Cross-cultural adaptation, reliability, internal consistency and validation of the Hand Function Sort (HFS©) for French speaking patients with upper limb complaints.

INTRODUCTION: Functional evaluation of upper limb is not only based on clinical findings but requires self-administered questionnaires to address patients' perspective. The Hand Function Sort (HFS©) was only validated in English. The aim of this study was the French cross cultural adaptation and validation of the HFS© (HFS-F). METHODS: 150 patients with various upper limbs impairments were recruited in a rehabilitation center. Translation and cross-cultural adaptation were made according to international guidelines. Construct validity was estimated through correlations with Disabilities Arm Shoulder and Hand (DASH) questionnaire, SF-36 mental component summary (MCS),SF-36 physical component summary (PCS) and pain intensity. Internal consistency was assessed by Cronbach's α and test-retest reliability by intraclass correlation. RESULTS: Cronbach's α was 0.98, test-retest reliability was excellent at 0.921 (95 % CI 0.871-0.971) same as original HFS©. Correlations with DASH were-0.779 (95 % CI -0.847 to -0.685); with SF 36 PCS 0.452 (95 % CI 0.276-0.599); with pain -0.247 (95 % CI -0.429 to -0.041); with SF 36 MCS 0.242 (95 % CI 0.042-0.422). There were no floor or ceiling effects. CONCLUSIONS: The HFS-F has the same good psychometric properties as the original HFS© (internal consistency, test retest reliability, convergent validity with DASH, divergent validity with SF-36 MCS, and no floor or ceiling effects). The convergent validity with SF-36 PCS was poor; we found no correlation with pain. The HFS-F could be used with confidence in a population of working patients. Other studies are necessary to study its psychometric properties in other populations.

Asthma outpatient education by multiple implementation strategy. Outcome of a programme using a personal notebook.

More than 10 years after publication, international guidelines remain poorly implemented. To better implement them, we need to develop new strategies adapted to the expectations of patients and health professionals outside hospital settings and to ensure better outpatient follow up in the community. We developed a bilingual education programme including a brochure designed to support an interdisciplinary health care network and measured hospitalisations (H), work absenteeism (WA), emergency visits (EV), asthma medication (AM) and quality of life (QL Juniper) before and 12 months after the intervention. All QL scores improved significantly in comparison with pre-intervention values. Health service use decreased dramatically when comparing the 12 months prior to and after the intervention(H: 35-8%, WA: 39-14%, EV: 88-53%). The final cost/benefit ratio of the programme was 1.96. Interdisciplinary implementation strategy of patient education is cost-effective, improves quality of life for asthmatics, and reduces strain on health services. Such a health care network does not require an expensive infrastructure and is better adapted to the reality and competences of clinical practice.

Multidimensional, mapping-based complex wavelet transforms.

Although the discrete wavelet transform (DWT) is a powerful tool for signal and image processing, it has three serious disadvantages: shift sensitivity, poor directionality, and lack of phase information. To overcome these disadvantages, we introduce multidimensional, mapping-based, complex wavelet transforms that consist of a mapping onto a complex function space followed by a DWT of the complex mapping. Unlike other popular transforms that also mitigate DWT shortcomings, the decoupled implementation of our transforms has two important advantages. First, the controllable redundancy of the mapping stage offers a balance between degree of shift sensitivity and transform redundancy. This allows us to create a directional, nonredundant, complex wavelet transform with potential benefits for image coding systems. To the best of our knowledge, no other complex wavelet transform is simultaneously directional and nonredundant. The second advantage of our approach is the flexibility to use any DWT in the transform implementation. As an example, we exploit this flexibility to create the complex double-density DWT: a shift-insensitive, directional, complex wavelet transform with a low redundancy of (3M - 1)/(2M - 1) in M dimensions. No other transform achieves all these properties at a lower redundancy, to the best of our knowledge. By exploiting the advantages of our multidimensional, mapping-based complex wavelet transforms in seismic signal-processing applications, we have demonstrated state-of-the-art results.

Bronchial asthma and self-management education: implementation of Guidelines by an interdisciplinary programme in health network.

