Validation of an ICD code for accurately identifying emergency department patients who suffer an out-of-hospital cardiac arrest.

AIM: International classification of disease (ICD-9) code 427.5 (cardiac arrest) is utilized to identify cohorts of patients who suffer out-of-hospital cardiac arrest (OHCA), though the use of ICD codes for this purpose has never been formally validated. We sought to validate the utility of ICD-9 code 427.5 by identifying patients admitted from the emergency department (ED) after OHCA. METHODS: Adult visits to a single ED between January 2007 and July 2012 were retrospectively examined and a keyword search of the electronic medical record (EMR) was used to identify patients. Cardiac arrest was confirmed; and ICD-9 information and location of return of spontaneous circulation (ROSC) were collected. Separately, the EMR was searched for patients who received ICD-9 code 427.5. The kappa coefficient (κ) was calculated, as was the sensitivity and specificity of the code for identifying OHCA. RESULTS: The keyword search identified 1717 patients, of which 385 suffered OHCA and 333 were assigned the code 427.5. The agreement between ICD-9 code and cardiac arrest was excellent (κ = 0.895). The ICD-9 code 427.5 was both specific (99.4%) and sensitive (86.5%). Of the 52 cardiac arrests that were not identified by ICD-9 code, 33% had ROSC before arrival to the ED. When searching independently on ICD-9 code, 347 patients with ICD-9 code 427.5 were found, of which 320 were true arrests. This yielded a positive predictive value of 92% for ICD-9 code 427.5 in predicting OHCA. CONCLUSIONS: ICD-9 code 427.5 is sensitive and specific for identifying ED patients who suffer OHCA with a positive predictive value of 92%

Duality Symmetric Strings, Dilatons and O(d,d) Effective Actions

We calculate the background field equations for the T-duality symmetric string building on previous work by including the effect of the Dilaton up to two-loops. Inclusion of the Dilaton allows us to obtain the full beta functionals of the duality symmetric sigma model. We are able to interpret the result in terms of a dimensionally reduced O(d,d) invariant target space effective action.Comment: 15 pages, latex; v2 reference added, typos fixe

Nonlinear time series and neural-network models of exchange rates between the US dollar and major currencies

This paper features an analysis of major currency exchange rate movements in relation to the US dollar, as constituted in US dollar terms. Euro, British pound, Chinese yuan, and Japanese yen are modelled using a variety of non- linear models, including smoot

Background Field Equations for the Duality Symmetric String

This paper describes the background field equations for strings in T-duality symmetric formalisms in which the dimension of target space is doubled and the sigma model supplemented with constraints. These are calculated by demanding the vanishing of the beta-functional of the sigma model couplings in the doubled target space. We demonstrate the equivalence with the background field equations of the standard string sigma model.Comment: 26 pages, latex, v2 typos correcte

An Effective Theory for Midgap States in Doped Spin Ladder and Spin-Peierls Systems: Liouville Quantum Mechanics

In gapped spin ladder and spin-Peierls systems the introduction of disorder, for example by doping, leads to the appearance of low energy midgap states. The fact that these strongly correlated systems can be mapped onto one dimensional noninteracting fermions provides a rare opportunity to explore systems which have both strong interactions and disorder. In this paper we show that the statistics of the zero energy midgap wave functions in these models can be effectively described by Liouville Quantum Mechanics. This enables us to calculate the disorder averaged N-point correlation functions of these states (the explicit calculation is performed for N=2,3). We find that whilst these midgap states are typically weakly correlated, their disorder averaged correlation are power law. This discrepancy arises because the correlations are not self-averaging and averages of the wave functions are dominated by anomalously strongly correlated configurations.Comment: 13 page latex fil

The Search for Ferroelectric domain structures in carbohydrate glasses using atomic force microscopy

D-glucose was studied as a possible candidate for ferroelectric domain imaging using an Atomic Force Microscope (AFM). The large dipole moment of carbohydrates is such that they may show localized ferroelectric domain formation in liquid phase. Samples were heated at their melting point on glass slides and then left to cool to room temperature in a desiccator. Differential Thermal Analysis (DTA) was used to test the effectiveness of this method, and it was found that the oven preparation created samples with 41% crystallinity, where both a glass transition and sharp melting peak were observed. DTA was again used to find a way to create a better amorphous sample. An assessment of the effect of cooling rate on glass formation was conducted using a Differential Scanning Calorimeter (DSC). Surface images of a ferroelectric ceramic and the surface of an amorphous glucose sample were taken using AFM Constant Force Topography

Evidence for a colour dependence in the size distribution of main belt asteroids

We present the results of a project to detect small (~1 km) main-belt asteroids with the 3.6 meter Canada-France-Hawaii Telescope (CFHT). We observed in 2 filters (MegaPrime g' and r') in order to compare the results in each band. Owing to the observational cadence we did not observe the same asteroids through each filter and thus do not have true colour information. However strong differences in the size distributions as seen in the two filters point to a colour-dependence at these sizes, perhaps to be expected in this regime where asteroid cohesiveness begins to be dominated by physical strength and composition rather than by gravity. The best fit slopes of the cumulative size distributions (CSDs) in both filters tend towards lower values for smaller asteroids, consistent with the results of previous studies. In addition to this trend, the size distributions seen in the two filters are distinctly different, with steeper slopes in r' than in g'. Breaking our sample up according to semimajor axis, the difference between the filters in the inner belt is found to be somewhat less pronounced than in the middle and outer belt, but the CSD of those asteroids seen in the r' filter is consistently and significantly steeper than in g' throughout. The CSD slopes also show variations with semimajor axis within a given filter, particularly in r'. We conclude that the size distribution of main belt asteroids is likely to be colour dependent at kilometer sizes and that this dependence may vary across the belt.Comment: 28 pages, 5 figures, submitted to the Astronomical Journa

A Call to Action: A Blueprint for Academic Health Sciences in the Era of Mass Incarceration

Over 100 million Americans have criminal records, and the U.S. incarcerates seven times more citizens than most developed countries. The burden of incarceration disproportionately affects people of color and ethnic minorities, and those living in poverty. While 95% of incarcerated people return to society, recidivism rates are high with nearly 75% arrested again within five years of release. Criminal records impede access to employment and other social services such as shelter and health care. Justice-involved people have higher rates of substance, mental health, and some chronic medical disorders than the general population; furthermore, the incarcerated population is rapidly aging. Only a minority of academic health science centers are engaged in health services research, workforce training, or correctional health care. This commentary provides rationale and a blueprint for engagement of academic health science institutions to harness their capabilities to tackle one of the country\u27s most vexing public health crises