Designing a generalized soil-adjusted vegetation index (GESAVI)

NASA Astrophysics Data System (ADS)

Gilabert, M. A.; Gonzalez Piqueras, Jose; Garcia-Haro, Joan; Melia, J.

1998-12-01

Operational monitoring of vegetative cover by remote sensing currently involves the utilization of vegetation indices (VIs), most of them being functions of the reflectance in red (R) and near-infrared (NIR) spectral bands. A generalized soil-adjusted vegetation index (GESAVI), theoretically based on a simple vegetation canopy model, is introduced. It is defined in terms of the soil line parameters (A and B) as: GESAVI equals (NIR-BR-A)/(R + Z), where Z is related to the red reflectance at the cross point between the soil line and vegetation isolines. Z can be considered as a soil adjustment coefficient which let this new index be considered as belonging to the SAVI family. In order to analyze the GESAVI sensitivity to soil brightness and soil color, both high resolution reflectance data from two laboratory experiments and data obtained by applying a radiosity model to simulate heterogeneous vegetation canopy scenes were used. VIs (including GESAVI, NDVI, PVI and SAVI family VIs) were computed and their correlation with LAI for the different soil backgrounds was analyzed. Results confirmed the lower sensitivity of GESAVI to soil background in most of the cases, thus becoming the most efficient index. This good index performance results from the fact that the isolines in the NIR-R plane are neither parallel to the soil line (as required by the PVI) nor convergent at the origin (as required by the NDVI) but they converge somewhere between the origin and infinity in the region of negative values of both NIR and R. This convergence point is not necessarily situated on the bisectrix, as required by other SAVI family indices.

5 CFR 591.224 - How does OPM adjust price indexes between surveys?

Code of Federal Regulations, 2011 CFR

2011-01-01

... price indexes between the triennial surveys in each COLA area that is not surveyed in that year. To do this, OPM uses the annual or biennial change in the Consumer Price Index (CPI) for the COLA area... Islands, OPM will adjust as warranted the price indexes and COLA rates for Puerto Rico, the U.S. Virgin...

5 CFR 591.224 - How does OPM adjust price indexes between surveys?

Code of Federal Regulations, 2010 CFR

2010-01-01

... price indexes between the triennial surveys in each COLA area that is not surveyed in that year. To do this, OPM uses the annual or biennial change in the Consumer Price Index (CPI) for the COLA area... Islands, OPM will adjust as warranted the price indexes and COLA rates for Puerto Rico, the U.S. Virgin...

5 CFR 591.224 - How does OPM adjust price indexes between surveys?

Code of Federal Regulations, 2014 CFR

2014-01-01

... price indexes between the triennial surveys in each COLA area that is not surveyed in that year. To do this, OPM uses the annual or biennial change in the Consumer Price Index (CPI) for the COLA area... Islands, OPM will adjust as warranted the price indexes and COLA rates for Puerto Rico, the U.S. Virgin...

5 CFR 591.224 - How does OPM adjust price indexes between surveys?

Code of Federal Regulations, 2012 CFR

2012-01-01

... price indexes between the triennial surveys in each COLA area that is not surveyed in that year. To do this, OPM uses the annual or biennial change in the Consumer Price Index (CPI) for the COLA area... Islands, OPM will adjust as warranted the price indexes and COLA rates for Puerto Rico, the U.S. Virgin...

5 CFR 591.224 - How does OPM adjust price indexes between surveys?

Code of Federal Regulations, 2013 CFR

2013-01-01

... price indexes between the triennial surveys in each COLA area that is not surveyed in that year. To do this, OPM uses the annual or biennial change in the Consumer Price Index (CPI) for the COLA area... Islands, OPM will adjust as warranted the price indexes and COLA rates for Puerto Rico, the U.S. Virgin...

Registered Replication Report: Rand, Greene, and Nowak (2012).

PubMed

Bouwmeester, S; Verkoeijen, P P J L; Aczel, B; Barbosa, F; Bègue, L; Brañas-Garza, P; Chmura, T G H; Cornelissen, G; Døssing, F S; Espín, A M; Evans, A M; Ferreira-Santos, F; Fiedler, S; Flegr, J; Ghaffari, M; Glöckner, A; Goeschl, T; Guo, L; Hauser, O P; Hernan-Gonzalez, R; Herrero, A; Horne, Z; Houdek, P; Johannesson, M; Koppel, L; Kujal, P; Laine, T; Lohse, J; Martins, E C; Mauro, C; Mischkowski, D; Mukherjee, S; Myrseth, K O R; Navarro-Martínez, D; Neal, T M S; Novakova, J; Pagà, R; Paiva, T O; Palfi, B; Piovesan, M; Rahal, R-M; Salomon, E; Srinivasan, N; Srivastava, A; Szaszi, B; Szollosi, A; Thor, K Ø; Tinghög, G; Trueblood, J S; Van Bavel, J J; van 't Veer, A E; Västfjäll, D; Warner, M; Wengström, E; Wills, J; Wollbrant, C E

2017-05-01

In an anonymous 4-person economic game, participants contributed more money to a common project (i.e., cooperated) when required to decide quickly than when forced to delay their decision (Rand, Greene & Nowak, 2012), a pattern consistent with the social heuristics hypothesis proposed by Rand and colleagues. The results of studies using time pressure have been mixed, with some replication attempts observing similar patterns (e.g., Rand et al., 2014) and others observing null effects (e.g., Tinghög et al., 2013; Verkoeijen & Bouwmeester, 2014). This Registered Replication Report (RRR) assessed the size and variability of the effect of time pressure on cooperative decisions by combining 21 separate, preregistered replications of the critical conditions from Study 7 of the original article (Rand et al., 2012). The primary planned analysis used data from all participants who were randomly assigned to conditions and who met the protocol inclusion criteria (an intent-to-treat approach that included the 65.9% of participants in the time-pressure condition and 7.5% in the forced-delay condition who did not adhere to the time constraints), and we observed a difference in contributions of -0.37 percentage points compared with an 8.6 percentage point difference calculated from the original data. Analyzing the data as the original article did, including data only for participants who complied with the time constraints, the RRR observed a 10.37 percentage point difference in contributions compared with a 15.31 percentage point difference in the original study. In combination, the results of the intent-to-treat analysis and the compliant-only analysis are consistent with the presence of selection biases and the absence of a causal effect of time pressure on cooperation.

Registered Replication Report: Rand, Greene, and Nowak (2012)

PubMed Central

Bouwmeester, S.; Verkoeijen, P. P. J. L.; Aczel, B.; Barbosa, F.; Bègue, L.; Brañas-Garza, P.; Chmura, T. G. H.; Cornelissen, G.; Døssing, F. S.; Espín, A. M.; Evans, A. M.; Ferreira-Santos, F.; Fiedler, S.; Flegr, J.; Ghaffari, M.; Glöckner, A.; Goeschl, T.; Guo, L.; Hauser, O. P.; Hernan-Gonzalez, R.; Herrero, A.; Horne, Z.; Houdek, P.; Johannesson, M.; Koppel, L.; Kujal, P.; Laine, T.; Lohse, J.; Martins, E. C.; Mauro, C.; Mischkowski, D.; Mukherjee, S.; Myrseth, K. O. R.; Navarro-Martínez, D.; Neal, T. M. S.; Novakova, J.; Pagà, R.; Paiva, T. O.; Palfi, B.; Piovesan, M.; Rahal, R.-M.; Salomon, E.; Srinivasan, N.; Srivastava, A.; Szaszi, B.; Szollosi, A.; Thor, K. Ø.; Tinghög, G.; Trueblood, J. S.; Van Bavel, J. J.; van ‘t Veer, A. E.; Västfjäll, D.; Warner, M.; Wengström, E.; Wills, J.; Wollbrant, C. E.

2017-01-01

In an anonymous 4-person economic game, participants contributed more money to a common project (i.e., cooperated) when required to decide quickly than when forced to delay their decision (Rand, Greene & Nowak, 2012), a pattern consistent with the social heuristics hypothesis proposed by Rand and colleagues. The results of studies using time pressure have been mixed, with some replication attempts observing similar patterns (e.g., Rand et al., 2014) and others observing null effects (e.g., Tinghög et al., 2013; Verkoeijen & Bouwmeester, 2014). This Registered Replication Report (RRR) assessed the size and variability of the effect of time pressure on cooperative decisions by combining 21 separate, preregistered replications of the critical conditions from Study 7 of the original article (Rand et al., 2012). The primary planned analysis used data from all participants who were randomly assigned to conditions and who met the protocol inclusion criteria (an intent-to-treat approach that included the 65.9% of participants in the time-pressure condition and 7.5% in the forced-delay condition who did not adhere to the time constraints), and we observed a difference in contributions of −0.37 percentage points compared with an 8.6 percentage point difference calculated from the original data. Analyzing the data as the original article did, including data only for participants who complied with the time constraints, the RRR observed a 10.37 percentage point difference in contributions compared with a 15.31 percentage point difference in the original study. In combination, the results of the intent-to-treat analysis and the compliant-only analysis are consistent with the presence of selection biases and the absence of a causal effect of time pressure on cooperation. PMID:28475467

A new casemix adjustment index for hospital mortality among patients with congestive heart failure.

PubMed

Polanczyk, C A; Rohde, L E; Philbin, E A; Di Salvo, T G

1998-10-01

Comparative analysis of hospital outcomes requires reliable adjustment for casemix. Although congestive heart failure is one of the most common indications for hospitalization, congestive heart failure casemix adjustment has not been widely studied. The purposes of this study were (1) to describe and validate a new congestive heart failure-specific casemix adjustment index to predict in-hospital mortality and (2) to compare its performance to the Charlson comorbidity index. Data from all 4,608 admissions to the Massachusetts General Hospital from January 1990 to July 1996 with a principal ICD-9-CM discharge diagnosis of congestive heart failure were evaluated. Massachusetts General Hospital patients were randomly divided in a derivation and a validation set. By logistic regression, odds ratios for in-hospital death were computed and weights were assigned to construct a new predictive index in the derivation set. The performance of the index was tested in an internal Massachusetts General Hospital validation set and in a non-Massachusetts General Hospital external validation set incorporating data from all 1995 New York state hospital discharges with a primary discharge diagnosis of congestive heart failure. Overall in-hospital mortality was 6.4%. Based on the new index, patients were assigned to six categories with incrementally increasing hospital mortality rates ranging from 0.5% to 31%. By logistic regression, "c" statistics of the congestive heart failure-specific index (0.83 and 0.78, derivation and validation set) were significantly superior to the Charlson index (0.66). Similar incrementally increasing hospital mortality rates were observed in the New York database with the congestive heart failure-specific index ("c" statistics 0.75). In an administrative database, this congestive heart failure-specific index may be a more adequate casemix adjustment tool to predict hospital mortality in patients hospitalized for congestive heart failure.

The RAND Health Insurance Experiment, Three Decades Later*

PubMed Central

Aron-Dine, Aviva; Einav, Liran; Finkelstein, Amy

2013-01-01

We re-present and re-examine the analysis from the famous RAND Health Insurance Experiment from the 1970s on the impact of consumer cost sharing in health insurance on medical spending. We begin by summarizing the experiment and its core findings in a manner that would be standard in the current age. We then examine potential threats to the validity of a causal interpretation of the experimental treatment effects stemming from different study participation and differential reporting of outcomes across treatment arms. Finally, we re-consider the famous RAND estimate that the elasticity of medical spending with respect to its out-of-pocket price is −0.2, emphasizing the challenges associated with summarizing the experimental treatment effects from non-linear health insurance contracts using a single price elasticity. PMID:24610973

5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

Code of Federal Regulations, 2013 CFR

2013-01-01

... adjustment factor to a COLA rate? 591.228 Section 591.228 Administrative Personnel OFFICE OF PERSONNEL... adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA rate as shown in the following table: Price index plus adjustment factor COLA rate subject to paragraph (b...

5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

Code of Federal Regulations, 2012 CFR

2012-01-01

... adjustment factor to a COLA rate? 591.228 Section 591.228 Administrative Personnel OFFICE OF PERSONNEL... adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA rate as shown in the following table: Price index plus adjustment factor COLA rate subject to paragraph (b...

5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

Code of Federal Regulations, 2011 CFR

2011-01-01

... adjustment factor to a COLA rate? 591.228 Section 591.228 Administrative Personnel OFFICE OF PERSONNEL... adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA rate as shown in the following table: Price index plus adjustment factor COLA rate subject to paragraph (b...

5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

Code of Federal Regulations, 2014 CFR

2014-01-01

... adjustment factor to a COLA rate? 591.228 Section 591.228 Administrative Personnel OFFICE OF PERSONNEL... adjustment factor to a COLA rate? (a) OPM converts the price index plus the adjustment factor to a COLA rate as shown in the following table: Price index plus adjustment factor COLA rate subject to paragraph (b...

On Atom-Bond Connectivity Index

NASA Astrophysics Data System (ADS)

Zhou, Bo; Xing, Rundan

2011-02-01

The atom-bond connectivity (ABC) index, introduced by Estrada et al. in 1998, displays an excellent correlation with the formation heat of alkanes. We give upper bounds for this graph invariant using the number of vertices, the number of edges, the Randíc connectivity indices, and the first Zagreb index. We determine the unique tree with the maximum ABC index among trees with given numbers of vertices and pendant vertices, and the n-vertex trees with the maximum, and the second, the third, and the fourth maximum ABC indices for n ≥ 6.

RandAgiamo™, a Pilot Project Increasing Adoptability of Shelter Dogs in the Umbria Region (Italy)

PubMed Central

Menchetti, Laura; Mancini, Stefania; Catalani, Maria Chiara; Boccini, Beatrice; Diverio, Silvana

2015-01-01

Simple Summary In Italy, dog shelters are overcrowded because the rate of dog adoption is lower than that of abandonment. A project called “RandAgiamo” was implemented in a rescue shelter in central Italy. RandAgiamo provides training, socialization and advertising of adult shelter dogs. Official data of the Umbria regional health authorities from the year 2014 showed a higher rate of adoption in shelters involved in the project. RandAgiamo dogs had triple odds of being adopted compared to others housed in shelters of the same province. The increase in adoption rate can be beneficial for both dog welfare and shelter management. Abstract Current Italian legislation does not permit euthanasia of dogs, unless they are ill or dangerous. Despite good intentions and ethical benefits, this “no-kill policy” has caused a progressive overpopulation of dogs in shelters, due to abandonment rates being higher than adoption rates. Shelter overcrowding has negative implications for dog welfare and increases public costs. The aim of this paper is to describe the pilot project “RandAgiamo” implemented in a rescue shelter in the Umbria Region and to evaluate its effectiveness on the rate of dog adoption using official data. RandAgiamo aimed to increase adult shelter dogs’ adoptability by a standard training and socialization programme. It also promoted dogs’ visibility by publicizing them through social media and participation in events. We analysed the official data of the Umbria regional health authorities regarding dog shelters of the Perugia province of the year 2014. In the RandAgiamo shelter, the dog adoption rate was 27.5% higher than that of dogs housed in other shelters located in the same geographical area (p < 0.001). The RandAgiamo project could be beneficial for the dogs’ welfare, owner satisfaction, shelter management, and public perception of shelter dogs. However, staff were required to provide dog training and related activities. PMID:26479385

Recent Contributions of Information Sciences Research at RAND to Modeling- and Simulation-Based Policy Analysis.

ERIC Educational Resources Information Center

Donohue, G. L.; And Others

This report presents examples of Rand's current research in the information sciences and illustrates the application of information science tools to specific policy studies. The projects discussed depict Rand's success with using corporate seed money to bridge the gap between the research and development of new information science tools and…

Adjustable internal structure for reconstructing gradient index profile of crystalline lens.

PubMed

Bahrami, Mehdi; Goncharov, Alexander V; Pierscionek, Barbara K

2014-03-01

Employing advanced technologies in studying the crystalline lens of the eye has improved our understanding of the refractive index gradient of the lens. Reconstructing and studying such a complex structure requires models with adaptable internal geometry that can be altered to simulate geometrical and optical changes of the lens with aging. In this Letter, we introduce an optically well-defined, geometrical structure for modeling the gradient refractive index profile of the crystalline lens with the advantage of an adjustable internal structure that is not available with existing models. The refractive index profile assigned to this rotationally symmetric geometry is calculated numerically, yet it is shown that this does not limit the model. The study provides a basis for developing lens models with sophisticated external and internal structures without the need for analytical solutions to calculate refractive index profiles.

Organizing complexity: the hopeful dreams and harsh realities of interdisciplinary collaboration at the rand corporation in the early cold war.

PubMed

Bessner, Daniel

2015-01-01

Historians argue that in the early Cold War an interdisciplinary research culture defined the RAND Corporation. However, a significant epistemological gap divided the members of RAND's Social Science Division (SSD) from the rest of the organization. While the social scientists used qualitative methods, most RAND researchers embraced quantified approaches and derided the social sciences as unscientific. This encouraged RAND's social scientists to develop a political-military simulation that embraced everything-politics, culture, and psychology-that RAND's other analysts largely ignored. Yet the fact that the SSD embraced gaming, a heuristic practiced throughout RAND, suggests that the political simulation was nonetheless inspired by social scientists' engagement with their colleagues. This indicates that the concept of interdisciplinarity should move beyond its implication of collaboration to incorporate instances in which research agendas are defined against but also shaped by colleagues in other disciplines. Such a rethinking of the term may make it possible to trace how varieties of interdisciplinary interaction historically informed knowledge production. © 2014 Wiley Periodicals, Inc.

Heat index and adjusted temperature as surrogates for wet bulb globe temperature to screen for occupational heat stress.

PubMed

Bernard, Thomas E; Iheanacho, Ivory

2015-01-01

Ambient temperature and relative humidity are readily ava-ilable and thus tempting metrics for heat stress assessment. Two methods of using air temperature and relative humidity to create an index are Heat Index and Adjusted Temperature. The purposes of this article are: (1) to examine how well Heat Index and Adjusted Temperature estimated the wet bulb globe temperature (WBGT) index, and (2) to suggest how Heat Index and Adjusted Temperature can be used to screen for heat stress level. Psychrometric relationships were used to estimate values of actual WBGT for conditions of air temperature, relative humidity, and radiant heat at an air speed of 0.5 m/s. A relationship between Heat Index [°F] and WBGT [°C] was described by WBGT = -0.0034 HI(2) + 0.96 HI - 34. At lower Heat Index values, the equation estimated WBGTs that were ± 2 °C-WBGT around the actual value, and to about ± 0.5 °C-WBGT for Heat Index values > 100 °F. A relationship between Adjusted Temperature [°F] and WBGT [°C] was described by WBGT = 0.45 Tadj - 16. The actual WBGT was between 1 °C-WBGT below the estimated value and 1.4 °C-WBGT above. That is, there was a slight bias toward overestimating WBGT from Adjusted Temperature. Heat stress screening tables were constructed for metabolic rates of 180, 300, and 450 W. The screening decisions were divided into four categories: (1) < alert limit, (2) < exposure limit, (3) hourly time-weighted averages (TWAs) of work and recovery, and (4) a caution zone for an exposure > exposure limit at rest. The authors do not recommend using Heat Index or Adjusted Temperature instead of WBGT, but they may be used to screen for circumstances when a more detailed analysis using WBGT is appropriate. A particular weakness is accounting for radiant heat; and neither air speed nor clothing was considered.

ECONOMICS DEPARTMENT PUBLICATIONS, 1960-1965: AN AUTHOR INDEX OF THE OPEN LITERATURE, WITH ABSTRACTS,

DTIC Science & Technology

This is an author index for RAND Economics Department publications issued between January 1, 1960 and December 31, 1965, and available in the open...As a reference aid, the names of all authors are given alphabetically in the Author List immediately preceding the Author Index .

11. Historic American Buildings Survey Marvin Rand, Photographer August 1971 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Historic American Buildings Survey Marvin Rand, Photographer August 1971 FIRST FLOOR: MUSIC ROOM (Stained Glass Windows Designed by Shepard) - Villa Montezuma, 1925 K Street, San Diego, San Diego County, CA

Development and characterization of adjustable refractive index scattering epoxy acrylate polymer layers

NASA Astrophysics Data System (ADS)

Eiselt, Thomas; Preinfalk, Jan; Gleißner, Uwe; Lemmer, Uli; Hanemann, Thomas

2017-03-01

Several polymer films for improved optical properties in optoelectronic devices are presented. In such optical applications, it is sometimes important to have a film with an adjusted refractive index, scattering properties, and a low surface roughness. These diffusing films can be used to increase the efficiency of optoelectronic components, such as organic light-emitting diodes. Three different epoxy acrylate mixtures containing Syntholux 291 EA, bisphenol A glycerolate dimethacrylate, and Sartomer SR 348 L are characterized and optimized with different additives. The adjustable refractive index of the material is achieved by chemical doping using 9-vinylcarbazole. Titanium nanoparticles in the mixtures generate light scattering and increase the refractive index additionally. A high-power stirrer is used to mix and disperse all chemical substances together to a homogenous mixture. The viscosity behavior of the mixtures is an important property for the selection of the production method and, therefore, the viscosity measurement results are presented. After the mixing, the monomer mixture is applied on glass substrates by screen printing. To initiate polymerization, the produced films are irradiated for 10 min with ultraviolet radiation and heat. Transmission measurements of the polymer matrix and roughness measurements complement the characterization.

5. Historic American Buildings Survey Frances Rand Smith Collection California ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Historic American Buildings Survey Frances Rand Smith Collection California Historical Society Original: After 1860's Re-photo: January 1940 FIRST FRAME CHURCH (LEFT) - Mission San Rafael Archangel, San Rafael, Marin County, CA

75 FR 20386 - Trane a Subsidiary of Ingersoll Rand Including On-Site Leased Workers From Aerotek, Express...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... Ingersoll Rand Including On-Site Leased Workers From Aerotek, Express Personnel Services, Select Staffing... Ingersoll Rand, including on-site leased workers from Aerotek, Express Personnel Staffing, and Select... from Aerotek, Express Personnel Staffing, Select Staffing, and Mechanical Contractors, Inc., Pueblo...

10. Historic American Buildings Survey Frances Rand Smith Collection California ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Historic American Buildings Survey Frances Rand Smith Collection California Historical Society Original: About 1890 Re-photo: January 1940 SECOND FRAME CHURCH REPLACING MISSION (1890) - Mission San Rafael Archangel, San Rafael, Marin County, CA

Social Security cost-of-living adjustments and the Consumer Price Index.

PubMed

Burdick, Clark; Fisher, Lynn

2007-01-01

OASDI benefits are indexed for inflation to protect beneficiaries from the loss of purchasing power implied by inflation. In the absence of such indexing, the purchasing power of Social Security benefits would be eroded as rising prices raise the cost of living. By statute, cost-of-living adjustments (COLAs) for Social Security benefits are calculated using the Bureau of Labor Statistics (BLS) Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). Some argue that this index does not accurately reflect the inflation experienced by the elderly population and should be changed to an elderly-specific price index such as the Experimental Consumer Price Index for Americans 62 Years of Age and Older, often referred to as the Consumer Price Index for the Elderly (CPI-E). Others argue that the measure of inflation underlying the COLA is technically biased, causing it to overestimate changes in the cost of living. This argument implies that current COLAs tend to increase, rather than merely maintain, the purchasing power of benefits over time. Potential bias in the CPI as a cost-of-living index arises from a number of sources, including incomplete accounting for the ability of consumers to substitute goods or change purchasing outlets in response to relative price changes. The BLS has constructed a new index called the Chained Consumer Price Index for All Urban Consumers (C-CPI-U) that better accounts for those consumer adjustments. Price indexes are not true cost-of-living indexes, but approximations of cost-of-living indexes (COLI). The Bureau of Labor Statistics (2006a) explains the difference between the two: As it pertains to the CPI, the COLI for the current month is based on the answer to the following question: "What is the cost, at this month ' market prices, of achieving the standard of living actually attained in the base period?" This cost is a hypothetical expenditure-the lowest expenditure level necessary at this month's prices to achieve the

The association between smoking and psychopathology adjusted for body mass index and gender.

PubMed

Dimitriadis, Dimitrios G; Mamplekou, Efterpi; Dimitriadis, Panayiotis G; Dimitriadis, George D; Papageorgiou, Charalambos

2016-10-01

This study examined the correlation between smoking habits and psychopathology status, as well as the impact of confounders such as body mass index and gender. A total of 134 non-smokers and 152 smokers were enrolled in this study. We measured psychopathology features using Symptom Checklist 90-Revised. We ran logistic regression models testing the smoking-psychopathology association, controlling for body mass index and gender. Smoking was positively correlated with depression, interpersonal sensitivity, hostility, somatization, paranoid ideation and psychoticism (P<0.05). Adjusting for body mass index and gender, the results remained largely unchanged, with a slight independent effect of body mass index. Our data suggest that smoking is a stronger predictor of psychopathology than body mass index and gender. © The Royal Australian and New Zealand College of Psychiatrists 2016.

8. Historic American Buildings Survey Frances Rand Smith Collection California ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Historic American Buildings Survey Frances Rand Smith Collection California Historical Society Original: 1870's Re-photo: January, 1940 FIRST FRAME CHURCH (LEFT), OLD MARIN COUNTY COURT HOUSE (CENTER) - Mission San Rafael Archangel, San Rafael, Marin County, CA

RandAgiamo™, a Pilot Project Increasing Adoptability of Shelter Dogs in the Umbria Region (Italy).

PubMed

Menchetti, Laura; Mancini, Stefania; Catalani, Maria Chiara; Boccini, Beatrice; Diverio, Silvana

2015-08-14

Current Italian legislation does not permit euthanasia of dogs, unless they are ill or dangerous. Despite good intentions and ethical benefits, this 'no-kill policy' has caused a progressive overpopulation of dogs in shelters, due to abandonment rates being higher than adoption rates. Shelter overcrowding has negative implications for dog welfare and increases public costs. The aim of this paper is to describe the pilot project "RandAgiamo" implemented in a rescue shelter in the Umbria Region and to evaluate its effectiveness on the rate of dog adoption using official data. RandAgiamo aimed to increase adult shelter dogs' adoptability by a standard training and socialization programme. It also promoted dogs' visibility by publicizing them through social media and participation in events. We analysed the official data of the Umbria regional health authorities regarding dog shelters of the Perugia province of the year 2014. In the RandAgiamo shelter, the dog adoption rate was 27.5% higher than that of dogs housed in other shelters located in the same geographical area (P < 0.001). The RandAgiamo project could be beneficial for the dogs' welfare, owner satisfaction, shelter management, and public perception of shelter dogs. However, staff were required to provide dog training and related activities.

Living on the edge: timing of Rand Flora disjunctions congruent with ongoing aridification in Africa.

PubMed

Pokorny, Lisa; Riina, Ricarda; Mairal, Mario; Meseguer, Andrea S; Culshaw, Victoria; Cendoya, Jon; Serrano, Miguel; Carbajal, Rodrigo; Ortiz, Santiago; Heuertz, Myriam; Sanmartín, Isabel

2015-01-01

The Rand Flora is a well-known floristic pattern in which unrelated plant lineages show similar disjunct distributions in the continental margins of Africa and adjacent islands-Macaronesia-northwest Africa, Horn of Africa-Southern Arabia, Eastern Africa, and Southern Africa. These lineages are now separated by environmental barriers such as the arid regions of the Sahara and Kalahari Deserts or the tropical lowlands of Central Africa. Alternative explanations for the Rand Flora pattern range from vicariance and climate-driven extinction of a widespread pan-African flora to independent dispersal events and speciation in situ. To provide a temporal framework for this pattern, we used published data from nuclear and chloroplast DNA to estimate the age of disjunction of 17 lineages that span 12 families and nine orders of angiosperms. We further used these estimates to infer diversification rates for Rand Flora disjunct clades in relation to their higher-level encompassing lineages. Our results indicate that most disjunctions fall within the Miocene and Pliocene periods, coinciding with the onset of a major aridification trend, still ongoing, in Africa. Age of disjunctions seemed to be related to the climatic affinities of each Rand Flora lineage, with sub-humid taxa dated earlier (e.g., Sideroxylon) and those with more xeric affinities (e.g., Campylanthus) diverging later. We did not find support for significant decreases in diversification rates in most groups, with the exception of older subtropical lineages (e.g., Sideroxylon, Hypericum, or Canarina), but some lineages (e.g., Cicer, Campylanthus) showed a long temporal gap between stem and crown ages, suggestive of extinction. In all, the Rand Flora pattern seems to fit the definition of biogeographic pseudocongruence, with the pattern arising at different times in response to the increasing aridity of the African continent, with interspersed periods of humidity allowing range expansions.

A MOLA-controlled RAND-USGS Control Network for Mars

NASA Technical Reports Server (NTRS)

Archinal, B. A.; Colvin, T. R.; Davies, M. E.; Kirk, R. L.; Duxbury, T. C.; Lee, E. M.; Cook, D.; Gitlin, A. R.

2002-01-01

We are undertaking, in support of the Mars Digital Image Mosaic (MDIM) 2.1, many improvements in the RAND-USGS photogrammetric control network for Mars, primarily involving the use of Mars Orbiter Laser Altimeter (MOLA)-derived radii and DIMs to improve control point absolute radii and horizontal positions. Additional information is contained in the original extended abstract.

Annual Report 2011-2012 (RAND National Security Research Division)

DTIC Science & Technology

2012-01-01

Charles Nemfakos, Chad J . R . Ohlandt, Caroline Reilly, Rena Rudavsky, Jerry M . Sollinger, Katharine Watkins Webb, and Carolyn Wong, MG-1171/1-OSD...Assessment of Marine Corps Intelligence, Christopher Paul, Harry J . Thie, Katharine Watkins Webb, Stephanie Young, Colin P . Clarke, Susan G . Straus...counterinsurgency campaign. For more information, see Reintegrating Afghan Insurgents, Seth G . Jones, OP-327-MCIA, 2011 . Online at www .rand .org/pubs

5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

Code of Federal Regulations, 2010 CFR

2010-01-01

... than 124.50 Price index plus the adjustment factor, minus 100, expressed to the nearest whole percent... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false How does OPM convert the price index plus... Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus...

Development and characterization of adjustable refractive index scattering epoxy acrylate polymer layers

NASA Astrophysics Data System (ADS)

Eiselt, Thomas; Preinfalk, Jan; Gleißner, Uwe; Lemmer, Uli; Hanemann, Thomas

2016-09-01

This work presents different polymer diffusing films for optical components. In optical applications it is sometimes important to have a film with an adjusted refractive index, scattering properties and a low surface roughness. These diffusing films can be used to increase the efficiency of optical components like organic light emitting diodes (OLEDs). In this study three different epoxy acrylate mixtures containing Syntholux 291 EA, bisphenol a glycerolate dimethacrylate, Sartomer SR 348 L are characterized and optimized with different additives. The adjustable refractive index of the material is achieved with a chemical doping by 9-vinylcarbazole. Titanium nanoparticles in the mixtures generate light scattering and increase the refractive index additionally. To prevent sedimentation and agglomeration of these nanoparticles, a stabilization agent [2-(2-methoxyethoxy)ethoxy]acetic acid is added to the mixture. Other ingredients are a UV-starter and thermal starter for the radical polymerization. A high power stirrer (ultraturrax) is used to mix and disperse all chemical substances together to a homogenous mixture. The viscosity behavior of the mixtures is an important property for the selection of the production method and gets characterized. After the mixing, the monomer mixture is applied on glass substrates by blade coating or screen printing. To initiate the chain growing (polymerization) the produced films are irradiated for 10 minutes long with UV light (UV LED Spot Hönle, 405 nm). After this step a final post bake from the layers in the oven (150°C, 30 min.) is operated. Light transmission measurements (UV-Vis) of the polymer matrix and roughness measurements complement the characterization.

Be aware of the Adjusted Treatment Index.

PubMed

Langford, Melvyn

2015-10-01

The authors of the interim report relating to the Review of Operational Productivity in NHS providers, published in June of this year, are, as many will know, developing a set of Adjusted Treatment Index (ATI) metrics, and are also to publish a model of their interpretation of what an estates department should look like in terms of its operational productivity and cost. This article argues that the underlying reason for the past failures was the creation of static 'point-value' metrics similar to the ATIs proposed, and that this can only be overcome by designing and populating a series of non-linear dynamic simulation models with feedback control of an organisation's estate in relation to its asset base and condition with respect to time, together with the resultant financial capital and revenue consequences. It concludes by calling on IHEEM's Council to urgently make representation to the authors of the June 2015 report, and suggests that the Institute's members be fully involved in the design, testing, and interpretation, of the estates model and ATIs. IHEEM's Technology Platforms are ideally placed to play a central role in this.

5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false What adjustment factors does OPM add to the price indexes? 591.227 Section 591.227 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances §...

Fels-Rand: an Xlisp-Stat program for the comparative analysis of data under phylogenetic uncertainty.

PubMed

Blomberg, S

2000-11-01

Currently available programs for the comparative analysis of phylogenetic data do not perform optimally when the phylogeny is not completely specified (i.e. the phylogeny contains polytomies). Recent literature suggests that a better way to analyse the data would be to create random trees from the known phylogeny that are fully-resolved but consistent with the known tree. A computer program is presented, Fels-Rand, that performs such analyses. A randomisation procedure is used to generate trees that are fully resolved but whose structure is consistent with the original tree. Statistics are then calculated on a large number of these randomly-generated trees. Fels-Rand uses the object-oriented features of Xlisp-Stat to manipulate internal tree representations. Xlisp-Stat's dynamic graphing features are used to provide heuristic tools to aid in analysis, particularly outlier analysis. The usefulness of Xlisp-Stat as a system for phylogenetic computation is discussed. Available from the author or at http://www.uq.edu.au/~ansblomb/Fels-Rand.sit.hqx. Xlisp-Stat is available from http://stat.umn.edu/~luke/xls/xlsinfo/xlsinfo.html. s.blomberg@abdn.ac.uk

Methods, systems and apparatus for adjusting modulation index to improve linearity of phase voltage commands

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

Gallegos-Lopez, Gabriel; Perisic, Milun; Kinoshita, Michael H.

2017-03-14

Embodiments of the present invention relate to methods, systems and apparatus for controlling operation of a multi-phase machine in a motor drive system. The disclosed embodiments provide a mechanism for adjusting modulation index of voltage commands to improve linearity of the voltage commands.

78 FR 8530 - Price Index Adjustments for Contribution and Expenditure Limitations and Lobbyist Bundling...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

...As mandated by provisions of the Federal Election Campaign Act of 1971, as amended (``FECA'' or ``the Act''), the Federal Election Commission (``FEC'' or ``the Commission'') is adjusting certain contribution and expenditure limitations and the lobbyist bundling disclosure threshold set forth in the Act, to index the amounts for inflation. Additional details appear in the supplemental information that follows.

77 FR 9925 - Price Index Adjustments for Expenditure Limitations and Lobbyist Bundling Disclosure Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-21

...As mandated by provisions of the Federal Election Campaign Act of 1971, as amended (``FECA'' or ``the Act''), the Federal Election Commission (``FEC'' or ``the Commission'') is adjusting certain expenditure limitations and the lobbyist bundling disclosure threshold set forth in the Act, to index the amounts for inflation. Additional details appear in the supplemental information that follows.

75 FR 8353 - Price Index Adjustments for Expenditure Limitations and Lobbyist Bundling Disclosure Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

...As mandated by provisions of the Federal Election Campaign Act of 1971, as amended (``FECA'' or ``the Act''), the Federal Election Commission (``FEC'' or ``the Commission'') is adjusting certain expenditure limitations and the lobbyist bundling disclosure threshold set forth in the Act, to index the amounts for inflation. Additional details appear in the supplemental information that follows.

Sexual Assault and Sexual Harassment in the U.S. Military: Highlights from the 2014 RAND Military Workplace Study

DTIC Science & Technology

2015-01-01

assault, sexual harassment , and gender discrimination in the military. The resulting study, the RAND Military Workplace Study (RMWS), invited close to...members are highlighted in this brief. Sexual Assault and Sexual Harassment in the U.S. Military HigHligHts from tHe 2014 rAND militAry WorkplAce stuDy...significantly higher rates than men : 22 percent of women and 7 percent of men experienced sexual harassment in the past year. In addition, we estimate

RAND’s Role in the Evolution of Balloon and Satellite Observation Systems and Related U.S. Space Technology

DTIC Science & Technology

1988-09-01

committee consisting of the Under Secre- tary of the Air Force, Joseph Charyk; the Deputy Director of Defense Research and Engineering , John H. Rubel...prepared as part of RAND-sponsored research, was originally intended to commemorate the fortieth anniversary of Project RAND (now Project AIR FORCE), a...simple matter either for the authors or for the U.S. government.(/-) Hence, a project begun two years ago to commemorate the fortieth anniversary of Air

58. View of high pressure IngersollRand dehumidifier/dessicator and compressor system ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

58. View of high pressure Ingersoll-Rand dehumidifier/dessicator and compressor system to supply dry pressurized air to waveguides. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

Simulation of two-dimensional adjustable liquid gradient refractive index (L-GRIN) microlens

NASA Astrophysics Data System (ADS)

Le, Zichun; Wu, Xiang; Sun, Yunli; Du, Ying

2017-07-01

In this paper, a two-dimensional liquid gradient refractive index (L-GRIN) microlens is designed which can be used in adjusting focusing direction and focal spot of light beam. Finite element method (FEM) is used to simulate the convection diffusion process happening in core inlet flow and cladding inlet flow. And the ray tracing method shows us the light beam focusing effect including the extrapolation of focal length and output beam spot size. When the flow rates of the core and cladding fluids are held the same between the internal and external, left and right, and upper and lower inlets, the focal length varied from 313 μm to 53.3 μm while the flow rate of liquids ranges from 500 pL/s to 10,000 pL/s. While the core flow rate is bigger than the cladding inlet flow rate, the light beam will focus on a light spot with a tunable size. By adjusting the ratio of cladding inlet flow rate including Qright/Qleft and Qup/Qdown, we get the adjustable two-dimensional focus direction rather than the one-dimensional focusing. In summary, by adjusting the flow rate of core inlet and cladding inlet, the focal length, output beam spot and focusing direction of the input light beam can be manipulated. We suppose this kind of flexible microlens can be used in integrated optics and lab-on-a-chip system.

A Variable-Selection Heuristic for K-Means Clustering.

ERIC Educational Resources Information Center

Brusco, Michael J.; Cradit, J. Dennis

2001-01-01

Presents a variable selection heuristic for nonhierarchical (K-means) cluster analysis based on the adjusted Rand index for measuring cluster recovery. Subjected the heuristic to Monte Carlo testing across more than 2,200 datasets. Results indicate that the heuristic is extremely effective at eliminating masking variables. (SLD)

76 FR 8368 - Price Index Adjustments for Contribution and Expenditure Limits and Lobbyist Bundling Disclosure...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-14

...As mandated by provisions of the Federal Election Campaign Act of 1971, as amended (``FECA'' or ``the Act''), the Federal Election Commission (``FEC'' or ``the Commission'') is adjusting certain contribution and expenditure limits and the lobbyist bundling disclosure threshold set forth in the Act, to index the amounts for inflation. Additional details appear in the supplemental information that follows.

Policy efficiency in the field of food sustainability. The adjusted food agriculture and nutrition index.

PubMed

Agovino, Massimiliano; Cerciello, Massimiliano; Gatto, Andrea

2018-07-15

This work introduces a revised version of the Food Sustainability Index, proposed by the Economist Intelligence Unit and the Barilla Center for Food and Nutrition in 2016. Our Adjusted Food Sustainability Index features two important advantages: 1) it employs the Mazziotta-Pareto method to compute weights, hence granting an objective aggregation criterion and 2) it does not take policy variables into account, thus focusing on the status quo. The policy variables are aggregated into the Policy Index, measuring the quality of the food sustainability policies. We compute the two indices for 25 countries worldwide, then we use the Data Envelopment Analysis to evaluate policy efficiency. Our results show that country-level variation in policy efficiency is wide and policies affect food sustainability significantly, especially when they target nutritional challenges. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adjusting site index and age to account for genetic effects in yield equations for loblolly pine

Treesearch

Steven A. Knowe; G. Sam Foster

2010-01-01

Nine combinations of site index curves and age adjustments methods were evaluated for incorporating genetic effects for open-pollinated loblolly pine (Pinus taeda L.) families. An explicit yield system consisting of dominant height, basal area, and merchantable green weight functions was used to compare the accuracy of predictions associated with...

