the Al2O3-Y2O3-R2O3 system as optical sensors of various types of ionizing radiation: significant advantages over volume analogs

NASA Astrophysics Data System (ADS)

Zorenko, Yuri V.; Batenchuk, M.; Gorbenco, V.; Pashkovsky, M.

1997-02-01

This investigation is dedicated to studying of peculiarities of luminescent properties of the single crystalline films (SCF) of Al2O3-Y2O3-R2O3 oxide system with alpha-Al2O3 and garnet structure, which are used as various types of ionizing radiation luminescent detectors. These peculiarities define the number of nontrivial advantages over their volume analogues. It is shown that SCF are characterized by the low concentrations of vacancy type defects and substituent defects, and the high concentration of Pb ion as dopant. This allows us to substantially increase the spatial resolution and selectivity of cathodoluminophores on the base of these compounds.

Preparing your organization's training program for ICD-10.

PubMed

Carolan, Katie; Reitzel, David

2011-10-01

Training for ICD-10 is going to be expensive, though predictions of how expensive vary widely. Healthcare finance executives should create a flexible, multiyear capital and operating budget to prepare for ICD-10 conversion and the training and support that will be required. Healthcare organizations also should assess staff knowledge in the critical ICD-10 areas and begin training now to be ready for go-live by early 2013.

Dollars and sense: Mitigating budget risk for ICD-10.

PubMed

Newell, Lucy Mancini; DeSilva, Joseph J

2013-02-01

The extended deadline for ICD-10 implementation is time that should not be wasted. Healthcare leaders should keep three things in mind: CFOs should approach the effort knowing the costs of ICD-10 implementation will be high and spread over multiple budget years. Training, productivity, and contractual issues are among key areas that will be challenged by ICD-10 implementation. Healthcare finance leaders should work to improve cash-on-hand and cash reserves prior to the ICD-10 deadline to ensure liquidity post-compliance.

[Indication of chemotherapy according to histological type of musculoskeletal sarcomas].

PubMed

Goto, Takahiro; Okuma, Tomotake; Ogura, Koichi; Imanishi, Jungo; Hozumi, Takahiro; Kondo, Taiji

2009-02-01

In high-grade musculoskeletal sarcomas, adjuvant chemotherapy is often performed to prevent distant metastases. As the efficacy of chemotherapy varies according to the histological type of sarcoma, its indication is determined according to the histological type and the stage. Prognoses are poor in patients with osteosarcoma, Ewing's sarcoma, or rhabdomyosarcoma, when surgery alone is performed. However, because these sarcomas are chemosensitive, their prognoses are improved with adjuvant chemotherapy, so it is absolutely necessary. Drugs commonly used for osteosarcoma include adriamycin, cisplatin, methotrexate, vincristine, and ifosfamide. For Ewing's sarcoma and rhabdomyosarcoma, vincristine, actinomycin-D, cyclophosphamide, etoposide, and ifosfamide are commonly used. On the other hand, the efficacy of chemotherapy is unclear in most of the non-round cell sarcomas, e. g., malignant fibrous histiocytoma, pleomorphic liposarcoma, and leiomyosarcoma, so adjuvant chemotherapy is relatively indicated and often performed preoperatively. The efficacy is evaluated by reduction of the tumor volume as a surrogate marker. Postoperative chemotherapy is performed when the preoperative chemotherapy is effective. Nowadays, several kinds of antitumor agents are usually used for non-round cell sarcomas, and many authors have reported various kinds of regimens and their clinical results. Among them, the key drugs are adriamycin and ifosfamide. Recently, taxanes and gemcitabine are sometimes used. For chemoresistant sarcomas, e. g., chondrosarcoma, chordoma, alveolar soft part sarcoma, chemotherapy is rarely indicated, even if the tumor is histologically high grade and large. Low-grade musculoskeletal sarcomas, e. g., low-grade chondrosarcoma, central low-grade osteosarcoma, parosteal osteosarcoma, well-differentiated liposarcoma, and dermatofibrosarcoma protuberans, are well cured only by surgical excision, and adjuvant chemotherapy is therefore not indicated. Superficially

Acute evaluation of transthoracic impedance vectors using ICD leads.

PubMed

Gottfridsson, Christer; Daum, Douglas; Kennergren, Charles; Ramuzat, Agnès; Willems, Roger; Edvardsson, Nils

2009-06-01

Minute ventilation (MV) has been proven to be very useful in rate responsive pacing. The aim of this study was to evaluate the feasibility of using implantable cardioverter-defibrillator (ICD) leads as part of the MV detection system. At implant in 10 patients, the transthoracic impedance was measured from tripolar ICD, tetrapolar ICD, and atrial lead vectors during normal, deep, and shallow voluntary respiration. MV and respiration rate (RespR) were simultaneously measured through a facemask with a pneumotachometer (Korr), and the correlations with impedance-based measurements were calculated. Air sensitivity was the change in impedance per change in respiratory tidal volume, ohms (Omega)/liter (L), and the signal-to-noise ratio (SNR) was the ratio of the respiratory and cardiac contraction components. The air sensitivity and SNR in tripolar ICD vector were 2.70 +/- 2.73 ohm/L and 2.19 +/- 1.31, respectively, and were not different from tetrapolar. The difference in RespR between tripolar ICD and Korr was 0.2 +/- 1.91 breaths/minute. The regressed correlation coefficient between impedance MV and Korr MV was 0.86 +/- 0.07 in tripolar ICD. The air sensitivity and SNR in tripolar and tetrapolar ICD lead vectors did not differ significantly and were in the range of the values in pacemaker leads currently used as MV sensors. The good correlations between impedance-based and Korr-based RespR and MV measurements imply that ICD leads may be used in MV sensor systems.

Synthesis, structure, and characterization of a new sandwich-type arsenotungstocerate, [As 2W 18Ce 3O 71(H 2O) 3] 12-

NASA Astrophysics Data System (ADS)

Alizadeh, M. H.; Eshtiagh-Hosseini, H.; Khoshnavazi, R.

2004-01-01

The rational synthesis of the new sandwich-type arsenotungstocerate [As 2W 18Ce 3O 71(H 2O) 3] 12- is reported for the first time by reaction of the trivacant lacunary species A-α-[AsW 9O 34] 9- with appropriate Ce IV. The single crystal structure analysis was carried out on K 7(H 3O) 5[As 2W 18Ce 3O 71(H 2O) 3]·9H 2O; H 39As 2Ce 3K 7O 88W 18; ( 2) which crystallizes in triclinic system, space group P overline1 with a=11.615(5) Å, b=17.638(7) Å, c=19.448(8) Å, α=73.643(7)°, β=88.799(7)°, γ=88.078(7)° and Z=2. The anion consists on two lacunary A-α-[AsW 9O 34] 9- Keggin moieties linked via a (H 2OCeO) 3 belt leading to a sandwich-type structure. Each cerium atom adopts tri-capped trigonal-prismatic coordination achieved by two terminal oxygen of an edge shared paired of WO 6 octahedra to each A-α-AsW 9O 349- moiety and two oxygen from the belt and the cap by one μ 3-O (As, W 2) to each A-α-AsW 9O 349- moiety and one external water ligand. The Ce-O bond lengths average in CeO 6 group, Ce-O(As, W 2) and Ce-O(nW) are 2.300(9), 2.887(3) and 2.682(5) Å, respectively. The acid/base titration curve reveals that the anion has two different titrable protons.

The subcutaneous ICD as an alternative to the conventional ICD system: Initial experience in Greece and a review of the literature.

PubMed

Sideris, Skevos; Archontakis, Stefanos; Gatzoulis, Konstantinos A; Anastasakis, Aristotelis; Sotiropoulos, Ilias; Arsenos, Petros; Kasiakogias, Alexandros; Terentes, Dimitrios; Trachanas, Konstantinos; Paschalidis, Eleftherios; Tousoulis, Dimitrios; Kallikazaros, Ioannis

The introduction of an implantable cardioverter defibrillator (ICD) in clinical practice has revolutionized our therapeutic approach for both primary and secondary prevention of sudden cardiac death (SCD), as it has proven to be superior to medical therapy in treating potentially life-threatening ventricular arrhythmias and has resulted in reduced mortality rates. However, implantation of a conventional ICD carries a non-negligible risk of periprocedural and long-term complications associated with the transvenous ICD leads. The entirely subcutaneous implantable cardioverter defibrillator (S-ICD) has recently emerged as a therapeutic alternative to the conventional ICD for patients with various cardiopathies and who are at high risk of SCD. The main advantage is the avoidance of vascular access and thus avoidance of complications associated with transvenous leads. Patients without pacing indications, such as bradycardia, a need for antitachycardia pacing or cardiac resynchronization, as well as those at higher risk of complications from transvenous lead implantation are perfect candidates for this novel technology. The subcutaneous ICD has proven to be equally safe and effective compared to transvenous ICD systems in early clinical trials. Further technical improvements of the system will likely lead to the expansion of indications and widespread use of this technology. In the present review, we discuss the indications for this system, summarize early clinical experiences and highlight the advantages and disadvantages of this novel technology. In addition, we present the first two cases of subcutaneous cardioverter defibrillator system implantation in Greece. Copyright © 2017 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Predicting trauma patient mortality: ICD [or ICD-10-AM] versus AIS based approaches.

PubMed

Willis, Cameron D; Gabbe, Belinda J; Jolley, Damien; Harrison, James E; Cameron, Peter A

2010-11-01

The International Classification of Diseases Injury Severity Score (ICISS) has been proposed as an International Classification of Diseases (ICD)-10-based alternative to mortality prediction tools that use Abbreviated Injury Scale (AIS) data, including the Trauma and Injury Severity Score (TRISS). To date, studies have not examined the performance of ICISS using Australian trauma registry data. This study aimed to compare the performance of ICISS with other mortality prediction tools in an Australian trauma registry. This was a retrospective review of prospectively collected data from the Victorian State Trauma Registry. A training dataset was created for model development and a validation dataset for evaluation. The multiplicative ICISS model was compared with a worst injury ICISS approach, Victorian TRISS (V-TRISS, using local coefficients), maximum AIS severity and a multivariable model including ICD-10-AM codes as predictors. Models were investigated for discrimination (C-statistic) and calibration (Hosmer-Lemeshow statistic). The multivariable approach had the highest level of discrimination (C-statistic 0.90) and calibration (H-L 7.65, P= 0.468). Worst injury ICISS, V-TRISS and maximum AIS had similar performance. The multiplicative ICISS produced the lowest level of discrimination (C-statistic 0.80) and poorest calibration (H-L 50.23, P < 0.001). The performance of ICISS may be affected by the data used to develop estimates, the ICD version employed, the methods for deriving estimates and the inclusion of covariates. In this analysis, a multivariable approach using ICD-10-AM codes was the best-performing method. A multivariable ICISS approach may therefore be a useful alternative to AIS-based methods and may have comparable predictive performance to locally derived TRISS models. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

76 FR 51985 - ICD-9-CM Coordination and Maintenance Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-19

... and Public Health Data Standards Staff, announces the following meeting. Name: ICD-9-CM Coordination.... 2012 ICD-10-PCS GEM and Reimbursement Map Updates. ICD-10-PCS Official Coding Guidelines. ICD-10 MS... Pickett, Medical Systems Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311...

Surface passivation of n-type doped black silicon by atomic-layer-deposited SiO2/Al2O3 stacks

NASA Astrophysics Data System (ADS)

van de Loo, B. W. H.; Ingenito, A.; Verheijen, M. A.; Isabella, O.; Zeman, M.; Kessels, W. M. M.

2017-06-01

Black silicon (b-Si) nanotextures can significantly enhance the light absorption of crystalline silicon solar cells. Nevertheless, for a successful application of b-Si textures in industrially relevant solar cell architectures, it is imperative that charge-carrier recombination at particularly highly n-type doped black Si surfaces is further suppressed. In this work, this issue is addressed through systematically studying lowly and highly doped b-Si surfaces, which are passivated by atomic-layer-deposited Al2O3 films or SiO2/Al2O3 stacks. In lowly doped b-Si textures, a very low surface recombination prefactor of 16 fA/cm2 was found after surface passivation by Al2O3. The excellent passivation was achieved after a dedicated wet-chemical treatment prior to surface passivation, which removed structural defects which resided below the b-Si surface. On highly n-type doped b-Si, the SiO2/Al2O3 stacks result in a considerable improvement in surface passivation compared to the Al2O3 single layers. The atomic-layer-deposited SiO2/Al2O3 stacks therefore provide a low-temperature, industrially viable passivation method, enabling the application of highly n- type doped b-Si nanotextures in industrial silicon solar cells.

Patient satisfaction and suggestions for improvement of remote ICD monitoring.

PubMed

Petersen, Helen Høgh; Larsen, Mie Christa Jensen; Nielsen, Olav Wendelboe; Kensing, Finn; Svendsen, Jesper Hastrup

2012-09-01

The study aim was to evaluate patient acceptance and content with remote follow-up (FU) of their implantable cardioverter defibrillator (ICD) and to estimate patients' wish for changes in remote follow-up routines. Four hundred seventy-four ICD patients at the device follow-up clinic at Rigshospitalet using CareLink® (Medtronic) remote follow-up, who had made ≥2 transmissions, received a questionnaire. Three hundred eighty-five patients (81.2%) answered. Mean time with ICD was 56 ± 45 months and mean age was 62 ± 13 years; 80% was male. Diagnosis related to ICD implant was: ischemic heart disease in 56% and dilated cardiomyopathy in 21%. Twenty-six percent had primary prophylactic indication. Mean time on remote FU was 16.4 ± 6.9 months. Mean time spent on in-clinic FU (two-way transport and FU) was 4 h and 36 min ± 7 h and 50 min, excluding 12 patients from Greenland and Faroe Islands. Ninety-five percent of the patients was very content or content with remote FU compared to in-clinic FU; 3% was less content and 2% was not content. For scheduled transmissions, 21% of the patients wished for a faster reply (sms or e-mail) compared to current practice with a letter. Eighty-four percent preferred more detailed information concerning ICD leads, battery status, and ICD therapies. A total of 96 patients (25%) had performed extra unscheduled remote transmissions: 20 due to shock, 20 due to alarm, 35 due to palpitations, and 18 for other or combined reasons. Ninety-five percent of the patients were content with the remote FU. Only 25% had unscheduled transmissions and most unscheduled transmissions were for appropriate reasons. Eighty-four percent of the patients wished for a more detailed response and 21% wished for a faster reply after routine transmissions.

Hypochondriasis: considerations for ICD-11.

PubMed

van den Heuvel, Odile A; Veale, David; Stein, Dan J

2014-01-01

The World Health Organization (WHO) is currently revisiting the ICD. In the 10th version of the ICD, approved in 1990, hypochondriacal symptoms are described in the context of both the primary condition hypochondriacal disorder and as secondary symptoms within a range of other mental disorders. Expansion of the research base since 1990 makes a critical evaluation and revision of both the definition and classification of hypochondriacal disorder timely. This article addresses the considerations reviewed by members of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders in their proposal for the description and classification of hypochondriasis. The proposed revision emphasizes the phenomenological overlap with both anxiety disorders (e.g., fear, hypervigilance to bodily symptoms, and avoidance) and obsessive-compulsive and related disorders (e.g., preoccupation and repetitive behaviors) and the distinction from the somatoform disorders (presence of somatic symptom is not a critical characteristic). This revision aims to improve clinical utility by enabling better recognition and treatment of patients with hypochondriasis within the broad range of global health care settings.

P-type ZnO:N Films Prepared by Thermal Oxidation of Zn3N2

NASA Astrophysics Data System (ADS)

Zhang, Bin; Li, Min; Wang, Jian-Zhong; Shi, Li-Qun

2013-02-01

We prepare p-type ZnO:N films by annealing Zn3N2 films in oxygen over a range of temperatures. The prepared films are characterized by various techniques, such as Rutherford backscattering spectroscopy, x-ray diffraction, x-ray photoemission spectroscopy, the Hall effect and photoluminescence spectra. The results show that the Zn3N2 films start to transform to ZnO at 300°C and the N content decreases with an increase in annealing temperature. N has two local chemical states: zinc oxynitride (ZnO1-xNx) and substitutional NO in O-rich local environments (α -NO). The conduction type changes from n-type to p-type upon oxidation at 400-600°C, indicating that N is an effective acceptor in the ZnO film. The photoluminescence spectra show the UV emission and defect-related emissions of ZnO:N films. The mechanism and efficiency of p-type doping are briefly discussed.

Variation in post-traumatic response: the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms.

PubMed

Hyland, Philip; Murphy, Jamie; Shevlin, Mark; Vallières, Frédérique; McElroy, Eoin; Elklit, Ask; Christoffersen, Mogens; Cloitre, Marylène

2017-06-01

The World Health Organization's 11th revision to the International Classification of Diseases manual (ICD-11) will differentiate between two stress-related disorders: PTSD and Complex PTSD (CPTSD). ICD-11 proposals suggest that trauma exposure which is prolonged and/or repeated, or consists of multiple forms, that also occurs under circumstances where escape from the trauma is difficult or impossible (e.g., childhood abuse) will confer greater risk for CPTSD as compared to PTSD. The primary objective of the current study was to provide an empirical assessment of this proposal. A stratified, random probability sample of a Danish birth cohort (aged 24) was interviewed by the Danish National Centre for Social Research (N = 2980) in 2008-2009. Data from this interview were used to generate an ICD-11 symptom-based classification of PTSD and CPTSD. The majority of the sample (87.1%) experienced at least one of eight traumatic events spanning childhood and early adulthood. There was some indication that being female increased the risk for both PTSD and CPTSD classification. Multinomial logistic regression results found that childhood sexual abuse (OR = 4.98) and unemployment status (OR = 4.20) significantly increased risk of CPTSD classification as compared to PTSD. A dose-response relationship was observed between exposure to multiple forms of childhood interpersonal trauma and risk of CPTSD classification, as compared to PTSD. Results provide empirical support for the ICD-11 proposals that childhood interpersonal traumatic exposure increases risk of CPTSD symptom development.

Implementation and impact of ICD-10 (Part II)

PubMed Central

Rahmathulla, Gazanfar; Deen, H. Gordon; Dokken, Judith A.; Pirris, Stephen M.; Pichelmann, Mark A.; Nottmeier, Eric W.; Reimer, Ronald; Wharen, Robert E.

2014-01-01

Background: The transition from the International Classification of Disease-9th clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. Methods: The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. Results: The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. Conclusion: With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices. PMID:25184098

Implementation and impact of ICD-10 (Part II).

PubMed

Rahmathulla, Gazanfar; Deen, H Gordon; Dokken, Judith A; Pirris, Stephen M; Pichelmann, Mark A; Nottmeier, Eric W; Reimer, Ronald; Wharen, Robert E

2014-01-01

The transition from the International Classification of Disease-9(th) clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices.

P-type field effect transistor based on Na-doped BaSnO3

NASA Astrophysics Data System (ADS)

Jang, Yeaju; Hong, Sungyun; Park, Jisung; Char, Kookrin

We fabricated field effect transistors (FET) based on the p-type Na-doped BaSnO3 (BNSO) channel layer. The properties of epitaxial BNSO channel layer were controlled by the doping rate. In order to modulate the p-type FET, we used amorphous HfOx and epitaxial BaHfO3 (BHO) gate oxides, both of which have high dielectric constants. HfOx was deposited by atomic-layer-deposition and BHO was epitaxially grown by pulsed laser deposition. The pulsed laser deposited SrRuO3 (SRO) was used as the source and the drain contacts. Indium-tin oxide and La-doped BaSnO3 were used as the gate electrodes on top of the HfOx and the BHO gate oxides, respectively. We will analyze and present the performances of the BNSO field effect transistor such as the IDS-VDS, the IDS-VGS, the Ion/Ioff ratio, and the field effect mobility. Samsung Science and Technology Foundation.

[Incidence and survival of esophageal cancer with different histological types in Linzhou between 2003 and 2012].

PubMed

Liu, S Z; Yu, L; Chen, Q; Quan, P L; Cao, X Q; Sun, X B

2017-05-06

Objective: To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods: All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results: There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95 %CI: -16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95 %CI: -9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95 %CI: -7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95 %CI: -9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95 %CI: 33.5%-35.6%). Conclusion: Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was

Validation of ICD-9-CM coding algorithm for improved identification of hypoglycemia visits.

PubMed

Ginde, Adit A; Blanc, Phillip G; Lieberman, Rebecca M; Camargo, Carlos A

2008-04-01

Accurate identification of hypoglycemia cases by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes will help to describe epidemiology, monitor trends, and propose interventions for this important complication in patients with diabetes. Prior hypoglycemia studies utilized incomplete search strategies and may be methodologically flawed. We sought to validate a new ICD-9-CM coding algorithm for accurate identification of hypoglycemia visits. This was a multicenter, retrospective cohort study using a structured medical record review at three academic emergency departments from July 1, 2005 to June 30, 2006. We prospectively derived a coding algorithm to identify hypoglycemia visits using ICD-9-CM codes (250.3, 250.8, 251.0, 251.1, 251.2, 270.3, 775.0, 775.6, and 962.3). We confirmed hypoglycemia cases by chart review identified by candidate ICD-9-CM codes during the study period. The case definition for hypoglycemia was documented blood glucose 3.9 mmol/l or emergency physician charted diagnosis of hypoglycemia. We evaluated individual components and calculated the positive predictive value. We reviewed 636 charts identified by the candidate ICD-9-CM codes and confirmed 436 (64%) cases of hypoglycemia by chart review. Diabetes with other specified manifestations (250.8), often excluded in prior hypoglycemia analyses, identified 83% of hypoglycemia visits, and unspecified hypoglycemia (251.2) identified 13% of hypoglycemia visits. The absence of any predetermined co-diagnosis codes improved the positive predictive value of code 250.8 from 62% to 92%, while excluding only 10 (2%) true hypoglycemia visits. Although prior analyses included only the first-listed ICD-9 code, more than one-quarter of identified hypoglycemia visits were outside this primary diagnosis field. Overall, the proposed algorithm had 89% positive predictive value (95% confidence interval, 86-92) for detecting hypoglycemia visits. The proposed algorithm

Insight into Ca-Substitution Effects on O3-Type NaNi1/3 Fe1/3 Mn1/3 O2 Cathode Materials for Sodium-Ion Batteries Application.

PubMed

Sun, Liqi; Xie, Yingying; Liao, Xiao-Zhen; Wang, Hong; Tan, Guoqiang; Chen, Zonghai; Ren, Yang; Gim, Jihyeon; Tang, Wan; He, Yu-Shi; Amine, Khalil; Ma, Zi-Feng

2018-04-18

O3-type NaNi 1/3 Fe 1/3 Mn 1/3 O 2 (NaNFM) is well investigated as a promising cathode material for sodium-ion batteries (SIBs), but the cycling stability of NaNFM still needs to be improved by using novel electrolytes or optimizing their structure with the substitution of different elements sites. To enlarge the alkali-layer distance inside the layer structure of NaNFM may benefit Na + diffusion. Herein, the effect of Ca-substitution is reported in Na sites on the structural and electrochemical properties of Na 1- x Ca x /2 NFM (x = 0, 0.05, 0.1). X-ray diffraction (XRD) patterns of the prepared Na 1- x Ca x /2 NFM samples show single α-NaFeO 2 type phase with slightly increased alkali-layer distance as Ca content increases. The cycling stabilities of Ca-substituted samples are remarkably improved. The Na 0.9 Ca 0.05 Ni 1/3 Fe 1/3 Mn 1/3 O 2 (Na 0.9 Ca 0.05 NFM) cathode delivers a capacity of 116.3 mAh g -1 with capacity retention of 92% after 200 cycles at 1C rate. In operando XRD indicates a reversible structural evolution through an O3-P3-P3-O3 sequence of Na 0.9 Ca 0.05 NFM cathode during cycling. Compared to NaNMF, the Na 0.9 Ca 0.05 NFM cathode shows a wider voltage range in pure P3 phase state during the charge/discharge process and exhibits better structure recoverability after cycling. The superior cycling stability of Na 0.9 Ca 0.05 NFM makes it a promising material for practical applications in sodium-ion batteries. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

GRID3O- FAST GENERATION OF MULTILEVEL, THREE-DIMENSIONAL BOUNDARY-CONFORMING O-TYPE COMPUTATIONAL GRIDS

NASA Technical Reports Server (NTRS)

Dulikravich, D. S.

1994-01-01

A fast algorithm has been developed for accurately generating boundary-conforming, three-dimensional consecutively refined computational grids applicable to arbitrary wing-body and axial turbomachinery geometries. This algorithm has been incorporated into the GRID3O computer program. The method employed in GRID3O is based on using an analytic function to generate two-dimensional grids on a number of coaxial axisymmetric surfaces positioned between the centerbody and the outer radial boundary. These grids are of the O-type and are characterized by quasi-orthogonality, geometric periodicity, and an adequate resolution throughout the flow field. Because the built-in nonorthogonal coordinate stretching and shearing cause the grid lines leaving the blade or wing trailing-edge to end at downstream infinity, use of the generated grid simplifies the numerical treatment of three-dimensional trailing vortex sheets. The GRID3O program is written in FORTRAN IV for batch execution and has been implemented on an IBM 370 series computer with a central memory requirement of approximately 450K of 8 bit bytes. The GRID3O program was developed in 1981.

Introducing ICD-resistant mortality as an end point to evaluate the clinical efficacy of an implantable cardioverter-defibrillator in ischaemic cardiomyopathy.

PubMed

Floré, Vincent; Vandenberk, Bert; Belmans, Ann; Garweg, Christophe; Ector, Joris; Willems, Rik

2018-02-01

A new end point called ICD-resistant mortality was evaluated to assess the clinical efficacy of ICD implantations. In 302 ICD patients with ischaemic cardiomyopathy, we investigated which clinical parameters predicted useful ICD implantations using cumulative incidence competing risk analysis. Implantation was deemed clinically useful when the ICD provided appropriate therapy and the patient survived implantation by 1 year and the first shock by 30 days. ICD-resistant mortality (ICDRM) was defined as death within 30 days after the first shock, within 1 year of implantation or without previous appropriate ICD therapy. After 5 years, ICDRM occurred in 23% of implantations, while 36% were clinically useful. After multivariable analysis, ICDRM was associated with LVEF <35% (HR: 2.63; p = .005), beta-blocker dose <50% (HR: 2.0; p = .01) and anterior or diffuse infarct location (HR: 3.61; p = .001 and HR: 2.89; p = .02). Useful ICD implantations were associated with beta-blocker dose <50% (HR: 1.64; p = .02) and non-anterior infarct location (HR: 3.22 vs anterior and 1.59 vs diffuse; combined p<.001). Five years after implantation, an ICD could be classified as useful in 1 out of 3, while ICDRM occurred in one out of four patients. At 10 years, up to 80% of implantations could be categorized. Lower LVEF was related with significantly higher incidence of ICDRM. Anterior infarcts were associated with more ICDRM and less useful implantations than non-anterior infarcts. Future risk stratification for ICD should focus more on the discrimination between arrhythmic risk, probably preventable by ICDs and ICD-resistant mortality risk.

Effect of supplemented intake of omega-3 fatty acids on arrhythmias in patients with ICD: fish oil therapy may reduce ventricular arrhythmia.

PubMed

Weisman, Dalit; Beinart, Roy; Erez, Aharon; Koren-Morag, Nira; Goldenberg, Ilan; Eldar, Michael; Glikson, Michael; Luria, David

2017-09-01

The aim of this study was to evaluate the effects of fish oils, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on ventricular tachyarrhythmic episodes (VTEs) in implantable cardioverter defibrillator (ICD) recipients with ischemic cardiomyopathy. One hundred five ICD recipients with ischemic cardiomyopathy received 3.6 g of EPA and DHA and placebo for 6 months, each at a random order, with a 4-month washout period between treatments. Eighty-seven patients completed the 16-month study protocol. The primary end point was any VTE (including sustained and non-sustained ventricular tachycardias at a rate of >150 bpm) as recorded by the ICDs. Secondary end points included device therapy (anti-tachycardia pacing (ATP) or shocks). During treatment with fish oils, there was a significant increase in EPA and DHA concentrations in red blood cells (RBCs) and subcutaneous fat tissue. Among 87 patients who completed the study protocol, the mean number of VTEs was significantly lower during treatment with fish oil (1.7) vs. placebo (5.6; p = 0.035). Appropriate device therapy for VTE occurred in 18 (21%) patients. Fish oil therapy was associated with a trend toward fewer VTEs terminated with ATP (2.8 ± 13.7 vs. 0.5 ± 2.1, respectively; p = 0.077). VTE terminated by ICD shocks, however, was rare, and rates were similar between both groups (0.11 ± 0.6 vs. 0.10 ± 0.4, p = not significant, respectively). Our data suggest that fish oil therapy may be associated with a reduction in the frequency of VTE in ICD recipients with ischemic cardiomyopathy.

Novel Method for Differentiating Histological Types of Gastric Adenocarcinoma by Using Confocal Raman Microspectroscopy

PubMed Central

Hsu, Chih-Wei; Huang, Chia-Chi; Sheu, Jeng-Horng; Lin, Chia-Wen; Lin, Lien-Fu; Jin, Jong-Shiaw; Chau, Lai-Kwan; Chen, Wenlung

2016-01-01

Gastric adenocarcinoma, a single heterogeneous disease with multiple epidemiological and histopathological characteristics, accounts for approximately 10% of cancers worldwide. It is categorized into four histological types: papillary adenocarcinoma (PAC), tubular adenocarcinoma (TAC), mucinous adenocarcinoma (MAC), and signet ring cell adenocarcinoma (SRC). Effective differentiation of the four types of adenocarcinoma will greatly improve the treatment of gastric adenocarcinoma to increase its five-year survival rate. We reported here the differentiation of the four histological types of gastric adenocarcinoma from the molecularly structural viewpoint of confocal Raman microspectroscopy. In total, 79 patients underwent laparoscopic or open radical gastrectomy during 2008–2011: 21 for signet ring cell carcinoma, 21 for tubular adenocarcinoma, 14 for papillary adenocarcinoma, 6 for mucinous carcinoma, and 17 for normal gastric mucosas obtained from patients underwent operation for other benign lesions. Clinical data were retrospectively reviewed from medical charts, and Raman data were processed and analyzed by using principal component analysis (PCA) and linear discriminant analysis (LDA). Two-dimensional plots of PCA and LDA clearly demonstrated that the four histological types of gastric adenocarcinoma could be differentiated, and confocal Raman microspectroscopy provides potentially a rapid and effective method for differentiating SRC and MAC from TAC or PAC. PMID:27472385

Uncommon combinations of ICD10-PCS or ICD-9-CM operative procedure codes account for most inpatient surgery at half of Texas hospitals.

PubMed

O'Neill, Liam; Dexter, Franklin; Park, Sae-Hwan; Epstein, Richard H

2017-09-01

Recently, there has been interest in activity-based cost accounting for inpatient surgical procedures to facilitate "value based" analyses. Research 10-20years ago, performed using data from 3 large teaching hospitals, found that activity-based cost accounting was practical and useful for modeling surgeons and subspecialties, but inaccurate for individual procedures. We hypothesized that these older results would apply to hundreds of hospitals, currently evaluable using administrative databases. Observational study. State of Texas hospital discharge abstract data for 1st quarter of 2016, 4th quarter of 2015, 1st quarter of 2015, and 4th quarter of 2014. Discharged from an acute care hospital in Texas with at least 1 major therapeutic ("operative") procedure. Counts of discharges for each procedure or combination of procedures, classified by ICD-10-PCS or ICD-9-CM. At the average hospital, most surgical discharges were for procedures performed at most once a month at the hospital (54%, 95% confidence interval [CI] 51% to 55%). At the average hospital, approximately 90% of procedures were performed at most once a month at the hospital (93%, CI 93% to 94%). The percentages were insensitive to the quarter of the year. The percentages were 3% to 6% greater with ICD-10-PCS than for the superseded ICD 9 CM. There are many different procedure codes, and many different combinations of codes, relative to the number of different hospital discharges. Since most procedures at most hospitals are performed no more than once a month, activity-based cost accounting with a sample size sufficient to be useful is impractical for the vast majority of procedures, in contrast to analysis by surgeon and/or subspecialty. Copyright © 2017 Elsevier Inc. All rights reserved.

Inappropriate ICD discharges due to "triple counting" during normal sinus rhythm.

PubMed

Khan, Ejaz; Voudouris, Apostolos; Shorofsky, Stephen R; Peters, Robert W

2006-11-01

To describe the clinical course of a patient with multiple ICD shocks in the setting of advanced renal failure and hyperkalemia. The patient was brought to the Electrophysiology Laboratory where the ICD was interrogated. The patient was found to be hyperkalemic (serum potassium 7.6 mg/dl). Analysis of stored intracardiac electrograms from the ICD revealed "triple counting" (twice during his QRS complex and once during the T wave) and multiple inappropriate shocks. Correction of his electrolyte abnormality normalized his electrogram and no further ICD activations were observed. Electrolyte abnormalities can distort the intracardiac electrogram in patients with ICD's and these changes can lead to multiple inappropriate shocks.

[Addiction in DSM V and ICD-11 state of the art].

PubMed

Lesch, O-M

2009-09-01

Diagnoses are made for identifying rather homogeneous groups of patients being thereby relevant for research and for therapy. Therefore diagnostic manuals, like the DSM-IV and the ICD-10 are subjected to changing knowledge derived from research on one hand and to changes of clinical necessities. The diagnosis of substance related disorders, published for DSM-IV in 1994 and for the ICD-10 in 1992, has proven of value for epidemiological research and economic validation. In spite of these advantages the concept has prove to be too broad and rather unspecific for research, specific therapeutic strategies and for defining an illness course. During the last 20 years research has yielded many criteria of interest, which never entered DSM IV or ICD-10, remaining therefore on the level of single items, which are nowadays additionally assigned to all patients (like e. g. early versus late onset) or on the level of typologies (like e. g. Lesch's typology) demanding different treatments. To give an example: acamprosate has lasting relapse preventing effects in Lesch types I and II, while naltrexone is effective in types III and IV. For rendering an expertise in Germany, the referring literature recommends to utilize Lesch's typology additionally to the ICD-10 diagnosis, especially when prognosis or therapeutic strategies are demanded. Since 1999 different expert groups strive for including new criteria into DSM IV and ICD-10. The revised manuals should include easily assignable items for severity of different arrays (time illness onset, co-morbidity, withdrawal symptoms, bridge symptoms and neurological sequela). Different therapy stages (e. g. withdrawal or relapse prevention) need a different weighting of individual symptoms (e. g. degree of intoxication, severity of withdrawal is needed for acute treatment, while an assignment of co-morbidity and personality factors is necessary for relapse prevention). This quantifier is rendered by Lesch's typology, which is available in

Dedifferentiated liposarcoma of the retro-peritoneum: histologically low-grade type.

PubMed

Parakh, Rugvedita Satyajeet; Zawar, Meera Prem; Gadgil, Pradeep Achyut; Kaujalagi, Neeraja Shashikant

2010-01-01

A dedifferentiated liposarcoma of the retro-peritoneum of a 45-year-old female is described in this case report. It showed dedifferentiation into a histological low-grade type and thus defies the traditional definition of dedifferentiated liposarcoma. The excised specimen was a huge, multi-nodular encapsulated mass surrounding the kidney and infiltrating into it. The mass showed a dedifferentiated focus different in color from the surrounding tumor and containing areas of necrosis and hemorrhage. The sections from the dedifferentiated part of the tumor appeared predominantly as benign spindle cell component on histology but the tumor was infiltrating into the kidney. Hence, a close and long-term follow-up is expected in such cases though they look benign. In the retro-peritoneum, a lipoma-like well-differentiated liposarcoma with spindle cell component, like the present tumor, which shows dedifferentiation, should not be overlooked.

Validating the Use of ICD-9 Code Mapping to Generate Injury Severity Scores

PubMed Central

Fleischman, Ross J.; Mann, N. Clay; Dai, Mengtao; Holmes, James F.; Wang, N. Ewen; Haukoos, Jason; Hsia, Renee Y.; Rea, Thomas; Newgard, Craig D.

2017-01-01

The Injury Severity Score (ISS) is a measure of injury severity widely used for research and quality assurance in trauma. Calculation of ISS requires chart abstraction, so it is often unavailable for patients cared for in nontrauma centers. Whether ISS can be accurately calculated from International Classification of Diseases, Ninth Revision (ICD-9) codes remains unclear. Our objective was to compare ISS derived from ICD-9 codes with those coded by trauma registrars. This was a retrospective study of patients entered into 9 U.S. trauma registries from January 2006 through December 2008. Two computer programs, ICDPIC and ICDMAP, were used to derive ISS from the ICD-9 codes in the registries. We compared derived ISS with ISS hand-coded by trained coders. There were 24,804 cases with a mortality rate of 3.9%. The median ISS derived by both ICDPIC (ISS-ICDPIC) and ICDMAP (ISS-ICDMAP) was 8 (interquartile range [IQR] = 4–13). The median ISS in the registry (ISS-registry) was 9 (IQR = 4–14). The median difference between either of the derived scores and ISS-registry was zero. However, the mean ISS derived by ICD-9 code mapping was lower than the hand-coded ISS in the registries (1.7 lower for ICDPIC, 95% CI [1.7, 1.8], Bland–Altman limits of agreement = −10.5 to 13.9; 1.8 lower for ICDMAP, 95% CI [1.7, 1.9], limits of agreement = −9.6 to 13.3). ICD-9-derived ISS slightly underestimated ISS compared with hand-coded scores. The 2 methods showed moderate to substantial agreement. Although hand-coded scores should be used when possible, ICD-9-derived scores may be useful in quality assurance and research when hand-coded scores are unavailable. PMID:28033134

High-pressure synthesis, crystal structure, and magnetic properties of KSbO3-type 5d oxides K0.84OsO3 and Bi2.93Os3O11

NASA Astrophysics Data System (ADS)

Yuan, Yahua; Feng, Hai L.; Shi, Youguo; Tsujimoto, Yoshihiro; Belik, Alexei A.; Matsushita, Yoshitaka; Arai, Masao; He, Jianfeng; Tanaka, Masahiko; Yamaura, Kazunari

2014-12-01

5d Solid-state oxides K0.84OsO3 (Os5.16+; 5d 2.84) and Bi2.93Os3O11 (Os4.40+; 5d 3.60) were synthesized under high-pressure and high-temperature conditions (6 GPa and 1500-1700 °C). Their crystal structures were determined by synchrotron x-ray diffraction and their 5d electronic properties and tunnel-like structure motifs were investigated. A KSbO3-type structure with a space group of Im-3 and Pn-3 was determined for K0.84OsO3 and Bi2.93Os3O11, respectively. The magnetic and electronic transport properties of the polycrystalline compounds were compared with those obtained theoretically. It was revealed that the 5d tunnel-like structures are paramagnetic with metallic charge conduction at temperatures above 2 K. This was similar to what was observed for structurally relevant 5d oxides, including Bi3Re3O11 (Re4.33+; 5d 2.66) and Ba2Ir3O9 (Ir4.66+; 5d 4.33). The absence of long-range magnetic order seems to be common among 5d KSbO3-like oxides, regardless of the number of 5d electrons (between 2.6 and 4.3 per 5d atom).

Single-coil and dual-coil defibrillator leads and association with clinical outcomes in a complete Danish nationwide ICD cohort.

PubMed

Larsen, Jacob M; Hjortshøj, Søren P; Nielsen, Jens C; Johansen, Jens B; Petersen, Helen H; Haarbo, Jens; Johansen, Martin B; Thøgersen, Anna Margrethe

2016-03-01

The best choice of defibrillator lead in patients with routine implantable cardioverter-defibrillator (ICD) is not settled. Traditionally, most physicians prefer dual-coil leads but the use of single-coil leads is increasing. The purpose of this study was to compare clinical outcomes in patients with single- and dual-coil leads. All 4769 Danish patients 18 years or older with first-time ICD implants from 2007 to 2011 were included from the Danish Pacemaker and ICD Register. Defibrillator leads were 38.9% single-coil leads and 61.1% dual-coil leads. The primary end point was all-cause mortality. Secondary end points were lowest successful energy at implant defibrillation testing, first shock failure in spontaneous arrhythmias, structural lead failure, and lead extraction outcomes. Single-coil leads were associated with lower all-cause mortality with an adjusted hazard ratio of 0.85 (95% confidence interval 0.73-0.99; P = .04). This finding was robust in a supplementary propensity score-matched analysis. However, dual-coil leads were used in patients with slightly higher preimplant morbidity, making residual confounding by indication the most likely explanation for the observed association between lead type and mortality. The lowest successful defibrillation energy was higher using single-coil leads (23.2 ± 4.3 J vs 22.1 ± 3.9 J; P < .001). No significant differences were observed for other secondary end points showing high shock efficacies and low rates of lead failures and extraction complications. Shock efficacy is high for modern ICD systems. The choice between single-coil and dual-coil defibrillator leads is unlikely to have a clinically significant impact on patient outcomes in routine ICD implants. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Piloting a Collaborative Web-Based System for Testing ICD-11.

