Conversion between 2 military combat-related injury coding systems

Deployable medical systems(DEPMEDS) patient conditions (PCs) and Military Combat Injury Scale (MCIS) are 2 important military medical coding systems. However, both of them have defects when applied in military medical planning. Although each PC code contains information about treatment, intensity of care, treatment time, length of stay, and probability of disposition that is relevant to simulation, its description is too comprehensive and ambiguous to code historical military medical records. Therefore, conversion between PC and other medical coding systems applied in standard medical data is required when validity is required following simulation. The information linked to each PC code is based on subject matter expert opinion instead of standard medical data from the theater that need to be continuously updated depending on the results of medical data analysis. MCIS, a combat-related injury coding system, shows significant promise in coding real medical data, but it does not seek detailed information important for prediction and simulation unlike PCs. Therefore, MCIS cannot be used in planning tools directly. Thus, the effort to map MCIS to PCs is significant for medical logistic planning. We aim to identify whether conversion between PCs and MCIS is possible and to evaluate inter-coder reliability.Three senior coders assigned all possible MCIS codes to 187 combat-related PC codes. The data records were structured based on an earlier study. Inter-rater reliability was measured by using Cohen's k statistic and percent agreement.Low inter-rater reliability indicated the difficulty in conversion between PCs and MCIS.The injury descriptors of PCs should be expanded by referring to new standard medical data. The existing MCIS codes need to be modified to include more information on treatment brief, treatment time, length of stay, and other key information, and historical data statistics need to be developed.

Characterisation and modelling of mixing processes in groundwaters of a potential geological repository for nuclear wastes in crystalline rocks of Sweden

This paper presents the mixing modelling results for the hydrogeochemical characterisation of groundwaters in the Laxemar area (Sweden). This area is one of the two sites that have been investigated, under the financial patronage of the Swedish Nuclear Waste and Management Co. (SKB), as possible candidates for hosting the proposed repository for the long-term storage of spent nuclear fuel. The classical geochemical modelling, interpreted in the light of the palaeohydrogeological history of the system, has shown that the driving process in the geochemical evolution of this groundwater system is the mixing between four end-member waters: a deep and old saline water, a glacial meltwater, an old marine water, and a meteoric water. In this paper we put the focus on mixing and its effects on the final chemical composition of the groundwaters using a comprehensive methodology that combines principal component analysis with mass balance calculations. This methodology allows us to test several combinations of end member waters and several combinations of compositional variables in order to find optimal solutions in terms of mixing proportions. We have applied this methodology to a dataset of 287 groundwater samples from the Laxemar area collected and analysed by SKB. The best model found uses four conservative elements (Cl, Br, oxygen-18 and deuterium), and computes mixing proportions with respect to three end member waters (saline, glacial and meteoric). Once the first order effect of mixing has been taken into account, water-rock interaction can be used to explain the remaining variability. In this way, the chemistry of each water sample can be obtained by using the mixing proportions for the conservative elements, only affected by mixing, or combining the mixing proportions and the chemical reactions for the non-conservative elements in the system, establishing the basis for predictive calculations.

Processes and impacts of acid discharges on a natural substratum under a landfill

Analyses of substratum samples under a landfill were performed to assess the pollution impact of waste over a clay-sand material after nine years of exposure. These samples presented different illite/kaolinite ratios and an acid pH, especially low near the waste/soil contact in a 1-1.5 m soil thickness with low density and despite the basic pH of the collected actual methanogenic leachate. This study has raised the effects of a presumably acid stage in the waste leachate on the substratum final quality of clay and its physical-chemical properties as an attenuation buffer. These effects were the dissolution of carbonate minerals, decrease of dry density, increase of hydraulic conductivity, release of metals and formation of clays with low cationic exchange capacity (CEC) as kaolinite. The large presence of H(+) and Al(OH)(3-x)(x+) depleted the neutralizing capacity of the substratum and occupied exchangeable sites, decreasing therefore the available sites for retaining leachate pollutants, which traveled further than the first-meter depth of the substratum. In order to combat and prevent pollution as well as to preserve the good barrier properties under new landfills it is proposed to select illitic materials better than kaolinitic substratum, to avoid acid landfilling and if not possible to add lime.

Expression of CD44v6 and integrin-β1 for the prognosis evaluation of pancreatic cancer patients after cryosurgery

BACKGROUND

Many previous studies demonstrated that cell adhesion molecules CD44v6 and integrin-β1 had been extensively investigated as potential prognostic markers of various cancers. However, data in PC are scarce.

METHODS

We now investigate CD44v6 and integrin-β1 mRNA expression in PBMC by a triplex real-time RT-PCR assay and protein expression in plasma by ELISA. All specimens were collected from 54 PC patients who received the treatment of cryosurgery as well as 20 healthy individuals (control).