Waist Circumference Adjusted for Body Mass Index and Intra-Abdominal Fat Mass

PubMed Central

Berentzen, Tina Landsvig; Ängquist, Lars; Kotronen, Anna; Borra, Ronald; Yki-Järvinen, Hannele; Iozzo, Patricia; Parkkola, Riitta; Nuutila, Pirjo; Ross, Robert; Allison, David B.; Heymsfield, Steven B.; Overvad, Kim; Sørensen, Thorkild I. A.; Jakobsen, Marianne Uhre

2012-01-01

Background The association between waist circumference (WC) and mortality is particularly strong and direct when adjusted for body mass index (BMI). One conceivable explanation for this association is that WC adjusted for BMI is a better predictor of the presumably most harmful intra-abdominal fat mass (IAFM) than WC alone. We studied the prediction of abdominal subcutaneous fat mass (ASFM) and IAFM by WC alone and by addition of BMI as an explanatory factor. Methodology/Principal Findings WC, BMI and magnetic resonance imaging data from 742 men and women who participated in clinical studies in Canada and Finland were pooled. Total adjusted squared multiple correlation coefficients (R2) of ASFM and IAFM were calculated from multiple linear regression models with WC and BMI as explanatory variables. Mean BMI and WC of the participants in the pooled sample were 30 kg/m2 and 102 cm, respectively. WC explained 29% of the variance in ASFM and 51% of the variance in IAFM. Addition of BMI to WC added 28% to the variance explained in ASFM, but only 1% to the variance explained in IAFM. Results in subgroups stratified by study center, sex, age, obesity level and type 2 diabetes status were not systematically different. Conclusion/Significance The prediction of IAFM by WC is not improved by addition of BMI. PMID:22384179

Sexual Assault and Sexual Harassment in the U.S. Military: Annex to Volume 3. Tabular Results from the 2014 RAND Military Workplace Study for Coast Guard Service Members

DTIC Science & Technology

2015-01-01

SEXUAL ASSAULT AND SEXUAL HARASSMENT IN THE U.S. MILITARY Annex to Volume 3. Tabular Results from the 2014 RAND Military Workplace Study for... Sexual Harassment in the U.S. Military: Top-Line Estimates for Active-Duty Service Members from the 2014 RAND Military Workplace Study • Sexual ...Assault and Sexual Harassment in the U.S. Military: Top-Line Estimates for Active-Duty Coast Guard Members from the 2014 RAND Military Workplace Study vi

The RAND Change Agent Study Ten Years Later: Macro Perspectives and Micro Realities.

ERIC Educational Resources Information Center

McLaughlin, Milbrey Wallin

From 1973 to 1978, the Rand Corporation conducted a national study of local public schools' responses to various federal programs requiring educational change--Title III of the 1965 Elementary and Secondary Education Act (ESEA), Title VII of the ESEA, programs financed by the 1968 Vocational Education Act, and the Right-to-Read program. This paper…

A Program Manager’s Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs. The RAND Toolkit, Volume 4

DTIC Science & Technology

2014-01-01

Hughes EFX, Boerstler H, O’Connor EJ. “Assessing the Impact of Continuous Quality Improvement/ Total Quality Management : Concept versus...facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity. Gery...RAND Program Manager’s Guide helps managers assess program performance, consider options for improvement, implement solutions, then assess whether the

Addiction research centres and the nurturing of creativity. RAND's Drug Policy Research Center.

PubMed

Reuter, Peter; Pacula, Rosalie Liccardo; Caulkins, Jonathan P

2011-02-01

In September 1989, amid an emotional and ideological debate regarding problematic drug use in the United States and the 'war on drugs', RAND's Drug Policy Research Center (DPRC) was created through private foundation funds. The purpose of this new research center was to provide objective empirical analysis on which to base sound drug policy. Twenty years later, RAND's DPRC continues its work, drawing on a broad range of analytical expertise to evaluate, compare and assess the effectiveness of a similarly broad range of drug policies. More than 60 affiliated researchers in the United States and Europe make up the Center, which attempts to provide objective empirical analyses to better inform drug policies within the United States and abroad. This paper provides a look back at the creation, evolution and growth of the Center. It then describes how the Center operates today and how it has maintained its clear identity and focus by drawing on the analytical capabilities of a talented group of researchers from a broad range of academic disciplines. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Investigation of DBMS for Use in a Research Environment. Rand Paper Series 7002.

ERIC Educational Resources Information Center

Rosenfeld, Pilar N.

This investigation of the use of database management systems (DBMS) in a research environment used the Rand Corporation as a case study. After a general introduction in section 1, eight sections present the major components of the study. Section 2 contains an overview of DBMS terminology and concepts, followed in section 3 by a general dsecription…

Investigating the utility of a GPA institutional adjustment index.

PubMed

Didier, Thomas; Kreiter, Clarence D; Buri, Russell; Solow, Catherine

2006-05-01

Grading standards vary widely across undergraduate institutions. If, during the medical school admissions process, GPA is considered without reference to the institution attended, it will disadvantage applicants from undergraduate institutions employing rigorous grading standards. A regression-based GPA institutional equating method using historical MCAT and GPA information is described. Classes selected from eight applicant pools demonstrate the impact of the GPA adjustment. The validity of the adjustment is examined by comparing adjusted and unadjusted GPAs' correlation with USMLE and medical college grades. The adjusted GPA demonstrated significantly improved congruence with MCAT estimates of applicant preparedness. The adjustment changed selection decisions for 21% of those admitted. The adjusted GPA enhanced prediction of USMLE and medical school grades only for students from institutions which required large adjustments. Unlike other indices, the adjustment described uses the same metric as GPA and is based only on an institution's history of preparing medical school applicants. The institutional adjustment is consequential in selection, significantly enhances congruence with a standardized measure of academic preparedness and may enhance the validity of the GPA.

Designing an Effective Prevention Program: Principles Underlying the Rand Smoking and Drug Prevention Experiment.

ERIC Educational Resources Information Center

Ellickson, Phyllis L.

This paper describes the Project ALERT program (Adolescent Learning Experiences in Resistance Training) which was established by the Rand Corporation to prevent smoking and drug use among seventh graders. The program is based on the social influence model of drug use initiation. Curriculum features are described including motivation to resist and…

Ayn Rand: To be Selfish or Not to be Selfish--That is the Question

ERIC Educational Resources Information Center

Doctor, Tyrus L.; Kritsonis, William Allan

2009-01-01

Ayn Rand's "The Virtue of Selfishness" (1961) is comprised of a philosophy that defies the entire premise of what our education system is and shall be built upon. The "Objectivist" perspective has depicted a clear distinction between the "Have's" and the "Have Not's" or the Bourgeoisie and Proletariat. The "Objectivist" perspective believes that…

Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

PubMed

Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

2017-12-13

Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.

A simulation based approach to optimize inventory replenishment with RAND algorithm: An extended study of corrected demand using Holt's method for textile industry

NASA Astrophysics Data System (ADS)

Morshed, Mohammad Sarwar; Kamal, Mostafa Mashnoon; Khan, Somaiya Islam

2016-07-01

Inventory has been a major concern in supply chain and numerous researches have been done lately on inventory control which brought forth a number of methods that efficiently manage inventory and related overheads by reducing cost of replenishment. This research is aimed towards providing a better replenishment policy in case of multi-product, single supplier situations for chemical raw materials of textile industries in Bangladesh. It is assumed that industries currently pursue individual replenishment system. The purpose is to find out the optimum ideal cycle time and individual replenishment cycle time of each product for replenishment that will cause lowest annual holding and ordering cost, and also find the optimum ordering quantity. In this paper indirect grouping strategy has been used. It is suggested that indirect grouping Strategy outperforms direct grouping strategy when major cost is high. An algorithm by Kaspi and Rosenblatt (1991) called RAND is exercised for its simplicity and ease of application. RAND provides an ideal cycle time (T) for replenishment and integer multiplier (ki) for individual items. Thus the replenishment cycle time for each product is found as T×ki. Firstly, based on data, a comparison between currently prevailing (individual) process and RAND is provided that uses the actual demands which presents 49% improvement in total cost of replenishment. Secondly, discrepancies in demand is corrected by using Holt's method. However, demands can only be forecasted one or two months into the future because of the demand pattern of the industry under consideration. Evidently, application of RAND with corrected demand display even greater improvement. The results of this study demonstrates that cost of replenishment can be significantly reduced by applying RAND algorithm and exponential smoothing models.

Defense Manpower Policy: Presentations from the 1976 Rand Conference on Defense Manpower

DTIC Science & Technology

1978-12-01

organizations working on defense manpower issues and problems, This book contains selected presentations from ti -a Rand Confer- ence on Defense Manpower...the complete Conference agenda.) Nevertheless, the papers included here provide a reasonably good sampling of the topics and issues addressed at the...one of the key concerns in the Pentagon and on Capitol Hill. Accordingly, the purpose of this book is to shed some light on some of the major issues

75 FR 49411 - Consumer Price Index Adjustments of Oil Pollution Act of 1990 Limits of Liability-Vessels and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... collection OMB Control Number 1625-0046 entitled ``Financial Responsibility for Water Pollution (Vessels... Consumer Price Index Adjustments of Oil Pollution Act of 1990 Limits of Liability--Vessels and Deepwater..., the Coast Guard amended the Oil Pollution Act of 1990 limits of liability for vessels and deepwater...

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT-INGERSOLL-RAND ENERGY SYSTEMS IR POWERWORKS(TM) 70 KW MICROTURBINE SYSTEM

EPA Science Inventory

The Environmental Technology Verification report discusses the technology and performance of the IR PowerWorks 70kW Microturbine System manufactured by Ingersoll-Rand Energy Systems. This system is a 70 kW electrical generator that puts out 480 v AC at 60 Hz and that is driven by...

Correspondence between the RAND-Negative Impact of Asthma on Quality of Life item bank and the Marks Asthma Quality of Life Questionnaire.

PubMed

Edelen, Maria Orlando; Stucky, Brian D; Sherbourne, Cathy; Eberhart, Nicole; Lara, Marielena

2014-05-01

In many research and clinical settings in which patient-reported outcome (PRO) measures are used, it is often desirable to link scores across disparate measures or to use scores from 1 measure to describe scores on a separate measure. However, PRO measures are scored by using a variety of metrics, making such comparisons difficult. The objective of this article was to provide an example of how to transform scores across disparate measures (the Marks Asthma Quality of Life Questionnaire [AQLQ-Marks] and the newly developed RAND-Negative Impact of Asthma on Quality of Life item bank [RAND-IAQL-Bank]) by using an item response theory (IRT)-based linking method. Our sample of adults with asthma (N = 2032) completed 2 measures of asthma-specific quality of life: the AQLQ-Marks and the RAND-IAQL-Bank. We use IRT-based co-calibration of the 2 measures to provide a linkage, or a common metric, between the 2 measures. Co-calibration refers to the process of using IRT to estimate item parameters that describe the responses to the scales' items according to a common metric; in this case, a normal distribution transformed to a T scale with a mean of 50 and an SD of 10. Respondents had an average age of 43 (15), were 60% female, and predominantly non-Hispanic White (56%), with 19% African American, 14% Hispanic, and 11% Asian. Most had at least some college education (83%), and 90% had experienced an asthma attack during the last 12 months. Our results indicate that the AQLQ-Marks and RAND-IAQL-Bank scales measured highly similar constructs and were sufficiently unidimensional for IRT co-calibration. Once linked, scores from the 2 measures were invariant across subgroups. A crosswalk is provided that allows researchers and clinicians using AQLQ-Marks to crosswalk to the RAND-IAQL toolkit. The ability to translate scores from the RAND-IAQL toolkit to other "legacy" (ie, commonly used) measures increases the value of the new toolkit, aids in interpretation, and will hopefully

The Occupational Mix Adjustment to the Medicare Hospital Wage Index: Why the Rural Impact Is Less than Expected

ERIC Educational Resources Information Center

Reiter, Kristin L.; Slifkin, Rebecca; Holmes, George M.

2008-01-01

Context: Rural hospitals are heavily dependent on Medicare for their long-term financial solvency. A recent change to Medicare prospective payment system reimbursement--the occupational mix adjustment (OMA) to the wage index--has attracted a great deal of attention in rural policy circles. Purpose: This paper explores variation in the OMA across…

RandSpg: An open-source program for generating atomistic crystal structures with specific spacegroups

NASA Astrophysics Data System (ADS)

Avery, Patrick; Zurek, Eva

2017-04-01

A new algorithm, RANDSPG, that can be used to generate trial crystal structures with specific space groups and compositions is described. The program has been designed for systems where the atoms are independent of one another, and it is therefore primarily suited towards inorganic systems. The structures that are generated adhere to user-defined constraints such as: the lattice shape and size, stoichiometry, set of space groups to be generated, and factors that influence the minimum interatomic separations. In addition, the user can optionally specify if the most general Wyckoff position is to be occupied or constrain select atoms to specific Wyckoff positions. Extensive testing indicates that the algorithm is efficient and reliable. The library is lightweight, portable, dependency-free and is published under a license recognized by the Open Source Initiative. A web interface for the algorithm is publicly accessible at http://xtalopt.openmolecules.net/randSpg/randSpg.html. RANDSPG has also been interfaced with the XTALOPT evolutionary algorithm for crystal structure prediction, and it is illustrated that the use of symmetric lattices in the first generation of randomly created individuals decreases the number of structures that need to be optimized to find the global energy minimum.

Body mass index adjustments to increase the validity of body fatness assessment in UK Black African and South Asian children.

PubMed

Hudda, M T; Nightingale, C M; Donin, A S; Fewtrell, M S; Haroun, D; Lum, S; Williams, J E; Owen, C G; Rudnicka, A R; Wells, J C K; Cook, D G; Whincup, P H

2017-07-01

Body mass index (BMI) (weight per height 2 ) is the most widely used marker of childhood obesity and total body fatness (BF). However, its validity is limited, especially in children of South Asian and Black African origins. We aimed to quantify BMI adjustments needed for UK children of Black African and South Asian origins so that adjusted BMI related to BF in the same way as for White European children. We used data from four recent UK studies that made deuterium dilution BF measurements in UK children of White European, South Asian and Black African origins. A height-standardized fat mass index (FMI) was derived to represent BF. Linear regression models were then fitted, separately for boys and girls, to quantify ethnic differences in BMI-FMI relationships and to provide ethnic-specific BMI adjustments. We restricted analyses to 4-12 year olds, to whom a single consistent FMI (fat mass per height 5 ) could be applied. BMI consistently underestimated BF in South Asians, requiring positive BMI adjustments of +1.12 kg m - 2 (95% confidence interval (CI): 0.83, 1.41 kg m - 2 ; P<0.0001) for boys and +1.07 kg m - 2 (95% CI: 0.74, 1.39 kg m - 2 ; P<0.0001) for girls of all age groups and FMI levels. BMI overestimated BF in Black Africans, requiring negative BMI adjustments for Black African children. However, these were complex because there were statistically significant interactions between Black African ethnicity and FMI (P=0.004 boys; P=0.003 girls) and also between FMI and age group (P<0.0001 for boys and girls). BMI adjustments therefore varied by age group and FMI level (and indirectly BMI); the largest adjustments were in younger children with higher unadjusted BMI and the smallest in older children with lower unadjusted BMI. BMI underestimated BF in South Asians and overestimated BF in Black Africans. Ethnic-specific adjustments, increasing BMI in South Asians and reducing BMI in Black Africans, can improve the accuracy of BF assessment in

Los Angeles County Juvenile Justice Crime Prevention Act. RAND Quarterly Report, October 2008. TR-621-LACPD

ERIC Educational Resources Information Center

Fain, Terry; Turner, Susan; Ridgeway, Greg

2008-01-01

In July 2008, RAND Corporation staff conducted Correctional Program Checklist (CPC) assessments of five home-based programs (Asian Youth Center, Communities in Schools, Inter-Agency Drug Abuse Recovery Programs, Soledad Enrichment Action, and Stars Behavioral Health Group) as part of its ongoing evaluation of Juvenile Justice Crime Prevention Act…

A temperature and vegetation adjusted NTL urban index for urban area mapping and analysis

NASA Astrophysics Data System (ADS)

Zhang, Xiya; Li, Peijun

2018-01-01

Accurate and timely information regarding the extent and spatial distribution of urban areas on regional and global scales is crucially important for both scientific and policy-making communities. Stable nighttime light (NTL) data from the Defense Meteorological Satellite Program (DMSP) Operational Linescan System (OLS) provides a unique proxy of human settlement and activity, which has been used in the mapping and analysis of urban areas and urbanization dynamics. However, blooming and saturation effects of DMSP/OLS NTL data are two unresolved problems in regional urban area mapping and analysis. This study proposed a new urban index termed the Temperature and Vegetation Adjusted NTL Urban Index (TVANUI). It is intended to reduce blooming and saturation effects and to enhance urban features by combining DMSP/OLS NTL data with Normalized Difference Vegetation Index (NDVI) and land surface temperature (LST) data from the Moderate Resolution Imaging Spectroradiometer onboard the Terra satellite. The proposed index was evaluated in two study areas by comparison with established urban indices. The results demonstrated the proposed TVANUI was effective in enhancing the variation of DMSP/OLS light in urban areas and in reducing blooming and saturation effects, showing better performance than three established urban indices. The TVANUI also significantly outperformed the established urban indices in urban area mapping using both the global-fixed threshold and the local-optimal threshold methods. Thus, the proposed TVANUI provides a useful variable for urban area mapping and analysis on regional scale, as well as for urbanization dynamics using time-series DMSP/OLS and related satellite data.

Standard and Amputation-Adjusted Body Mass Index Measures: Comparison and Relevance to Functional Measures, Weight-Related Comorbidities, and Dieting.

PubMed

Wong, Christopher Kevin; Wong, Ryan J

2017-12-01

People with limb loss may misjudge weight-related health when not adjusting body mass index (BMI) for amputation level. This cross-sectional, community-based study compared BMI and amputation-adjusted BMI (A-BMI) and evaluated relationships among BMI categories, function, and dieting. Subjects provided self-reported demographic, functional, and medical/prosthetic data including height and weight and completed performance-based balance and gait measures. A Web-based A-BMI calculator adjusted for amputation levels. Results for 294 subjects from 11 states (68.4% men; 76.5% white; average age, 55.6 [15.1] y) were reported, with vascular (49.7%) and unilateral transtibial (40.8%) amputations as the most common. Body mass index and A-BMI were closely correlated (Pearson r = 0.99), but a BMI of 28.6 (6.7) was less than an A-BMI of 30.3 (6.2) (t test, P < 0.001). Agreement among Centers for Disease Control BMI categories was moderate (κ = 0.48); 39.7% of BMI categories were underestimated without adjusting for amputations. Functional measures did not differ among BMI/A-BMI categories (P > 0.05). A larger than random proportion categorized as overweight by BMI dieted (χ, P < 0.05), and people categorized as overweight by A-BMI did not (38.3% classified as normal BMI). Functional abilities did not differ among BMI categories (Kruskal-Wallis and analysis of variance, P > 0.05). People with limb loss using BMI may underestimate weight-related health; a Web-based A-BMI calculator may help monitor weight to make dieting decisions.

Body mass index adjustments to increase the validity of body fatness assessment in UK Black African and South Asian children

PubMed Central

Hudda, M T; Nightingale, C M; Donin, A S; Fewtrell, M S; Haroun, D; Lum, S; Williams, J E; Owen, C G; Rudnicka, A R; Wells, J C K; Cook, D G; Whincup, P H

2017-01-01

Background/Objectives: Body mass index (BMI) (weight per height2) is the most widely used marker of childhood obesity and total body fatness (BF). However, its validity is limited, especially in children of South Asian and Black African origins. We aimed to quantify BMI adjustments needed for UK children of Black African and South Asian origins so that adjusted BMI related to BF in the same way as for White European children. Methods: We used data from four recent UK studies that made deuterium dilution BF measurements in UK children of White European, South Asian and Black African origins. A height-standardized fat mass index (FMI) was derived to represent BF. Linear regression models were then fitted, separately for boys and girls, to quantify ethnic differences in BMI–FMI relationships and to provide ethnic-specific BMI adjustments. Results: We restricted analyses to 4–12 year olds, to whom a single consistent FMI (fat mass per height5) could be applied. BMI consistently underestimated BF in South Asians, requiring positive BMI adjustments of +1.12 kg m−2 (95% confidence interval (CI): 0.83, 1.41 kg m−2; P<0.0001) for boys and +1.07 kg m−2 (95% CI: 0.74, 1.39 kg m−2; P<0.0001) for girls of all age groups and FMI levels. BMI overestimated BF in Black Africans, requiring negative BMI adjustments for Black African children. However, these were complex because there were statistically significant interactions between Black African ethnicity and FMI (P=0.004 boys; P=0.003 girls) and also between FMI and age group (P<0.0001 for boys and girls). BMI adjustments therefore varied by age group and FMI level (and indirectly BMI); the largest adjustments were in younger children with higher unadjusted BMI and the smallest in older children with lower unadjusted BMI. Conclusions: BMI underestimated BF in South Asians and overestimated BF in Black Africans. Ethnic-specific adjustments, increasing BMI in South Asians and reducing BMI in Black

An Analysis of the Objectivist Ethics in Educational Leadership through Ayn Rand's "The Virtues of Selfishness" (1964)

ERIC Educational Resources Information Center

Jacobs, Karen Dupre; Kritsonis, William Allan

2007-01-01

Educational leadership is vital to sustain quality educational institutions. It is the role of the school leader to indoctrinate stakeholders with the objectivist ethics-embracing egoism and relinquishing altruistic ideals when it comes to invigorating the system with sustainable change. Ayn Rand's timeless piece of literature "The Virtue of…

Antireflective coatings with adjustable refractive index and porosity synthesized by micelle-templated deposition of MgF2 sol particles.

PubMed

Bernsmeier, Denis; Polte, Jörg; Ortel, Erik; Krahl, Thoralf; Kemnitz, Erhard; Kraehnert, Ralph

2014-11-26

Minimizing efficiency losses caused by unwanted light reflection at the interface between lenses, optical instruments and solar cells with the surrounding medium requires antireflective coatings with adequate refractive index and coating thickness. We describe a new type of antireflective coating material with easily and independently tailorable refractive index and coating thickness based on the deposition of colloidal MgF2 nanoparticles. The material synthesis employs micelles of amphiphilic block copolymers as structure directing agent to introduce controlled mesoporosity into MgF2 film. The coatings thickness can be easily adjusted by the applied coating conditions. The coatings refractive index is determined by the materials porosity, which is controlled by the amount of employed pore template. The refractive index can be precisely tuned between 1.23 and 1.11, i.e., in a range that is not accessible to nonporous inorganic materials. Hence, zero reflectance conditions can be established for a wide range of substrate materials.

Occupational adjustment of the prospective payment system wage index

PubMed Central

Pope, Gregory C.

1989-01-01

In this article, the bias in the Medicare prospective payment system (PPS) hospital wage index that results from its failure to hold hospital occupation mix constant is examined. On average, the difference between the current PPS wage index and a fixed-occupation-mix Laspeyres index is small, approximately 2 percent. However, occupation-mix distortions are substantially larger for a small proportion of labor market areas, especially some in the South. Biases in the wage index resulting from its failure to appropriately account for labor substitution and intra-occupational worker characteristics are also analyzed but are not found to be significant. PMID:10313354

Generating Stock Trading Rules Using Genetic Network Programming with Flag Nodes and Adjustment of Importance Indexes

NASA Astrophysics Data System (ADS)

Mabu, Shingo; Chen, Yan; Hirasawa, Kotaro

Genetic Network Programming (GNP) is an evolutionary algorithm which represents its solutions using graph structures. Since GNP can create quite compact programs and has an implicit memory function, GNP works well especially in dynamic environments. In addition, a study on creating trading rules on stock markets using GNP with Importance Index (GNP-IMX) has been done. IMX is one of the criterions for decision making. However, the values of IMXs must be deteminined by our experience/knowledge. Therefore in this paper, IMXs are adjusted appropriately during the stock trading in order to predict the rise and fall of the stocks. Moreover, newly defined flag nodes are introduced to GNP, which can appropriately judge the current situation of the stock prices, and also contributes to the use of many kinds of nodes in GNP program. In the simulation, programs are evolved using the stock prices of 20 companies. Then the generalization ability is tested and compared with GNP without flag nodes, GNP without IMX adjustment and Buy&Hold.

42 CFR 412.316 - Geographic adjustment factors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Geographic adjustment factors. 412.316 Section 412... Costs § 412.316 Geographic adjustment factors. (a) Local cost variation. CMS adjusts for local cost... part. The adjustment factor equals the hospital wage index value applicable to the hospital raised to...

A label field fusion bayesian model and its penalized maximum rand estimator for image segmentation.

PubMed

Mignotte, Max

2010-06-01

This paper presents a novel segmentation approach based on a Markov random field (MRF) fusion model which aims at combining several segmentation results associated with simpler clustering models in order to achieve a more reliable and accurate segmentation result. The proposed fusion model is derived from the recently introduced probabilistic Rand measure for comparing one segmentation result to one or more manual segmentations of the same image. This non-parametric measure allows us to easily derive an appealing fusion model of label fields, easily expressed as a Gibbs distribution, or as a nonstationary MRF model defined on a complete graph. Concretely, this Gibbs energy model encodes the set of binary constraints, in terms of pairs of pixel labels, provided by each segmentation results to be fused. Combined with a prior distribution, this energy-based Gibbs model also allows for definition of an interesting penalized maximum probabilistic rand estimator with which the fusion of simple, quickly estimated, segmentation results appears as an interesting alternative to complex segmentation models existing in the literature. This fusion framework has been successfully applied on the Berkeley image database. The experiments reported in this paper demonstrate that the proposed method is efficient in terms of visual evaluation and quantitative performance measures and performs well compared to the best existing state-of-the-art segmentation methods recently proposed in the literature.

Computing Robust, Bootstrap-Adjusted Fit Indices for Use with Nonnormal Data

ERIC Educational Resources Information Center

Walker, David A.; Smith, Thomas J.

2017-01-01

Nonnormality of data presents unique challenges for researchers who wish to carry out structural equation modeling. The subsequent SPSS syntax program computes bootstrap-adjusted fit indices (comparative fit index, Tucker-Lewis index, incremental fit index, and root mean square error of approximation) that adjust for nonnormality, along with the…

The Social Cognition Psychometric Evaluation Study: Results of the Expert Survey and RAND Panel

PubMed Central

Pinkham, Amy E.; Penn, David L.; Green, Michael F.; Buck, Benjamin; Healey, Kristin; Harvey, Philip D.

2014-01-01

Background: In schizophrenia, social cognition is strongly linked to functional outcome and is increasingly seen as a viable treatment target. The goal of the Social Cognition Psychometric Evaluation (SCOPE) study is to identify and improve the best existing measures of social cognition so they can be suitably applied in large-scale treatment studies. Initial phases of this project sought to (1) develop consensus on critical domains of social cognition and (2) identify the best existing measures of social cognition for use in treatment studies. Methods: Experts in social cognition were invited to nominate key domains of social cognition and the best measures of those domains. Nominations for measures were reduced according to set criteria, and all available psychometric information about these measures was summarized and provided to RAND panelists. Panelists rated the quality of each measure on multiple criteria, and diverging ratings were discussed at the in-person meeting to obtain consensus. Results: Expert surveys identified 4 core domains of social cognition—emotion processing, social perception, theory of mind/mental state attribution, and attributional style/bias. Using RAND panel consensus ratings, the following measures were selected for further evaluation: Ambiguous Intentions Hostility Questionnaire, Bell Lysaker Emotion Recognition Task, Penn Emotion Recognition Test, Relationships Across Domains, Reading the Mind in the Eyes Test, The Awareness of Social Inferences Test, Hinting Task, and Trustworthiness Task. Discussion: While it was possible to establish consensus, only a limited amount of psychometric information is currently available for the candidate measures, which underscores the need for well-validated and standardized measures in this area. PMID:23728248

Highly Transparent w/o Pickering Emulsions without Adjusting the Refractive Index of the Stabilizing Particles.

PubMed

Sihler, Susanne; Lindén, Mika; Ziener, Ulrich

2017-10-03

Pickering emulsions with a remarkable transmittance of up to 86% across the visible spectrum have been prepared without adjusting the refractive index (RI) of the stabilizing particles to those of the aqueous and oil phases. Commercially available hydrophilic silica particles with a diameter of 20 nm, which are hydrophobized partially in situ, were used to stabilize water droplets with diameters below 400 nm in IsoparM. In this system, the stabilizing particles and the emulsion droplets act as one single scattering object, which renders RI-matching of the particles unnecessary. By either evaporation of some water from the droplets or addition of an appropriate organic liquid to the oil phase, it is possible to match the RI of the droplets (aqueous phase + particles) with that of the continuous phase, which minimizes scattering and results in highly transparent emulsions.

78 FR 59093 - Quarterly Rail Cost Adjustment Factor

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the fourth quarter 2013 rail cost adjustment factor (RCAF) and cost index filed by the Association of American Railroads. The fourth quarter 2013 RCAF...

Cost Indexing and Unit Price Adjustments for Construction Materials

DOT National Transportation Integrated Search

2012-10-30

This project was focused on the assimilation of information regarding unit price adjustment clauses, or PACs, : that are offered for construction materials at the state Departments of Transportation (DOTs). It is intended to : provide the South Carol...

Sexual Assault and Sexual Harassment in the U.S. Military: Evaluating Estimates from the 2014 RAND Military Workplace Study

DTIC Science & Technology

2016-01-01

harassment, and gender discrimination in the military. The RAND Military Workplace Study (RMWS) included one of the largest surveys of its kind: Almost...approach to counting service members who experienced sexual assault, sexual harassment, and gender discrimination , providing DoD with unprecedented...harassment, or gender discrimination . Specifically, both the phone and web follow-up surveys revealed possible nonresponse bias in the RMWS estimates, but

Adjusting Health Expenditures for Inflation: A Review of Measures for Health Services Research in the United States.

PubMed

Dunn, Abe; Grosse, Scott D; Zuvekas, Samuel H

2018-02-01

To provide guidance on selecting the most appropriate price index for adjusting health expenditures or costs for inflation. Major price index series produced by federal statistical agencies. We compare the key characteristics of each index and develop suggestions on specific indexes to use in many common situations and general guidance in others. Price series and methodological documentation were downloaded from federal websites and supplemented with literature scans. The gross domestic product implicit price deflator or the overall Personal Consumption Expenditures (PCE) index is preferable to the Consumer Price Index (CPI-U) to adjust for general inflation, in most cases. The Personal Health Care (PHC) index or the PCE health-by-function index is generally preferred to adjust total medical expenditures for inflation. The CPI medical care index is preferred for the adjustment of consumer out-of-pocket expenditures for inflation. A new, experimental disease-specific Medical Care Expenditure Index is now available to adjust payments for disease treatment episodes. There is no single gold standard for adjusting health expenditures for inflation. Our discussion of best practices can help researchers select the index best suited to their study. © Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Prognostic validation of the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index in inoperable non-small-cell lung cancer.

PubMed

Denehy, Linda; Hornsby, Whitney E; Herndon, James E; Thomas, Samantha; Ready, Neal E; Granger, Catherine L; Valera, Lauren; Kenjale, Aarti A; Eves, Neil D; Jones, Lee W

2013-12-01

To investigate the prognostic utility of the body mass index, severity of airflow obstruction, measures of exertional dyspnea, and exercise capacity (BODE) index in patients with inoperable non-small-cell lung cancer (NSCLC). One hundred consecutive patients with inoperable NSCLC and performance status 0 to 3 completed pulmonary function testing, the modified Medical Research Council dyspnea scale, a 6-minute walk test, and body mass index-the multidimensional 10-point BODE index. Cox proportional models were used to estimate the risk of all-cause mortality according to the BODE index with or without adjustment for traditional prognostic factors. Median follow-up was 31.5 months; 61 deaths (61%) were reported during this period. There was a significant univariate association between the BODE index score and mortality (adjusted p(trend) = 0.027). Compared with patients with a BODE index of 0, the adjusted hazard ratio for risk of death was 1.37 (95% confidence interval [CI], 0.74-2.55) for a BODE index of 1, 1.22 (95% CI, 0.45-3.25) for a BODE index of 2, and 2.44 (95% CI, 1.19-4.99) for a BODE index more than 2. The BODE index provided incremental prognostic information beyond that provided traditional markers of prognosis (adjusted p(trend) = 0.051). Every one-point increase in the BODE index, the risk of death increased by 25% (hazard ratio = 1.25; 95% CI, 1.27-4.64). The BODE index is a strong independent predictor of survival in inoperable NSCLC beyond traditional risk factors. Use of this multidimensional tool may improve risk stratification and prognostication in NSCLC.

The heat rate index indicator

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

Lasasso, M.; Runyan, B.; Napoli, J.

1995-06-01

This paper describes a method of tracking unit performance through the use of a reference number called the Heat Rate Index Indicator. The ABB Power Plant Controls OTIS performance monitor is used to determine when steady load conditions exist and then to collect controllable and equipment loss data which significantly impact thermal efficiency. By comparing these loss parameters to those found during the previous heat balance, it is possible to develop a new adjusted heat rate curve. These impacts on heat rate are used to changes the shape of the tested heat rate curve by the appropriate percentages over amore » specified load range. Mathcad is used to determine the Heat Rate Index by integrating for the areas beneath the adjusted heat rate curve and a heat rate curve that represents the unit`s ideal heat rate curve is the Heat Rate Index. An index of 1.0 indicates that the unit is operating at an ideal efficiency, while an index of less than 1.0 indicates that the unit is operating at less than ideal conditions. A one per cent change in the Heat Rate Index is equivalent to a one percent change in heat rate. The new shape of the adjusted heat rate curve and the individual curves generated from the controllable and equipment loss parameters are useful for determining performance problems in specific load ranges.« less

Color vision deficiency compensation for Visual Processing Disorder using Hardy-Rand-Rittler test and color transformation

NASA Astrophysics Data System (ADS)

Balbin, Jessie R.; Pinugu, Jasmine Nadja J.; Bautista, Joshua Ian C.; Nebres, Pauline D.; Rey Hipolito, Cipriano M.; Santella, Jose Anthony A.

2017-06-01

Visual processing skill is used to gather visual information from environment however, there are cases that Visual Processing Disorder (VPD) occurs. The so called visual figure-ground discrimination is a type of VPD where color is one of the factors that contributes on this type. In line with this, color plays a vital role in everyday living, but individuals that have limited and inaccurate color perception suffers from Color Vision Deficiency (CVD) and still not aware on their case. To resolve this case, this study focuses on the design of KULAY, a Head-Mounted Display (HMD) device that can assess whether a user has a CVD or not thru the standard Hardy-Rand-Rittler (HRR) test. This test uses pattern recognition in order to evaluate the user. In addition, color vision deficiency simulation and color correction thru color transformation is also a concern of this research. This will enable people with normal color vision to know how color vision deficient perceives and vice-versa. For the accuracy of the simulated HRR assessment, its results were validated thru an actual assessment done by a doctor. Moreover, for the preciseness of color transformation, Structural Similarity Index Method (SSIM) was used to compare the simulated CVD images and the color corrected images to other reference sources. The output of the simulated HRR assessment and color transformation shows very promising results indicating effectiveness and efficiency of the study. Thus, due to its form factor and portability, this device is beneficial in the field of medicine and technology.

Identifying Future Disease Hot Spots: Infectious Disease Vulnerability Index.

PubMed

Moore, Melinda; Gelfeld, Bill; Okunogbe, Adeyemi; Paul, Christopher

2017-06-01

Recent high-profile outbreaks, such as Ebola and Zika, have illustrated the transnational nature of infectious diseases. Countries that are most vulnerable to such outbreaks might be higher priorities for technical support. RAND created the Infectious Disease Vulnerability Index to help U.S. government and international agencies identify these countries and thereby inform programming to preemptively help mitigate the spread and effects of potential transnational outbreaks. The authors employed a rigorous methodology to identify the countries most vulnerable to disease outbreaks. They conducted a comprehensive review of relevant literature to identify factors influencing infectious disease vulnerability. Using widely available data, the authors created an index for identifying potentially vulnerable countries and then ranked countries by overall vulnerability score. Policymakers should focus on the 25 most-vulnerable countries with an eye toward a potential "disease belt" in the Sahel region of Africa. The infectious disease vulnerability scores for several countries were better than what would have been predicted on the basis of economic status alone. This suggests that low-income countries can overcome economic challenges and become more resilient to public health challenges, such as infectious disease outbreaks.

A preference-based measure of health: the VR-6D derived from the veterans RAND 12-Item Health Survey.

PubMed

Selim, Alfredo J; Rogers, William; Qian, Shirley X; Brazier, John; Kazis, Lewis E

2011-10-01

The Veterans RAND 12-Item Health Survey (VR-12) is currently the major endpoint used in the Medicare managed care outcomes measure in the Healthcare Effectiveness Data and Information Set (HEDIS(®)), referred to as the Health Outcomes Survey (HOS). The purpose of this study is to adapt the Brazier SF-6D utility measure to the VR-12 to generate a single utility index. We used the HOS cohorts 2 and 3 for SF-36 data and 9 for VR-12 data. We calculated SF-6D scores from the SF-36 using the algorithms developed by Brazier and colleagues. The values of the Brazier SF-6D were used to estimate utility scores from the VR-12 using a mapping approach based on a 2-stage mapping procedure, named as VR-6D. The VR-6D derived from the VR-12 has similar distributional properties as the SF-6D. The change in VR-6D showed significant variations across disease groups with different levels of morbidity and mortality. This study produced a utility measure for the VR-12 that is comparable to the SF-6D and responsive to change. The VR-6D can be used in evaluations of health care plans and cost-effectiveness analysis to compare the health gains that health care interventions can achieve.

Index to Estimate the Efficiency of an Ophthalmic Practice.