PubMed

Donada, Marc; Kostanjsek, Nenad; Della Mea, Vincenzo; Celik, Can; Jakob, Robert

2017-01-01

The 11^th revision of the International Classification of Diseases (ICD-11), for the first time in ICD history, deployed web-based collaboration of experts and ICT tools. To ensure that ICD-11 is working well, it needs to be systematically field tested in different settings, across the world. This will be done by means of a number of experiments. In order to support its implementation, a web-based system (ICDfit) has been designed and developed. The present paper illustrates the current prototype of the system and its technical testing. the system has been designed according to WHO requirements, and implemented using PHP and MySQL. Then, a preliminary technical test has been designed and run in January 2016, involving 8 users. They had to carry out double coding, that is, coding case summaries with both ICD-10 and ICD-11, and answering quick questions on the coding difficulty. the 8 users coded 632 cases each, spending an average of 163 seconds per case. While we found an issue in the mechanism used to record coding times, no further issues were found. the proposed system seems to be technically adequate for supporting future ICD-11 testing.

Optimal programming management of ventricular tachycardia storm in ICD patients

PubMed Central

Qian, Zhiyong; Guo, Jianghong; Zhang, Zhiyong; Wang, Yao; Hou, Xiaofeng; Zou, Jiangang

2015-01-01

Abstract Ventricular tachycardia storm (VTS) is defined as a life-threatening syndrome of three or more separate episodes of ventricular tachycardia (VT) leading to implantable cardioverter defibrillator (ICD) therapy within 24 hours. Patients with VTS have poor outcomes and require immediate medical attention. ICD shocks have been shown to be associated with increased mortality in several studies. Optimal programming in minimization of ICD shocks may decrease mortality. Large controlled trials showed that long detection time and high heart rate detection threshold reduced ICD shock burden without an increase in syncope or death. As a fundamental therapy of ICD, antitachycardia pacing (ATP) can terminate most slow VT with a low risk of acceleration. For fast VT, burst pacing is more effective and less likely to result in acceleration than ramp pacing. One algorithm of optimal programming management during a VTS is presented in the review. PMID:25745473

Predicting in-hospital mortality of traffic victims: A comparison between AIS-and ICD-9-CM-related injury severity scales when only ICD-9-CM is reported.

PubMed

Van Belleghem, Griet; Devos, Stefanie; De Wit, Liesbet; Hubloue, Ives; Lauwaert, Door; Pien, Karen; Putman, Koen

2016-01-01

Injury severity scores are important in the context of developing European and national goals on traffic safety, health-care benchmarking and improving patient communication. Various severity scores are available and are mostly based on Abbreviated Injury Scale (AIS) or International Classification of Diseases (ICD). The aim of this paper is to compare the predictive value for in-hospital mortality between the various severity scores if only International Classification of Diseases, 9th revision, Clinical Modification ICD-9-CM is reported. To estimate severity scores based on the AIS lexicon, ICD-9-CM codes were converted with ICD Programmes for Injury Categorization (ICDPIC) and four AIS-based severity scores were derived: Maximum AIS (MaxAIS), Injury Severity Score (ISS), New Injury Severity Score (NISS) and Exponential Injury Severity Score (EISS). Based on ICD-9-CM, six severity scores were calculated. Determined by the number of injuries taken into account and the means by which survival risk ratios (SRRs) were calculated, four different approaches were used to calculate the ICD-9-based Injury Severity Scores (ICISS). The Trauma Mortality Prediction Model (TMPM) was calculated with the ICD-9-CM-based model averaged regression coefficients (MARC) for both the single worst injury and multiple injuries. Severity scores were compared via model discrimination and calibration. Model comparisons were performed separately for the severity scores based on the single worst injury and multiple injuries. For ICD-9-based scales, estimation of area under the receiver operating characteristic curve (AUROC) ranges between 0.94 and 0.96, while AIS-based scales range between 0.72 and 0.76, respectively. The intercept in the calibration plots is not significantly different from 0 for MaxAIS, ICISS and TMPM. When only ICD-9-CM codes are reported, ICD-9-CM-based severity scores perform better than severity scores based on the conversion to AIS. Copyright © 2015 Elsevier Ltd. All

Reconstruction of an 8-lead surface ECG from two subcutaneous ICD vectors.

PubMed

Wilson, David G; Cronbach, Peter L; Panfilo, D; Greenhut, Saul E; Stegemann, Berthold P; Morgan, John M

2017-06-01

Techniques exist which allow surface ECGs to be reconstructed from reduced lead sets. We aimed to reconstruct an 8-lead ECG from two independent S-ICD sensing electrodes vectors as proof of this principle. Participants with ICDs (N=61) underwent 3minute ECGs using a TMSi Porti7 multi-channel signal recorder (TMS international, The Netherlands) with electrodes in the standard S-ICD and 12-lead positions. Participants were randomised to either a training (N=31) or validation (N=30) group. The transformation used was a linear combination of the 2 independent S-ICD vectors to each of the 8 independent leads of the 12-lead ECG, with coefficients selected that minimized the root mean square error (RMSE) between recorded and derived ECGs when applied to the training group. The transformation was then applied to the validation group and agreement between the recorded and derived lead pairs was measured by Pearson correlation coefficient (r) and normalised RMSE (NRMSE). In total, 27 patients with complete data sets were included in the validation set consisting of 57,888 data points from 216 full lead sets. The distribution of the r and NRMSE were skewed. Mean r=0.770 (SE 0.024), median r=0.925. NRMSE mean=0.233 (SE 0.015) median=0.171. We have demonstrated that the reconstruction of an 8-lead ECG from two S-ICD vectors is possible. If perfected, the ability to generate accurate multi-lead surface ECG data from an S-ICD would potentially allow recording and review of clinical arrhythmias at follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

Training and support to improve ICD coding quality: A controlled before-and-after impact evaluation.

PubMed

Dyers, Robin; Ward, Grant; Du Plooy, Shane; Fourie, Stephanus; Evans, Juliet; Mahomed, Hassan

2017-05-24

The proposed National Health Insurance policy for South Africa (SA) requires hospitals to maintain high-quality International Statistical Classification of Diseases (ICD) codes for patient records. While considerable strides had been made to improve ICD coding coverage by digitising the discharge process in the Western Cape Province, further intervention was required to improve data quality. The aim of this controlled before-and-after study was to evaluate the impact of a clinician training and support initiative to improve ICD coding quality. To compare ICD coding quality between two central hospitals in the Western Cape before and after the implementation of a training and support initiative for clinicians at one of the sites. The difference in differences in data quality between the intervention site and the control site was calculated. Multiple logistic regression was also used to determine the odds of data quality improvement after the intervention and to adjust for potential differences between the groups. The intervention had a positive impact of 38.0% on ICD coding completeness over and above changes that occurred at the control site. Relative to the baseline, patient records at the intervention site had a 6.6 (95% confidence interval 3.5 - 16.2) adjusted odds ratio of having a complete set of ICD codes for an admission episode after the introduction of the training and support package. The findings on impact on ICD coding accuracy were not significant. There is sufficient pragmatic evidence that a training and support package will have a considerable positive impact on ICD coding completeness in the SA setting.

Salt intake and gastric cancer risk according to Helicobacter pylori infection, smoking, tumour site and histological type.

PubMed

Peleteiro, B; Lopes, C; Figueiredo, C; Lunet, N

2011-01-04

Although salt intake is considered a probable risk factor for gastric cancer, relevant studies have provided heterogeneous results, and the magnitude of the association has not been accurately quantified. To quantify gastric cancer risk in relation to dietary salt exposure according to Helicobacter pylori infection status and virulence, smoking, tumour site, and histological type, we evaluated 422 gastric cancer cases and 649 community controls. Salt exposure was estimated in the year before the onset of symptoms through: sodium intake (estimated by a food frequency questionnaire (FFQ)); main food items/groups contributing to dietary sodium intake; visual analogical scale for salt intake preference; use of table salt; and duration of refrigerator ownership. Comparing subjects with the highest with those with the lowest salt exposure (3rd vs 1st third), sodium intake (OR=2.01, 95% CI: 1.16-3.46), consumption of food items with high contribution to sodium intake (OR=2.54, 95% CI: 1.56-4.14) and salt intake evaluated by visual analogical scale (OR=1.83, 95% CI: 1.28-2.63) were associated with an increased gastric cancer risk. Subjects owning a refrigerator for >50 years had a lower risk for gastric cancer (OR=0.28, 95% CI: 0.14-0.57). These associations were observed regardless of H. pylori infection status and virulence, smoking, tumour site or histological type. Our results support the view that salt intake is an important dietary risk factor for gastric cancer, and confirms the evidence of no differences in risk according to H. pylori infection and virulence, smoking, tumour site and histological type.

Identification of ICD Codes Suggestive of Child Maltreatment

ERIC Educational Resources Information Center

Schnitzer, Patricia G.; Slusher, Paula L.; Kruse, Robin L.; Tarleton, Molly M.

2011-01-01

Objective: In order to be reimbursed for the care they provide, hospitals in the United States are required to use a standard system to code all discharge diagnoses: the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9). Although ICD-9 codes specific for child maltreatment exist, they do not identify all…

Diagnostic Concordance between DSM-5 and ICD-10 Cannabis Use Disorders.

PubMed

Proctor, Steven L; Williams, Daniel C; Kopak, Albert M; Voluse, Andrew C; Connolly, Kevin M; Hoffmann, Norman G

2016-07-01

With the recent federal mandate that all U.S. health care settings transition to ICD-10 billing codes, empirical evidence is necessary to determine if the DSM-5 designations map to their respective ICD-10 diagnostic categories/billing codes. The present study examined the concordance between DSM-5 and ICD-10 cannabis use disorder diagnoses. Data were derived from routine clinical assessments of 6871 male and 801 female inmates recently admitted to a state prison system from 2000 to 2003. DSM-5 and ICD-10 diagnostic determinations were made from algorithms corresponding to the respective diagnostic formulations. Past 12-month prevalence rates of cannabis use disorders were comparable across classification systems. The vast majority of inmates with no DSM-5 diagnosis continued to have no diagnosis per the ICD-10, and a similar proportion with a DSM-5 severe diagnosis received an ICD-10 dependence diagnosis. Most of the variation in diagnostic classifications was accounted for by those with a DSM-5 moderate diagnosis in that approximately half of these cases received an ICD-10 dependence diagnosis while the remaining cases received a harmful use diagnosis. Although there appears to be a generally high level of agreement between diagnostic classification systems for those with no diagnosis or those evincing symptoms of a more severe condition, concordance between DSM-5 moderate and ICD-10 dependence diagnoses was poor. Additional research is warranted to determine the appropriateness and implications of the current DSM-5 coding guidelines regarding the assignment of an ICD-10 dependence code for those with a DSM-5 moderate diagnosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Histopathologic diversity of gastric cancers: Relationship between enhancement pattern on dynamic contrast-enhanced CT and histological type.

PubMed

Tsurumaru, Daisuke; Miyasaka, Mitsutoshi; Muraki, Toshio; Nishie, Akihiro; Asayama, Yoshiki; Oki, Eiji; Oda, Yoshinao; Honda, Hiroshi

2017-12-01

To evaluate the diagnostic value of contrast-enhanced computed tomography gastrography (CE-CTG) to predict the histological type of gastric cancer. We analyzed 47 consecutive patients with resectable advanced gastric cancer preoperatively evaluated by multiphasic dynamic contrast-enhanced CT. Two radiologists independently reviewed the CT images and they determined the peak enhancement phase, and then measured the CT attenuation value of the gastric lesion for each phase. The histological types of gastric cancers were assigned to three groups as differentiated-type, undifferentiated-type, and mixed-type. We compared the peak enhancement phase of the three types and compared the CT attenuation values in each phase. The peak enhancement was significantly different between the three types of gastric cancers for both readers (reader 1, p=0.001; reader 2, p=0.009); most of the undifferentiated types had peak enhancement in the delayed phase. The CT attenuation values of undifferentiated type were significantly higher than those of differentiated or mixed type in the delayed phase according to both readers (reader 1, p=0.002; reader 2, p=0.004). CE-CTG could provide helpful information in diagnosing the histological type of gastric cancers preoperatively. Copyright © 2017 Elsevier B.V. All rights reserved.

Minding the body: situating gender identity diagnoses in the ICD-11.

PubMed

Drescher, Jack; Cohen-Kettenis, Peggy; Winter, Sam

2012-12-01

The World Health Organization (WHO) is in the process of revising the International Statistical Classification of Diseases and Related Health Problems (ICD) and ICD-11 has an anticipated publication date of 2015. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) is charged with evaluating clinical and research data to inform the revision of diagnostic categories related to sexuality and gender identity that are currently included in the mental and behavioural disorders chapter of ICD-10, and making initial recommendations regarding whether and how these categories should be represented in the ICD-11. The diagnostic classification of disorders related to (trans)gender identity is an area long characterized by lack of knowledge, misconceptions and controversy. The placement of these categories has shifted over time within both the ICD and the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), reflecting developing views about what to call these diagnoses, what they mean and where to place them. This article reviews several controversies generated by gender identity diagnoses in recent years. In both the ICD-11 and DSM-5 development processes, one challenge has been to find a balance between concerns related to the stigmatization of mental disorders and the need for diagnostic categories that facilitate access to healthcare. In this connection, this article discusses several human rights issues related to gender identity diagnoses, and explores the question of whether affected populations are best served by placement of these categories within the mental disorders section of the classification. The combined stigmatization of being transgender and of having a mental disorder diagnosis creates a doubly burdensome situation for this group, which may contribute adversely to health status and to the attainment and enjoyment of human rights. The ICD-11 Working Group on the Classification of Sexual Disorders and

Atmospheric, Magnetospheric and Plasmas in Space (AMPS) spacelab payload definition study. Volume 3: Interface control documents. Part 2: AMPS payload to spacelab ICD

NASA Technical Reports Server (NTRS)

1976-01-01

The AMPS to Spacelab Interface Control Document which is to be used as a guide for format and information content in generating specific AMPS Mission ICDs is presented. This document is meant to supplement the Spacelab Payload Accommodations Handbook in that it only defines interfaces which are not discussed in the handbook to the level required for design purposes. The AMPS Top Level Requirements Tree, illustrates this ICD by a shaded area and its relationship to the other AMPS technical documents. Other interface documents shown are the Level II, AMPS to Space Shuttle Vehicle ICD and the Level III, AMPS to Instruments ICD.

Rb3In(H2O)Si5O13: a novel indium silicate with a CdSO4-topological-type structure.

PubMed

Hung, Ling-I; Wang, Sue-Lein; Chen, Chia-Yi; Chang, Bor-Chen; Lii, Kwang-Hwa

2005-05-02

A novel indium silicate, Rb3In(H2O)Si5O13, has been synthesized using a high-temperature, high-pressure hydrothermal method and characterized by single-crystal X-ray diffraction. The structure consists of five-membered rings of corner-sharing SiO4 tetrahedra connected via corner sharing to four adjacent five-membered rings to form a 3D silicate framework that belongs to the CdSO4 topological type. The InO6 octahedron shares five of its corners with five different SiO4 tetrahedra to form a 3D frame-work that delimits two types of channels to accommodate the rubidium cations. The sixth corner of InO6 is coordinated H2O. The structure is related to that of the titanium silicate ETS-10, and these are the only two metal silicates that have the CdSO4-topological-type structure. In addition, the crystal of Rb3In(H2O)Si5O13 shows an intense second harmonic generation signal. Crystal data: H2Rb3InSi5O14, monoclinic, space group Cc (No. 9), a = 9.0697(5) A, b = 11.5456(6) A, c = 13.9266(8) A, beta = 102.300(1) degrees, V = 1424.8(1) A3, and Z = 4.

Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot.

PubMed

Opić, Petra; Utens, Elisabeth M W J; Moons, Philip; Theuns, Dominic A M J; van Dijk, Arie P J; Hoendermis, Elke S; Vliegen, Hubert W; de Groot, Natasja M S; Witsenburg, Maarten; Schalij, Martin; Roos-Hesselink, Jolien W

2012-07-01

To investigate the psychosocial impact of having an implantable cardioverter defibrillator (ICD) in adults with Tetralogy of Fallot (ToF). Included were 26 ToF-patients with an ICD (age 44 ± 12 years), and two control groups consisting of 28 ToF-patients without an ICD (age 40 ± 10 years) and a group of 35 ICD-patients of older age without ToF (age 72.0 ± 8 years). This last control group was chosen to represent the "older general ICD population" with acquired heart disease seen at the out-patient clinic. Psychosocial functioning encompassed daily functioning, subjective health status, quality of life, anxiety, depression, coping and social support. ToF-patients with ICD showed diminished psychosocial functioning in comparison to ToF-patients without ICD. This was reflected by diminished subjectively perceived physical functioning (p = 0.01), general health perception (p < 0.01) and a lower satisfaction with life (p = 0.02). In comparison to older ICD-patients, ToF-patients with ICD showed less satisfaction with life (p = 0.03), experienced more anxiety (p = 0.01) and showed less favourable coping styles, although physical functioning was better for ToF-patients with ICD than for older ICD-patients (p = 0.01). More inappropriate shocks were found in ToF-patients with ICD compared to the older ICD-patients. In patients with ToF, ICD implantation had a major impact on psychosocial functioning which should be taken into account when considering ICD implantation in these young patients. To help improve psychosocial functioning, psychological counselling attuned to the specific needs of these patients may be useful.

A Strategic Plan for Integrating ICD-10 in Your Practice and Workflow.

PubMed

Bowman, Sue; Cleland, Risë Marie; Staggs, Stuart

2015-01-01

The adoption of the International Classification of Disease (ICD) 10th Revision (ICD-10) diagnosis code set in the United States has been legislatively delayed several times with the most recent date for implementation set for October 1, 2015. The transition from ICD-9 to ICD-10 will be a major undertaking that will require a substantial amount of planning. In the following article, we outline the steps to develop and implement a strategic plan for the transition to the new code set, identify training needs throughout the practice, and review the challenges and opportunities associated with the transition to ICD-10.

Inadvertent transposition of defibrillator coil terminal pins causing inappropriate ICD therapies.

PubMed

Issa, Ziad F

2008-06-01

We report the case of a 65-year-old man with chronic atrial fibrillation (AF) and severe ischemic cardiomyopathy who underwent implantation of a prophylactic single-chamber implantable cardioverter-defibrillator (ICD). The patient experienced inappropriate ICD therapies due to oversensing of pectoral muscle myopotential secondary to reversal of the defibrillator coil terminal pins in the ICD header. Recognizing this possibility is important to avoid misinterpretation of spontaneous oversensing as hardware failure (e.g., lead fracture or insulation breech) and potentially unnecessary ICD system surgical intervention, including lead extraction.

Exposure to secondhand tobacco smoke and lung cancer by histological type: a pooled analysis of the International Lung Cancer Consortium (ILCCO)

PubMed Central

Kim, Claire H; Lee, Yuan-Chin Amy; Hung, Rayjean J; McNallan, Sheila R; Cote, Michele L; Lim, Wei-Yen; Chang, Shen-Chih; Kim, Jin Hee; Ugolini, Donatella; Chen, Ying; Liloglou, Triantafillos; Andrew, Angeline S; Onega, Tracy; Duell, Eric J; Field, John K; Lazarus, Philip; Le Marchand, Loic; Neri, Monica; Vineis, Paolo; Kiyohara, Chikako; Hong, Yun-Chul; Morgenstern, Hal; Matsuo, Keitaro; Tajima, Kazuo; Christiani, David C; McLaughlin, John R; Bencko, Vladimir; Holcatova, Ivana; Boffetta, Paolo; Brennan, Paul; Fabianova, Eleonora; Foretova, Lenka; Janout, Vladimir; Lissowska, Jolanta; Mates, Dana; Rudnai, Peter; Szeszenia-Dabrowska, Neonila; Mukeria, Anush; Zaridze, David; Seow, Adeline; Schwartz, Ann G; Yang, Ping; Zhang, Zuo-Feng

2014-01-01

While the association between exposure to secondhand smoke and lung cancer risk is well established, few studies with sufficient power have examined the association by histological type. In this study, we evaluated the secondhand smoke-lung cancer relationship by histological type based on pooled data from 18 case-control studies in the International Lung Cancer Consortium (ILCCO), including 2,504 cases and 7,276 controls who were never smokers and 10,184 cases and 7,176 controls who were ever smokers. We used multivariable logistic regression, adjusting for age, sex, race/ethnicity, smoking status, pack-years of smoking, and study. Among never smokers, the odds ratios (OR) comparing those ever exposed to secondhand smoke with those never exposed were 1.31 (95% CI: 1.17–1.45) for all histological types combined, 1.26 (95% CI: 1.10–1.44) for adenocarcinoma, 1.41 (95% CI: 0.99–1.99) for squamous cell carcinoma, 1.48 (95% CI: 0.89–2.45) for large cell lung cancer, and 3.09 (95% CI: 1.62–5.89) for small cell lung cancer. The estimated association with secondhand smoke exposure was greater for small cell lung cancer than for non-small cell lung cancers (OR=2.11, 95% CI: 1.11–4.04). This analysis is the largest to date investigating the relation between exposure to secondhand smoke and lung cancer. Our study provides more precise estimates of the impact of secondhand smoke on the major histological types of lung cancer, indicates the association with secondhand smoke is stronger for small cell lung cancer than for the other histological types, and suggests the importance of intervention against exposure to secondhand smoke in lung cancer prevention. PMID:24615328

Synthesis, crystal structure, and properties of KSbO{sub 3}-type Bi{sub 3}Mn{sub 1.9}Te{sub 1.1}O{sub 11}

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li Manrong; Retuerto, Maria; Bok Go, Yong

2013-01-15

Single crystals of Bi{sub 3}Mn{sub 1.9}Te{sub 1.1}O{sub 11} were prepared from NaCl+KCl flux. This compound adopts KSbO{sub 3}-type crystal structure as evidenced by electron and single crystal X-ray diffraction analysis. The three-dimensional channel structure is formed by corner-sharing octahedral (Mn{sub 0.63}Te{sub 0.37}){sub 2}O{sub 10} dimers and two identical (Bi1){sub 4}(Bi2){sub 2} interpenetrating lattices. The intra-dimer Mn/Te-Mn/Te distances in Bi{sub 3}Mn{sub 1.9}Te{sub 1.1}O{sub 11} are short and are consistent with weak metal-metal interactions. The mixed oxidation state of manganese and the edge-sharing octahedral features are confirmed by X-ray near edge absorption spectroscopy measurements, which indicate Bi{sub 3}(Mn{sup III}{sub 1.1}Mn{sup IV}{sub 0.8})Te{supmore » VI}{sub 1.1}O{sub 11} with 57.7% Mn{sup 3+} and 42.3% Mn{sup 4+}. The partial substitution of Te for Mn perturbs long-range magnetic interactions, thereby destroying the ferromagnetic ordering found in Bi{sub 3}Mn{sub 3}O{sub 11} (T{sub C}=150 K). - Graphical abstract: Single crystal of Bi{sub 3}Mn{sub 1.9}Te{sub 1.1}O{sub 11} was grown from NaCl+KCl binary flux, suggesting that the high pressure Bi{sub 3}Mn{sub 3}O{sub 11} phase can be stabilized by partial substitution of Mn by Te at ambient pressure. Bi{sub 3}Mn{sub 1.9}Te{sub 1.1}O{sub 11} adopts a typical three dimensional KSbO{sub 3}-type crystal structure with three interpenetrating lattices and weak intra-dimmer metal-metal interaction caused by the d electrons of Mn. The edge-shared (Mn{sub 0.63}Te{sub 0.37}){sub 2}O{sub 10} octahedral dimer and mixed oxidation state of manganese (Bi{sub 3}(Mn{sup III}{sub 1.1}Mn{sup IV}{sub 0.8})Te{sup VI}{sub 1.1}O{sub 11} with 57.7% Mn{sup 3+} and 42.3% Mn{sup 4+}) features were evidenced by X-ray absorption near edge spectroscopy. Compared with Bi{sub 3}Mn{sub 3}O{sub 11}, the Te substituted Bi{sub 3}Mn{sub 1.9}Te{sub 1.1}O{sub 11} relaxes the crystal structure, but destroys the long

Type 1 and type 2 diabetes in celiac disease: prevalence and effect on clinical and histological presentation.

PubMed

Kylökäs, Antti; Kaukinen, Katri; Huhtala, Heini; Collin, Pekka; Mäki, Markku; Kurppa, Kalle

2016-07-25

Association between celiac disease and type 1 diabetes in adults is still somewhat unclear, and that between celiac disease and type 2 diabetes even less known. We studied these issues in a large cohort of adult celiac disease patients. The prevalence of type 1 and type 2 diabetes in 1358 celiac patients was compared with the population-based values. Furthermore, patients with celiac disease and concomitant type 1 or type 2 diabetes and those with celiac disease only underwent comparisons of clinical and histological features and adherence to gluten-free diet. The prevalence of type 1 diabetes (men/women) was 8.0 % /1.8 % in celiac patients and 0.7 % /0.3 % in the population, and that of type 2 diabetes 4.3 % /2.5 % and 4.4 % /3.0 %, respectively. Celiac patients with concomitant type 1 diabetes were younger (45 years vs 65 years and 52 years, P < 0.001) and more often screen-detected (43 % vs 13 % and 14 %, P < 0.001), had less other gastrointestinal diseases (8 % vs 40 % and 25 %, P = 0.028), more thyroidal diseases (18 % vs 16 % and 13 %, P = 0.043) and lower dietary adherence (71 % vs 95 % and 96 %, P < 0.001) compared with celiac patients with concomitant type 2 diabetes and patients with celiac disease only. Patients with concomitant type 2 diabetes had more hypercholesterolemia than the other groups (8 % vs 6 % and 4 %, P = 0.024), and both diabetes groups more hypertension (47 % and 31 % vs 15 %, P < 0.001) and coronary artery disease (29 % and 18 % vs 3 %, P < 0.001) than the patients with celiac disease only. Type 1 diabetes was markedly overrepresented in celiac disease, especially in men, whereas the prevalence of type 2 diabetes was comparable with the population. Concomitant type 1 or type 2 diabetes predisposes celiac patients to severe co-morbidities and type 1 diabetes also to poor dietary adherence.

Two symmetric n-type interfaces SrTiO{sub 3}/LaAlO{sub 3} in perovskite: Electronic properties from density functional theory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reshak, A. H., E-mail: maalidph@yahoo.co.uk, E-mail: mabujafar@najah.edu; Center of Excellence Geopolymer and Green Technology, School of Material Engineering, University Malaysia Perlis, 01007 Kangar, Perlis; Abu-Jafar, M. S., E-mail: maalidph@yahoo.co.uk, E-mail: mabujafar@najah.edu

2016-06-28

The first principles study of the (001) two symmetric n-type interfaces between two insulating perovskites, the nonpolar SrTiO{sub 3} (STO), and the polar LaAlO{sub 3} (LAO) was performed. We have analyzed the formation of metallic interface states between the STO and LAO heterointerfaces by using the all-electron full-potential linearized augmented plane-wave approach based on the density functional theory, within the local density approximation, the Perdew-Burke-Ernzerhof generalized gradient approximation (PBE-GGA), and the Engel-Vosko GGA (EVGGA) formalism. It has been found that some bands cross the Fermi energy level (E{sub F}), forming a metallic nature of two symmetric n-type 6.5STO/1.5LAO interfaces withmore » density of states at E{sub F}, N(E{sub F}) of about 3.56 (state/eV/unit cell), and bare electronic specific heat coefficient (γ) of about 0.62 mJ/(mol cell K{sup 2}). The electronic band stature and the partial density of states in the vicinity of E{sub F} are mainly originated from Ti1,2,3,4-3dxy orbitals. These bands are responsible for the metallic behavior and the forming of the Fermi surface of the two symmetric n-type 6.5STO/1.5LAO interfaces. To obtain a clear map of the valence band electronic charge density distribution of the two symmetric n-type 6.5STO/1.5LAO interfaces, we have investigated the bond's nature and the interactions between the atoms. It reveals that the charge is attracted towards O atoms as it is clear that the O atoms are surrounded by uniform blue spheres which indicate the maximum charge accumulation.« less

The Evolution and Physical Parameters of WN3/O3s: A New Type of Wolf–Rayet Star

DOE Office of Scientific and Technical Information (OSTI.GOV)

Neugent, Kathryn F.; Massey, Philip; Hillier, D. John

As part of a search for Wolf–Rayet (WR) stars in the Magellanic Clouds, we have discovered a new type of WR star in the Large Magellanic Cloud (LMC). These stars have both strong emission lines, as well as He ii and Balmer absorption lines and spectroscopically resemble a WN3 and O3V binary pair. However, they are visually too faint to be WN3+O3V binary systems. We have found nine of these WN3/O3s, making up ∼6% of the population of LMC WRs. Using cmfgen, we have successfully modeled their spectra as single stars and have compared the physical parameters with those ofmore » more typical LMC WNs. Their temperatures are around 100,000 K, a bit hotter than the majority of WN stars (by around 10,000 K), though a few hotter WNs are known. The abundances are what you would expect for CNO equilibrium. However, most anomalous are their mass-loss rates, which are more like that of an O-type star than a WN star. While their evolutionary status is uncertain, their low mass-loss rates and wind velocities suggest that they are not products of homogeneous evolution. It is possible instead that these stars represent an intermediate stage between O stars and WNs. Since WN3/O3 stars are unknown in the Milky Way, we suspect that their formation depends upon metallicity, and we are investigating this further by a deep survey in M33, which possesses a metallicity gradient.« less

Harmonisation of ICD-11 and DSM-V: opportunities and challenges.

PubMed

First, Michael B

2009-11-01

Differences in the ICD-10 and DSM-IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM-V and ICD-11 offers an opportunity to harmonise the two classifications. This paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems. DSM-IV-TR criteria sets and the ICD-10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional. Of the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences. Harmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM-V and ICD-11 development process. Prior experience with the DSM-IV and ICD-10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.

ICD-10: from assessment to remediation to strategic opportunity.

PubMed

Dugan, John K

2012-02-01

Healthcare finance teams should perform an enterprisewide assessment to determine what ICD-10 means to their organization, strategically, operationally, and financially. CFOs should strategically evaluate the impact of ICD-10 on the organization's entire financial operation. Organizations should have a contingency plan in place across all processes.

Postmortem ICD interrogation in mode of death classification.

PubMed

Nikolaidou, Theodora; Johnson, Miriam J; Ghosh, Justin M; Marincowitz, Carl; Shah, Saumil; Lammiman, Michael J; Schilling, Richard J; Clark, Andrew L

2018-04-01

The definition of sudden death due to arrhythmia relies on the time interval between onset of symptoms and death. However, not all sudden deaths are due to arrhythmia. In patients with an implantable cardioverter defibrillator (ICD), postmortem device interrogation may help better distinguish the mode of death compared to a time-based definition alone. This study aims to assess the proportion of "sudden" cardiac deaths in patients with an ICD that have confirmed arrhythmia. We conducted a literature search for studies using postmortem ICD interrogation and a time-based classification of the mode of death. A modified QUADAS-2 checklist was used to assess risk of bias in individual studies. Outcome data were pooled where sufficient data were available. Our search identified 22 studies undertaken between 1982 and 2015 with 23,600 participants. The pooled results (excluding studies with high risk of bias) suggest that ventricular arrhythmias are present at the time of death in 76% of "sudden" deaths (95% confidence interval [CI] 67-85; range 42-88). Postmortem ICD interrogation identifies 24% of "sudden" deaths to be nonarrhythmic. Postmortem device interrogation should be considered in all cases of unexplained sudden cardiac death. © 2018 Wiley Periodicals, Inc.

Clashing Diagnostic Approaches: DSM-ICD versus RDoC

PubMed Central

Lilienfeld, Scott O.; Treadway, Michael T.

2016-01-01

Since at least the middle of the past century, one overarching model of psychiatric classification, namely, that of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases (DSM-ICD), has reigned supreme. This DSM-ICD approach embraces an Aristotelian view of mental disorders as largely discrete entities that are characterized by distinctive signs, symptoms, and natural histories. Over the past several years, however, a competing vision, namely, the Research Domain Criteria (RDoC) initiative launched by the National Institute of Mental Health, has emerged in response to accumulating anomalies within the DSM-ICD system. In contrast to DSM-ICD, RDoC embraces a Galilean view of psychopathology as the product of dysfunctions in neural circuitry. RDoC appears to be a valuable endeavor that holds out the long-term promise of an alternative system of mental illness classification. We delineate three sets of pressing challenges – conceptual, methodological, and logistical/pragmatic – that must be addressed for RDoC to realize its scientific potential, and conclude with a call for further research, including investigation of a rapprochement between Aristotelian and Galilean approaches to psychiatric classification. PMID:26845519

Stereotyped movement disorder in ICD-11.

PubMed

Stein, Dan J; Woods, Douglas W

2014-01-01

According to current proposals for ICD-11, stereotyped movement disorder will be classified in the grouping of neurodevelopmental disorders, with a qualifier to indicate whether self-injury is present, similar to the classification of stereotypic movement disorder in DSM-5. At the same time, the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders has proposed a grouping of body-focused repetitive behavior disorders within the obsessive-compulsive and related disorders (OCRD) cluster to include trichotillomania and skin-picking disorder. DSM-5 has taken a slightly different approach: trichotillomania and excoriation (skin picking) disorder are included in the OCRD grouping, while body-focused repetitive behavior disorder is listed under other specified forms of OCRD. DSM-5 also includes a separate category of nonsuicidal self-injury in the section on "conditions for further study." There are a number of unresolved nosological questions regarding the relationships among stereotyped movement disorder, body-focused repetitive behavior disorders, and nonsuicidal self-injury. In this article, we attempt to provide preliminary answers to some of these questions as they relate to the ICD-11 classification of mental and behavioral disorders.

Reduction in depressive symptoms in primary prevention ICD scheduled patients - One year prospective study.

PubMed

Amiaz, Revital; Asher, Elad; Rozen, Guy; Czerniak, Efrat; Levi, Linda; Weiser, Mark; Glikson, Michael

2017-09-01

Implantable Cardioverter Defibrillators (ICDs), have previously been associated with the onset of depression and anxiety. The aim of this one-year prospective study was to evaluate the rate of new onset psychopathological symptoms after elective ICD implantation. A total of 158 consecutive outpatients who were scheduled for an elective ICD implantation were diagnosed and screened based on the Mini International Neuropsychiatric Interview (MINI). Depression and anxiety were evaluated using the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A). Patient's attitude toward the ICD device was evaluated using a Visual Analog Scale (VAS). Patients' mean age was 64±12.4years; 134 (85%) were men, with the majority of patients performing the procedure for reasons of 'primary prevention'. According to the MINI diagnosis at baseline, three (2%) patients suffered from major depressive disorder and ten (6%) from dysthymia. Significant improvement in HAM-D mean scores was found between baseline, three months and one year after implantation (6.50±6.4; 4.10±5.3 and 2.7±4.6, respectively F(2100)=16.42; p<0.001). There was a significantly more positive attitude toward the device over time based on the VAS score [F(2122)=53.31, p<0.001]. ICD implantation significantly contributes to the reduction of depressive symptoms, while the overall mindset toward the ICD device was positive and improved during the one-year follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

Validation of ICD-9 Codes for Stable Miscarriage in the Emergency Department.

PubMed

Quinley, Kelly E; Falck, Ailsa; Kallan, Michael J; Datner, Elizabeth M; Carr, Brendan G; Schreiber, Courtney A

2015-07-01

International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes have not been validated for identifying cases of missed abortion where a pregnancy is no longer viable but the cervical os remains closed. Our goal was to assess whether ICD-9 code "632" for missed abortion has high sensitivity and positive predictive value (PPV) in identifying patients in the emergency department (ED) with cases of stable early pregnancy failure (EPF). We studied females ages 13-50 years presenting to the ED of an urban academic medical center. We approached our analysis from two perspectives, evaluating both the sensitivity and PPV of ICD-9 code "632" in identifying patients with stable EPF. All patients with chief complaints "pregnant and bleeding" or "pregnant and cramping" over a 12-month period were identified. We randomly reviewed two months of patient visits and calculated the sensitivity of ICD-9 code "632" for true cases of stable miscarriage. To establish the PPV of ICD-9 code "632" for capturing missed abortions, we identified patients whose visits from the same time period were assigned ICD-9 code "632," and identified those with actual cases of stable EPF. We reviewed 310 patient records (17.6% of 1,762 sampled). Thirteen of 31 patient records assigned ICD-9 code for missed abortion correctly identified cases of stable EPF (sensitivity=41.9%), and 140 of the 142 patients without EPF were not assigned the ICD-9 code "632"(specificity=98.6%). Of the 52 eligible patients identified by ICD-9 code "632," 39 cases met the criteria for stable EPF (PPV=75.0%). ICD-9 code "632" has low sensitivity for identifying stable EPF, but its high specificity and moderately high PPV are valuable for studying cases of stable EPF in epidemiologic studies using administrative data.

Cu3V2O8 hollow spheres in photocatalysis and primary lithium batteries

NASA Astrophysics Data System (ADS)

Zhang, Shaoyan; Sun, Yan; Li, Chunsheng; Ci, Lijie

2013-11-01

In this paper, Cu3V2O8 hollow spheres have been successfully synthesized via a liquid precipitation method with colloidal carbon spheres as template followed by a subsequent heat treatment process. On the basis of XRD analysis, SEM observation, and TG-DSC analysis of the precursor and products, the formation mechanism of Cu3V2O8 hollow spheres was proposed. UV-vis diffuse reflectance spectra showed that the Cu3V2O8 hollow spheres exhibit strong absorption in a wide wavelength range from UV to visible light. The photocatalytic activity experiment indicated that the as-prepared Cu3V2O8 hollow spheres exhibited good photocatalytic activity in degradation of methyl orange (MO) under 150-W xenon arc lamp light irradiation. Furthermore, electrochemical measurements showed that the Cu3V2O8 hollow spheres exhibited high discharge capacity and excellent high-rate capability, indicating potential cathode candidates for primary lithium batteries used in long-term implantable cardiac defibrillators (ICDs).

Single orthorhombic b axis orientation and antiferromagnetic ordering type in multiferroic CaMnO3 thin film with La0.67Ca0.33MnO3 buffer layer

NASA Astrophysics Data System (ADS)

Wang, F.; Dong, B. J.; Zhang, Y. Q.; Liu, W.; Zhang, H. R.; Bai, Y.; Li, S. K.; Yang, T.; Sun, J. R.; Wang, Z. J.; Zhang, Z. D.

2017-09-01

The detailed crystal structure and antiferromagnetic properties of a 42 nm thick CaMnO3 film grown on a LaAlO3 substrate with a 9 nm La0.67Ca0.33MnO3 buffer layer have been investigated. Compared with a CaMnO3 film directly grown on a LaAlO3 substrate, only one kind of orthorhombic b axis orientation along the [100] axis of the substrate is observed in the CaMnO3 film with a La0.67Ca0.33MnO3 buffer layer. To determine the antiferromagnetic ordering type of our CaMnO3 film with a buffer layer, the first-principles calculations were carried out with the results, indicating that the CaMnO3 film, even under a tensile strain of 1.9%, is still a compensated G-type antiferromagnetic order, the same as the bulk. Moreover, the exchange bias effect is observed at the interface of the CaMnO3/La0.67Ca0.33MnO3 film, further confirming the antiferromagnetic ordering of the CaMnO3 film with a buffer layer. In addition, it is concluded that the exchange bias effect originates from the spin glass state at the La0.67Ca0.33MnO3/CaMnO3 interface, which arises from a competition between the double-exchange ferromagnetic La0.67Ca0.33MnO3 and super-exchange antiferromagnetic CaMnO3 below the spin glass freezing temperature.

Prospective evaluation of defibrillation threshold and postshock rhythm in young ICD recipients.

PubMed

Radbill, Andrew E; Triedman, John K; Berul, Charles I; Walsh, Edward P; Alexander, Mark E; Webster, Gregory; Cecchin, Frank

2012-12-01

Adaptation of implantable cardioverter defibrillator (ICD) systems to the needs of pediatric and congenital heart patients is problematic due to constraints of vascular and thoracic anatomy. An improved understanding of the defibrillation energy and postshock pacing requirements in such patients may help direct more tailored ICD therapy. We describe the first prospective evaluation of defibrillation threshold (DFT) and postshock rhythm in this population. We prospectively studied patients ≤ 60 kg at time of ICD intervention. DFTs were obtained using a binary search protocol with three VF inductions. Postshock pacing was programmed using a stepwise protocol, lowering the rate prior to each VF induction. Twenty patients were enrolled: 11 had channelopathy, five congenital heart disease, and four cardiomyopathy. The median age was 16 years, median weight 48 kg. Twelve patients had a transvenous high-voltage coil; eight had pericardial +/- subcutaneous coil(s). Median DFT was 7 J (range 3-31 J); 19/20 patients had DFT ≤ 15 J and all patients <25 kg had DFT ≤ 9 J (n = 6). There was no difference in DFT between patients with transvenous versus pericardial +/- subcutaneous coils (median 7 J vs 6 J, P = 0.59). No patient with normal atrioventricular conduction prior to defibrillation required postshock pacing (n = 16). There were no adverse events. These data suggest that many pediatric ICD patients have low DFTs and adequate postshock escape rhythm. This may help determine appropriate parameters for future design of pediatric-specific ICDs. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

The relationship between baseline and follow-up left ventricular ejection fraction with adverse events among primary prevention ICD patients.

