Accuracy of VA databases for diagnoses of knee replacement and hip replacement

SummaryPurposeTo examine the validity of International Classification of Diseases-Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes for knee replacement and hip replacement in Veterans Affairs (VA) databases.MethodsFrom a cohort of veterans who received health care at Minneapolis VA Medical Center and/or affiliated medical facilities, we obtained four random samples of 50 patients each with: neither hip nor knee replacement code, knee replacement code only, hip replacement code only and both knee and hip replacement codes. The gold standard was documentation of knee or hip replacement surgery in patient medical records. Accuracy of ICD-9 or CPT code for knee and hip replacement was assessed by calculating sensitivity, specificity, positive and negative predictive values (PPV and NPV).ResultsOf the 200 patients, medical records were available for 166:140 (70%) had complete medical records and 26 (13%) had incomplete medical records. Knee replacement codes were accurate with excellent PPV of 95%, sensitivity of 95%, specificity of 96% and NPV of 96%. Hip replacement codes were accurate with excellent PPV of 98%, sensitivity of 96%, specificity of 99% and NPV of 96%. Sensitivity analyses that included incomplete charts had little impact on these estimates. The procedure dates found in VA databases matched exactly with medical records in 96%.ConclusionsThe ICD-9 and CPT codes for knee replacement and hip replacement in VA databases are valid. These codes may be used to identify cohorts of veterans with knee replacement and hip replacement for research studies

Bianchi type-II cosmological model: some remarks

Within the framework of Bianchi type-II (BII) cosmological model the behavior of matter distribution has been considered. It is shown that the non-zero off-diagonal component of Einstein tensor implies some severe restriction on the choice of matter distribution. In particular for a locally rotationally symmetric Bianchi type-II (LRS BII) space-time it is proved that the matter distribution should be strictly isotropic if the corresponding matter field possesses only non-zero diagonal components of the energy-momentum tensor.Comment: 3 page

Investigations for the Prediction of Resonant Frequency of Microstrip Patch Antenna Using RBF Neural Network

In this paper, an application of radial basis function (RBF) neural network is presented for the prediction of resonant frequency of microstrip patch antenna. The training and testing data for artificial neural network (ANN) model are generated with the help of method of moment based IE3D simulation software. ANN model predicted accurate results for resonant frequency of microstrip patch antenna. Simulated and ANN model results are compared with the experimental results which are available in the literature and found in good agreement

Scoping biological indicators of soil quality Phase II. Defra Final Contract Report SP0534

This report presents results from a field assessment of a limited suite of potential biological indicators of soil quality to investigate their suitability for national-scale soil monitoring

Computational Investigation of the Pressure and Skin Friction Coefficient Distribution on a Mixed Hypersonic Inline Intake with Blunt Nose

A study has been carried out to find out the flowfield inside a three dimensional hypersonic intake with different nose bluntness using commercial computational fluid dynamics software. This study has been carried out for a free stream Mach number of 6.5, a unit Reynolds number 1.6 x 10 6 per meter with an intake contraction ratio of 2.88. The purpose of this analysis was to investigate the effect of nose bluntness on the external and internal compression in a mixed compression inline intake. An intake models with different nose bluntness has been analyzed using 3 - D numerical simulations based on a commercially available CFD code. The CFD code and the turbulence model used is validated by comparing the experimental results available in literature with computational results. Computational results show that the nose bluntness has significant influence on pressure distribution on hypersonic intake. Nose bluntness affects the shock wave/boundary layer interactions on intake upper surface significantly. Numer ical results of three dimensional simulations are also compared with two dimensional numerical simulations to study the effect of third dimensions on internal and external compression

Magnetic Ordering and Superconductivity in the RE2_2Ir3_3Ge5_5 (RE = Y, La-Tm, Lu) System

We find that the compounds for RE = Y, La-Dy, crystallize in the tetragonal Ibam (U$_2$Co$_3$Si$_5$ type) structure whereas the compounds for RE = Er-Lu, crystallize in a new orthorhombic structure with a space group Pmmn. Samples of Ho$_2$Ir$_3$Ge$_5$ were always found to be multiphase. The compounds for RE = Y to Dy which adopt the Ibam type structure show a metallic resistivity whereas the compounds with RE = Er, Tm and Lu show an anomalous behavior in the resistivity with a semiconducting increase in $\rho$ as we go down in temperature from 300K. Interestingly we had earlier found a positive temperature coefficient of resistivity for the Yb sample in the same temperature range. We will compare this behavior with similar observations in the compounds RE$_3$Ru$_4$Ge$_{13}$ and REBiPt. La$_2$Ir$_3$Ge$_5$ and Y$_2$Ir$_3$Ge$_5$ show bulk superconductivity below 1.8K and 2.5K respectively. Our results confirm that Ce$_2$Ir$_3$Ge$_5$ shows a Kondo lattice behavior and undergoes antiferromagnetic ordering below 8.5K. Most of the other compounds containing magnetic rare-earth elements undergo a single antiferromagnetic transition at low temperatures (T$\leq$12K) while Gd$_2$Ir$_3$Ge$_5$, Dy$_2$Ir$_3$Ge$_5$ and Nd$_2$Ir$_3$Ge$_5$ show multiple transitions. The T$_N$'s for most of the compounds roughly scale with the de Gennes factor. which suggests that the chief mechanism of interaction leading to the magnetic ordering of the magnetic moments may be the RKKY interaction.Comment: 25 pages, 16 figure

Integrated Green Lean Six Sigma-Industry 4.0 approach to combat COVID-19: from literature review to framework development