PubMed

Chen, Andrew; Kim, Eun Ah; Aigner, Dennis J; Afifi, Abdelmonem; Caprioli, Joseph

2015-08-01

A metric of efficiency, a function of the ratio of quality to cost per patient, will allow the health care system to better measure the impact of specific reforms and compare the effectiveness of each. To develop and evaluate an efficiency index that estimates the performance of an ophthalmologist's practice as a function of cost, number of patients receiving care, and quality of care. Retrospective review of 36 ophthalmology subspecialty practices from October 2011 to September 2012 at a university-based eye institute. The efficiency index (E) was defined as a function of adjusted number of patients (N(a)), total practice adjusted costs (C(a)), and a preliminary measure of quality (Q). Constant b limits E between 0 and 1. Constant y modifies the influence of Q on E. Relative value units and geographic cost indices determined by the Centers for Medicare and Medicaid for 2012 were used to calculate adjusted costs. The efficiency index is expressed as the following: E = b(N(a)/C(a))Q(y). Independent, masked auditors reviewed 20 random patient medical records for each practice and filled out 3 questionnaires to obtain a process-based quality measure. The adjusted number of patients, adjusted costs, quality, and efficiency index were calculated for 36 ophthalmology subspecialties. The median adjusted number of patients was 5516 (interquartile range, 3450-11,863), the median adjusted cost was 1.34 (interquartile range, 0.99-1.96), the median quality was 0.89 (interquartile range, 0.79-0.91), and the median value of the efficiency index was 0.26 (interquartile range, 0.08-0.42). The described efficiency index is a metric that provides a broad overview of performance for a variety of ophthalmology specialties as estimated by resources used and a preliminary measure of quality of care provided. The results of the efficiency index could be used in future investigations to determine its sensitivity to detect the impact of interventions on a practice such as training

Observational intensity bias associated with illness adjustment: cross sectional analysis of insurance claims

PubMed Central

Staiger, Douglas O; Sharp, Sandra M; Gottlieb, Daniel J; Bevan, Gwyn; McPherson, Klim; Welch, H Gilbert

2013-01-01

Objective To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases. Setting Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877). Main outcome measures The effect of illness adjustment on regional mortality and spending rates using standard and visit corrected illness methods for adjustment. The standard method adjusts using comorbidity measures based on diagnoses listed in administrative databases; the modified method corrects these measures for the frequency of visits by physicians. Three conventions for measuring comorbidity are used: the Charlson comorbidity index, Iezzoni chronic conditions, and hierarchical condition categories risk scores. Results The visit corrected Charlson comorbidity index explained more of the variation in age, sex, and race mortality across the 306 hospital referral regions than did the standard index (R2=0.21 v 0.11, P<0.001) and, compared with sex and race adjusted mortality, reduced regional variation, whereas adjustment using the standard Charlson comorbidity index increased it. Although visit corrected and age, sex, and race adjusted mortality rates were similar in hospital referral regions with the highest and lowest fifths of visits, adjustment using the standard index resulted in a rate that was 18% lower in the highest fifth (46.4 v 56.3 deaths per 1000, P<0.001). Age, sex, and race adjusted spending as well as visit corrected spending was more than 30% greater in the highest fifth of visits than in the lowest fifth, but only 12% greater after adjustment using the standard index. Similar results were obtained using the Iezzoni and the hierarchical condition categories conventions for measuring comorbidity. Conclusion The

Validating Measures of Real-World Outcome: The Results of the VALERO Expert Survey and RAND Panel

PubMed Central

Leifker, Feea R.; Patterson, Thomas L.; Heaton, Robert K.; Harvey, Philip D.

2011-01-01

Background: People with schizophrenia demonstrate considerable discrepancy between self-reported functioning and informant reports. It is not clear whether these discrepancies originate from the instruments used or from the perspectives of different informants. The goal of the Validation of Everyday Real-World Outcomes (VALERO) Study is to enhance the measurement of real-world (RW) outcomes in the social, residential, and vocational domains through selection of optimal scales and informants using a multistep process similar to the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. Methods: Forty-eight experts provided their opinion regarding the best scales measuring RW outcomes. Fifty-nine measures were nominated. The investigators selected the 11 scales that were the most highly nominated, had the most published validity data, and best represented the domains of interest. Information was provided to other experts who served as RAND panelists. Panelists rated each measure for its suitability across multiple a priori domains. Discrepant ratings were discussed until consensus was reached. Results: Following the RAND Panel, the 2 scales that scored highest across the various criteria for each of the classes of scales (hybrid, social functioning, and everyday living skills) were selected for use in the first substudy of VALERO. The scales selected were the Quality-of-Life Scale, Specific Levels of Functioning Scale, Social Behavior Schedule, Social Functioning Scale, Independent Living Skills Schedule, and Life Skills Profile. Discussion: The results show that although there are significant limitations with current scales used for the assessment of RW outcome in schizophrenia, a consensus is possible. Further, several existing instruments were rated as useful for measuring social, residential, and vocational outcomes. PMID:19525354

Objective and Subjective Attractiveness and Early Adolescent Adjustment.

ERIC Educational Resources Information Center

Jovanovic, Jasna; And Others

1989-01-01

Used data from Pennsylvania Early Adolescent Transitions Study to assess how objective physical attractiveness (PA), indexed by appraisals from others, and subjective PA, indexed by self-appraisals, related to each other and to early adolescent adjustment. Findings indicated low relationship between objective and subjective PA; only subjective PA…

Sexual Assault and Sexual Harassment in the U.S. Military: Top-Line Estimates for Active-Duty Service Members from the 2014 RAND Military Workplace Study

DTIC Science & Technology

2014-01-01

enhance the validity of their answers. The development of this new approach to measuring sexual assault and sex-based MEO violations was completed...include the buttocks, inner thigh, breast, groin, anus, vagina, penis and testicles. Top-Line Results from the RAND Military Workplace Study 41 12

78 FR 78508 - Quarterly Rail Cost Adjustment Factor

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... Procedures--Productivity Adjustment, 5 I.C.C.2d 434 (1989), aff'd sub nom. Edison Electric Institute v. ICC... quarterly index for a measure of productivity. The provisions of 49 U.S.C. 10708 direct the Surface Transportation Board (Board) to continue to publish both an unadjusted RCAF and a productivity-adjusted RCAF. In...

Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method

PubMed Central

Power, Emma; Thomas, Emma; Worrall, Linda; Rose, Miranda; Togher, Leanne; Nickels, Lyndsey; Hersh, Deborah; Godecke, Erin; O'Halloran, Robyn; Lamont, Sue; O'Connor, Claire; Clarke, Kim

2015-01-01

Objectives To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation. Design Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM). Participants A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers. Main outcome measures Statements that achieved a high level of agreement and an overall median score of 7–9 on a nine-point scale were rated as ‘appropriate’. Results 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements. Conclusions This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://www.aphasiapathway.com.au) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation. PMID:26137883

Proceedings of the Annual RAND-China Reform Forum Conference (6th) Held in Santa Monica, California on August 28-29, 2003

DTIC Science & Technology

2005-01-01

documents for commercial use. Limited Electronic Distribution Rights For More Information CHILD POLICY CIVIL JUSTICE EDUCATION ENERGY AND ENVIRONMENT HEALTH...Reform Forum Conference. August 28-29, 2003 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...have been reviewed and approved by RAND Science and Technology. Proceedings of the 6th Annual RAND–China Reform Forum Conference August 28–29

The Dutch Healthy Diet index (DHD-index): an instrument to measure adherence to the Dutch Guidelines for a Healthy Diet.

PubMed

van Lee, Linde; Geelen, Anouk; van Huysduynen, Eveline J C Hooft; de Vries, Jeanne H M; van't Veer, Pieter; Feskens, Edith J M

2012-07-20

The objective was to develop an index based on the Dutch Guidelines for a healthy Diet of 2006 that reflects dietary quality and to apply it to the Dutch National Food Consumption Survey (DNFCS) to examine the associations with micronutrient intakes. A total of 749 men and women, aged 19-30 years, contributed two 24-hour recalls and additional questionnaires in the DNFCS of 2003. The Dutch Healthy Diet index (DHD-index) includes ten components representing the ten Dutch Guidelines for a Healthy Diet. Per component the score ranges between zero and ten, resulting in a total score between zero (no adherence) and 100 (complete adherence). The mean ± SD of the DHD-index was 60.4 ± 11.5 for women and 57.8 ± 10.8 for men (P for difference = 0.002). Each component score increased across the sex-specific quintiles of the DHD-index. An inverse association was observed between the sex-specific quintiles of the DHD-index and total energy intake. Calcium, riboflavin, and vitamin E intake decreased with increasing DHD-index, an inverse association which disappeared after energy adjustment. Vitamin C showed a positive association across quintiles, also when adjusted for energy. For folate, iron, magnesium, potassium, thiamin, and vitamin B6 a positive association emerged after adjustment for energy. The DHD-index is capable of ranking participants according to their adherence to the Dutch Guidelines for a Healthy Diet by reflecting variation in nine out of ten components that constitute the index when based on two 24-hour recalls. Furthermore, the index showed to be a good measure of nutrient density of diets.

A population health approach to reducing observational intensity bias in health risk adjustment: cross sectional analysis of insurance claims

PubMed Central

Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J

2014-01-01

Objective To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Setting Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n=5 153 877). Main outcome measures The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services—Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare’s administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Results Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for

A population health approach to reducing observational intensity bias in health risk adjustment: cross sectional analysis of insurance claims.

PubMed

Wennberg, David E; Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J; Wennberg, John E

2014-04-10

To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Cross sectional analysis. 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n = 5,153,877). The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services--Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare's administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for the standard HCC index, 0.21 for the population health index, 0.12 for the

Illuminant and observer metamerism and the Hardy-Rand-Rittler color vision test editions.

PubMed

Dain, Stephen J

2006-01-01

A previous study identified a significant metamerism in the several editions of the Hardy-Rand-Rittller pseudoisochromatic plates (HRR) but did not proceed to quantify the consequences of that metamerism (Dain, 2004). Metamerism arises from two sources and is almost inevitable when a printed color vision test is reproduced in several editions. Metamerism has two consequences; these are illuminant/source-based changes in performance and changes in performance with observer (less well known) when assessing anomalous trichromats. This study addresses the effects of illuminant/source and observer metamerism on the fourth editions of HRR. Groups of colors intended to lie on a dichromat confusion line generally remain on a confusion line when the source id changed. The plates appear to be resistant to each form of metamerism, perhaps because the features of the spectral reflectance are similar for figure color and background gray. As a consequence, the clinician needs to be less concerned about using a non-recommended source than was previously believed.

24 CFR 203.49 - Eligibility of adjustable rate mortgages.

Code of Federal Regulations, 2010 CFR

2010-04-01

... corresponding to changes in the interest rate index. (d) Frequency of interest rate changes. (1) The interest...) Interest-rate index. Changes in the interest rate charged on an adjustable rate mortgage must correspond either to changes in the one-year London Interbank Offered Rate (LIBOR) or to changes in the weekly...

An Analytical Study on an Orthodontic Index: Index of Complexity, Outcome and Need (ICON)

PubMed Central

Torkan, Sepide; Pakshir, Hamid Reza; Fattahi, Hamid Reza; Oshagh, Morteza; Momeni Danaei, Shahla; Salehi, Parisa; Hedayati, Zohreh

2015-01-01

Statement of the Problem The validity of the Index of Complexity, Outcome and Need (ICON) which is an orthodontic index developed and introduced in 2000 should be studied in different ethnic groups. Purpose The aim of this study was to perform an analysis on the ICON and to verify whether this index is valid for assessing both the need and complexity of orthodontic treatment in Iran. Materials and Method Five orthodontists were asked to score pre-treatment diagnostic records of 100 patients with a uniform distribution of different types of malocclusions determined by Dental Health Component of the Index of Treatment Need. A calibrated examiner also assessed the need for orthodontic treatment and complexity of the cases based on the ICON index as well as the Index of Orthodontic Treatment Need (IOTN). 10 days later, 25% of the cases were re-scored by the panel of experts and the calibrated orthodontist. Results The weighted kappa revealed the inter-examiner reliability of the experts to be 0.63 and 0.51 for the need and complexity components, respectively. ROC curve was used to assess the validity of the index. A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. This cut-off point showed the highest level of sensitivity and specificity in our society for orthodontic treatment need (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment. Conclusion ICON is a valid index in assessing the need for treatment in Iran when the cut-off point is adjusted to 35. As for complexity of treatment, the index is not validated for our society. It seems that ICON is a well-suited substitute for the IOTN index. PMID:26331142

14 CFR 254.6 - Periodic adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.6 Periodic adjustments. The Department of Transportation will... the Consumer Price Index for All Urban Consumers as of July of each review year to calculate the...

Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia

PubMed Central

Kim, Kyoung Min; Jang, Hak Chul; Lim, Soo

2016-01-01

Aging processes are inevitably accompanied by structural and functional changes in vital organs. Skeletal muscle, which accounts for 40% of total body weight, deteriorates quantitatively and qualitatively with aging. Skeletal muscle is known to play diverse crucial physical and metabolic roles in humans. Sarcopenia is a condition characterized by significant loss of muscle mass and strength. It is related to subsequent frailty and instability in the elderly population. Because muscle tissue is involved in multiple functions, sarcopenia is closely related to various adverse health outcomes. Along with increasing recognition of the clinical importance of sarcopenia, several international study groups have recently released their consensus on the definition and diagnosis of sarcopenia. In practical terms, various skeletal muscle mass indices have been suggested for assessing sarcopenia: appendicular skeletal muscle mass adjusted for height squared, weight, or body mass index. A different prevalence and different clinical implications of sarcopenia are highlighted by each definition. The discordances among these indices have emerged as an issue in defining sarcopenia, and a unifying definition for sarcopenia has not yet been attained. This review aims to compare these three operational definitions and to introduce an optimal skeletal muscle mass index that reflects the clinical implications of sarcopenia from a metabolic perspective. PMID:27334763

Two aspects of feedforward postural control: anticipatory postural adjustments and anticipatory synergy adjustments.

PubMed

Klous, Miriam; Mikulic, Pavle; Latash, Mark L

2011-05-01

We used the framework of the uncontrolled manifold hypothesis to explore the relations between anticipatory synergy adjustments (ASAs) and anticipatory postural adjustments (APAs) during feedforward control of vertical posture. ASAs represent a drop in the index of a multimuscle-mode synergy stabilizing the coordinate of the center of pressure in preparation to an action. ASAs reflect early changes of an index of covariation among variables reflecting muscle activation, whereas APAs reflect early changes in muscle activation levels averaged across trials. The assumed purpose of ASAs is to modify stability of performance variables, whereas the purpose of APAs is to change magnitudes of those variables. We hypothesized that ASAs would be seen before APAs and that this finding would be consistent with regard to the muscle-mode composition defined on the basis of different tasks and phases of action. Subjects performed a voluntary body sway task and a quick, bilateral shoulder flexion task under self-paced and reaction time conditions. Surface muscle activity of 12 leg and trunk muscles was analyzed to identify sets of 4 muscle modes for each task and for different phases within the shoulder flexion task. Variance components in the muscle-mode space and indexes of multimuscle-mode synergy stabilizing shift of the center of pressure were computed. ASAs were seen ∼ 100-150 ms prior to the task initiation, before APAs. The results were consistent with respect to different sets of muscle modes defined over the two tasks and different shoulder flexion phases. We conclude that the preparation for a self-triggered postural perturbation is associated with two types of anticipatory adjustments, ASAs and APAs. They reflect different feedforward processes within the hypothetical hierarchical control scheme, resulting in changes in patterns of covariation of elemental variables and in their patterns averaged across trials, respectively. The results show that synergies quantified

[Causal relationship between assertiveness and adjustment in children: A short-term longitudinal study].

PubMed

Eguchi, Megumi; Hamaguchi, Yoshikazu

2015-08-01

This study examined the causal relationships between assertiveness and both internal and external adjustment in children. Elementary school children in grades four through six (N = 284) participated in the study, which used a short-term longitudinal design. The children completed questionnaires twice during a 6-months period. They responded to assertiveness questionnaires that included two components: "self-expression" and "consideration of others". They also completed a self-esteem scale as an index of internal adjustment, and the Class Life Satisfaction scale as an index of external adjustment. There was a positive causative relationship between "self-expression" and internal adjustment and between "consideration for others" and external adjustment. In addition, the effects on adjustment varied according to the type of assertiveness. Cluster analysis and MANOVA indicated that the group with high "self-expression" and "consideration for others" had high internal and external adjustment, while the children with poor assertiveness showed the lowest degree of adaptivity.

Age-adjusted Charlson comorbidity index score as predictor of survival of patients with digestive system cancer who have undergone surgical resection.

PubMed

Tian, Yaohua; Jian, Zhong; Xu, Beibei; Liu, Hui

2017-10-03

Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015. The Cox proportional hazard regression model was applied to evaluate the effect of ACCI score on postoperative mortality, with adjustments for sex, type of resection, anesthesia methods, and caseload of each healthcare institution. The postoperative in-hospital mortality rate in the study cohort was 1.2% (3,631/315,464). ACCI score had a positive graded association with the risk of postoperative in-hospital mortality for all cancer subtypes. The adjusted HRs for postoperative in-hospital mortality scores ≥ 6 for esophagus, stomach, colorectum, pancreas, and liver and gallbladder cancer were 2.05 (95% CI: 1.45-2.92), 2.00 (95% CI: 1.60-2.49), 2.54 (95% CI: 2.02-3.21), 2.58 (95% CI: 1.68-3.97), and 4.57 (95% CI: 3.37-6.20), respectively, compared to scores of 0-1. These findings suggested that a high ACCI score is an independent predictor of postoperative in-hospital mortality in Chinese patients with digestive system cancer who have undergone surgical resection.

Transportation Services Index An Economic Index Measuring Output in the For-Hire Transportation Sector.

DOT National Transportation Integrated Search

2015-01-01

The Bureau of Transportation Statistics (BTS) is a leader in the collection, analysis, and dissemination of transportation data. The Transportation Services Index (TSI) measures the seasonally adjusted movement of freight traffic and passenger travel...

The effects of muscle vibration on anticipatory postural adjustments.

PubMed

Slijper, Harm; Latash, Mark L

2004-07-23

The current study investigated the influence of changes in sensory information related to postural stability on anticipatory postural adjustments (APAs) in standing subjects. Subjects performed fast arm movements and a load release task while standing on a stable force platform or on an unstable board. We manipulated sensory information through vibration of the Achilles tendons and additional finger touch (contact forces under 1 N). Changes in the background activity of leg, trunk, and arm muscles and displacements of the center of pressure (COP) were quantified within time intervals typical for APAs. In the arm movement task, leg and trunk muscles showed a significant drop in the APAs with finger touch, while the vibration and standing on the unstable board each led to an increase in the APA magnitude. In the load release task, ventral muscles decreased their APA activity with touch, while dorsal muscles showed increased inhibition during APAs. During vibration, dorsal and ventral muscles showed increased excitation and inhibition during APAs, respectively. An additional analysis of APAs at a joint level, has shown that in both tasks, an index related to the co-activation of agonist-antagonist muscle pairs (C-index) was modulated with touch, vibration, and stability particularly in leg muscles. Small changes in the other index related to reciprocal activation (R-index) were found only in trunk muscles. Light touch and vibration induced opposing changes in the C-index, suggesting their opposite effects on the stabilization of a reference point or vertical. We conclude that the central nervous system deploys patterns of adjustments in which increased co-contraction of distal muscles and reciprocal adjustments in trunk muscles are modified to ensure equilibrium under postural instability.

77 FR 61031 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

.......... 09/18/12 09/11/12 One-Stop). 81976 Custom Food (State/One- Shreveport, LA........ 09/18/12 09/17/12... 81980 Bank of America (State/One- Addison, TX 09/19/12 09/18/12 Stop). 81981 Ingersoll Rand (Aire Fort...

Attrition in the RAND Health Insurance Experiment: a response to Nyman.

PubMed

Newhouse, Joseph P; Brook, Robert H; Duan, Naihua; Keeler, Emmett B; Leibowitz, Arleen; Manning, Willard G; Marquis, M Susan; Morris, Carl N; Phelps, Charles E; Rolph, John E

2008-04-01

In a prior article in this journal, John Nyman argues that the effect on health care use and spending found in the RAND Health Insurance Experiment is an artifact of greater voluntary attrition in the cost-sharing plans relative to the free care plan. Specifically, he speculates that those in the cost-sharing plans, when faced with a hospitalization, withdrew. His argument is implausible because (1) families facing a hospitalization would be worse off financially by withdrawing; (2) a large number of observational studies find a similar effect of cost sharing on use; (3) those who left did not differ in their utilization prior to leaving; (4) if there had been no attrition and cost sharing did not reduce hospitalization rates, each adult in each family that withdrew would have had to have been hospitalized once each year for the duration of time they would otherwise have been in the experiment, an implausibly high rate; (5) there are benign explanations for the higher attrition in the cost-sharing plans. Finally, we obtained follow-up health-status data on the great majority of those who left prematurely. We found the health-status findings were insensitive to the inclusion of the attrition cases.

Investigating the prostate specific antigen, body mass index and age relationship: is an age-BMI-adjusted PSA model clinically useful?

PubMed

Harrison, Sean; Tilling, Kate; Turner, Emma L; Lane, J Athene; Simpkin, Andrew; Davis, Michael; Donovan, Jenny; Hamdy, Freddie C; Neal, David E; Martin, Richard M

2016-12-01

Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an age-BMI-adjusted PSA model would be clinically useful for detecting prostate cancer. Cross-sectional analysis nested within the UK ProtecT trial of treatments for localized cancer. Of 18,238 men aged 50-69 years, 9,457 men without screen-detected prostate cancer (controls) and 1,836 men with prostate cancer (cases) met inclusion criteria: no history of prostate cancer or diabetes; PSA < 10 ng/ml; BMI between 15 and 50 kg/m 2 . Multivariable linear regression models were used to investigate the relationship between log-PSA, age, and BMI in all men, controlling for prostate cancer status. In the 11,293 included men, the median PSA was 1.2 ng/ml (IQR: 0.7-2.6); mean age 61.7 years (SD 4.9); and mean BMI 26.8 kg/m 2 (SD 3.7). There were a 5.1% decrease in PSA per 5 kg/m 2 increase in BMI (95% CI 3.4-6.8) and a 13.6% increase in PSA per 5-year increase in age (95% CI 12.0-15.1). Interaction tests showed no evidence for different associations between age, BMI, and PSA in men above and below 3.0 ng/ml (all p for interaction >0.2). The age-BMI-adjusted PSA model performed as well as an age-adjusted model based on National Institute for Health and Care Excellence (NICE) guidelines at detecting prostate cancer. Age and BMI were associated with small changes in PSA. An age-BMI-adjusted PSA model is no more clinically useful for detecting prostate cancer than current NICE guidelines. Future studies looking at the effect of different variables on PSA, independent of their effect on prostate cancer, may improve the discrimination of PSA for prostate cancer.

Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method.

PubMed

Power, Emma; Thomas, Emma; Worrall, Linda; Rose, Miranda; Togher, Leanne; Nickels, Lyndsey; Hersh, Deborah; Godecke, Erin; O'Halloran, Robyn; Lamont, Sue; O'Connor, Claire; Clarke, Kim

2015-07-02

To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation. Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM). A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers. Statements that achieved a high level of agreement and an overall median score of 7-9 on a nine-point scale were rated as 'appropriate'. 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements. This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://www.aphasiapathway.com.au) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already

The adjusted effect of maternal body mass index, energy and macronutrient intakes during pregnancy, and gestational weight gain on body composition of full-term neonates.

PubMed

Pereira-da-Silva, Luis; Cabo, Catarina; Moreira, Ana Catarina; Virella, Daniel; Guerra, Tatiana; Camoes, Tania; Silva, Ana Rita; Neves, Rute; Ferreira, Goncalo Cordeiro

2014-11-01

To evaluate the effect of prepregnancy body mass index (BMI), energy and macronutrient intakes during pregnancy, and gestational weight gain (GWG) on the body composition of full-term appropriate-for-gestational age neonates. This is a cross-sectional study of a systematically recruited convenience sample of mother-infant pairs. Food intake during pregnancy was assessed by food frequency questionnaire and its nutritional value by the Food Processor Plus (ESHA Research Inc, Salem, OR). Neonatal body composition was assessed both by anthropometry and air displacement plethysmography. Explanatory models for neonatal body composition were tested by multiple linear regression analysis. A total of 100 mother-infant pairs were included. Prepregnancy overweight was positively associated with offspring weight, weight/length, BMI, and fat-free mass in the whole sample; in males, it was also positively associated with midarm circumference, ponderal index, and fat mass. Higher energy intake from carbohydrate was positively associated with midarm circumference and weight/length in the whole sample. Higher GWG was positively associated with weight, length, and midarm circumference in females. Positive adjusted associations were found between both prepregnancy BMI and energy intake from carbohydrate and offspring body size in the whole sample. Positive adjusted associations were also found between prepregnancy overweight and adiposity in males, and between GWG and body size in females. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Colorimetric analysis of four editions of the Hardy-Rand-Rittler pseudoisochromatic tests.

PubMed

Dain, Stephen J

2004-01-01

At the Göttingen meeting of the International Colour Vision Society, I reported on a comparison of the second edition of the American Optical Hardy-Rand-Rittler Pseudoisochromatic plates (AO HRR) with the Richmond Products third edition of the same test and concluded that the chromaticities were exceptionally poorly matched and that the new edition was a "pale imitation of the real thing" (unpublished). This conclusion led to our abandoning a clinical trial. In 2002, Richmond Products has published a fourth edition and, in 2003, Waggoner has published a modified HRR with additional (Ishihara style) plates and the tetartan confusion figures removed. As a precursor to any clinical trial, the colors used in the plates have been measured and comparisons drawn between the four editions. While the two most recent editions much more closely resemble the original AO HRR and the chromaticities are much better aligned on the dichromatic confusion lines, the excitation purities (and therefore the degree of difficulty) of the plates are less well matched in the Richmond Products editions. In addition, there is a significant degree of metamerism in the third edition and Waggoner edition that makes variations in illuminant more critical to performance.

Extensive validation of the pain disability index in 3 groups of patients with musculoskeletal pain.

PubMed

Soer, Remko; Köke, Albère J A; Vroomen, Patrick C A J; Stegeman, Patrick; Smeets, Rob J E M; Coppes, Maarten H; Reneman, Michiel F

2013-04-20

A cross-sectional study design was performed. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. The PDI is a widely used and studied instrument for disability related to various pain syndromes, although there is conflicting evidence concerning factor structure, test-retest reliability, and missing items. Additionally, an official translation of the Dutch language version has never been performed. For reliability, internal consistency, factor structure, test-retest reliability and measurement error were calculated. Validity was tested with hypothesized correlations with pain intensity, kinesiophobia, Rand-36 subscales, Depression, Roland-Morris Disability Questionnaire, Quality of Life, and Work Status. Structural validity was tested with independent backward translation and approval from the original authors. One hundred seventy-eight patients with acute back pain, 425 patients with chronic low back pain and 365 with widespread pain were included. Internal consistency of the PDI was good. One factor was identified with factor analyses. Test-retest reliability was good for the PDI (intraclass correlation coefficient, 0.76). Standard error of measurement was 6.5 points and smallest detectable change was 17.9 points. Little correlations between the PDI were observed with kinesiophobia and depression, fair correlations with pain intensity, work status, and vitality and moderate correlations with the Rand-36 subscales and the Roland-Morris Disability Questionnaire. The PDI-Dutch language version is internally consistent as a 1-factor structure, and test-retest reliable. Missing items seem high in sexual and professional items. Using the PDI as a 2-factor questionnaire has no additional value and is unreliable.

The ISTSS/Rand guidelines on mental health training of primary healthcare providers for trauma-exposed populations in conflict-affected countries.

PubMed

Eisenman, David; Weine, Stevan; Green, Bonnie; de Jong, Joop; Rayburn, Nadine; Ventevogel, Peter; Keller, Allen; Agani, Ferid

2006-02-01

Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.

How Is Deployment to Iraq and Afghanistan Affecting U.S. Service Members and Their Families? An Overview of Early Rand Research on the Topic

DTIC Science & Technology

2011-01-01

herein are protected by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is...shorter or much longer than expected decreased the intention to stay in the military. This finding implies that service members feel discontent when...when the deployment will occur and how long it will be, and to feel assured that expectations will be met. • The intention to stay in the military

Validation of quality indicators for the organization of palliative care: a modified RAND Delphi study in seven European countries (the Europall project).

PubMed

Woitha, Kathrin; Van Beek, Karen; Ahmed, Nisar; Jaspers, Birgit; Mollard, Jean M; Ahmedzai, Sam H; Hasselaar, Jeroen; Menten, Johan; Vissers, Kris; Engels, Yvonne

2014-02-01

Validated quality indicators can help health-care professionals to evaluate their medical practices in a comparative manner to deliver optimal clinical care. No international set of quality indicators to measure the organizational aspects of palliative care settings exists. To develop and validate a set of structure and process indicators for palliative care settings in Europe. A two-round modified RAND Delphi process was conducted to rate clarity and usefulness of a previously developed set of 110 quality indicators. In total, 20 multi-professional palliative care teams of centers of excellence from seven European countries. In total, 56 quality indicators were rated as useful. These valid quality indicators concerned the following domains: the definition of a palliative care service (2 quality indicators), accessibility to palliative care (16 quality indicators), specific infrastructure to deliver palliative care (8 quality indicators), symptom assessment tools (1 quality indicator), specific personnel in palliative care services (9 quality indicators), documentation methodology of clinical data (14 quality indicators), evaluation of quality and safety procedures (1 quality indicator), reporting of clinical activities (1 quality indicator), and education in palliative care (4 quality indicator). The modified RAND Delphi process resulted in 56 international face-validated quality indicators to measure and compare organizational aspects of palliative care. These quality indicators, aimed to assess and improve the organization of palliative care, will be pilot tested in palliative care settings all over Europe and be used in the EU FP7 funded IMPACT project.

47 CFR 1.1117 - Adjustments to charges.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (1) The fees will be adjusted by the Commission to reflect the percentage change in the Consumer Price Index for all Urban Consumers (CPI-U) from the date of enactment of the authorizing legislation... these decisions be subject to petitions for reconsideration under § 1.429 of the rules. Requests for...

Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients.

PubMed

Zemack, Göran; Romner, Bertil

2002-12-01

We sought to assess the value of adjusting shunt valve opening pressure, complications, and outcomes with the use of an adjustable shunt valve in the treatment of patients with normal-pressure hydrocephalus (NPH). In a single-center retrospective study, 231 adjustable valves (range, 30-200 mm H(2)O) were the first shunt implantations in 147 patients with idiopathic NPH (INPH) and 71 patients with secondary NPH (SNPH). The effect of adjustment on gait disturbance, cognitive impairment, urinary incontinence and other symptoms were evaluated, and an improvement index was created. In the INPH group, 138 adjustments were performed in 49.0% of the patients (average, 0.94 adjustments/patient). For the SNPH group, 49 adjustments were performed in 32.4% of the patients (average, 0.69 adjustments/patient). The reasons for adjustment were overdrainage in 48 patients (25.7%), underdrainage in 98 patients (52.4%), subdural hematoma in 37 patients (19.8%), and other reasons in 2 patients (2.1%). Clinical status improved after 56 (49.1%) of all 114 adjustments, whereas 23 (42.6%) of 54 minor (< or =20 mm H2O) and 33 (66.0%) of 50 larger adjustments improved the patient's clinical status. The correlation of the improvement index with the size of the individual adjustments was not significant. Complications occurred in 43 (19.7%) of 218 patients, valve malfunction occurred in 3 patients (1.3%), infection occurred in 14 patients (6.4%), and nontraumatic subdural effusion occurred in 15 patients (6.9%; 8 were treated by adjustment alone). The 5-year shunt survival rate was 80.2%. Outcomes were excellent or good in 71 (78.9%) of 90 patients with INPH and in 30 (69.8%) of 43 patients with SNPH. Noninvasive, particularly consecutive, minor or single larger adjustments to the valve opening pressure can further improve outcome in patients with NPH who undergo shunting.

Congressional Testimony on Educational Innovations. Testimony to the Subcommittee on Elementary, Secondary and Vocational Education Committee on Education and Labor. U.S. House of Representatives. Rand Paper Series No. 5983.

ERIC Educational Resources Information Center

Berman, Paul

This testimony summarizes the results of the Rand Corporation's change agent study of educational innovations funded by federal programs. The second section consists of policy recommendations for ESEA Title IV Consolidated Programs, Part C. The study aimed to help improve federal policies by describing how the process of innovation and educational…

78 FR 1253 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... Trade Commission as a member of a domestic industry in an investigation resulting in-- (A) An... date 82,024 Thermo King Corporation, Louisville, GA........ October 1, 2011. Ingersoll-Rand, Manpower... Pine, NC....... October 31, 2011. Recreational Products, Outboard Engine Division, Manpower. Negative...

[Effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patient with implant restoration].

PubMed

Wang, Rong; Xu, Xin

2015-12-01

To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration. Twenty patients, each with a single edentulous posterior dentition with no distal dentition were selected, and divided into 2 groups. Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique. Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment. Data was collected and measurements for balanced occlusal measuring standards were obtained, including central occlusion force (COF), asymmetry index of molar occlusal force(AMOF). Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position, average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position(ICP), Astot, masseter muscle asymmetry index, and anterior temporalis asymmetry index (ASTA). Statistical analysis was performed using Student 's t test with SPSS 18.0 software package. Three months after occlusion adjustment, parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards. Six months after occlusion adjustment, parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards, but was no significant difference in balanced

Optical phantoms with adjustable subdiffusive scattering parameters

NASA Astrophysics Data System (ADS)

Krauter, Philipp; Nothelfer, Steffen; Bodenschatz, Nico; Simon, Emanuel; Stocker, Sabrina; Foschum, Florian; Kienle, Alwin

2015-10-01

A new epoxy-resin-based optical phantom system with adjustable subdiffusive scattering parameters is presented along with measurements of the intrinsic absorption, scattering, fluorescence, and refractive index of the matrix material. Both an aluminium oxide powder and a titanium dioxide dispersion were used as scattering agents and we present measurements of their scattering and reduced scattering coefficients. A method is theoretically described for a mixture of both scattering agents to obtain continuously adjustable anisotropy values g between 0.65 and 0.9 and values of the phase function parameter γ in the range of 1.4 to 2.2. Furthermore, we show absorption spectra for a set of pigments that can be added to achieve particular absorption characteristics. By additional analysis of the aging, a fully characterized phantom system is obtained with the novelty of g and γ parameter adjustment.

Mentorship in the context of interdisciplinary geriatric research: lessons learned from the RAND/Hartford Program for Building Interdisciplinary Geriatric Research Centers.

PubMed

Keyser, Donna J; Abedin, Zainab; Schultz, Dana J; Pincus, Harold Alan

2012-08-01

In light of the growing trend toward formalized research mentorship for effectively transmitting the values, standards, and practices of science from one generation of researchers to the next, this article provides the results of an exploratory study. It reports on research mentorship in the context of interdisciplinary geriatric research based on experiences with the RAND/Hartford Program for Building Interdisciplinary Geriatric Research Centers. At the end of the 2-year funding period, staff from the RAND Coordinating Center conducted 60- to 90-minute open-ended telephone interviews with the co-directors of the seven centers. Questions focused on interdisciplinary mentorship activities, barriers to implementing these activities, and strategies for overcoming them, as well as a self-assessment tool with regard to programs, policies, and structures across five domains, developed to encourage research mentorship. In addition, the mentees at the centers were surveyed to assess their experiences with interdisciplinary mentoring and the center. According to the interviewees, some barriers to successful interdisciplinary mentoring included the mentor's lack of time, structural support, and the lack of a clear definition of interdisciplinary research. Most centers had formal policies in place for mentor identification and limited policies on mentor incentives. Mentees uniformly reported their relationships with their mentors as positive. More than 50% of mentees reported having a primary mentor from within their discipline and had more contact with their primary mentor than their secondary mentors. Further research is needed to understand the complexity of institutional levers that emerging programs might employ to encourage and support research mentorship. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Guidelines for sinkhole and subsidence rehabilitation based on generic geological models of a dolomite environment on the East Rand, South Africa

NASA Astrophysics Data System (ADS)

Kleinhans, Ilse; Van Rooy, J. Louis

2016-05-01

A sound understanding of the various factors influencing and associated with the formation of sinkholes or subsidences on dolomite land is essential for the selection of appropriate rehabilitation methods. The investigation and rehabilitation of numerous sinkholes and subsidences located on dolomite in the East Rand of South Africa, created an opportunity to develop a broad based understanding of different karst environments, their susceptibility to sinkhole and subsidence formation and best practice rehabilitation methods. This paper is based on the guidelines developed whereby the geological model of the sinkhole or subsidence is used to recommend an appropriate rehabilitation method. Nine typical geological models with recommended rehabilitation methods are presented in this paper.

[Interpersonal motivation in a First Year Experience class influences freshmen's university adjustment].

PubMed

Nakayama, Rumiko; Nakanishi, Yoshifumi; Nagahama, Fumiyo; Nakajima, Makoto

2015-06-01

The present study examined the influence of interpersonal motivation on university adjustment in freshman students enrolled in a First Year Experience (FYE) class. An interpersonal motivation scale and a university adjustment (interpersonal adjustment and academic adjustment) scale were administered twice to 116 FYE students; data from the 88 students who completed both surveys were analyzed. Results from structural equation modeling indicated a causal relationship between interpersonal, motivation and university adjustment: interpersonal adjustment served as a mediator between academic adjustment and interpersonal motivation, the latter of which was assessed using the internalized motivation subscale of the Interpersonal Motivation Scale as well as the Relative Autonomy Index, which measures the autonomy in students' interpersonal attitudes. Thus, revising the FYE class curriculum to include approaches to lowering students' feelings of obligation and/or anxiety in their interpersonal interactions might improve their adjustment to university.

Nanometer-thick flat lens with adjustable focus

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

Son, T. V.; Haché, A.; Ba, C. O. F.

2014-12-08

We report laser beam focusing by a flat, homogeneous film with a thickness of less than 100 nm. The effect relies on refractive index changes occurring in vanadium dioxide as it undergoes a phase transition from insulator to metal. Phase front curvature is achieved by means of temperature gradients, and adjustable focal lengths from infinity to 30 cm are attained.

More reliable inference for the dissimilarity index of segregation

PubMed Central

Allen, Rebecca; Burgess, Simon; Davidson, Russell; Windmeijer, Frank

2015-01-01

Summary The most widely used measure of segregation is the so‐called dissimilarity index. It is now well understood that this measure also reflects randomness in the allocation of individuals to units (i.e. it measures deviations from evenness, not deviations from randomness). This leads to potentially large values of the segregation index when unit sizes and/or minority proportions are small, even if there is no underlying systematic segregation. Our response to this is to produce adjustments to the index, based on an underlying statistical model. We specify the assignment problem in a very general way, with differences in conditional assignment probabilities underlying the resulting segregation. From this, we derive a likelihood ratio test for the presence of any systematic segregation, and bias adjustments to the dissimilarity index. We further develop the asymptotic distribution theory for testing hypotheses concerning the magnitude of the segregation index and show that the use of bootstrap methods can improve the size and power properties of test procedures considerably. We illustrate these methods by comparing dissimilarity indices across school districts in England to measure social segregation. PMID:27774035

Experimental comparison between speech transmission index, rapid speech transmission index, and speech intelligibility index.

PubMed

Larm, Petra; Hongisto, Valtteri

2006-02-01

During the acoustical design of, e.g., auditoria or open-plan offices, it is important to know how speech can be perceived in various parts of the room. Different objective methods have been developed to measure and predict speech intelligibility, and these have been extensively used in various spaces. In this study, two such methods were compared, the speech transmission index (STI) and the speech intelligibility index (SII). Also the simplification of the STI, the room acoustics speech transmission index (RASTI), was considered. These quantities are all based on determining an apparent speech-to-noise ratio on selected frequency bands and summing them using a specific weighting. For comparison, some data were needed on the possible differences of these methods resulting from the calculation scheme and also measuring equipment. Their prediction accuracy was also of interest. Measurements were made in a laboratory having adjustable noise level and absorption, and in a real auditorium. It was found that the measurement equipment, especially the selection of the loudspeaker, can greatly affect the accuracy of the results. The prediction accuracy of the RASTI was found acceptable, if the input values for the prediction are accurately known, even though the studied space was not ideally diffuse.

Discriminative power of Campylobacter phenotypic and genotypic typing methods.

PubMed

Duarte, Alexandra; Seliwiorstow, Tomasz; Miller, William G; De Zutter, Lieven; Uyttendaele, Mieke; Dierick, Katelijne; Botteldoorn, Nadine

2016-06-01

The aim of this study was to compare different typing methods, individually and combined, for use in the monitoring of Campylobacter in food. Campylobacter jejuni (n=94) and Campylobacter coli (n=52) isolated from different broiler meat carcasses were characterized using multilocus sequence typing (MLST), flagellin gene A restriction fragment length polymorphism typing (flaA-RFLP), antimicrobial resistance profiling (AMRp), the presence/absence of 5 putative virulence genes; and, exclusively for C. jejuni, the determination of lipooligosaccharide (LOS) class. Discriminatory power was calculated by the Simpson's index of diversity (SID) and the congruence was measured by the adjusted Rand index and adjusted Wallace coefficient. MLST was individually the most discriminative typing method for both C. jejuni (SID=0.981) and C. coli (SID=0.957). The most discriminative combination with a SID of 0.992 for both C. jejuni and C. coli was obtained by combining MLST with flaA-RFLP. The combination of MLST with flaA-RFLP is an easy and feasible typing method for short-term monitoring of Campylobacter in broiler meat carcass. Copyright © 2016 Elsevier B.V. All rights reserved.