PubMed

Friedman, Daniel J; Fudim, Marat; Overton, Robert; Shaw, Linda K; Patel, Divyang; Pokorney, Sean D; Velazquez, Eric J; Al-Khatib, Sana M

2018-07-01

Left ventricular ejection fraction (LVEF) is used to select patients for primary prevention implantable cardioverter defibrillators (ICDs). The relationship between baseline and long-term follow-up LVEF and clinical outcomes among primary prevention ICD patients remains unclear. We studied 195 patients with a baseline LVEF ≤35% ≤6 months prior to ICD implantation and follow-up LVEF 1-3 years after ICD implantation without intervening left ventricular assist device (LVAD) or transplant. The co-primary study endpoints were: (1) a composite of time to death, LVAD, or transplant and (2) appropriate ICD therapy. We examined multivariable Cox proportional hazard models with a 3-year post-implant landmark view; the LVEF closest to the 3-year mark was considered the follow-up LVEF for analyses. Follow-up LVEF was examined using 2 definitions: (1) ≥10% improvement compared to baseline or (2) actual value of ≥40%. Fifty patients (26%) had a LVEF improvement of ≥10% and 44 (23%) had a follow-up LVEF ≥40%. Neither baseline nor follow-up LVEF was significantly associated with the composite endpoint. In contrast, both baseline and follow-up LVEF were associated with risk for long-term ICD therapies, whether follow-up LVEF was modeled as a ≥10% absolute improvement (baseline LVEF HR 0.87, CI 0.91-0.93, P < .001; follow-up LVEF HR 0.18, CI 0.06-0.53, P = .002) or a ≥40% follow-up value (baseline LVEF HR 0.89, CI 0.83-0.96, P = .001, follow-up LVEF HR 0.26, CI 0.08-0.87, P = .03). Among primary prevention ICD recipients, both baseline and follow-up LVEF were independently associated with long-term risk for appropriate ICD therapy, but they were not associated with time to the composite of LVAD, transplant, or death. Copyright © 2018 Elsevier Inc. All rights reserved.

Impact of the diagnostic changes to post-traumatic stress disorder for DSM-5 and the proposed changes to ICD-11.

PubMed

O'Donnell, Meaghan L; Alkemade, Nathan; Nickerson, Angela; Creamer, Mark; McFarlane, Alexander C; Silove, Derrick; Bryant, Richard A; Forbes, David

2014-09-01

There have been changes to the criteria for diagnosing post-traumatic stress disorder (PTSD) in DSM-5 and changes are proposed for ICD-11. To investigate the impact of the changes to diagnostic criteria for PTSD in DSM-5 and the proposed changes in ICD-11 using a large multisite trauma-exposed sample and structured clinical interviews. Randomly selected injury patients admitted to four hospitals were assessed 72 months post trauma (n = 510). Structured clinical interviews for PTSD and major depressive episode, as well as self-report measures of disability and quality of life were administered. Current prevalence of PTSD under DSM-5 scoring was not significantly different from DSM-IV (6.7% v. 5.9%, z = 0.53, P = 0.59). However, the ICD-11 prevalence was significantly lower than ICD-10 (3.3% v. 9.0%, z = -3.8, P<0.001). The PTSD current prevalence was significantly higher for DSM-5 than ICD-11 (6.7% v. 3.3%, z = 2.5, P = 0.01). Using ICD-11 tended to show lower rates of comorbidity with depression and a slightly lower association with disability. The diagnostic systems performed in different ways in terms of current prevalence rates and levels of comorbidity with depression, but on other broad key indicators they were relatively similar. There was overlap between those with PTSD diagnosed by ICD-11 and DSM-5 but a substantial portion met one but not the other set of criteria. This represents a challenge for research because the phenotype that is studied may be markedly different according to the diagnostic system used. Royal College of Psychiatrists.

Primary ICD-therapy in patients with advanced heart failure: selection strategies and future trials.

PubMed

Frankenstein, Lutz; Zugck, Christian; Nelles, Manfred; Schellberg, Dieter; Remppis, Andrew; Katus, Hugo

2008-09-01

For allocation of primary ICD-therapy, a possible lower limit of inclusion criteria--defining overly advanced heart failure--is less well investigated. Also, a multi-variable approach to stratification beyond ejection fraction (LVEF) appears warranted. We examined whether adding a selection limit of peak VO(2) ICD-therapy. All cause mortality was considered as end point. Median follow-up was 45 (18-86) months. ICD was not a significant predictor of outcome either for the entire population, or grouped according to aetiology of CHF. Still, 3-year mortality was 15% (ICD-patients) Vs. 28% (non-ICD-patients); P = 0.05; under combination medical therapy. Inversely, in ICD-patients medical combination therapy conveyed a significant survival benefit (P < 0.001). Consequently, the number-needed-to-treat was eight under combination therapy and the size estimate amounts to 300 patients for a prospective trial in this cohort. A cut-off of LVEF ICD-therapy. Our results indicate the need for a specific randomized trial in this cohort. The according mortality data and a size estimate are provided.

Ultrahigh-sensitive sensing platform based on p-type dumbbell-like Co3O4 network

NASA Astrophysics Data System (ADS)

Zhou, Tingting; Zhang, Tong; Zhang, Rui; Lou, Zheng; Deng, Jianan; Wang, Lili

2017-12-01

Development of high performance room temperature sensors remains a grand challenge for high demand of practical application. Metal oxide semiconductors (MOSs) have many advantages over others due to their easy functionalization, high surface area, and low cost. However, they typically need a high work temperature during sensing process. Here, p-type sensing layer is reported, consisting of pore-rich dumbbell-like Co3O4 particles (DP-Co3O4) with intrinsic high catalytic activity. The gas sensor (GS) based DP-Co3O4 catalyst exhibits ultrahigh NH3 sensing activity along with excellent stability over other structure based NH3 GSs in room temperature work environment. In addition, the unique structure of DP-Co3O4 with pore-rich and high catalytic activity endows fast gas diffusion rate and high sensitivity at room temperature. Taken together, the findings in this work highlight the merit of integrating highly active materials in p-type materials, offering a framework to develop high-sensitivity room temperature sensing platforms.

Cage-Type Highly Graphitic Porous Carbon-Co3O4 Polyhedron as the Cathode of Lithium-Oxygen Batteries.

PubMed

Tang, Jing; Wu, Shichao; Wang, Tao; Gong, Hao; Zhang, Huabin; Alshehri, Saad M; Ahamad, Tansir; Zhou, Haoshen; Yamauchi, Yusuke

2016-02-03

A novel cage-type highly graphitic porous carbon-Co3O4 (GPC-Co3O4) polyhedron was designed and successfully prepared for the first time by executing a two-step annealing of core-shell structured metal-organic frameworks (MOFs). The low graphitic carbon cores were selectively removed during the secondary annealing in air atmospheres, leaving the interior voids due to their lower thermal stability compared with the graphitic carbon shells. Inspired by the unique properties of the cage-type GPC-Co3O4 polyhedron, GPC-Co3O4 was assembled as an oxygen electrode for a rechargeable Li-O2 battery without the additional conductive agent. The efficient generation of Li2O2 during discharging and the reversible decomposition of Li2O2 during charging were clearly observed by XRD patterns and SEM images. The GPC-Co3O4 polyhedron integrates the beneficial properties, including high electronic conductivity, the rigid cage-type structure consisting of the mesoporous walls and interior void space, as well as the uniformly embedded catalytically active Co3O4 nanoparticles. As a result, the GPC-Co3O4 cathode displays a low charge overpotential of 0.58 V, a good rate capability, and a long cycle life in a Li-O2 battery.

Heart rate turbulence predicts ICD-resistant mortality in ischaemic heart disease.

PubMed

Marynissen, Thomas; Floré, Vincent; Heidbuchel, Hein; Nuyens, Dieter; Ector, Joris; Willems, Rik

2014-07-01

In high-risk patients, implantable cardioverter-defibrillators (ICDs) can convert the mode of death from arrhythmic to pump failure death. Therefore, we introduced the concept of 'ICD-resistant mortality' (IRM), defined as death (a) without previous appropriate ICD intervention (AI), (b) within 1 month after the first AI, or (c) within 1 year after the initial ICD implantation. Implantable cardioverter-defibrillator implantation in patients with a high risk of IRM should be avoided. Implantable cardioverter-defibrillator patients with ischaemic heart disease were included if a digitized 24 h Holter was available pre-implantation. Demographic, electrocardiographic, echocardiographic, and 24 h Holter risk factors were collected at device implantation. The primary endpoint was IRM. Cox regression analyses were used to test the association between predictors and outcome. We included 130 patients, with a mean left ventricular ejection fraction (LVEF) of 33.6 ± 10.3%. During a follow-up of 52 ± 31 months, 33 patients died. There were 21 cases of IRM. Heart rate turbulence (HRT) was the only Holter parameter associated with IRM and total mortality. A higher New York Heart Association (NYHA) class and a lower body mass index were the strongest predictors of IRM. Left ventricular ejection fraction predicted IRM on univariate analysis, and was the strongest predictor of total mortality. The only parameter that predicted AI was non-sustained ventricular tachycardia. Implantable cardioverter-defibrillator implantation based on NYHA class and LVEF leads to selection of patients with a higher risk of IRM and death. Heart rate turbulence may have added value for the identification of poor candidates for ICD therapy. Available Holter parameters seem limited in their ability to predict AI. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.

A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD.

PubMed

Brewin, Chris R; Cloitre, Marylène; Hyland, Philip; Shevlin, Mark; Maercker, Andreas; Bryant, Richard A; Humayun, Asma; Jones, Lynne M; Kagee, Ashraf; Rousseau, Cécile; Somasundaram, Daya; Suzuki, Yuriko; Wessely, Simon; van Ommeren, Mark; Reed, Geoffrey M

2017-12-01

The World Health Organization's proposals for posttraumatic stress disorder (PTSD) in the 11th edition of the International Classification of Diseases, scheduled for release in 2018, involve a very brief set of symptoms and a distinction between two sibling disorders, PTSD and Complex PTSD. This review of studies conducted to test the validity and implications of the diagnostic proposals generally supports the proposed 3-factor structure of PTSD symptoms, the 6-factor structure of Complex PTSD symptoms, and the distinction between PTSD and Complex PTSD. Estimates derived from DSM-based items suggest the likely prevalence of ICD-11 PTSD in adults is lower than ICD-10 PTSD and lower than DSM-IV or DSM-5 PTSD, but this may change with the development of items that directly measure the ICD-11 re-experiencing requirement. Preliminary evidence suggests the prevalence of ICD-11 PTSD in community samples of children and adolescents is similar to DSM-IV and DSM-5. ICD-11 PTSD detects some individuals with significant impairment who would not receive a diagnosis under DSM-IV or DSM-5. ICD-11 CPTSD identifies a distinct group who have more often experienced multiple and sustained traumas and have greater functional impairment than those with PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation

PubMed Central

2014-01-01

Background The pediatric complex chronic conditions (CCC) classification system, developed in 2000, requires revision to accommodate the International Classification of Disease 10th Revision (ICD-10). To update the CCC classification system, we incorporated ICD-9 diagnostic codes that had been either omitted or incorrectly specified in the original system, and then translated between ICD-9 and ICD-10 using General Equivalence Mappings (GEMs). We further reviewed all codes in the ICD-9 and ICD-10 systems to include both diagnostic and procedural codes indicative of technology dependence or organ transplantation. We applied the provisional CCC version 2 (v2) system to death certificate information and 2 databases of health utilization, reviewed the resulting CCC classifications, and corrected any misclassifications. Finally, we evaluated performance of the CCC v2 system by assessing: 1) the stability of the system between ICD-9 and ICD-10 codes using data which included both ICD-9 codes and ICD-10 codes; 2) the year-to-year stability before and after ICD-10 implementation; and 3) the proportions of patients classified as having a CCC in both the v1 and v2 systems. Results The CCC v2 classification system consists of diagnostic and procedural codes that incorporate a new neonatal CCC category as well as domains of complexity arising from technology dependence or organ transplantation. CCC v2 demonstrated close comparability between ICD-9 and ICD-10 and did not detect significant discontinuity in temporal trends of death in the United States. Compared to the original system, CCC v2 resulted in a 1.0% absolute (10% relative) increase in the number of patients identified as having a CCC in national hospitalization dataset, and a 0.4% absolute (24% relative) increase in a national emergency department dataset. Conclusions The updated CCC v2 system is comprehensive and multidimensional, and provides a necessary update to accommodate widespread implementation of ICD-10

The discriminatory cost of ICD-10-CM transition between clinical specialties: metrics, case study, and mitigating tools

PubMed Central

Boyd, Andrew D; Li, Jianrong ‘John’; Burton, Mike D; Jonen, Michael; Gardeux, Vincent; Achour, Ikbel; Luo, Roger Q; Zenku, Ilir; Bahroos, Neil; Brown, Stephen B; Vanden Hoek, Terry; Lussier, Yves A

2013-01-01

Objective Applying the science of networks to quantify the discriminatory impact of the ICD-9-CM to ICD-10-CM transition between clinical specialties. Materials and Methods Datasets were the Center for Medicaid and Medicare Services ICD-9-CM to ICD-10-CM mapping files, general equivalence mappings, and statewide Medicaid emergency department billing. Diagnoses were represented as nodes and their mappings as directional relationships. The complex network was synthesized as an aggregate of simpler motifs and tabulation per clinical specialty. Results We identified five mapping motif categories: identity, class-to-subclass, subclass-to-class, convoluted, and no mapping. Convoluted mappings indicate that multiple ICD-9-CM and ICD-10-CM codes share complex, entangled, and non-reciprocal mappings. The proportions of convoluted diagnoses mappings (36% overall) range from 5% (hematology) to 60% (obstetrics and injuries). In a case study of 24 008 patient visits in 217 emergency departments, 27% of the costs are associated with convoluted diagnoses, with ‘abdominal pain’ and ‘gastroenteritis’ accounting for approximately 3.5%. Discussion Previous qualitative studies report that administrators and clinicians are likely to be challenged in understanding and managing their practice because of the ICD-10-CM transition. We substantiate the complexity of this transition with a thorough quantitative summary per clinical specialty, a case study, and the tools to apply this methodology easily to any clinical practice in the form of a web portal and analytic tables. Conclusions Post-transition, successful management of frequent diseases with convoluted mapping network patterns is critical. The http://lussierlab.org/transition-to-ICD10CM web portal provides insight in linking onerous diseases to the ICD-10 transition. PMID:23645552

Psychotic disorders in DSM-5 and ICD-11.

PubMed

Biedermann, Falko; Fleischhacker, W Wolfgang

2016-08-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems.

Wilms tumour histology is determined by distinct types of precursor lesions and not epigenetic changes.

PubMed

Fukuzawa, R; Anaka, M R; Heathcott, R W; McNoe, L A; Morison, I M; Perlman, E J; Reeve, A E

2008-08-01

Current models of Wilms tumour development propose that histological features of the tumours are programmed by the underlying molecular aberrations. For example, tumours associated with WT1 mutations arise from intralobar nephrogenic rests (ILNR), concur with CTNNB1 mutations and have distinct histology, whereas tumours with IGF2 loss of imprinting (LOI) often arise from perilobar nephrogenic rests (PLNR). Intriguingly, ILNR and PLNR are found simultaneously in Wilms tumours in children with overgrowth who have constitutional IGF2 LOI. We therefore examined whether the precursor lesions or early epigenetic changes are the primary determinant of Wilms tumour histology. We examined the histological features and gene expression profiles of IGF2 LOI tumours and WT1-mutant tumours which are associated with PLNR and/or ILNR. Two distinct types of IGF2 LOI tumours were identified: the first type had a blastemal-predominant histology associated with PLNR, while the second subtype had a myogenic histology, increased expression of mesenchymal lineage genes and an association with ILNR, similar to WT1-mutant tumours. These ILNR-associated IGF2 LOI tumours also showed signatures of activation of the WNT signalling pathway: differential expression of beta-catenin targets (MMP2, RARG, DKK1) and WNT antagonist genes (DKK1, WIF1, SFRP4). Unexpectedly, the majority of these tumours had CTNNB1 mutations, which are normally only seen in WT1-mutant tumours. The absence of WT1 mutations in tumours with IGF2 LOI indicated that CTNNB1 mutations occur predominantly in tumours arising from ILNR independent of the presence or absence of WT1 mutations. Thus, even though these two classes of tumours with IGF2 LOI have the same underlying predisposing epigenetic error, the tumour histology and the gene expression profiles are determined by the nature of the precursor cells within the nephrogenic rests and subsequent CTNNB1 mutations. Copyright (c) 2008 Pathological Society of Great Britain and

Body-focused repetitive behavior disorders in ICD-11.

PubMed

Grant, Jon E; Stein, Dan J

2014-01-01

This article addresses the question of how body-focused repetitive behavior disorders (e.g., trichotillomania and skin-picking disorder) should be characterized in ICD-11. The article reviews the historical nosology of the two disorders and the current approaches in DSM-5 and ICD-10. Although data are limited and mixed regarding the optimal relationship between body-focused repetitive behavior disorders and nosological categories, these conditions should be included within the obsessive-compulsive and related disorders category, as this is how most clinicians see these behaviors, and as this may optimize clinical utility. The descriptions of these disorders should largely mirror those in DSM-5, given the evidence from recent field surveys. The recommendations regarding ICD-11 and body-focused repetitive behavior disorders should promote the global identification and treatment of these conditions in primary care settings.

77 FR 48985 - Notice of Meeting of the ICD-9-CM Coordination and Maintenance Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

... Topics: ICD-10 Implementation Announcements Expansion of Thoracic Aorta Body Part Under Heart and Great... from thoracic aorta to abdominal aorta) ICD-10 MS-DRGs ICD-10 HAC Translations ICD-10 MCE Translations...

Magnetic Orders of LaTiO3 and YTiO3 Under Epitaxial Strain: a First-Principles study

NASA Astrophysics Data System (ADS)

Weng, Yakui; Huang, Xin; Tang, Yankun; Dong, Shuai

2014-03-01

Perovskite RTiO3 family is a typical Mott-insulator with localized 3d electrons. In this work, the epitaxial strain effects on the ground magnetic orders of LaTiO3 and YTiO3 films have been studied using the first-principles density-functional theory. For the YTiO3 films, A-type antiferromagnetic order emerges against the original ferromagnetic order under the in-plane compressive strain by LaAlO3 (001) substrate, although the A-type antiferromagnetic order does not exist in any RTiO3 bulks. Then, for the LaTiO3 films under the compressive strain, e.g. LaTiO3 films grown on LaAlO3, LaGaO3, and SrTiO3 substrates, undergo a phase transition from the original G-type antiferromagnetism to A-type antiferromagnetism. While under the tensile strain, e.g. grown on the BaTiO3 and LaScO3 substrate, LaTiO3 films show a tendency to transit to the C-type antiferromagnetism. Furthermore, our calculations find that the magnetic transitions under epitaxial strain do not change the insulating fact of LaTiO3 and YTiO3.

Biocompatibility property of 100% strontium-substituted SiO2 -Al2 O3 -P2 O5 -CaO-CaF2 glass ceramics over 26 weeks implantation in rabbit model: Histology and micro-Computed Tomography analysis.

PubMed

Basu, Bikramjit; Sabareeswaran, A; Shenoy, S J

2015-08-01

One of the desired properties for any new biomaterial composition is its long-term stability in a suitable animal model and such property cannot be appropriately assessed by performing short-term implantation studies. While hydroxyapatite (HA) or bioglass coated metallic biomaterials are being investigated for in vivo biocompatibility properties, such study is not extensively being pursued for bulk glass ceramics. In view of their inherent brittle nature, the implant stability as well as impact of long-term release of metallic ions on bone regeneration have been a major concern. In this perspective, the present article reports the results of the in vivo implantation experiments carried out using 100% strontium (Sr)-substituted glass ceramics with the nominal composition of 4.5 SiO2 -3Al2 O3 -1.5P2 O5 -3SrO-2SrF2 for 26 weeks in cylindrical bone defects in rabbit model. The combination of histological and micro-computed tomography analysis provided a qualitative and quantitative understanding of the bone regeneration around the glass ceramic implants in comparison to the highly bioactive HA bioglass implants (control). The sequential polychrome labeling of bone during in vivo osseointegration using three fluorochromes followed by fluorescence microscopy observation confirmed homogeneous bone formation around the test implants. The results of the present study unequivocally confirm the long-term implant stability as well as osteoconductive property of 100% Sr-substituted glass ceramics, which is comparable to that of a known bioactive implant, that is, HA-based bioglass. © 2014 Wiley Periodicals, Inc.

Reliability and Validity of the Self Efficacy Expectations and Outcome Expectations After ICD Implantation Scales

PubMed Central

Dougherty, Cynthia M.; Johnston, Sandra K.; Thompson, Elaine Adams

2009-01-01

The purpose of this study was to assess the reliability and validity characteristics of two new scales that measure self-efficacy expectations (SE-ICD) and outcome expectations (OE-ICD) in survivors (n=168) of sudden cardiac arrest (SCA), all of whom received an implantable cardioverter defibrillator (ICD). Cronbach's alpha reliability demonstrated good internal consistency (SE-ICD α = 0.93 and OE-ICD α = 0.81). Correlations with other self-efficacy instruments (general self-efficacy and social self-efficacy) were consistently high. The instruments were responsive to change across time with effect sizes of 0.46 for SE-ICD, and 0.26 for OE-ICD. These reliable, valid, and responsive instruments for measurement of self-efficacy expectations and outcome expectations after an ICD can be used in research and clinical settings. PMID:17693214

P-type hole mobility measurement in Na-doped BaSnO3

NASA Astrophysics Data System (ADS)

Hong, Sungyun; Jang, Yeaju; Park, Jisung; Char, Kookrin

P-type doping in oxide materials has been a difficult task because of the oxygen vacancies. Taking advantage of the excellent oxygen stability in BaSnO3 (BSO), we replaced Ba with Na in BSO to achieve p-type doping. Ba1-xNaxSnO3 (BNSO) films with varying dopant ratios were epitaxially grown by the pulsed laser deposition technique. We confirmed that the BNSO films were properly grown and determined their lattice constants with respect to the dopant ratio by x-ray diffraction. Due to the high resistance of the films at room temperature, we measured the transport properties of the BNSO films at temperatures ranging from 200 C to 400 C. Hall resistance measurements in a +/- 5 kG magnetic field were performed to confirm that the films are indeed p-type. As the temperature increased, the hole carrier concentration of the films increased while the film resistance decreased. The hole mobility values, in the tens of cm2/Vsec range, were found to decrease with the temperature. We will present the complete doping rate and temperature dependence of the hole mobility and compare their behavior with those of n-type La-doped BSO. Samsung science and technology foundation.

Infrared absorption and visible transparency in heavily doped p-type BaSnO 3

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Yuwei; Sun, Jifeng; Singh, David J.

2017-01-30

The recent experimental work shows that perovskite BaSnO 3 can be heavily doped by K to become a stable p-type semiconductor. Here, we find that p-type perovskite BaSnO 3 retains transparency for visible light while absorbing strongly in the infrared below 1.5 eV. The origin of the remarkable optical transparency even with heavy doping is that the interband transitions that are enabled by empty states at the top of the valence band are concentrated mainly in the energy range from 0.5 to 1.5 eV, i.e., not extending past the near IR. In contrast to n-type, the Burstein-Moss shift is slightlymore » negative, but very small reflecting the heavier valence bands relative to the conduction bands.« less

Cobalt-Doped Perovskite-Type Oxide LaMnO3 as Bifunctional Oxygen Catalysts for Hybrid Lithium-Oxygen Batteries.

PubMed

Liu, Xiao; Gong, Hao; Wang, Tao; Guo, Hu; Song, Li; Xia, Wei; Gao, Bin; Jiang, Zhongyi; Feng, Linfei; He, Jianping

2018-03-02

Perovskite-type oxides based on rare-earth metals containing lanthanum manganate are promising catalysts for the oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) in alkaline electrolyte. Perovskite-type LaMnO 3 shows excellent ORR performance, but poor OER activity. To improve the OER performance of LaMnO 3 , the element cobalt is doped into perovskite-type LaMnO 3 through a sol-gel method followed by a calcination process. To assess electrocatalytic activities for the ORR and OER, a series of LaMn 1-x Co x O 3 (x=0, 0.05, 0.1, 0.2, 0.3, 0.4, and 0.5) perovskite oxides were synthesized. The results indicate that the amount of doped cobalt has a significant effect on the catalytic performance of LaMn 1-x Co x O 3 . If x=0.3, LaMn 0.7 Co 0.3 O 3 not only shows a tolerable electrocatalytic activity for the ORR, but also exhibits a great improvement (>200 mV) on the catalytic activity for the OER; this indicates that the doping of cobalt is an effective approach to improve the OER performance of LaMnO 3 . Furthermore, the results demonstrate that LaMn 0.7 Co 0.3 O 3 is a promising cost-effective bifunctional catalyst with high performance in the ORR and OER for application in hybrid Li-O 2 batteries. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Medium voltage therapy for preventing and treating asystole and PEA in ICDs.

PubMed

Gilman, Byron L; Brewer, James E; Kroll, Kai; Kroll, Mark W

2009-01-01

Sudden cardiac death (SCD) takes up to 500,000 lives each year before a victim can even be treated. To address this the implantable cardioverter defibrillator (ICD) was developed to treat those identified at high risk of SCD. Unfortunately, there are a significant number of cases in which the ICD does not successfully return a victim to normal rhythm and effective perfusion of the blood. The vast majority of cases that are not responsive to the ICD therapy require cardio-pulmonary resuscitation (CPR) according to current resuscitation guidelines. A novel electrical stimulus called medium voltage therapy (MVT) has shown efficacy in producing coronary and carotid blood flow during ventricular fibrillation. This report presents the case that the same stimulus may be effective and feasible for use in ICD patients that do not respond to their ICD therapy, or do not have a rhythm in which, an ICD shock is indicated. The inclusion of MVT technology in implantable devices may be effective in preparing the heart for successful defibrillation or in improving the metabolic condition of the heart to the extent that a pulsatile rhythm may spontaneously develop.

Dominant Suppression of β1 Integrin by Ectopic CD98-ICD Inhibits Hepatocellular Carcinoma Progression

PubMed Central

Wu, Bo; Zhou, Yang; Wang, Yu; Yang, Xiang-Min; Liu, Zhen-Yu; Li, Jiang-Hua; Feng, Fei; Chen, Zhi-Nan; Jiang, Jian-Li

2016-01-01

Hepatocellular carcinoma (HCC) is currently the third most common cause of cancer-related death in the Asia-Pacific region. Our previous work showed that knockdown of CD98 significantly inhibits malignant HCC cell phenotypes in vitro and in vivo. The level of CD98 in the membrane is tightly regulated to mediate complex processes associated with cell–cell communication and intracellular signaling. In addition, the intracellular domain of CD98 (CD98-ICD) seems to be of vital importance for recycling CD98 to the membrane after it is endocytosed. The intracellular and transmembrane domains of CD98 associate with β-integrins (primarily β1 but also β3), and this association is essential for CD98 mediation of integrin-like signaling and complements dominant suppression of β1-integrin. We speculated that isolated CD98-ICD would similarly suppress β1-integrin activation and inhibit the malignant behaviors of cancer cells. In particular, the exact role of CD98-ICD has not been studied independently in HCC. In this study, we found that ectopic expression of CD98-ICD inhibited the malignant phenotypes of HCC cells, and the mechanism possibly involves β1-integrin suppression. Moreover, the expression levels of CD98, β1-integrin-A (the activated form of β1-integrin) and Ki-67 were significantly increased in HCC tissues relative to those of normal liver tissues. Therefore, our preliminary study indicates that ectopic CD98-ICD has an inhibitory role in the malignant development of HCC, and shows that CD98-ICD acts as a dominant negative mutant of CD98 that attenuates β1-integrin activation. CD98-ICD may emerge as a promising candidate for antitumor treatment. PMID:27834933

Facile synthesis of nanorod-type graphitic carbon nitride/Fe{sub 2}O{sub 3} composite with enhanced photocatalytic performance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jiangpeng; Li, Changqing; Cong, Jingkun

2016-06-15

Here we report a facile synthesis of nanorod-type graphitic carbon nitride/Fe{sub 2}O{sub 3} composite (Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4}) by using Fe-melamine supramolecular framework as precursor. The chemical and optical properties of the nanocomposites are well-characterized. The Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4} nanocomposite demonstrated excellent photocatalytic activities under visible light due to the efficient utilization of sunlight and the construction of Z-scheme electron transfer pathway. The results indicated that it could be a promising approach for the preparation of efficient g-C{sub 3}N{sub 4} nanocomposites photocatalysts by using metal-melamine supramolecular framework as precursors. - Graphical abstract: Nanorod-type graphitic carbon nitride/Fe{sub 2}O{submore » 3} composite (Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4}) was synthesized by using Fe-melamine supramolecular framework as precursor. The Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4} nanocomposite demonstrated excellent photocatalytic activities under visible light. Display Omitted - Highlights: • Nanorod-type graphitic carbon nitride/Fe{sub 2}O{sub 3} composite (Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4}) was synthesized. • Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4} showed strong optical absorption in the visible-light region. • The Fe{sub 2}O{sub 3}-g-C{sub 3}N{sub 4} nanocomposite demonstrated excellent photocatalytic activities.« less

ICD defibrillation failure solved in an unusual fashion.

PubMed

Oliveira, Ricardo Gil; Madeira, Francisco; Ferreira, Ana Rita; Antunes, Susana; Morais, Carlos; Gil, Victor

2010-04-01

An implantable cardioverter defibrillator (ICD) is designed to sense life-threatening ventricular arrhythmias and terminate them, either by rapid pacing or by delivering an electrical shock. Nowadays it is a proven therapy for both primary and secondary prevention of sudden cardiac death. The typical configuration of an ICD consists of a right ventricular sensing/defibrillator lead with two coils (one distal, located in the right ventricle, and one proximal, located at the superior vena cava-right atrium junction) and an active can, the so-called "ventricular triad". Although effective in the vast majority of patients, it could be argued that this is not the most rational arrangement in electrical terms, since the main shock vector is anteriorly displaced in relation to the greater portion of the left ventricular mass. We describe a case of an ICD defibrillation failure that was solved by placing an additional defibrillator lead in a tributary of the coronary sinus.

An O3-type Oxide with Low Sodium Content as the Phase-Transition-Free Anode for Sodium-Ion Batteries.

PubMed

Zhao, Chenglong; Avdeev, Maxim; Chen, Liquan; Hu, Yong-Sheng

2018-06-11

Layered transition metal oxides Na x MO 2 (M=transition metal) with P2 or O3 structure have attracted attention in sodium-ion batteries (NIBs). A universal law is found to distinguish structural competition between P2 and O3 types based on the ratio of interlayer distances of the alkali metal layer d (O-Na-O) and transition-metal layer d (O-M-O) . The ratio of about 1.62 can be used as an indicator. O3-type Na 0.66 Mg 0.34 Ti 0.66 O 2 oxide is prepared as a stable anode for NIBs, in which the low Na-content (ca. 0.66) usually undergoes a P2-type structure with respect to Na x MO 2 . This material delivers an available capacity of about 98 mAh g -1 within a voltage range of 0.4-2.0 V and exhibits a better cycling stability (ca. 94.2 % of capacity retention after 128 cycles). In situ X-ray diffraction reveals a single-phase reaction in the discharge-charge process, which is different from the common phase transitions reported in O3-type electrodes, ensuring long-term cycling stability. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Implantable intravascular defibrillator: defibrillation thresholds of an intravascular cardioverter-defibrillator compared with those of a conventional ICD in humans.

PubMed

Neuzil, Petr; Reddy, Vivek Y; Merkely, Bela; Geller, Laszlo; Molnar, Levente; Bednarek, Jacek; Bartus, Krzysztof; Richey, Mark; Bsee, T J Ransbury; Sanders, William E

2014-02-01

A percutaneous intravascular cardioverter-defibrillator (PICD) has been developed with a right ventricular (RV) single-coil lead and titanium electrodes in the superior vena cava (SVC)-brachiocephalic vein (BCV) region and the inferior vena cava (IVC). To compare defibrillation thresholds (DFTs) of the PICD with those of a conventional ICD in humans. Ten patients with ischemic cardiomyopathy and ejection fraction ≤35% were randomized to initial testing with either PICD or conventional ICD. A standard dual-coil lead was positioned in the RV apex. If randomized to PICD, the device was placed into the vasculature such that 1 titanium electrode was positioned in the SVC-BCV region and the second in the IVC. For PICD DFTs, the RV coil of the conventional ICD lead was connected to the PICD mandrel [shock vector: RV (+) to SVC-BCV (-) + IVC (-)]. When testing the conventional ICD, a subcutaneous pocket was formed in the left pectoralis region and the ICD was connected to the lead system and positioned in the pocket [shock vector: RV (+) to SVC (-) + active can (-)]. Each device was removed before testing with the other. A step-down binary search protocol determined the DFT, with the initial shock being 9 J. The mean PICD DFT was 7.6 ± 3.3 J, and the conventional ICD system demonstrated a mean DFT of 9.5 ± 4.7 J (N = 10; paired t test, P = .28). The intravascular defibrillator has DFTs similar to those of commercially available ICDs. Published by Heart Rhythm Society on behalf of Heart Rhythm Society.

Development of Al2O3 fiber-reinforced Al2O3-based ceramics.

PubMed

Tanimoto, Yasuhiro; Nemoto, Kimiya

2004-09-01

The purpose of this study was to use a tape casting technique to develop an Al2O3 fiber-reinforced Al2O3-based ceramic material (Al2O3-fiber/Al2O3 composite) into a new type of dental ceramic. The Al2O3-based ceramic used a matrix consisting of 60 wt% Al2O3 powder and 40 wt% SiO2-B2O3 powder. The prepreg sheets of Al2O3-fiber/Al2O3 composite (in which uniaxially aligned Al2O3 fibers were infiltrated with the Al2O3-based matrix) were fabricated continuously using tape casting technique with a doctor blade system. Multilayer preforms of Al2O3-fiber/Al2O3 composite sheets were then sintered at a maximum temperature of 1000 degrees C under an atmospheric pressure in a furnace. The results showed that the shrinkage and bending properties of Al2O3-fiber/Al2O3 composite exceeded those of unreinforced Al2O3--hence demonstrating the positive effects of fiber reinforcement. In conclusion, the tape casting technique has been utilized to successfully develop a new type of dental ceramic material.

Recurrent otitis media with effusion in preterm infants with histologic chorioamnionitis--a 3 years follow-up study.

PubMed

De Felice, Claudio; De Capua, Bruno; Costantini, Daniele; Martufi, Carla; Toti, Paolo; Tonni, Gabriele; Laurini, Ricardo; Giannuzzi, Annalisa; Latini, Giuseppe

2008-10-01

Recurrent otitis media with effusion (OME) is a leading cause of acquired hearing loss in childhood. Histological chorioamnionitis (HCA) is an important cause of preterm delivery and neonatal morbidity and mortality. Here, we tested the hypothesis of an association between recurrent OME during the first 3 years of life and HCA in very low birth weight (VLBW) infants. A total of 110 randomly selected VLBW preterm newborns with HCA and 135 gestational age and gender-matched, HCA-negative VLBW infants were evaluated prospectively during the first 3 years of life for the presence of OME, as diagnosed on the basis of otoscopy, type B or C tympanogram, ipsilateral absence of transient evoked otoacoustic emissions responses, and ipsilaterally increased threshold at diagnostic auditory brain responses evaluation. Potential risk factors for OME were also examined in the two groups. The HCA-positive infants showed a approximately six times higher frequency of recurrent OME (P<0.0001), increased frequency (>5/yr) of clinical otitis media episodes (P=0.000020), approximately five times higher frequency of adenoid hypertrophy (P<0.00001), a significant seasonal pattern of birth with autumn predominance (P<0.00001), and the first OME occurred earlier (P<0.0001), as compared to the HCA-negative counterparts. Recurrent OME was significantly associated with HCA (O.R.=17.76, 95% CI: 8.98-35.13, P<0.00001), adenoid hypertrophy (O.R.=9.96, 95% CI: 5.17-19.18, P<0.00001), frequency of acute otitis episodes >5/yr (O.R.=8.91, 95% CI: 1.96-40.41, P=0.0005), and birth in autumn (O.R.=5.58, 95% CI: 2.79-11.12, P<0.00001). These findings indicate that HCA is a previously unrecognized risk factor for the development of recurrent bilateral OME in VLBW preterm infants during the first 3 years of life.

High-pressure investigations of yttrium(III) oxoarsenate(V): Crystal structure and luminescence properties of Eu3+-doped scheelite-type Y[AsO4] from xenotime-type precursors

NASA Astrophysics Data System (ADS)

Ledderboge, Florian; Nowak, Jan; Massonne, Hans-Joachim; Förg, Katharina; Höppe, Henning A.; Schleid, Thomas

2018-07-01

Colourless, water- and air-stable single crystals of yttrium(III) oxoarsenate(V) Y[AsO4] in the xenotime-type crystal structure were prepared by the reaction of yttrium sesquioxide (Y2O3) dissolved in aqueous nitric acid (13%) with a solution of arsenic(V) oxide hydrate (As2O5·3H2O) and subsequent neutralization with 1 M caustic soda. Y[AsO4] crystallizes tetragonally in the space group I41/amd with the lattice parameters a = 704.63(6) and c = 628.94(5) pm for Z = 4 and is isotypic to the minerals xenotime RE[PO4] (RE: mainly Y and Yb) and chernovite RE[AsO4] (RE: mainly Y and Ce). This xenotime-type yttrium compound was used as precursor in a high-pressure experiment (20 kbar) at 700 °C to create a new tetragonal modification of Y[AsO4]. It shows the scheelite-type structure (space group: I41/a) with the lattice parameters a = 498.23(4) and c = 1120.71(9) pm for Z = 4, named after the mineral scheelite (Ca[WO4]). Both tetragonal structures are characterized by only one crystallographically unique position for each of the Y3+, As5+ and O2- ions with distances of d(Y-O) = 232 and 241 pm (C.N. = 8) as well as d(As-O) = 169 pm (C.N. = 4) in the case of the scheelite-type structure. The xenotime-type compound shows an unexpected slight decrease in average bond lengths for the yttrium to oxygen (d(Y-O) = 230 and 241 pm, C.N. = 8) as well as for the arsenic to oxygen distances (d(As-O) = 168 pm, C.N. = 4), accompanied by a drastic density increase from Dx = 4.85 (xenotime type) to Dx = 5.44 g • cm-3 (scheelite type). Luminescence spectroscopic measurements of the Eu3+-doped Y[AsO4] samples, obtained in experiments at similar conditions as for the pure compounds, show a bright, reddish lighting for the scheelite type, which does not occur for the xenotime type of yttrium(III) oxoarsenate(V).

Design, development and first validation of a transcoding system from ICD-9-CM to ICD-10 in the IT.DRG Italian project.

PubMed

Della Mea, Vincenzo; Vuattolo, Omar; Frattura, Lucilla; Munari, Flavia; Verdini, Eleonora; Zanier, Loris; Arcangeli, Laura; Carle, Flavia

2015-01-01

In Italy, ICD-9-CM is currently used for coding health conditions at hospital discharge, but ICD-10 is being introduced thanks to the IT-DRG Project. In this project, one needed component is a set of transcoding rules and associated tools for easing coders work in the transition. The present paper illustrates design and development of those transcoding rules, and their preliminary testing on a subset of Italian hospital discharge data.

Magnetic Susceptibility and Spin Exchange Interactions of the Hexagonal Perovskite-Type Oxides Sr 4/3(Mn 2/3Ni 1/3)O 3

NASA Astrophysics Data System (ADS)

El Abed, A.; Gaudin, E.; Darriet, J.; Whangbo, M.-H.

2002-02-01

Magnetic susceptibility measurements were carried out for two hexagonal perovskite-type oxides Sr1+x(Mn1-xNix)O3 with slightly different compositions (i.e., x={1}/{3} and 0.324). A significant difference in the susceptibilities of the two phases demonstrates the need to control phase compositions accurately. Sr4/3(Mn2/3Ni1/3)O3 consists of two spin sublattices, i.e., the Mn4+ and the Ni2+ ion sublattices. Spin dimer analysis was carried out to examine the relative strengths in the spin exchange interactions of the Mn4+ ion sublattice. The temperature dependence of the magnetic susceptibility of Sr4/3(Mn2/3Ni1/3)O3 was found consistent with a picture in which the Mn4+ ion sublattice has weakly interacting antiferromagnetically coupled (Mn4+)2 dimers, the Ni2+ ion sublattice acts as a paramagnetic system, and the two sublattices are nearly independent.

Retrospective study of cancer types in different ethnic groups and genders at Karachi.

PubMed

Khaliq, Sheikh Abdul; Naqvi, Syed Baqir; Fatima, Anab

2013-12-01

Retrospective study of Cancer types in different ethnic groups & genders determines the pattern of cancers in different ethnic groups & genders during the last eight years reported in Oncology wards of hospitals of Karachi, Pakistan. Every single one male & female case with histologically and cytologically established cancer was enrolled from January 2003 to December 2010. Data for all patients were collected retrospectively by patient's file & charts, which represents the population of Karachi, Interior Sindh & Balochistan. 5134 patients (Male = 2432 / Female = 2702) investigated for their diagnosis of cancer type, ethnicity, age & gender. Classification of malignancy was done according to the International Classification of Disease coding system by W.H.O (ICD-10). The statistical analysis was performed for mean, standard error & proportions for ethnic groups & genders. Proportionately 47.37% males and among which major ethnic groups 17% Sindhi, 17% Immigrant, 4% Baloch, 3% Pukhtoon, ≈ 4% Punjabi, 1% Siraiki, 2% Minorities and 52.62% females, in which 16% Sindhi, 21% Immigrant, 4% Baloch 3% Pukhtoon, 5% Punjabi, 1% Siraiki, 3% Minorities. Mean age of males = 45.75 years, SE ± 0.227 and for females = 44.07, SE ± 0.183. The three most occurring tumors in all cancers of male were found Head & Neck, Adenoma/Carcinoma of Glands & Body cavity membranes, GIT, and females Breast, Head & Neck, Adenoma/Carcinoma of Glands & Body cavity membranes, GIT. The analysis of data indicates Head & Neck is most common cancer among male, in the similar way Breast cancer is the most common malignancy among female.