UNLABELLED: Asthma is a chronic disease generating very high costs even for Switzerland. Self-management education (SME) is effective and recommended as an integral part of management in the most recent guidelines on asthma treatment. Its aim is to reduce morbidity [hospitalisations (H), lost workdays (LW), emergency consultations (EC)] and improve quality of life (QOL) in these patients. METHOD: Integrated programme with educational platforms (two-language booklet), SME in 66 patients (30 m, 36 f) with interdisciplinary quality team (pneumologists, primary care physicians, pharmacists, specialised nursing staff), QOL questionnaire. Measurement of morbidity parameters 12 months before and after SME. Measurement of QOL before and 12 months after SME. RESULTS: Hospitalisations fell from 35 to 8%*, EC from 88 to 53%*. and LW from 39 to 14%* (*p <0.001). Overall, SME resulted in a health cost saving of CHF 202,510 in terms of LW and CHF 131,200 in terms of days in hospital, i.e. a total of CHF 333,710. Costs saved per patient were CHF 5,056 per year. QOL improved with the following scores: overall QOL 4.5 +/- 0.9 to 5.2 +/- 0.9*; activities 4.5 +/- 0.9 to 5.2 +/- 0.9*; symptoms 4.2 +/- 1.1 to 5.2 +/- 1.1*; emotions 4.9 +/- 1.1 to 5.6 +/- 1*; environment 4.5 +/- 1.4 to 4.9 +/- 1.3* (*p <0.001). CONCLUSION: SME by interdisciplinary health network is effective. It brings a steep fall in costs for asthma treatment by cutting back hospitalisations and lost workdays and by improving the asthmatics' quality of life. It should be recognised and better supported by the health system.

A new class of biorthogonal wavelet systems for image transform coding.

We construct general biorthogonal Coifman wavelet systems, a new class of compactly supported biorthogonal wavelet systems with vanishing moments equally distributed for a scaling function and wavelet pair. A time-domain design method is employed and closed-form expressions for the impulse responses and the frequency responses of the corresponding dual filters are derived. The resulting filter coefficients are all dyadic fractions, which is an attractive feature in the realization of multiplication-free discrete wavelet transform. Even-ordered systems in this family are symmetric, which correspond to linear-phase dual filters. In particular, three filterbanks (FBs) in this family are systematically verified to have competitive compression potential to the 9-7 tap biorthogonal wavelet FB by Cohen et al., which is currently the most widely used one in the field of wavelet transform coding. In addition, the proposed FB's have much smaller computational complexity in terms of floating-point operations required in transformation, and therefore indicate a better tradeoff between compression performance and computational complexity.

On cosine-modulated wavelet orthonormal bases.

Multiplicity M, K-regular, orthonormal wavelet bases (that have implications in transform coding applications) have previously been constructed by several authors. The paper describes and parameterizes the cosine-modulated class of multiplicity M wavelet tight frames (WTFs). In these WTFs, the scaling function uniquely determines the wavelets. This is in contrast to the general multiplicity M case, where one has to, for any given application, design the scaling function and the wavelets. Several design techniques for the design of K regular cosine-modulated WTFs are described and their relative merits discussed. Wavelets in K-regular WTFs may or may not be smooth, Since coding applications use WTFs with short length scaling and wavelet vectors (since long filters produce ringing artifacts, which is undesirable in, say, image coding), many smooth designs of K regular WTFs of short lengths are presented. In some cases, analytical formulas for the scaling and wavelet vectors are also given. In many applications, smoothness of the wavelets is more important than K regularity. The authors define smoothness of filter banks and WTFs using the concept of total variation and give several useful designs based on this smoothness criterion. Optimal design of cosine-modulated WTFs for signal representation is also described. All WTFs constructed in the paper are orthonormal bases.

Optical interconnects using top-surface-emitting microlasers and planar optics.

Optical interconnections made using two-dimensional arrays of top-surface-emitting microlasers and integrated free-space optics are discussed for use in chip-to-chip communications. A demonstration setup with a 2 x 2 array of lasers is presented. System parameters, such as light efficiency, the number of data channels, thermal effects, power requirements, and the issue of hybrid integration of laser chips with passive optics, are considered.

Uniform performance of high-efficiency room-temperature GaInAsSb/GaSb photodiodes for 1.75 < lambda < 2.2 mum.

A group of 126 experimental, packaged, backilluminated, 1.75-2.2-microm wavelength, GaInAsSb mesa (~85-microm diameter) photodetectors have been assembled and evaluated. Average room-temperature properties were peak quantum efficiency, 86%; zero-bias capacitance, 3.9 pF; dark current at -0.5-V bias, 7.4 microA.

Neuropeptide-Y. A peptide found in human coronary arteries constricts primarily small coronary arteries to produce myocardial ischemia in dogs.