RESULTS

The mRNA and protein expression levels of CD44v6 and integrin-β1 in patients were significantly increased compared with control group (P<0.05). The high CD44v6 mRNA and protein expression were significantly correlated with clinical stage, tumor differentiation, LNM, liver metastasis and decreased median DFS (P<0.05), while the high integrin-β1 mRNA and protein expression were significantly correlated with clinical stage, LNM, liver metastasis and decreased median DFS (P<0.05). Clinical stage, LNM, liver metastasis, CD44v6 mRNA and protein expression were the independent predictors of survival in PC patients (P<0.05). Moreover, CD44v6 and integrin-β1 mRNA and protein expression levels were significantly decreased in patients in 3 months after cryosurgery (P<0.05). No significant difference was found in CD44v6 mRNA and protein expression between patients in 3 months after cryosurgery and control group (P>0.05).

CONCLUSION

CD44v6 and integrin-β1 mRNA and protein expression in blood may serve as biomarkers for the development and metastasis of PC, and as prognostic indicators for PC. They may become useful predictors in assessing outcome of PC patients after cryosurgery.

VIRTUAL SLIDES

The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4035308681009006.

Neural coding mechanisms underlying perceived roughness of finely textured surfaces

Combined psychophysical and neurophysiological studies have shown that the perceived roughness of surfaces with element spacings of >1 mm is based on spatial variation in the firing rates of slowly adapting type 1 (SA1) afferents (mean absolute difference in firing rates between SA1 afferents with receptive fields separated by approximately 2 mm). The question addressed here is whether this mechanism accounts for the perceived roughness of surfaces with element spacings of <1 mm. Twenty triangular and trapezoidal gratings plus a smooth surface were used as stimulus patterns [spatial periods, 0.1-2.0 mm; groove widths (GWs), 0.1-2.0 mm; and ridge widths (RWs), 0-1.0 mm]. In the human psychophysical studies, we found that the following equation described the mean roughness magnitude estimates of the subjects accurately (0.99 correlation): 0.2 + 1.6GW - 0.5RW - 0.25GW(2). In the neurophysiological studies, these surfaces were scanned across the receptive fields of SA1, rapidly adapting, and Pacinian (PC) afferents, innervating the glabrous skin of anesthetized macaque monkeys. SA1 spatial variation was highly correlated (0.97) with human roughness judgments. There was no consistent relationship between PC responses and roughness judgments; PC afferents responded strongly and almost equally to all of the patterns. Spatial variation in SA1 firing rates is the only neural code that accounts for the perceived roughness of surfaces with finely and coarsely spaced elements. When surface elements are widely spaced, the spatial variation in firing rates is determined primarily by the surface pattern; when the elements are finely spaced, the variation in firing rates between SA1 afferents is determined by stochastic variation in spike rates.

Mixed echo train acquisition displacement encoding with stimulated echoes: an optimized DENSE method for in vivo functional imaging of the human heart

Mixed echo train acquisition displacement encoding with stimulated echoes (meta-DENSE) is a phase-based displacement mapping technique suitable for imaging myocardial function. This method has been optimized for use with patients who have a history of myocardial infarction. The total scan time is 12-14 heartbeats for an in-plane resolution of 2.8 x 2.8 mm2. Myocardial strain is mapped at this resolution with an accuracy of 2% strain in vivo. Compared to standard stimulated echo (STE) methods, both data acquisition speed and resolution are improved with inversion-recovery FID suppression and the meta-DENSE readout scheme. Data processing requires minimal user intervention and provides a rapid quantitative feedback on the MRI scanner for evaluating cardiac function. Published 2001 Wiley-Liss, Inc.

DENSE: displacement encoding with stimulated echoes in cardiac functional MRI

Displacement encoding with stimulated echoes (DENSE) was developed for high-resolution myocardial displacement mapping. Pixel phase is modulated by myocardial displacement and data spatial resolution is limited only by pixel size. 2D displacement vector maps were generated for the systolic action in canines with 0.94 x 1.9 mm nominal in-plane resolution and 2.3 mm/pi displacement encoding. A radial strain of 0.208 was measured across the free left ventricular wall over 105 ms during systole. DENSE displacement maps require small first-order gradient moments for encoding. DENSE magnitude images exhibit black-blood contrast which allows for better myocardial definition and reduced motion-related artifacts.

Epstein-Barr virus, human papillomavirus, and flow cytometric cell cycle kinetics in nasopharyngeal carcinoma and inverted papilloma among Egyptian patients

It is widely accepted that the Epstein-Barr virus is etiologically associated with the development of nasopharyngeal carcinoma. The human papillomavirus is also associated with inverted papilloma. We used the polymerase chain reaction technique to detect both viruses in both types of tumors. Flow cytometry was also used to study the DNA pattern and proliferative behavior of the tumors in relation to the viruses. EBV was detected in 13/20 (65%) of NPC specimens, and in none of IP (n = 10) or control specimens (n = 10). This indicates the contribution of EBV as an etiologic factor in NPC. Five cases of NPC (25%) were positive for HPV 16, two of them were EBV positive. Four HPV 16 positive cases were found among cases with inverted papilloma, but none among the control cases. Flow cytometry revealed that all NPC, IP, and control samples were diploid except one aneuploid NPC sample. Proliferative capacity (PC) of primary tumors was predictive of tumor recurrence in NPC. Using 13.6% as a cut-off point for PC, we were able to discriminate between high risk and low risk groups with 100% sensitivity and 86% specificity. PC can be used as a baseline prognostic parameter in NPC, making it possible to modify courses of treatment in an attempt to inhibit tumor recurrence.