The Evolution and Physical Parameters of WN3/O3s: A New Type of Wolf-Rayet Star

NASA Astrophysics Data System (ADS)

Neugent, Kathryn F.; Massey, Philip; Hillier, D. John; Morrell, Nidia

2017-05-01

As part of a search for Wolf-Rayet (WR) stars in the Magellanic Clouds, we have discovered a new type of WR star in the Large Magellanic Cloud (LMC). These stars have both strong emission lines, as well as He II and Balmer absorption lines and spectroscopically resemble a WN3 and O3V binary pair. However, they are visually too faint to be WN3+O3V binary systems. We have found nine of these WN3/O3s, making up ˜6% of the population of LMC WRs. Using cmfgen, we have successfully modeled their spectra as single stars and have compared the physical parameters with those of more typical LMC WNs. Their temperatures are around 100,000 K, a bit hotter than the majority of WN stars (by around 10,000 K), though a few hotter WNs are known. The abundances are what you would expect for CNO equilibrium. However, most anomalous are their mass-loss rates, which are more like that of an O-type star than a WN star. While their evolutionary status is uncertain, their low mass-loss rates and wind velocities suggest that they are not products of homogeneous evolution. It is possible instead that these stars represent an intermediate stage between O stars and WNs. Since WN3/O3 stars are unknown in the Milky Way, we suspect that their formation depends upon metallicity, and we are investigating this further by a deep survey in M33, which possesses a metallicity gradient. This paper includes data gathered with the 6.5 m Magellan Telescopes located at Las Campanas Observatory, Chile. It is additionally based on observations made with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. These observations were associated with program GO-13780.

Preparation and catalytic activities of LaFeO3 and Fe2O3 for HMX thermal decomposition.

PubMed

Wei, Zhi-Xian; Xu, Yan-Qing; Liu, Hai-Yan; Hu, Chang-Wen

2009-06-15

Perovskite-type LaFeO(3) and alpha-Fe(2)O(3) with high specific surface areas were directly prepared with appropriate stearic acid-nitrates ratios by a novel stearic acid solution combustion method. The obtained powders were characterized by XRD, FT-IR and XPS techniques. The catalytic activities of perovskite-type LaFeO(3) and alpha-Fe(2)O(3) for the thermal decomposition of octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) were investigated by TG and TG-EGA techniques. The experimental results show that the catalytic activity of perovskite-type LaFeO(3) was much higher than that of alpha-Fe(2)O(3) because of higher concentration of surface-adsorbed oxygen (O(ad)) and hydroxyl of LaFeO(3). The study points out a potential way to develop new and more active perovskite-type catalysts for the HMX thermal decomposition.

Hierarchical Porous Intercalation-Type V2 O3 as High-Performance Anode Materials for Li-Ion Batteries.

PubMed

Liu, Pengcheng; Zhu, Kongjun; Xu, Yuan; Bian, Kan; Wang, Jing; Tai, Guo'an; Gao, Yanfeng; Luo, Hongjie; Lu, Li; Liu, Jinsong

2017-06-01

As intercalation-type anode materials for Li-ion batteries (LIBs), the commercially used graphite and Li 4 Ti 5 O 12 exhibit good cycling and rate properties, but their theoretical specific capacities are too low to meet the ever-growing demands of high-energy applications such as electric vehicles. Therefore, the development of new intercalation-type anode materials with larger capacity is very desirable. Herein, we design and synthesize novel 3 D hierarchical porous V 2 O 3 @C micro/nanostructures consisting of crumpled nanosheets, through self-reduction under annealing from the structurally similar VO 2 (B)@C precursors without the addition of any other reducing reagent or gas. Excitingly, it is found for the first time through ex situ XRD technology that V 2 O 3 is a new, promising intercalation-type anode material for LIBs with a high capacity. V 2 O 3 @C micro/nanostructures can deliver a large capacity of 732 mAh g -1 without capacity loss at 100 mA g -1 even after 136 cycles, as well as exhibiting excellent cycling and rate performances. The application of V 2 O 3 for Na-ion batteries (NIBs) is elaborated for the first time, and excitingly, it is found that V 2 O 3 @C micro/nanostructures may be promising anode materials for NIBs. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Assessment of type 1 and type 3 deiodinase expression levels in depressive disorders.

PubMed

Gałecka, Elżbieta; Kumor-Kisielewska, Anna; Orzechowska, Agata; Maes, Michael; Górski, Paweł; Szemraj, Janusz

2017-01-01

A depressive disorder is a disease characterized by a heterogenous background. The important processes observed and diagnosed in depressed patients indicate that the etiology of depression may include disturbances in thyroid hormone (TH) levels and the occurrence of immune-inflammatory activation. Type 1 (DIO1) and type 3 (DIO3) iodothyronine deiodinases are the enzymes which determine the peripheral and tissue levels of TH, but also interfere with immunological cells and inflammatory processes. We aimed to investigate the levels of DIO1 and DIO3 in the patients suffering from recurrent depressive disorders (rDD). Data collected from 91 rDD patients and 105 healthy controls were analyzed. The diagnoses were made based on the ICD-10 criteria (F33.0-F33.8). The expression levels of DIO1 and DIO3 were estimated using the polymerase chain reaction method and the enzyme-linked immunosorbent assay (ELISA). The expression of DIO1 on mRNA/protein levels in the rDD patients was reduced in comparison to the control subjects, while the expression of DIO3 was higher in the patients suffering from depression. No significant relationship was found between the investigated DIOs and other clinical parameters. Our results indicate and suggest a role of DIO1 and DIO3-related pathways in the pathophysiology of depression. The results represent a promising way to investigate the biological markers of depression.

The proportion of uncoded diagnoses in computerized health insurance claims in Japan in May 2010 according to ICD-10 disease categories.

PubMed

Tanihara, Shinichi

2014-01-01

Uncoded diagnoses in computerized health insurance claims are excluded from statistical summaries of health-related risks and other factors. The effects of these uncoded diagnoses, coded according to ICD-10 disease categories, have not been investigated to date in Japan. I obtained all computerized health insurance claims (outpatient medical care, inpatient medical care, and diagnosis procedure-combination per-diem payment system [DPC/PDPS] claims) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010. These were classified according to the disease categories of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). I used accompanying text documentation related to the uncoded diagnoses to classify these diagnoses. Using these classifications, I calculated the proportion of uncoded diagnoses by ICD-10 category. The number of analyzed diagnoses was 3,804,246, with uncoded diagnoses accounting for 9.6% of the total. The proportion of uncoded diagnoses in claims for outpatient medical care, inpatient medical care, and DPC/PDPS were 9.3%, 10.9%, and 14.2%, respectively. Among the diagnoses, Congenital malformations, deformations, and chromosomal abnormalities had the highest proportion of uncoded diagnoses (19.3%), and Diseases of the respiratory system had the lowest proportion of uncoded diagnoses (4.7%). The proportion of uncoded diagnoses differed by the type of health insurance claim and disease category. These findings indicate that Japanese health statistics computed using computerized health insurance claims might be biased by the exclusion of uncoded diagnoses.

Follow-up of the first patients with a totally subcutaneous ICD in Germany from implantation till battery depletion.

PubMed

Bettin, Markus; Rath, Benjamin; Ellermann, Christian; Leitz, Patrick; Reinke, Florian; Köbe, Julia; Eckardt, Lars; Frommeyer, Gerrit

2018-06-12

The subcutaneous ICD is a promising treatment option in patients at risk for sudden cardiac death. Approved in 2009, the first S-ICD ® in Germany was implanted in June 2010. Although large prospective registry studies have shown safety and efficacy of the system, there is a lack of long-term data with regard to battery longevity of the S-ICD ® . Therefore, we report follow-up of our first initial S-ICD ® cases from implantation till battery depletion. All S-ICD ® patients with device replacement for battery depletion in our large single-center S-ICD ® registry were included in this study. Baseline characteristics, appropriate and inappropriate shocks, and complications were documented in a median follow-up of 75.9 ± 6.8 months. Twenty-eight patients with S-ICD ® systems were included in this study. Of these patients, 21 were male and 7 were female, with an overall mean age of 41.9 ± 12.6 years. Primary prevention of sudden cardiac death was the indication in 19 patients (67.9%). Ventricular tachycardia was adequately terminated in two patients (7.1%). In 7 patients, non-sustained ventricular arrhythmias were not treated. A total of three inappropriate shocks occurred in three patients (10.7%). Mean time from implantation till battery depletion was 65.8 ± 8.1 months. Only one patient presented premature elective replacement criteria because of rapid battery depletion. No lead-related complication occurred during follow-up and no complications were seen regarding device replacement. In one patient (3.6%), the system was explanted without replacement due to patient's preference. The estimated battery longevity of S-ICD ® of about 5 years was reached in all but one patient. Compared to larger S-ICD ® registry studies, frequency of inappropriate shocks was relatively high in the initial S-ICD ® cases. Both technological improvement as well as programming and operators' experience have led to a reduction of complications. Replacement of the S-ICD

Physicians’ Outlook on ICD-10-CM/PCS and Its Effect on Their Practice

PubMed Central

Watzlaf, Valerie; Alkarwi, Zahraa; Meyers, Sandy; Sheridan, Patty

2015-01-01

Background The United States is one of the last countries to change from ICD-9-CM to ICD-10-CM/PCS. The compliance date for implementation of ICD-10-CM/PCS is expected to fall on October 1, 2015. Objectives Evaluate physicians’ perceptions on the change from ICD-9-CM to ICD-10-CM/PCS and its effect on their practice, determine how HIM professionals can assist in this transition, and assess what resources are needed to aid in the transition. Results Twenty physicians were asked to participate in one of three focus groups. Twelve physicians (60 percent) agreed to participate. Top concerns included electronic health record software readiness, increase in documentation specificity and time, ability of healthcare professionals to learn a new language, and inadequacy of current training methods and content. Conclusion Physicians expressed that advantages of ICD-10-CM/PCS were effective data analytics and complexity of patient cases with more specific codes. Health information management professionals were touted as needed during the transition to create simple, clear specialty guides and crosswalks as well as education and training tools specific for physicians. PMID:26807074

A promising p-type transparent conducting material: Layered oxysulfide [Cu2S2][Sr3Sc2O5

NASA Astrophysics Data System (ADS)

Liu, Min-Ling; Wu, Li-Bin; Huang, Fu-Qiang; Chen, Li-Dong; Chen, I.-Wei

2007-12-01

Sr3Cu2Sc2O5S2, a layered oxysulfide, composed of anti-PbO-like [Cu2S2] slabs alternating with perovskitelike [Sr3Sc2O5] slabs, was systematically studied as a p-type transparent conducting material. The material has a wide energy gap of 3.1eV and a p-type electrical conductivity of 2.8Scm-1 at room temperature. The hole mobility of +150cm2V-1S-1 at room temperature, which is much higher than the typical value of ˜10-1-10width="0.3em"/>cm2V-1S-1 found in other copper compounds. The performances of bulk undoped Sr3Cu2Sc2O5S2 show the promise of copper oxysulfides as a class of p-type transparent conductive materials that is essential for optoelectronic applications.

A Comparison of the Quality of Life of Patients With an Entirely Subcutaneous Implantable Defibrillator System Versus a Transvenous System (from the EFFORTLESS S-ICD Quality of Life Substudy).

PubMed

Pedersen, Susanne S; Mastenbroek, Mirjam H; Carter, Nathan; Barr, Craig; Neuzil, Petr; Scholten, Marcoen; Lambiase, Pier D; Boersma, Lucas; Johansen, Jens B; Theuns, Dominic A M J

2016-08-15

The first clinical results from the Evaluation of Factors Impacting Clinical Outcome and Cost Effectiveness of the subcutaneous implantable cardioverter defibrillator (EFFORTLESS S-ICD) Registry on the entirely S-ICD system are promising, but the impact of the S-ICD system on patients' quality of life (QoL) is not known. We evaluated the QoL of patients with an S-ICD against an unrelated cohort with a transvenous (TV)-ICD system during 6 months of follow-up. Consecutively implanted patients with an S-ICD system were matched with patients with a TV-ICD system on a priori selected variables including baseline QoL. QoL was measured with the Short-Form Health Survey at baseline, 3, and 6 months after implant and compared using multivariable modeling with repeated measures. Patients with an S-ICD (n = 167) versus a TV-ICD system (n = 167) did not differ significantly on physical (p = 0.8157) and mental QoL scores (p = 0.9080) across baseline, 3, and 6 months after implantation in adjusted analyses. The evolution in physical (p = 0.0503) and mental scores (p = 0.3772) during follow-up was similar for both cohorts, as indicated by the nonsignificant interaction effect for ICD system by time. Both patients with an S-ICD system and a TV-ICD system experienced significant improvements in physical and mental QoL between time of implant and 3 months (both p's <0.0001) and between time of implant and 6 months (both p's <0.0001) but not between 3 and 6 months (both p's >0.05). In conclusion, these first results show that the QoL of patients with an S-ICD versus TV-ICD system is similar and that patients with either system experience improvements in QoL on the short term. Copyright © 2016 Elsevier Inc. All rights reserved.

Thermoelectric properties of n-type double substituted SrTiO3 bulk materials.

PubMed

Cui, Yanjie; He, Jian; Amow, Gisele; Kleinke, Holger

2010-01-28

A series of La, Ta double substituted Sr(1-x)La(x)Ti(1-x)Ta(x)O(3), with x = 0.01, 0.05 and 0.10, and La, Nb double substituted Sr(0.90)La(0.10)Ti(0.90)Nb(0.10)O(3) for comparison were investigated in this project. Rietveld refinements were performed to check for purity and symmetry reduction. Electronic structure calculations indicate n-type conduction with steep and flat bands in the vicinity of the Fermi level for x = 0.125. Seebeck coefficient, electrical conductivity, and thermal conductivity measurements on hot-pressed and spark-plasma-sintered samples were performed over a wide range of temperatures. Best results were obtained by spark-plasma-sintering of double substituted Sr(0.99)La(0.01)Ti(0.99)Ta(0.01)O(3) with a thermoelectric figure-of-merit of 0.13 at 660 K.

Overcoming barriers to population-based injury research: development and validation of an ICD10-to-AIS algorithm.

PubMed

Haas, Barbara; Xiong, Wei; Brennan-Barnes, Maureen; Gomez, David; Nathens, Avery B

2012-02-01

Hospital administrative databases are a useful source of population-level data on injured patients; however, these databases use the International Classification of Diseases (ICD) system, which does not provide a direct means of estimating injury severity. We created and validated a crosswalk to derive Abbreviated Injury Scale (AIS) scores from injury-related diagnostic codes in the tenth revision of the ICD (ICD-10). We assessed the validity of the crosswalk using data from the Ontario Trauma Registry Comprehensive Data Set (OTRCDS). The AIS and Injury Severity Scores (ISS) derived using the algorithm were compared with those assigned by expert abstractors. We evaluated the ability of the algorithm to identify patients with AIS scores of 3 or greater. We used κ and intraclass correlation coefficients (ICC) as measures of concordance. In total, 10 431 patients were identified in the OTRCDS. The algorithm accurately identified patients with at least 1 AIS score of 3 or greater (κ 0.65), as well as patients with a head AIS score of 3 or greater (κ 0.78). Mapped and abstracted ISS were similar; ICC across the entire cohort was 0.83 (95% confidence interval 0.81-0.84), indicating good agreement. When comparing mapped and abstracted ISS, the difference between scores was 10 or less in 87% of patients. Concordance between mapped and abstracted ISS was similar across strata of age, mechanism of injury and mortality. Our ICD-10-to-AIS algorithm produces reliable estimates of injury severity from data available in administrative databases. This algorithm can facilitate the use of administrative data for population-based injury research in jurisdictions using ICD-10.

Associations between residual disease and survival in epithelial ovarian cancer by histologic type.

PubMed

Melamed, Alexander; Manning-Geist, Beryl; Bregar, Amy J; Diver, Elisabeth J; Goodman, Annekathryn; Del Carmen, Marcela G; Schorge, John O; Rauh-Hain, J Alejandro

2017-11-01

Surgical cytoreduction has been postulated to affect survival by increasing the efficacy of chemotherapy in ovarian cancer. We hypothesized that women with high-grade serous ovarian cancer, which usually responds to chemotherapy, would derive greater benefit from complete cytoreduction than those with histologic subtypes that are less responsive to chemotherapy, such as mucinous and clear cell carcinoma. We conducted a retrospective cohort study of patients who underwent primary cytoreductive surgery and adjuvant chemotherapy for stage IIIC or IV epithelial ovarian cancer from 2011 to 2013 using data from the National Cancer Database. We constructed multivariable models to quantify the magnitude of associations between residual disease status (no residual disease, ≤1cm, or >1cm) and all-cause mortality by histologic type among women with clear cell, mucinous, and high-grade serous ovarian cancer. Because 26% of the sample had unknown residual disease status, we used multiple imputations in the primary analysis. We identified 6,013 women with stage IIIC and IV high-grade serous, 307 with clear cell, and 140 with mucinous histology. The association between residual disease status and mortality hazard did not differ significantly among histologic subtypes of ovarian cancer (p for interaction=0.32). In covariate adjusted models, compared to suboptimal cytoreduction, cytoreduction to no gross disease was associated with a hazard reduction of 42% in high-grade serous carcinoma (hazard ratio [HR]=0.58, 95% confidence interval [CI]=0.49-0.68), 61% in clear cell carcinoma (HR=0.39, 95% CI=0.22-0.69), and 54% in mucinous carcinoma (HR=0.46, 95% CI=0.22-0.99). We found no evidence that surgical cytoreduction was of greater prognostic importance in high-grade serous carcinomas than in histologies that are less responsive to chemotherapy. Copyright © 2017 Elsevier Inc. All rights reserved.

Obsessive-compulsive disorder for ICD-11: proposed changes to the diagnostic guidelines and specifiers

PubMed Central

Simpson, Helen Blair; Reddy, Y. C. Janardhan

2016-01-01

Since the approval of the ICD-10 by the World Health Organization (WHO) in 1990, global research on obsessive-compulsive disorder (OCD) has expanded dramatically. This article evaluates what changes may be needed to enhance the scientific validity, clinical utility, and global applicability of OCD diagnostic guidelines in preparation for ICD-11. Existing diagnostic guidelines for OCD were compared. Key issues pertaining to clinical description, differential diagnosis, and specifiers were identified and critically reviewed on the basis of the current literature. Specific modifications to ICD guidelines are recommended, including: clarifying the definition of obsessions (i.e., that obsessions can be thoughts, images, or impulses/urges) and compulsions (i.e., clarifying that these can be behaviors or mental acts and not calling these “stereotyped”); stating that compulsions are often associated with obsessions; and removing the ICD-10 duration requirement of at least 2 weeks. In addition, a diagnosis of OCD should no longer be excluded if comorbid with Tourette syndrome, schizophrenia, or depressive disorders. Moreover, the ICD-10 specifiers (i.e., predominantly obsessional thoughts, compulsive acts, or mixed) should be replaced with a specifier for insight. Based on new research, modifications to the ICD-10 diagnostic guidelines for OCD are recommended for ICD-11. PMID:25388607

Investigating histological aspects of scars in children.

PubMed

Westra, I; Verhaegen, P D H M; Ibrahim Korkmaz, H; Braam, K I; Kaspers, G J L; Niessen, H W M; Niessen, F B

2017-05-02

Very little is known about histological aspects of paediatric scars and the possible role of the immune system during their formation. In this study, the histology thoracic scars caused by the placement of an implantable central venous access device in children who underwent treatment for cancer was assessed. The amount and type of collagen, the collagen orientation, the type of elastic fibres, the vascularsation, and the count of neutrophils, macrophages, and lymphocytes were analysed. The severity of scarring was assessed using the Vancouver scar scale (VSS). To evaluate the role of the immune system on scar severity and histology, the scars of children suffering from acute lymphoblastic leukaemia (ALL) were compared with the scars of children suffering from other types of childhood cancer. Our results showed an extremely random orientation of the collagen fibres of the paediatric scars with a mean collagen orientation index of 0.22 (standard deviation (SD) 0.10, zero indicating a perfectly random orientation and a perfectly parallel orientation). A lower collagen orientation index was seen in scars with a lower VSS score (VSS score <3: 0.19 versus VSS score ≥3 0.29, p=0.037). A higher total VSS score, resembling a worse scar, was assessed to the scars in the non-ALL group compared with the children with ALL (mean ALL: 0.91 (0-3) versus mean non-ALL: 2.50 (0-6), p=0.037). To our knowledge, this is the first study investigating a wide array of histological aspects in paediatric scars. Compared with adult scars, an extremely random collagen orientation was found (0.22 in children versus 0.41 and 0.46 adult normotrophic and hypertrophic scars, respectively). A lower collagen orientation index was found in scars with a lower VSS score. In addition, less severe scarring was measured in children suffering from ALL compared with children suffering from other types of childhood cancer. This suggests that the immune system could play a role in the development of

Device Longevity in a Contemporary Cohort of ICD/CRT-D Patients Undergoing Device Replacement.

PubMed

Zanon, Francesco; Martignani, Cristian; Ammendola, Ernesto; Menardi, Endrj; Narducci, Maria Lucia; DE Filippo, Paolo; Santamaria, Matteo; Campana, Andrea; Stabile, Giuseppe; Potenza, Domenico Rosario; Pastore, Gianni; Iori, Matteo; LA Rosa, Concetto; Biffi, Mauro

2016-07-01

The longevity of defibrillators (ICD) is extremely important from both a clinical and economic perspective. We studied the reasons for device replacement, the longevity of removed ICD, and the existence of possible factors associated with shorter service life. Consecutive patients who underwent ICD replacement from March 2013 to May 2015 in 36 Italian centers were included in this analysis. Data on replaced devices were collected. A total of 953 patients were included in this analysis. In 813 (85%) patients the reason for replacement was battery depletion, while 88 (9%) devices were removed for clinical reasons and the remaining 52 because of system failure (i.e., lead or ICD generator failure or a safety advisory indication). The median service life was 5.9 years (25th-75th percentile, 4.9-6.9) for single- and dual-chamber ICD and 4.9 years (25th-75th percentile, 4.0-5.7) for CRT-D. On multivariate analysis, the factors CRT-D device, SC/DC ICD generator from Biotronik, percentage of ventricular pacing, and the occurrence of a system failure were positively associated with a replacement procedure. By contrast, the device from Boston Scientific was an independent protective factor against replacement. Considerable differences were seen in battery duration in both ICD and CRT-D. Specifically, Biotronik devices showed the shortest longevity among ICD and Boston Scientific showed the longest longevity among CRT-D (log-rank test, P < 0.001 for pairwise comparisons). Several factors were associated with shorter service life of ICD devices: CRT-D, occurrence of system failure and percentage of ventricular pacing. Our results confirmed significant differences among manufacturers. © The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals, Inc.

Gender incongruence of childhood in the ICD-11: controversies, proposal, and rationale.

PubMed

Drescher, Jack; Cohen-Kettenis, Peggy T; Reed, Geoffrey M

2016-03-01

As part of the development of the eleventh revision of the International Classification of Diseases (ICD-11), WHO appointed a Working Group on Sexual Disorders and Sexual Health to recommend changes necessary in the classification of mental and behavioural disorders in ICD-10 that are related to sexuality and gender identity. This Personal View focuses on the Working Group's proposals to include the diagnosis gender incongruence of childhood in ICD-11 and to move gender incongruence of childhood out of the mental and behavioural disorders chapter of ICD-11. We outline the history of ICD and DSM child gender diagnoses, expert consensus, knowledge gaps, and controversies related to the diagnosis and treatment of extremely gender-variant children. We argue that retaining the gender incongruence of childhood category is justified as a basis to structure clinical care and to ensure access to appropriate services for this vulnerable population, which provides opportunities for education and informed consent, the development of standards and pathways of care to help guide clinicians and family members, and a basis for future research efforts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Accessible switching of electronic defect type in SrTi O3 via biaxial strain

NASA Astrophysics Data System (ADS)

Chi, Yen-Ting; Youssef, Mostafa; Sun, Lixin; Van Vliet, Krystyn J.; Yildiz, Bilge

2018-05-01

Elastic strain is used widely to alter the mobility of free electronic carriers in semiconductors, but a predictive relationship between elastic lattice strain and the extent of charge localization of electronic defects is still underdeveloped. Here we considered SrTi O3 , a prototypical perovskite as a model functional oxide for thin film electronic devices and nonvolatile memories. We assessed the effects of biaxial strain on the stability of electronic defects at finite temperature by combining density functional theory (DFT) and quasiharmonic approximation (QHA) calculations. We constructed a predominance diagram for free electrons and small electron polarons in this material, as a function of biaxial strain and temperature. We found that biaxial tensile strain in SrTi O3 can stabilize the small polaron, leading to a thermally activated and slower electronic transport, consistent with prior experimental observations on SrTi O3 and distinct from our prior theoretical assessment of the response of SrTi O3 to hydrostatic stress. These findings also resolved apparent conflicts between prior atomistic simulations and conductivity experiments for biaxially strained SrTi O3 thin films. Our computational approach can be extended to other functional oxides, and for the case of SrTi O3 our findings provide concrete guidance for conditions under which strain engineering can shift the electronic defect type and concentration to modulate electronic transport in thin films.

Comparative studies on the room-temperature ferrielectric and ferrimagnetic Ni3TeO6-type A2FeMoO6 compounds (A = Sc, Lu)

PubMed Central

Song, Guang; Zhang, Weiyi

2016-01-01

First-principles calculations have been carried out to study the structural, electric, and magnetic properties of Ni3TeO6-type A2FeMoO6 compounds (A = Sc, Lu). Their electric and magnetic properties behave like room-temperature ferrielectric and ferrimagnetic insulators where polarization comes from the un-cancelled antiparallel dipoles of (A(1), Fe3+) and (A(2), Mo3+) ion groups, and magnetization from un-cancelled antiparallel moments of Fe3+ and Mo3+ ions. The net polarization increases with A’s ionic radius and is 7.1 and 8.7 μCcm−2 for Sc2FeMoO6 and Lu2FeMoO6, respectively. The net magnetic moment is 2 μB per formula unit. The magnetic transition temperature is estimated well above room-temperature due to the strong antiferromagnetic superexchange coupling among Fe3+ and Mo3+ spins. The estimated paraelectric to ferrielectric transition temperature is also well above room-temperature. Moreover, strong magnetoelectric coupling is also anticipated because the magnetic ions are involved both in polarization and magnetization. The fully relaxed Ni3TeO6-type A2FeMoO6 structures are free from soft-phonon modes and correspond to stable structures. As a result, Ni3TeO6-type A2FeMoO6 compounds are possible candidates for room-temperature multiferroics with large magnetization and polarization. PMID:26831406

Right versus left parasternal electrode position in the entirely subcutaneous ICD.

PubMed

Bettin, Markus; Dechering, Dirk; Frommeyer, Gerrit; Larbig, Robert; Löher, Andreas; Reinke, Florian; Köbe, Julia; Eckardt, Lars

2018-05-01

The subcutaneous implantable cardioverter defibrillator (S-ICD ® ) has been established as an alternative to conventional transvenous ICD for the prevention of sudden cardiac death. Initial studies have shown safety and efficacy of the system with a left parasternal (LP) electrode. However, several case studies reported a right parasternal (RP) position. The purpose of this study was to analyze shock efficacy and safety of an RP electrode position. Between June 2010 and May 2016, 120 S-ICD ® were implanted at our institution. On the basis of the heart location on preoperative chest radiography (CXR), the investigators decided on an RP (n = 52) or LP electrode position (n = 68). All perioperative induced VF episodes, and spontaneous appropriate and inappropriate episodes during follow-up were analyzed. Patients with an RP electrode did not differ in terms of age, sex, or ejection fraction. A statistically significant difference in underlying cardiac disease was observed between the RP and LP electrode group, with more patients with channelopathies in the RP electrode group and more patients with non-ischemic cardiomyopathy in the LP electrode group. During a mean follow-up of 24.3 ± 19.5 months, 27 appropriate (19 in the LP group and 8 in the RP group) and 28 inappropriate (18 LP and 10 RP) ICD shocks occurred (p value = NS). In the present study, an RP electrode position was chosen on the basis of chest radiographic characteristics and was efficient in terms of sensing and shock efficacy. Thus, a right-sided electrode implant might be an alternative if a left-sided electrode implant is inadequate. It might also be favorable for young patients with narrow heart silhouettes in the midsagittal position.

Impulse control disorders and related behaviours (ICD-RBs) in Parkinson's disease patients: Assessment using "Questionnaire for impulsive-compulsive disorders in Parkinson's disease" (QUIP).

PubMed

Sharma, Ashish; Goyal, Vinay; Behari, Madhuri; Srivastva, Achal; Shukla, Garima; Vibha, Deepti

2015-01-01

There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs) in Indian patients with Parkinson's Disease (PD). In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders. To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated "Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP)" and to examine their association with Dopamine replacement therapy (DRT). This was a hospital based observational cross-sectional study. After taking informed consent, patients and their informants (spouse, or primary caregiver) were made to complete the QUIP, and were instructed to answer questions based on behaviors that occurred anytime during PD that lasted at least four consecutive weeks. Total of 299 patients participated in the study. At least one ICD-RB was present in 128 (42.8%), at least one Impulse control disorder (ICD) was present in 74 (24.75%) and at least one Impulse control related compulsive behaviour (ICRB) was present in 93 (31.1%) patients. Punding was the most frequent (12.4%) followed by hyper sexuality (11.04%), compulsive hobbyism (9.4%), compulsive shopping (8.4%), compulsive medication use (7.7%), compulsive eating (5.35%), walkabout (4%) and pathological gambling (3.3%). ≥ 2 ICD-RBs were observed in 15.7% of patients. After multivariate analysis, younger age of onset, being unmarried were specifically associated with presence of ICD. Longer disease duration was specifically associated with presence of ICRB. Whereas smoking and higher dopamine levodopa equivalent daily doses (DA LEDD) were associated with both presence of ICD and ICRB. Higher LD LEDD was specifically associated with presence of ICD-RB. Our study revealed a relatively higher frequency of ICD-RBs, probably because of the use of screening instrument and because

Refusing Implantable Cardioverter Defibrillator (ICD) Replacement in Elderly Persons-The Same as Giving Up Life: A Qualitative Study.

PubMed

Svanholm, Jette Rolf; Nielsen, Jens Cosedis; Mortensen, Peter; Christensen, Charlotte Fuglesang; Birkelund, Regner

2015-11-01

More than 20% of implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices are implanted in the elderly population aged 80 years or older. In recent scientific literature it is suggested to consider termination of ICD therapy, rather than ICD replacement, in this patient group. The aim of this study was to explore the experiences of persons above 80 years of age concerning replacement of the ICD battery, and the shared communication and decision making with healthcare professionals. We performed a qualitative, explorative study, inspired by Ricoeur's narrative, with a phenomenological-hermeneutic approach, involving 11 ICD patients older than 80 years. The study period was 2011-2012. The meaning of the patients' experiences of living with an ICD was formulated into two themes: (1) "Feeling safe with the ICD" with the subthemes: "The ICD-a life keeper," "The battery level is important," "ICD shock-no problem." (2) "The physician is an authority" with the subthemes: "Being trustful," "Feeling fine knowing nothing," "Criminal act to deactivate the ICD." The elderly ICD recipients tended not to be aware of the option of declining replacement of their ICD. They tended to expect to have their ICD replaced and not to be involved actively in decision making concerning this. Healthcare professionals have an obligation to discuss options and ensure that every patient understands these. More research is needed to change practices and create more realistic, person-centered, ethically acceptable, and constructive healthcare for elderly persons with an ICD. © 2015 Wiley Periodicals, Inc.

Updating Allergy and/or Hypersensitivity Diagnostic Procedures in the WHO ICD-11 Revision.

PubMed

Tanno, Luciana Kase; Calderon, Moises A; Li, James; Casale, Thomas; Demoly, Pascal

2016-01-01

The classification of allergy and/or hypersensitivity conditions for the World Health Organization (WHO) International Classification of Diseases (ICD)-11 provides the appropriate corresponding codes for allergic diseases, assuming that the final diagnosis is correct. This classification should be linked to in vitro and in vivo diagnostic procedures. Considering the impact for our specialty, we decided to review the codification of these procedures into the ICD aiming to have a baseline and to suggest changes and/or submit new proposals. For that, we prepared a list of the relevant allergy and/or hypersensitivity diagnostic procedures that health care professionals are dealing with on a daily basis. This was based on the main current guidelines and selected all possible and relevant corresponding terms from the ICD-10 (2015 version) and the ICD-11 β phase foundation (June 2015 version). More than 90% of very specific and important diagnostic procedures currently used by the allergists' community on a daily basis are missing. We observed that some concepts usually used by the allergist community on a daily basis are not fully recognized by other specialties. The whole scheme and the correspondence in the ICD-10 (2015 version) and ICD-11 foundation (June 2015 version) provided us a big picture of the missing or imprecise terms and how they are scattered in the current ICD-11 framework, allowing us to submit new proposals to increase the visibility of the allergy and/or hypersensitivity conditions and diagnostic procedures. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. All rights reserved.

Mental and behavioural disorders in the ICD-11: concepts, methodologies, and current status.

PubMed

Gaebel, Wolfgang; Zielasek, Jürgen; Reed, Geoffrey M

2017-04-30

This review provides an overview of the concepts, methods and current status of the development of the Eleventh Revision of the Mental and Behavioural Disorders chapter of the International Classification of Diseases and Related Health Problems (ICD-11) by the World Health Organization (WHO). Given the global use of the current version (ICD-10) for a wide range of applications in clinical practice and health statistics, a major aim of the development process for ICD-11 has been to increase the utility of the classification system. Expert working groups with responsibility for specific disorder groupings first suggested a set of revised diagnostic guidelines. Then surveys were performed to obtain suggestions for revisions from practicing health professionals. A completely revised structure for the classification of mental and behavioural disorders was developed and major revisions were suggested, for example, for schizophrenia and other primary psychotic disorders, substance use disorders, affective disorders and personality disorders. A new category of "gaming disorder" has been proposed and conditions related to sexual health and gender identity will be classified separately from mental disorders. An ICD-11 beta draft is freely available on the internet and public comments are invited. Field studies of the revised diagnostic guidelines are in process to obtain additional information about necessary improvements. A tabulated crosswalk from previous ICD-10 to then ICD-11 criteria will be necessary to ascertain the continuity of diagnoses for epidemiological and other statistical purposes. The final version of ICD-11 is currently scheduled for release by the World Health Assembly in 2018.

Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 2: Is there value in testing troponin levels after ICD discharge?

PubMed

Targett, Chris; Harris, Tim

2014-03-01

A short cut review was carried out to establish whether testing for troponin levels is useful after discharge of an Implanted Cardioverter-Defibrillator (ICD). Many papers were found using the reported searches, none of which directly addressed the problem but some 13 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that the number of ICD discharges must be taken into account when evaluating any troponin level rise. Overall a positive troponin assay post ICD discharge is independently associated with an increased mortality.

Steps through the revision process of reproductive health sections of ICD-11.

PubMed

Chou, Doris; Tunçalp, Özge; Hotamisligil, Selen; Norman, Jane; Say, Lale; Volkmer, Björn; Pattinson, Bob; Rooney, Cleo; Serour, Gamal; de Mouzon, Jacques; Gardosi, Jason; Thueroff, Joachim; Mark, Morgan; D'Hooghe, Thomas

2012-01-01

In 2007, the WHO initiated an organizational structure for the 11th revision of the International Classification of Diseases (ICD). Effective deployment of ICD-derived tools facilitates the use and collection of health information in a variety of resource settings, promoting quantitatively informed decisions. They also facilitate comparison of disease incidence and outcomes between different countries and different health care systems around the world. The Department of Reproductive Health and Research (RHR) coordinates the revision of chapters 14 (diseases of the genitourinary system), 15 (pregnancy, childbirth, and puerperium), and 16 (conditions originating in the perinatal period). RHR convened a technical advisory group (TAG), the Genito-Urinary Reproductive Medicine (GURM) TAG, for the ICD revision. The TAG's work reflects the collective understanding of sexual and reproductive health and is now available for review within the ICD-11 revision process. Copyright © 2012 S. Karger AG, Basel.

Structural characterization of a new vacancy ordered perovskite modification found for Ba{sub 3}Fe{sub 3}O{sub 7}F (BaFeO{sub 2.333}F{sub 0.333}): Towards understanding of vacancy ordering for different perovskite-type ferrites

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clemens, Oliver, E-mail: oliver.clemens@kit.edu; Karlsruher Institut für Technologie, Institut für Nanotechnologie, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen

2015-05-15

The new vacancy ordered perovskite-type compound Ba{sub 3}Fe{sub 3}O{sub 7}F (BaFeO{sub 2.33}F{sub 0.33}) was prepared by topochemical low-temperature fluorination of Ba{sub 2}Fe{sub 2}O{sub 5} (BaFeO{sub 2.5}) using stoichiometric amounts of polyvinylidene difluoride (PVDF). The vacancy order was found to be unique so far for perovskite compounds, and the connectivity pattern can be explained by the formula Ba{sub 3}(FeX{sub 6/2}) (FeX{sub 5/2}) (FeX{sub 3/2}X{sub 1/1}), with X=O/F. Mössbauer measurements were used to confirm the structural analysis and agree with the presence of Fe{sup 3+} in the above mentioned coordination environments. Group–subgroup relationships were used to build a starting model for themore » structure solution and to understand the relationship to the cubic perovskite structure. Furthermore, a comparison of a variety of vacancy-ordered iron-containing perovskite-type structures is given, highlighting the factors which favour one structure type over the other depending on the composition. - Graphical abstract: The crystal structure of Ba{sub 3}Fe{sub 3}O{sub 7}F in comparison to other perovskite type ferrites. - Highlights: • The crystal structure of Ba{sub 3}Fe{sub 3}O{sub 7}F in comparison to other perovskite type ferrites. • Ba{sub 3}Fe{sub 3}O{sub 7}F was synthesized by low temperature fluorination of Ba{sub 2}Fe{sub 2}O{sub 5}. • Ba{sub 3}Fe{sub 3}O{sub 7}F shows a unique vacancy order not found for other perovskite type compounds. • The structure of Ba{sub 3}Fe{sub 3}O{sub 7}F was solved using group–subgroup relationships. • A systematic comparison to other ferrite type compounds reveals structural similarities and differences. • The A-site coordination of the cation is shown to play an important role for the type of vacancy order found.« less

The Role of Conventional and Right-Sided ECG Screening for Subcutaneous ICD in a Tetralogy of Fallot Population.

PubMed

Alonso, Pau; Osca, Joaquín; Cano, Oscar; Pimenta, Pedro; Andrés, Ana; Yagüe, Jaime; Millet, José; Rueda, Joaquín; Sancho-Tello, María José

2017-02-01

Information regarding suitability for subcutaneous implantable cardioverter-defibrillator (S-ICD) implant in tetralogy of Fallot (ToF) population is scarce and needs to be further explored. (1) to determine the proportion of patients with ToF eligible for S-ICD, (2) to identify the optimal sensing vector in ToF patients, (3) to test specifically the eligibility for S-ICD with right-sided screening, and (4) to compare with the proportion of eligible patients in a nonselected ICD population. We recruited 60 consecutive patients with ToF and 40 consecutive nonselected patients. Conventional electrocardiographic screening was performed as usual. Right-sided alternative screening was studied by positioning the left arm and right arm electrodes 1 cm right lateral to the xiphoid midline. The Boston Scientific electrocardiogram (ECG) screening tool was utilized. We found a higher proportion of patients with right-sided positive screening in comparison with standard screening (77 ± 0.4% vs. 67 ± 0.4%; P < 0.0001) and a trend to higher number of appropriate leads in right-sided screening (1.3 ± 1 vs. 1.1 ± 1 ms; P = 0.07). Patients who failed the screening had a longer QRS duration and longer QT interval. Standard and right-sided screening showed a higher percent of positive patients in the control group compared to ToF patients (P < 0.001). Right-sided screening was associated with a significant 10% increase in S-ICD eligibility in ToF patients. When comparing with an acquired cardiomyopathies group, ToF showed a lower eligibility for S-ICD. The most appropriate ECG vector was the alternate vector in contrast to what is observed in the general population. © 2017 Wiley Periodicals, Inc.

Overcoming barriers to population-based injury research: development and validation of an ICD-10–to–AIS algorithm

PubMed Central

Haas, Barbara; Xiong, Wei; Brennan-Barnes, Maureen; Gomez, David; Nathens, Avery B.