Purpose: The Coronavirus (COVID-19) pandemic has led to a surge in demand for healthcare facilities, medicines, vaccines, and other healthcare items. Integrating Green Lean Six Sigma (GLSS) and Industry 4.0 (I4.0) has the potential to meet the modern demand of healthcare units and also leads to improving the quality of inpatient care with better safety, hygiene, and real-time diagnoses. A systematic review has been conducted to determine the tools/techniques, challenges, application areas, and potential benefits for the adoption of an integrated GLSS-I4.0 approach within healthcare facilities from the perspective of COVID management. Further, a conceptual framework of integrated GLSS- I4.0 has been proposed for better COVID management. Methodology: To conduct literature, authors used Preferred reporting items for systematic reviews and meta-analysis (PRISMA) and covers relevant articles from the arrival of COVID-19. Based on the systematic understanding of the different facets of the integrated GLSS- I 4.0 approach and through insights of experts (academicians, and healthcare personnel), a conceptual framework is proposed to combat COVID-19 for better detection, prevention, and cure. Findings: The systematic review presented here provides different avenues to comprehend the different facets of the integrated GLSS-I4.0 approach in different areas of COVID healthcare management. In this study, the proposed framework reveals that IOT (Internet of Things), Big Data, and Artificial Intelligence (AI) are the major constituents of I4.0 technologies that lead to better COVID management. Moreover, integration of I4.0 with GLSS aids during different stages of the COVID management right from diagnosis, manufacture of items, inpatient and outpatient care of the affected person. Implications: This study provides a significant knowledge database to the practitioners by understanding different tools and techniques of integrated approach for better COVID management. Moreover, the proposed framework aids to grab day-to-day information from the affected people and ensures reduced hospital stay with better space utilization and the creation of a healthy environment around the patient. This inclusive implementation of the proposed framework will enhance knowledge-based in medical areas and provides different novel prospects to combat other medical urgencies

Cognitive, behavioural and psychological barriers to the prevention of severe hypoglycaemia: A qualitative study of adults with type 1 diabetes

Objectives: Severe hypoglycaemia affects approximately one in three people with type 1 diabetes and is the most serious side effect of insulin therapy. Our aim was to explore individualistic drivers of severe hypoglycaemia events. Methods: In-depth semi-structured interviews were conducted with a purposive sample of 17 adults with type 1 diabetes and a history of recurrent severe hypoglycaemia, to elicit experiences of hypoglycaemia (symptoms/awareness, progression from mild to severe and strategies for prevention/treatment). Interviews were analysed using an adapted grounded theory approach. Results: Three main themes emerged: hypoglycaemia-induced cognitive impairment, behavioural factors and psychological factors. Despite experiencing early hypoglycaemic symptoms, individuals often delayed intervention due to impaired/distracted attention, inaccurate risk assessment, embarrassment, worry about rebound hyperglycaemia or unavailability of preferred glucose source. Delay coupled with use of a slow-acting glucose source compromised prevention of severe hypoglycaemia. Conclusion: Our qualitative data highlight the multifaceted, idiosyncratic nature of severe hypoglycaemia and confirm that individuals with a history of recurrent severe hypoglycaemia may have specific thought and behaviour risk profiles. Individualised prevention plans are required, emphasising both the need to attend actively to mild hypoglycaemic symptoms and to intervene promptly with an appropriate, patient-preferred glucose source to prevent progression to severe hypoglycaemia

Lepton distribution as a probe of new physics in production and decay of the t quark and its polarization

We investigate the possibilities of studying new physics in various processes of t-quark production using kinematical distributions of the secondary lepton coming from decay of t quarks. We show that the angular distributions of the secondary lepton are insensitive to the anomalous tbW vertex and hence are pure probes of new physics in a generic process of t-quark production. The energy distribution of the lepton is distinctly affected by anomalous tbW couplings and can be used to analyze them independent of the production process of t quarks. The effects of t polarization on the distributions of the decay lepton are demonstrated for top-pair production process at a gamma-gamma collider mediated by a heavy Higgs boson.Comment: 15 pages, 7 figures, uses axodraw.sty (included), references added. v3 to appear in Journal of High Energy Physics. Incorporates minor changes in the discussion on radiative corrections which do not affect the results. Typo in reference correcte

Antiferromagnetic ordering in the Kondo lattice system Yb2_2Fe3_3Si5_5

Compounds belonging to the R$_2$Fe$_3$Si$_5$ series exhibit unusual superconducting and magnetic properties. Although a number of studies have been made on the first reentrant antiferromagnet superconductor Tm$_2$Fe$_3$Si$_5$, the physical properties of Yb$_2$Fe$_3$Si$_5$ are largely unexplored. In this work, we attempt to provide a comprehensive study of bulk properties such as, resistivity, susceptibility and heat-capacity of a well characterized polycrystalline Yb$_2$Fe$_3$Si$_5$. Our measurements indicate that Yb$^{3+}$ moments order antiferromagnetically below 1.7 K. Moreover, the system behaves as a Kondo lattice with large Sommerfeld coefficient ($\gamma$) of 0.5~J/Yb mol K$^{2}$ at 0.3 K, which is well below T$_N$. The absence of superconductivity in Yb$_2$Fe$_3$Si$_5$ down to 0.3 K at ambient pressure is attributed to the presence of the Kondo effect.Comment: 10 pages, 3 figures, tex document. A fuller version has appeared in PRB. Here we have omitted the figures showing the crystal structure and the fitting of the X-ray pattern. Also the table with the lattice parameters obtained from fitting has been remove