How Is Deployment to Iraq and Afghanistan Affecting U.S. Service Members and Their Families?: An Overview of Early RAND Research on the Topic.

PubMed

Hosek, James

2011-01-01

The conflicts in Iraq and Afghanistan, which have extended over the past decade, have put America's all-volunteer force to its most severe test since its inception in 1973. In this environment of ongoing demand for battle-ready soldiers, sailors, airmen, and marines, there is concern about the effects and consequences of prolonged stress on the force as a whole and on individual service members and their families. The well-being of troops and the people close to them is an issue of much importance, both because it affects military readiness and the ability of the U.S. armed forces to carry out their mission and because the nation is committed to acting on its appreciation of the sacrifices made by military families. To devise policies effective for facilitating the well-being of this community, there must first be a comprehensive understanding of the myriad issues and consequences that service members and their families may face because of deployment. Yet for much of the 2000s, this understanding was largely lacking. Recognizing the need for analysis, RAND launched a program of research around 2005, its goal being to investigate this topic and, where possible, offer policymakers informed recommendations. This article introduces this body of work-still being added to today-through descriptions of six of RAND's earliest studies on various aspects of the topic. It calls attention to the pressing policy questions; summarizes the key findings, insights into the issues, and policy implications; and, where applicable, lays out recommendations.

Adjustment to Spinal Cord Injury: A Comprehensive Follow-Up Study.

ERIC Educational Resources Information Center

Cook, Daniel; And Others

This document reports a comprehensive followup study to describe postservice life status of former vocational rehabilitation clients and to develop an empirical index of postservice adjustment to spinal cord injury. Significant findings, conclusions, and implications are found at the beginning. The introduction section summarizes followup studies…

A beat-to-beat calculator for the diastolic pressure time index and the tension time index.

PubMed

Nose, Y; Tajimi, T; Watanabe, Y; Yokota, M; Akazawa, K; Nakamura, M

1987-01-01

We have developed a beat-to-beat calculator which can calculate in real-time the ratio of the diastolic pressure time index (DPTI), and the tension time index (TTI) as an index of the myocardial oxygen supply/demand balance. Physicians set up presumed value for the left ventricular endodiastolic pressure, a search area for the dicrotic notch, a threshold for the onset of the up-slope and the corresponding value of the calibration signal on the digital switches of the calculator. Next, the arterial pressure analog signal is input into the calculator. The calculator searches automatically for both the onset of the up-slope and the dicrotic notch. The arterial pressure curve is displayed beat-to-beat with the recognized onset and the dicrotic notch on the CRT to be confirmed by physicians. When physicians do not agree with the automatic recognition they can fit the automatic recognition to the observation. If the recognition of the onset is inadequate, the threshold can be re-adjusted to trigger the onset. If recognition of the dicrotic notch is inadequate, the physician can adjust the search-area. Therefore, physicians who operate the calculator can rely on the calculated DPTI/TTI. This calculator can continuously monitor the myocardial oxygen supply/demand balance in patients with acute myocardial infarction or just after open-heart surgery.

20 CFR 416.405 - Cost-of-living adjustments in benefits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... which the title II benefits are being increased based on the Consumer Price Index, or, if greater, the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Cost-of-living adjustments in benefits. 416.405 Section 416.405 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME...

A Novel Index Using Soluble CD36 Is Associated with the Prevalence of Type 2 Diabetes Mellitus: Comparison Study with Triglyceride-Glucose Index.

PubMed

Kim, Ho Jin; Moon, Jun Sung; Park, Il Rae; Kim, Joong Hee; Yoon, Ji Sung; Won, Kyu Chang; Lee, Hyoung Woo

2017-09-01

Plasma soluble cluster determinant 36 (sCD36) level is closely related with insulin resistance and atherosclerosis, but little is known whether it could be a surrogate for estimating risk of developing diabetes or not. To address this, we evaluated association between sCD36 index, the product of sCD36 and fasting plasma glucose (FPG), and the prevalence of type 2 diabetes mellitus (T2DM), and then compared with triglyceride-glucose (TyG) index which has been suggested simple index for insulin resistance. This was cross-sectional study, and participants were classified as normal glucose tolerance (NGT), prediabetes, and T2DM according to glucose tolerance. The formula of TyG index was 'ln [FPG (mg/dL)×triglyceride (mg/dL)/2],' and the sCD36 index was 'ln [sCD36 (pg/mL)×FPG (mg/dL)/2].' One hundred and fifty-five subjects (mean age, 55.2 years) were enrolled, and patients with T2DM were 75. Both indexes were significantly increased in prediabetes and T2DM rather than NGT, and sCD36 index was positively correlated with both glycosylated hemoglobin and homeostasis model assessment of insulin resistance (r=0.767 and r=0.453, respectively; P<0.05) and negatively with homeostasis model assessment estimate of β-cell function (r=-0.317). The odds ratio (OR) of sCD36 index for T2DM was 4.39 (95% confidential interval, 1.51 to 12.77) after adjusting age, gender, blood pressure, smoking, alcohol, non-high density lipoprotein cholesterol and high-sensitivity C-reactive protein. However, OR of TyG index did not remained significance after adjustment. sCD36 index has an independent association with the risk of T2DM, and showed better correlation than TyG index. These results suggest sCD36 index might be useful surrogate marker for the risk of diabetes. Copyright © 2017 Korean Endocrine Society

Development and evaluation of the Dutch Healthy Diet index 2015.

PubMed

Looman, Moniek; Feskens, Edith Jm; de Rijk, Mariëlle; Meijboom, Saskia; Biesbroek, Sander; Temme, Elisabeth Hm; de Vries, Jeanne; Geelen, Anouk

2017-09-01

To update the Dutch Healthy Diet index, a measure of diet quality, to reflect adherence to the Dutch dietary guidelines 2015 and to evaluate against participants' characteristics and nutrient intakes with the score based on 24 h recall (24 hR) data and FFQ data. The Dutch Healthy Diet index 2015 (DHD15-index) consists of fifteen components representing the fifteen food-based Dutch dietary guidelines of 2015. Per component the score ranges between 0 and 10, resulting in a total score between 0 (no adherence) and 150 (complete adherence). Wageningen area, the Netherlands, 2011-2013. Data of 885 men and women, aged 20-70 years, participating in the longitudinal NQplus study, who filled out two 24 hR and one FFQ, were used. Mean (sd) score of the DHD15-index was 68·7 (16·1) for men and 79·4 (16·0) for women. Significant inverse trends were found between the DHD15-index and BMI, smoking, and intakes of energy, total fat and saturated fat. Positive trends were seen across sex-specific quintiles of the DHD15-index score with energy-adjusted micronutrient intakes. Mean DHD15-index score of the FFQ data was 15·5 points higher compared with 24 hR data, with a correlation coefficient of 0·56 between the scores. Observed trends of the DHD15-index based on FFQ with participant characteristics, macronutrient and energy-adjusted micronutrient intakes were similar to those with the DHD15-index based on 24 hR. The DHD15-index score assesses adherence to the Dutch dietary guidelines 2015 and indicates diet quality. The DHD15-index score can be based on 24 hR data and on FFQ data.

How does sagittal imbalance affect the appropriateness of surgical indications and selection of procedure in the treatment of degenerative scoliosis? Findings from the RAND/UCLA Appropriate Use Criteria study.

PubMed

Daubs, Michael D; Brara, Harsimran S; Raaen, Laura B; Chen, Peggy Guey-Chi; Anderson, Ashaunta T; Asch, Steven M; Nuckols, Teryl K

2018-05-01

Degenerative lumbar scoliosis (DLS) is often associated with sagittal imbalance, which may affect patients' health outcomes before and after surgery. The appropriateness of surgery and preferred operative approaches has not been examined in detail for patients with DLS and sagittal imbalance. The goals of this article were to describe what is currently known about the relationship between sagittal imbalance and health outcomes among patients with DLS and to determine how indications for surgery in patients with DLS differ when sagittal imbalance is present. This study included a literature review and an expert panel using the RAND/University of California at Los Angeles (UCLA) Appropriateness Method. To develop appropriate use criteria for DLS, researchers at the RAND Corporation recently employed the RAND/UCLA Appropriateness Method, which involves a systematic review of the literature and multidisciplinary expert panel process. Experts reviewed a synopsis of published literature and rated the appropriateness of five common operative approaches for 260 different clinical scenarios. In the present work, we updated the literature review and compared panelists' ratings in scenarios where imbalance was present versus absent. This work was funded by the Collaborative Spine Research Foundation, a group of surgical specialty societies and device manufacturers. On the basis of 13 eligible studies that examined sagittal imbalance and outcomes in patients with DLS, imbalance was associated with worse functional status in the absence of surgery and worse symptoms and complications postoperatively. Panelists' ratings demonstrated a consistent pattern across the diverse clinical scenarios. In general, when imbalance was present, surgery was more likely to be appropriate or necessary, including in some situations where surgery would otherwise be inappropriate. For patients with moderate to severe symptoms and imbalance, a deformity correction procedure was usually appropriate

Revisiting nurse turnover costs: adjusting for inflation.

PubMed

Jones, Cheryl Bland

2008-01-01

Organizational knowledge of nurse turnover costs is important, but gathering these data frequently may not always be feasible in today's fast-paced and complex healthcare environment. The author presents a method to inflation adjust baseline nurse turnover costs using the Consumer Price Index. This approach allows nurse executives to gain current knowledge of organizational nurse turnover costs when primary data collection is not practical and to determine costs and potential savings if nurse retention investments are made.

5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

Code of Federal Regulations, 2013 CFR

2013-01-01

... table shows the adjustment factor for each area: COLA area Amount Anchorage, AK 7.0 Fairbanks, AK 9.0 Juneau, AK 9.0 Rest of the State of Alaska 9.0 City and County of Honolulu, HI 5.0 Hawaii County, HI 7.0...

5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

Code of Federal Regulations, 2012 CFR

2012-01-01

... table shows the adjustment factor for each area: COLA area Amount Anchorage, AK 7.0 Fairbanks, AK 9.0 Juneau, AK 9.0 Rest of the State of Alaska 9.0 City and County of Honolulu, HI 5.0 Hawaii County, HI 7.0...

5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

Code of Federal Regulations, 2011 CFR

2011-01-01

... table shows the adjustment factor for each area: COLA area Amount Anchorage, AK 7.0 Fairbanks, AK 9.0 Juneau, AK 9.0 Rest of the State of Alaska 9.0 City and County of Honolulu, HI 5.0 Hawaii County, HI 7.0...

5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

Code of Federal Regulations, 2014 CFR

2014-01-01

... table shows the adjustment factor for each area: COLA area Amount Anchorage, AK 7.0 Fairbanks, AK 9.0 Juneau, AK 9.0 Rest of the State of Alaska 9.0 City and County of Honolulu, HI 5.0 Hawaii County, HI 7.0...

Obesity in children with congenital adrenal hyperplasia in the Minnesota cohort: importance of adjusting body mass index for height-age.

PubMed

Sarafoglou, Kyriakie; Forlenza, Gregory P; Yaw Addo, O; Kyllo, Jennifer; Lteif, Aida; Hindmarsh, P C; Petryk, Anna; Gonzalez-Bolanos, Maria Teresa; Miller, Bradley S; Thomas, William

2017-05-01

To evaluate obesity and overweight in children with congenital adrenal hyperplasia (CAH) and associations with glucocorticoids, fludrocortisone and disease control. Adjusting body mass index-for-height-age (BMI HA ) percentile is proposed to correct misclassification of obese/overweight status in CAH children with advanced bone age and tall-for-age stature. Longitudinal. One hundred and ninety-four children with CAH seen from 1970 to 2013: 124 salt wasting (SW); 70 simple virilizing (SV); 102 females. Body mass index (BMI) end-points were overweight (85-94 percentile) and obese (≥95 percentile). Approximately 50% of the children had at least one BMI measurement ≥95 percentile and about 70% had at least one ≥85 percentile. Using BMI HA percentiles, obesity incidence decreased slightly in SW children (47-43%) and markedly in SV children (50-33%); however, overweight status was not reduced. Only 6% of SW and 1% of SV children were persistently obese (≥3 clinic visits) when BMI HA was applied, whereas overweight status persisted in 35% of SW and 33% of SV children. Most obesity or overweight when using BMI HA occurred before age 10 and there was no association with hydrocortisone (HC) or fludrocortisone dosing. Adiposity rebound for SW children occurred by 3·3 years and in SV females by age 3·8 years, over a year earlier than the adiposity rebound for healthy children. Children with CAH are at higher risk for early onset obesity and overweight with or without using BMI HA but rates of persistent obesity were lower than previously reported. Careful HC dosing during early childhood is needed to prevent increased weight gain and an early adiposity rebound. © 2017 John Wiley & Sons Ltd.

The role of premorbid adjustment in schizophrenia: Focus on cognitive remediation outcome.

PubMed

Buonocore, Mariachiara; Bosinelli, Francesca; Bechi, Margherita; Spangaro, Marco; Piantanida, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella Rita; Cavallaro, Roberto; Bosia, Marta

2018-02-19

Premorbid adjustment has been associated with several outcomes in schizophrenia and has been proposed as an index of cognitive reserve. This study aims to comprehensively analyse the relation between premorbid adjustment and clinical, neurocognitive, socio-cognitive and functional assessments, as well as to investigate the effect of premorbid adjustment on cognitive improvements after a cognitive remediation therapy protocol. Seventy-nine clinically stabilised outpatients with schizophrenia underwent a combined intervention consisting of cognitive remediation therapy added to standard rehabilitation therapy. All patients were assessed at baseline for psychopathology, premorbid adjustment, intellectual level, cognition and functioning. Cognitive evaluations were also repeated after the intervention. At baseline, significant correlations were observed between premorbid adjustment and working memory. The global cognitive improvement after treatment was significantly predicted by age and premorbid adjustment. This study confirms the association between premorbid adjustment and cognitive impairment and is the first to highlight the possible role of premorbid adjustment on the capacity to recover from cognitive deficits through a cognitive remediation therapy protocol. The data suggest that cognitive remediation may be particularly effective for people in the early course and that the assessment of premorbid adjustment could be of value to design individualised interventions.

Direct sampling for stand density index

Treesearch

Mark J. Ducey; Harry T. Valentine

2008-01-01

A direct method of estimating stand density index in the field, without complex calculations, would be useful in a variety of silvicultural situations. We present just such a method. The approach uses an ordinary prism or other angle gauge, but it involves deliberately "pushing the point" or, in some cases, "pulling the point." This adjusts the...

Mechanisms for Aiding Worker Adjustment to Technological Change: Volume 2: Concepts, Review of the Literature, Abstracts.

ERIC Educational Resources Information Center

Utah Univ., Salt Lake City. Human Resources Inst.

Volume 2, which accompanies "Mechanisms for Aiding Worker Adjustment to Technological Change, Volume 1," consists of a key word index for locating specific topics and the abstracts of literature reviewed in Volume 1. Key words, referring to aspects of worker adjustment to technological change appearing in the abstracted literature, are grouped…

[Adjustment processes of foreign exchange high school students in Japan].

PubMed

Nagai, S

1988-04-01

The main purpose of the present study was to excavate the adjustment problems of 93 high school exchange students in Japan. Questionnaires including Cornell Medical Index (CMI) were administered longitudinally. In addition, individual interviews were held with those who had failed to adjust to the Japanese society. As for the subjective psychosomatic symptoms manifested in CMI, there was no significant sex difference while Asians were successively found to be significantly more liable to diseases and less adjusted than non-Asians. The questionnaires other than CMI disclosed difficulties which exchange students found in adjusting at Japanese home, including delicate personal relationships with host siblings, apparent lack of affective gestures (hugs and kisses), and early curfew. In the meanwhile, language barrier and trifling rules constituted the primary difficulties they faced at host school. On account of prejudice against women, girls had more unpleasant experiences than boys. Through individual interviews, all of the early returners were found to have already had a basic problem in their home countries.

Antipsychotics and mortality: adjusting for mortality risk scores to address confounding by terminal illness.

PubMed

Park, Yoonyoung; Franklin, Jessica M; Schneeweiss, Sebastian; Levin, Raisa; Crystal, Stephen; Gerhard, Tobias; Huybrechts, Krista F

2015-03-01

To determine whether adjustment for prognostic indices specifically developed for nursing home (NH) populations affect the magnitude of previously observed associations between mortality and conventional and atypical antipsychotics. Cohort study. A merged data set of Medicaid, Medicare, Minimum Data Set (MDS), Online Survey Certification and Reporting system, and National Death Index for 2001 to 2005. Dual-eligible individuals aged 65 and older who initiated antipsychotic treatment in a NH (N=75,445). Three mortality risk scores (Mortality Risk Index Score, Revised MDS Mortality Risk Index, Advanced Dementia Prognostic Tool) were derived for each participant using baseline MDS data, and their performance was assessed using c-statistics and goodness-of-fit tests. The effect of adjusting for these indices in addition to propensity scores (PSs) on the association between antipsychotic medication and mortality was evaluated using Cox models with and without adjustment for risk scores. Each risk score showed moderate discrimination for 6-month mortality, with c-statistics ranging from 0.61 to 0.63. There was no evidence of lack of fit. Imbalances in risk scores between conventional and atypical antipsychotic users, suggesting potential confounding, were much lower within PS deciles than the imbalances in the full cohort. Accounting for each score in the Cox model did not change the relative risk estimates: 2.24 with PS-only adjustment versus 2.20, 2.20, and 2.22 after further adjustment for the three risk scores. Although causality cannot be proven based on nonrandomized studies, this study adds to the body of evidence rejecting explanations other than causality for the greater mortality risk associated with conventional antipsychotics than with atypical antipsychotics. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

NDVI saturation adjustment: a new approach for improving cropland performance estimates in the Greater Platte River Basin, USA

USGS Publications Warehouse

Gu, Yingxin; Wylie, Bruce K.; Howard, Daniel M.; Phuyal, Khem P.; Ji, Lei

2013-01-01

In this study, we developed a new approach that adjusted normalized difference vegetation index (NDVI) pixel values that were near saturation to better characterize the cropland performance (CP) in the Greater Platte River Basin (GPRB), USA. The relationship between NDVI and the ratio vegetation index (RVI) at high NDVI values was investigated, and an empirical equation for estimating saturation-adjusted NDVI (NDVIsat_adjust) based on RVI was developed. A 10-year (2000–2009) NDVIsat_adjust data set was developed using 250-m 7-day composite historical eMODIS (expedited Moderate Resolution Imaging Spectroradiometer) NDVI data. The growing season averaged NDVI (GSN), which is a proxy for ecosystem performance, was estimated and long-term NDVI non-saturation- and saturation-adjusted cropland performance (CPnon_sat_adjust, CPsat_adjust) maps were produced over the GPRB. The final CP maps were validated using National Agricultural Statistics Service (NASS) crop yield data. The relationship between CPsat_adjust and the NASS average corn yield data (r = 0.78, 113 samples) is stronger than the relationship between CPnon_sat_adjust and the NASS average corn yield data (r = 0.67, 113 samples), indicating that the new CPsat_adjust map reduces the NDVI saturation effects and is in good agreement with the corn yield ground observations. Results demonstrate that the NDVI saturation adjustment approach improves the quality of the original GSN map and better depicts the actual vegetation conditions of the GPRB cropland systems.

Current Risk Adjustment and Comorbidity Index Underperformance in Predicting Post-Acute Utilization and Hospital Readmissions After Joint Replacements: Implications for Comprehensive Care for Joint Replacement Model.

PubMed

Kumar, Amit; Karmarkar, Amol; Downer, Brian; Vashist, Amit; Adhikari, Deepak; Al Snih, Soham; Ottenbacher, Kenneth

2017-11-01

To compare the performances of 3 comorbidity indices, the Charlson Comorbidity Index, the Elixhauser Comorbidity Index, and the Centers for Medicare & Medicaid Services (CMS) risk adjustment model, Hierarchical Condition Category (HCC), in predicting post-acute discharge settings and hospital readmission for patients after joint replacement. A retrospective study of Medicare beneficiaries with total knee replacement (TKR) or total hip replacement (THR) discharged from hospitals in 2009-2011 (n = 607,349) was performed. Study outcomes were post-acute discharge setting and unplanned 30-, 60-, and 90-day hospital readmissions. Logistic regression models were built to compare the performance of the 3 comorbidity indices using C statistics. The base model included patient demographics and hospital use. Subsequent models included 1 of the 3 comorbidity indices. Additional multivariable logistic regression models were built to identify individual comorbid conditions associated with high risk of hospital readmissions. The 30-, 60-, and 90-day unplanned hospital readmission rates were 5.3%, 7.2%, and 8.5%, respectively. Patients were most frequently discharged to home health (46.3%), followed by skilled nursing facility (40.9%) and inpatient rehabilitation facility (12.7%). The C statistics for the base model in predicting post-acute discharge setting and 30-, 60-, and 90-day readmission in TKR and THR were between 0.63 and 0.67. Adding the Charlson Comorbidity Index, the Elixhauser Comorbidity Index, or HCC increased the C statistic minimally from the base model for predicting both discharge settings and hospital readmission. The health conditions most frequently associated with hospital readmission were diabetes mellitus, pulmonary disease, arrhythmias, and heart disease. The comorbidity indices and CMS-HCC demonstrated weak discriminatory ability to predict post-acute discharge settings and hospital readmission following joint replacement. © 2017, American College of

Is It Better to Enter a Volume CT Dose Index Value before or after Scan Range Adjustment for Radiation Dose Optimization of Pediatric Cardiothoracic CT with Tube Current Modulation?

PubMed Central

2018-01-01

Objective To determine whether the body size-adapted volume computed tomography (CT) dose index (CTDvol) in pediatric cardiothoracic CT with tube current modulation is better to be entered before or after scan range adjustment for radiation dose optimization. Materials and Methods In 83 patients, cardiothoracic CT with tube current modulation was performed with the body size-adapted CTDIvol entered after (group 1, n = 42) or before (group 2, n = 41) scan range adjustment. Patient-related, radiation dose, and image quality parameters were compared and correlated between the two groups. Results The CTDIvol after the CT scan in group 1 was significantly higher than that in group 2 (1.7 ± 0.1 mGy vs. 1.4 ± 0.3 mGy; p < 0.0001). Image noise (4.6 ± 0.5 Hounsfield units [HU] vs. 4.5 ± 0.7 HU) and image quality (1.5 ± 0.6 vs. 1.5 ± 0.6) showed no significant differences between the two (p > 0.05). In both groups, all patient-related parameters, except body density, showed positive correlations (r = 0.49–0.94; p < 0.01) with the CTDIvol before and after the CT scan. The CTDIvol after CT scan showed modest positive correlation (r = 0.49; p ≤ 0.001) with image noise in group 1 but no significant correlation (p > 0.05) in group 2. Conclusion In pediatric cardiothoracic CT with tube current modulation, the CTDIvol entered before scan range adjustment provides a significant dose reduction (18%) with comparable image quality compared with that entered after scan range adjustment.

Laparoscopic adjustable gastric bandings: a prospective randomized study of 400 operations performed with 2 different devices.

PubMed

Gravante, Gianpiero; Araco, Antonino; Araco, Francesco; Delogu, Daniela; De Lorenzo, Antonino; Cervelli, Valerio

2007-10-01

To evaluate potential differences between 2 devices used to perform laparoscopic adjustable gastric bandings (the Swedish adjustable gastric band and the Lap-Band). The following groups were considered eligible: (1) patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of greater than 40; (2) patients with a body mass index between 35 and 40, with associated comorbidities; and (3) patients with a body mass index of greater than 60 who could not undergo derivative procedures. We recruited 400 patients. The mean +/- SD body mass index decreased to 40.6 +/- 3.0 after the first year and to 35.2 +/- 7.0 after 2 years. The average excess weight loss reduction was 48.2% after 1 year and 56.0% after 2 years. The excess weight loss reduction was inversely related to the initial weight: patients with an estimated weight excess of 50 kg or less (108 patients [27.0%]) had an excess weight loss reduction of 55% after 2 years; those with a weight excess of greater than 50 kg (292 patients [73.0%]) had an excess weight loss reduction of 44% (P = .004). We recorded 1 death (0.2%). Transient gastric occlusions (24 patients [6.0%]) and slippages (12 patients [3.0%]) were the most common complications. The devices used (Swedish adjustable gastric band and Lap-Band) were similar in terms of correction of obesity and morbidity. Laparoscopic adjustable gastric banding is a safe and feasible technique with specific indications in moderately obese patients and, secondarily, in highly obese patients who are unfit for more invasive techniques. No differences were found among the devices examined. isrctn.org Identifier: ISRCTN22839090.

Developing a policy guidance for financing dental care in Iran using the RAND Appropriateness Method.

PubMed

Jadidfard, M P; Yazdani, S; Khoshnevisan, M H

2013-12-01

This study aimed to provide recommendations on health care financing with special emphasis on dental care. The RAND Appropriateness Method was employed to obtain the collective opinion of a multidisciplinary panel of experts on a set of recommendation statements regarding Iranian dental care financing. An initial set of recommendations were identified from a literature review. Panel members, selected purposively and by peer nomination, each rated the appropriateness and necessity of the recommendations in a structured process of two rounds. Each recommendation was classified as inappropriate, uncertain, appropriate but not necessary, or appropriate and necessary according to the median rating score and the level of disagreement among the panellists. Of 28 initial recommendations, 25 were agreed on as appropriate, of which 22 were considered as necessary. Altogether, these recommendations provide a holistic picture of an oral health system's financing in three domains: revenue collection, pooling of revenues and purchasing of dental services. The policy guidance recommendations are intended to provide the Iranian oral health authorities with an evidence-base for financing dental care. The recommendations may be transferrable, at least in part, particularly to developing countries with similar hybrid health system structures. Finally, the method used to develop the recommendations can serve as a model for use elsewhere.

Adjusting Quality index Log Values to Represent Local and Regional Commercial Sawlog Product Values

Treesearch

Orris D. McCauley; Joseph J. Mendel; Joseph J. Mendel

1969-01-01

The primary purpose of this paper is not only to report the results of a comparative analysis as to how well the Q.I. method predicts log product values when compared to commercial sawmill log output values, but also to develop a methodology which will facilitate the comparison and provide the adjustments needed by the sawmill operator.

Refractive index dependence of L3 photonic crystal nano-cavities.

PubMed

Adawi, A M; Chalcraft, A R; Whittaker, D M; Lidzey, D G

2007-10-29

We model the optical properties of L3 photonic crystal nano-cavities as a function of the photonic crystal membrane refractive index n using a guided mode expansion method. Band structure calculations revealed that a TE-like full band-gap exists for materials of refractive index as low as 1.6. The Q-factor of such cavities showed a super-linear increase with refractive index. By adjusting the relative position of the cavity side holes, the Q-factor was optimised as a function of the photonic crystal membrane refractive index n over the range 1.6 to 3.4. Q-factors in the range 3000-8000 were predicted from absorption free materials in the visible range with refractive index between 2.45 and 2.8.

Fat mass and obesity-associated gene rs11642015 polymorphism is significantly associated with prediabetes and type 2 diabetes subsequent to adjustment for body mass index.

PubMed

Han, Liyuan; Tang, Linlin; Wang, Changyi; Chen, Zhongwei; Zhang, Tao; Chen, Sihan; Liu, Shengyuan; Peng, Xiaolin; Mai, Yifeng; Duan, Shiwei

2014-09-01

The association of the fat mass and obesity-associated gene ( FTO ) rs11642015 polymorphism with prediabetes, type 2 diabetes and obesity in certain populations has not been previously reported. A population-based study was conducted that included 490 type 2 diabetic, 471 prediabetic and 575 normal subjects. The main outcomes of the study were prediabetes, type 2 diabetes and obesity. Binary logistic regression was performed to estimate the association of FTO rs11642015 with the risk of prediabetes, type 2 diabetes and obesity following adjustment for the corresponding confounders. A meta-analysis was also conducted to evaluate the association between FTO rs11642015 and obesity. FTO rs11642015 was significantly associated with prediabetes in the whole sample under the additive model [odds ratio (OR), 1.50; 95% confidence interval (CI), 1.17-1.93; P=0.002], particularly in females. The polymorphism remained consistently significant following adjustment for age and body mass index (BMI), showing an increased prediabetes risk with an additive effect (OR, 1.55; 95% CI, 1.19-2.01; P=0.001). In addition, a significant association was found for rs11642015 with prediabetes and type 2 diabetes under the dominant model. However, under the stringent Bonferroni's correction there was no evidence of positive associations for FTO rs11642015 with obesity in the whole sample, females or males. Findings of the meta-analysis showed that FTO rs11642015 was not predisposed to obesity. In conclusion, the T allele of FTO rs11642015 is positively associated with an increased risk of prediabetes, even after adjustment for age and BMI, particularly in females. Subjects carrying the CT + TT genotype are predisposed to prediabetes and type 2 diabetes. Therefore, results of the population-based study and follow-up meta-analysis suggested that FTO rs11642015 is not significantly associated with susceptibility to obesity.

Cost-of-living indexes and demographic change.

PubMed

Diamond, C A

1990-06-01

The Consumer Price Index (CPI), although not without problems, is the most often used mechanism for adjusting contracts for cost-of-living changes in the US. The US Bureau of Labor Statistics lists several problems associated with using the CPI as a cost-of-living index where the proportion of 2-worker families is increasing, population is shifting, and work week hours are changing. This study shows how to compute cost-of-living indexes which are inexpensive to update, use less restrictive assumptions about consumer preferences, do not require statistical estimation, and handle the problem of increasing numbers of families where both the husband and wife work. This study attempts to how widely in fact the CPI varies with alternative true cost-of-living varies with alternative true cost-of-living indexes although in the end this de facto cost-of-living measure holds up quite well. In times of severe price inflation people change their preferences by substitution, necessitating a flexible cost-of-living index that accounts for this fundamental economic behavior.

Stream-profile analysis and stream-gradient index

USGS Publications Warehouse

Hack, John T.

1973-01-01

The generally regular three-dimensional geometry of drainage networks is the basis for a simple method of terrain analysis providing clues to bedrock conditions and other factors that determine topographic forms. On a reach of any stream, a gradient-index value can be obtained which allows meaningful comparisons of channel slope on streams of different sizes. The index is believed to reflect stream power or competence and is simply the product of the channel slope at a point and channel length measured along the longest stream above the pointwhere the calculation is made. In an adjusted topography, changes in gradient-index values along a stream generally correspond to differences in bedrock or introduced load. In any landscape the gradient index of a stream is related to total relief and stream regimen. Thus, climate, tectonic events, and geomorphic history must be considered in using the gradient index. Gradient-index values can be obtained quickly by simple measurements on topographic maps, or they can be obtained by more sophisticated photogrammetric measurements that involve simple computer calculations from x, y, z coordinates.

Evaluating Hyperspectral Vegetation Indices for Leaf Area Index Estimation of Oryza sativa L. at Diverse Phenological Stages

PubMed Central

Din, Mairaj; Zheng, Wen; Rashid, Muhammad; Wang, Shanqin; Shi, Zhihua

2017-01-01

Hyperspectral reflectance derived vegetation indices (VIs) are used for non-destructive leaf area index (LAI) monitoring for precise and efficient N nutrition management. This study tested the hypothesis that there is potential for using various hyperspectral VIs for estimating LAI at different growth stages of rice under varying N rates. Hyperspectral reflectance and crop canopy LAI measurements were carried out over 2 years (2015 and 2016) in Meichuan, Hubei, China. Different N fertilization, 0, 45, 82, 127, 165, 210, 247, and 292 kg ha-1, were applied to generate various scales of VIs and LAI values. Regression models were used to perform quantitative analyses between spectral VIs and LAI measured under different phenological stages. In addition, the coefficient of determination and RMSE were employed to evaluate these models. Among the nine VIs, the ratio vegetation index, normalized difference vegetation index (NDVI), modified soil-adjusted vegetation index (MSAVI), modified triangular vegetation index (MTVI2) and exhibited strong and significant relationships with the LAI estimation at different phenological stages. The enhanced vegetation index performed moderately. However, the green normalized vegetation index and blue normalized vegetation index confirmed that there is potential for crop LAI estimation at early phenological stages; the soil-adjusted vegetation index and optimized soil-adjusted vegetation index were more related to the soil optical properties, which were predicted to be the least accurate for LAI estimation. The noise equivalent accounted for the sensitivity of the VIs and MSAVI, MTVI2, and NDVI for the LAI estimation at phenological stages. The results note that LAI at different crop phenological stages has a significant influence on the potential of hyperspectral derived VIs under different N management practices. PMID:28588596

The use of PROMIS and the RAND VSQ9 in chiropractic patients receiving care with the Webster Technique.

PubMed

Alcantara, Joel; Ohm, Jeanne; Alcantara, Junjoe

2016-05-01

Our ongoing efforts to demonstrate effectiveness of care examined the quality of life (QoL) and patient satisfaction of chiropractic patients presenting for care in a PBRN. In addition to socio-demographic and clinical care information, we examined visit-specific satisfaction and QoL using the RAND VSQ and PROMIS-29, respectively. Our study population was comprised of 126 subjects (average age = 39.68; 97 females). The majority of respondents presented with musculoskeletal complaints with an average mean duration of 7.188 years. The mean PROMIS-25 mean T Scores were: depression (47.80); pain interference (53.49); fatigue (51.02); physical function (49.02); satisfaction with social role (52.10); anxiety (50.14); and sleep disturbance (49.88). The VSQ9 mean score was 93.4% indicating high satisfaction. Adults attending care in a chiropractic PBRN were able to successfully complete the PROMIS29 and VSQ9 instruments. Future longitudinal studies should quantify the minimal clinically important difference in mean T score changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pharmacokinetic evaluation of doxorubicin plasma levels in normal and overweight patients with breast cancer and simulation of dose adjustment by different indexes of body mass.

PubMed

Barpe, Deise Raquel; Rosa, Daniela Dornelles; Froehlich, Pedro Eduardo

2010-11-20

Although being used for decades in the treatment of several types of cancer, either alone or in association, only a few data about the pharmacokinetics of doxorubicin (DOX) in humans are available. DOX is frequently used in association with other anticancer drugs in the management of breast cancer. Pharmacokinetic data available in the literature show that after i.v. administration DOX follows a two-compartment open model, with a fast distribution phase followed by a very slow elimination phase. The objective of this work is to perform a pilot study in order to verify if the usual dose adjustment based on body surface area (BSA) would be producing the same plasma concentration-time profiles in patients with normal (<25) and above normal (>25) body mass index (BMI). In order to assess the pharmacokinetics of DOX after a short-term i.v. infusion of 60mg/m(2) of BSA, an experimental design using only five plasma samples of each patient was applied. Samples were collected at 0.00, 0.66 (right after the end of infusion), 1.66, 8.66, and 24.66h. DOX pharmacokinetic profiles were evaluated after quantification of DOX using a new HPLC method developed and validated. Pharmacokinetic parameters (AUC(0-24.66) and C(max)) were analyzed by non-compartmental and compartmental approaches. Significant differences (α=0.05) between overweight and normal weight groups were found with respect to AUC and C(max). After adjustment of dose by weight and by BMI, the compartmental model was used to simulate plasma concentrations and new values for C(max) and AUC(0-24.66) were calculated. The new values obtained using both body weight (BW) and BMI were closer to the normal group than those obtained with BSA. According to the simulation, the differences of AUC and C(max) between the overweight group and the group of patients with normal weight were lower when the dose was adjusted by BW and BMI. These results suggest that more studies must be conducted, with more patients, in order to

Construction and Evolution of a Multidimensional Well-Being Index for the Spanish Regions

ERIC Educational Resources Information Center

Jurado, Antonio; Perez-Mayo, Jesus

2012-01-01

The study presented here is an attempt to calculate a comparative multidimensional index of economic well-being for the Spanish Autonomous Communities. Based on the dimensions of adjusted consumption, real wealth, equity and economic security per inhabitant, we obtain one relative index using a system of uniform weightings, a second resulting from…

A review on the relationship between marital adjustment and maternal attachment.

PubMed

Mutlu, Birsen; Erkut, Zeynep; Yıldırım, Zeynem; Gündoğdu, Nurgül

2018-03-01

To determine the relationship between marital adjustment of mothers who have babies between 1-4 months old and their maternal attachment; as well as the relationship of maternal attachment and marital adjustment with sociodemographic characteristics. The research is descriptive and correlational. Its sample consists of 113 mothers. Maternal Attachment Index (MAI) and Marital Adjustment Scale (MAS) are used as data collection tools. We found that, for mothers who participated in this research, the average level of maternal attachment is 92.17 ± 8.49, and the average level of marital adjustment is 43.06 ± 7.90. We discovered that the maternal attachment level is higher for mothers who have completed high school and university, those who breastfeed their babies exclusively and whose spouses help care for the baby. We also discovered that the Marital Adjustment Score is higher among mothers who are employed, get married by companionship (not arranged), continue attending pregnancy classes and whose duration of marriage is between 1-5 years and 10-15 years. There is weak positive relationship (r=0.38; p=0.00) between marital adjustment and maternal attachment; and the regression analysis that is run to explain this relationship is statistically significant (F=26.131; p<0.05). In our study, the level of maternal attachment was high, while the level of marital adjustment was liminal. There are many factors affecting sociodemographic characteristics, pregnancy and baby care. The level of marital adjustment for mothers increases the maternal attachment.

Parsimonious estimation of the Wechsler Memory Scale, Fourth Edition demographically adjusted index scores: immediate and delayed memory.

PubMed

Miller, Justin B; Axelrod, Bradley N; Schutte, Christian

2012-01-01

The recent release of the Wechsler Memory Scale Fourth Edition contains many improvements from a theoretical and administration perspective, including demographic corrections using the Advanced Clinical Solutions. Although the administration time has been reduced from previous versions, a shortened version may be desirable in certain situations given practical time limitations in clinical practice. The current study evaluated two- and three-subtest estimations of demographically corrected Immediate and Delayed Memory index scores using both simple arithmetic prorating and regression models. All estimated values were significantly associated with observed index scores. Use of Lin's Concordance Correlation Coefficient as a measure of agreement showed a high degree of precision and virtually zero bias in the models, although the regression models showed a stronger association than prorated models. Regression-based models proved to be more accurate than prorated estimates with less dispersion around observed values, particularly when using three subtest regression models. Overall, the present research shows strong support for estimating demographically corrected index scores on the WMS-IV in clinical practice with an adequate performance using arithmetically prorated models and a stronger performance using regression models to predict index scores.

Effect of Fixed Versus Adjusted Transcutaneous Electrical Nerve Stimulation Amplitude on Chronic Mechanical Low Back Pain.

PubMed

Elserty, Noha; Kattabei, Omaima; Elhafez, Hytham

2016-07-01

This study aimed to investigate the effect of adjusting pulse amplitude of transcutaneous electrical nerve stimulation versus fixed pulse amplitude in treatment of chronic mechanical low back pain. Randomized clinical trial. El-sahel Teaching Hospital, Egypt. Forty-five patients with chronic low back pain assigned to three equal groups. Their ages ranged from 20 to 50 years. The three groups received the same exercise program. Group A received transcutaneous electrical nerve stimulation with fixed pulse amplitude for 40 minutes. Group B received transcutaneous electrical nerve stimulation with adjusted pulse amplitude for 40 minutes, with the pulse amplitude adjusted every 5 minutes. Group C received exercises only. Treatment sessions were applied three times per week for 4 weeks for the three groups. A visual analogue scale was used to assess pain severity, the Oswestry Disability Index was used to assess functional level, and a dual inclinometer was used to measure lumbar range of motion. Evaluations were performed before and after treatment. Visual analogue scale, Oswestry Disability Index, and back range of motion significantly differed between the two groups that received transcutaneous electrical nerve stimulation and the control group and did not significantly differ between fixed and adjusted pulse amplitude of transcutaneous electrical nerve stimulation. Adjusting pulse amplitude of transcutaneous electrical nerve stimulation does not produce a difference in the effect of transcutaneous electrical nerve stimulation used to treat chronic low back pain.