2012-01-01

Background Hospital administrative databases are a useful source of population-level data on injured patients; however, these databases use the International Classification of Diseases (ICD) system, which does not provide a direct means of estimating injury severity. We created and validated a crosswalk to derive Abbreviated Injury Scale (AIS) scores from injury-related diagnostic codes in the tenth revision of the ICD (ICD-10). Methods We assessed the validity of the crosswalk using data from the Ontario Trauma Registry Comprehensive Data Set (OTR-CDS). The AIS and Injury Severity Scores (ISS) derived using the algorithm were compared with those assigned by expert abstractors. We evaluated the ability of the algorithm to identify patients with AIS scores of 3 or greater. We used κ and intraclass correlation coefficients (ICC) as measures of concordance. Results In total, 10 431 patients were identified in the OTR-CDS. The algorithm accurately identified patients with at least 1 AIS score of 3 or greater (κ 0.65), as well as patients with a head AIS score of 3 or greater (κ 0.78). Mapped and abstracted ISS were similar; ICC across the entire cohort was 0.83 (95% confidence interval 0.81–0.84), indicating good agreement. When comparing mapped and abstracted ISS, the difference between scores was 10 or less in 87% of patients. Concordance between mapped and abstracted ISS was similar across strata of age, mechanism of injury and mortality. Conclusion Our ICD-10–to–AIS algorithm produces reliable estimates of injury severity from data available in administrative databases. This algorithm can facilitate the use of administrative data for population-based injury research in jurisdictions using ICD-10. PMID:22269308

Galectin-3 Performance in Histologic and Cytologic Assessment of Thyroid Nodules: A Systematic Review and Meta-Analysis

PubMed Central

Trimboli, Pierpaolo; Virili, Camilla; Romanelli, Francesco; Crescenzi, Anna; Giovanella, Luca

2017-01-01

The literature on Galectin-3 (Gal-3) was systematically reviewed to achieve more robust information on its histologic reliability in identifying thyroid cancers and on the concordance between Gal-3 test in histologic and cytologic samples. A computer search of the PubMed and Scopus databases was conducted by combinations of the terms thyroid and Gal-3. Initially, 545 articles were found and, after their critical review, 52 original papers were finally included. They reported 8172 nodules with histologic evaluation of Gal-3, of which 358 with also preoperative FNAC Gal-3 assessment. At histology, Gal-3 sensitivity was 87% (95% confidence intervals [CI] from 86% to 88%), and specificity 87% (95% CI from 86% to 88%); in both cases, we found heterogeneity (I2 85% and 93%, respectively) and significant publication bias (p < 0.001). The pooled rate of positive Gal-3 at fine needle aspiration (FNAC) among cancers with histologically proven Gal-3 positivity was 94% (95% CI from 89% to 97%), with neither heterogeneity (I2 14.5%) nor bias (p = 0.086). These data show high reliability of Gal-3 for thyroid cancer at histology, while its sensitivity on FNAC samples is lower. The limits of cytologic preparations and interpretation of Gal-3 results have to be solved. PMID:28800068

Propriétés électrostrictives de céramiques massives du type PbMg{1/3}Nb{2/3}O3 (PMN)

NASA Astrophysics Data System (ADS)

Lattard, E.; Lejeune, M.; Abelard, P.

1994-07-01

Loop hysteresis, dielectric and electrostrictive properties of bulk ceramics (1 - x) PbMg{1/3}Nb{2/3}O3 - xPbTiO3 - yMgO for x = 0, 5, 10 % and y = 0, 6, 12 % have been investigated. An initial lead oxide magnesium excess stabilises the perovskite structure during its formation and leads to an improvement of the electrical properties. These materials are relaxor type ferroelectrics with high permittivities in a large space of temperature around - 12 ^circC for x = 0 % to + 45 ^circC for x = 10 %. They exhibit, at 25 ^circC, large electrostrictive longitudinal (x_3 = Δ e/e) and transversal (x_1 = Δ d/d) strains without hysteresis, under an electric field of ± 2 kV/mm and at low frequency (F = 20 mHz) : x_3 = 3.5 × 10^{-4} and x_1 =10^{-4} for PMN 0.12-MgO and x_3 = 10^{-3} and x_1 = 2 × 10^{-4} for 0.9 PMN-0.1 PT-0.12 MgO. Additions of titanium improve the polarization of material which largely contribute to large strains whereas electrostrictive coefficients Q_{ij} (x_i = Q_{ij} \\cdot P_j^2), determined at 25 ^circC, slightly increase with PbTiO3 percent (for a constant magnesium excess). Les propriétés diélectriques, d'hystérésis de polarisation et électrostrictives (déformation sous champ électrique) ont été étudiées sur des composés massifs du type (1 - x) PbMg{1/3}Nb{2/3}O3 - xPbTiO3 - y Mgo pour x = 0, 5, 10 % et y = 0, 6, 12 %. L'excès initial d'oxyde de magnésium stabilise la phase pérovskite lors de sa formation et permet d'éviter la dégradation des propriétés électriques observée sur un composé de type PMN stœchiométrique. Ces matériaux sont des relaxeurs ferroélectriques caractérisés par une transition ferroélectrique diffuse. Les permittivités sont élevées dans un domaine de température centré autour de - 12 ^circC pour x = 0 % à + 45 ^circC pour x = 10 %. Ils présentent, à 25 ^circC, des déformations notables en mode longitudinal (x_3 = Δ e/e) et transversal (x_1 = Δ d/d), dépourvues d'hystérèse, d

Collaboration between specialties for respiratory allergies in the International Classification of Diseases (ICD)-11.

PubMed

Tanno, Luciana Kase; Calderon, Moises; Linzer, Jeffrey F; Chalmers, Robert J G; Demoly, Pascal

2017-02-10

The International Classification of Diseases (ICD) has been grouping the allergic and hypersensitivity disorders involving the respiratory tract under topographic distribution, regardless of the underlying mechanisms, triggers or concepts currently in use for allergic and hypersensitivity conditions. In order to strengthen awareness and deliberate the creation of the new "Allergic or hypersensitivity disorders involving the respiratory tract" section of the ICD-11, we here propose make the building process public. The new frame has been constructed to cover the gaps previously identified and was based on consensus academic reports and ICD-11 principles. Constant and bilateral discussion was kept with relevant groups representing specialties and resulted in proposals submission into the ICD-11 online platform. The "Allergic or hypersensitivity disorders involving the respiratory tract" section covers 64 entities distributed across five main categories. All the 79 proposals submitted resulted from an intensive collaboration of the Allergy working group, relevant Expert working groups and the WHO ICD governance. The establishment of the ICD-11 "Allergic or hypersensitivity disorders involving the respiratory tract" section will allow the dissemination of the updated concepts to be used in clinical practice by many different specialties and health professionals.

Incidence of lung cancer histologic cell-types according to neighborhood factors: A population based study in California

PubMed Central

McKinley, Meg; Gali, Kathleen; Patel, Manali; Clarke, Christina; Wakelee, Heather; Haile, Robert; Gomez, Scarlett Lin; Cheng, Iona

2018-01-01

Background The relationships between neighborhood factors (i.e., neighborhood socioeconomic status (nSES) and ethnic enclave) and histologic subtypes of lung cancer for racial/ethnic groups, particularly Hispanics and Asian American/Pacific Islanders (AAPIs), are poorly understood. Methods We conducted a population-based study of 75,631 Californians diagnosed with lung cancer from 2008 through2012. We report incidence rate ratios (IRRs) for lung cancer histologic cell-types by nSES among racial/ethnic groups (non-Hispanic (NH) Whites, NH Blacks, Hispanics and AAPIs) and according to Hispanic or Asian neighborhood ethnic enclave status among Hispanics and AAPIs, respectively. In addition, we examined incidence jointly by nSES and ethnic enclave. Results Patterns of lung cancer incidence by nSES and ethnic enclave differed across race/ethnicity, sex, and histologic cell-type. For adenocarcinoma, Hispanic males and females, residing in both low nSES and high nSES neighborhoods that were low enclave, had higher incidence rates compared to those residing in low nSES, high enclave neighborhoods; males (IRR, 1.17 [95% CI, 1.04–1.32] and IRR, 1.15 [95% CI, 1.02–1.29], respectively) and females (IRR, 1.29 [95% CI, 1.15–1.44] and IRR, 1.51 [95% CI, 1.36–1.67], respectively). However, AAPI males residing in both low and high SES neighborhoods that were also low enclave had lower adenocarcinoma incidence. Conclusions Neighborhood factors differentially influence the incidence of lung cancer histologic cell-types with heterogeneity in these associations by race/ethnicity and sex. For Hispanic males and females and AAPI males, neighborhood ethnic enclave status is strongly associated with lung adenocarcinoma incidence. PMID:29791458

A Gauss-Seidel Iteration Scheme for Reference-Free 3-D Histological Image Reconstruction

PubMed Central

Daum, Volker; Steidl, Stefan; Maier, Andreas; Köstler, Harald; Hornegger, Joachim

2015-01-01

Three-dimensional (3-D) reconstruction of histological slice sequences offers great benefits in the investigation of different morphologies. It features very high-resolution which is still unmatched by in-vivo 3-D imaging modalities, and tissue staining further enhances visibility and contrast. One important step during reconstruction is the reversal of slice deformations introduced during histological slice preparation, a process also called image unwarping. Most methods use an external reference, or rely on conservative stopping criteria during the unwarping optimization to prevent straightening of naturally curved morphology. Our approach shows that the problem of unwarping is based on the superposition of low-frequency anatomy and high-frequency errors. We present an iterative scheme that transfers the ideas of the Gauss-Seidel method to image stacks to separate the anatomy from the deformation. In particular, the scheme is universally applicable without restriction to a specific unwarping method, and uses no external reference. The deformation artifacts are effectively reduced in the resulting histology volumes, while the natural curvature of the anatomy is preserved. The validity of our method is shown on synthetic data, simulated histology data using a CT data set and real histology data. In the case of the simulated histology where the ground truth was known, the mean Target Registration Error (TRE) between the unwarped and original volume could be reduced to less than 1 pixel on average after 6 iterations of our proposed method. PMID:25312918

Removing transgender identity from the classification of mental disorders: a Mexican field study for ICD-11.

PubMed

Robles, Rebeca; Fresán, Ana; Vega-Ramírez, Hamid; Cruz-Islas, Jeremy; Rodríguez-Pérez, Victor; Domínguez-Martínez, Tecelli; Reed, Geoffrey M

2016-09-01

for body transformation, most commonly hormones (182 [73%)], with the first such intervention at a mean age of 25·0 years (SD 9·1, range 10-54). 84 (46%) of those who had used hormones did so initially without medical supervision. During adolescence, distress related to gender identity was very common, but not universal (n=208 [83%]), and average level of distress was quite high among those who reported it (79·9 on a scale of 0 [none at all] to 100 [extreme], SD 20·7, range 20-100). Most participants (n=226 [90%] reported experiencing family, social, or work or scholastic dysfunction related to their gender identity, but this was typically moderate (on a scale of 0 [not at all disrupted] to 10 [extremely disrupted], family dysfunction mean 5·3 [SD 3·9, range 0-10]; social dysfunction mean 5·0 [SD 3·8, range 0-10]; work or scholastic dysfunction mean 4·8 [SD 3·6, range 0-10]). Multivariate logistic regression models indicated that distress and all types of dysfunction were strongly predicted by experiences of social rejection (odds ratios [ORs] 2·29-8·15) and violence (1·99-3·99). A current male gender identity also predicted distress (OR 3·90). Of the indicators of gender incongruence, only asking to be treated as a different gender was a significant predictor, and only of work or scholastic dysfunction (OR 1·82). This study provides additional support for classifying health-related categories related to transgender identity outside the classification of mental disorders in the ICD-11. The reconceptualisation and related reclassification of transgender-related health conditions in the ICD-11 could serve as a useful instrument in the discussion of public health policies aimed at increasing access to appropriate services and reducing the victimisation of transgender people. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico. Copyright © 2016 Elsevier Ltd. All rights reserved.

Vacancy-type defects in Al2O3/GaN structure probed by monoenergetic positron beams

NASA Astrophysics Data System (ADS)

Uedono, Akira; Nabatame, Toshihide; Egger, Werner; Koschine, Tönjes; Hugenschmidt, Christoph; Dickmann, Marcel; Sumiya, Masatomo; Ishibashi, Shoji

2018-04-01

Defects in the Al2O3(25 nm)/GaN structure were probed by using monoenergetic positron beams. Al2O3 films were deposited on GaN by atomic layer deposition at 300 °C. Temperature treatment above 800 °C leads to the introduction of vacancy-type defects in GaN due to outdiffusion of atoms from GaN into Al2O3. The width of the damaged region was determined to be 40-50 nm from the Al2O3/GaN interface, and some of the vacancies were identified to act as electron trapping centers. In the Al2O3 film before and after annealing treatment at 300-900 °C, open spaces with three different sizes were found to coexist. The density of medium-sized open spaces started to decrease above 800 °C, which was associated with the interaction between GaN and Al2O3. Effects of the electron trapping/detrapping processes of interface states on the flat band voltage and the defects in GaN were also discussed.

Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations.

PubMed

Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Quan, Hude; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

2016-08-05

With steady increases in 'big data' and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Accuracy of ICD-10 Coding System for Identifying Comorbidities and Infectious Conditions Using Data from a Thai University Hospital Administrative Database.

PubMed

Rattanaumpawan, Pinyo; Wongkamhla, Thanyarak; Thamlikitkul, Visanu

2016-04-01

To determine the accuracy of International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) coding system in identifying comorbidities and infectious conditions using data from a Thai university hospital administrative database. A retrospective cross-sectional study was conducted among patients hospitalized in six general medicine wards at Siriraj Hospital. ICD-10 code data was identified and retrieved directly from the hospital administrative database. Patient comorbidities were captured using the ICD-10 coding algorithm for the Charlson comorbidity index. Infectious conditions were captured using the groups of ICD-10 diagnostic codes that were carefully prepared by two independent infectious disease specialists. Accuracy of ICD-10 codes combined with microbiological dataf or diagnosis of urinary tract infection (UTI) and bloodstream infection (BSI) was evaluated. Clinical data gathered from chart review was considered the gold standard in this study. Between February 1 and May 31, 2013, a chart review of 546 hospitalization records was conducted. The mean age of hospitalized patients was 62.8 ± 17.8 years and 65.9% of patients were female. Median length of stay [range] was 10.0 [1.0-353.0] days and hospital mortality was 21.8%. Conditions with ICD-10 codes that had good sensitivity (90% or higher) were diabetes mellitus and HIV infection. Conditions with ICD-10 codes that had good specificity (90% or higher) were cerebrovascular disease, chronic lung disease, diabetes mellitus, cancer HIV infection, and all infectious conditions. By combining ICD-10 codes with microbiological results, sensitivity increased from 49.5 to 66%for UTI and from 78.3 to 92.8%for BS. The ICD-10 coding algorithm is reliable only in some selected conditions, including underlying diabetes mellitus and HIV infection. Combining microbiological results with ICD-10 codes increased sensitivity of ICD-10 codes for identifying BSI. Future research is

Synthesis of p-type ZnO films

NASA Astrophysics Data System (ADS)

Ryu, Y. R.; Zhu, S.; Look, D. C.; Wrobel, J. M.; Jeong, H. M.; White, H. W.

2000-06-01

p-Type ZnO obtained by arsenic (As) doping is reported for the first time. Arsenic-doped ZnO (ZnO : As) films have been deposited on (0 0 1)-GaAs substrates by pulsed laser ablation. The process of synthesizing p-type ZnO : As films was performed in an ambient gas of ultra-pure (99.999%) oxygen. The ambient gas pressure was 35 mTorr with the substrate temperature in the range 300-450°C. ZnO films grown at 400°C and 450°C are p-type and As is a good acceptor. The acceptor peak is located at 3.32 eV and its binding energy is about 100 meV. Acceptor concentrations of As atoms in ZnO films were in the range from high 10 17 to high 10 21 atoms/cm 3 as determined by secondary ion mass spectroscopy (SIMS) and Hall effect measurements.

Impulse control disorders and related behaviours (ICD-RBs) in Parkinson's disease patients: Assessment using “Questionnaire for impulsive-compulsive disorders in Parkinson's disease” (QUIP)

PubMed Central

Sharma, Ashish; Goyal, Vinay; Behari, Madhuri; Srivastva, Achal; Shukla, Garima; Vibha, Deepti

2015-01-01

Background: There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs) in Indian patients with Parkinson's Disease (PD). In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders. Objectives: To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated “Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP)” and to examine their association with Dopamine replacement therapy (DRT). Materials and Methods: This was a hospital based observational cross-sectional study. After taking informed consent, patients and their informants (spouse, or primary caregiver) were made to complete the QUIP, and were instructed to answer questions based on behaviors that occurred anytime during PD that lasted at least four consecutive weeks. Results: Total of 299 patients participated in the study. At least one ICD-RB was present in 128 (42.8%), at least one Impulse control disorder (ICD) was present in 74 (24.75%) and at least one Impulse control related compulsive behaviour (ICRB) was present in 93 (31.1%) patients. Punding was the most frequent (12.4%) followed by hyper sexuality (11.04%), compulsive hobbyism (9.4%), compulsive shopping (8.4%), compulsive medication use (7.7%), compulsive eating (5.35%), walkabout (4%) and pathological gambling (3.3%). ≥ 2 ICD-RBs were observed in 15.7% of patients. After multivariate analysis, younger age of onset, being unmarried were specifically associated with presence of ICD. Longer disease duration was specifically associated with presence of ICRB. Whereas smoking and higher dopamine levodopa equivalent daily doses (DA LEDD) were associated with both presence of ICD and ICRB. Higher LD LEDD was specifically associated with presence of ICD-RB. Conclusions: Our study revealed a relatively higher frequency of

Effective Identification of Similar Patients Through Sequential Matching over ICD Code Embedding.

PubMed

Nguyen, Dang; Luo, Wei; Venkatesh, Svetha; Phung, Dinh

2018-04-11

Evidence-based medicine often involves the identification of patients with similar conditions, which are often captured in ICD (International Classification of Diseases (World Health Organization 2013)) code sequences. With no satisfying prior solutions for matching ICD-10 code sequences, this paper presents a method which effectively captures the clinical similarity among routine patients who have multiple comorbidities and complex care needs. Our method leverages the recent progress in representation learning of individual ICD-10 codes, and it explicitly uses the sequential order of codes for matching. Empirical evaluation on a state-wide cancer data collection shows that our proposed method achieves significantly higher matching performance compared with state-of-the-art methods ignoring the sequential order. Our method better identifies similar patients in a number of clinical outcomes including readmission and mortality outlook. Although this paper focuses on ICD-10 diagnosis code sequences, our method can be adapted to work with other codified sequence data.

Application of radiofrequency energy in surgical and interventional procedures: are there interactions with ICDs?

PubMed

Fiek, Michael; Dorwarth, Uwe; Durchlaub, Ilka; Janko, Sabine; Von Bary, Christian; Steinbeck, Gerhard; Hoffmann, Ellen

2004-03-01

During surgical and interventional procedures, interference may occur between ICDs and electrical cautery or with the application of RF energy. This may lead to the false induction of ICD therapies or could even result in device malfunction, which represents a potential perioperative hazard for the patient. This study analyzed the intraoperative interactions in 45 consecutive ICD patients in reference to different surgical and interventional procedures. A total of 33 surgical operations (general surgery [n = 14], urologic [n = 5], abdominal [n = 10], gynecological [n = 2], thoracic [n = 1], neurosurgical [n = 1]) and 12 interventional therapies (RF catheter ablation [n = 10], endoscopic papillotomy [n = 2]) were performed. The ICD devices were all located in left pectoral position and consisted of 25 single and 20 dual chamber defibrillators. During the procedure, tachyarrhythmia detection (VF 296 +/- 20 ms, VT 376 +/- 49 ms) of the devices was maintained active (monitoring mode), only ICD therapies were inactivated. The indifferent electrode of the electrical cauter/RF generator was placed in standard positions (right/left mid-femoral position [n = 27/8], thoracic spine area [n = 10]). After the procedure, the ICD memory was checked for detections and for changes in the programming. There was no oversensing, reprogramming, or damage of any defibrillator caused by RF energy. Despite the lack of undesired interactions, ICDs should be inactivated preoperatively to assure maximum patient safety. However, should inactivation not be possible, or the achievement uncertain, electromagnetic interference is highly unlikely.

Histologic characterization of canine dilated cardiomyopathy.

PubMed

Tidholm, A; Jönsson, L

2005-01-01

Dilated cardiomyopathy (DCM), characterized by chamber dilatation and myocardial systolic and diastolic dysfunction, is one of the most common heart diseases in dogs. The clinical diagnosis is based on findings on echocardiographic and Doppler examinations, with the active exclusion of other acquired or congenital heart diseases. However, the echocardiographic criteria for the diagnosis of DCM are not wholly specific for the disease, and histologic examination may be necessary for final diagnosis. Review of reports on histologic findings in dogs with clinically diagnosed DCM reveals two histologically distinct forms of DCM: 1) cardiomyopathy of Boxers and Doberman Pinschers, corresponding to the "fatty infiltration-degenerative" type and 2) the form seen in many giant, large-, and medium-sized breeds, including some Boxers and Doberman Pinschers, classified as the "attenuated wavy fiber" type of DCM. The histologic changes of the attenuated wavy fiber type of DCM may precede clinical and echocardiographic signs of heart disease, thus indicating an early stage of DCM.

Intermolecular Coulombic Decay (ICD) Occuring in Triatomic Molecular Dimer

NASA Astrophysics Data System (ADS)

Iskandar, Wael; Gatton, Averell; Gaire, Bishwanath; Champenois, Elio; Larsen, Kirk; Shivaram, Niranjan; Moradmand, Ali; Severt, Travis; Williams, Joshua; Slaughter, Daniel; Weber, Thorsten

2017-04-01

For over two decades, the production of ICD process has been extensively investigated theoretically and experimentally in different systems bounded by a week force (ex. van-der-Waals or Hydrogen force). Furthermore, the ICD process has been demonstrated a strong implication in biological system (DNA damage and DNA repair mechanism) because of the production of genotoxic low energy electrons during the decay cascade. Studying large complex system such as triatomic molecular dimer may be helpful for further exploration of ``Auger electron driven cancer therapy''. The present experiment investigates the dissociation dynamics happened in collision between a photons and CO2 dimer. We will focus more specifically on the CO2++CO2+ fragmentation channel and the detection in coincidence of the two ionic fragments and the two electrons will be done using a COld Target Recoil Ion Momentum Spectroscopy (COLTRIMS). The measurements of the Kinetic Energy Release of the two fragments and the relative angular distribution of the electrons in the molecular frame reveal that the ICD is the only mechanism responsible for the production of this fragmentation channel.

Histological Changes in Gills of Two Fish Species as Indicators of Water Quality in Jansen Lagoon (São Luís, Maranhão State, Brazil)

PubMed Central

Santos, Débora M. S.; Melo, Mércia Regina S.; Mendes, Denise Carla S.; Rocha, Iolanda Karoline B. S.; Silva, Jakeline Priscila L.; Cantanhêde, Sildiane M.; Meletti, Paulo C.

2014-01-01

Water quality of the Jansen Lagoon (São Luís, Maranhão State, Brazil) was assessed through histological biomarkers and microbiological parameters. To this end, 29 fish specimens (11 Centropomus undecimalis and 18 Sardinella sp) and eight water samples were collected during the rainy and dry periods of 2013. The lagoon water showed thermotolerant coliform indices above the limit set forth in CONAMA Resolution 357/2005. Histological changes observed in the gills were: lifting of the respiratory epithelium, hyperplasia of the lamellar epithelium, incomplete and complete fusion of several lamellae, disorganization of the lamellae, congestion of blood vessels, aneurysms, hypertrophy of the respiratory epithelium, hemorrhage and rupture of the lamellar epithelium and parasite. The histological alteration index (HAI) average value to Sardinella sp was 31.8 and to C. undecimalis was 22.2. The average HAI value in both species corresponds to category 21–50, with tissue injuries being classified from moderate to severe. The presence of histological injuries and the HAI values indicate that the fish sampled from the Jansen Lagoon are reacting to non-specific xenobiotics present at the site. PMID:25514148

The impact of proposed changes to ICD-11 on estimates of PTSD prevalence and comorbidity.

PubMed

Wisco, Blair E; Miller, Mark W; Wolf, Erika J; Kilpatrick, Dean; Resnick, Heidi S; Badour, Christal L; Marx, Brian P; Keane, Terence M; Rosen, Raymond C; Friedman, Matthew J

2016-06-30

The World Health Organization's posttraumatic stress disorder (PTSD) work group has published a proposal for the forthcoming edition of the International Classification of Diseases (ICD-11) that would yield a very different diagnosis relative to DSM-5. This study examined the impact of the proposed ICD-11 changes on PTSD prevalence relative to the ICD-10 and DSM-5 definitions and also evaluated the extent to which these changes would accomplish the stated aim of reducing the comorbidity associated with PTSD. Diagnostic prevalence estimates were compared using a U.S. national community sample and two U.S. Department of Veterans Affairs clinical samples. The ICD-11 definition yielded prevalence estimates 10-30% lower than DSM-5 and 25% and 50% lower than ICD-10 with no reduction in the prevalence of common comorbidities. Findings suggest that by constraining the diagnosis to a narrower set of symptoms, the proposed ICD-11 criteria set would substantially reduce the number of individuals with the disorder. These findings raise doubt about the extent to which the ICD-11 proposal would achieve the aim of reducing comorbidity associated with PTSD and highlight the public health and policy implications of such a redefinition. Published by Elsevier Ireland Ltd.

Frequency domain kinetic of positron-electron annihilation in the MgO-Al2O3 spinel-type ceramics

NASA Astrophysics Data System (ADS)

Fl'unt, Orest; Klym, Halyna; Ingram, Adam

2018-03-01

In this work, the kinetic of positron-electron annihilation in the MgO-Al2O3 spinel-type ceramics sintered at different temperatures (1100, 1200 and 1400 °C) has been calculated and analyzed in a frequency domain. The spectra of real (in-phase) and imaginary (quadrature) components of positron-electron annihilation kinetic have been obtained numerically from usual temporal characteristics using integral Fourier transform. The numerical calculations were carried out using cubic spline interpolation of the pulse characteristics of MgO-Al2O3 ceramics in time domain with following analytical calculations of integrals. The obtained spectra as real so imaginary part of MgO-Al2O3 ceramics in frequency domain almost good obey a Debye law denying correlation between elementary positron annihilation processes. Complex diagrams of frequency domain responses of as-prepared samples have a shape of semicircles with close characteristic frequencies. Some deviation on low-frequency side of the semicircles is observed confirming an availability of longer time kinetic processes. Sintering temperature dependencies of the relaxation times and characteristic frequencies of positron-electron annihilation processes have been obtained. It is shown that position of large maxima on the frequency dependencies of imaginary part corresponds to fast average relaxation lifetime representing the most intensive interaction process of positrons with small cavity traps in solids.

Effect of aging on ZnO and nitrogen doped P-Type ZnO

NASA Astrophysics Data System (ADS)

Majumdar, Sayanee; Bhunia, S.

2012-06-01

The withholding of p-type conductivity in as-prepared and 3% nitrogen (N) doped zinc oxide (ZnO) even after 2 months of preparation was systematically studied. The films were grown on glass substrates by pulsed laser deposition (PLD) at 350 °C under different conditions, viz. under vacuum and at oxygen (O) ambience using 2000 laser pulses. In O ambience for as-prepared ZnO the carrier concentration reduces and mobility increases with increasing number of laser shots. The resistivity of as-prepared and 3% N-doped ZnO is found to increase with reduction in hole concentration after 60 days of aging while maintaining its p-type conductivity irrespective of growth condition. AFM and electrical properties showed aging effect on the doped and undoped samples. For as-prepared ZnO, with time, O migration makes the film high resistive by reducing free electron concentrations. But for N-doped p-type ZnO, O-migration, metastable N and hydrogen atom present in the source induced instability in structure makes it less conducting p-type.

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study.

PubMed

Cazzo, Everton; Jimenez, Laísa Simakawa; Gallo, Fábio de Felice; Pareja, José Carlos; Chaim, Elinton Adami

2016-01-01

Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare the histological alterations observed in morbidly obese individuals with and without T2DM who underwent Roux-en-Y gastric bypass. Cross-sectional study in a tertiary-level public hospital. This was a cross-sectional study on 197 individuals who underwent gastric bypass surgery between 2011 and 2013. NAFLD was assessed through liver biopsies. T2DM was diagnosed through the International Diabetes Federation criteria. Non-diabetics presented significantly more biopsies without any histological abnormalities, regarding steatosis (42.6% versus 25.5%; P = 0.0400), fibrosis (60.6% versus 36.2%; P = 0.0042) and steatohepatitis (27.3% versus 12.8%; P = 0.0495), while diabetics presented significantly higher frequency of moderate forms of steatosis (36.2% versus 20%; P = 0.0307) and fibrosis (23.4% versus 4%; P = 0.0002). T2DM was associated with more advanced forms of NAFLD within the population studied. NAFLD has previously been correlated with severe forms of heart disease. Screening for and early detecting of NAFLD in high-risk populations are important for avoiding further development of severe forms and the need for liver transplantation.

Transformation from insulating p-type to semiconducting n-type conduction in CaCu3Ti4O12-related Na(Cu5/2Ti1/2)Ti4O12 ceramics

NASA Astrophysics Data System (ADS)

Li, Ming; Sinclair, Derek C.

2013-07-01

A double doping mechanism of Na+ + 1/2 Ti4+ → Ca2+ + 1/2 Cu2+ on the general formula Ca1-xNax(Cu3-x/2Tix/2)Ti4O12 has been used to prepare a series of isostructural CaCu3Ti4O12 (CCTO)-type perovskites. A complete solid solution exists for 0 ≤ x ≤ 1 and all compositions exhibit incipient ferroelectric behaviour with higher than expected intrinsic relative permittivity. Although CCTO ceramics typically exhibit n-type semiconductivity (room temperature, RT, resistivity of ˜10-100 Ω cm), Na(Cu5/2Ti1/2)Ti4O12 (NCTO) ceramics sintered at 950 °C consist of two insulating bulk phases (RT resistivity > 1 GΩ cm), one p-type and the other n-type. With increasing sintering temperature/period, the p-type phase transforms into the n-type phase. During the transformation, the resistivity and activation energy for electrical conduction (Ea ˜ 1.0 eV) of the p-type phase remain unchanged, whereas the n-type phase becomes increasingly conductive with Ea decreasing from ˜ 0.71 to 0.11 eV with increasing sintering temperature. These changes are attributed to small variations in stoichiometry that occur during high temperature ceramic processing with oxygen-loss playing a crucial role.

Trends in Gastroenteritis-associated Mortality in the United States 1985-2005: Variations by ICD-9 and ICD-10 Codes

EPA Science Inventory

BackgroundTrends in gastroenteritis-associated mortality are changing over time with development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In 1999, ICD-10 coding was introduced for mortality records which can also ...

SU-E-T-169: Characterization of Pacemaker/ICD Dose in SAVI HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalavagunta, C; Lasio, G; Yi, B

2015-06-15

Purpose: It is important to estimate dose to pacemaker (PM)/Implantable Cardioverter Defibrillator (ICD) before undertaking Accelerated Partial Breast Treatment using High Dose Rate (HDR) brachytherapy. Kim et al. have reported HDR PM/ICD dose using a single-source balloon applicator. To the authors knowledge, there have so far not been any published PM/ICD dosimetry literature for the Strut Adjusted Volume Implant (SAVI, Cianna Medical, Aliso Viejo, CA). This study aims to fill this gap by generating a dose look up table (LUT) to predict maximum dose to the PM/ICD in SAVI HDR brachytherapy. Methods: CT scans for 3D dosimetric planning were acquiredmore » for four SAVI applicators (6−1-mini, 6−1, 8−1 and 10−1) expanded to their maximum diameter in air. The CT datasets were imported into the Elekta Oncentra TPS for planning and each applicator was digitized in a multiplanar reconstruction window. A dose of 340 cGy was prescribed to the surface of a 1 cm expansion of the SAVI applicator cavity. Cartesian coordinates of the digitized applicator were determined in the treatment leading to the generation of a dose distribution and corresponding distance-dose prediction look up table (LUT) for distances from 2 to 15 cm (6-mini) and 2 to 20 cm (10–1).The deviation between the LUT doses and the dose to the cardiac device in a clinical case was evaluated. Results: Distance-dose look up table were compared to clinical SAVI plan and the discrepancy between the max dose predicted by the LUT and the clinical plan was found to be in the range (−0.44%, 0.74%) of the prescription dose. Conclusion: The distance-dose look up tables for SAVI applicators can be used to estimate the maximum dose to the ICD/PM, with a potential usefulness for quick assessment of dose to the cardiac device prior to applicator placement.« less

Metrics and tools for consistent cohort discovery and financial analyses post-transition to ICD-10-CM.

PubMed

Boyd, Andrew D; Li, Jianrong John; Kenost, Colleen; Joese, Binoy; Yang, Young Min; Kalagidis, Olympia A; Zenku, Ilir; Saner, Donald; Bahroos, Neil; Lussier, Yves A

2015-05-01

In the United States, International Classification of Disease Clinical Modification (ICD-9-CM, the ninth revision) diagnosis codes are commonly used to identify patient cohorts and to conduct financial analyses related to disease. In October 2015, the healthcare system of the United States will transition to ICD-10-CM (the tenth revision) diagnosis codes. One challenge posed to clinical researchers and other analysts is conducting diagnosis-related queries across datasets containing both coding schemes. Further, healthcare administrators will manage growth, trends, and strategic planning with these dually-coded datasets. The majority of the ICD-9-CM to ICD-10-CM translations are complex and nonreciprocal, creating convoluted representations and meanings. Similarly, mapping back from ICD-10-CM to ICD-9-CM is equally complex, yet different from mapping forward, as relationships are likewise nonreciprocal. Indeed, 10 of the 21 top clinical categories are complex as 78% of their diagnosis codes are labeled as "convoluted" by our analyses. Analysis and research related to external causes of morbidity, injury, and poisoning will face the greatest challenges due to 41 745 (90%) convolutions and a decrease in the number of codes. We created a web portal tool and translation tables to list all ICD-9-CM diagnosis codes related to the specific input of ICD-10-CM diagnosis codes and their level of complexity: "identity" (reciprocal), "class-to-subclass," "subclass-to-class," "convoluted," or "no mapping." These tools provide guidance on ambiguous and complex translations to reveal where reports or analyses may be challenging to impossible.Web portal: http://www.lussierlab.org/transition-to-ICD9CM/Tables annotated with levels of translation complexity: http://www.lussierlab.org/publications/ICD10to9. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Metrics and tools for consistent cohort discovery and financial analyses post-transition to ICD-10-CM

PubMed Central

Boyd, Andrew D; ‘John’ Li, Jianrong; Kenost, Colleen; Joese, Binoy; Min Yang, Young; Kalagidis, Olympia A; Zenku, Ilir; Saner, Donald; Bahroos, Neil; Lussier, Yves A

2015-01-01

In the United States, International Classification of Disease Clinical Modification (ICD-9-CM, the ninth revision) diagnosis codes are commonly used to identify patient cohorts and to conduct financial analyses related to disease. In October 2015, the healthcare system of the United States will transition to ICD-10-CM (the tenth revision) diagnosis codes. One challenge posed to clinical researchers and other analysts is conducting diagnosis-related queries across datasets containing both coding schemes. Further, healthcare administrators will manage growth, trends, and strategic planning with these dually-coded datasets. The majority of the ICD-9-CM to ICD-10-CM translations are complex and nonreciprocal, creating convoluted representations and meanings. Similarly, mapping back from ICD-10-CM to ICD-9-CM is equally complex, yet different from mapping forward, as relationships are likewise nonreciprocal. Indeed, 10 of the 21 top clinical categories are complex as 78% of their diagnosis codes are labeled as “convoluted” by our analyses. Analysis and research related to external causes of morbidity, injury, and poisoning will face the greatest challenges due to 41 745 (90%) convolutions and a decrease in the number of codes. We created a web portal tool and translation tables to list all ICD-9-CM diagnosis codes related to the specific input of ICD-10-CM diagnosis codes and their level of complexity: “identity” (reciprocal), “class-to-subclass,” “subclass-to-class,” “convoluted,” or “no mapping.” These tools provide guidance on ambiguous and complex translations to reveal where reports or analyses may be challenging to impossible. Web portal: http://www.lussierlab.org/transition-to-ICD9CM/ Tables annotated with levels of translation complexity: http://www.lussierlab.org/publications/ICD10to9 PMID:25681260

Calculation of Phase Equilibria in the Y2O3-Yb2O3-ZrO2 System

NASA Technical Reports Server (NTRS)

Jacobson, Nathan S.; Liu, Zi-Kui; Kaufman, Larry; Zhang, Fan

2001-01-01

Rare earth oxide stabilized zirconias find a wide range of applications. An understanding of phase equilibria is essential to all applications. In this study, the available phase boundary data and thermodynamic data is collected and assessed. Calphad-type databases are developed to completely describe the Y2O3-ZrO2, Yb2O3-ZrO2, and Y2O3-Yb2O3 systems. The oxide units are treated as components and regular and subregular solution models are used. The resultant calculated phase diagrams show good agreement with the experimental data. Then the binaries are combined to form the database for the Y2O3-Yb2O3-ZrO2 psuedo-ternary.

ICD-11 Prevalence Rates of Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in a German Nationwide Sample.

PubMed

Maercker, Andreas; Hecker, Tobias; Augsburger, Mareike; Kliem, Sören

2018-04-01

Prevalence rates are still lacking for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) diagnoses based on the new ICD-11 criteria. In a nationwide representative German sample (N = 2524; 14-99 years), exposure to traumatic events and symptoms of PTSD or CPTSD were assessed with the International Trauma Questionnaire. A clinical variant of CPTSD with a lower threshold for core PTSD symptoms was also calculated, in addition to conditional prevalence rates dependent on trauma type and differential predictors. One-month prevalence rates were as follows: PTSD, 1.5%; CPTSD, 0.5%; and CPTSD variant, 0.7%. For PTSD, the highest conditional prevalence was associated with kidnapping or rape, and the highest CPTSD rates were associated with sexual childhood abuse or rape. PTSD and CPTSD were best differentiated by sexual violence. Combined PTSD and CPTSD (ICD-11) rates were in the range of previously reported prevalences for unified PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; ICD-10). Evidence on differential predictors of PTSD and CPTSD is still preliminary.

Radiofrequency ablation of fast ventricular tachycardia causing an ICD storm in an infant with hypertrophic cardiomyopathy.

PubMed

Ergul, Yakup; Ozyilmaz, Isa; Bilici, Meki; Ozturk, Erkut; Haydin, Sertaç; Guzeltas, Alper

2018-04-01

An implantable cardioverter defibrillator (ICD) storm involves very frequent arrhythmia episodes and ICD shocks, and it is associated with poor short-term and long-term prognosis. Radiofrequency catheter ablation can be used as an effective rescue treatment for patients with an ICD storm. To our knowledge, this is the first report of an infant with hypertrophic cardiomyopathy presenting with an ICD storm and undergoing successful radiofrequency catheter ablation salvage treatment for the fast left posterior fascicular ventricular tachycardia. © 2017 Wiley Periodicals, Inc.

Educational videos to reduce racial disparities in ICD therapy via innovative designs (VIVID): a randomized clinical trial.

PubMed

Thomas, Kevin L; Zimmer, Louise O; Dai, David; Al-Khatib, Sana M; Allen LaPointe, Nancy M; Peterson, Eric D

2013-07-01

Black individuals eligible for an implantable cardioverter/defibrillator (ICD) are considerably less likely than white individuals to receive one. This disparity may, in part, be explained by racial differences in patient preferences. We hypothesized that a targeted patient-centered educational video could improve knowledge of sudden cardiac arrest (SCA) and ICDs and reduce racial differences in ICD preferences. We conducted a pilot study to assess the feasibility of testing this hypothesis in a randomized trial. We created a video that included animation, physician commentary, and patient testimonials on SCA and ICDs. The primary outcome was the decision to have an ICD implanted as a function of race and intervention. Between January 1, 2011, and December 31, 2011, 59 patients (37 white and 22 black) were randomized to the video or health care provider counseling/usual care. Relative to white patients, black patients were younger (median age, 55 vs 68 years) and more likely to have attended college or technical school. Baseline SCA and ICD knowledge was similar and improved significantly in both racial groups after the intervention. Black patients viewing the video were as likely as white patients to want an ICD (60.0% vs 79.2%, P = .20); and among those in the usual care arm, black patients were less likely than white patients to want an ICD (42.9% vs 84.6% P = .05). Among individuals eligible for an ICD, a video decision aid increased patient knowledge and reduced racial differences in patient preference for an ICD. Copyright © 2013 Mosby, Inc. All rights reserved.

Contemporary rates of appropriate shock therapy in patients who receive implantable device therapy in a real-world setting: From the Israeli ICD Registry.