Neuropeptide-Y (NPY), a brain peptide, is located in the walls of human coronary arteries. This study assessed the effects of NPY on the coronary circulation in 40 chloralose-anesthetized, open-chest dogs. Intracoronary NPY (42 nmol over 5.2 min) caused a 39% reduction in coronary blood flow without changing heart rate or aortic pressure. To determine whether this vasoconstriction could produce ischemia, intramyocardial pH was measured in seven dogs (group I) and decreased from 7.45 +/- 0.06 to 7.37 +/- 0.06 pH units after NPY in the subendocardium (P less than 0.0002), and from 7.45 +/- 0.06 to 7.40 +/- 0.05 pH units (P less than 0.04) in the subepicardium of the infused zone. Left ventricular ejection fraction (LVEF), measured by radionuclide angiography, decreased from 0.52 +/- 0.08 to 0.42 +/- 0.12 U (n = 5, P less than 0.01) during NPY. NPY-induced vasoconstriction was also associated with ST-T wave changes on the electrocardiogram (ECG) in eight of nine other animals (group V). In another group of six dogs (group IV), the change in small vessel resistance accounted for 94% of the increase in total resistance, so that the primary vasoconstrictor effect of NPY was exerted on small coronary arteries. Thus, NPY, a peptide found in human coronary arteries, caused constriction of primarily small coronary arteries that was severe enough to produce myocardial ischemia as determined by ECG ST-T wave changes, and decreases in intramyocardial pH and LVEF in dogs.

Optical-level shifter and self-linearized optical modulator using a quantum-well self-electro-optic effect device.

We demonstrate an optical-level shifter and a modulator whose transmission varies linearly with drive current, both based on a new, negative-feedback mode of operation of the recently discovered quantum-well self-electro-optic effect device. The system is compatible with both laser diodes and low-power semiconductor electronics and is applicable in both analog and digital optical processing. An extension of the system gives inverted, linear modulation of a coherent beam by an incoherent light source.

Optical gain exceeding 35 dB at 1.56 microm due to stimulated Raman scattering by molecular D(2) in a solid silica optical fiber.

A stimulated-Raman-gain medium at 1.56-microm wavelength, consisting of molecular deuterium dissolved in low-loss silica optical fiber and pumped by 1.06-microm Nd:YAG laser light, is described. In a 100-m-long fiber with pump power of 130 W, InGaAsP injection-laser probe light at 1.56 microm was amplified by a factor of 4000 to an output power of 150 mW. The measured stimulated-Raman-gain coefficient at 1.56 microm is 7 x 10(-12) cm/W, about equal to the Raman gain of SiO(2) at the same wavelength.

Gas-in-glass-a new Raman-gain medium: molecular hydrogen in solid-silica optical fibers.

A new Raman-gain medium consisting of molecular hydrogen dissolved at high pressure in low-loss solid-silica optical fibers is described. Stimulated Raman gain at 0.88-microm wavelength was measured in a half-kilometer length of this H(2)-diffused fiber by using a krypton-laser pump and an injection-laser probe. The gain coefficient determined from these experiments at 0.88 microm is 5 x 10(-12) cm/W. The overtone absorption spectrum of high-pressure hydrogen in silica was observed.

Arterial pressure contour analysis for estimating human vascular properties.

The form of an arterial blood pressure curve during the diastolic portion of the cardiac cycle was here employed to identify parameters in a third-order model of the vascular system. Calculated elastic and intertial characteristics of this fitted model then became clinically accessible indices of corresponding real vascular properties. This technique incurred no risk and little discomfort for the patient. Tested in theory, in animal experimentation, and in human observations, our procedure utilized a Gauss-Newton algorithm via digital computer to provide rapid model solutions from different starting values, from multiple measurements sites, and from normal or diseased patients. Model parameters thus determined defined ranges of normal variation and suggested a less compliant arterial bed in hypertensive than in normotensive patients.

Focusing Effects in Interferometric Analysis of Graded-index Optical Fibers.

The effects of ray bending due to graded refractive-index profiles have been studied in relation to the measurement of optical-fiber refractive-index profiles by microscopic interferometric techniques. In particular, the wavefront curvature produced by a simple parabolic profile has been calculated analytically. It is concluded that profile measurements by currently used methods require samples for which the fiber thickness (length) is much less than the effective focal length of the fiber. For parabolic profile fibers with diameter d greater, similar 100 microm, this poses no problem; however, for small-core versions of this fiber, sample thicknesses of 10-15 microm may be required and an alternate measurement technique is described. Interferograms made on a Leitz transmitted-light interference microscope are included in illustrations.