Optimal level of continuous positive airway pressure: auto-adjusting titration versus titration with a predictive equation.

PubMed

Choi, Ji Ho; Jun, Young Joon; Oh, Jeong In; Jung, Jong Yoon; Hwang, Gyu Ho; Kwon, Soon Young; Lee, Heung Man; Kim, Tae Hoon; Lee, Sang Hag; Lee, Seung Hoon

2013-05-01

The aims of the present study were twofold. We sought to compare two methods of titrating the level of continuous positive airway pressure (CPAP) - auto-adjusting titration and titration using a predictive equation - with full-night manual titration used as the benchmark. We also investigated the reliability of the two methods in patients with obstructive sleep apnea syndrome (OSAS). Twenty consecutive adult patients with OSAS who had successful, full-night manual and auto-adjusting CPAP titration participated in this study. The titration pressure level was calculated with a previously developed predictive equation based on body mass index and apnea-hypopnea index. The mean titration pressure levels obtained with the manual, auto-adjusting, and predictive equation methods were 9.0 +/- 3.6, 9.4 +/- 3.0, and 8.1 +/- 1.6 cm H2O,respectively. There was a significant difference in the concordance within the range of +/- 2 cm H2O (p = 0.019) between both the auto-adjusting titration and the titration using the predictive equation compared to the full-night manual titration. However, there was no significant difference in the concordance within the range of +/- 1 cm H2O (p > 0.999). When compared to full-night manual titration as the standard method, auto-adjusting titration appears to be more reliable than using a predictive equation for determining the optimal CPAP level in patients with OSAS.

Adjusting Spectral Indices for Spectral Response Function Differences of Very High Spatial Resolution Sensors Simulated from Field Spectra

PubMed Central

Cundill, Sharon L.; van der Werff, Harald M. A.; van der Meijde, Mark

2015-01-01

The use of data from multiple sensors is often required to ensure data coverage and continuity, but differences in the spectral characteristics of sensors result in spectral index values being different. This study investigates spectral response function effects on 48 spectral indices for cultivated grasslands using simulated data of 10 very high spatial resolution sensors, convolved from field reflectance spectra of a grass covered dike (with varying vegetation condition). Index values for 48 indices were calculated for original narrow-band spectra and convolved data sets, and then compared. The indices Difference Vegetation Index (DVI), Global Environmental Monitoring Index (GEMI), Enhanced Vegetation Index (EVI), Modified Soil-Adjusted Vegetation Index (MSAVI2) and Soil-Adjusted Vegetation Index (SAVI), which include the difference between the near-infrared and red bands, have values most similar to those of the original spectra across all 10 sensors (1:1 line mean 1:1R2 > 0.960 and linear trend mean ccR2 > 0.997). Additionally, relationships between the indices’ values and two quality indicators for grass covered dikes were compared to those of the original spectra. For the soil moisture indicator, indices that ratio bands performed better across sensors than those that difference bands, while for the dike cover quality indicator, both the choice of bands and their formulation are important. PMID:25781511

Adjusting tidal volume to stress index in an open lung condition optimizes ventilation and prevents overdistension in an experimental model of lung injury and reduced chest wall compliance.

PubMed

Ferrando, Carlos; Suárez-Sipmann, Fernando; Gutierrez, Andrea; Tusman, Gerardo; Carbonell, Jose; García, Marisa; Piqueras, Laura; Compañ, Desamparados; Flores, Susanie; Soro, Marina; Llombart, Alicia; Belda, Francisco Javier

2015-01-13

The stress index (SI), a parameter derived from the shape of the pressure-time curve, can identify injurious mechanical ventilation. We tested the hypothesis that adjusting tidal volume (VT) to a non-injurious SI in an open lung condition avoids hypoventilation while preventing overdistension in an experimental model of combined lung injury and low chest-wall compliance (Ccw). Lung injury was induced by repeated lung lavages using warm saline solution, and Ccw was reduced by controlled intra-abdominal air-insufflation in 22 anesthetized, paralyzed and mechanically ventilated pigs. After injury animals were recruited and submitted to a positive end-expiratory pressure (PEEP) titration trial to find the PEEP level resulting in maximum compliance. During a subsequent four hours of mechanical ventilation, VT was adjusted to keep a plateau pressure (Pplat) of 30 cmH2O (Pplat-group, n = 11) or to a SI between 0.95 and 1.05 (SI-group, n = 11). Respiratory rate was adjusted to maintain a 'normal' PaCO2 (35 to 65 mmHg). SI, lung mechanics, arterial-blood gases haemodynamics pro-inflammatory cytokines and histopathology were analyzed. In addition Computed Tomography (CT) data were acquired at end expiration and end inspiration in six animals. PaCO2 was significantly higher in the Pplat-group (82 versus 53 mmHg, P = 0.01), with a resulting lower pH (7.19 versus 7.34, P = 0.01). We observed significant differences in VT (7.3 versus 5.4 mlKg(-1), P = 0.002) and Pplat values (30 versus 35 cmH2O, P = 0.001) between the Pplat-group and SI-group respectively. SI (1.03 versus 0.99, P = 0.42) and end-inspiratory transpulmonary pressure (PTP) (17 versus 18 cmH2O, P = 0.42) were similar in the Pplat- and SI-groups respectively, without differences in overinflated lung areas at end- inspiration in both groups. Cytokines and histopathology showed no differences. Setting tidal volume to a non-injurious stress index in an open lung condition improves

Gender Inequality Index Appropriateness for Measuring Inequality.

PubMed

Amin, Elham; Sabermahani, Asma

2017-01-01

Gender inequality means unequal distribution of wealth, power, and benefits among women and men. The gender inequality index (GII) measures the lost human development in three important dimensions: reproductive health, political empowerment, and economic status. The first purpose of this study was to calculate the index for provinces of Iran, and the second purpose was to survey the appropriateness of that, for comparing different regions, through regression estimations. In this study, GII has been calculated for Iran between the years 2006-2011 and provinces have been ranked based on it. Then, a panel composed of 30 sections was estimated for five years to determine the most important factor affecting level of index. Some changes have been made to analyze values of the index and the ranking of provinces. Based on panel model, share of parliamentary seats was the most effective factor for determination of the index. After applying adjustments, some differences were seen in the ranking of provinces and general level of index. Weighing of dimensions of the index and considering an overall variable, such as life expectancy in the field of health, will give a more accurate comparison of the GII among different regions though concurrent attention to non-discriminatory cultural dimensions of political participation of women; therefore, making more analyses possible for a more correct comparison of the extensive geographical regions, such as countries.

Long-term vocational adjustment of cancer patients diagnosed during adolescence.

PubMed

Tebbi, C K; Bromberg, C; Piedmonte, M

1989-01-01

Long-term vocational achievements of 40 survivors of cancer diagnosed during adolescence were examined and compared with 40 healthy sex-matched and age-matched controls. Patients' ages at diagnosis ranged from 13 to 19 years (mean, 16.15). Study subjects had survived cancer for over 5 years and were on no cancer therapy. Assessment measures included the Rand General Well-Being Scale, the Rand Functional Limitations and Physical Abilities Batteries, and a semistructured interview. The relation of physical disability and limitations caused by cancer to patients' achievements also was evaluated. Although cancer patients, on the average, were more concerned about their health and reported lower general spirits than controls, no differences were found between control and study groups with regard to overall general well-being. More cancer patients than controls reported that their health limited their ability to engage in vigorous activities. A greater functional deficit was found among unemployed than employed cancer patients. Employers and co-workers often were aware of the patient's diagnosis (85% and 67%, respectively). Cancer patients reported disease-related discrimination in hiring (7.4%), induction into the military (66.7%), and obtaining health, life, and disability insurance (31.5%). There was no significant relationship between health status and employment. Nevertheless, cancer patients had a higher average income than controls. Sixty-four percent of patients believed that changes in certain physical features of the workplace were necessary to facilitate readjustment to the job. Despite the disabilities experienced by cancer patients and generally negative public attitudes, long-term survivors have a good outlook on life and are competitive members of the workplace and society.

Food Composition of the Diet in Relation to Changes in Waist Circumference Adjusted for Body Mass Index

PubMed Central

Romaguera, Dora; Ängquist, Lars; Du, Huaidong; Jakobsen, Marianne Uhre; Forouhi, Nita G.; Halkjær, Jytte; Feskens, Edith J. M.; van der A, Daphne L.; Masala, Giovanna; Steffen, Annika; Palli, Domenico; Wareham, Nicholas J.; Overvad, Kim; Tjønneland, Anne; Boeing, Heiner; Riboli, Elio; Sørensen, Thorkild I.

2011-01-01

Background Dietary factors such as low energy density and low glycemic index were associated with a lower gain in abdominal adiposity. A better understanding of which food groups/items contribute to these associations is necessary. Objective To ascertain the association of food groups/items consumption on prospective annual changes in “waist circumference for a given BMI” (WCBMI), a proxy for abdominal adiposity. Design We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WCBMI was defined as the residuals of waist circumference regressed on BMI, and annual change in WCBMI (ΔWCBMI, cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between food groups/items and ΔWCBMI was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Results Higher fruit and dairy products consumption was associated with a lower gain in WCBMI whereas the consumption of white bread, processed meat, margarine, and soft drinks was positively associated with ΔWCBMI. When these six food groups/items were analyzed in combination using a summary score, those in the highest quartile of the score – indicating a more favourable dietary pattern –showed a ΔWCBMI of −0.11 (95% CI −0.09 to −0.14) cm/y compared to those in the lowest quartile. Conclusion A dietary pattern high in fruit and dairy and low in white bread, processed meat, margarine, and soft drinks may help to prevent abdominal fat accumulation. PMID:21858094

Bridging the divide: openness in adoption and postadoption psychosocial adjustment among birth and adoptive parents.

PubMed

Ge, Xiaojia; Natsuaki, Misaki N; Martin, David M; Leve, Leslie D; Neiderhiser, Jenae M; Shaw, Daniel S; Villareal, Georgette; Scaramella, Laura; Reid, John B; Reiss, David

2008-08-01

Using 323 matched parties of birth mothers and adoptive parents, this study examined the association between the degree of adoption openness (e.g., contact and knowledge between parties) and birth and adoptive parents' postadoption adjustment shortly after the adoption placement (6 to 9 months). Data from birth fathers (N = 112), an understudied sample, were also explored. Openness was assessed by multiple informants. Results indicated that openness was significantly related to satisfaction with adoption process among adoptive parents and birth mothers. Increased openness was positively associated with birth mothers' postplacement adjustment, as indexed by birth mothers' self-reports and the interviewers' impression of birth mothers' adjustment. Birth fathers' report of openness was associated with their greater satisfaction with the adoption process and better postadoption adjustment.

PEDIATRIC VISCERAL ADIPOSITY INDEX ADAPTATION CORRELATES WITH HOMA-IR, MATSUDA, AND TRANSAMINASES.

PubMed

Hernández, María José Garcés; Klünder, Miguel; Nieto, Nayely Garibay; Alvarenga, Juan Carlos López; Gil, Jenny Vilchis; Huerta, Samuel Flores; Siccha, Rosa Quispe; Hernandez, Joselin

2018-03-01

Visceral adiposity index (VAI) is a mathematical model associated with cardiometabolic risk in adults, but studies on children failed to support this association. Our group has proposed a pediatric VAI model using pediatric ranges, but it has not yet been evaluated and needs further adjustments. The objective of this study was to further adjust the proposed pediatric VAI by age, creating a new pediatric metabolic index (PMI), and assess the correlation of the PMI with insulin resistance indexes and hepatic enzymes. A cross-sectional design with data from 396 children (age 5 to 17 years) was analyzed with a generalized linear model to find the coefficients for triglycerides, high-density-lipoprotein cholesterol, and waist circumference-body mass index quotient. The model was constructed according to sex and age and designated PMI. A cross-validation analysis was performed and a receiver operating characteristic curve was used to determine cut-off points. Significant moderate correlation was found between PMI and homeostatic model assessment of insulin resistance (HOMA-IR) ( r = 0.452; P = .003), Matsuda ( r = -0.366; P = .019), alanine aminotransferase ( r = 0.315, P = .045), and γ-glutamyltransferase ( r = 0.397; P = .010). A PMI score >1.7 was considered as risk. PMI correlates with HOMA-IR, Matsuda, and hepatic enzymes. It could be helpful for identifying children at risk for cardiometabolic diseases. ALT = alanine transaminase BMI = body mass index GGT = γ-glutamyltransferase HDL-C = high-density-lipoprotein cholesterol HOMA-IR = homeostatic model assessment of insulin resistance hs-CRP = high sensitivity C-reactive protein ISI = insulin sensitivity index NAFLD = nonalcoholic fatty liver disease PMI = pediatric metabolic index QUICKI = quantitative insulin sensitivity check index ROC = receiver operating characteristic TG = triglyceride TNF-α = tumor necrosis factor-alpha VAI = visceral adiposity index VAT = visceral adipose tissue WC = waist circumference.

Stomatal conductance, canopy temperature, and leaf area index estimation using remote sensing and OBIA techniques

Treesearch

S. Panda; D.M. Amatya; G. Hoogenboom

2014-01-01

Remotely sensed images including LANDSAT, SPOT, NAIP orthoimagery, and LiDAR and relevant processing tools can be used to predict plant stomatal conductance (gs), leaf area index (LAI), and canopy temperature, vegetation density, albedo, and soil moisture using vegetation indices like normalized difference vegetation index (NDVI) or soil adjusted...

Light-adjustable lens.

PubMed Central

Schwartz, Daniel M

2003-01-01

PURPOSE: First, to determine whether a silicone light-adjustable intraocular lens (IOL) can be fabricated and adjusted precisely with a light delivery device (LDD). Second, to determine the biocompatibility of an adjustable IOL and whether the lens can be adjusted precisely in vivo. METHODS: After fabrication of a light-adjustable silicone formulation, IOLs were made and tested in vitro for cytotoxicity, leaching, precision of adjustment, optical quality after adjustment, and mechanical properties. Light-adjustable IOLs were then tested in vivo for biocompatibility and precision of adjustment in a rabbit model. In collaboration with Zeiss-Meditec, a digital LDD was developed and tested to correct for higher-order aberrations in light-adjustable IOLs. RESULTS: The results establish that a biocompatible silicone IOL can be fabricated and adjusted using safe levels of light. There was no evidence of cytotoxicity or leaching. Testing of mechanical properties revealed no significant differences from commercial controls. Implantation of light-adjustable lenses in rabbits demonstrated- excellent biocompatibility after 6 months, comparable to a commercially available IOL. In vivo spherical (hyperopic and myopic) adjustment in rabbits was achieved using an analog light delivery system. The digital light delivery system was tested and achieved correction of higher-order aberrations. CONCLUSION: A silicone light-adjustable IOL and LDD have been developed to enable postoperative, noninvasive adjustment of lens power. The ability to correct higher-order aberrations in these materials has broad potential applicability for optimization of vision in patients undergoing cataract and refractive surgery. PMID:14971588

Salivary Cortisol as a Predictor of Socioemotional Adjustment during Kindergarten: A Prospective Study.

ERIC Educational Resources Information Center

Smider, N. A.; Essex, M. J.; Kalin, N. H.; Buss, K. A.; Klein, M. H.; Davidson, R. J.; Goldsmith, H. H.

2002-01-01

Examined whether activation of the hypothalamic-pituitary-adrenocortical system, as indexed by average home afternoon levels of cortisol in children age 4.5 years, would predict socioemotional adjustment measured a year and a half later. Found that higher cortisol levels were associated with withdrawal-type behaviors of internalizing and social…

Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12).

PubMed

Selim, Alfredo J; Rogers, William; Fleishman, John A; Qian, Shirley X; Fincke, Benjamin G; Rothendler, James A; Kazis, Lewis E

2009-02-01

The purpose of this project was to develop an updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). We used a well-defined and nationally representative sample of the U.S. population from 52,425 responses to the Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002. We applied modified regression estimates to update the non-proprietary 1990 scoring algorithms. We applied the updated standard to the Medicare Health Outcomes Survey (HOS) to compute the VR-12 physical (PCS((MEPS standard))) and mental (MCS((MEPS standard))) component summaries based on the MEPS. We compared these scores to PCS and MCS based on the 1990 U.S. population standard. Using the updated U.S. population standard, the average VR-12 PCS((MEPS standard)) and MCS((MEPS standard)) scores in the Medicare HOS were 39.82 (standard deviation [SD] = 12.2) and 50.08 (SD = 11.4), respectively. For the same Medicare HOS, the average PCS and MCS scores based on the 1990 standard were 1.40 points higher and 0.99 points lower in comparison to VR-12 PCS and MCS, respectively. Changes in the U.S. population between 1990 and today make the old standard obsolete for the VR-12, so the updated standard developed here is widely available to serve as such a contemporary standard for future applications for health-related quality of life (HRQoL) assessments.

Relationship Between Resilience, Adjustment, and Psychological Functioning After Traumatic Brain Injury: A Preliminary Report.

PubMed

Lukow, Herman R; Godwin, Emilie E; Marwitz, Jennifer H; Mills, Ana; Hsu, Nancy H; Kreutzer, Jeffrey S

2015-01-01

To examine the relationship between resilience, psychological distress, adjustment, and community participation after traumatic brain injury (TBI). Large university health system. Adult survivors of mild to severe TBI (N = 96). Descriptive, preliminary. The Connor-Davidson Resilience Scale (10-item version) was used to assess resilience, the Brief Symptom Inventory (BSI-18) was used to characterize psychological distress, and the Mayo-Portland Adaptability Index (MPAI-4) was used to measure ability, adjustment, and participation. Resilience scores were substantially lower than those of the general population. Significant relationships were found between resilience, psychological distress, and adjustment. Partial correlations (adjusting for the other MPAI-4 indices) showed significant correlation (P < .05) between MPAI-4 Adjustment and resilience. Partial correlations (adjusting for the other BSI-18 scales) also showed significance for Depression (P < .01) and resilience. Resilience scores differed significantly (P < .001) between individuals meeting BSI-18 caseness criteria for psychological distress (n = 55) and those not meeting criteria (n = 41). Individuals with TBI are at risk for low resilience, which was found to correlate with psychological distress and psychosocial maladjustment. Developing interventions to strengthen resilience skills has the potential to improve postinjury psychosocial adjustment, an important area for future research.

On the Importance of Age-Adjustment Methods in Ecological Studies of Social Determinants of Mortality

PubMed Central

Milyo, Jeffrey; Mellor, Jennifer M

2003-01-01

Objective To illustrate the potential sensitivity of ecological associations between mortality and certain socioeconomic factors to different methods of age-adjustment. Data Sources Secondary analysis employing state-level data from several publicly available sources. Crude and age-adjusted mortality rates for 1990 are obtained from the U.S. Centers for Disease Control. The Gini coefficient for family income and percent of persons below the federal poverty line are from the U.S. Bureau of Labor Statistics. Putnam's (2000) Social Capital Index was downloaded from ; the Social Mistrust Index was calculated from responses to the General Social Survey, following the method described in Kawachi et al. (1997). All other covariates are obtained from the U.S. Census Bureau. Study Design We use least squares regression to estimate the effect of several state-level socioeconomic factors on mortality rates. We examine whether these statistical associations are sensitive to the use of alternative methods of accounting for the different age composition of state populations. Following several previous studies, we present results for the case when only mortality rates are age-adjusted. We contrast these results with those obtained from regressions of crude mortality on age variables. Principal Findings Different age-adjustment methods can cause a change in the sign or statistical significance of the association between mortality and various socioeconomic factors. When age variables are included as regressors, we find no significant association between mortality and either income inequality, minority racial concentration, or social capital. Conclusions Ecological associations between certain socioeconomic factors and mortality may be extremely sensitive to different age-adjustment methods. PMID:14727797

77 FR 34050 - Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel-June 25, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... productivity adjustment. This meeting is open to the public in accordance with the Federal Advisory Committee...). The review will include the inputs, input weights, price-measurement proxies, and productivity... the index's productivity adjustment. II. Meeting Format This meeting is open to the public. There will...

Developing an operational rangeland water requirement satisfaction index

USGS Publications Warehouse

Senay, Gabriel B.; Verdin, James P.; Rowland, James

2011-01-01

Developing an operational water requirement satisfaction index (WRSI) for rangeland monitoring is an important goal of the famine early warning systems network. An operational WRSI has been developed for crop monitoring, but until recently a comparable WRSI for rangeland was not successful because of the extremely poor performance of the index when based on published crop coefficients (K c) for rangelands. To improve the rangeland WRSI, we developed a simple calibration technique that adjusts the K c values for rangeland monitoring using long-term rainfall distribution and reference evapotranspiration data. The premise for adjusting the K c values is based on the assumption that a viable rangeland should exhibit above-average WRSI (values >80%) during a normal year. The normal year was represented by a median dekadal rainfall distribution (satellite rainfall estimate from 1996 to 2006). Similarly, a long-term average for potential evapotranspiration was used as input to the famine early warning systems network WRSI model in combination with soil-water-holding capacity data. A dekadal rangeland WRSI has been operational for east and west Africa since 2005. User feedback has been encouraging, especially with regard to the end-of-season WRSI anomaly products that compare the index's performance to ‘normal’ years. Currently, rangeland WRSI products are generated on a dekadal basis and posted for free distribution on the US Geological Survey early warning website at http://earlywarning.usgs.gov/adds/

Influencing agent group behavior by adjusting cultural trait values.

PubMed

Tuli, Gaurav; Hexmoor, Henry

2010-10-01

Social reasoning and norms among individuals that share cultural traits are largely fashioned by those traits. We have explored predominant sociological and cultural traits. We offer a methodology for parametrically adjusting relevant traits. This exploratory study heralds a capability to deliberately tune cultural group traits in order to produce a desired group behavior. To validate our methodology, we implemented a prototypical-agent-based simulated test bed for demonstrating an exemplar from intelligence, surveillance, and reconnaissance scenario. A group of simulated agents traverses a hostile territory while a user adjusts their cultural group trait settings. Group and individual utilities are dynamically observed against parametric values for the selected traits. Uncertainty avoidance index and individualism are the cultural traits we examined in depth. Upon the user's training of the correspondence between cultural values and system utilities, users deliberately produce the desired system utilities by issuing changes to trait. Specific cultural traits are without meaning outside of their context. Efficacy and timely application of traits in a given context do yield desirable results. This paper heralds a path for the control of large systems via parametric cultural adjustments.

The impact of body mass index on the prevalence of low back pain: the HUNT study.

PubMed

Heuch, Ingrid; Hagen, Knut; Heuch, Ivar; Nygaard, Øystein; Zwart, John-Anker

2010-04-01

A cross-sectional population-based study. To examine the association between body mass index and chronic low back pain, with adjustment for potential confounders. Although many studies have investigated this association, it is still unclear whether there is a general relationship between body mass index and low back pain which applies to all populations. This study is based on data collected in the HUNT 2 study in the county of Nord-Trøndelag in Norway between 1995 and 1997. Among a total of 92,936 persons eligible for participation, 30,102 men and 33,866 women gave information on body mass index and indicated whether they suffered from chronic low back pain (69% participation rate). A total of 6293 men (20.9%) and 8923 women (26.3%) experienced chronic low back pain. Relations were assessed by logistic regression of low back pain with respect to body mass index and other variables. In both sexes, a high body mass index was significantly associated with an increased prevalence of low back pain. In men the estimated OR per 5 kg/m increase in body mass index was 1.07 (95% CI: 1.03-1.12) and in women 1.17 (95% CI: 1.14-1.21), after adjustment for age, with a significantly stronger association in women. Additional adjustment for education, smoking status, leisure time physical activity, employment status, and activity at work hardly affected these associations. No interactions were found with most other factors. This large population-based study indicates that obesity is associated with a high prevalence of low back pain. Further studies are needed to determine if the association is causal.

Balancing Demand and Supply for Veterans' Health Care: A Summary of Three RAND Assessments Conducted Under the Veterans Choice Act.

PubMed

Farmer, Carrie M; Hosek, Susan D; Adamson, David M

2016-06-20

In response to concerns that the Department of Veterans Affairs (VA) has faced about veterans' access to care and the quality of care delivered, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 ("Veterans Choice Act") in August 2014. The law was passed to help address access issues by expanding the criteria through which veterans can seek care from civilian providers. In addition, the law called for a series of independent assessments of the VA health care system across a broad array of topics related to the delivery of health care services to veterans in VA-owned and -operated facilities, as well as those under contract to VA. RAND conducted three of these assessments: Veteran demographics and health care needs (A), VA health care capabilities (B), and VA authorities and mechanisms for purchasing care (C). This article summarizes the findings of our assessments and includes recommendations from the reports for improving the match between veterans' needs and VA's capabilities, including VA's ability to purchase necessary care from the private sector.

Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups

PubMed Central

Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

2009-01-01

Background The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Methods Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Results Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. Conclusion It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running

Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups.

PubMed

Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

2009-04-30

The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to

Socioeconomic and behavioral correlates of body mass index in black adults: the Pitt County Study.

PubMed Central

Croft, J B; Strogatz, D S; James, S A; Keenan, N L; Ammerman, A S; Malarcher, A M; Haines, P S

1992-01-01

BACKGROUND. Obesity is more prevalent among Black women than Black men, but there is little information on the correlates of obesity in Blacks. This study describes the relations of sociodemographic factors and health behaviors to body mass index in a southern, Black population. METHODS. In 1988, a community probability sample of 1784 Black adults, aged 25 to 50, was examined in Pitt County, NC. RESULTS. More women than men were at least 20% overweight (57% vs 36%). The relation of socioeconomic status (a composite of education and occupation) to age-adjusted body mass index level was inverse in women but not in men. Body mass index did not differ with either current energy intake or energy expenditure. Smokers and drinkers had lower age-adjusted levels than non-smokers and abstainers. CONCLUSIONS. Since the excess body mass index levels associated with low socioeconomic status in women could not be explained after controlling for adverse health behaviors, further epidemiologic study of risk factors for obesity in Black women is recommended. PMID:1585962

The impact of age and sex adjusted body mass index (ISO-BMI) in obese versus non-obese children and adolescents with cholecystectomy.

PubMed

Kiuru, Eveliina; Kokki, Hannu; Juvonen, Petri; Lintula, Hannu; Paajanen, Hannu; Gissler, Mika; Eskelinen, Matti

2014-01-01

The impact of the age and sex adjusted body mass index (ISO-BMI) in the obese vs. non-obese children and adolescents with cholecystectomy for cholelithias is rarely reported. The national database was searched for cholecystectomies performed in paediatric patients between 1997 and 2011, and the 59 paediatric and adolescent patients having cholecystectomy in the Kuopio University Hospital district were divided in two groups by age and sex adjusted BMI (ISO-BMI) using the cut-off point of overweight (ISO-BMI 25 kg/m(2)) based on the Finnish growth standards. Nationwide a total of 840 cholecystectomies were performed during the 15 years study period in Finland, most of which included females (77%), resulting in a mean of annual frequency of 4.8 (range: 3.9-6.1) procedures/100,000 population. In the study sample, most of the patients with the cholelithiasis were female (50/59, 85%). The gender distribution was equal among the younger patients, but among adolescents 6/52 (12%) of the patients with cholelithiasis were boys and 46/52 (88%) of the patients with cholelithiasis were girls. Obesity did not affect on operative parameters. The median operative time was 70 min (range, 30-155) and 66 min (44-130) in the high ISO-BMI-group. The recovery was similar in the two groups: the median length of hospital stay was 4 days in both groups. The patients in the low ISO-BMI-group vs. high ISO-BMI-group had a trend of higher serum bilirubin (p=0.16) and serum AFOS values (p=0.19). In the histological examination of the gallbladders 19/28 (68%) patients in the low ISO-BMI-group had inflammation vs. 26/31 (84%) patients in the high ISO-BMI-group (p=0.15). Our results between obese and non-obese children and adolescents with cholelithiasis are not statistically significant. The obese adolescents with female gender are in greater risk for cholelithiasis. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Case-mix adjustment for diabetes indicators: a systematic review.

PubMed

Calsbeek, Hiske; Markhorst, Joekle G M; Voerman, Gerlienke E; Braspenning, Jozé C C

2016-02-01

Case-mix adjustment is generally considered indispensable for fair comparison of healthcare performance. Inaccurate results are also unfair to patients as they are ineffective for improving quality. However, little is known about what factors should be adjusted for. We reviewed case-mix factors included in adjustment models for key diabetes indicators, the rationale for their inclusion, and their impact on performance. Systematic review. This systematic review included studies published up to June 2013 addressing case-mix factors for 6 key diabetes indicators: 2 outcomes and 2 process indicators for glycated hemoglobin (A1C), low-density lipoprotein cholesterol, and blood pressure. Factors were categorized as demographic, diabetes-related, comorbidity, generic health, geographic, or care-seeking, and were evaluated on the rationale for inclusion in the adjustment models, as well as their impact on indicator scores and ranking. Thirteen studies were included, mainly addressing A1C value and measurement. Twenty-three different case-mix factors, mostly demographic and diabetes-related, were identified, and varied from 1 to 14 per adjustment model. Six studies provided selection motives for the inclusion of case-mix factors. Marital status and body mass index showed a significant impact on A1C value. For the other factors, either no or conflicting associations were reported, or too few studies (n ≤ 2) investigated this association. Scientific knowledge about the relative importance of case-mix factors for diabetes indicators is emerging, especially for demographic and diabetes-related factors and indicators on A1C, but is still limited. Because arbitrary adjustment potentially results in inaccurate quality information, meaningful stratification that demonstrates inequity in care might be a better guide, as it can be a driver for quality improvement.

Indexing Mount For Rotation Of Optical Component

NASA Technical Reports Server (NTRS)

Reichle, Donald J., Jr.; Barnes, Norman P.

1993-01-01

Indexing mount for polarizer, wave plate, birefringent plate, or other optical component facilitates rotation of component to one or more preset angles. Includes hexagonal nut holding polarizer or other optical component. Ball bearing loaded by screw engages notch on cylindrical extension of nut engaging bracket. Time-consuming and tedious angular adjustment unnecessary: component turned quickly and easily, by hand or by use of wrench, to preset angular positions maintained by simple ball-detent mechanism.

Impact of socioeconomic adjustment on physicians' relative cost of care.

PubMed

Timbie, Justin W; Hussey, Peter S; Adams, John L; Ruder, Teague W; Mehrotra, Ateev

2013-05-01

Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES). The importance of SES adjustment has not been explored in cost-profiling applications that measure costs using an episode of care framework. We assessed the relationship between SES and episode costs and the impact of adjusting for SES on physicians' relative cost rankings. We analyzed claims submitted to 3 Massachusetts commercial health plans during calendar years 2004 and 2005. We grouped patients' care into episodes, attributed episodes to individual physicians, and standardized costs for price differences across plans. We accounted for differences in physicians' case mix using indicators for episode type and a patient's severity of illness. A patient's SES was measured using an index of 6 indicators based on the zip code in which the patient lived. We estimated each physician's case mix-adjusted average episode cost and percentile rankings with and without adjustment for SES. Patients in the lowest SES quintile had $80 higher unadjusted episode costs, on average, than patients in the highest quintile. Nearly 70% of the variation in a physician's average episode cost was explained by case mix of their patients, whereas the contribution of SES was negligible. After adjustment for SES, only 1.1% of physicians changed relative cost rankings >2 percentiles. Accounting for patients' SES has little impact on physicians' relative cost rankings within an episode cost framework.

Validation of prescribing appropriateness criteria for older Australians using the RAND/UCLA appropriateness method

PubMed Central

Basger, Benjamin Joseph; Chen, Timothy Frank; Moles, Rebekah Jane

2012-01-01

Objective To further develop and validate previously published national prescribing appropriateness criteria to assist in identifying drug-related problems (DRPs) for commonly occurring medications and medical conditions in older (≥65 years old) Australians. Design RAND/UCLA appropriateness method. Participants A panel of medication management experts were identified consisting of geriatricians/pharmacologists, clinical pharmacists and disease management advisors to organisations that produce Australian evidence-based therapeutic publications. This resulted in a round-one panel of 15 members, and a round-two panel of 12 members. Main outcome measure Agreement on all criteria. Results Forty-eight prescribing criteria were rated. In the first rating round via email, there was disagreement regarding 17 of the criteria according to median panel ratings. During a face-to-face second round meeting, discussion resulted in retention of 25 criteria after amendments, agreement for 14 criteria with no changes required and deletion of 9 criteria. Two new criteria were added, resulting in a final validated list of 41 prescribing appropriateness criteria. Agreement after round two was reached for all 41 criteria, measured by median panel ratings and the amount of dispersion of panel ratings, based on the interpercentile range. Conclusions A set of 41 Australian prescribing appropriateness criteria were validated by an expert panel. Use of these criteria, together with clinical judgement and other medication review processes such as patient interview, is intended to assist in improving patient care by efficiently detecting potential DRPs related to commonly occurring medicines and medical conditions in older Australians. These criteria may also contribute to the medication management education of healthcare professionals. PMID:22983875

LACE+ index: extension of a validated index to predict early death or urgent readmission after hospital discharge using administrative data

PubMed Central

van Walraven, Carl; Wong, Jenna; Forster, Alan J

2012-01-01

Background Death or urgent readmission after hospital discharge is a common adverse event that can be used to compare outcomes of care between institutions. To accurately adjust for risk and to allow for interhospital comparisons of readmission rates, we used administrative data to derive and internally validate an extension of the LACE index, a previously validated index for 30-day death or urgent readmission. Methods We randomly selected 500 000 medical and surgical patients discharged to the community from any Ontario hospital between 1 April 2003 and 31 March 2009. We derived a logistic regression model on 250 000 randomly selected patients from this group and modified the final model into an index scoring system, the LACE+ index. We internally validated the LACE+ index using data from the remaining 250 000 patients and compared its performance with that of the original LACE index. Results Within 30 days of discharge to the community, 33 825 (6.8%) of the patients had died or had been urgently readmitted. In addition to the variables included in the LACE index (length of stay in hospital [L], acuity of admission [A], comorbidity [C] and emergency department utilization in the 6 months before admission [E]), the LACE+ index incorporated patient age and sex, teaching status of the discharge hospital, acute diagnoses and procedures performed during the index admission, number of days on alternative level of care during the index admission, and number of elective and urgent admissions to hospital in the year before the index admission. The LACE+ index was highly discriminative (C statistic 0.771, 95% confidence interval 0.767–0.775), was well calibrated across most of its range of scores and had a model performance that exceeded that of the LACE index. Interpretation The LACE+ index can be used to predict the risk of postdischarge death or urgent readmission on the basis of administrative data for the Ontario population. Its performance exceeds that of the LACE

The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma.

PubMed

Naraghi, Reza; Bremner, Alexandra; Slack-Smith, Linda; Bryant, Alan

2016-01-01

groups ( p  < 0.001 for both feet). Logistic regression models, adjusted for age, sex, foot posture index and body mass index estimated that the odds of having an intermetatarsal neuroma in the right foot increased by 61% (OR 1.61; 95% CI 1.32-1.96) with each one degree reduction of ankle dorsiflexion, and in the left foot by 43% (OR 1.43; 95% CI 1.22-1.69). No relationships were found between foot posture index and body mass index with intermetatarsal neuroma, or between foot posture index and the interspaces affected. However, a strong association was demonstrated between the presence of intermetatarsal neuroma and a restriction of ankle dorsiflexion.

Bridging the Divide: Openness in Adoption and Post-adoption Psychosocial Adjustment among Birth and Adoptive Parents

PubMed Central

Ge, Xiaojia; Natsuaki, Misaki N.; Martin, David; Leve, Leslie; Neiderhiser, Jenae; Shaw, Daniel S.; Villareal, Georgette; Scaramella, Laura; Reid, John; Reiss, David

2008-01-01

Using 323 matched parties of birth mothers and adoptive parents, this study examined the association between the degree of adoption openness (e.g., contact and knowledge between parties) and birth and adoptive parents’ post-adoption adjustment shortly after the adoption placement (6 to 9 months). Data from birth fathers (N=112), an understudied sample, also were explored. Openness was assessed by multiple informants. Results indicated that openness was significantly related to satisfaction with adoption process among adoptive parents and birth mothers. Increased openness was positively associated with birth mothers’ post-placement adjustment as indexed by birth mothers’ self reports and the interviewers’ impression of birth mothers’ adjustment. Birth fathers’ report of openness was associated with their greater satisfaction with the adoption process and better post-adoption adjustment. PMID:18729667

Prevalence of depression, anxiety, and adjustment disorders in women with spontaneous abortion in Germany - A retrospective cohort study.

PubMed

Jacob, Louis; Polly, Ines; Kalder, Matthias; Kostev, Karel

2017-12-01

The aim of this study was to analyze the prevalence of depression, anxiety, and adjustment disorders in women within the year following miscarriage in Germany. This study included women between the ages of 16 and 45 with a first pregnancy terminated by spontaneous abortion between January 2007 and December 2015 (index date). These women were followed in 262 gynecological practices. Women with a spontaneous abortion were matched (1:1) with pregnant women without spontaneous abortion by age, index year, diagnosis of female infertility prior to the index date, procreative management prior to the index date, and physician. This retrospective cohort study included 12,158 women with a spontaneous abortion and 12,158 pregnant women without a spontaneous abortion. The mean age was 31.6 (SD: 5.5).years. One year after the index date, 8.9% of women with spontaneous abortion and 5.7% of controls were diagnosed with depression, anxiety, or adjustment disorder. Individuals who had previously undergone a spontaneous abortion were more likely to have one of these three psychiatric disorders compared to controls (OR = 1.53). Similar results were found in the age groups 21-30 and 31-40. Spontaneous abortion is associated with an increased prevalence of developing psychiatric diseases within the first year. Copyright © 2017 Elsevier B.V. All rights reserved.

High-refractive index of acrylate embedding resin clarifies mouse brain tissue

NASA Astrophysics Data System (ADS)

Zhou, Hongfu; Xiong, Yumiao; Wang, Yu; Wang, Xiaojun; Li, Pei; Gang, Yadong; Liu, Xiuli; Zeng, Shaoqun

2017-11-01

Biological tissue transparency combined with light-sheet fluorescence microscopy is a useful method for studying the neural structure of biological tissues. The development of light-sheet fluorescence microscopy also promotes progress in biological tissue clearing methods. The current clarifying methods mostly use liquid reagent to denature protein or remove lipids first, to eliminate or reduce the scattering index or refractive index of the biological tissue. However, denaturing protein and removing lipids require complex procedures or an extended time period. Therefore, here we have developed acrylate resin with a high refractive index, which causes clearing of biological tissue directly after polymerization. This method can improve endogenous fluorescence retention by adjusting the pH value of the resin monomer.

New social adaptability index predicts overall mortality.

PubMed

Goldfarb-Rumyantzev, Alexander; Barenbaum, Anna; Rodrigue, James; Rout, Preeti; Isaacs, Ross; Mukamal, Kenneth

2011-08-01

Definitions of underprivileged status based on race, gender and geographic location are neither sensitive nor specific; instead we proposed and validated a composite index of social adaptability (SAI). Index of social adaptability was calculated based on employment, education, income, marital status, and substance abuse, each factor contributing from 0 to 3 points. Index of social adaptability was validated in NHANES-3 by association with all-cause and cause-specific mortality. Weighted analysis of 19,593 subjects demonstrated mean SAI of 8.29 (95% CI 8.17-8.40). Index of social adaptability was higher in Whites, followed by Mexican-Americans and then the African-American population (ANOVA, p < 0.001). The SAI was higher in subjects living in metropolitan compared to rural areas (T-test, p < 0.001), and was greater in men than in women (T-test, p < 0.001). In Cox models adjusted for age, comorbidity index, BMI, race, sex, geographic location, hemoglobin, serum creatinine, albumin, cholesterol, and glycated hemoglobin levels, SAI was inversely associated with mortality (HR 0.87 per point, 95% CI 0.84-0.90, p < 0.001). This association was confirmed in subgroups. We proposed and validated an indicator of social adaptability with a strong association with mortality, which can be used to identify underprivileged populations at risk of death.