PubMed

Sabbag, Avi; Suleiman, Mahmoud; Laish-Farkash, Avishag; Samania, Nimer; Kazatsker, Mark; Goldenberg, Ilan; Glikson, Michael; Beinart, Roy

2015-12-01

Implantable cardioverter-defibrillators (ICDs) have become the mainstay of preventive measures for sudden cardiac death (SCD). However, there are limited data on rates of appropriate life-saving ICD shock therapies in contemporary real-life settings. The purpose of the study was to evaluate the rate of appropriate life-saving ICD shock therapies in a contemporary registry. The Israeli ICD Registry includes all implants and other ICD operative procedures nationwide. The present study comprises 2349 consecutive cases who were enrolled in the Registry and prospectively followed up for information regarding survival, hospitalizations, and ICD therapies since 2010. Kaplan-Meier survival analysis showed that the rate of appropriate ICD shock therapy at 30-month follow-up was 2.6% among patients who received an ICD for primary prevention compared with 7.4% among those who received a device for secondary prevention (log-rank P < .001). Rates of appropriate ICD shocks among primary prevention patients were 1.1% at 1-year of follow-up and 2.6% at 30 months, whereas the corresponding rates in the secondary prevention group were 3.8% at 1 year and 7.4% at 30 months (log-rank P < .001). A total of 253 patients (4.8%) died during follow-up, 65% of noncardiac causes. Rates of life-saving appropriate ICD shock therapies among patients implanted with a defibrillator for the primary prevention of SCD in a contemporary real-world setting are lower than reported previously. These findings suggest a need for improved risk stratification and patient selection in this population. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Homologous compounds of type ARO3(ZnO)m in the system Ga-Sn-Zn-O

NASA Astrophysics Data System (ADS)

Eichhorn, Simon; Schmid, Herbert; Assenmacher, Wilfried; Mader, Werner

2017-02-01

Several members of hitherto unknown homologous compounds [Sn0.5Zn0.5]GaO3(ZnO)m (m=3-7) of the general formula ARO3(ZnO)m were prepared by solid state methods from the binary oxides in sealed Pt-tubes. UV-vis measurements confirm these compounds to be transparent oxides with an optical band gap in the UV region with Eg≈3 eV. Rietveld refinements on powder samples of [Sn0.5Zn0.5]GaO3(ZnO)m proved the compounds to be isostructural with InGaO3(ZnO)m, where In3+ on octahedral sites is replaced statistically by Sn4+ and Zn2+ in equal amounts preserving an average charge of 3+. Additionally, the structure of [Sn0.5Zn0.5]GaO3(ZnO)3 has been determined from flux-grown single crystals by X-ray diffraction (R 3 ̅ m , Z=3, a=3.2387(7) Å, c=41.78(1) Å, 19 parameters, 201 independent reflections, R1=0.047, wR2=0.074). The compound [Sn0.5Zn0.5]GaO3(ZnO)3 is isostructural with InGaO3(ZnO)3. [Sn0.5Zn0.5]GaO3(ZnO)3 was furthermore analyzed by High Angle Annular Dark Field (HAADF) scanning TEM and EELS spectroscopic imaging, supporting the structure model derived from X-ray diffraction data.

Outcomes in African Americans undergoing cardioverter-defibrillator implantation for primary prevention of sudden cardiac death: findings from the Prospective Observational Study of Implantable Cardioverter-Defibrillators (PROSE-ICD).

PubMed

Zhang, Yiyi; Kennedy, Robert; Blasco-Colmenares, Elena; Butcher, Barbara; Norgard, Sanaz; Eldadah, Zayd; Dickfeld, Timm; Ellenbogen, Kenneth A; Marine, Joseph E; Guallar, Eliseo; Tomaselli, Gordon F; Cheng, Alan

2014-08-01

Implantable cardioverter-defibrillators (ICDs) reduce the risk of death in patients with left ventricular dysfunction. Little is known regarding the benefit of this therapy in African Americans (AAs). The purpose of this study was to determine the association between AA race and outcomes in a cohort of primary prevention ICD patients. We conducted a prospective cohort study of patients with systolic heart failure who underwent ICD implantation for primary prevention of sudden cardiac death. The primary end-point was appropriate ICD shock defined as a shock for rapid ventricular tachyarrhythmias. The secondary end-point was all-cause mortality. There were 1189 patients (447 AAs and 712 non-AAs) enrolled. Over a median follow-up of 5.1 years, a total of 137 patients experienced an appropriate ICD shock, and 343 died (294 of whom died without receiving an appropriate ICD shock). The multivariate adjusted hazard ratio (95% confidence interval) comparing AAs vs non-AAs were 1.24 (0.96-1.59) for all-cause mortality, 1.33 (1.02, 1.74) for all-cause mortality without receiving appropriate ICD shock, and 0.78 (0.51, 1.19) for appropriate ICD shock. Ejection fraction, diabetes, and hypertension appeared to explain 24.1% (10.1%-69.5%), 18.7% (5.3%-58.0%), and 13.6% (3.8%-53.6%) of the excess risk of mortality in AAs, with a large proportion of the mortality difference remaining unexplained. In patients with primary prevention ICDs, AAs had an increased risk of dying without receiving an appropriate ICD shock compared to non-AAs. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Revisiting Desensitization and Allergen Immunotherapy Concepts for the International Classification of Diseases (ICD)-11.

PubMed

Tanno, Luciana Kase; Calderon, Moises A; Papadopoulos, Nikolaos G; Sanchez-Borges, Mario; Rosenwasser, Lanny J; Bousquet, Jean; Pawankar, Ruby; Sisul, Juan Carlos; Cepeda, Alfonso Mario; Li, James; Muraro, Antonella; Fineman, Stanley; Sublett, James L; Katelaris, Constance H; Chang, Yoon-Seok; Moon, Hee-Bom; Casale, Thomas; Demoly, Pascal

2016-01-01

Allergy and hypersensitivity intervention management procedures, such as desensitization and/or tolerance induction and immunotherapy, have not been pondered up to now in the content of International Classification of Diseases (ICD) context because the focus has been on prioritizing the condition implementations. Tremendous efforts have been devoted to implementing allergic and hypersensitivity conditions in the forthcoming ICD-11. However, we consider that it is crucial now to have nomenclature and classification universally accepted for these procedures to be able to provide scientifically consistent proposals into the new ICD-11 platform for the best practice parameters of our specialty. With the aim of promoting a harmonized comprehension and aligning it with the ICD-11 revision, we have reviewed the definitions and concepts currently used for desensitization and/or tolerance induction and immunotherapy. We strongly believe that this review is a key instrument to support the allergy specialty identity into the ICD-11 framework and serves as a platform to perform positive quality improvement in clinical practice. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. All rights reserved.

Clinician's Primer to ICD-10-CM Coding for Cleft Lip/Palate Care.

PubMed

Allori, Alexander C; Cragan, Janet D; Della Porta, Gina C; Mulliken, John B; Meara, John G; Bruun, Richard; Shusterman, Stephen; Cassell, Cynthia H; Raynor, Eileen; Santiago, Pedro; Marcus, Jeffrey R

2017-01-01

On October 1, 2015, the United States required use of the Clinical Modification of the International Classification of Diseases, 10th Revision (ICD-10-CM) for diagnostic coding. This primer was written to assist the cleft care community with understanding and use of ICD-10-CM for diagnostic coding related to cleft lip and/or palate (CL/P).

Electrical conduction and thermoelectric properties of perovskite-type BaBi1-xSbxO3

NASA Astrophysics Data System (ADS)

Yasukawa, Masahiro; Shiga, Yuta; Kono, Toshio

2012-06-01

To elucidate the thermoelectric properties at high temperatures, the electrical conductivity and Seebeck coefficient were measured at temperatures between 423 K and 973 K for perovskite-type ceramics of BaBi1-xSbxO3 solid solutions with x=0.0-0.5. All the ceramics exhibit p-type semiconducting behaviors and electrical conduction is attributed to hopping of small polaronic holes localized on the pentavalent cations. Substitution of Bi with Sb causes the electrical conductivity σ and cell volume to decrease, but the Seebeck coefficient S to increase, suggesting that the Sb atoms are doped as Sb5+ and replace Bi5+, reducing 6s holes conduction from Bi5+(6s0) to Bi3+ (6s2). The thermoelectric power factor S2σ has values of 6×10-8-3×10-5 W m-1 K-2 in the measured temperature range, and is maximized for an Sb-undoped BaBiO3-δ, but decreases upon Sb doping due to the decreased σ values.

Thermal conversion of Cu4O3 into CuO and Cu2O and the electrical properties of magnetron sputtered Cu4O3 thin films

NASA Astrophysics Data System (ADS)

Murali, Dhanya S.; Aryasomayajula, Subrahmanyam

2018-03-01

Among the three oxides of copper (CuO, Cu2O, and Cu4O3), Cu4O3 phase (paramelaconite is a natural, and very scarce mineral) is very difficult to synthesize. It contains copper in both + 1 and + 2 valence states, with an average composition Cu2 1+Cu2 2+O3. We have successfully synthesized Cu4O3 phase at room temperature (300 K) by reactive DC magnetron sputtering by controlling the oxygen flow rate (Murali and Subrahmanyam in J Phys D Appl Phys 49:375102, 2016). In the present communication, Cu4O3 thin films are converted to CuO phases by annealing in the air at 680 K and to Cu2O phase when annealed in argon at 720 K; these phase changes are confirmed by temperature-dependent Raman spectroscopy studies. Probably, this is the first report of the conversion of Cu4O3-CuO and Cu2O by thermal annealing. The temperature-dependent (300-200 K) electrical transport properties of Cu4O3 thin films show that the charge transport above 190 K follows Arrhenius-type behavior with activation energy of 0.14 eV. From photo-electron spectroscopy and electrical transport measurements of Cu4O3 thin films, a downward band bending is observed at the surface of the thin film, which shows its p-type semiconducting nature. The successful preparation of phase pure p-type semiconducting Cu4O3 could provide opportunities to further explore its potential applications.

Towards eradication of inappropriate therapies for ICD lead failure by combining comprehensive remote monitoring and lead noise alerts.

PubMed

Ploux, Sylvain; Swerdlow, Charles D; Strik, Marc; Welte, Nicolas; Klotz, Nicolas; Ritter, Philippe; Haïssaguerre, Michel; Bordachar, Pierre

2018-06-02

Recognition of implantable cardioverter defibrillator (ICD) lead malfunction before occurrence of life threatening complications is crucial. We aimed to assess the effectiveness of remote monitoring associated or not with a lead noise alert for early detection of ICD lead failure. From October 2013 to April 2017, a median of 1,224 (578-1,958) ICD patients were remotely monitored with comprehensive analysis of all transmitted materials. ICD lead failure and subsequent device interventions were prospectively collected in patients with (RMLN) and without (RM) a lead noise alert (Abbott Secure Sense™ or Medtronic Lead Integrity Alert™) in their remote monitoring system. During a follow-up of 4,457 patient years, 64 lead failures were diagnosed. Sixty-one (95%) of the diagnoses were made before any clinical complication occurred. Inappropriate shocks were delivered in only one patient of each group (3%), with an annual rate of 0.04%. All high voltage conductor failures were identified remotely by a dedicated impedance alert in 10 patients. Pace-sense component failures were correctly identified by a dedicated alert in 77% (17 of 22) of the RMLN group versus 25% (8 of 32) of the RM group (P = 0.002). The absence of a lead noise alert was associated with a 16-fold increase in the likelihood of initiating either a shock or ATP (OR: 16.0, 95% CI 1.8-143.3; P = 0.01). ICD remote monitoring with systematic review of all transmitted data is associated with a very low rate of inappropriate shocks related to lead failure. Dedicated noise alerts further reduce inappropriate detection of ventricular arrhythmias. © 2018 Wiley Periodicals, Inc.

Increased confidence to engage in physical exertion: older ICD recipients' experiences of participating in an exercise training programme.

PubMed

Morken, Ingvild Margreta; Norekvål, Tone M; Isaksen, Kjetil; Munk, Peter S; Karlsen, Bjørg; Larsen, Alf I

2013-06-01

Research suggests that exercise training (ET) programmes may improve both physical and psychosocial functioning in implantable cardioverter defibrillator (ICD) recipients. Most of this research has been conducted by means of quantitative methods. However, knowledge of older ICD recipients' experiences of participating in such programmes is sparse. There is thus a need for more detailed qualitative data from the perspective of older patients. To describe older ICD recipients' experiences of participating in an ET programme. A qualitative design with semistructured interviews involving 12 older ICD recipients who had participated in a 3-month ET programme. Mini-disc recordings of the interviews were transcribed verbatim and analysed using content analysis. The analysis revealed two major themes: (1) 'increased confidence to engage in physical exertion'; and (2) 'increased satisfaction with life'. The first theme is illustrated by three subthemes: 'perceived support from physiotherapists', 'perceiving the heart rate monitor as a motivation to exercise', and 'perceiving peers as motivators for enjoyment and making the effort to exercise'. The second theme was illustrated by the following subthemes: 'perceived psychosocial benefits', 'perceived physical benefits', and 'exercise as a new health habit'. The findings indicate that exercising in a cardiac rehabilitation centre together with peers and supervised by skilled healthcare professionals may increase motivation to exert oneself, leading to emotional and physical benefits as well as a more social and active lifestyle for older ICD recipients.

Prognostic value of tumor-infiltrating lymphocytes differs depending on histological type and smoking habit in completely resected non-small-cell lung cancer.

PubMed

Kinoshita, T; Muramatsu, R; Fujita, T; Nagumo, H; Sakurai, T; Noji, S; Takahata, E; Yaguchi, T; Tsukamoto, N; Kudo-Saito, C; Hayashi, Y; Kamiyama, I; Ohtsuka, T; Asamura, H; Kawakami, Y

2016-11-01

T-cell infiltration in tumors has been used as a prognostic tool in non-small-cell lung cancer (NSCLC). However, the influence of smoking habit and histological type on tumor-infiltrating lymphocytes (TILs) in NSCLC remains unclear. We evaluated the prognostic significance of TILs (CD4 + , CD8 + , CD20 + , and FOXP3 + ) according to histological type and smoking habit using automatic immunohistochemical staining and cell counting in 218 patients with NSCLC. In multivariate survival analyses of clinical, pathological, and immunological factors, a high ratio of FOXP3 + to CD4 + T cells (FOXP3/CD4) [hazard ratio (HR): 4.46, P < 0.01 for overall survival (OS); HR: 1.96, P < 0.05 for recurrence-free survival (RFS)] and a low accumulation of CD20 + B cells (HR: 2.45, P = 0.09 for OS; HR: 2.86, P < 0.01 for RFS) were identified as worse prognostic factors in patients with adenocarcinoma (AD). In non-AD, a low number of CD8 + T cells were correlated with an unfavorable outcome (HR: 7.69, P < 0.01 for OS; HR: 3.57, P < 0.02 for RFS). Regarding smoking habit in AD, a high FOXP3/CD4 ratio was poorly prognostic with a smoking history (HR: 5.21, P < 0.01 for OS; HR: 2.38, P < 0.03 for RFS), whereas a low accumulation of CD20 + B cells (HR: 4.54, P = 0.03 for OS; HR: 2.94, P < 0.01 for RFS) was confirmed as an unfavorable factor in non-smokers with AD. A low number of CD8 + T cells in non-AD, a high FOXP3/CD4 ratio in smokers with AD, and a low number of CD20 + B cells in non-smokers with AD were identified as independent unfavorable prognostic factors in resected NSCLC. Evaluating the influence of histological type and smoking habit on the immunological environment may lead to the establishment of immunological diagnosis and appropriate individualized immunotherapy for NSCLC. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

T-wave loop area from a pre-implant 12-lead ECG is associated with appropriate ICD shocks

PubMed Central

Hnatkova, Katerina; Friede, Tim; Malik, Marek; Zabel, Markus

2017-01-01

Aims In implantable cardioverter-defibrillator (ICD) patients, predictors of ICD shocks and mortality are needed to improve patient selection. Electrocardiographic (ECG) markers are simple to obtain and have been demonstrated to predict mortality. We aimed to assess the association of T-wave loop area and circularity with ICD shocks. Methods The study investigated patients with ICDs implanted between 1998 and 2010 for whom digital 12-lead ECGs (Schiller CS200 ECG-Network) of sufficient quality were obtained within 1 month prior to the implantation. T-wave loop area and circularity were calculated. Follow-up data of appropriate shocks were obtained during ICD clinic visits that included reviews of device stored electrograms. Results A total of 605 patients (82% males) were included; 68% had ischemic cardiomyopathy and 72% were treated for primary prevention. Over 3.8±1.4 years of follow-up, 114 patients (19%) experienced appropriate shock(s). Those with smaller T-wave loop area received fewer shocks (TLA, hazard ratio, HR, per increase of 1 technical unit, 0.71; [95% confidence interval, 0.53–0.94]; P = 0.02) and those with larger T-wave loop circularity (TLC) representing rounder T wave loop received more shocks (HR per 1% TLC increase 2.96; [0.85–10.36]; P = 0.09). When the quartile containing the largest TLA and TLC values, respectively, were compared to the remaining cases, TLA remained significantly associated with fewer and TLC with more frequent shocks also after multivariate adjustment for clinical variables (HR, 0.59 [0.35–0.99], P = 0.044; and 1.64 [1.08–2.49], P = 0.021, respectively). Conclusions The size and shape of the T-wave loop calculated from pre-implantation 12-lead ECGs are associated with appropriate ICD shocks. PMID:28291831

DSM-5 AND ICD-11 DEFINITIONS OF POSTTRAUMATIC STRESS DISORDER: INVESTIGATING “NARROW” AND “BROAD” APPROACHES

PubMed Central

Stein, Dan J.; McLaughlin, Katie A.; Koenen, Karestan C.; Atwoli, Lukoye; Friedman, Matthew J.; Hill, Eric D.; Maercker, Andreas; Petukhova, Maria; Shahly, Victoria; van Ommeren, Mark; Alonso, Jordi; Borges, Guilherme; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia; Karam, Elie G.; Kawakami, Norito; Matschinger, Herbert; Okoliyski, Michail; Posada-Villa, Jose; Scott, Kate M.; Viana, Maria Carmen; Kessler, Ronald C.

2014-01-01

Background The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. Methods WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSMIV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. Results A total of 5.6% of respondents met criteria for “broadly defined” PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. Conclusions These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies. PMID:24894802

Patterns in lung cancer incidence rates and trends by histologic type in the United States, 2004-2009.

PubMed

Houston, Keisha A; Henley, S Jane; Li, Jun; White, Mary C; Richards, Thomas B

2014-10-01

The examination of lung cancer by histology type is important for monitoring population trends that have implications for etiology and prevention, screening and clinical diagnosis, prognosis and treatment. We provide a comprehensive description of recent histologic lung cancer incidence rates and trends in the USA using combined population-based registry data for the entire nation. Histologic lung cancer incidence data was analyzed from CDC's National Program of Cancer Registries (NPCR) and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program. Standardized rates and trends were calculated for men and women by age, race/ethnicity, and U.S. Census region. Rate ratios were examined for differences in rates between men and women, and annual percent change was calculated to quantify changes in incidence rates over time. Trend analysis demonstrate that overall rates have decreased, but incidence has remained stable for women aged 50 or older. Adenocarcinoma and squamous cell carcinoma were the two most common histologic subtypes. Adenocarcinoma rates continued to increase in men and women, and squamous cell rates increased in women only. All histologic subtype rates for white women exceeded rates for black women. Histologic rates for black men exceeded those for white men, except for small cell carcinoma. The incidence rate for Hispanics was nearly half the rate for blacks and whites. The continuing rise in incidence of lung adenocarcinoma, the rise of squamous cell cancer in women, and differences by age, race, ethnicity and region points to the need to better understand factors acting in addition to, or in synergy with, cigarette smoking that may be contributing to observed differences in lung cancer histology. Published by Elsevier Ireland Ltd.

Comparison of ICD-9-based, retrospective, and prospective assessments of perioperative complications: assessment of accuracy in reporting.

PubMed

Campbell, Peter G; Malone, Jennifer; Yadla, Sanjay; Chitale, Rohan; Nasser, Rani; Maltenfort, Mitchell G; Vaccaro, Alex; Ratliff, John K

2011-01-01

large studies of ICD-9-based complication and hospital-acquired condition (HAC) chart reviews have not been validated through a comparison with prospective assessments of perioperative adverse event occurrence. Retrospective chart review, while generally assumed to underreport complication occurrence, has not been subjected to prospective study. It is unclear whether ICD-9-based population studies are more accurate than retrospective reviews or are perhaps equally susceptible to bias. To determine the validity of an ICD-9-based assessment of perioperative complications, the authors compared a prospective independent evaluation of such complications with ICD-9-based HAC data in a cohort of patients who underwent spine surgery. For further comparison, a separate retrospective review of the same cohort of patients was completed as well. a prospective assessment of complications in spine surgery over a 6-month period (May to December 2008) was completed using an independent auditor and a validated definition of perioperative complications. The auditor maintained a prospective database, which included complications occurring in the initial 30 days after surgery. All medical adverse events were included in the assessment. All patients undergoing spine surgery during the study period were eligible for inclusion; the only exclusionary criterion used was the availability of the auditor for patient assessment. From the overall patient database, 100 patients were randomly extracted for further review; in these patients ICD-9-based HAC data were obtained from coder data. Separately, a retrospective assessment of complication incidence was completed using chart and electronic medical record review. The same definition of perioperative adverse events and the inclusion of medical adverse events were applied in the prospective, ICD-9-based, and retrospective assessments. ninety-two patients had adequate records for the ICD-9 assessment, whereas 98 patients had adequate chart

The 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden.

PubMed

Nilsson, Johan; Östling, Svante; Waern, Margda; Karlsson, Björn; Sigström, Robert; Guo, Xinxin; Skoog, Ingmar

2012-11-01

To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression. During 2005-2006, a comprehensive semistructured psychiatric interview was conducted by trained nurses in a representative population sample of 75-year-olds without dementia in Gothenburg, Sweden (N = 777; 299 men and 478 women). All psychiatric diagnoses were made according to DSM-IV. GAD was also diagnosed according to ICD-10 and DSM-V. The 1-month prevalence of GAD was 4.1% (N = 32) according to DSM-IV, 4.5% (N = 35) according to DSM-V, and 3.7% (N = 29) according to ICD-10. Only 46.9% of those with DSM-IV GAD fulfilled ICD-10 criteria, and only 51.7% and 44.8% of those with ICD-10 GAD fulfilled DSM-IV/V criteria. Instead, 84.4% and 74.3% of those with DSM-IV/V GAD and 89.7% of those with ICD-10 GAD had depression. Also other psychiatric diagnoses were common in those with ICD-10 and DSM-IV GAD. Only a small minority with GAD, irrespective of criteria, had no other comorbid psychiatric disorder. ICD-10 GAD was related to an increased mortality rate. While GAD was common in 75-year-olds, DSM-IV/V and ICD-10 captured different individuals. Current definitions of GAD may comprise two different expressions of the disease. There was greater congruence between GAD in either classification system and depression than between DSM-IV/V GAD and ICD-10 GAD, emphasizing the close link between these entities. 2012 American Association for Geriatric Psychiatry

Thermoelectric Properties and Microstructure of Ca3 Co 4 O 9 thin films on SrTiO3 and Al2 O 3 Substrates

NASA Astrophysics Data System (ADS)

Paulauskas, T.; Qiao, Q.; Gulec, A.; Klie, R. F.; Ozdemir, M.; Boyraz, C.; Mazumdar, D.; Gupta, A.

2011-03-01

Ca 3 Co 4 O9 (CCO), a misfit layered structure exhibiting large Seebeck coefficient at temperatures up to 1000K has attracted increasing attention as a novel high-temperature thermoelectric material. In this work, we investigate CCO thin films grown on SrTi O3 (001) and Al 2 O3 (0001) using pulsed laser deposition. Quality of the thin films was examined using high-resolution transmission electron microscopy and thermoelectric transport measurements. HRTEM images show incommensurate stacks of Cd I2 -type Co O2 layer alternating with rock-salt-type Ca 2 Co O3 layer along the c-axis. Perovskite buffer layer about 10nm thick was found present between CCO and SrTi O3 accompanied by higher density of stacking faults. The CCO grown on Al 2 O3 exhibited numerous misoriented grains and presence of Ca x Co O2 phase. Seebeck coefficient measurements yield an improvement for both samples compared to the bulk value. We suggest that thermoelectric properties of CCO increase due to additional phonon scattering at the stacking faults as well as at the film surfaces/interfaces. This research was supported by the US Army Research Office (W911NF-10-1-0147) and the Sivananthan Undergraduate Research Fellowship.

Custom fit 3D-printed brain holders for comparison of histology with MRI in marmosets.

PubMed

Guy, Joseph R; Sati, Pascal; Leibovitch, Emily; Jacobson, Steven; Silva, Afonso C; Reich, Daniel S

2016-01-15

MRI has the advantage of sampling large areas of tissue and locating areas of interest in 3D space in both living and ex vivo systems, whereas histology has the ability to examine thin slices of ex vivo tissue with high detail and specificity. Although both are valuable tools, it is currently difficult to make high-precision comparisons between MRI and histology due to large differences inherent to the techniques. A method combining the advantages would be an asset to understanding the pathological correlates of MRI. 3D-printed brain holders were used to maintain marmoset brains in the same orientation during acquisition of ex vivo MRI and pathologic cutting of the tissue. The results of maintaining this same orientation show that sub-millimeter, discrete neuropathological features in marmoset brain consistently share size, shape, and location between histology and ex vivo MRI, which facilitates comparison with serial imaging acquired in vivo. Existing methods use computational approaches sensitive to data input in order to warp histologic images to match large-scale features on MRI, but the new method requires no warping of images, due to a preregistration accomplished in the technique, and is insensitive to data formatting and artifacts in both MRI and histology. The simple method of using 3D-printed brain holders to match brain orientation during pathologic sectioning and MRI acquisition enables rapid and precise comparison of small features seen on MRI to their underlying histology. Published by Elsevier B.V.

Assessment of community contribution to the ICDS scheme in district Agra: a case study.

PubMed

Nayar, D; Kapil, U; Nandan, D

1999-01-01

This study was conducted to assess community contribution to the Integrated Child Development Services (ICDS) program, which promotes mother and child health in the Agra district, Uttar Pradesh, India. Three rural ICDS projects in the district were selected, out of which a total of 74 Anganwadi centers (AWCs) were chosen for the study. The Anganwadi workers (AWWs) were interviewed through a semi-structured questionnaire to assess the community¿s contribution during the previous 6 months. Results revealed that about 68% of AWWs had been able to receive assistance in bringing the children to the AWC. 53.3% had received free accommodation for AWC, and 42.6% had obtained assistance in implementation of health activities. Only 4% and 12% of the AWWs reported community assistance in the preparation and distribution of nutritional supplements, respectively. There had been no contribution received in terms of raw food for supplementary nutrition and fuel for cooking. The study concludes that rural area free accommodation for the AWC and community assistance in bringing children to the AWC were the most common forms of community contribution to the ICDS program.

Inappropriate shock and battery switching to "End of Life" in a patient with biventricular ICD during magnetic resonance imaging.

PubMed

Atar, İlyas; Bal, Uğur; Ertan, Çağatay; Özin, Bülent; Müderrisoğlu, Haldun

2016-01-01

Presence of a cardiac pacemaker or implantable cardioverter defibrillator (ICD) is a relative contraindication to magnetic resonance imaging (MRI). Biventricular ICDs are often used in the treatment of advanced heart failure; however, reports on experience with biventricular ICDs are lacking in the literature. In this case report, we describe a pacemaker-dependent patient with a biventricular ICD on whom an MRI of the lumbar spine was performed without having realized the presence of the ICD.

Three Diagnostic Systems for Autism: DSM-III, DSM-III-R, and ICD-10.

ERIC Educational Resources Information Center

Volkmar, Fred R.; And Others

1992-01-01

This paper compared clinicians' diagnosis and DSM-III (Diagnostic and Statistical Manual), DSM-III-R (Revised), and ICD-10 (International Classification of Diseases) diagnoses of 52 individuals with autism and 62 nonautistic, developmentally disordered individuals. The DSM-III-R system overdiagnosed the presence of autism, and ICD-10 closely…

Preliminary study of brain glucose metabolism changes in patients with lung cancer of different histological types.

PubMed

Li, Wei-Ling; Fu, Chang; Xuan, Ang; Shi, Da-Peng; Gao, Yong-Ju; Zhang, Jie; Xu, Jun-Ling

2015-02-05

Cerebral glucose metabolism changes are always observed in patients suffering from malignant tumors. This preliminary study aimed to investigate the brain glucose metabolism changes in patients with lung cancer of different histological types. One hundred and twenty patients with primary untreated lung cancer, who visited People's Hospital of Zhengzhou University from February 2012 to July 2013, were divided into three groups based on histological types confirmed by biopsy or surgical pathology, which included adenocarcinoma (52 cases), squamous cell carcinoma (43 cases), and small-cell carcinoma (25 cases). The whole body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) of these cases was retrospectively studied. The brain PET data of three groups were analyzed individually using statistical parametric maps (SPM) software, with 50 age-matched and gender-matched healthy controls for comparison. The brain resting glucose metabolism in all three lung cancer groups showed regional cerebral metabolic reduction. The hypo-metabolic cerebral regions were mainly distributed at the left superior and middle frontal, bilateral superior and middle temporal and inferior and middle temporal gyrus. Besides, the hypo-metabolic regions were also found in the right inferior parietal lobule and hippocampus in the small-cell carcinoma group. The area of the total hypo-metabolic cerebral regions in the small-cell carcinoma group (total voxel value 3255) was larger than those in the adenocarcinoma group (total voxel value 1217) and squamous cell carcinoma group (total voxel value 1292). The brain resting glucose metabolism in patients with lung cancer shows regional cerebral metabolic reduction and the brain hypo-metabolic changes are related to the histological types of lung cancer.

Deriving ICD-11 personality disorder domains from dsm-5 traits: initial attempt to harmonize two diagnostic systems.

PubMed

Bach, B; Sellbom, M; Kongerslev, M; Simonsen, E; Krueger, R F; Mulder, R

2017-07-01

The personality disorder domains proposed for the ICD-11 comprise Negative Affectivity, Detachment, Dissociality, Disinhibition, and Anankastia, which are reasonably concordant with the higher-order trait domains in the Alternative DSM-5 Model for Personality Disorders. We examined (i) whether designated DSM-5 trait facets can be used to describe the proposed ICD-11 trait domains, and (ii) how these ICD-11 trait features are hierarchically organized. A mixed Danish derivation sample (N = 1541) of 615 psychiatric out-patients and 925 community participants along with a US replication sample (N = 637) completed the Personality Inventory for DSM-5 (PID-5). Sixteen PID-5 traits were designated to cover features of the ICD-11 trait domains. Exploratory structural equation modeling (ESEM) analyzes showed that the designated traits were meaningfully organized in the proposed ICD-11 five-domain structure as well as other recognizable higher-order models of personality and psychopathology. Model fits revealed that the five proposed ICD-11 personality disorder domains were satisfactorily resembled, and replicated in the independent US sample. The proposed ICD-11 personality disorder domains can be accurately described using designated traits from the DSM-5 personality trait system. A scoring algorithm for the ICD-11 personality disorder domains is provided in appendix. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Wideband Arrhythmia-Insensitive-Rapid (AIR) Pulse Sequence for Cardiac T1 mapping without Image Artifacts induced by ICD

PubMed Central

Hong, KyungPyo; Jeong, Eun-Kee; Wall, T. Scott; Drakos, Stavros G.; Kim, Daniel

2015-01-01

Purpose To develop and evaluate a wideband arrhythmia-insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by implantable-cardioverter-defibrillator (ICD). Methods We developed a wideband AIR pulse sequence by incorporating a saturation pulse with wide frequency bandwidth (8.9 kHz), in order to achieve uniform T1 weighting in the heart with ICD. We tested the performance of original and “wideband” AIR cardiac T1 mapping pulse sequences in phantom and human experiments at 1.5T. Results In 5 phantoms representing native myocardium and blood and post-contrast blood/tissue T1 values, compared with the control T1 values measured with an inversion-recovery pulse sequence without ICD, T1 values measured with original AIR with ICD were considerably lower (absolute percent error >29%), whereas T1 values measured with wideband AIR with ICD were similar (absolute percent error <5%). Similarly, in 11 human subjects, compared with the control T1 values measured with original AIR without ICD, T1 measured with original AIR with ICD was significantly lower (absolute percent error >10.1%), whereas T1 measured with wideband AIR with ICD was similar (absolute percent error <2.0%). Conclusion This study demonstrates the feasibility of a wideband pulse sequence for cardiac T1 mapping without significant image artifacts induced by ICD. PMID:25975192

Multi-class texture analysis in colorectal cancer histology

NASA Astrophysics Data System (ADS)

Kather, Jakob Nikolas; Weis, Cleo-Aron; Bianconi, Francesco; Melchers, Susanne M.; Schad, Lothar R.; Gaiser, Timo; Marx, Alexander; Zöllner, Frank Gerrit

2016-06-01

Automatic recognition of different tissue types in histological images is an essential part in the digital pathology toolbox. Texture analysis is commonly used to address this problem; mainly in the context of estimating the tumour/stroma ratio on histological samples. However, although histological images typically contain more than two tissue types, only few studies have addressed the multi-class problem. For colorectal cancer, one of the most prevalent tumour types, there are in fact no published results on multiclass texture separation. In this paper we present a new dataset of 5,000 histological images of human colorectal cancer including eight different types of tissue. We used this set to assess the classification performance of a wide range of texture descriptors and classifiers. As a result, we found an optimal classification strategy that markedly outperformed traditional methods, improving the state of the art for tumour-stroma separation from 96.9% to 98.6% accuracy and setting a new standard for multiclass tissue separation (87.4% accuracy for eight classes). We make our dataset of histological images publicly available under a Creative Commons license and encourage other researchers to use it as a benchmark for their studies.

Morphometric and histological analysis of the lungs of Syrian golden hamsters.

PubMed Central

Kennedy, A R; Desrosiers, A; Terzaghi, M; Little, J B

1978-01-01

Hamster lung morphometry and histology have been studied in an attempt to determine differences between hamster and human lungs which may have relevance for lung carcinogenesis studies. Morphometric measurements were made on fresh lungs, lung casts, and histological sections. Cell type and frequency measurements were determined from frozen, paraffin, 1 micron plastic (glycol methacrylate) and electron microscopic sections. A standard terminology for hamster lung histology is established, and differences between hamster and human lung morphometry and histology are discussed. Images Fig. 2 Fig. 3 Fig. 4 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 22 PMID:640957

[Coding in general practice-Will the ICD-11 be a step forward?

PubMed

Kühlein, Thomas; Virtanen, Martti; Claus, Christoph; Popert, Uwe; van Boven, Kees

2018-07-01

Primary care physicians in Germany don't benefit from coding diagnoses-they are coding for the needs of others. For coding, they mostly are using either the thesaurus of the German Institute of Medical Documentation and Information (DIMDI) or self-made cheat-sheets. Coding quality is low but seems to be sufficient for the main use case of the resulting data, which is the morbidity adjusted risk compensation scheme that distributes financial resources between the many German health insurance companies.Neither the International Classification of Diseases and Health Related Problems (ICD-10) nor the German thesaurus as an interface terminology are adequate for coding in primary care. The ICD-11 itself will not recognizably be a step forward from the perspective of primary care. At least the browser database format will be advantageous. An implementation into the 182 different electronic health records (EHR) on the German market would probably standardize the coding process and make code finding easier. This method of coding would still be more cumbersome than the current coding with self-made cheat-sheets.The first steps towards a useful official cheat-sheet for primary care have been taken, awaiting implementation and evaluation. The International Classification of Primary Care (ICPC-2) already provides an adequate classification standard for primary care that can also be used in combination with ICD-10. A new version of ICPC (ICPC-3) is under development. As the ICPC-2 has already been integrated into the foundation layer of ICD-11 it might easily become the future standard for coding in primary care. Improving communication between the different EHR would make taking over codes from other healthcare providers possible. Another opportunity to improve the coding quality might be creating use cases for the resulting data for the primary care physicians themselves.

ICD-11 complex PTSD among Israeli male perpetrators of intimate partner violence: Construct validity and risk factors.

PubMed

Gilbar, Ohad; Hyland, Philip; Cloitre, Marylene; Dekel, Rachel

2018-03-01

The International Classification of Diseases 11th Version (ICD-11) will include Complex Posttraumatic Stress Disorder (CPTSD) as a unique diagnostic entity comprising core PTSD and DSO (disturbances in self-organization) symptoms. The current study had three aims: (1) assessing the validity of CPTSD in a unique population of male perpetrators of intimate partner violence; (2) examining whether exposure to different types of traumatic events would be associated with the two proposed CPTSD factors, namely PTSD or DSO; and (3) assessing the differential association of various sociodemographic and symptom characteristics with each factor. Participants were 234 males drawn randomly from a sample of 2600 men receiving treatment at 66 domestic violence centers in Israel. Data were collected using the International Trauma Questionnaire (ITQ) - Hebrew version. Confirmatory factor analysis supported the factorial validity of ICD-11 CPTSD. Cumulative lifetime trauma and physical childhood neglect were associated with PTSD and DSO, while cumulative childhood violence exposure was associated only with DSO. Anxiety was associated only with DSO; depression more strongly with DSO than PTSD. Religious level contributed only to PTSD; compulsory military service only to DSO. The study supports the distinction between PTSD and DSO in the CPTSD construct and introduces the role of cultural variables. Copyright © 2018 Elsevier Ltd. All rights reserved.

Physical and electrical properties of SrTiO3 and SrZrO3

NASA Astrophysics Data System (ADS)

Fashren Muhamad, Norhizatol; Aina Maulat Osman, Rozana; Sobri Idris, Mohd; Yasin, Mohd Najib Mohd

2017-11-01

Perovskite type oxide strontium titanate (SrTiO3) and strontium zirconate (SrZrO3) ceramic powder has been synthesized using conventional solid state reaction method. The powders were mixed and ground undergone calcinations at 1400°C for 12 h and sintered at 1550°C for 5h. X-ray Diffraction exposes physical properties SrTiO3 which exhibit cubic phase (space group: pm-3m) at room temperature meanwhile SrZrO3 has Orthorhombic phase (space group: pnma). The electrical properties such as dielectric constant (ɛr), dielectric loss (tan δ), and conductivity (σ) were studied in variation temperature and frequency. High dielectric constant of SrTiO3 and SrZrO3 were observed at 10 kHz for both samples about 240 and 21 respectively at room temperature. The dielectric loss of SrTiO3 and SrZrO3 is very low loss value approximately 0.00076 and 0.67512 indicates very good dielectric.

A natural language based search engine for ICD10 diagnosis encoding.

PubMed

Baud, Robert

2004-01-01

We have developed a multiple step process for implementing an ICD10 search engine. The complexity of the task has been shown and we recommend collecting adequate expertise before starting any implementation. Underestimation of the expert time and inadequate data resources are probable reasons for failure. We also claim that when all conditions are met in term of resource and availability of the expertise, the benefits of a responsive ICD10 search engine will be present and the investment will be successful.

Synthesis and properties of γ-Ga2O3-Al2O3 solid solutions

NASA Astrophysics Data System (ADS)

Afonasenko, T. N.; Leont'eva, N. N.; Talzi, V. P.; Smirnova, N. S.; Savel'eva, G. G.; Shilova, A. V.; Tsyrul'nikov, P. G.

2017-10-01

The textural and structural properties of mixed oxides Ga2O3-Al2O3, obtained via impregnating γ-Al2O3 with a solution of Ga(NO3)3 and subsequent heat treatment, are studied. According to the results from X-ray powder diffraction, gallium ions are incorporated into the structure of aluminum oxide to form a solid solution of spinel-type γ-Ga2O3-Al2O3 up to a Ga2O3 content of 50 wt % of the total weight of the sample, accompanied by a reduction in the specific surface area, volume, and average pore diameter. It is concluded that when the Ga2O3 content exceeds 50 wt %, the β-Ga2O3 phase is observed along with γ-Ga2O3-Al2O3 solid solution. 71Ga and 27Al NMR spectroscopy shows that gallium replaces aluminum atoms from the tetrahedral position to the octahedral coordination in the structure of γ-Ga2O3-Al2O3.

Critical Evaluations and Thermodynamic Optimizations of the MnO-Mn2O3-SiO2 and FeO-Fe2O3-MnO-Mn2O3-SiO2 Systems

NASA Astrophysics Data System (ADS)

Kang, Youn-Bae; Jung, In-Ho

2017-06-01

A critical evaluation and thermodynamic modeling for thermodynamic properties of all oxide phases and phase diagrams in the Fe-Mn-Si-O system (MnO-Mn2O3-SiO2 and FeO-Fe2O3-MnO-Mn2O3-SiO2 systems) are presented. Optimized Gibbs energy parameters for the thermodynamic models of the oxide phases were obtained which reproduce all available and reliable experimental data within error limits from 298 K (25°C) to above the liquidus temperatures at all compositions covering from known oxide phases, and oxygen partial pressure from metal saturation to 0.21 bar. The optimized thermodynamic properties and phase diagrams are believed to be the best estimates presently available. Slag (molten oxide) was modeled using the modified quasichemical model in the pair approximation. Olivine (Fe2SiO4-Mn2SiO4) was modeled using two-sublattice model in the framework of the compound energy formalism (CEF), while rhodonite (MnSiO3-FeSiO3) and braunite (Mn7SiO_{12} with excess Mn2O3) were modeled as simple Henrian solutions. It is shown that the already developed models and databases of two spinel phases (cubic- and tetragonal-(Fe, Mn)3O4) using CEF [Kang and Jung, J. Phys. Chem. Solids (2016), vol. 98, pp. 237-246] can successfully be integrated into a larger thermodynamic database to be used in practically important higher order system such as silicate. The database of the model parameters can be used along with a software for Gibbs energy minimization in order to calculate any type of phase diagram section and thermodynamic properties.

Array-type NH.sub.3 sensor

DOEpatents

West, David Lawrence; Montgomery, Frederick Charles; Armstrong, Timothy R; Warmack, Robert J

2013-12-31

An array-type sensor that senses NH.sub.3 includes non-Nernstian sensing elements constructed from metal and/or metal-oxide electrodes on an O.sub.2 ion conducting substrate. In one example sensor, one electrode may be made of platinum, another electrode may be made of manganese (III) oxide (Mn.sub.2O.sub.3), and another electrode may be made of tungsten trioxide (WO.sub.3). Some sensing elements may further include an electrode made of La.sub.0.6Sr.sub.0.4Co.sub.0.2Fe.sub0.8O.sub.3 and another electrode made of LaCr.sub.0.95.Mg.sub.0.05O.sub.3.