The great contribution: Index Medicus, Index-Catalogue, and IndexCat

PubMed Central

Greenberg, Stephen J.; Gallagher, Patricia E.

2009-01-01

Objective: The systematic indexing of medical literature by the Library of the Surgeon-General's Office (now the National Library of Medicine) has been called “America's greatest contribution to medical knowledge.” In the 1870s, the library launched two indexes: the Index Medicus and the Index-Catalogue of the Library of the Surgeon-General's Office. Index Medicus is better remembered today as the forerunner of MEDLINE, but Index Medicus began as the junior partner of what the library saw as its major publication, the Index-Catalogue. However, the Index-Catalogue had been largely overlooked by many medical librarians until 2004, when the National Library of Medicine released IndexCat, the online version of Index-Catalogue. Access to this huge amount of material raised new questions: What was the coverage of the Index-Catalogue? How did it compare and overlap with the Index Medicus? Method: Over 1,000 randomly generated Index Medicus citations were cross-referenced in IndexCat. Results: Inclusion, form, content, authority control, and subject headings were evaluated, revealing that the relationship between the two publications was neither simple nor static through time. In addition, the authors found interesting anomalies that shed light on how medical literature was selected and indexed in “America's greatest contribution to medical knowledge.” PMID:19404501

Methods for semi-automated indexing for high precision information retrieval

NASA Technical Reports Server (NTRS)

Berrios, Daniel C.; Cucina, Russell J.; Fagan, Lawrence M.

2002-01-01

OBJECTIVE: To evaluate a new system, ISAID (Internet-based Semi-automated Indexing of Documents), and to generate textbook indexes that are more detailed and more useful to readers. DESIGN: Pilot evaluation: simple, nonrandomized trial comparing ISAID with manual indexing methods. Methods evaluation: randomized, cross-over trial comparing three versions of ISAID and usability survey. PARTICIPANTS: Pilot evaluation: two physicians. Methods evaluation: twelve physicians, each of whom used three different versions of the system for a total of 36 indexing sessions. MEASUREMENTS: Total index term tuples generated per document per minute (TPM), with and without adjustment for concordance with other subjects; inter-indexer consistency; ratings of the usability of the ISAID indexing system. RESULTS: Compared with manual methods, ISAID decreased indexing times greatly. Using three versions of ISAID, inter-indexer consistency ranged from 15% to 65% with a mean of 41%, 31%, and 40% for each of three documents. Subjects using the full version of ISAID were faster (average TPM: 5.6) and had higher rates of concordant index generation. There were substantial learning effects, despite our use of a training/run-in phase. Subjects using the full version of ISAID were much faster by the third indexing session (average TPM: 9.1). There was a statistically significant increase in three-subject concordant indexing rate using the full version of ISAID during the second indexing session (p < 0.05). SUMMARY: Users of the ISAID indexing system create complex, precise, and accurate indexing for full-text documents much faster than users of manual methods. Furthermore, the natural language processing methods that ISAID uses to suggest indexes contributes substantially to increased indexing speed and accuracy.

Methods for semi-automated indexing for high precision information retrieval.

PubMed

Berrios, Daniel C; Cucina, Russell J; Fagan, Lawrence M

2002-01-01

To evaluate a new system, ISAID (Internet-based Semi-automated Indexing of Documents), and to generate textbook indexes that are more detailed and more useful to readers. Pilot evaluation: simple, nonrandomized trial comparing ISAID with manual indexing methods. Methods evaluation: randomized, cross-over trial comparing three versions of ISAID and usability survey. Pilot evaluation: two physicians. Methods evaluation: twelve physicians, each of whom used three different versions of the system for a total of 36 indexing sessions. Total index term tuples generated per document per minute (TPM), with and without adjustment for concordance with other subjects; inter-indexer consistency; ratings of the usability of the ISAID indexing system. Compared with manual methods, ISAID decreased indexing times greatly. Using three versions of ISAID, inter-indexer consistency ranged from 15% to 65% with a mean of 41%, 31%, and 40% for each of three documents. Subjects using the full version of ISAID were faster (average TPM: 5.6) and had higher rates of concordant index generation. There were substantial learning effects, despite our use of a training/run-in phase. Subjects using the full version of ISAID were much faster by the third indexing session (average TPM: 9.1). There was a statistically significant increase in three-subject concordant indexing rate using the full version of ISAID during the second indexing session (p < 0.05). Users of the ISAID indexing system create complex, precise, and accurate indexing for full-text documents much faster than users of manual methods. Furthermore, the natural language processing methods that ISAID uses to suggest indexes contributes substantially to increased indexing speed and accuracy.

Methods for Semi-automated Indexing for High Precision Information Retrieval

PubMed Central

Berrios, Daniel C.; Cucina, Russell J.; Fagan, Lawrence M.

2002-01-01

Objective. To evaluate a new system, ISAID (Internet-based Semi-automated Indexing of Documents), and to generate textbook indexes that are more detailed and more useful to readers. Design. Pilot evaluation: simple, nonrandomized trial comparing ISAID with manual indexing methods. Methods evaluation: randomized, cross-over trial comparing three versions of ISAID and usability survey. Participants. Pilot evaluation: two physicians. Methods evaluation: twelve physicians, each of whom used three different versions of the system for a total of 36 indexing sessions. Measurements. Total index term tuples generated per document per minute (TPM), with and without adjustment for concordance with other subjects; inter-indexer consistency; ratings of the usability of the ISAID indexing system. Results. Compared with manual methods, ISAID decreased indexing times greatly. Using three versions of ISAID, inter-indexer consistency ranged from 15% to 65% with a mean of 41%, 31%, and 40% for each of three documents. Subjects using the full version of ISAID were faster (average TPM: 5.6) and had higher rates of concordant index generation. There were substantial learning effects, despite our use of a training/run-in phase. Subjects using the full version of ISAID were much faster by the third indexing session (average TPM: 9.1). There was a statistically significant increase in three-subject concordant indexing rate using the full version of ISAID during the second indexing session (p < 0.05). Summary. Users of the ISAID indexing system create complex, precise, and accurate indexing for full-text documents much faster than users of manual methods. Furthermore, the natural language processing methods that ISAID uses to suggest indexes contributes substantially to increased indexing speed and accuracy. PMID:12386114

Multimode interference tapered fiber refractive index sensors.

PubMed

Biazoli, Claudecir R; Silva, Susana; Franco, Marcos A R; Frazão, Orlando; Cordeiro, Cristiano M B

2012-08-20

Real-time monitoring of the fabrication process of tapering down a multimode-interference-based fiber structure is presented. The device is composed of a pure silica multimode fiber (MMF) with an initial 125 μm diameter spliced between two single-mode fibers. The process allows a thin MMF with adjustable parameters to obtain a high signal transmittance, arising from constructive interference among the guided modes at the output end of the MMF. Tapered structures with waist diameters as low as 55 μm were easily fabricated without the limitation of fragile splices or difficulty in controlling lateral fiber alignments. The sensing device is shown to be sensitive to the external environment, and a maximum sensitivity of 2946 nm/refractive index unit in the refractive index range of 1.42-1.43 was attained.

The Australian Natural Disaster Resilience Index

NASA Astrophysics Data System (ADS)

Thoms, Martin

2016-04-01

The Australian Natural Disaster Resilience Index Martin Thoms, Melissa Parsons, Phil Morley Bushfire and Natural Hazards Cooperative Research Centre, Geography and Planning, University of New England, Armidale NSW 2351, Australia. Natural hazard management policy directions in Australia - and indeed internationally - are increasingly being aligned to ideas of resilience. Resilience to natural hazards is the ability of individuals and communities to cope with disturbance and adversity and to maintain adaptive behaviour. Operationalizing the measurement and assessment of disaster resilience is often undertaken using a composite index, but this exercise is yet to be undertaken in Australia. The Australian Natural Disaster Resilience Index is a top-down, national scale assessment of the resilience of communities to natural hazards. Resilience is assessed based on two sets of capacities: coping and adaptive capacities. Coping capacity relates to the factors influencing the ability of a community to prepare for, absorb and recover from a natural hazard event. Adaptive capacity relates to the arrangements and processes that enable adjustment through learning, adaptation and transformation. Indicators are derived under themes of social character, economic capital, infrastructure and planning, emergency services, community capital, information and engagement and governance/leadership/policy, using existing data sets (e.g. census data) or evaluation of policy and procedure (e.g. disaster management planning). A composite index of disaster resilience is then computed for each spatial division, giving national scale coverage. The results of the Australian Natural Disaster Resilience Index will be reported in a State of Disaster Resilience report, due in 2018. The index is co-designed with emergency service agencies, and will support policy development, planning, community engagement and emergency management.

Theoretical study of polarization dependence of carrier-induced refractive index change of quantum dot.

PubMed

Miao, Qingyuan; Yang, Ziyi; Dong, Jianji; He, Ping-An; Huang, Dexiu

2018-02-05

The influences of dot material component, barrier material component, aspect ratio and carrier density on the refractive index changes of TE mode and TM mode of columnar quantum dot are analyzed, and a multiparameter adjustment method is proposed to realize low polarization dependence of refractive index change. Then the quantum dots with low polarization dependence of refractive index change (<1.5%) within C-band (1530 nm - 1565 nm) are designed, and it shows that quantum dots with different material parameters are anticipated to have similar characteristics of low polarization dependence.

Measuring input prices for physicians: The revised Medicare Economic Index

PubMed Central

Freeland, Mark S.; Chulis, George S.; Arnett, Ross H.; Brown, Aaron P.

1991-01-01

Medicare payments for physician services under Part B were historically restrained by capping prevailing charges using the Medicare Economic Index (MEI). The MEI, an input price index for physician services that incorporates an adjustment for economywide labor productivity, has not undergone a major revision since 1975. The MEI is an important determinant of the annual volume performance standard that will be used to set aggregate increases in the revised system for paying physicians under Medicare beginning in 1992. The MEI will also be used in establishing the annual changes to the payment conversion factors under the new payment system. PMID:10170807

Influence of marital and educational status on clients' psychosocial adjustment to HIV/AIDS in Calabar, Nigeria.

PubMed

Akpabio, Idongesit I; Uyanah, David A; Osuchukwu, Nelson C; Samson-Akpan, Patience E

2010-06-01

A comparative descriptive design and a stratified random sampling technique were adopted to study the influence of marital and educational status on the psychological, social, and spiritual adjustment of 280 respondents living with HIV/AIDS in two randomly selected clinics within Calabar, Nigeria. A 30 item questionnaire, with a content validity index of 0.92 and a Cronbach's alpha reliability coefficient of 0.94, was used for data collection, with due attention to ethical considerations. The findings showed that marital status had a significant influence on the respondents' psychological and social adjustment but not on their spiritual adjustment. Those that were married and those with higher educational qualifications had better psychological adjustment than those who had never married. The marital and educational status of clients should be considered when conducting education or counseling, making recommendations, or organizing support groups for living with HIV/AIDS. Furthermore, advocacy aimed at meeting the psychosocial needs of single and less-educated clients could enhance their psychosocial adjustment.

Neurocognitive functioning predicts frailty index in HIV.

PubMed

Oppenheim, Hannah; Paolillo, Emily W; Moore, Raeanne C; Ellis, Ronald J; Letendre, Scott L; Jeste, Dilip V; Grant, Igor; Moore, David J

2018-06-06

To evaluate the association between a frailty index (i.e., scale of accumulated deficits) and neurocognitive functioning among persons living with HIV/AIDS (PLWHA). Observational, cross-sectional data were gathered from the University of California, San Diego, HIV Neurobehavioral Research Program from 2002 to 2016. Eight hundred eleven PLWHA aged 18 to 79 years completed comprehensive physical, neuropsychological, and neuromedical evaluations. The frailty index was composed of 26 general and HIV-specific health maintenance measures, and reflects the proportion of accumulated deficits from 0 (no deficits) to 1 (all 26 deficits). Multiple linear regression was used to examine the association between continuous frailty index scores and neurocognitive functioning. Participants had a mean age of 44.6 years (11.2), and were mostly male (86.9%) and white (60.2%) with a mean frailty index of 0.26 (0.11). Over the study period, prevalence of HIV-related components (e.g., low CD4) decreased, while non-HIV comorbidities (e.g., diabetes) increased. There were no changes in the frailty index by study year. Higher frailty index was associated with worse global neurocognitive functioning, even after adjusting for covariates (age, employment, and premorbid intellectual functioning; b = -0.007; 95% confidence interval [CI] = -0.0112 to -0.003; p < 0.001). The cognitive domains of verbal fluency (b = -0.004; 95% CI = -0.006 to -0.002), executive functioning (b = -0.004; 95% CI = -0.006 to -0.002), processing speed (b = -0.005; 95% CI = -0.007 to -0.003), and motor skills (b = -0.006; 95% CI = -0.007 to -0.005) also significantly predicted worse frailty index score ( p values <0.001). A frailty index can standardize how clinicians identify PLWHA who may be at higher risk of neurocognitive impairment. © 2018 American Academy of Neurology.

Prediction of Mortality with A Body Shape Index in Young Asians: Comparison with Body Mass Index and Waist Circumference.

PubMed

Lee, Da-Young; Lee, Mi-Yeon; Sung, Ki-Chul

2018-06-01

This paper investigated the impact of A Body Shape Index (ABSI) on the risk of all-cause mortality compared with the impact of waist circumference (WC) and body mass index (BMI). This paper reviewed data of 213,569 Korean adults who participated in health checkups between 2002 and 2012 at Kangbuk Samsung Hospital in Seoul, Korea. A multivariate Cox proportional hazard analysis was performed on the BMI, WC, and ABSI z score continuous variables as well as quintiles. During 1,168,668.7 person-years, 1,107 deaths occurred. As continuous variables, a significant positive relationship with the risk of all-cause death was found only in ABSI z scores after adjustment for age, sex, current smoking, alcohol consumption, regular exercise, presence of diabetes or hypertension, and history of cardiovascular diseases. In Cox analysis of quintiles, quintile 5 of the ABSI z score showed significantly increased hazard ratios (HRs) for mortality risk (HR [95% CI] was 1.32 [1.05-1.66]), whereas the risk for all-cause mortality, on the other hand, decreased in quintiles 3 through 5 of BMI and WC compared with their first quintiles after adjusting for several confounders. This study showed that the predictive value of ABSI for mortality risk was strong for a sample of young Asian participants and that its usefulness was better than BMI or WC. © 2018 The Obesity Society.

Environmental Chemicals in Urine and Blood: Improving Methods for Creatinine and Lipid Adjustment.

PubMed

O'Brien, Katie M; Upson, Kristen; Cook, Nancy R; Weinberg, Clarice R

2016-02-01

Investigators measuring exposure biomarkers in urine typically adjust for creatinine to account for dilution-dependent sample variation in urine concentrations. Similarly, it is standard to adjust for serum lipids when measuring lipophilic chemicals in serum. However, there is controversy regarding the best approach, and existing methods may not effectively correct for measurement error. We compared adjustment methods, including novel approaches, using simulated case-control data. Using a directed acyclic graph framework, we defined six causal scenarios for epidemiologic studies of environmental chemicals measured in urine or serum. The scenarios include variables known to influence creatinine (e.g., age and hydration) or serum lipid levels (e.g., body mass index and recent fat intake). Over a range of true effect sizes, we analyzed each scenario using seven adjustment approaches and estimated the corresponding bias and confidence interval coverage across 1,000 simulated studies. For urinary biomarker measurements, our novel method, which incorporates both covariate-adjusted standardization and the inclusion of creatinine as a covariate in the regression model, had low bias and possessed 95% confidence interval coverage of nearly 95% for most simulated scenarios. For serum biomarker measurements, a similar approach involving standardization plus serum lipid level adjustment generally performed well. To control measurement error bias caused by variations in serum lipids or by urinary diluteness, we recommend improved methods for standardizing exposure concentrations across individuals.

Why Summary Comorbidity Measures Such As the Charlson Comorbidity Index and Elixhauser Score Work.

PubMed

Austin, Steven R; Wong, Yu-Ning; Uzzo, Robert G; Beck, J Robert; Egleston, Brian L

2015-09-01

Comorbidity adjustment is an important component of health services research and clinical prognosis. When adjusting for comorbidities in statistical models, researchers can include comorbidities individually or through the use of summary measures such as the Charlson Comorbidity Index or Elixhauser score. We examined the conditions under which individual versus summary measures are most appropriate. We provide an analytic proof of the utility of comorbidity summary measures when used in place of individual comorbidities. We compared the use of the Charlson and Elixhauser scores versus individual comorbidities in prognostic models using a SEER-Medicare data example. We examined the ability of summary comorbidity measures to adjust for confounding using simulations. We devised a mathematical proof that found that the comorbidity summary measures are appropriate prognostic or adjustment mechanisms in survival analyses. Once one knows the comorbidity score, no other information about the comorbidity variables used to create the score is generally needed. Our data example and simulations largely confirmed this finding. Summary comorbidity measures, such as the Charlson Comorbidity Index and Elixhauser scores, are commonly used for clinical prognosis and comorbidity adjustment. We have provided a theoretical justification that validates the use of such scores under many conditions. Our simulations generally confirm the utility of the summary comorbidity measures as substitutes for use of the individual comorbidity variables in health services research. One caveat is that a summary measure may only be as good as the variables used to create it.

High-refractive index of acrylate embedding resin clarifies mouse brain tissue.

PubMed

Zhou, Hongfu; Xiong, Yumiao; Wang, Yu; Wang, Xiaojun; Li, Pei; Gang, Yadong; Liu, Xiuli; Zeng, Shaoqun

2017-11-01

Biological tissue transparency combined with light-sheet fluorescence microscopy is a useful method for studying the neural structure of biological tissues. The development of light-sheet fluorescence microscopy also promotes progress in biological tissue clearing methods. The current clarifying methods mostly use liquid reagent to denature protein or remove lipids first, to eliminate or reduce the scattering index or refractive index of the biological tissue. However, denaturing protein and removing lipids require complex procedures or an extended time period. Therefore, here we have developed acrylate resin with a high refractive index, which causes clearing of biological tissue directly after polymerization. This method can improve endogenous fluorescence retention by adjusting the pH value of the resin monomer. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Adjusted hospital death rates: a potential screen for quality of medical care.

PubMed

Dubois, R W; Brook, R H; Rogers, W H

1987-09-01

Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist.

Risk Adjustment for Medicare Total Knee Arthroplasty Bundled Payments.

PubMed

Clement, R Carter; Derman, Peter B; Kheir, Michael M; Soo, Adrianne E; Flynn, David N; Levin, L Scott; Fleisher, Lee

2016-09-01

The use of bundled payments is growing because of their potential to align providers and hospitals on the goal of cost reduction. However, such gain sharing could incentivize providers to "cherry-pick" more profitable patients. Risk adjustment can prevent this unintended consequence, yet most bundling programs include minimal adjustment techniques. This study was conducted to determine how bundled payments for total knee arthroplasty (TKA) should be adjusted for risk. The authors collected financial data for all Medicare patients (age≥65 years) undergoing primary unilateral TKA at an academic center over a period of 2 years (n=941). Multivariate regression was performed to assess the effect of patient factors on the costs of acute inpatient care, including unplanned 30-day readmissions. This analysis mirrors a bundling model used in the Medicare Bundled Payments for Care Improvement initiative. Increased age, American Society of Anesthesiologists (ASA) class, and the presence of a Medicare Major Complications/Comorbid Conditions (MCC) modifier (typically representing major complications) were associated with increased costs (regression coefficients, $57 per year; $729 per ASA class beyond I; and $3122 for patients meeting MCC criteria; P=.003, P=.001, and P<.001, respectively). Differences in costs were not associated with body mass index, sex, or race. If the results are generalizable, Medicare bundled payments for TKA encompassing acute inpatient care should be adjusted upward by the stated amounts for older patients, those with elevated ASA class, and patients meeting MCC criteria. This is likely an underestimate for many bundling models, including the Comprehensive Care for Joint Replacement program, incorporating varying degrees of postacute care. Failure to adjust for factors that affect costs may create adverse incentives, creating barriers to care for certain patient populations. [Orthopedics. 2016; 39(5):e911-e916.]. Copyright 2016, SLACK Incorporated.

Biconcave micro-optofluidic lens with low-refractive-index liquids.

PubMed

Song, Chaolong; Nguyen, Nam-Trung; Asundi, Anand Krishna; Low, Cassandra Lee-Ngo

2009-12-01

One of the current problems of micro-optofluidics is the choice of a suitable liquid with a high refractive index (RI). We report the use of a low-RI liquid in a biconcave liquid-core liquid-cladding lens for focusing light. For the characterization of the lens, a telescope system was constructed from polydimethylsiloxane lenses to collimate and expand a light beam emitted from an optical fiber. The tunable optofluidic biconcave lens focuses the parallel beam. Fluorescent dye diluted in an index-matching liquid was used for the visualization of the light rays in a beam-tracing chamber. The focused beam is tuned by adjusting the flow rate ratio between core and cladding streams.

Anticipatory synergy adjustments reflect individual performance of feedforward force control.

PubMed

Togo, Shunta; Imamizu, Hiroshi

2016-10-06

We grasp and dexterously manipulate an object through multi-digit synergy. In the framework of the uncontrolled manifold (UCM) hypothesis, multi-digit synergy is defined as the coordinated control mechanism of fingers to stabilize variable important for task success, e.g., total force. Previous studies reported anticipatory synergy adjustments (ASAs) that correspond to a drop of the synergy index before a quick change of the total force. The present study compared ASA's properties with individual performances of feedforward force control to investigate a relationship of those. Subjects performed a total finger force production task that consisted of a phase in which subjects tracked target line with visual information and a phase in which subjects produced total force pulse without visual information. We quantified their multi-digit synergy through UCM analysis and observed significant ASAs before producing total force pulse. The time of the ASA initiation and the magnitude of the drop of the synergy index were significantly correlated with the error of force pulse, but not with the tracking error. Almost all subjects showed a significant increase of the variance that affected the total force. Our study directly showed that ASA reflects the individual performance of feedforward force control independently of target-tracking performance and suggests that the multi-digit synergy was weakened to adjust the multi-digit movements based on a prediction error so as to reduce the future error. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Development of Multiple-Locus Variable-Number Tandem-Repeat Analysis for Molecular Subtyping of Campylobacter jejuni by Using Capillary Electrophoresis

PubMed Central

Techaruvichit, Punnida; Vesaratchavest, Mongkol; Keeratipibul, Suwimon; Kuda, Takashi; Kimura, Bon

2015-01-01

Campylobacter jejuni is a common cause of the frequently reported food-borne diseases in developed and developing nations. This study describes the development of multiple-locus variable-number tandem-repeat (VNTR) analysis (MLVA) using capillary electrophoresis as a novel typing method for microbial source tracking and epidemiological investigation of C. jejuni. Among 36 tandem repeat loci detected by the Tandem Repeat Finder program, 7 VNTR loci were selected and used for characterizing 60 isolates recovered from chicken meat samples from retail shops, samples from chicken meat processing factory, and stool samples. The discrimination ability of MLVA was compared with that of multilocus sequence typing (MLST). MLVA (diversity index of 0.97 with 31 MLVA types) provided slightly higher discrimination than MLST (diversity index of 0.95 with 25 MLST types). The overall concordance between MLVA and MLST was estimated at 63% by adjusted Rand coefficient. MLVA predicted MLST type better than MLST predicted MLVA type, as reflected by Wallace coefficient (Wallace coefficient for MLVA to MLST versus MLST to MLVA, 86% versus 51%). MLVA is a useful tool and can be used for effective monitoring of C. jejuni and investigation of epidemics caused by C. jejuni. PMID:26025899

Use of the Posterior/Anterior Corneal Curvature Radii Ratio to Improve the Accuracy of Intraocular Lens Power Calculation: Eom's Adjustment Method.

PubMed

Kim, Mingue; Eom, Youngsub; Lee, Hwa; Suh, Young-Woo; Song, Jong Suk; Kim, Hyo Myung

2018-02-01

To evaluate the accuracy of IOL power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio. Nine hundred twenty-eight eyes from 928 reference subjects and 158 eyes from 158 cataract patients who underwent phacoemulsification surgery were enrolled. Adjusted corneal power of cataract patients was calculated using the fictitious refractive index that was obtained from the geometric mean posterior/anterior corneal curvature radii ratio of reference subjects and adjusted anterior and predicted posterior corneal curvature radii from conventional keratometry (K) using the posterior/anterior corneal curvature radii ratio. The median absolute error (MedAE) based on the adjusted corneal power was compared with that based on conventional K in the Haigis and SRK/T formulae. The geometric mean posterior/anterior corneal curvature radii ratio was 0.808, and the fictitious refractive index of the cornea for a single Scheimpflug camera was 1.3275. The mean difference between adjusted corneal power and conventional K was 0.05 diopter (D). The MedAE based on adjusted corneal power (0.31 D in the Haigis formula and 0.32 D in the SRK/T formula) was significantly smaller than that based on conventional K (0.41 D and 0.40 D, respectively; P < 0.001 and P < 0.001, respectively). The percentage of eyes with refractive prediction error within ± 0.50 D calculated using adjusted corneal power (74.7%) was significantly greater than that obtained using conventional K (62.7%) in the Haigis formula (P = 0.029). IOL power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio provided more accurate refractive outcomes than calculation using conventional K.

49 CFR 393.53 - Automatic brake adjusters and brake adjustment indicators.

Code of Federal Regulations, 2010 CFR

2010-10-01

... indicators. 393.53 Section 393.53 Transportation Other Regulations Relating to Transportation (Continued... brake adjustment indicators. (a) Automatic brake adjusters (hydraulic brake systems). Each commercial... vehicle at the time it was manufactured. (c) Brake adjustment indicator (air brake systems). On each...

49 CFR 393.53 - Automatic brake adjusters and brake adjustment indicators.

Code of Federal Regulations, 2011 CFR

2011-10-01

... indicators. 393.53 Section 393.53 Transportation Other Regulations Relating to Transportation (Continued... brake adjustment indicators. (a) Automatic brake adjusters (hydraulic brake systems). Each commercial... vehicle at the time it was manufactured. (c) Brake adjustment indicator (air brake systems). On each...

Adjusting body cell mass for size in women of differing nutritional status.

PubMed

Wells, Jonathan C K; Murphy, Alexia J; Buntain, Helen M; Greer, Ristan M; Cleghorn, Geoffrey J; Davies, Peter S W

2004-08-01

Body cell mass (BCM) may be estimated in clinical practice to assess functional nutritional status, eg, in patients with anorexia nervosa. Interpretation of the data, especially in younger patients who are still growing, requires appropriate adjustment for size. Previous investigations of this general issue have addressed chemical rather than functional components of body composition and have not considered patients at the extremes of nutritional status, in whom the ability to make longitudinal comparisons is of particular importance. Our objective was to determine the power by which height should be raised to adjust BCM for height in women of differing nutritional status. BCM was estimated by (40)K counting in 58 healthy women, 33 healthy female adolescents, and 75 female adolescents with anorexia nervosa. The relation between BCM and height was explored in each group by using log-log regression analysis. The powers by which height should be raised to adjust BCM were 1.73, 1.73, and 2.07 in the women, healthy female adolescents, and anorexic female adolescents, respectively. A simplified version of the index, BCM/height(2), was appropriate for all 3 categories and was negligibly correlated with height. In normal-weight women, the relation between height and BCM is consistent with that reported previously between height and fat-free mass. Although the consistency of the relation between BCM and fat-free mass decreases with increasing weight loss, the relation between height and BCM is not significantly different between normal-weight and underweight women. The index BCM/height(2) is easy to calculate and applicable to both healthy and underweight women. This information may be helpful in interpreting body-composition data in clinical practice.

Association between ratio indexes of body composition phenotypes and metabolic risk in Italian adults.

PubMed

Powell, M; Lara, J; Mocciaro, G; Prado, C M; Battezzati, A; Leone, A; Tagliabue, A; de Amicis, R; Vignati, L; Bertoli, S; Siervo, M

2016-12-01

The ratio between fat mass (FM) and fat-free mass (FFM) has been used to discriminate individual differences in body composition and improve prediction of metabolic risk. Here, we evaluated whether the use of a visceral adipose tissue-to-fat-free mass index (VAT:FFMI) ratio was a better predictor of metabolic risk than a fat mass index to fat-free mass index (FMI:FFMI) ratio. This is a cross-sectional study including 3441 adult participants (age range 18-81; men/women: 977/2464). FM and FFM were measured by bioelectrical impedance analysis and VAT by ultrasonography. A continuous metabolic risk Z score and harmonised international criteria were used to define cumulative metabolic risk and metabolic syndrome (MetS), respectively. Multivariate logistic and linear regression models were used to test associations between body composition indexes and metabolic risk. In unadjusted models, VAT:FFMI was a better predictor of MetS (OR 8.03, 95%CI 6.69-9.65) compared to FMI:FFMI (OR 2.91, 95%CI 2.45-3.46). However, the strength of association of VAT:FFMI and FMI:FFMI became comparable when models were adjusted for age, gender, clinical and sociodemographic factors (OR 4.06, 95%CI 3.31-4.97; OR 4.25, 95%CI 3.42-5.27, respectively). A similar pattern was observed for the association of the two indexes with the metabolic risk Z score (VAT:FFMI: unadjusted b = 0.69 ± 0.03, adjusted b = 0.36 ± 0.03; FMI:FFMI: unadjusted b = 0.28 ± 0.028, adjusted b = 0.38 ± 0.02). Our results suggest that there is no real advantage in using either VAT:FFMI or FMI:FFMI ratios as a predictor of metabolic risk in adults. However, these results warrant confirmation in longitudinal studies. © 2016 World Obesity Federation.

Urban sprawl and body mass index among displaced Hurricane Katrina survivors.

PubMed

Arcaya, Mariana; James, Peter; Rhodes, Jean E; Waters, Mary C; Subramanian, S V

2014-08-01

Existing research suggests that walkable environments are protective against weight gain, while sprawling neighborhoods may pose health risks. Using prospective data on displaced Hurricane Katrina survivors, we provide the first natural experimental data on sprawl and body mass index (BMI). The analysis uses prospectively collected pre- (2003-2005) and post-hurricane (2006-2007) data from the Resilience in Survivors of Katrina (RISK) project on 280 displaced Hurricane Katrina survivors who had little control over their neighborhood placement immediately after the disaster. The county sprawl index, a standardized measure of built environment, was used to predict BMI at follow-up, adjusted for baseline BMI and sprawl; hurricane-related trauma; and demographic and economic characteristics. Respondents from 8 New Orleans-area counties were dispersed to 76 counties post-Katrina. Sprawl increased by an average of 1.5 standard deviations (30 points) on the county sprawl index. Each one point increase in sprawl was associated with approximately .05kg/m(2) higher BMI in unadjusted models (95%CI: .01-.08), and the relationship was not attenuated after covariate adjustment. We find a robust association between residence in a sprawling county and higher BMI unlikely to be caused by self-selection into neighborhoods, suggesting that the built environment may foster changes in weight. Copyright © 2014 Elsevier Inc. All rights reserved.

Urban Sprawl and Body Mass Index Among Displaced Hurricane Katrina Survivors

PubMed Central

Arcaya, Mariana; James, Peter; Rhodes, Jean; Waters, Mary C; Subramanian, S V

2014-01-01

Objective Existing research suggests that walkable environments are protective against weight gain, while sprawling neighborhoods may pose health risks. Using prospective data on displaced Hurricane Katrina survivors, we provide the first natural experimental data on sprawl and body mass index (BMI). Methods The analysis uses prospectively collected pre- (2003–2005) and post-hurricane (2006–2007) data from the Resilience in Survivors of Katrina (RISK) project on 280 displaced Hurricane Katrina survivors who had little control over their neighborhood placement immediately after the disaster. The county sprawl index, a standardized measure of built environment, was used to predict BMI at follow-up, adjusted for baseline BMI and sprawl; Hurricane-related trauma; and demographic and economic characteristics. Results Respondents from 8 New Orleans-area counties were dispersed to 76 counties post-Katrina. Sprawl increased by an average of 1.5 standard deviations (30 points) on the county sprawl index. Each one point increase in sprawl was associated with approximately .05 kg/m2 higher BMI in unadjusted models (95%CI: .01–.08), and the relationship was not attenuated after covariate adjustment. Conclusions We find a robust association between residence in a sprawling county and higher BMI unlikely to be caused by self-selection into neighborhoods, suggesting that the built environment may foster changes in weight. PMID:24732717

Use of Dietary Indexes among Children in Developed Countries12

PubMed Central

Lazarou, Chrystalleni; Newby, P. K.

2011-01-01

In this article, we review studies that have used dietary indexes to assess different aspects of diet in relation to health outcomes and sociodemographic factors in childhood populations of developed countries. Eighty-four papers published from 1980 to mid-2010 including 90 unique dietary indexes were reviewed. Seventy-two indexes were developed (or have been adapted) specifically for childhood populations; 38 of these were used to assess diet-disease associations, mostly of diet and obesity. In the majority of these studies, small inverse associations between dietary indexes and obesity indexes were shown. Children who were younger, female, and from high-income families had better dietary quality scores. Forty-nine indexes (of 90) were compared with other aspects of dietary intakes or behaviors, with correlations ranging from very low to modest (∼r = 0.05–0.50). Only 2 validation studies compared an index with nutritional biomarkers, and correlations were quite weak for most plasma nutrients (P < 0.10). Overall, a large number of indexes have been created and used, but the majority of studies are descriptive. Fewer analytic studies on index-health associations have been performed, and most analyses insufficiently adjusted for confounders. Thus, prospective and intervention research in diverse populations is needed to further test these tools. In conclusion, indexes are potentially useful methods for dietary assessment, because they offer valuable information on overall dietary patterns in children. However, understanding the advantages and limitations when applying them in research and public health settings is important, and more research is needed to further develop their utility. PMID:22332071

Parenting and adolescents' psychological adjustment: Longitudinal moderation by adolescents' genetic sensitivity.

PubMed

Stocker, Clare M; Masarik, April S; Widaman, Keith F; Reeb, Ben T; Boardman, Jason D; Smolen, Andrew; Neppl, Tricia K; Conger, Katherine J

2017-10-01

We examined whether adolescents' genetic sensitivity, measured by a polygenic index score, moderated the longitudinal associations between parenting and adolescents' psychological adjustment. The sample included 323 mothers, fathers, and adolescents (177 female, 146 male; Time 1 [T1] average age = 12.61 years, SD = 0.54 years; Time 2 [T2] average age = 13.59 years, SD = 0.59 years). Parents' warmth and hostility were rated by trained, independent observers using videotapes of family discussions. Adolescents reported their symptoms of anxiety, depressed mood, and hostility at T1 and T2. The results from autoregressive linear regression models showed that adolescents' genetic sensitivity moderated associations between observations of both mothers' and fathers' T1 parenting and adolescents' T2 composite maladjustment, depression, anxiety, and hostility. Compared to adolescents with low genetic sensitivity, adolescents with high genetic sensitivity had worse adjustment outcomes when parenting was low on warmth and high on hostility. When parenting was characterized by high warmth and low hostility, adolescents with high genetic sensitivity had better adjustment outcomes than their counterparts with low genetic sensitivity. The results support the differential susceptibility model and highlight the complex ways that genes and environment interact to influence development.

Documentation for the NCES Comparable Wage Index Files. EFSC 2006-865

ERIC Educational Resources Information Center

Taylor, Lori L.; Glander, Mark C.

2006-01-01

The Comparable Wage Index (CWI) is a measure of the systematic, regional variations in the salaries of college graduates who are not educators. It can be used by researchers to adjust district-level finance data at different levels in order to make better comparisons across geographic areas. The CWI was developed by Dr. Lori L. Taylor at the Bush…

Magnetically adjustable intraocular lens.

PubMed

Matthews, Michael Wayne; Eggleston, Harry Conrad; Pekarek, Steven D; Hilmas, Greg Eugene

2003-11-01

To provide a noninvasive, magnetic adjustment mechanism to the repeatedly and reversibly adjustable, variable-focus intraocular lens (IOL). University of Missouri-Rolla, Rolla, and Eggleston Adjustable Lens, St. Louis, Missouri, USA. Mechanically adjustable IOLs have been fabricated and tested. Samarium and cobalt rare-earth magnets have been incorporated into the poly(methyl methacrylate) (PMMA) optic of these adjustable lenses. The stability of samarium and cobalt in the PMMA matrix was examined with leaching studies. Operational force testing of the magnetic optics with emphasis on the rotational forces of adjustment was done. Prototype optics incorporating rare-earth magnetic inserts were consistently produced. After 32 days in solution, samarium and cobalt concentration reached a maximum of 5 ppm. Operational force measurements indicate that successful adjustments of this lens can be made using external magnetic fields with rotational torques in excess of 0.6 ounce inch produced. Actual lenses were remotely adjusted using magnetic fields. The magnetically adjustable version of this IOL is a viable and promising means of handling the common issues of postoperative refractive errors without the requirement of additional surgery. The repeatedly adjustable mechanism of this lens also holds promise for the developing eyes of pediatric patients and the changing needs of all patients.

Respiratory Cancer and Non-Malignant Respiratory Disease-Related Mortality among Older Construction Workers-Findings from the Health and Retirement Study

PubMed Central

Wang, Xuanwen; Dong, Xiuwen Sue; Welch, Laura; Largay, Julie

2016-01-01

Objective This study explored the risk of respiratory cancer and non-malignant respiratory disease (NMRD)-related mortality among older construction workers. Methods Analyzed data from the 1992–2010 RAND Health and Retirement Study (HRS) and the HRS National Death Index – Cause of Death file. About 25,183 workers aged 50 years and older were examined, including 5,447 decedents and 19,736 survivors, of which 1,460 reported their longest job was in construction. Multinomial logistic regression assessed the differences in mortality between workers’ longest occupations, controlling for confounders. Results After adjusting for smoking and demographics, construction workers were almost twice as likely to die from respiratory cancer (OR = 1.65; CI: 1.10–2.47) or NMRD (OR = 1.73; CI: 1.16–2.58) compared to white-collar workers. Conclusions This study adds to the growing evidence that respiratory cancer and NMRD are frequently associated with construction exposure. PMID:27500180

Do subfertile women adjust their habits when trying to conceive?

PubMed

Joelsson, Lana Salih; Berglund, Anna; Wånggren, Kjell; Lood, Mikael; Rosenblad, Andreas; Tydén, Tanja

2016-08-01

The aim of this study was to investigate lifestyle habits and lifestyle adjustments among subfertile women trying to conceive. Women (n = 747) were recruited consecutively at their first visit to fertility clinics in mid-Sweden. Participants completed a questionnaire. Data were analyzed using logistic regression, t tests, and chi-square tests. The response rate was 62% (n = 466). Mean duration of infertility was 1.9 years. During this time 13.2% used tobacco daily, 13.6% drank more than three cups of coffee per day, and 11.6% consumed more than two glasses of alcohol weekly. In this sample, 23.9% of the women were overweight (body mass index, BMI 25-29.9 kg/m(2)), and 12.5% were obese (BMI ≥30 kg/m(2)). Obese women exercised more and changed to healthy diets more frequently than normal-weight women (odds ratio 7.43; 95% confidence interval 3.7-14.9). Six out of ten women (n = 266) took folic acid when they started trying to conceive, but 11% stopped taking folic acid after some time. Taking folic acid was associated with a higher level of education (p < 0.001). Among subfertile women, one-third were overweight or obese, and some had other lifestyle factors with known adverse effects on fertility such as use of tobacco. Overweight and obese women adjusted their habits but did not reduce their body mass index. Women of fertile age would benefit from preconception counseling, and the treatment of infertility should routinely offer interventions for lifestyle changes.

A Longitudinal Study of Perceived Family Adjustment and Emotional Adjustment in Early Adolescence.

ERIC Educational Resources Information Center

Ohannessian, Christine McCauley; And Others

1994-01-01

Examined the predictive relationship between family adjustment and emotional adjustment during early adolescence and the influence of adolescents' levels of self-worth, peer support, and coping abilities. Found that family adjustment and emotional adjustment are reciprocally related and that high levels of self-worth, peer support, and coping…

A physarum-inspired prize-collecting steiner tree approach to identify subnetworks for drug repositioning.

PubMed

Sun, Yahui; Hameed, Pathima Nusrath; Verspoor, Karin; Halgamuge, Saman

2016-12-05

Drug repositioning can reduce the time, costs and risks of drug development by identifying new therapeutic effects for known drugs. It is challenging to reposition drugs as pharmacological data is large and complex. Subnetwork identification has already been used to simplify the visualization and interpretation of biological data, but it has not been applied to drug repositioning so far. In this paper, we fill this gap by proposing a new Physarum-inspired Prize-Collecting Steiner Tree algorithm to identify subnetworks for drug repositioning. Drug Similarity Networks (DSN) are generated using the chemical, therapeutic, protein, and phenotype features of drugs. In DSNs, vertex prizes and edge costs represent the similarities and dissimilarities between drugs respectively, and terminals represent drugs in the cardiovascular class, as defined in the Anatomical Therapeutic Chemical classification system. A new Physarum-inspired Prize-Collecting Steiner Tree algorithm is proposed in this paper to identify subnetworks. We apply both the proposed algorithm and the widely-used GW algorithm to identify subnetworks in our 18 generated DSNs. In these DSNs, our proposed algorithm identifies subnetworks with an average Rand Index of 81.1%, while the GW algorithm can only identify subnetworks with an average Rand Index of 64.1%. We select 9 subnetworks with high Rand Index to find drug repositioning opportunities. 10 frequently occurring drugs in these subnetworks are identified as candidates to be repositioned for cardiovascular diseases. We find evidence to support previous discoveries that nitroglycerin, theophylline and acarbose may be able to be repositioned for cardiovascular diseases. Moreover, we identify seven previously unknown drug candidates that also may interact with the biological cardiovascular system. These discoveries show our proposed Prize-Collecting Steiner Tree approach as a promising strategy for drug repositioning.

Health-adjusted life expectancy in Canada.

PubMed

Bushnik, Tracey; Tjepkema, Michael; Martel, Laurent

2018-04-18

Over the past century, life expectancy at birth in Canada has risen substantially. However, these gains in the quantity of life say little about gains in the quality of life. Health-adjusted life expectancy (HALE), an indicator of quality of life, was estimated for the household and institutional populations combined every four years from 1994/1995 to 2015. Health status was measured by the Health Utilities Index Mark 3 instrument in two national population health surveys, and was used to adjust life expectancy. The percentage of the population living in health-related institutions was estimated based on the Census of Population. Attribute-deleted HALE was calculated to determine how various aspects of health status contributed to the differences between life expectancy and HALE. HALE has increased in Canada. Greater gains among males have narrowed the gap between males and females. The ratio of HALE to life expectancy changed little for males, and a marginal improvement was observed for females aged 65 or older. Mobility problems and pain, the latter mainly among females, accounted for an increased share of the burden of ill health over time. Exclusion of the institutional population significantly increased the estimates of HALE and yielded higher ratios of HALE to life expectancy. Although people are living longer, the share of years spent in good functional health has remained fairly constant. Data for both the household and institutional populations are necessary for a complete picture of health expectancy in Canada.

Rural Hospital Wages and the Area Wage Index

PubMed Central

Dalton, Kathleen; Slifkin, Rebecca T.; Howard, Hilda A.

2002-01-01

We examined data on hospital hourly wages and the prospective payment system (PPS) wage index from 1990 to 1997, to determine if incremental changes to the index have improved its precision and equity as a regional cost adjuster. The differential between average rural and urban PPS hourly wages has declined by almost one-fourth over the 8-year study period. Nearly one-half of the decrease is attributable to regulatory and reporting changes in the annual hospital wage survey. Patterns of within-market wage variation across rural-urban continuum codes identify three separate sub-markets within the State-level aggregates defining rural labor markets. Geographic reclassification decisions appear to eliminate one of the three. Remaining systematic within-market rural wage differences work to the reimbursement advantage of hospitals in the smaller and more isolated communities. PMID:12545604

Workpapers in Teaching English as a Second Language, Vol. 11.

ERIC Educational Resources Information Center

Povey, John, Ed.

This issue of the workpapers includes the following reports and papers: "The ESL Service Courses at UCLA: A Progress Report," by Kathleen M. Bailey; "A Comparison of Item Analysis Programs," by Earl Rand; "Stereotypes in Media - or - How to Avoid Functional Fixedness," by James Heaton; "The Search for a Second Language Acquisition Index of…

Environmental Chemicals in Urine and Blood: Improving Methods for Creatinine and Lipid Adjustment

PubMed Central

O’Brien, Katie M.; Upson, Kristen; Cook, Nancy R.; Weinberg, Clarice R.

2015-01-01

Background Investigators measuring exposure biomarkers in urine typically adjust for creatinine to account for dilution-dependent sample variation in urine concentrations. Similarly, it is standard to adjust for serum lipids when measuring lipophilic chemicals in serum. However, there is controversy regarding the best approach, and existing methods may not effectively correct for measurement error. Objectives We compared adjustment methods, including novel approaches, using simulated case–control data. Methods Using a directed acyclic graph framework, we defined six causal scenarios for epidemiologic studies of environmental chemicals measured in urine or serum. The scenarios include variables known to influence creatinine (e.g., age and hydration) or serum lipid levels (e.g., body mass index and recent fat intake). Over a range of true effect sizes, we analyzed each scenario using seven adjustment approaches and estimated the corresponding bias and confidence interval coverage across 1,000 simulated studies. Results For urinary biomarker measurements, our novel method, which incorporates both covariate-adjusted standardization and the inclusion of creatinine as a covariate in the regression model, had low bias and possessed 95% confidence interval coverage of nearly 95% for most simulated scenarios. For serum biomarker measurements, a similar approach involving standardization plus serum lipid level adjustment generally performed well. Conclusions To control measurement error bias caused by variations in serum lipids or by urinary diluteness, we recommend improved methods for standardizing exposure concentrations across individuals. Citation O’Brien KM, Upson K, Cook NR, Weinberg CR. 2016. Environmental chemicals in urine and blood: improving methods for creatinine and lipid adjustment. Environ Health Perspect 124:220–227; http://dx.doi.org/10.1289/ehp.1509693 PMID:26219104

Identification of chronic kidney disease risk in relatively lean Southern Chinese: the hypertriglyceridemic waist phenotype vs. anthropometric indexes.

PubMed

Zhou, Chaomin; Li, Yongqiang; Shao, Xiaofei; Zou, Hequn

2018-01-25

Assessing and comparing the ability of the hypertriglyceridemic waist (HW) phenotype and anthropometric obesity indexes to identify subjects at high risk of chronic kidney disease (CKD) in a relatively lean population in South China. Using data from a community-based, cross-sectional study conducted in Zhuhai City, Southern China, we examined associations between the HW phenotype, anthropometric obesity indexes, and incident CKD risk in a relatively lean population. Multiple logistic regression analyses were used to evaluate the associations. The HW phenotype associated with CKD significantly in the unadjusted analysis (OR 3.53, 95% CI 1.65-7.52, P = 0.001). Further adjustment for gender, age, and other potential confounding variables had an impact on the odd ratios (OR); the OR decreased but still existed (OR 2.91, 95% 1.23-6.87, P = 0.016). The association of the HW phenotype with CKD remained significant after further adjustment for hypertension and diabetes. No significant association between the anthropometric indexes and incident CKD was found. The HW phenotype, but not the anthropometric indexes, is associated with an elevated risk of CKD in relatively lean subjects. The HW phenotype appears to be a better predictor of CKD than the anthropometric indexes. Level V, descriptive study.

Maintaining the Balance Between Manpower, Skill Levels, and PERSTEMPO

DTIC Science & Technology

2006-01-01

requirement processes. Models and tools that integrate these dimensions would help crys- tallize issues, identify embedded assumptions , and surface...problems will change if the planning assumptions are incorrect or if the other systems are incapable of making the nec- essary adjustments. Static...Carrillo, Background and Theory Behind the Compensations, Accessions, and Personnel ( CAPM ) Model, Santa Monica, Calif.: RAND Corporation, MR-1667

Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

PubMed

Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

2015-08-15

The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. Copyright © 2015 Elsevier Inc. All rights reserved.

Posttraumatic symptoms, marital intimacy, dyadic adjustment, and sexual satisfaction among ex-prisoners of war.

PubMed

Zerach, Gadi; Anat, Ben-David; Solomon, Zahava; Heruti, Rafi

2010-08-01

The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on marital intimacy and sexual satisfaction has been examined in several studies. Nevertheless, the toll of war captivity on marital intimacy in relation to dyadic adjustment and sexual satisfaction remains unknown. In particular, the mediating role of marital intimacy in the relationship between PTSD symptoms and dyadic adjustment and between PTSD symptoms and sexual satisfaction has not yet been systematically explored thus far. Aims.  This study aimed to examine the interrelationships of PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy among ex-prisoners of war (ex-POWs). A sample of Israeli veterans ex-POWs (ex-POWs: N = 105) from the 1973 Yom Kippur War and a matched comparison group of veterans who participated in the same war but were not held captive (control: N = 94) were compared in the study variables. The PTSD inventory, dyadic adjustment scale, index of sexual satisfaction, and capacity for intimacy questionnaire. Results.  Findings revealed that ex-POWs reported higher levels of PTSD symptoms and lower levels of dyadic adjustment and sexual satisfaction than comparable controls. There were also differences between the groups in the pattern of relations between PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy. Finally, for ex-POWs, marital intimacy partially mediated the relationships between PTSD symptoms and dyadic adjustment and sexual satisfaction outcome measures. PTSD symptoms are implicated in marital problems of ex-POWs. A significant relationship was found between the traumatized ex-POW's capacity for intimacy and both their sexual satisfaction and dyadic adjustment. © 2010 International Society for Sexual Medicine.

Adiponectin-resistin index and its strong association with acute coronary syndrome in South Indian men.

PubMed

Singh, Prerna; Sridhar, M G; Rajappa, Medha; Balachander, J; Kadhiravan, Tamilarasu

2014-11-01

India has the highest burden of acute coronary syndromes worldwide. Apart from certain lipid alterations that have been established to be definite risk factors, low level of adiponectin, high levels of resistin, and IL-6 have been shown to be risk factors for cardiovascular events. Insulin resistance is also a significant predictor of poor outcome in patients admitted with ACS. 69 male patients with ACS and 70 age-matched healthy males were recruited in the study. Insulin, total adiponectin, resistin, and IL-6 levels were assayed in all study subjects. Indices of insulin resistance and novel adipokine indices were calculated using standard formulae. Multiple logistic regression analysis was done to find out the best predictor of ACS. Resistin, IL-6, insulin resistance indices, AR index, and IRAR index were found to be significantly higher, while insulin sensitivity indices and total adiponectin were found to be lower in cases, as compared with controls (p < 0.001). Insulin resistance was found to be higher in the admission sample, when compared to the fasting sample in patients with ACS (p = 0.01). On multivariate logistic regression analysis, HOMA-IR and AR index were found to be significantly associated with ACS. AR index was the best independent predictor of ACS, with the highest odds ratio (AR index: adjusted OR 17.528, p < 0.0001 versus HOMA-IR: adjusted OR 1.146, p = 0.001). The present results implicate that adipokines are significantly associated with pathogenesis of ACS, warranting adequate and early appropriate treatment to reverse this metabolic dysregulation. In our study, AR index was the best predictor of ACS. Hence, the novel AR index might be useful in routine clinical practice for screening persons with increased risk of future development of ACS.

Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk?

PubMed

Silverstein, Barbara; Fan, Z Joyce; Smith, Caroline K; Bao, Stephen; Howard, Ninica; Spielholz, Peregrin; Bonauto, David; Viikari-Juntura, Eira

2009-03-01

The aim was to explore whether "adjustment" for gender masks important exposure differences between men and women in a study of rotator cuff syndrome (RCS) and carpal tunnel syndrome (CTS) and work exposures. This cross-sectional study of 733 subjects in 12 health care and manufacturing workplaces used detailed individual health and work exposure assessment methods. Multiple logistic regression analysis was used to compare gender stratified and adjusted models. Prevalence of RCS and CTS among women was 7.1% and 11.3% respectively, and among men 7.8% and 6.4%. In adjusted (gender, age, body mass index) multivariate analyses of RCS and CTS, gender was not statistically significantly different. For RCS, upper arm flexion >/=45 degrees and forceful pinch increased the odds in the gender-adjusted model (OR 2.66, 95% CI 1.26-5.59) but primarily among women in the stratified analysis (OR 6.68, 95% CI 1.81-24.66 versus OR 1.45, 95% CI 0.53-4.00). For CTS, wrist radial/ulnar deviation >/=4% time and lifting >/=4.5kg >3% time, the adjusted OR was higher for women (OR 4.85, 95% CI 2.12-11.11) and in the gender stratified analyses, the odds were increased for both genders (women OR 5.18, 95% CI 1.70-15.81 and men OR 3.63, 95% CI 1.08-12.18). Gender differences in response to physical work exposures may reflect gender segregation in work and potential differences in pinch and lifting capacity. Reduction in these exposures may reduce prevalence of upper extremity disorders for all workers.

Using multilevel modeling to assess case-mix adjusters in consumer experience surveys in health care.

PubMed

Damman, Olga C; Stubbe, Janine H; Hendriks, Michelle; Arah, Onyebuchi A; Spreeuwenberg, Peter; Delnoij, Diana M J; Groenewegen, Peter P

2009-04-01

Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings.

SYSTEMATIC REVIEW OF HEALTHY EATING INDEXES IN ADULTS AND ELDERLY: APPLICABILITY AND VALIDITY.

PubMed

Pinto de Souza Fernandes, Dalila; Queiroz Ribeiro, Andréia; Lopes Duarte, Maria Sônia; Castro Franceschini, Sylvia do Carmo

2015-08-01

The Healthy Eating Index (HEI) assesses a combination of different types of foods, nutrients and dietary components. It has been adapted in some countries, considering the local dietary habits. in this article, the Healthy Eating Indexes published to date were identified by means of a systematic review. Besides, issues relating to their validity, applicability and limitations were discussed. an electronic search was performed in the PUBMED, SCIENCE DIRECT, BVS and SciELO data base containing studies on the adaptation, review, update or validation of the HEI. The descriptors Healthy Eating Index, Index of Diet Quality, Quality of diet, Diet surveys were used, in different combinations. a total of 11 studies were described and critically analyzed. One of the studies dealt with the development of the index; six proposed adjustments; two assessed validity and reliability of the index, and the other two proposed revision and update. The Healthy Eating Indexes reveal the actual quality of the diet, but the absence of a methodological standard hinders the comparison of the results found in different populations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Creatinine-based equations for the adjustment of drug dosage in an obese population.

PubMed

Bouquegneau, Antoine; Vidal-Petiot, Emmanuelle; Moranne, Olivier; Mariat, Christophe; Boffa, Jean-Jacques; Vrtovsnik, François; Scheen, André-Jean; Krzesinski, Jean-Marie; Flamant, Martin; Delanaye, Pierre

2016-02-01

For drug dosing adaptation, the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend using estimated glomerular filtration rate (eGFR) by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, after 'de-indexation' by body surface area (BSA). In pharmacology, the Cockcroft-Gault (CG) equation is still recommended to adapt drug dosage. In the context of obesity, adjusted ideal body weight (AIBW) is sometimes preferred to actual body weight (ABW) for the CG equation. The aim of the present study was to compare the performance of the different GFR-estimating equations, non-indexed or de-indexed by BSA for the purpose of drug-dosage adaptation in obese patients. We analysed data from patients with a body mass index (BMI) higher than 30 kg m(-2) who underwent a GFR measurement. eGFR was calculated using the CKD-EPI and Modification of Diet in Renal Disease (MDRD) equations, de-indexed by BSA, and the CG equation, using either ABW, AIBW or lean body weight (LBW) for the weight variable and compared with measured GFR, expressed in ml min(-1). In our population of obese patients, use of the AIBW instead of the ABW in the CG equation, markedly improved the overall accuracy of this equation [57% for CGABW and 79% for CGAIBW (P < 0.05)]. For high BMI (over 40 kg m(-2)), the accuracy of the CG equations is no different when using LBW than when using AIBW. The MDRD and CKD-EPI equations de-indexed by the BSA also performed well, with an overall higher accuracy for the MDRD de-indexed equation [(80% and 76%, respectively (P < 0.05)]. The de-indexed MDRD equation appeared to be the most suitable for estimating the non-indexed GFR for the purpose of drug dosage adaptation in obese patients. © 2015 The British Pharmacological Society.

Predictive value of European Scleroderma Group Activity Index in an early scleroderma cohort.

PubMed

Nevskaya, Tatiana; Baron, Murray; Pope, Janet E

2017-07-01

To estimate the effect of disease activity, as measured by the European Scleroderma Research Group Activity Index (EScSG-AI), on the risk of subsequent organ damage in a large systemic sclerosis (SSc) cohort. Of 421 SSc patients from the Canadian Scleroderma Research Group database with disease duration of ⩽ 3 years, 197 who had no evidence of end-stage organ damage initially and available 3 year follow-up were included. Disease activity was assessed by the EScSG-AI with two variability measures: the adjusted mean EScSG-AI (the area under the curve of the EScSG-AI over the observation period) and persistently active disease/flare. Outcomes were based on the Medsger severity scale and included accrual of a new severity score (Δ ⩾ 1) overall and within organ systems or reaching a significant level of deterioration in health status. After adjustment for covariates, the adjusted mean EScSG-AI was the most consistent predictor of risk across the study outcomes over 3 years in dcSSc: disease progression defined as Δ ⩾ 1 in any major internal organ, significant decline in forced vital capacity and diffusing capacity of carbon monoxide, severity of visceral disease and HAQ Disability Index worsening. In multivariate analysis, progression of lung disease was predicted solely by adjusted mean EScSG-AI, while the severity of lung disease was predicted the adjusted mean EScSG-AI, older age, modified Rodnan skin score (mRSS) and initial severity. The EScSG-AI was associated with patient- and physician-assessed measures of health status and overpowered the mRSS in predicting disease outcomes. Disease activity burden quantified with the adjusted mean EScSG-AI predicted the risk of deterioration in health status and severe organ involvement in dcSSc. The EScSG-AI is more responsive when done repeatedly and averaged. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email

A comparative evaluation of risk-adjustment models for benchmarking amputation-free survival after lower extremity bypass.

PubMed

Simons, Jessica P; Goodney, Philip P; Flahive, Julie; Hoel, Andrew W; Hallett, John W; Kraiss, Larry W; Schanzer, Andres

2016-04-01

Providing patients and payers with publicly reported risk-adjusted quality metrics for the purpose of benchmarking physicians and institutions has become a national priority. Several prediction models have been developed to estimate outcomes after lower extremity revascularization for critical limb ischemia, but the optimal model to use in contemporary practice has not been defined. We sought to identify the highest-performing risk-adjustment model for amputation-free survival (AFS) at 1 year after lower extremity bypass (LEB). We used the national Society for Vascular Surgery Vascular Quality Initiative (VQI) database (2003-2012) to assess the performance of three previously validated risk-adjustment models for AFS. The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL), Finland National Vascular (FINNVASC) registry, and the modified Project of Ex-vivo vein graft Engineering via Transfection III (PREVENT III [mPIII]) risk scores were applied to the VQI cohort. A novel model for 1-year AFS was also derived using the VQI data set and externally validated using the PIII data set. The relative discrimination (Harrell c-index) and calibration (Hosmer-May goodness-of-fit test) of each model were compared. Among 7754 patients in the VQI who underwent LEB for critical limb ischemia, the AFS was 74% at 1 year. Each of the previously published models for AFS demonstrated similar discriminative performance: c-indices for BASIL, FINNVASC, mPIII were 0.66, 0.60, and 0.64, respectively. The novel VQI-derived model had improved discriminative ability with a c-index of 0.71 and appropriate generalizability on external validation with a c-index of 0.68. The model was well calibrated in both the VQI and PIII data sets (goodness of fit P = not significant). Currently available prediction models for AFS after LEB perform modestly when applied to national contemporary VQI data. Moreover, the performance of each model was inferior to that of the novel VQI-derived model

Risk of depression, anxiety, and adjustment disorders in women with a suspected but unconfirmed diagnosis of breast or genital organ cancer in Germany.

PubMed

Kostev, Karel; Jacob, Louis; Kalder, Matthias

2017-10-01

Breast cancer (BC) and genital organ cancers (GOC) are known to have a major impact on the quality of life of patients. The aim of this study was to analyze the risk of depression, anxiety, and adjustment disorders in women in Germany with a suspected but unconfirmed diagnosis of BC or GOC in their medical history. This study included women who received a suspected diagnosis of BC or GOC and were followed between 2007 and 2015 (index date). These women were matched (1:1:1) by age to women with a confirmed diagnosis of BC or GOC and women without a cancer diagnosis. The main outcome measure of the study was the rate of depression, anxiety, and adjustment disorder diagnoses within 3 years of the index date. The present analysis included a total of 4,842 patients (mean age = 49.3 years). Within 3 years of the index date, 23.5% of women with a confirmed diagnosis of BC or GOC, 14.1% of those with a suspected diagnosis of BC or GOC, and 10.5% of those without a cancer diagnosis developed depression, anxiety, or an adjustment disorder (log-rank p value <0.001). Women with a suspected diagnosis of cancer were at a higher risk for these psychiatric conditions than those without a cancer diagnosis (BC and GOC: HR 1.32; BC: HR 1.21; GOC: HR 1.50). A suspected diagnosis of BC or GOC in a woman's medical history is associated with an increased risk of developing depression, anxiety, and adjustment disorders.

Severity-Adjusted Mortality in Trauma Patients Transported by Police

PubMed Central

Band, Roger A.; Salhi, Rama A.; Holena, Daniel N.; Powell, Elizabeth; Branas, Charles C.; Carr, Brendan G.

2018-01-01

Study objective Two decades ago, Philadelphia began allowing police transport of patients with penetrating trauma. We conduct a large, multiyear, citywide analysis of this policy. We examine the association between mode of out-of-hospital transport (police department versus emergency medical services [EMS]) and mortality among patients with penetrating trauma in Philadelphia. Methods This is a retrospective cohort study of trauma registry data. Patients who sustained any proximal penetrating trauma and presented to any Level I or II trauma center in Philadelphia between January 1, 2003, and December 31, 2007, were included. Analyses were conducted with logistic regression models and were adjusted for injury severity with the Trauma and Injury Severity Score and for case mix with a modified Charlson index. Results Four thousand one hundred twenty-two subjects were identified. Overall mortality was 27.4%. In unadjusted analyses, patients transported by police were more likely to die than patients transported by ambulance (29.8% versus 26.5%; OR 1.18; 95% confidence interval [CI] 1.00 to 1.39). In adjusted models, no significant difference was observed in overall mortality between the police department and EMS groups (odds ratio [OR] 0.78; 95% CI 0.61 to 1.01). In subgroup analysis, patients with severe injury (Injury Severity Score >15) (OR 0.73; 95% CI 0.59 to 0.90), patients with gunshot wounds (OR 0.70; 95% CI 0.53 to 0.94), and patients with stab wounds (OR 0.19; 95% CI 0.08 to 0.45) were more likely to survive if transported by police. Conclusion We found no significant overall difference in adjusted mortality between patients transported by the police department compared with EMS but found increased adjusted survival among 3 key subgroups of patients transported by police. This practice may augment traditional care. PMID:24387925

It Takes Two: Sexual Communication Patterns and the Sexual and Relational Adjustment of Couples Coping With Provoked Vestibulodynia.

PubMed

Rancourt, Kate M; Flynn, Michelle; Bergeron, Sophie; Rosen, Natalie O

2017-03-01

Provoked vestibulodynia (PVD) is a prevalent vulvovaginal pain condition that is associated with sexual and relational consequences for women and their partners. Greater perceived quality of sexual communication has been associated with women's lower pain during intercourse and with couples' better sexual and relational well-being. Whether couples' collaborative (eg, expressing feelings or problem solving) and negative (eg, withdrawing or criticizing) sexual communication patterns (SCPs) are differentially associated with couples' adjustment to PVD is unknown. To examine associations between collaborative and negative SCPs and women's pain and the sexual and relationship adjustment of women with PVD and their partners. Women diagnosed with PVD (N = 87) and their partners completed the Sexual Communication Patterns Questionnaire and measurements of pain (women only), sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction. (i) Numerical rating scale of pain during intercourse, (ii) Female Sexual Function Index and International Index of Erectile Function, (iii) Global Measure of Sexual Satisfaction, (iv) Female Sexual Distress Scale-Revised, and (v) Couple Satisfaction Index. When women reported greater collaborative SCP, they also reported higher sexual and relationship satisfaction. When women reported greater negative SCP, they reported less relationship satisfaction and had partners who reported greater sexual distress. When partners reported greater collaborative SCP, they also reported higher relationship satisfaction and had female partners who were less sexually distressed. When partners reported higher negative SCP, they also reported less relationship satisfaction. There were no associations between SCP and women's or partners' sexual functioning or women's pain. Collaborative SCP may benefit couples' sexual and relational well-being, whereas negative SCP may impede sexual and relational adjustment to PVD. Findings

Cardiac index is associated with brain aging: the Framingham Heart Study.

PubMed

Jefferson, Angela L; Himali, Jayandra J; Beiser, Alexa S; Au, Rhoda; Massaro, Joseph M; Seshadri, Sudha; Gona, Philimon; Salton, Carol J; DeCarli, Charles; O'Donnell, Christopher J; Benjamin, Emelia J; Wolf, Philip A; Manning, Warren J

2010-08-17

Cardiac dysfunction is associated with neuroanatomic and neuropsychological changes in aging adults with prevalent cardiovascular disease, theoretically because systemic hypoperfusion disrupts cerebral perfusion, contributing to subclinical brain injury. We hypothesized that cardiac function, as measured by cardiac index, would be associated with preclinical brain magnetic resonance imaging (MRI) and neuropsychological markers of ischemia and Alzheimer disease in the community. Brain MRI, cardiac MRI, neuropsychological, and laboratory data were collected on 1504 Framingham Offspring Cohort participants free of clinical stroke, transient ischemic attack, or dementia (age, 61+/-9 years; 54% women). Neuropsychological and brain MRI variables were related to cardiac MRI-assessed cardiac index (cardiac output/body surface area). In multivariable-adjusted models, cardiac index was positively related to total brain volume (P=0.03) and information processing speed (P=0.02) and inversely related to lateral ventricular volume (P=0.048). When participants with clinically prevalent cardiovascular disease were excluded, the relation between cardiac index and total brain volume remained (P=0.02). Post hoc comparisons revealed that participants in the bottom cardiac index tertile (values <2.54) and middle cardiac index tertile (values between 2.54 and 2.92) had significantly lower brain volumes (P=0.04) than participants in the top cardiac index tertile (values >2.92). Although observational data cannot establish causality, our findings are consistent with the hypothesis that decreasing cardiac function, even at normal cardiac index levels, is associated with accelerated brain aging.

Cardiac index is associated with brain aging: The Framingham Heart Study

PubMed Central

Jefferson, Angela L.; Himali, Jayandra J.; Beiser, Alexa S.; Au, Rhoda; Massaro, Joseph M.; Seshadri, Sudha; Gona, Philimon; Salton, Carol J.; DeCarli, Charles; O’Donnell, Christopher J.; Benjamin, Emelia J.; Wolf, Philip A.; Manning, Warren J.

2010-01-01

Background Cardiac dysfunction is associated with neuroanatomic and neuropsychological changes in aging adults with prevalent cardiovascular disease (CVD), theoretically because systemic hypoperfusion disrupts cerebral perfusion, contributing to subclinical brain injury. We hypothesized that cardiac function, as measured by cardiac index, would be associated with pre-clinical brain magnetic resonance imaging (MRI) and neuropsychological markers of ischemia and Alzheimer’s disease in the community. Methods and Results Brain MRI, cardiac MRI, neuropsychological, and laboratory data were collected on 1504 Framingham Offspring Cohort participants free from clinical stroke, transient ischemic attack, or dementia (61±9 years; 54% women). Neuropsychological and brain MRI variables were related to cardiac MRI-assessed cardiac index (cardiac output/body surface area). In multivariable-adjusted models, cardiac index was positively related to total brain volume (P=0.03) and information processing speed (P=0.02) and inversely related to lateral ventricular volume (P=0.048). When participants with clinically prevalent CVD were excluded, the relation between cardiac index and total brain volume remained (P=0.02). Post-hoc comparisons revealed that participants in the bottom cardiac index tertile (values<2.54) and middle cardiac index tertile (values between 2.54 and 2.92) had significantly lower brain volumes (P=0.04) than participants in the top cardiac index tertile (values>2.92). Conclusions Although observational data cannot establish causality, our findings are consistent with the hypothesis that decreasing cardiac function, even at normal cardiac index levels, is associated with accelerated brain aging. PMID:20679552

Weighted triangulation adjustment

USGS Publications Warehouse

Anderson, Walter L.

1969-01-01

The variation of coordinates method is employed to perform a weighted least squares adjustment of horizontal survey networks. Geodetic coordinates are required for each fixed and adjustable station. A preliminary inverse geodetic position computation is made for each observed line. Weights associated with each observed equation for direction, azimuth, and distance are applied in the formation of the normal equations in-the least squares adjustment. The number of normal equations that may be solved is twice the number of new stations and less than 150. When the normal equations are solved, shifts are produced at adjustable stations. Previously computed correction factors are applied to the shifts and a most probable geodetic position is found for each adjustable station. Pinal azimuths and distances are computed. These may be written onto magnetic tape for subsequent computation of state plane or grid coordinates. Input consists of punch cards containing project identification, program options, and position and observation information. Results listed include preliminary and final positions, residuals, observation equations, solution of the normal equations showing magnitudes of shifts, and a plot of each adjusted and fixed station. During processing, data sets containing irrecoverable errors are rejected and the type of error is listed. The computer resumes processing of additional data sets.. Other conditions cause warning-errors to be issued, and processing continues with the current data set.

Improving Army Basic Research: Report of an Expert Panel on the Future of Army Laboratories

DTIC Science & Technology

2012-01-01

commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under...complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND documents to a non-RAND website is prohibited. RAND...Inspired senior scientists and technologists with vision will be essential in research as well as in the design , development, evaluation, and

Assessing the Cost-Effectiveness of Modernizing the KC-10 to Meet Global Air Traffic Management Mandates

DTIC Science & Technology

2009-01-01

representation of RAND intellectual property is provided for non-commercial use only. Unauthorized posting of RAND PDFs to a non-RAND Web site is...duplicated for commercial purposes. Unauthorized posting of RAND documents to a non-RAND Web site is prohibited. RAND documents are protected under...Employment; Manpower, Personnel, and Train- ing; Resource Management; and Strategy and Doctrine. Additional information about PAF is available on our Web

The NLM Indexing Initiative's Medical Text Indexer.

PubMed

Aronson, Alan R; Mork, James G; Gay, Clifford W; Humphrey, Susanne M; Rogers, Willie J

2004-01-01

The Medical Text Indexer (MTI) is a program for producing MeSH indexing recommendations. It is the major product of NLM's Indexing Initiative and has been used in both semi-automated and fully automated indexing environments at the Library since mid 2002. We report here on an experiment conducted with MEDLINE indexers to evaluate MTI's performance and to generate ideas for its improvement as a tool for user-assisted indexing. We also discuss some filtering techniques developed to improve MTI's accuracy for use primarily in automatically producing the indexing for several abstracts collections.

ADJUSTABLE DOUBLE PULSE GENERATOR

DOEpatents

Gratian, J.W.; Gratian, A.C.

1961-08-01

>A modulator pulse source having adjustable pulse width and adjustable pulse spacing is described. The generator consists of a cross coupled multivibrator having adjustable time constant circuitry in each leg, an adjustable differentiating circuit in the output of each leg, a mixing and rectifying circuit for combining the differentiated pulses and generating in its output a resultant sequence of negative pulses, and a final amplifying circuit for inverting and square-topping the pulses. (AEC)

Prediction of WBGT-based clothing adjustment values from evaporative resistance

PubMed Central

BERNARD, Thomas E.; ASHLEY, Candi D.; GARZON, Ximena P.; KIM, Jung-Hyun; COCA, Aitor

2017-01-01

Wet bulb globe temperature (WBGT) index is used by many professionals in combination with metabolic rate and clothing adjustments to assess whether a heat stress exposure is sustainable. The progressive heat stress protocol is a systematic method to prescribe a clothing adjustment value (CAV) from human wear trials, and it also provides an estimate of apparent total evaporative resistance (Re,T,a). It is clear that there is a direct relationship between the two descriptors of clothing thermal effects with diminishing increases in CAV at high Re,T,a. There were data to suggest an interaction of CAV and Re,T,a with relative humidity at high evaporative resistance. Because human trials are expensive, manikin data can reduce the cost by considering the static total evaporative resistance (Re,T,s). In fact, as the static evaporative resistance increases, the CAV increases in a similar fashion as Re,T,a. While the results look promising that Re,T,s can predict CAV, some validation remains, especially for high evaporative resistance. The data only supports air velocities near 0.5 m/s. PMID:29033404

Occupation and educational inequalities in laryngeal cancer: the use of a job index

PubMed Central

2013-01-01

Background Previous studies tried to assess the association between socioeconomic status and laryngeal cancer. Alcohol and tobacco consumption explain already a large part of the social inequalities. Occupational exposures might explain a part of the remaining but the components and pathways of the socioeconomic contribution have yet to be fully disentangled. The aim of this study was to evaluate the role of occupation using different occupational indices, differentiating between physical, psycho-social and toxic exposures and trying to summarize the occupational burden into one variable. Methods A population-based case–control study conducted in Germany in 1998–2000 included 208 male cases and 702 controls. Information on occupational history, smoking, alcohol consumption and education was collected with face-to-face interviews. A recently developed job-classification index was used to account for the occupational burden. A sub-index focussed on jobs involving potentially carcinogenic agents (CAI) for the upper aero digestive tract. Results When adjusted for smoking and alcohol consumption, higher odds ratios (ORs) were found for lower education. This OR decreased after further adjustment using the physical and psycho-social job indices (OR = 3.2, 95%-CI: 1.5-6.8), similar to the OR using the sub-index CAI (OR = 3.0, 95%-CI: 1.4-6.5). Conclusions The use of an easily applicable control variable, simply constructed on standard occupational job classifications, provides the possibility to differentiate between educational and occupational contributions. Such an index might indirectly reflect the effect of carcinogenic agents, which are not collected in many studies. PMID:24246148

Association between triglyceride glucose index and arterial stiffness in Korean adults.

PubMed

Lee, Sang Bae; Ahn, Chul Woo; Lee, Byoung Kwon; Kang, Shinae; Nam, Ji Sun; You, Ji Hong; Kim, Min Jin; Kim, Min Kyung; Park, Jong Suk

2018-03-21

The triglyceride glucose (TyG) index has been suggested as a simple surrogate marker of insulin resistance. However, there are limited data regarding the association between the TyG index and arterial stiffness in adults. Therefore, we evaluated the relationship between the TyG index and arterial stiffness as measured based on brachial ankle pulse wave velocity (baPWV) in Korean adults. A total of 3587 subjects were enrolled in this study. Anthropometric and cardiovascular risk factors were measured. The TyG index was calculated as ln[fasting triglycerides(mg/dl) × fasting glucose(mg/dl)/2], and the insulin resistance index of homeostasis model assessment (HOMA-IR) was estimated. Arterial stiffness was determined by measuring baPWV. The subjects were stratified into four groups based on the TyG index. There were significant differences in cardiovascular parameters among the groups; the mean baPWV increased significantly with increasing TyG index. According to the logistic regression analysis after adjusting for multiple risk factors, the odds ratio (95% CI) for increased baPWV (> 75th percentile) for the highest and lowest quartiles of the TyG index was 2.92 (1.92-4.44) in men and 1.84 (1.15-2.96) in women, and the odds ratio for increased baPWV for the highest and lowest quartiles of the HOMA-IR was 1.80 (1.17-2.78) in men and 1.46 (1.06-2.47) in women, respectively. The TyG index is more independently associated with increased arterial stiffness than HOMA-IR in Korean adults.

Association between lifestyle factors and quality-adjusted life years in the EPIC-NL cohort.

PubMed

Fransen, Heidi P; May, Anne M; Beulens, Joline W J; Struijk, Ellen A; de Wit, G Ardine; Boer, Jolanda M A; Onland-Moret, N Charlotte; Hoekstra, Jeljer; van der Schouw, Yvonne T; Bueno-de-Mesquita, H Bas; Peeters, Petra H M

2014-01-01

The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet) to health expectancy, using quality-adjusted life years (QALYs) in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7), followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend <0.0001). A healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14]).

Review and Evaluation of the VA Enrollee Health Care Projection Model

DTIC Science & Technology

2008-01-01

prohibited. RAND PDFs are protected under copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research ...Visit RAND at www.rand.org Explore the RAND Center for Military Health Policy Research View document details For More Information This PDF document was...SUBSTANCE ABUSE TERRORISM AND HOMELAND SECURITY TRANSPORTATION AND INFRASTRUCTURE WORKFORCE AND WORKPLACE The RAND Corporation is a nonprofit research

Reflecting Warfighter Needs in Air Force Programs: Prototype Analysis

DTIC Science & Technology

2010-01-01

representation of RAND intellectual property is provided for non -commercial use only. Unauthorized posting of RAND PDFs to a non -RAND Web site is prohibited...duplicated for commercial purposes. Unauthorized posting of RAND documents to a non -RAND website is prohibited. RAND documents are protected under...Secretary of Defense for Acqui- sition, Technology, and Logistics (USD/AT&L). Step One is to sharpen understanding of the mission area and its seams

Do subfertile women adjust their habits when trying to conceive?

PubMed Central

Joelsson, Lana Salih; Berglund, Anna; Wånggren, Kjell; Lood, Mikael; Rosenblad, Andreas; Tydén, Tanja

2016-01-01

Aim The aim of this study was to investigate lifestyle habits and lifestyle adjustments among subfertile women trying to conceive. Materials and methods Women (n = 747) were recruited consecutively at their first visit to fertility clinics in mid-Sweden. Participants completed a questionnaire. Data were analyzed using logistic regression, t tests, and chi-square tests. Results The response rate was 62% (n = 466). Mean duration of infertility was 1.9 years. During this time 13.2% used tobacco daily, 13.6% drank more than three cups of coffee per day, and 11.6% consumed more than two glasses of alcohol weekly. In this sample, 23.9% of the women were overweight (body mass index, BMI 25–29.9 kg/m2), and 12.5% were obese (BMI ≥30 kg/m2). Obese women exercised more and changed to healthy diets more frequently than normal-weight women (odds ratio 7.43; 95% confidence interval 3.7–14.9). Six out of ten women (n = 266) took folic acid when they started trying to conceive, but 11% stopped taking folic acid after some time. Taking folic acid was associated with a higher level of education (p < 0.001). Conclusions Among subfertile women, one-third were overweight or obese, and some had other lifestyle factors with known adverse effects on fertility such as use of tobacco. Overweight and obese women adjusted their habits but did not reduce their body mass index. Women of fertile age would benefit from preconception counseling, and the treatment of infertility should routinely offer interventions for lifestyle changes. PMID:27216564

Is there a relationship between periodontal disease and smoking after adjusting for job classification in Japanese employed males?