Protein biomarkers identify patients unlikely to benefit from primary prevention implantable cardioverter defibrillators: findings from the Prospective Observational Study of Implantable Cardioverter Defibrillators (PROSE-ICD).

PubMed

Cheng, Alan; Zhang, Yiyi; Blasco-Colmenares, Elena; Dalal, Darshan; Butcher, Barbara; Norgard, Sanaz; Eldadah, Zayd; Ellenbogen, Kenneth A; Dickfeld, Timm; Spragg, David D; Marine, Joseph E; Guallar, Eliseo; Tomaselli, Gordon F

2014-12-01

Primary prevention implantable cardioverter defibrillators (ICDs) reduce all-cause mortality, but the benefits are heterogeneous. Current risk stratification based on left ventricular ejection fraction has limited discrimination power. We hypothesize that biomarkers for inflammation, neurohumoral activation, and cardiac injury can predict appropriate shocks and all-cause mortality in patients with primary prevention ICDs. The Prospective Observational Study of Implantable Cardioverter Defibrillators (PROSe-ICD) enrolled 1189 patients with systolic heart failure who underwent ICD implantation for primary prevention of sudden cardiac death. The primary end point was an ICD shock for adjudicated ventricular tachyarrhythmia. The secondary end point was all-cause mortality. After a median follow-up of 4.0 years, 137 subjects experienced an appropriate ICD shock and 343 participants died (incidence rates of 3.2 and 5.8 per 100 person-years, respectively). In multivariable-adjusted models, higher interleukin-6 levels increased the risk of appropriate ICD shocks. In contrast, C-reactive protein, interleukin-6, tumor necrosis factor-α receptor II, pro-brain natriuretic peptide (pro-BNP), and cardiac troponin T showed significant linear trends for increased risk of all-cause mortality across quartiles. A score combining these 5 biomarkers identified patients who were much more likely to die than to receive an appropriate shock from the ICD. An increase in serum biomarkers of inflammation, neurohumoral activation, and myocardial injury increased the risk for death but poorly predicted the likelihood of an ICD shock. These findings highlight the potential importance of serum-based biomarkers in identifying patients who are unlikely to benefit from primary prevention ICDs. clinicaltrials.gov; Unique Identifier: NCT00733590. © 2014 American Heart Association, Inc.

Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11.

PubMed

Marras, Anna; Fineberg, Naomi; Pallanti, Stefano

2016-08-01

Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.

Application of V2O5/WO3/TiO2 for Resistive-Type SO2 Sensors

PubMed Central

Izu, Noriya; Hagen, Gunter; Schönauer, Daniela; Röder-Roith, Ulla; Moos, Ralf

2011-01-01

A study on the application of V2O5/WO3/TiO2 (VWT) as the sensitive material for resistive-type SO2 sensor was conducted, based on the fact that VWT is a well-known catalyst material for good selective catalytic nitrogen oxide reduction with a proven excellent durability in exhaust gases. The sensors fabricated in this study are planar ones with interdigitated electrodes of Au or Pt. The vanadium content of the utilized VWT is 1.5 or 3.0 wt%. The resistance of VWT decreases with an increasing SO2 concentration in the range from 20 ppm to 5,000 ppm. The best sensor response to SO2 occurs at 400 °C using Au electrodes. The sensor response value is independent on the amount of added vanadium but dependent on the electrode materials at 400 °C. These results are discussed and a sensing mechanism is discussed. PMID:22163780

Persisting malnutrition in Chandigarh: decadal underweight trends and impact of ICDS program.

PubMed

Thakur, Jarnail Singh; Prinja, Shankar; Bhatia, Satpal Singh

2011-04-01

Decline in malnutrition levels has been dismal since the 1990s. We ascertained decadal trend in childhood nutritional status between 1997 and 2007 in Chandigarh, India and assessed impact of Integrated Child Development Services (ICDS) on childhood undernutrition. A total of 803 under-five children, 547 children between 12-23 months age, and 218 women with an infant child were recruited for the study. Findings of present study were compared with another methodologically similar study (1997) from Chandigarh and Reproductive and Child Health Rapid Household Survey (1998) to draw decadal trends. Prevalence of underweight among under-five children remained almost stagnant in the last one decade from 51.6%; (1997) to 50.4%; (2007). There was insignificant difference (P=0.3) in prevalence of underweight among children registered under ICDS program (52.1%;) and those not registered (48.4%;) in 2007. Other health and service provision indicators had mixed results in the past decade. Health services utilization was poorest in urban slums.

How well do the DSM-5 alcohol use disorder designations map to the ICD-10 disorders?

PubMed

Hoffmann, Norman G; Kopak, Albert M

2015-04-01

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10), both establish diagnostic criteria for alcohol use disorders. The dimensional severity perspective provided by the DSM-5 may overlap in important ways but also may diverge from the categorical harmful use versus dependence designations presented by the ICD-10. It is especially important to consider the convergence of these 2 diagnostic approaches as the DSM is widely used by clinicians, but the U.S. Centers for Medicare and Medicaid Services has recently required that providers bill for services using the ICD-10 designations. Data from 6,871 male and 801 female admissions to a state prison system were used to compare the DSM-5 severity index for alcohol use disorder to the ICD-10 clinical and research formulations for harmful use and dependence. The DSM-5 and the ICD-10 were highly convergent for the most severe alcohol use disorders and also for those who did not receive a diagnosis. Most DSM-5 moderate alcohol use disorder cases were classified as dependence cases under both the clinical and research ICD criteria. In contrast, there was much more variation in the DSM mild cases. These were divided into categories of harmful use or misuse, depending on whether the clinical or research ICD criteria were applied. Results were similar among male and female inmates. The DSM-5 and ICD-10 exhibit a high level of agreement for cases that would not receive a diagnosis as well as the most severe cases. However, there are important distinctions to be made between the 2 approaches for mild and moderate DSM disorders in addition to harmful use/misuse cases in the ICD. The cases influenced by these discrepancies are most likely to be affected by recently implemented service provider billing practices. Copyright © 2015 by the Research Society on Alcoholism.

CADDIS Volume 5. Causal Databases: Interactive Conceptual Diagrams (ICDs)

EPA Pesticide Factsheets

In Interactive Conceptual Diagram (ICD) section of CADDIS allows users to create conceptual model diagrams, search a literature-based evidence database, and then attach that evidence to their diagrams.

Formation mechanism of Ruddlesden-Popper-type antiphase boundaries during the kinetically limited growth of Sr rich SrTiO3 thin films

PubMed Central

Xu, Chencheng; Du, Hongchu; van der Torren, Alexander J. H.; Aarts, Jan; Jia, Chun-Lin; Dittmann, Regina

2016-01-01

We elucidated the formation process for Ruddlesden-Popper-type defects during pulsed laser deposition of Sr rich SrTiO3 thin films by a combined analysis of in-situ atomic force microscopy, low energy electron diffraction and high resolution scanning transmission electron microscopy. At the early growth stage of 1.5 unit cells, the excess Sr results in the formation of SrO on the surface, resulting in a local termination change from TiO2 to SrO, thereby forming a Sr rich (2 × 2) surface reconstruction. With progressive SrTiO3 growth, islands with thermodynamically stable SrO rock-salt structure are formed, coexisting with TiO2 terminated islands. During the overgrowth of these thermodynamically stable islands, both lateral as well as vertical Ruddlesden-Popper-type anti-phase boundaries are formed, accommodating the Sr excess of the SrTiO3 film. We suggest the formation of thermodynamically stable SrO rock-salt structures as origin for the formation of Ruddlesden-Popper-type antiphase boundaries, which are as a result of kinetic limitations confined to certain regions on the surface. PMID:27922069

Formation mechanism of Ruddlesden-Popper-type antiphase boundaries during the kinetically limited growth of Sr rich SrTiO3 thin films

NASA Astrophysics Data System (ADS)

Xu, Chencheng; Du, Hongchu; van der Torren, Alexander J. H.; Aarts, Jan; Jia, Chun-Lin; Dittmann, Regina

2016-12-01

We elucidated the formation process for Ruddlesden-Popper-type defects during pulsed laser deposition of Sr rich SrTiO3 thin films by a combined analysis of in-situ atomic force microscopy, low energy electron diffraction and high resolution scanning transmission electron microscopy. At the early growth stage of 1.5 unit cells, the excess Sr results in the formation of SrO on the surface, resulting in a local termination change from TiO2 to SrO, thereby forming a Sr rich (2 × 2) surface reconstruction. With progressive SrTiO3 growth, islands with thermodynamically stable SrO rock-salt structure are formed, coexisting with TiO2 terminated islands. During the overgrowth of these thermodynamically stable islands, both lateral as well as vertical Ruddlesden-Popper-type anti-phase boundaries are formed, accommodating the Sr excess of the SrTiO3 film. We suggest the formation of thermodynamically stable SrO rock-salt structures as origin for the formation of Ruddlesden-Popper-type antiphase boundaries, which are as a result of kinetic limitations confined to certain regions on the surface.

Subcutaneous ICD screening with the Boston Scientific ZOOM programmer versus a 12-lead ECG machine.

PubMed

Chang, Shu C; Patton, Kristen K; Robinson, Melissa R; Poole, Jeanne E; Prutkin, Jordan M

2018-02-24

The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires preimplant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12-lead electrocardiogram (ECG) machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. Subjects were recruited if they had a transvenous single-lead ICD without pacing requirements or were candidates for a new ICD. Screening was performed using both a Boston Scientific ZOOM programmer (Marlborough, MA, USA) and General Electric MAC 5000 ECG machine (Fairfield, CT, USA). A pass was defined as having at least one lead that fit within the screening template in both supine and sitting positions. A total of 69 subjects were included and 27 sets of ECG leads had differing screening results between the two machines (7%). Of these sets, 22 (81%) passed using the ECG machine but failed using the programmer and five (19%) passed using the ECG machine but failed using the programmer (P < 0.001). Four subjects (6%) passed screening using the ECG machine but failed using the programmer. No subject passed screening with the programmer but failed with the ECG machine. There can be occasional disagreement in S-ICD patient screening between an ICD programmer and ECG machine, all of whom passed with the ECG machine but failed using the programmer. On a per lead basis, the ECG machine passes more subjects. It is unknown what the inappropriate shock rate would be if an S-ICD was implanted. Clinical judgment should be used in borderline cases. © 2018 Wiley Periodicals, Inc.

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter-defibrillator in swine

PubMed Central

KILLINGSWORTH, CHERYL R.; MELNICK, SHARON B.; LITOVSKY, SILVIO H.; IDEKER, RAYMOND E.; WALCOTT, GREGORY P.

2013-01-01

Background A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. Methods During sinus rhythm, anesthetized pigs (38±6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24-hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semi-quantitative scoring. Results Troponin I was significantly elevated at 4- and 24-hours (22.6±16.3 and 3.1±1.3 ng/ml; baseline 0.07±0.09 ng/ml) in control pigs but not in S-ICD pigs (0.12±0.11 and 0.13±0.13 ng/ml; baseline 0.06±0.03 ng/ml). CK-MM was significantly elevated in S-ICD pigs after shocks (6544±1496 and 9705±6240 U/L; baseline 704±398 U/L) but not in controls. ECG changes occurred post-shock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Conclusion Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. PMID:23713608

Epidemiological changes in the histological subtypes of 35,018 non-small-cell lung cancer cases in Brazil.

PubMed

Costa, Guilherme; Thuler, Luiz Claudio Santos; Ferreira, Carlos Gil

2016-07-01

Regarding the fatality rates stemming from various existing forms of cancers worldwide, lung cancer (LC) is ranked as the main cause of death amongst those who suffer from cancer. Although the epidemiological, clinical, and histological profile of patients with this type of cancer is largely unknown, Brazil has made tremendous efforts to generate data for supporting healthcare policies concerning lung cancer. Taking these factors into account, this study aims to analyse the epidemiological, clinical, and histological profiles of patients with non-small-cell lung cancer (NSCLC) in Brazil. For this study, a cross-sectional epidemiological study was conducted to nationally analyse patient's data within the cancer hospital registries found in the National Cancer Institute (INCA) and the São Paulo Cancer Foundation (FOSP) between 2000 and 2011. A total of 35,018 patients diagnosed with NSCLC in Brazil between 2000 and 2011 were analysed. The analysis demonstrated the occurrence of an epidemiological shift, related to the most prevalent histological type of NSCLC in the study population from 2003. The shift resulted in a higher percentage of adenocarcinoma (43.3%) over squamous cell carcinoma (36.5%). Additionally, there was a significant increase in both the number of cases of LC in women and in the rates of patients diagnosed with metastatic disease. The use of filtered cigarettes since the 60's and the increase in the number of LC cases in women, were one of the causes for the switch in the histological profile of NSCLC in Brazil. Consequently, adenocarcinoma is now the predominant type of cancer detected. Late diagnosis is a hallmark sign. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Safety of mid-septal electrode placement in implantable cardioverter defibrillator recipients--results of the SPICE (Septal Positioning of ventricular ICD Electrodes) study.

PubMed

Kolb, Christof; Solzbach, Ulrich; Biermann, Jürgen; Semmler, Verena; Kloppe, Axel; Klein, Norbert; Lennerz, Carsten; Szendey, Istvan; Andrikopoulos, George; Tzeis, Stylianos; Asbach, Stefan

2014-07-01

Detrimental effects of right ventricular (RV) apical pacing have directed the interest toward alternative pacing sites such as the RV mid-septum. As safety data are scarce for implantable cardioverter defibrillator (ICD) recipients the study aims to evaluate ICD lead performance in the mid-septal position. A total of 299 ICD recipients (79% male, aged 65.2 ± 12.1 years, 83% primary prevention of sudden cardiac death) were randomized to receive the RV ICD electrode either in a mid-septal (n=145) or apical (n=154) location. Event-free survival was evaluated at 3 (primary endpoint) and 12 months (secondary endpoint). Events included a composite of lead revision, suboptimal right ventricular electrode performance (including defibrillation thresholds (DFT)>25 J) or lead position not in accordance with randomized location. Event-free survival at 3 (12) months was observed in 80.6% (72.3%) of patients randomized to a mid-septal and in 82.2% (72.1%) of patients randomized to an apical lead position, p=0.726 (p=0.969). Pre-defined margins for non-inferiority were not reached at 3 or 12 months. High DFT was found in 7 patients (5.0%) of the mid-septal and in 3 (2.2%) patients of the apical group (p=0.209). In ICD recipients electrode positioning to the RV mid-septum or the RV apex results in slightly different rates concerning the survival free of lead revision, suboptimal right ventricular electrode performance or non-randomized lead position. Non-inferiority of the mid-septal lead location cannot be concluded. This should be taken into consideration when a mid-septal lead position is pursued. ClinicalTrials.gov identifier NCT00745745. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Gastritis: the histology report.

PubMed

Rugge, Massimo; Pennelli, Gianmaria; Pilozzi, Emanuela; Fassan, Matteo; Ingravallo, Giuseppe; Russo, Valentina M; Di Mario, Francesco

2011-03-01

Gastritis is defined as inflammation of the gastric mucosa. In histological terms, it is distinguishable into two main categories, i.e. non-atrophic and atrophic. In the gastric mucosa, atrophy is defined as the loss of appropriate glands. There are several etiological types of gastritis, their different etiology being related to different clinical manifestations and pathological features. Atrophic gastritis (resulting mainly from long-standing Helicobacter pylori infection) is a major risk factor for the onset of (intestinal type) gastric cancer. The extent and site of the atrophic changes correlate significantly with the cancer risk. The current format for histology reporting in cases of gastritis fails to establish an immediate link between gastritis phenotype and risk of malignancy. Building on current knowledge of the biology of gastritis, an international group of pathologists [Operative Link for Gastritis Assessment (OLGA)] has proposed a system for reporting gastritis in terms of its stage (the OLGA Staging System): this system places the histological phenotypes of gastritis on a scale of progressively increasing gastric cancer risk, from the lowest (Stage 0) to the highest (Stage IV). The aim of this tutorial is to provide unequivocal information on how to standardize histology reports on gastritis in diagnostic practice. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

Strain Coupling of Conversion-type Fe 3O 4 Thin Films for Lithium Ion Batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hwang, Sooyeon; Meng, Qingping; Chen, Ping-Fan

2017-05-29

Lithiation/delithiation induces significant stresses and strains into the electrodes for lithium ion batteries, which can severely degrade their cycling performance. Moreover, this electrochemically induced strain can interact with the local strain existing at solid–solid interfaces. It is not clear how this interaction affects the lithiation mechanism. The effect of this coupling on the lithiation kinetics in epitaxial Fe 3O 4 thin film on a Nb-doped SrTiO 3 substrate is investigated. In-situ and ex-situ transmission electron microscopy (TEM) results show that the lithiation is suppressed by the compressive interfacial strain. At the interface between the film and substrate, the existence ofmore » Li xFe 3O 4 rock-salt phase during lithiation consequently restrains the film from delamination. 2D phase-field simulation verifies the effect of strain. This work provides critical insights of understanding the solid–solid interfaces of conversion-type electrodes.« less

42 CFR Appendix A to Part 81 - Glossary of ICD-9 Codes and Their Cancer Descriptions 1

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Glossary of ICD-9 Codes and Their Cancer.... 81, App. A Appendix A to Part 81—Glossary of ICD-9 Codes and Their Cancer Descriptions 1 ICD-9 code Cancer description 140 Malignant neoplasm of lip. 141 Malignant neoplasm of tongue. 142 Malignant...

Intratumoral histologic heterogeneity of gliomas. A quantitative study.

PubMed

Paulus, W; Peiffer, J

1989-07-15

Quantitative data for intratumoral histologic heterogeneity were obtained by investigating ten small and ten large punched samples from 50 unembedded supratentorial gliomas. The 1000 samples were diagnosed according to the World Health Organization (WHO) classification and six histopathologic features associated with malignancy were evaluated (cellular density, nuclear pleomorphism, necroses, histologic architecture, vessels, and mitoses), each with defined gradations. The slides were read independently by two observers. The initially high interobserver variability (grade, 22.2%; type, 10.3%; and tumor presence/absence, 7.1%) was for the most part due to intermediate grades and types and was reduced to 1.7% after mutual review. Small samples showed lower mean grade than large samples and more often absence of tumor (7.6% versus 2.4%). Of all gliomas, 48% showed differently typed samples, 82% differently graded samples, and 62% benign and malignant grades. Intratumoral heterogeneity was higher for the necroses than for the other histopathologic features. Our results underscore the importance of extensive tissue sampling.

The solid-solution region for the langasite-type Ca3TaGa3Si2O14 crystal as determined by a lever rule

NASA Astrophysics Data System (ADS)

Zhao, Hengyu; Uda, Satoshi; Maeda, Kensaku; Nozawa, Jun; Koizumi, Haruhiko; Fujiwara, Kozo

2015-04-01

A lever rule was applied to data concerning the compositions and proportions of secondary phases coexisting with a Ca3TaGa3Si2O14 (CTGS) matrix to determine the boundary compositions of the solid-solution region for CTGS at 1320 °C, as a means of ascertaining the solid-solution for the langasite-type phase in the quaternary CaO-Ta2O5-Ga2O3-SiO2 system. The compositions and proportions of secondary phases were assessed by electron probe micro-analysis as well as through back-scattered electron images. The experimental results showed that the narrow solid-solution region for CTGS is located in a Ta-poor, Ga-poor and Si-rich region relative to its stoichiometric composition.

[Breast cancer: histological prognosis from biopsy material].

PubMed

Veith, F; Picco, C

1977-01-01

Two histological factors to be taken into consideration for prognosis in pretreatment schedules of breast cancer have been studied on a group of 352 cases treated by non-mutilating therapeutics at the Fondation Curie between 1960 and 1970. The tumour material the slides of which we have reexamined "blindly", i.e. ignoring the evolution of the case had been obtained mostly by drill-biopsy. Histological groups and types have been determined following an analytical classification for computer purpose. The degree of malignancy was calculated with the method of Scarff-Bloom-Richardson. The analyzed data have been memorized on computer and then confronted with the elements of the T.N.M. classification and the survival of the patients involved. It appeared that if drill-biopsie have been performed correctly the histological type may be defined in eighty percent of cases. And it is likewise possible to calculate the histological grade of malignancy for each mammary cancer. With such a material the value for prognosis by means of the Scarff-Bloom-Richardson method still remains if applied only to adenocarcinoma of the "common infiltrating type".

Designing Air-Stable O 3-Type Cathode Materials by Combined Structure Modulation for Na-Ion Batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yao, Hu-Rong; Wang, Peng-Fei; Gong, Yue

As promising high-capacity cathode materials for Na-ion batteries, O 3-type Na-based metal oxides always suffer from their poor air stability originating from the spontaneous extraction of Na and oxidation of transition metals when exposed to air. Here, a combined structure modulation is proposed to tackle concurrently the two handicaps via reducing Na layers spacing and simultaneously increasing valence state of transition metals. Guided by density functional theory calculations, we demonstrate such a modulation can be subtly realized through cosubstitution of one kind of heteroatom with comparable electronegativity and another one with substantially different Fermi level, by adjusting the structure ofmore » NaNi 0.5Mn 0.5O 2 via Cu/Ti codoping. The as-obtained NaNi 0.45Cu 0.05Mn 0.4Ti 0.1O 2 exhibits an increase of 20 times in stable air-exposure period and 9 times in capacity retention after 500 cycles, and even retains its structure and capacity after being soaked in water. In such a simple and effective structure modulation reveals a new avenue for high-performance O 3-type cathodes and pushes the large-scale industrialization of Na-ion batteries a decisive step forward.« less

Designing Air-Stable O 3-Type Cathode Materials by Combined Structure Modulation for Na-Ion Batteries

DOE PAGES

Yao, Hu-Rong; Wang, Peng-Fei; Gong, Yue; ...

2017-06-09

As promising high-capacity cathode materials for Na-ion batteries, O 3-type Na-based metal oxides always suffer from their poor air stability originating from the spontaneous extraction of Na and oxidation of transition metals when exposed to air. Here, a combined structure modulation is proposed to tackle concurrently the two handicaps via reducing Na layers spacing and simultaneously increasing valence state of transition metals. Guided by density functional theory calculations, we demonstrate such a modulation can be subtly realized through cosubstitution of one kind of heteroatom with comparable electronegativity and another one with substantially different Fermi level, by adjusting the structure ofmore » NaNi 0.5Mn 0.5O 2 via Cu/Ti codoping. The as-obtained NaNi 0.45Cu 0.05Mn 0.4Ti 0.1O 2 exhibits an increase of 20 times in stable air-exposure period and 9 times in capacity retention after 500 cycles, and even retains its structure and capacity after being soaked in water. In such a simple and effective structure modulation reveals a new avenue for high-performance O 3-type cathodes and pushes the large-scale industrialization of Na-ion batteries a decisive step forward.« less

Wearable cardioverter defibrillator: a life vest till the life boat (ICD) arrives.

PubMed

Francis, Johnson; Reek, Sven

2014-01-01

It is well established that implantable cardioverter defibrillator (ICD) is a life saving device ensuring protection against life threatening ventricular arrhythmias. But there are certain situations like a recent myocardial infarction where the standard guidelines do not recommend the implantation of an ICD while the patient can still be at a risk of demise due to a life threatening ventricular arrhythmia. There could also be a temporary indication for protection while explanting an infected ICD system. The wearable cardioverter defibrillator (WCD) is a device which comes to the rescue in such situations. In this brief review, we discuss the historical aspects of the development of a WCD, technical aspects as well as the clinical trial data and real world scenario of its use. Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Multimodal-3D imaging based on μMRI and μCT techniques bridges the gap with histology in visualization of the bone regeneration process.

PubMed

Sinibaldi, R; Conti, A; Sinjari, B; Spadone, S; Pecci, R; Palombo, M; Komlev, V S; Ortore, M G; Tromba, G; Capuani, S; Guidotti, R; De Luca, F; Caputi, S; Traini, T; Della Penna, S

2018-03-01

Bone repair/regeneration is usually investigated through X-ray computed microtomography (μCT) supported by histology of extracted samples, to analyse biomaterial structure and new bone formation processes. Magnetic resonance imaging (μMRI) shows a richer tissue contrast than μCT, despite at lower resolution, and could be combined with μCT in the perspective of conducting non-destructive 3D investigations of bone. A pipeline designed to combine μMRI and μCT images of bone samples is here described and applied on samples of extracted human jawbone core following bone graft. We optimized the coregistration procedure between μCT and μMRI images to avoid bias due to the different resolutions and contrasts. Furthermore, we used an Adaptive Multivariate Clustering, grouping homologous voxels in the coregistered images, to visualize different tissue types within a fused 3D metastructure. The tissue grouping matched the 2D histology applied only on 1 slice, thus extending the histology labelling in 3D. Specifically, in all samples, we could separate and map 2 types of regenerated bone, calcified tissue, soft tissues, and/or fat and marrow space. Remarkably, μMRI and μCT alone were not able to separate the 2 types of regenerated bone. Finally, we computed volumes of each tissue in the 3D metastructures, which might be exploited by quantitative simulation. The 3D metastructure obtained through our pipeline represents a first step to bridge the gap between the quality of information obtained from 2D optical microscopy and the 3D mapping of the bone tissue heterogeneity and could allow researchers and clinicians to non-destructively characterize and follow-up bone regeneration. Copyright © 2017 John Wiley & Sons, Ltd.

The Utility and Challenges of Using ICD Codes in Child Maltreatment Research: A Review of Existing Literature

ERIC Educational Resources Information Center

Scott, Debbie; Tonmyr, Lil; Fraser, Jenny; Walker, Sue; McKenzie, Kirsten

2009-01-01

Objective: The objectives of this article are to explore the extent to which the International Statistical Classification of Diseases and Related Health Problems (ICD) has been used in child abuse research, to describe how the ICD system has been applied, and to assess factors affecting the reliability of ICD coded data in child abuse research.…

Reduced long-term overall mortality in heart failure patients with prolonged QRS treated with CRT combined with ICD vs. heart failure patients with narrow QRS treated with ICD only.

PubMed

Palmisano, Pietro; Accogli, Michele; Pisanò, Ennio Carmine Luigi; Zaccaria, Maria; De Blasi, Sergio; Ponzetta, Maria Antonietta; Valsecchi, Sergio; Milanese, Giovanni; Lauretti, Maurelio; Magliari, Francesco

2016-09-01

It is not known whether heart failure (HF) patients with prolonged QRS who undergo cardiac resynchronization therapy combined with a defibrillator (CRT-D) have a prognostic advantage over HF patients with narrow QRS (therefore without indication for CRT) treated with an implantable cardioverter defibrillator (ICD) only. The aim of this study was to compare the long-term mortality of a group of HF patients with prolonged QRS receiving CRT-D with that of a similar group of patients with narrow QRS receiving ICD only. A total of 312 patients (mean age 66 ± 13 years; 84% male, mean left ventricular ejection fraction 25 ± 4%, mean New York Heart Association class 2.6 ± 0.5) were included in the analysis. Of these, 138 with a QRS complex duration ≥120 ms received a CRT-D. During follow-up, the time and cause of death were assessed. During a median follow-up of 46 months, CRT-D patients showed significantly lower overall mortality (P = 0.038). Compared with patients receiving ICD only, CRT-D patients showed lower HF mortality (P = 0.003). Coronary mortality, non-cardiac mortality, and sudden mortality were similar in both groups (all P > 0.05). A positive response to CRT was an independent predictor of reduced mortality on multivariate analysis (hazard ratio: 0.27; P = 0.047). In HF patients treated with ICD, the subgroup of patients with prolonged QRS who receive CRT-D displays better long-term survival than narrow QRS ICD recipients, owing to their reduced HF mortality. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Influence of CaCO3 and SiO2 additives on magnetic properties of M-type Sr ferrites

NASA Astrophysics Data System (ADS)

Huang, Ching-Chien; Jiang, Ai-Hua; Hung, Yung-Hsiung; Liou, Ching-Hsuan; Wang, Yi-Chen; Lee, Chi-Ping; Hung, Tong-Yin; Shaw, Chun-Chung; Kuo, Ming-Feng; Cheng, Chun-Hu

2018-04-01

An experiment was carried out to investigate the influence of CaCO3 and SiO2 additives on the magnetic and physical properties of M-type Sr ferrites by changing experimental parameters such as the additive composition and Ca/Si ratio. Specimens were prepared by conventional ceramic techniques. It was found that the magnetic properties (Br = 4.42 kG, iHc = 3.32 kOe and (BH)max = 4.863 MGOe) were considerably improved upon adding CaCO3 = 1.1% and SiO2 = 0.4 wt% together with Co3O4, and the mechanical properties thereof were acceptable for motor applications. It was revealed that CaCO3 and SiO2 additives led to an upswing in the magnetic properties via the enhancement of uniform grain growth, particle alignment, and the densification of Sr ferrite.

Strategic Mobility 21 Initial Capabilities Document (ICD)

DTIC Science & Technology

2006-07-28

MANDATORY ARCHITECTURE FRAMWORK DOCUMENT .......................................A-1 APPENDIX B: REFERENCES...Document July 27, 2006 JPPSP ICD Version 1.0 A-1 APPENDIX A: MANDATORY ARCHITECTURE FRAMWORK DOCUMENT Legend next page. Initial Capabilities...SM21 will combine several end-to-end Force Projection Process enablers. Some of the enablers described below are at the conceptual stage while others

Catatonia from its creation to DSM-V: Considerations for ICD.

PubMed

Fink, Max

2011-07-01

Catatonia was delineated only as a type of schizophrenia in the many American Psychiatric Association DSM classifications and revisions from 1952 until 1994 when "catatonia secondary to a medical condition" was added. Since the 1970s the diagnosis of catatonia has been clarified as a syndrome of rigidity, posturing, mutism, negativism, and other motor signs of acute onset. It is found in about 10% of psychiatric hospital admissions, in patients with depressed and manic mood states and in toxic states. It is quickly treatable to remission by benzodiazepines and by ECT. The DSM-V revision proposes catatonia in two major diagnostic classes, specifiers for 10 principal diagnoses, and deletion of the designation of schizophrenia, catatonic type. This complex recommendation serves no clinical or research purpose and confuses treatment options. Catatonia is best considered in the proposed ICD revision as a unique syndrome of multiple forms warranting a single unique defined class similar to that of delirium.

Suppressing the chromium disproportionation reaction in O3-type layered cathode materials for high capacity sodium-ion batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cao, Ming -Hui; Wang, Yong; Shadike, Zulipiya

Chromium-based layered cathode materials suffer from the irreversible disproportionation reaction of Cr 4+ to Cr 3+ and Cr 6+, which hinders the reversible multi-electron redox of Cr ions in layered cathodes, and limits their capacity and reversibility. To address this problem, a novel O3-type layer-structured transition metal oxide of NaCr 1/3Fe 1/3Mn 1/3O 2 (NCFM) was designed and studied as a cathode material. A high reversible capacity of 186 mA h g –1 was achieved at a current rate of 0.05C in a voltage range of 1.5 to 4.2 V. X-ray diffraction revealed an O3 → (O3 + P3) →more » (P3 + O3'') → O3'' phase-transition pathway for NCFM during charge. X-ray absorption, X-ray photoelectron and electron energy-loss spectroscopy measurements revealed the electronic structure changes of NCFM during Na + deintercalation/intercalation processes. It is confirmed that the disproportionation reaction of Cr 4+ to Cr 3+ and Cr 6+ can be effectively suppressed by Fe 3+ and Mn 4+ substitution. Lastly, these results demonstrated that the reversible multi-electron oxidation/reduction of Cr ions can be achieved in NCFM during charge and discharge accompanied by CrO 6 octahedral distortion and recovery.« less

Suppressing the chromium disproportionation reaction in O3-type layered cathode materials for high capacity sodium-ion batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cao, Ming-Hui; Wang, Yong; Shadike, Zulipiya

Chromium-based layered cathode materials suffer from the irreversible disproportionation reaction of Cr4+ to Cr3+ and Cr6+, which hinders the reversible multi-electron redox of Cr ions in layered cathodes, and limits their capacity and reversibility. To address this problem, a novel O3-type layer-structured transition metal oxide of NaCr1/3Fe1/3Mn1/3O2 (NCFM) was designed and studied as a cathode material. A high reversible capacity of 186 mA h g-1 was achieved at a current rate of 0.05C in a voltage range of 1.5 to 4.2 V. X-ray diffraction revealed an O3 → (O3 + P3) → (P3 + O3'') → O3'' phase-transition pathway formore » NCFM during charge. X-ray absorption, X-ray photoelectron and electron energy-loss spectroscopy measurements revealed the electronic structure changes of NCFM during Na+ deintercalation/intercalation processes. It is confirmed that the disproportionation reaction of Cr4+ to Cr3+ and Cr6+ can be effectively suppressed by Fe3+ and Mn4+ substitution. These results demonstrated that the reversible multi-electron oxidation/reduction of Cr ions can be achieved in NCFM during charge and discharge accompanied by CrO6 octahedral distortion and recovery.« less

Suppressing the chromium disproportionation reaction in O3-type layered cathode materials for high capacity sodium-ion batteries

DOE PAGES

Cao, Ming -Hui; Wang, Yong; Shadike, Zulipiya; ...

2017-02-14

Chromium-based layered cathode materials suffer from the irreversible disproportionation reaction of Cr 4+ to Cr 3+ and Cr 6+, which hinders the reversible multi-electron redox of Cr ions in layered cathodes, and limits their capacity and reversibility. To address this problem, a novel O3-type layer-structured transition metal oxide of NaCr 1/3Fe 1/3Mn 1/3O 2 (NCFM) was designed and studied as a cathode material. A high reversible capacity of 186 mA h g –1 was achieved at a current rate of 0.05C in a voltage range of 1.5 to 4.2 V. X-ray diffraction revealed an O3 → (O3 + P3) →more » (P3 + O3'') → O3'' phase-transition pathway for NCFM during charge. X-ray absorption, X-ray photoelectron and electron energy-loss spectroscopy measurements revealed the electronic structure changes of NCFM during Na + deintercalation/intercalation processes. It is confirmed that the disproportionation reaction of Cr 4+ to Cr 3+ and Cr 6+ can be effectively suppressed by Fe 3+ and Mn 4+ substitution. Lastly, these results demonstrated that the reversible multi-electron oxidation/reduction of Cr ions can be achieved in NCFM during charge and discharge accompanied by CrO 6 octahedral distortion and recovery.« less

The Bi{sub 2}O{sub 3}–Fe{sub 2}O{sub 3}–Sb{sub 2}O{sub 5} system phase diagram refinement, Bi{sub 3}FeSb{sub 2}O{sub 11} structure peculiarities and magnetic properties

DOE Office of Scientific and Technical Information (OSTI.GOV)

Egorysheva, A.V., E-mail: anna_egorysheva@rambler.ru; Ellert, O.G.; Gajtko, O.M.

2015-05-15

The refinement of the Bi{sub 2}O{sub 3}–Fe{sub 2}O{sub 3}–Sb{sub 2}O{sub 5} system phase diagram has been performed and the existence of the two ternary compounds has been confirmed. The first one with a pyrochlore-type structure (sp. gr. Fd 3-barm) exists in the wide solid solution region, (Bi{sub 2−x}Fe{sub x})Fe{sub 1+y}Sb{sub 1−y}O{sub 7±δ}, where x=0.1–0.4 and y=−0.13–0.11. The second one, Bi{sub 3}FeSb{sub 2}O{sub 11}, corresponds to the cubic KSbO{sub 3}-type structure (sp. gr. Pn 3-bar) with unit cell parameter a=9.51521(2) Å. The Rietveld structure refinement showed that this compound is characterized by disordered structure. The Bi{sub 3}FeSb{sub 2}O{sub 11} factor groupmore » analysis has been carried out and a Raman spectrum has been investigated. According to magnetization measurements performed at the temperature range 2–300 K it may be concluded that the Bi{sub 3}FeSb{sub 2}O{sub 11} magnetic properties can be substantially described as a superposition of strong short-range antiferromagnetic exchange interactions realizing inside the [(FeSb{sub 2})O{sub 9}] 3D-framework via different pathways. - Graphical abstract: The refinement of the Bi{sub 2}O{sub 3}–Fe{sub 2}O{sub 3}–Sb{sub 2}O{sub 5} system phase diagram has been performed and the existence of the solid solution with a pyrochlore-type structure (sp. gr. Fd 3-barm) and Bi{sub 3}FeSb{sub 2}O{sub 11}, correspond of the cubic KSbO{sub 3}-type structure (sp. gr. Pn 3-bar has been confirmed. The structure refinement, Raman spectroscopy as well as magnetic measurements data of Bi{sub 3}FeSb{sub 2}O{sub 11} are presented. - Highlights: • The Bi{sub 2}O{sub 3}–Fe{sub 2}O{sub 3}–Sb{sub 2}O{sub 5} system phase diagram refinement has been performed. • The Bi{sub 3}FeSb{sub 2}O{sub 11} existence along with pyrochlore structure compound is shown. • It was determined that the Bi{sub 3}FeSb{sub 2}O{sub 11} is of disordered cubic KSbO{sub 3}-type structure. • Factor group

Phase compatibilities of YBa2Cu3O(9-delta) type structure in quintenary systems Y-Ba-Cu-O-X (impurity)

NASA Technical Reports Server (NTRS)

Karen, P.; Fjellvag, H.; Kjekshus, A.

1990-01-01

Electrical transport properties of the oxidic high T(sub c) superconductors are significantly affected by the presence of minor amounts of various elements adventing as impurities, e.g., from the chemical environment during manufacturing. YBa2Cu3O(9-delta) is prone to an extinction of the superconductivity on (partial) substitution of all four elemental components. E.g., Pr (for Y), La (for Ba), Zn (for Cu) or peroxygroup (for O) substituents will alter some of the superconductivity preconditions, like mixed valence state in Cu3O7/O(9-delta) network or structural distortion of the network. Although various pseudoternary chemical equilibrium phase diagrams of the Y(O)-Ba(O)-Cu(O) system now are available, no consensus is generally shown, however, this is partly due to lack of compatible definitions of the equilibrium conditions. Less information is available about the phase compatibilities in the appropriate quaternary phase diagram (including oxygen) and virtually no information exists about any pentenary phase diagrams (including one impurity). Unfortunately, complexity of such systems, stemming both from number of quaternary or pentenary compounds and from visualizing the five-component phase system, limits this presentation to more or less close surroundings of the YBa2Cu3O(9-delta) type phase in appropriate pseudoquaternary or pseudopseudoternary diagrams, involving Y-Ba-Cu and O, O-CO2, alkaline metals, Mg and alkaline earths, and Sc and most of the 3-d and 4-f elements. The systems were investigated by means of x ray diffraction, neutron diffraction and chemical analytical methods on samples prepared by sol-gel technique from citrates. The superconductivity was characterized by measuring the diamagnetic susceptibility by SQUID.

Projected impact of the ICD-10-CM/PCS conversion on longitudinal data and the Joint Commission Core Measures.

PubMed

Fenton, Susan H; Benigni, Mary Sue

2014-01-01

The transition from ICD-9-CM to ICD-10-CM/PCS is expected to result in longitudinal data discontinuities, as occurred with cause-of-death in 1999. The General Equivalence Maps (GEMs), while useful for suggesting potential maps do not provide guidance regarding the frequency of any matches. Longitudinal data comparisons can only be reliable if they use comparability ratios or factors which have been calculated using records coded in both classification systems. This study utilized 3,969 de-identified dually coded records to examine raw comparability ratios, as well as the comparability ratios between the Joint Commission Core Measures. The raw comparability factor results range from 16.216 for Nicotine dependence, unspecified, uncomplicated to 118.009 for Chronic obstructive pulmonary disease, unspecified. The Joint Commission Core Measure comparability factor results range from 27.15 for Acute Respiratory Failure to 130.16 for Acute Myocardial Infarction. These results indicate significant differences in comparability between ICD-9-CM and ICD-10-CM code assignment, including when the codes are used for external reporting such as the Joint Commission Core Measures. To prevent errors in decision-making and reporting, all stakeholders relying on longitudinal data for measure reporting and other purposes should investigate the impact of the conversion on their data.

Magnetic properties of solid solutions between BiCrO3 and BiGaO3 with perovskite structures

NASA Astrophysics Data System (ADS)

Belik, Alexei A.

2015-04-01

Magnetic properties of BiCr1-xGaxO3 perovskite-type solid solutions are reported, and a magnetic phase diagram is established. As-synthesized BiCrO3 and BiCr0.9Ga0.1O3 crystallize in a monoclinic (m) C2/c structure. The Néel temperature (TN) decreases from 111 K in BiCrO3 to 98 K in BiCr0.9Ga0.1O3, and spin-reorientation transition temperature increases from 72 K in BiCrO3 to 83 K in BiCr0.9Ga0.1O3. o-BiCr0.9Ga0.1O3 with a PbZrO3-type orthorhombic structure is obtained by heating m-BiCr0.9Ga0.1O3 up to 573 K in air; it shows similar magnetic properties with those of m-BiCr0.9Ga0.1O3. TN of BiCr0.8Ga0.2O3 is 81 K, and TN of BiCr0.7Ga0.3O3 is 63 K. Samples with x = 0.4, 0.5, 0.6 and 0.7 crystallize in a polar R3c structure. Long-range antiferromagnetic order with weak ferromagnetism is observed below TN = 56 K in BiCr0.6Ga0.4O3, TN = 36 K in BiCr0.5Ga0.5O3 and TN = 18 K in BiCr0.4Ga0.6O3. BiCr0.3Ga0.7O3 shows a paramagnetic behaviour because the Cr concentration is below the percolation threshold of 31%.

Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in DSM-5 and ICD-11: Clinical and Behavioral Correlates.

PubMed

Hyland, Philip; Shevlin, Mark; Fyvie, Claire; Karatzias, Thanos

2018-04-01

The American Psychiatric Association and the World Health Organization provide distinct trauma-based diagnoses in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), and the forthcoming 11th version of the International Classification of Diseases (ICD-11), respectively. The DSM-5 conceptualizes posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas the ICD-11 proposes two "sibling" disorders: PTSD and complex PTSD (CPTSD). The objectives of the current study were to: (a) compare prevalence rates of PTSD/CPTSD based on each diagnostic system; (b) identify clinical and behavioral variables that distinguish ICD-11 CPTSD and PTSD diagnoses; and (c) examine the diagnostic associations for ICD-11 CPTSD and DSM-5 PTSD. Participants in a predominately female clinical sample (N = 106) completed self-report scales to measure ICD-11 PTSD and CPTSD, DSM-5 PTSD, and depression, anxiety, borderline personality disorder, dissociation, destructive behaviors, and suicidal ideation and self-harm. Significantly more people were diagnosed with PTSD according to the DSM-5 criteria (90.4%) compared to those diagnosed with PTSD and CPTSD according to the ICD-11 guidelines (79.8%). An ICD-11 CPTSD diagnosis was distinguished from an ICD-11 PTSD diagnosis by higher levels of dissociation (d = 1.01), depression (d = 0.63), and borderline personality disorder (d = 0.55). Diagnostic associations with depression, anxiety, and suicidal ideation and self-harm were higher for ICD-11 CPTSD compared to DSM-5 PTSD (by 10.7%, 4.0%, and 7.0%, respectively). These results have implications for differential diagnosis and for the development of targeted treatments for CPTSD. Copyright © 2018 International Society for Traumatic Stress Studies.

Structural and thermoelectric properties of n-type Sr1- x Ti x MnO3- δ perovskite system

NASA Astrophysics Data System (ADS)

Kim, C. M.; Seo, J. W.; Choi, S.-M.; Seo, W.-S.; Lee, S.; Lim, Y. S.; Park, K.

2015-03-01

A series of Sr1- x Ti x MnO3- δ (0.05 ≤ x ≤ 0.3) was fabricated by the solid-state reaction method. We studied the structural and thermoelectric properties of Sr1- x Ti x MnO3- δ , with respect to the partial substitution of Ti4+ for Sr2+. The sintered Sr1- x Ti x MnO3- δ crystallized in the hexagonal perovskite-type structure with a space group of P6 3 / mmc. For x ≤ 0.1, the partial substitution of Ti4+ for Sr2+ led to increases in the electrical conductivity and the absolute value of the Seebeck coefficient, thus enhancing the power factor. The highest power factor (2.5 × 10-5 Wm-1K-2) was obtained for Sr0.9Ti0.1MnO3- δ at 800°C. The partial substitution of Ti4+ for Sr2+ in SrMnO3- δ led to a significant improvement in the thermoelectric properties. [Figure not available: see fulltext.

Isolated limb perfusion for the management limb threatening soft tissue sarcomas: The role of histological type on clinical outcomes.

PubMed

Rastrelli, M; Mocellin, S; Stramare, R; Brunello, A; Maruzzo, M; Basso, U; Scarzello, G; Buzzaccarini, M S; Pilati, P; Saadeh, L M; Del Fiore, S P; Tosi, A; Montesco, C; Campana, L G; Tropea, S; Rossi, C R

2017-02-01

Hyperthermic isolated limb perfusion (HILP) is an effective neoadjuvant treatment to avoid amputation in patients with locally advanced extremity soft tissue sarcomas (STS). We aimed to investigate whether STS histological type plays a role in predicting clinical outcomes. This study reports a retrospective analysis of 125 patients with limb threatening STS (liposarcoma, n = 41; malignant peripheral nerve sheath tumor, n = 20; leiomyosarcoma, n = 20; miscellany, n = 44), who underwent HILP from 1990 through 2015 at our institution. The following endpoints were evaluated: tumor response (assessed by radiological imaging and histology), limb sparing rate, local progression-free survival (LPFS) and overall survival (OS). On average, overall (complete + partial) tumor response was significantly greater in patients affected with liposarcoma as compared to those with other histotypes (radiological response rate: 38/41, 92.7% vs 66/84, 78.6%, P-value: 0.048; mean histological necrosis: 83.6% vs 52.9%, P < 0.0001). Limb sparing rate was also higher among patients with liposarcoma as compared to other histotypes (39/41, 95.1% vs 62/84, 73.8%, P-value: 0.005). As regards survival, LPFS was similar across tumor types, whereas OS resulted significantly worse in patients with limb leiomyosarcoma (log-rank P-value: 0.009). HILP is a very effective treatment modality for limb threatening STS. In our series, liposarcoma appears to be the histological type most sensitive to HILP in terms of tumor response and thus limb sparing, which might help clinicians in the patient selection process. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Developing 3D microscopy with CLARITY on human brain tissue: Towards a tool for informing and validating MRI-based histology.

PubMed

Morawski, Markus; Kirilina, Evgeniya; Scherf, Nico; Jäger, Carsten; Reimann, Katja; Trampel, Robert; Gavriilidis, Filippos; Geyer, Stefan; Biedermann, Bernd; Arendt, Thomas; Weiskopf, Nikolaus

2017-11-28

Recent breakthroughs in magnetic resonance imaging (MRI) enabled quantitative relaxometry and diffusion-weighted imaging with sub-millimeter resolution. Combined with biophysical models of MR contrast the emerging methods promise in vivo mapping of cyto- and myelo-architectonics, i.e., in vivo histology using MRI (hMRI) in humans. The hMRI methods require histological reference data for model building and validation. This is currently provided by MRI on post mortem human brain tissue in combination with classical histology on sections. However, this well established approach is limited to qualitative 2D information, while a systematic validation of hMRI requires quantitative 3D information on macroscopic voxels. We present a promising histological method based on optical 3D imaging combined with a tissue clearing method, Clear Lipid-exchanged Acrylamide-hybridized Rigid Imaging compatible Tissue hYdrogel (CLARITY), adapted for hMRI validation. Adapting CLARITY to the needs of hMRI is challenging due to poor antibody penetration into large sample volumes and high opacity of aged post mortem human brain tissue. In a pilot experiment we achieved transparency of up to 8 mm-thick and immunohistochemical staining of up to 5 mm-thick post mortem brain tissue by a combination of active and passive clearing, prolonged clearing and staining times. We combined 3D optical imaging of the cleared samples with tailored image processing methods. We demonstrated the feasibility for quantification of neuron density, fiber orientation distribution and cell type classification within a volume with size similar to a typical MRI voxel. The presented combination of MRI, 3D optical microscopy and image processing is a promising tool for validation of MRI-based microstructure estimates. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Predictive Validity of ICD-11 PTSD as Measured by the Impact of Event Scale-Revised: A 15-Year Prospective Study of Political Prisoners.

PubMed

Hyland, Philip; Brewin, Chris R; Maercker, Andreas

2017-04-01

The 11 th edition of the International Classification of Diseases (ICD-11; World Health Organization, 2017) proposes a model of posttraumatic stress disorder (PTSD) that includes 6 symptoms. This study assessed the ability of a classification-independent measure of posttraumatic stress symptoms, the Impact of Event Scale-Revised (Weiss & Marmar, 1996), to capture the ICD-11 model of PTSD. The current study also provided the first assessment of the predictive validity of ICD-11 PTSD. Former East German political prisoners were assessed in 1994 (N = 144) and in 2008-2009 (N = 88) on numerous psychological variables using self-report measures. Of the participants, 48.2% and 36.8% met probable diagnosis for ICD-11 PTSD at the first and second assessments, respectively. Confirmatory factor analysis supported the factorial validity of the 3-factor ICD-11 model of PTSD, as represented by items selected from the Impact of Event Scale-Revised. Hierarchical multiple regression analysis demonstrated that, controlling for sex, the symptom clusters of ICD-11 PTSD (reexperiencing, avoidance, and sense of threat) significantly contributed to the explanation of depression (R 2 = .17), quality of life (R 2 = .21), internalized anger (R 2 = .10), externalized anger (R 2 = .12), hatred of perpetrators (R 2 = .15), dysfunctional disclosure (R 2 = .27), and social acknowledgment as a victim (R 2 = .12) across the 15-year study period. Current findings add support for the factorial and predictive validity of ICD-11 PTSD within a unique cohort of political prisoners. Copyright © 2017 International Society for Traumatic Stress Studies.

A comparison of DSM-III-R and ICD-10 personality disorder criteria in an out-patient population.

PubMed

Sara, G; Raven, P; Mann, A

1996-01-01

This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of these disorders and the need for reliable diagnostic criteria, such a comparison has not previously been reported. DSM-III-R and ICD-10 have converged in their classification of personality disorders, but some important differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using the Standardized Assessment of Personality (SAP), a brief, informant-based interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diagnosis that had an equivalent form in both systems, but only 10 subjects (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly more personality disorder diagnoses. The lower diagnostic threshold of the ICD-10 contributed most of this effect. Further modifications in ICD-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personality disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshold in ICD-10 DCR, do seem to have been helpful in promoting convergence.

[CH(3)(CH(2))(11)NH(3)]SnI(3): a hybrid semiconductor with MoO(3)-type tin(II) iodide layers.

PubMed

Xu, Zhengtao; Mitzi, David B

2003-10-20

The organic-inorganic hybrid [CH(3)(CH(2))(11)NH(3)]SnI(3) presents a lamellar structure with a Sn-I framework isotypic to that of MoO(3). The SnI(3)(-) layer consists of edge and corner-sharing SnI(6) octahedra in which one of the six Sn-I bonds is distinctly elongated (e.g., 3.62 A), indicating lone-pair stereoactivity for the Sn(II) atom. The overall electronic character remains comparable with that of the well-studied SnI(4)(2)(-)-based perovskite semiconductors, such as [CH(3)(CH(2))(11)NH(3)](2)SnI(4), with a red-shifted and broadened exciton peak associated with the band gap, apparently due to the increased dimensionality of the Sn-I framework. The title compound offers, aside from the hybrid perovskites, a new type of solution-processable Sn-I network for potential applications in semiconductive devices.

Fabrication and assembly of two-dimensional TiO2/WO3·H2O heterostructures with type II band alignment for enhanced photocatalytic performance

NASA Astrophysics Data System (ADS)

Xu, Tao; Wang, Yun; Zhou, Xiaofang; Zheng, Xiaoli; Xu, Qun; Chen, Zhimin; Ren, Yumei; Yan, Bo

2017-05-01

The recombination of photo-induced charges is one of the main issues to limit the large-scale applications in photocatalysis and photoelectrocatalysis. To improve the charge separation, we fabricate a novel type II 2D ultrathin TiO2/WO3·H2O heterostructures with the assistance of supercritical CO2 (SC CO2) in this work. The as-fabricated heterostructures possess high photocatalytic activity for the degradation of methyl orange(MO) and high photocurrent response under simulated solar light (AM 1.5). For the TiO2/WO3·H2O heterostructures, the MO solution could be degraded by 95.5% in 150 min, and the photocurrent density reaches to 6.5 μA cm-2, exhibiting a significant enhancement compared with pure TiO2 and WO3·H2O nanosheets.

ICD-10 codes used to identify adverse drug events in administrative data: a systematic review.

PubMed

Hohl, Corinne M; Karpov, Andrei; Reddekopp, Lisa; Doyle-Waters, Mimi; Stausberg, Jürgen

2014-01-01

Adverse drug events, the unintended and harmful effects of medications, are important outcome measures in health services research. Yet no universally accepted set of International Classification of Diseases (ICD) revision 10 codes or coding algorithms exists to ensure their consistent identification in administrative data. Our objective was to synthesize a comprehensive set of ICD-10 codes used to identify adverse drug events. We developed a systematic search strategy and applied it to five electronic reference databases. We searched relevant medical journals, conference proceedings, electronic grey literature and bibliographies of relevant studies, and contacted content experts for unpublished studies. One author reviewed the titles and abstracts for inclusion and exclusion criteria. Two authors reviewed eligible full-text articles and abstracted data in duplicate. Data were synthesized in a qualitative manner. Of 4241 titles identified, 41 were included. We found a total of 827 ICD-10 codes that have been used in the medical literature to identify adverse drug events. The median number of codes used to search for adverse drug events was 190 (IQR 156-289) with a large degree of variability between studies in the numbers and types of codes used. Authors commonly used external injury (Y40.0-59.9) and disease manifestation codes. Only two papers reported on the sensitivity of their code set. Substantial variability exists in the methods used to identify adverse drug events in administrative data. Our work may serve as a point of reference for future research and consensus building in this area.

ICD-10 codes used to identify adverse drug events in administrative data: a systematic review

PubMed Central

Hohl, Corinne M; Karpov, Andrei; Reddekopp, Lisa; Stausberg, Jürgen

2014-01-01

Background Adverse drug events, the unintended and harmful effects of medications, are important outcome measures in health services research. Yet no universally accepted set of International Classification of Diseases (ICD) revision 10 codes or coding algorithms exists to ensure their consistent identification in administrative data. Our objective was to synthesize a comprehensive set of ICD-10 codes used to identify adverse drug events. Methods We developed a systematic search strategy and applied it to five electronic reference databases. We searched relevant medical journals, conference proceedings, electronic grey literature and bibliographies of relevant studies, and contacted content experts for unpublished studies. One author reviewed the titles and abstracts for inclusion and exclusion criteria. Two authors reviewed eligible full-text articles and abstracted data in duplicate. Data were synthesized in a qualitative manner. Results Of 4241 titles identified, 41 were included. We found a total of 827 ICD-10 codes that have been used in the medical literature to identify adverse drug events. The median number of codes used to search for adverse drug events was 190 (IQR 156–289) with a large degree of variability between studies in the numbers and types of codes used. Authors commonly used external injury (Y40.0–59.9) and disease manifestation codes. Only two papers reported on the sensitivity of their code set. Conclusions Substantial variability exists in the methods used to identify adverse drug events in administrative data. Our work may serve as a point of reference for future research and consensus building in this area. PMID:24222671

p-i-n heterojunctions with BiFeO3 perovskite nanoparticles and p- and n-type oxides: photovoltaic properties.

PubMed

Chatterjee, Soumyo; Bera, Abhijit; Pal, Amlan J

2014-11-26

We formed p-i-n heterojunctions based on a thin film of BiFeO3 nanoparticles. The perovskite acting as an intrinsic semiconductor was sandwiched between a p-type and an n-type oxide semiconductor as hole- and electron-collecting layer, respectively, making the heterojunction act as an all-inorganic oxide p-i-n device. We have characterized the perovskite and carrier collecting materials, such as NiO and MoO3 nanoparticles as p-type materials and ZnO nanoparticles as the n-type material, with scanning tunneling spectroscopy; from the spectrum of the density of states, we could locate the band edges to infer the nature of the active semiconductor materials. The energy level diagram of p-i-n heterojunctions showed that type-II band alignment formed at the p-i and i-n interfaces, favoring carrier separation at both of them. We have compared the photovoltaic properties of the perovskite in p-i-n heterojunctions and also in p-i and i-n junctions. From current-voltage characteristics and impedance spectroscopy, we have observed that two depletion regions were formed at the p-i and i-n interfaces of a p-i-n heterojunction. The two depletion regions operative at p-i-n heterojunctions have yielded better photovoltaic properties as compared to devices having one depletion region in the p-i or the i-n junction. The results evidenced photovoltaic devices based on all-inorganic oxide, nontoxic, and perovskite materials.

Observation of multiple dielectric relaxations in BaTiO3-Bi(Li1/3Ti2/3)O3 ceramics

NASA Astrophysics Data System (ADS)

Zhou, Changrong; Feteira, Antonio

2017-11-01

Dense (1 - x)BaTiO3- xBi(Li1/3Ti2/3)O3 ceramics were fabricated by the solid state reaction route. Powder X-ray diffraction analyses revealed an increase in the unit cell volume with increasing x and a change on the average crystal structure from tetragonal (space group P4mm) to cubic ( Pm\\bar{3}m ) at x > 0.10. Raman spectroscopy analyses corroborated a change of symmetry, but also showed the local structure for x > 0.10 to be inconsistent with the centrosymmetric ( Pm\\bar{3}m ) space group. The dielectric measurements revealed for the first time, to our knowledge, a double relaxor behaviour in a BaTiO3-based solid solution. Basically, with increasing x, the sharp ferroelectric anomaly at the Curie temperature ( T c) shifts towards lower temperatures until a relaxor-type response is observed, but simultaneously, another relaxation emerges above T c. The first arises from poor coupling between polar nanoregions, whereas the later obeys the Arrhenius Law and may be associated either with a defect-dipole reorientation or a Skanavi-type mechanism.

Mechanical writing of n-type conductive layers on the SrTiO3 surface in nanoscale

PubMed Central

Wang, Yuhang; Zhao, Kehan; Shi, Xiaolan; Li, Geng; Xie, Guanlin; Lai, Xubo; Ni, Jun; Zhang, Liuwan

2015-01-01

The fabrication and control of the conductive surface and interface on insulating SrTiO3 bulk provide a pathway for oxide electronics. The controllable manipulation of local doping concentration in semiconductors is an important step for nano-electronics. Here we show that conductive patterns can be written on bare SrTiO3 surface by controllable doping in nanoscale using the mechanical interactions of atomic force microscopy tip without applying external electric field. The conductivity of the layer is n-type, oxygen sensitive, and can be effectively tuned by the gate voltage. Hence, our findings have potential applications in oxide nano-circuits and oxygen sensors. PMID:26042679

Love-type surface acoustic wave on Y-X LiTaO3 with amorphous Ta2O5 thin film

NASA Astrophysics Data System (ADS)

Kakio, Shoji; Fukasawa, Haruka; Hosaka, Keiko

2015-07-01

In this study, to obtain a substrate structure with a lower phase velocity, the propagation properties of a Love-type surface acoustic wave (Love SAW) on Y-X LiTaO3 (LT) with an amorphous tantalum pentoxide (a-Ta2O5) thin film were investigated using a simple delay line and a resonator with a wavelength λ of 8 µm. The insertion loss of a simple delay line was decreased markedly by loading with an a-Ta2O5 film owing to a transformation from a leaky SAW (LSAW) to a non-leaky Love SAW. A phase velocity of 3,340 m/s, a coupling factor of 5.8%, and a propagation loss of 0.03 dB/λ were obtained for a normalized thickness h/λ of 0.120. Moreover, the resonance properties of the Love SAW were almost equal or superior to those for an LSAW on Al/36° Y-X LT, except for the fractional bandwidth.

Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11).

PubMed

Krueger, Richard B; Reed, Geoffrey M; First, Michael B; Marais, Adele; Kismodi, Eszter; Briken, Peer

2017-07-01

The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged with reviewing and making recommendations for categories related to sexuality that are contained in the chapter of Mental and Behavioural Disorders in ICD-10 (World Health Organization 1992a). Among these categories was the ICD-10 grouping F65, Disorders of sexual preference, which describes conditions now widely referred to as Paraphilic Disorders. This article reviews the evidence base, rationale, and recommendations for the proposed revisions in this area for ICD-11 and compares them with DSM-5. The WGSDSH recommended that the grouping, Disorders of sexual preference, be renamed to Paraphilic Disorders and be limited to disorders that involve sexual arousal patterns that focus on non-consenting others or are associated with substantial distress or direct risk of injury or death. Consistent with this framework, the WGSDSH also recommended that the ICD-10 categories of Fetishism, Fetishistic Transvestism, and Sadomasochism be removed from the classification and new categories of Coercive Sexual Sadism Disorder, Frotteuristic Disorder, Other Paraphilic Disorder Involving Non-Consenting Individuals, and Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals be added. The WGSDSH's proposals for Paraphilic Disorders in ICD-11 are based on the WHO's role as a global public health agency and the ICD's function as a public health reporting tool.

Thermodynamic Properties of α-Fe 2O 3 and Fe 3O 4 Nanoparticles

DOE PAGES

Spencer, Elinor C.; Ross, Nancy L.; Olsen, Rebecca E.; ...

2015-04-21

Here we comprehansively assessed the thermodynamic properties of hydrated α-Fe 2O 3 (hematite) and Fe 3O 4 (magnetite) nanoparticles. In addition to 9 nm Fe 3O 4, three α-e 2O 3nanoparticles samples of different sizes (11, 14, and 25 nm) and bulk α-e 2O 3 have been evaluated by inelastic neutron scattering methods. The contribution of the two-level magnetic spin flip transition to the heat capacity of the α-e 2O 3 particles has been determined. The isochoric heat capacity of the water confined on the surface of these two types of iron oxide particles have been calculated from their INSmore » spectra, and is affected by the chemical composition of the underlying particle. Furthermore, the heat capacity and dynamics of the particle hydration layers appear to be influenced by a complex array of factors including particle size, water coverage, and possibly the magnetic state of the particle itself.« less

At last! The single-crystal X-ray structure of a naturally occurring sample of the ilmenite-type oxide FeCrO3.

PubMed

Pérez-Cruz, María Ana; Elizalde-González, María de la Paz; Escudero, Roberto; Bernès, Sylvain; Silva-González, Rutilo; Reyes-Ortega, Yasmi

2015-10-01

A natural single crystal of the ferrimagnetic oxide FeCrO3, which was found in an opencast mine situated in the San Luis Potosí State in Mexico, has been characterized in order to elucidate some outstanding issues about the actual structure of this material. The single-crystal X-ray analysis unambiguously shows that transition metal cations are segregated in alternating layers normal to the threefold crystallographic axis, affording a structure isomorphous to that of ilmenite (FeTiO3), in the space group R3̅. The possible occurrence of cation antisite and vacancy defects is below the limit of detection available from X-ray data. Structural and magnetic results are in agreement with the coherent slow intergrowth of magnetic phases provided by the two antiferromagnetic corundum-type parent oxides Fe2O3 (hematite) and Cr2O3 (eskolaite). Our results are consistent with the most recent density functional theory (DFT) studies carried out on digital FeCrO3 [Sadat Nabi & Pentcheva (2011). Phys. Rev. B, 83, 214424], and suggest that synthetic samples of FeCrO3 might present a cation distribution different to that of the ilmenite structural type.

Novel "203" type of heterostructured MoS2-Fe3O4-C ternary nanohybrid: Synthesis, and enhanced microwave absorption properties

NASA Astrophysics Data System (ADS)

Yang, Erqi; Qi, Xiaosi; Xie, Ren; Bai, Zhongchen; Jiang, Yang; Qin, Shuijie; Zhong, Wei; Du, Youwei

2018-06-01

It is widely recognized that constructing multiple interface structures to enhance interface polarization is very good for the attenuation of electromagnetic (EM) wave. Here, a novel "203" type of heterostructured nanohybrid consisting of two-dimensional (2D) MoS2 nanosheets, zero-dimensional (0D) Fe3O4 nanoparticles and three-dimensional (3D) carbon layers was elaborately designed and successfully synthesized by a two-step method: Fe3O4 nanoparticles were deposited onto the surface of few-layer MoS2 nanosheets by a hydrothermal method, followed by the carbonation process by a chemical vapor deposition method. Compared to that of "20" type MoS2-Fe3O4, the as-prepared heterostructured "203" type MoS2-Fe3O4-C ternary nanohybrid exhibited remarkably enhanced EM and microwave absorption properties. And the minimum reflection loss (RL) value of the obtained MoS2-Fe3O4-C ternary nanohybrid could reach -53.03 dB at 14.4 GHz with a matching thickness of 7.86 mm. Moreover, the excellent EM wave absorption property of the as-prepared ternary nanohybrid was proved to be attributed to the quarter-wavelength matching model. Therefore, a simple and effective route was proposed to produce MoS2-based mixed-dimensional van der Waals heterostructure, which provided a new platform for the designing and production of high performance microwave absorption materials.

Novel porous Al2O3-SiO2-TiO2 bone grafting materials: formation and characterization.

PubMed

Naga, Salma M; El-Kady, Abeer M; El-Maghraby, Hesham F; Awaad, Mohamed; Detsch, Rainer; Boccaccini, Aldo R

2014-02-01

The present article deals with the development of 3D porous scaffolds for bone grafting. They were prepared based on rapid fluid infiltration of Al2O3-SiO2 sol into a polyethylene non-woven fabric template structure. Titanium dioxide in concentration equal to 5 wt% was added to the Al2O3-SiO2 mixture to produce Al2O3-SiO2-TiO2 composite scaffolds. The prepared scaffolds are characterized by means of X-ray diffraction, scanning electron microscopy and three-point bending test techniques. The bioactivity of the produced bodies is discussed, including the in vitro and in vivo assessments. The produced scaffolds exhibit mean total porosity of 66.0% and three-point bending strength of 7.1 MPa. In vitro studies showed that MG-63 osteoblast-like cells attach and spread on the scaffolds surfaces. Furthermore, cells grew through the scaffolds and start to produce extra-cellular matrix. Additionally, in vivo studies revealed the ability of the porous scaffolds to regenerate bone tissue in femur defects of albino rats 5 months post surgery. Histological analysis showed that the defect is almost entirely filled with new bone. The formed bone is characterized as a mature bone. The produced bone grafts are intended to be used as bone substitute or bone filler as their degradation products caused no inflammatory effects.

n-type dopants in (001) β-Ga2O3 grown on (001) β-Ga2O3 substrates by plasma-assisted molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Han, Sang-Heon; Mauze, Akhil; Ahmadi, Elaheh; Mates, Tom; Oshima, Yuichi; Speck, James S.

2018-04-01

Ge and Sn as n-type dopants in (001) β-Ga2O3 films were investigated using plasma-assisted molecular beam epitaxy. The Ge concentration showed a strong dependence on the growth temperature, whereas the Sn concentration remains independent of the growth temperature. The maximum growth temperature at which a wide range of Ge concentrations (from 1017 to 1020 cm-3) could be achieved was 675 °C while the same range of Sn concentration could be achieved at growth temperature of 750 °C. Atomic force microscopy results revealed that higher growth temperature shows better surface morphology. Therefore, our study reveals a tradeoff between higher Ge doping concentration and high quality surface morphology on (001) β-Ga2O3 films grown by plasma-assisted molecular beam epitaxy. The Ge doped films had an electron mobility of 26.3 cm2 V-1 s-1 at the electron concentration of 6.7 × 1017 cm-3 whereas the Sn doped films had an electron mobility of 25.3 cm2 V-1 s-1 at the electron concentration of 1.1 × 1018 cm-3.

Integrated Child Development Services (ICDS): harbinger of safe motherhood and child development.

PubMed

Lal, S

1993-01-01

Editorial comment was provided on the features that made the Integrated Child Development Services (ICDS) program in India unique and on whether or not the system could focus on younger age groups (e.g., 2-3 years of age). As part of a worldwide effort, India's ICDS program has been directed to human resource development. Over the past 17 years, the program has expanded to include almost 50% of the country's most vulnerable and deprived population. The focus on children aimed to improve their nutrition and health by reducing the incidence of morbidity, mortality, malnutrition, and school dropouts. The concern encompassed physical, social, and psychological development. The focus on mothers stressed enabling them to better care for the health and nutrition of their children. The program included prenatal care, safe delivery, and post natal concern for lactation, breast feeding, and physical growth monitoring in the early years. The program's unique features were its voluntary membership of community health workers, integrated services, and targeted coverage of economically weaker and deprived populations during critical child development periods. Indigenous Indian resources provided the primary financial support. Nation coverage was given for universal immunization, family welfare, child and maternal health, diarrheal disease control, vitamin A supplementation, and anemia screening and treatment. The multisectoral nature of the program has been realized at the village, sector, block, and district levels with linkages within Health, Education, and Social Welfare sectors, and with the Medical Colleges and Home Science Colleges. Feedback from operations research studies and other research activities was provided at the local program level, and interactions occurred between students in training programs and health care delivery systems. The program will be expanded to include the entire country. Health and nutrition education were considered the weakest part of ICDS

Validity of registration of ICD codes and prescriptions in a research database in Swedish primary care: a cross-sectional study in Skaraborg primary care database

PubMed Central

2010-01-01

Background In recent years, several primary care databases recording information from computerized medical records have been established and used for quality assessment of medical care and research. However, to be useful for research purposes, the data generated routinely from every day practice require registration of high quality. In this study we aimed to investigate (i) the frequency and validity of ICD code and drug prescription registration in the new Skaraborg primary care database (SPCD) and (ii) to investigate the sources of variation in this registration. Methods SPCD contains anonymous electronic medical records (ProfDoc III) automatically retrieved from all 24 public health care centres (HCC) in Skaraborg, Sweden. The frequencies of ICD code registration for the selected diagnoses diabetes mellitus, hypertension and chronic cardiovascular disease and the relevant drug prescriptions in the time period between May 2002 and October 2003 were analysed. The validity of data registration in the SPCD was assessed in a random sample of 50 medical records from each HCC (n = 1200 records) using the medical record text as gold standard. The variance of ICD code registration was studied with multi-level logistic regression analysis and expressed as median odds ratio (MOR). Results For diabetes mellitus and hypertension ICD codes were registered in 80-90% of cases, while for congestive heart failure and ischemic heart disease ICD codes were registered more seldom (60-70%). Drug prescription registration was overall high (88%). A correlation between the frequency of ICD coded visits and the sensitivity of the ICD code registration was found for hypertension and congestive heart failure but not for diabetes or ischemic heart disease. The frequency of ICD code registration varied from 42 to 90% between HCCs, and the greatest variation was found at the physician level (MORPHYSICIAN = 4.2 and MORHCC = 2.3). Conclusions Since the frequency of ICD code registration varies

Validity of registration of ICD codes and prescriptions in a research database in Swedish primary care: a cross-sectional study in Skaraborg primary care database.

PubMed

Hjerpe, Per; Merlo, Juan; Ohlsson, Henrik; Bengtsson Boström, Kristina; Lindblad, Ulf

2010-04-23

In recent years, several primary care databases recording information from computerized medical records have been established and used for quality assessment of medical care and research. However, to be useful for research purposes, the data generated routinely from every day practice require registration of high quality. In this study we aimed to investigate (i) the frequency and validity of ICD code and drug prescription registration in the new Skaraborg primary care database (SPCD) and (ii) to investigate the sources of variation in this registration. SPCD contains anonymous electronic medical records (ProfDoc III) automatically retrieved from all 24 public health care centres (HCC) in Skaraborg, Sweden. The frequencies of ICD code registration for the selected diagnoses diabetes mellitus, hypertension and chronic cardiovascular disease and the relevant drug prescriptions in the time period between May 2002 and October 2003 were analysed. The validity of data registration in the SPCD was assessed in a random sample of 50 medical records from each HCC (n = 1200 records) using the medical record text as gold standard. The variance of ICD code registration was studied with multi-level logistic regression analysis and expressed as median odds ratio (MOR). For diabetes mellitus and hypertension ICD codes were registered in 80-90% of cases, while for congestive heart failure and ischemic heart disease ICD codes were registered more seldom (60-70%). Drug prescription registration was overall high (88%). A correlation between the frequency of ICD coded visits and the sensitivity of the ICD code registration was found for hypertension and congestive heart failure but not for diabetes or ischemic heart disease.The frequency of ICD code registration varied from 42 to 90% between HCCs, and the greatest variation was found at the physician level (MORPHYSICIAN = 4.2 and MORHCC = 2.3). Since the frequency of ICD code registration varies between different diagnoses, each

Effect of multiple deposition of NiO layer on the performance of inverted type organic solar cell based on ZnO/P3HT:PCBM

NASA Astrophysics Data System (ADS)

Sabri, Nasehah Syamin; Lim, Eng Liang; Yap, Chi Chin; Yahaya, Muhammad; Salleh, Muhamad Mat; Jumali, Mohammad Hafizuddin Haji

2017-05-01

In this work, the effect of multiple deposition of nickel oxide (NiO) hole transport layer (HTL) on the performance of inverted type organic solar cell with a configuration of fluorine tin oxide (FTO)/zinc oxide (ZnO) nanorods/ poly(3-hexylthiopene):[6,6]-phenyl-C61-butyric acid methyl ester (P3HT:PCBM)/NiO/silver (Ag) was investigated. The NiO nanoparticles solution was spin-coated on top of the photoactive layer (P3HT:PCBM) prior to deposition of Ag electrode. Different numbers of NiO layers (1, 2, and 4) were deposited on the photoactive layer to obtain the optimum surface morphology of HTL. The device with 2 layers of NiO exhibited the optimum power conversion efficiency of 1.10%. It is believed that the optimum NiO deposition layer gives the complete coverage at photoactive layer and forms ohmic contact between the photoactive layer and Ag electrode.

Thermodynamic characterization of Ni3TeO6, Ni2Te3O8 and NiTe2O5

NASA Astrophysics Data System (ADS)

Dawar, Rimpi; Babu, R.; Ananthasivan, K.; Anthonysamy, S.

2017-09-01

Measurement of vapour pressure of TeO2(g) over the biphasic mixture Ni3TeO6 (s) + NiO(s) in the temperature range 1143-1272 K was carried out using transpiration-thermogravimetric technique (TTG). Gibbs energy of formation of Ni3TeO6 was obtained from the temperature dependence of vapour pressure of TeO2 (g) generated by the incongruent vapourisation reaction, Ni3TeO6 (s) → NiO(s) + TeO2 (g) + 1/2 O2 in the temperature range 1143-1272 K. An isoperibol type drop calorimeter was used to measure the enthalpy increments of Ni3TeO6, Ni2Te3O8 and NiTe2O5. Thermodynamic functions viz., heat capacity, entropy and Gibbs energy functions of these compounds were derived from the experimentally measured enthalpy increment values. Third-law analysis was carried out to ascertain absence of temperature dependent systematic errors in the measurement of vapour pressure of TeO2 (g). A value of -1265.1 ± 1.5 kJ mol-1 was obtained for Δ Hf,298K o (Ni3TeO6) using third-law analysis.

Displacement-type ferroelectric transition with magnetic Mn ions in perovskite Sr1-xBaxMnO3

NASA Astrophysics Data System (ADS)

Sakai, Hideaki; Fujioka, Jun; Fukuda, Tatsuo; Okuyama, Daisuke; Hashizume, Daisuke; Kagawa, Fumitaka; Nakao, Hironori; Murakami, Youich; Arima, Takahisa; Baron, Alfred Q. R.; Taguchi, Yasujiro; Tokura, Yoshinori

2012-02-01

Almost all the proper ferroelectrics with a perovskite structure discovered so far have no d-electrons in the off-center transition metal site, as exemplified by BaTiO3 and Pb(Zr,Ti)O3. This empirical d^0 rule is incompatible with the emergence of magnetism and has significantly restricted the variety of multiferroic materials. In this work, we have discovered a displacement-type ferroelectric transition originating from off-center Mn^4+ ions in antiferromagnetic Mott insulators Sr1-xBaxMnO3. As Ba concentration increases, the perovskite lattice shows the typical soft mode dynamics, and the ferroelectricity shows up for x .45. In addition to the large polarization and high transition temperature comparable to BaTiO3, we demonstrate that the magnetic order suppresses the ferroelectric lattice dilation by ˜70% and increases the soft-phonon energy by ˜50%, indicating gigantic magnetoelectric effects [1]. This work was supported by the FIRST program on ``Quantum Science on Strong Correlation''. [4pt] [1] H. Sakai et al., Phys. Rev. Lett. 107, 137601 (2011).

Validation and optimisation of an ICD-10-coded case definition for sepsis using administrative health data

PubMed Central

Jolley, Rachel J; Jetté, Nathalie; Sawka, Keri Jo; Diep, Lucy; Goliath, Jade; Roberts, Derek J; Yipp, Bryan G; Doig, Christopher J

2015-01-01

Objective Administrative health data are important for health services and outcomes research. We optimised and validated in intensive care unit (ICU) patients an International Classification of Disease (ICD)-coded case definition for sepsis, and compared this with an existing definition. We also assessed the definition's performance in non-ICU (ward) patients. Setting and participants All adults (aged ≥18 years) admitted to a multisystem ICU with general medicosurgical ICU care from one of three tertiary care centres in the Calgary region in Alberta, Canada, between 1 January 2009 and 31 December 2012 were included. Research design Patient medical records were randomly selected and linked to the discharge abstract database. In ICU patients, we validated the Canadian Institute for Health Information (CIHI) ICD-10-CA (Canadian Revision)-coded definition for sepsis and severe sepsis against a reference standard medical chart review, and optimised this algorithm through examination of other conditions apparent in sepsis. Measures Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results Sepsis was present in 604 of 1001 ICU patients (60.4%). The CIHI ICD-10-CA-coded definition for sepsis had Sn (46.4%), Sp (98.7%), PPV (98.2%) and NPV (54.7%); and for severe sepsis had Sn (47.2%), Sp (97.5%), PPV (95.3%) and NPV (63.2%). The optimised ICD-coded algorithm for sepsis increased Sn by 25.5% and NPV by 11.9% with slightly lowered Sp (85.4%) and PPV (88.2%). For severe sepsis both Sn (65.1%) and NPV (70.1%) increased, while Sp (88.2%) and PPV (85.6%) decreased slightly. Conclusions This study demonstrates that sepsis is highly undercoded in administrative data, thus under-ascertaining the true incidence of sepsis. The optimised ICD-coded definition has a higher validity with higher Sn and should be preferentially considered if used for surveillance purposes. PMID:26700284

Validation and optimisation of an ICD-10-coded case definition for sepsis using administrative health data.

PubMed

Jolley, Rachel J; Quan, Hude; Jetté, Nathalie; Sawka, Keri Jo; Diep, Lucy; Goliath, Jade; Roberts, Derek J; Yipp, Bryan G; Doig, Christopher J

2015-12-23

Administrative health data are important for health services and outcomes research. We optimised and validated in intensive care unit (ICU) patients an International Classification of Disease (ICD)-coded case definition for sepsis, and compared this with an existing definition. We also assessed the definition's performance in non-ICU (ward) patients. All adults (aged ≥ 18 years) admitted to a multisystem ICU with general medicosurgical ICU care from one of three tertiary care centres in the Calgary region in Alberta, Canada, between 1 January 2009 and 31 December 2012 were included. Patient medical records were randomly selected and linked to the discharge abstract database. In ICU patients, we validated the Canadian Institute for Health Information (CIHI) ICD-10-CA (Canadian Revision)-coded definition for sepsis and severe sepsis against a reference standard medical chart review, and optimised this algorithm through examination of other conditions apparent in sepsis. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated. Sepsis was present in 604 of 1001 ICU patients (60.4%). The CIHI ICD-10-CA-coded definition for sepsis had Sn (46.4%), Sp (98.7%), PPV (98.2%) and NPV (54.7%); and for severe sepsis had Sn (47.2%), Sp (97.5%), PPV (95.3%) and NPV (63.2%). The optimised ICD-coded algorithm for sepsis increased Sn by 25.5% and NPV by 11.9% with slightly lowered Sp (85.4%) and PPV (88.2%). For severe sepsis both Sn (65.1%) and NPV (70.1%) increased, while Sp (88.2%) and PPV (85.6%) decreased slightly. This study demonstrates that sepsis is highly undercoded in administrative data, thus under-ascertaining the true incidence of sepsis. The optimised ICD-coded definition has a higher validity with higher Sn and should be preferentially considered if used for surveillance purposes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

μCT of ex-vivo stained mouse hearts and embryos enables a precise match between 3D virtual histology, classical histology and immunochemistry

PubMed Central

Larsson, Emanuel; Martin, Sabine; Lazzarini, Marcio; Tromba, Giuliana; Missbach-Guentner, Jeannine; Pinkert-Leetsch, Diana; Katschinski, Dörthe M.; Alves, Frauke

2017-01-01

The small size of the adult and developing mouse heart poses a great challenge for imaging in preclinical research. The aim of the study was to establish a phosphotungstic acid (PTA) ex-vivo staining approach that efficiently enhances the x-ray attenuation of soft-tissue to allow high resolution 3D visualization of mouse hearts by synchrotron radiation based μCT (SRμCT) and classical μCT. We demonstrate that SRμCT of PTA stained mouse hearts ex-vivo allows imaging of the cardiac atrium, ventricles, myocardium especially its fibre structure and vessel walls in great detail and furthermore enables the depiction of growth and anatomical changes during distinct developmental stages of hearts in mouse embryos. Our x-ray based virtual histology approach is not limited to SRμCT as it does not require monochromatic and/or coherent x-ray sources and even more importantly can be combined with conventional histological procedures. Furthermore, it permits volumetric measurements as we show for the assessment of the plaque volumes in the aortic valve region of mice from an ApoE-/- mouse model. Subsequent, Masson-Goldner trichrome staining of paraffin sections of PTA stained samples revealed intact collagen and muscle fibres and positive staining of CD31 on endothelial cells by immunohistochemistry illustrates that our approach does not prevent immunochemistry analysis. The feasibility to scan hearts already embedded in paraffin ensured a 100% correlation between virtual cut sections of the CT data sets and histological heart sections of the same sample and may allow in future guiding the cutting process to specific regions of interest. In summary, since our CT based virtual histology approach is a powerful tool for the 3D depiction of morphological alterations in hearts and embryos in high resolution and can be combined with classical histological analysis it may be used in preclinical research to unravel structural alterations of various heart diseases. PMID:28178293

Pressure dependence of thermal physical properties of A-type R2O3 (R=Y, La): A first-principles study