PubMed

Morita, Ichizo; Sheiham, Aubrey; Nakagaki, Haruo; Yoshii, Saori; Mizuno, Kinichiro; Sabbah, Wael

2011-01-01

The objective of this study is to examine whether the well-known association between periodontal disease and smoking persists after adjusting for job classification. A sample of 16,110 employed Japanese males aged 20-69 years was included in the study. Periodontal examinations were conducted using the Community Periodontal Index. The association between periodontal disease and smoking status was examined using logistic regression adjusting for age, diabetes and job classification. Job classification was based on criteria of the Japanese Ministry of Health, Labour and Welfare. There are nine major job groups: (1) Professional (professionals, specialists), (2) Managers, (3) Office workers (computer operators, clerks, secretaries), (4) Skilled worker (factory workers, construction workers), (5) Salesperson (shop assistants), (6) Service occupations (superintendents, cleaners or car park attendants), (7) Security (guards), (8) Farmers and fishermen, (9) Transport and telecommunication workers (truck drivers). Current and former smokers were more likely to have periodontal disease than non-smokers. Adjusting for job classification attenuated the association between smoking and periodontal disease but did not eliminate the association. The odds ratios for the association between smoking and Community Periodontal Index score 3 or 4 attenuated from 2.25 to 2.04 and from 2.62 to 2.52 for individuals aged 20 to 39 and 40 to 69 years, respectively. The effect of job classification on the association between periodontal disease and smoking was higher among younger participants aged 20 to 39 years. Smoking persisted as an important determinant of periodontal disease after adjusting for job classification in Japanese employed males.

CATS EYES Adjustment Procedures

DTIC Science & Technology

1993-04-01

AL-TR-1 993-0025 AD-A264 069 CATS EYES ADJUSTMENT PROCEDURES A R M Joseph C. Antonio DTIC S ELECTET University of Dayton Research Institute MAY 13...Final November 1992 - January 1993 4. TITLE AND SUBTITLE S. FUNDING NUMBERS C F33615-90-C-0005 CATS EYES Adjustment Procedures PE - 62205F 6. AUTHOR(S) PR...the loss of NVG performance resulting from improper goggle adjustments. This report describes correct adjustment procedures for the CATS EYES NVG system

Quality of life and emotional state in chronic skin disease.

PubMed

Pärna, Ene; Aluoja, Anu; Kingo, Külli

2015-03-01

The aim of this study was to evaluate the associations between chronic inflammatory skin conditions and patients' emotional state and quality of life. The following self-rated questionnaires were used: Emotional State Questionnaire, a self-report scale assessing depression and anxiety symptoms; Dermatology Life Quality Index (DLQI); and RAND-36, a measure of health-related quality of life. The study group comprised 40 patients with psoriasis, 40 with eczema, 40 with acne, 15 with seborrhoeic dermatitis and 40 healthy controls. Patients with chronic skin diseases had lower DLQI and lower RAND-36 physical functioning scores, more perceived physical limitations and pain, and lower emotional well-being and general health ratings compared with the control group. In conclusion, chronic skin diseases are associated with symptoms of emotional distress, in particular insomnia and general anxiety.

Fitts’ Law in Early Postural Adjustments

PubMed Central

Bertucco, M.; Cesari, P.; Latash, M.L

2012-01-01

We tested a hypothesis that the classical relation between movement time and index of difficulty (ID) in quick pointing action (Fitts’ Law) reflects processes at the level of motor planning. Healthy subjects stood on a force platform and performed quick and accurate hand movements into targets of different size located at two distances. The movements were associated with early postural adjustments that are assumed to reflect motor planning processes. The short distance did not require trunk rotation, while the long distance did. As a result, movements over the long distance were associated with substantiual Coriolis forces. Movement kinematics and contact forces and moments recorded by the platform were studied. Movement time scaled with ID for both movements. However, the data could not be fitted with a single regression: Movements over the long distance had a larger intercept corresponding to movement times about 140 ms longer than movements over the shorter distance. The magnitude of postural adjustments prior to movement initiation scaled with ID for both short and long distances. Our results provide strong support for the hypothesis that Fitts’ Law emerges at the level of motor planning, not at the level of corrections of ongoing movements. They show that, during natural movements, changes in movement distance may lead to changes in the relation between movement time and ID, for example when the contribution of different body segments to the movement varies and when the action of Coriolis force may require an additional correction of the movement trajectory. PMID:23211560

Adaptive upstream optical power adjustment depending on required power budget in PON access

NASA Astrophysics Data System (ADS)

Yeh, C. H.; Chow, C. W.; Liu, Y. L.

2012-11-01

According to the present passive optical network (PON) standard, the fiber transmission lengths are from 500 m to 20 km between the optical line terminal (OLT) and different optical network units (ONUs). It will result in difference power losses (ΔPloss) from 4 to 5 dB. Hence, we propose to adjust adaptively the output optical power of the upstream laser diode (LD) depending on the different fiber lengths. With the different fiber transmission lengths, we can properly adjust the bias current and modulation index of upstream LD for energy-saving. We characterize and analyze experimentally the relationship of output optical power and modulation amplitude Vamp under different fiber transmissions in PON access. Moreover, due to the adaptive power control of upstream signal, the optical upstream equalization also can be retrieved with power variation of 1.1 dB in this experiment.

Impaired renal function is associated with worse self-reported outcomes after kidney transplantation.

PubMed

Neri, Luca; Dukes, Jonathan; Brennan, Daniel C; Salvalaggio, Paulo R; Seelam, Susmitha; Desiraju, Srividya; Schnitzler, Mark

2011-12-01

We sought to determine the association between health-related quality of life (HRQOL) and graft function in renal transplant recipients. We enrolled 577 kidney transplant recipients aged 18-74 years (response rate 87%). Recipients with multiple or multi-organ transplantation, creatine kinase >200 U/L, acute renal failure or cellular rejection (n = 64), and without creatinine assessments in 3 months pre-enrollment (n = 127) were excluded. The questionnaire included Euro QOL 5 Dimensions (EQ-5D), Health Utility Index III (HUI-III), Kidney Disease Quality of Life-36 (KDQOL36) which include a generic section (RAND SF-12). Data on medical conditions, therapy regimens, and biochemistry results were extracted from clinical charts. We used general linear models adjusted for demographic, socioeconomic, and clinical characteristics to assess the association between HRQOL and severity of chronic kidney disease (CKD). Patients with more advanced CKD were more likely to be African-American, covered by public insurance, more likely to have shorter time after transplantation, higher phosphorus and lower hemoglobin, serum albumin, and calcium levels. All HRQOL scales were inversely associated with CKD severity. All associations were robust to adjustment for possible confounders. Several health-related quality of life dimensions may be affected by poor renal function after transplantation.

Novel immunological and nutritional-based prognostic index for gastric cancer.

PubMed

Sun, Kai-Yu; Xu, Jian-Bo; Chen, Shu-Ling; Yuan, Yu-Jie; Wu, Hui; Peng, Jian-Jun; Chen, Chuang-Qi; Guo, Pi; Hao, Yuan-Tao; He, Yu-Long

2015-05-21

To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively. PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.

77 FR 76839 - Home Mortgage Disclosure (Regulation C): Adjustment To Asset-Size Exemption Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

...The Bureau of Consumer Financial Protection (Bureau) is publishing a final rule amending the official commentary that interprets the requirements of the Bureau's Regulation C (Home Mortgage Disclosure) to reflect a change in the asset-size exemption threshold for banks, savings associations, and credit unions based on the annual percentage change in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The exemption threshold is adjusted to increase to $42 million from $41 million. The adjustment is based on the 2.23 percent increase in the average of the CPI-W for the 12-month period ending in November 2012. Therefore, banks, savings associations, and credit unions with assets of $42 million or less as of December 31, 2012, are exempt from collecting data in 2013.

78 FR 79285 - Home Mortgage Disclosure (Regulation C): Adjustment to Asset-Size Exemption Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

...The Bureau of Consumer Financial Protection (Bureau) is publishing a final rule amending the official commentary that interprets the requirements of the Bureau's Regulation C (Home Mortgage Disclosure) to reflect a change in the asset-size exemption threshold for banks, savings associations, and credit unions based on the annual percentage change in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The exemption threshold is adjusted to increase to $43 million from $42 million. The adjustment is based on the 1.4 percent increase in the average of the CPI-W for the 12-month period ending in November 2013. Therefore, banks, savings associations, and credit unions with assets of $43 million or less as of December 31, 2013, are exempt from collecting data in 2014.

Cross-Cultural Adjustment of Chinese Students in Japan: School Adjustment and Educational Support

ERIC Educational Resources Information Center

Li, Yuan Xiang; Sano, Hideki; Ahn, Ruth

2013-01-01

This study investigates Chinese immigrant students' cross-cultural and school adjustment issues in Japanese schools. Using a quantitative method, a survey which collected students' demographic information, cross-cultural adjustment, and school adjustment questions was administered to 143 Chinese junior high and high school students in Tokyo and…

Psychological adjustment in Spanish young adult domestic adoptees: Mental health and licit substance consumption.

PubMed

Sánchez-Sandoval, Yolanda; Melero, Sandra

2018-05-24

Although adoptive families have been shown to provide a protective context for human development, some adopted children and adolescents are at increased risk for psychological adjustment problems. On the other hand, little is known about psychological adjustment of young adult adoptees. The aim of this study is to analyze the mental health and legal substance consumption (tobacco and alcohol) of young adults (n = 134) who were domestically adopted by Spanish families. Young adults showed significantly worse scores on the Symptom Check-List-90-R (Derogatis, 1975) and also more substance use than did the Spanish general population, but fewer difficulties than did the clinical population. On the Global Severity Index (GSI), 65.7% of adoptees were within the normal range, 24.6% were at risk, and 9.7% were within the clinical range. Male adoptees scored higher than expected for the general population on all subscales, whereas female adoptees did not. Age at adoption was not found to have a significant impact on adjustment. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Exercise addiction in men is associated with lower fat-adjusted leptin levels.

PubMed

Lichtenstein, Mia B; Andries, Alin; Hansen, Stinus; Frystyk, Jan; Støving, René K

2015-03-01

To test a hypothesized association between resting leptin levels (adjusted for body fat percentage) and symptoms of primary exercise addiction. Cross-sectional design. Habitual amateur exercisers participating in running, fitness, weight training, and biking. Twenty men with exercise addiction as defined by the Exercise Addiction Inventory (EAI scores 24-30) and 20 men in an exercise control group (EAI scores 6-16) matched on body mass index. Plasma leptin and sex hormones were measured in blood samples collected under fasting and resting conditions. Body composition was assessed by dual-energy x-ray absorptiometry. Eating disorder symptoms were identified by the Eating Disorder Inventory 2. The exercise addiction group had significantly (P < 0.001) lower leptin levels (1.1 μg/L, SD = 1.3) than controls (4.3 μg/L, SD = 2.9). Even when adjusted for body fat percentage, the addiction group had significantly (P < 0.001) lower leptin levels (0.1 μg/L, SD = 0.1) than the controls (0.2 μg/L, SD = 0.1). Body fat-adjusted leptin correlated with free bioavailable testosterone, but it was only significant in nonaddictive exercisers. None of the exercisers seemed to suffer from an eating disorder. This is the first study showing that excessive training in exercise addiction is associated with low levels of body fat-adjusted leptin levels. Hypoleptinemia could be involved in the pathogenesis of exercise addiction. However, further studies are needed to explore the potential causal relationship.

Adjustable task lighting: Field study assesses the benefits in an office environment.

PubMed

Joines, Sharon; James, Tamara; Liu, Siwen; Wang, Wenjiao; Dunn, Rebecca; Cohen, Shane

2015-01-01

Lighting is a part of every work task in the office environment, yet it is often overlooked. Research links direct and indirect glare to increased risk of visual discomfort among office workers with symptoms ranging from dry eyes to blurry vision or headaches. Researchers have been primarily concerned with those characteristics of task lighting that cause glare including luminance level, position (line of sight), and control. It is unknown what the benefits of adjustable task lights are and whether or not their use has an effect on musculoskeletal comfort or posture. No comprehensive field evaluations of this type were found among peer-reviewed, indexed journals. The purpose of this study was to assess the ergonomic and calculated utility power consumption benefits of adjustable LED task lighting in an office environment using a control/intervention experiment design. One hundred participants were originally recruited and randomly assigned to intervention and control groups. Self-reported data was collected on level of eye fatigue, perception of job content, intervention usability, and musculoskeletal discomfort. Data was also collected on workspace level of illumination and posture during standardized tasks (assessed using RULA). Comparing baseline data to follow-up data for the intervention group, the use of the adjustable, LED task lights provided statistically significant, positive impacts on users' rating of discomfort, eye fatigue, perception of job content, and posture between baseline and the short-term follow up. Significant benefits to musculoskeletal comfort, posture, and visual comfort were documented when participants used the adjustable task lights. Participants' assessments of the light's usability, usefulness and desirability were positive. There were no negative results found with adjustable task light use.

A regression model for calculating the second dimension retention index in comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry.

PubMed

Wang, Bing; Shen, Hao; Fang, Aiqin; Huang, De-Shuang; Jiang, Changjun; Zhang, Jun; Chen, Peng

2016-06-17

Comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry (GC×GC/TOF-MS) system has become a key analytical technology in high-throughput analysis. Retention index has been approved to be helpful for compound identification in one-dimensional gas chromatography, which is also true for two-dimensional gas chromatography. In this work, a novel regression model was proposed for calculating the second dimension retention index of target components where n-alkanes were used as reference compounds. This model was developed to depict the relationship among adjusted second dimension retention time, temperature of the second dimension column and carbon number of n-alkanes by an exponential nonlinear function with only five parameters. Three different criteria were introduced to find the optimal values of parameters. The performance of this model was evaluated using experimental data of n-alkanes (C7-C31) at 24 temperatures which can cover all 0-6s adjusted retention time area. The experimental results show that the mean relative error between predicted adjusted retention time and experimental data of n-alkanes was only 2%. Furthermore, our proposed model demonstrates a good extrapolation capability for predicting adjusted retention time of target compounds which located out of the range of the reference compounds in the second dimension adjusted retention time space. Our work shows the deviation was less than 9 retention index units (iu) while the number of alkanes were added up to 5. The performance of our proposed model has also been demonstrated by analyzing a mixture of compounds in temperature programmed experiments. Copyright © 2016 Elsevier B.V. All rights reserved.

SLIT ADJUSTMENT CLAMP

DOEpatents

McKenzie, K.R.

1959-07-01

An electrode support which permits accurate alignment and adjustment of the electrode in a plurality of planes and about a plurality of axes in a calutron is described. The support will align the slits in the electrode with the slits of an ionizing chamber so as to provide for the egress of ions. The support comprises an insulator, a leveling plate carried by the insulator and having diametrically opposed attaching screws screwed to the plate and the insulator and diametrically opposed adjusting screws for bearing against the insulator, and an electrode associated with the plate for adjustment therewith.

Do Flexible Goal Adjustment and Acceptance Help Preserve Quality of Life in Patients with Multiple Sclerosis?

PubMed

Van Damme, Stefaan; De Waegeneer, Annelies; Debruyne, Jan

2016-06-01

Goal regulation strategies such as flexible goal adjustment and acceptance are believed to be protective factors in persons with chronic illness, but research on their relative contributions to quality of life in multiple sclerosis (MS) is lacking. We aimed to test the idea that acceptance and flexible goal adjustment (in contrast to tenacious goal pursuit) may help preserve the quality of life in persons with MS. A sample of 117 patients with MS was recruited. They completed questionnaires measuring quality of life (physical functioning, psychological distress), acceptance, flexible goal adjustment, and tenacious goal pursuit. Acceptance significantly accounted for variance in all three indexes of quality of life, beyond the effects of demographic and illness characteristics. The role of goal regulation style was less clear. Flexible goal adjustment significantly accounted for psychological well-being only. Surprisingly, tenacious goal pursuit predicted better psychological functioning and less psychological distress. No support was found for the hypothesis that acceptance and flexible goal adjustment would moderate the relation between illness severity and quality of life. The findings suggest the potential importance of acceptance in understanding MS patients' quality of life, although its hypothesized protective function could not be confirmed. Further conceptual work on acceptance and goal regulation style is needed, as well as prospective work investigating their causal status.

Aerobic granulation in a modified oxidation ditch with an adjustable volume intraclarifier.

PubMed

Li, Jun; Cai, Ang; Wang, Miao; Ding, Libin; Ni, Yongjiong

2014-04-01

A modified oxidation ditch (MOD) with an adjustable volume intraclarifier was proposed and used to achieve aerobic sludge granulation in continuous flow process. This MOD with working volume of 60L treated onsite wastewater from a town. Excellent aerobic granules with mean diameter of 600μm and sludge volume index (SVI) of 44mL/g were obtained in 120day. Bacterial community analysis revealed that most species from seed sludge were preserved in both MOD and granule SBR (G-SBR) except bacteria (Bacteroidetes) might be easily washed out during granulation. Some different bacterial communities were found in sludges from sequencing batch and continuous flow reactors. Presence of metal ions and inorganics in raw wastewater had positive effect on granule formation, but an adjustable volume intraclarifier for controlling selection pressure and deleting return sludge pump played a key role in aerobic sludge granulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Changes in psychosocial adjustment of adolescent girls in the lessons of physical education.

PubMed

Klizas, Šarūnas; Malinauskas, Romualdas; Karanauskienė, Diana; Senikienė, Žibuoklė; Klizienė, Irina

2012-01-01

The aim of the present study was to establish the changes in psychosocial adjustment of adolescent girls in the modified lessons of physical education. An experimental design was used in the study. The experimental group included 14- to 15-year-old adolescent girls (n=128), and the control group comprised adolescent girls of the same school and the same age (n=137). The girls of the experimental group participated in modified physical education lessons. Once a month, they had a theory class where they received knowledge on communication disorders among adolescents and ways of preventing them by means of physical activities. In practical classes, the girls of the experimental group had sports games (basketball, volleyball, and football), enhancing physical abilities, and Pilates exercises. For the estimation of the level of adolescents' psychosocial adjustment and its components (self-esteem and domination), an adapted questionnaire developed by Rogers and Dymond was applied. An adapted questionnaire developed by Huebner was administered to measure students' satisfaction with life. The analysis of the data demonstrated that when comparing the psychosocial adjustment of the adolescent girls in the experimental group before and after the experiment, a significant differences in the score of the psychosocial adjustment scale was established (53.81±8.34 vs. 59.41±7.66, P<0.05). After the experiment, high life satisfaction was reported by 42.19% of the girls (P<0.05). After the educational experiment, the index of the psychosocial adjustment scale in the experimental group improved statistically significantly.

Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea

PubMed Central

Lettieri, Christopher J.; Paolino, Nathalie; Eliasson, Arn H.; Shah, Anita A.; Holley, Aaron B.

2011-01-01

Study Objectives: To compare the efficacy of adjustable and fixed oral appliances for the treatment of OSA. Methods: Retrospective review of consecutive patients with OSA treated with either adjustable or fixed oral appliances. Polysomnography was conducted before and during therapy. Effective treatment was defined as an apnea-hypopnea index (AHI) < 5 events/h or < 10 events/h with resolution of sleepiness (Epworth < 10). We compared efficacy rates between fixed and adjustable appliances and sought to identify factors associated with greater success. Results: We included 805 patients, 602 (74.8%) treated with an adjustable and 203 (25.2%) a fixed oral appliances. Among the cohort, 86.4% were men; mean age was 41.3 ± 9.2 years. Mean AHI was 30.7 ± 25.6, with 34.1% having mild (AHI 5-14.9), 29.2% moderate (AHI 15-29.9), and 36.8% severe (AHI ≥ 30) OSA. Successful therapy was significantly more common with adjustable appliances. Obstructive events were reduced to < 5/h in 56.8% with adjustable compared to 47.0% with fixed appliances (p = 0.02). Similarly, a reduction of events to < 10 with resolution of sleepiness occurred in 66.4% with adjustable appliances versus 44.9% with fixed appliances (p < 0.001). For both devices, success was more common in younger patients, with lower BMI and less severe disease. Conclusions: Adjustable devices produced greater reductions in obstructive events and were more likely to provide successful therapy, especially in moderate-severe OSA. Fixed appliances were effective in mild disease, but were less successful in those with higher AHIs. Given these findings, the baseline AHI should be considered when selecting the type of oral appliance. Citation: Lettieri CJ; Paolino N; Eliasson AH; Shah AA; Holley AB. Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea. J Clin Sleep Med 2011;7(5):439-445. PMID:22003337

Doppler indexes of left ventricular systolic and diastolic flow and central pulse pressure in relation to renal resistive index.

PubMed

Kuznetsova, Tatiana; Cauwenberghs, Nicholas; Knez, Judita; Thijs, Lutgarde; Liu, Yan-Ping; Gu, Yu-Mei; Staessen, Jan A

2015-04-01

The cardio-renal interaction occurs via hemodynamic and humoral factors. Noninvasive assessment of renal hemodynamics is currently possible by assessment of renal resistive index (RRI) derived from intrarenal Doppler arterial waveforms as ((peak systolic velocity - end-diastolic velocity)/peak systolic velocity). Limited information is available regarding the relationship between RRI and cardiac hemodynamics. We investigated these associations in randomly recruited subjects from a general population. In 171 participants (48.5% women; mean age, 52.2 years), using pulsed wave Doppler, we measured RRI (mean, 0.60) and left ventricular outflow tract (LVOT) and transmitral (E and A) blood flow peak velocities and its velocity time integrals (VTI). Using carotid applanation tonometry, we measured central pulse pressure and arterial stiffness indexes such as augmentation pressure and carotid-femoral pulse wave velocity. In stepwise regression analysis, RRI independently and significantly increased with female sex, age, body weight, brachial pulse pressure, and use of β-blockers, whereas it decreased with body height and mean arterial pressure. In multivariable-adjusted models with central pulse pressure and arterial stiffness indexes as the explanatory variables, we observed a significant and positive correlation of RRI only with central pulse pressure (P < 0.0001). Among the Doppler indexes of left ventricular blood flow, RRI was significantly and positively associated with LVOT and E peak velocities (P ≤ 0.012) and VTIs (P ≤ 0.010). We demonstrated that in unselected subjects RRI was significantly associated with central pulse pressure and left ventricular systolic and diastolic Doppler blood flow indexes. Our findings imply that in addition to the anthropometric characteristics, cardiac hemodynamic factors influence the intrarenal arterial Doppler waveform patterns. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email

Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

PubMed Central

2010-01-01

Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs). However, a recent report described a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP) as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI) and the Helkimo Clinical Dysfunction Index (CDI) before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p < 0.001). The changes in the mean HOP-BPOP differences on the x-axis (mediolateral) and the y-axis (anteroposterior) were significant (p < 0.05), whereas the change on the z-axis (superoinferior) was not significant (p > 0.1). Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted. PMID:20346167

Context Specificity of Post-Error and Post-Conflict Cognitive Control Adjustments

PubMed Central

Forster, Sarah E.; Cho, Raymond Y.

2014-01-01

There has been accumulating evidence that cognitive control can be adaptively regulated by monitoring for processing conflict as an index of online control demands. However, it is not yet known whether top-down control mechanisms respond to processing conflict in a manner specific to the operative task context or confer a more generalized benefit. While previous studies have examined the taskset-specificity of conflict adaptation effects, yielding inconsistent results, control-related performance adjustments following errors have been largely overlooked. This gap in the literature underscores recent debate as to whether post-error performance represents a strategic, control-mediated mechanism or a nonstrategic consequence of attentional orienting. In the present study, evidence of generalized control following both high conflict correct trials and errors was explored in a task-switching paradigm. Conflict adaptation effects were not found to generalize across tasksets, despite a shared response set. In contrast, post-error slowing effects were found to extend to the inactive taskset and were predictive of enhanced post-error accuracy. In addition, post-error performance adjustments were found to persist for several trials and across multiple task switches, a finding inconsistent with attentional orienting accounts of post-error slowing. These findings indicate that error-related control adjustments confer a generalized performance benefit and suggest dissociable mechanisms of post-conflict and post-error control. PMID:24603900

Development Of Index To Assess Drought Conditions Using Geospatial Data A Case Study Of Jaisalmer District, Rajasthan, India

NASA Astrophysics Data System (ADS)

Chhajer, Vaidehi; Prabhakar, Sumati; Rama Chandra Prasad, P.

2015-12-01

The Jaisalmer district of Rajasthan province of India was known to suffer with frequent drought due to poor and delayed monsoon, abnormally high summer-temperature and insufficient water resources. However flood-like situation prevails in the drought prone Jaisalmer district of Rajasthan as torrential rains are seen to affect the region in the recent years. In the present study, detailed analysis of meteorological, hydrological and satellite data of the Jaisalmer district has been carried out for the years 2006-2008. Standardized Precipitation Index (SPI), Consecutive Dry Days (CDD) and Effective Drought Index (EDI) have been used to quantify the precipitation deficit. Standardized Water-Level Index (SWI) has been developed to assess ground-water recharge-deficit. Vegetative drought indices like Vegetation Condition Index (VCI), Temperature Condition Index (TCI), Vegetation Health Index (VHI), Normalized Difference Vegetation Index (NDVI) and Modified Soil-Adjusted Vegetation Index 2 have been calculated. We also introduce two new indices Soil based Vegetation Condition Index (SVCI) and Composite Drought Index (CDI) specifically for regions like Jaisalmer where aridity in soil and affects vegetation and water-level.

Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.

PubMed

Martínez-González, Miguel A; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

2014-01-01

Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Controlled-Trials.com ISRCTN35739639.

Single-pulse interference caused by temporal reflection at moving refractive-index boundaries

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

Plansinis, Brent W.; Donaldson, William R.; Agrawal, Govind P.

Here, we show numerically and analytically that temporal reflections from a moving refractive-index boundary act as an analog of Lloyd’s mirror, allowing a single pulse to produce interference fringes in time as it propagates inside a dispersive medium. This interference can be viewed as the pulse interfering with a virtual pulse that is identical to the first, except for a π-phase shift. Furthermore, if a second moving refractive-index boundary is added to create the analog of an optical waveguide, a single pulse can be self-imaged or made to produce two or more pulses by adjusting the propagation length in amore » process similar to the Talbot effect.« less

Single-pulse interference caused by temporal reflection at moving refractive-index boundaries

DOE PAGES

Plansinis, Brent W.; Donaldson, William R.; Agrawal, Govind P.

2017-09-29

Here, we show numerically and analytically that temporal reflections from a moving refractive-index boundary act as an analog of Lloyd’s mirror, allowing a single pulse to produce interference fringes in time as it propagates inside a dispersive medium. This interference can be viewed as the pulse interfering with a virtual pulse that is identical to the first, except for a π-phase shift. Furthermore, if a second moving refractive-index boundary is added to create the analog of an optical waveguide, a single pulse can be self-imaged or made to produce two or more pulses by adjusting the propagation length in amore » process similar to the Talbot effect.« less

The effect of accuracy motivation on anchoring and adjustment: do people adjust from provided anchors?

PubMed

Simmons, Joseph P; LeBoeuf, Robyn A; Nelson, Leif D

2010-12-01

Increasing accuracy motivation (e.g., by providing monetary incentives for accuracy) often fails to increase adjustment away from provided anchors, a result that has led researchers to conclude that people do not effortfully adjust away from such anchors. We challenge this conclusion. First, we show that people are typically uncertain about which way to adjust from provided anchors and that this uncertainty often causes people to believe that they have initially adjusted too far away from such anchors (Studies 1a and 1b). Then, we show that although accuracy motivation fails to increase the gap between anchors and final estimates when people are uncertain about the direction of adjustment, accuracy motivation does increase anchor-estimate gaps when people are certain about the direction of adjustment, and that this is true regardless of whether the anchors are provided or self-generated (Studies 2, 3a, 3b, and 5). These results suggest that people do effortfully adjust away from provided anchors but that uncertainty about the direction of adjustment makes that adjustment harder to detect than previously assumed. This conclusion has important theoretical implications, suggesting that currently emphasized distinctions between anchor types (self-generated vs. provided) are not fundamental and that ostensibly competing theories of anchoring (selective accessibility and anchoring-and-adjustment) are complementary. PsycINFO Database Record (c) 2010 APA, all rights reserved.

Medium-Index Mixed-Oxide Layers for Use in AR-Coatings

NASA Astrophysics Data System (ADS)

Ganner, Peter

1986-10-01

Ttedesign philosophy of MC-AR-Coatings can be divided into two categories: a) Restriction to two film materials, namely one high-index and one low-index material and b) Use of medium-index layers in addition to high- and low-index layers. Both philosophies have advan-tages and drawbacks. In case a) the total number of layers necessary to obtain a required reflectance curve has to be higher. Thus in case of production errors it can be a problem to find out which layer was responsible for a deviation of the measured reflectance from the nominal one. In case b) using more than two materials reduces the total number of layers and consequently, pinpointing the cause of even small production errors is made simpler. Unfortunately there are not many materials commercially available which can be used to make hard, durable and robust films in the medium-index range namely between n=1.65 and n=2.00. In this paper the results of homogeneous mixtures of Alumina (Al203) and Tantala (Ta205) used for EB-gun evaporated medium-index films in AR-coatings is presented. It is shown that by proper adjustment of the weight percentages of the oxide mixture one can get homogeneous films in this index range. A number of design examples show the favourable application of such layers in AR-coatings. Among the most important ones is the well known QHQ-design for BBAR-coatings as well as AR-designs of the multiple half wave type with extended bandwidth. Further applications of the mixed-oxide layers are AR-coatings for cemented optical elements and beam splitters.

The utility of fat mass index vs. body mass index and percentage of body fat in the screening of metabolic syndrome.

PubMed

Liu, Pengju; Ma, Fang; Lou, Huiping; Liu, Yanping

2013-07-03

It has been well documented that obesity is closely associated with metabolic syndrome (MetS). Although body mass index (BMI) is the most frequently used method to assess overweightness and obesity, this method has been criticized because BMI does not always reflect true body fatness, which may be better evaluated by assessment of body fat and fat-free mass. The objective of this study was to investigate the best indicator to predict the presence of MetS among fat mass index, BMI and percentage of body fat (BF %) and determine its optimal cut-off value in the screening of MetS in practice. A cross-sectional study of 1698 subjects (aged 20-79 years) who participated in the annual health check-ups was employed. Body composition was measured by bioelectrical impedance analysis (BIA). Fat mass index (FMI) was calculated. Sex-specific FMI quartiles were defined as follows: Q1: <4.39, Q2:4.39- < 5.65, Q3:5.65- < 7.03, Q4:≥7.03,in men; and Q1:<5.25, Q2:5.25- < 6.33, Q3:6.33- < 7.93,Q4:≥7.93, in women. MetS was defined by National Cholesterol Education Program/Adult Treatment Panel III criteria. The association between FMI quartiles and MetS was assessed using Binary logistic regression. Receiver operating curve (ROC) analysis was used to determine optimal cutoff points for BMI,BF% and FMI in relation to the area under the curve (AUC), sensitivity and specificity in men and women. The adjusted odds ratios (95% CI) for the presence of MetS in the highest FMI quartile versus lowest quartile were 79.143(21.243-294.852) for men (P < 0.01) and 52.039(4.144-653.436) for women (P < 0.01) after adjusting age, BMI, BF%, TC, LDL, CRP, smoking status and exercise status, and the odds ratios were 9.166(2.157-38.952) for men (P < 0.01) and 25.574(1.945-336.228) for women (P < 0.05) when WC was also added into the adjustment. It was determined that BMI values of 27.45 and 23.85 kg/m2, BF% of 23.95% and 31.35% and FMI of 7.00 and 7.90 kg/m2 were the

The Effect of Complementary and Alternative Medicine Claims on Risk Adjustment

PubMed Central

Lind, Bonnie K.; Abrams, Chad; Lafferty, William E.; Kiehr, Paula K.; Grembowski, David E.

2006-01-01

Objective To assess how the inclusion of diagnoses from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients. Methods Claims data from Washington State were used to create two versions of a case-mix index. One version included claims from all provider types; the second version omitted claims from CAM providers who are covered under commercial insurance. Expected resource use was also calculated. The distribution of expected and actual resource use was then compared for the two indices. Results Inclusion of CAM providers shifts many patients into higher morbidity categories; 54% of 61,914 CAM users had higher risk scores in the index which included CAM providers. When expected resource use categories were defined based on all providers, CAM users in the highest morbidity category had average (± s.d.) annual expenditures of $6661 (± $13,863). This was less than those in the highest morbidity category when CAM providers were not included in the index ($8562 ± $16,354), and was also lower than the highest morbidity patients who did not use any CAM services ($8419 ± $18,885). Conclusions Inclusion of services from CAM providers under third party payment increases risk scores for their patients but expectations of costs for this group are lower than expected had costs been estimated based only on services from traditional providers. Additional work is needed to validate risk adjustment indices when adding services from provider groups not included in the development of the index. PMID:17122711

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2014 CFR

2014-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2013 CFR

2013-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2012 CFR

2012-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

Prediction of WBGT-based clothing adjustment values from evaporative resistance.

PubMed

Bernard, Thomas E; Ashley, Candi D; Garzon, Ximena P; Kim, Jung-Hyun; Coca, Aitor

2017-12-07

Wet bulb globe temperature (WBGT) index is used by many professionals in combination with metabolic rate and clothing adjustments to assess whether a heat stress exposure is sustainable. The progressive heat stress protocol is a systematic method to prescribe a clothing adjustment value (CAV) from human wear trials, and it also provides an estimate of apparent total evaporative resistance (R e,T,a ). It is clear that there is a direct relationship between the two descriptors of clothing thermal effects with diminishing increases in CAV at high R e,T,a . There were data to suggest an interaction of CAV and R e,T,a with relative humidity at high evaporative resistance. Because human trials are expensive, manikin data can reduce the cost by considering the static total evaporative resistance (R e,T,s ). In fact, as the static evaporative resistance increases, the CAV increases in a similar fashion as R e,T,a . While the results look promising that R e,T,s can predict CAV, some validation remains, especially for high evaporative resistance. The data only supports air velocities near 0.5 m/s.

The relationship between body mass index and uric acid: a study on Japanese adult twins.

PubMed

Tanaka, Kentaro; Ogata, Soshiro; Tanaka, Haruka; Omura, Kayoko; Honda, Chika; Hayakawa, Kazuo

2015-09-01

The present study aimed to investigate the association between body mass index (BMI) and uric acid (UA) using the twin study methodology to adjust for genetic factors. The association between BMI and UA was investigated in a cross-sectional study using data from both monozygotic and dizygotic twins registered at the Osaka University Center for Twin Research and the Osaka University Graduate School of Medicine. From January 2011 to March 2014, 422 individuals participated in the health examination. We measured height, weight, age, BMI, lifestyle habits (Breslow's Health Practice Index), serum UA, and serum creatinine. To investigate the association between UA and BMI with adjustment for the clustering of a twin within a pair, individual-level analyses were performed using generalized linear mixed models (GLMMs). To investigate an association with adjustment for genetic and family environmental factors, twin-pair difference values analyses were performed. In all analysis, BMI was associated with UA in men and women. Using the GLMMs, standardized regression coefficients were 0.194 (95 % confidence interval: 0.016-0.373) in men and 0.186 (95 % confidence interval: 0.071-0.302) in women. Considering twin-pair difference value analyses, standardized regression coefficients were 0.333 (95 % confidence interval: 0.072-0.594) in men and 0.314 (95 % confidence interval: 0.151-0.477) in women. The present study shows that BMI was significantly associated with UA, after adjusting for both genetic and familial environment factors in both men and women.

The influence of the winter North Atlantic Oscillation index on hospital admissions through diseases of the circulatory system in Lisbon, Portugal.

PubMed

Almendra, Ricardo; Santana, Paula; Vasconcelos, João; Silva, Giovani; Gonçalves, Fábio; Ambrizzi, Tércio

2017-02-01

The aim of this paper is to analyze the relationship between North Atlantic Oscillation (NAO), meteorological variables, air pollutants, and hospital admissions due to diseases of circulatory systems in Lisbon (Portugal) during winter months (2003-2012). This paper is one of the few studies analyzing the impact of NAO on health through its influence on thermal stress and air pollution and is the first to be conducted in Lisbon. This study uses meteorological data (synthetized into a thermal comfort index), air pollutant metrics, and the NAO index (all clustered in 10-day cycles to overcome daily variability of the NAO index). The relationship between morbidity, thermal comfort index, NAO index, and air pollutants was explored through several linear models adjusted to seasonality through a periodic function. The possible indirect effect between the NAO index and hospital admissions was tested, assuming that NAO (independent variable) is affecting hospital admissions (outcome variable) through thermal discomfort and/or pollution levels (tested as individual mediators). This test was conducted through causal mediation analysis and adjusted for seasonal variation. The results from this study suggest a possible indirect relationship between NAO index and hospital admissions. Although NAO is not significantly associated with hospital admissions, it is significantly associated with CO, PM 2.5 , NO, and SO 2 levels, which in turn increase the probability of hospitalization. The discomfort index (built with temperature and relative humidity) is significantly associated with hospital admissions, but its variability is not explained by the NAO index. This study highlights the impacts of the atmospheric circulation patterns on health. Furthermore, understanding the influence of the atmospheric circulation patterns can support the improvement of the existing contingency plans.

Resource and cost adjustment in the design of allocation funding formulas in public health programs.

PubMed

Buehler, James W; Bernet, Patrick M; Ogden, Lydia L

2012-01-01

Multiple federal public health programs use funding formulas to allocate funds to states. To characterize the effects of adjusting formula-based allocations for differences among states in the cost of implementing programs, the potential for generating in-state resources, and income disparities, which might be associated with disease risk. Fifty US states and the District of Columbia. Formula-based funding allocations to states for 4 representative federal public health programs were adjusted using indicators of cost (average salaries), potential within-state revenues (per-capita income, the Federal Medical Assistance Percentage, per-capita aggregate home values), and income disparities (Theil index). Percentage of allocation shifted by adjustment, the number of states and the percentage of US population living in states with a more than 20% increase or decrease in funding, maximum percentage increase or decrease in funding. Each adjustor had a comparable impact on allocations across the 4 program allocations examined. Approximately 2% to 8% of total allocations were shifted, with adjustments for variations in income disparity and housing values having the least and greatest effects, respectively. The salary cost and per-capita income adjustors were inversely correlated and had offsetting effects on allocations. With the exception of the housing values adjustment, fewer than 10 states had more than 20% increases or decreases in allocations, and less than 10% of the US population lived in such states. Selection of adjustors for formula-based funding allocations should consider the impacts of different adjustments, correlations between adjustors and other data elements in funding formulas, and the relationship of formula inputs to program objectives.

Leveraging Observations of Security Force Assistance in Afghanistan for Global Operations

DTIC Science & Technology

2013-01-01

commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under...copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use . For...contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of

Comparison of U.S. Geological Survey and Ohio Environmental Protection Agency fish-collection methods using the index of biotic integrity and modified index of well-being, 1996-97

USGS Publications Warehouse

Covert, S. Alex

2001-01-01

The U.S. Geological Survey (USGS) and Ohio Environmental Protection Agency (OEPA) collected data on fish from 10 stream sites in 1996 and 3 stream sites in 1997 as part of a comparative study of fish community assessment methods. The sites sampled represent a wide range of basin sizes (ranging from 132?6,330 square kilometers) and surrounding land-use types (urban, agricultural, and mixed). Each agency used its own fish-sampling protocol. Using the Index of Biotic Integrity and Modified Index of Well-Being, differences between data sets were tested for significance by means of the Wilcoxon signed-ranks test (a = 0.05). Results showed that the median of Index of Biotic Integrity differences between data sets was not significantly different from zero (p = 0.2521); however, the same statistical test showed the median differences in the Modified Index of Well-Being scores to be significantly different from zero (p = 0.0158). The differences observed in the Index of Biotic Integrity scores are likely due to natural variability, increased variability at sites with degraded water quality, differences in sampling methods, and low-end adjustments in the Index of Biotic Integrity calculation when fewer than 50 fish were collected. The Modified Index of Well-Being scores calculated by OEPA were significantly higher than those calculated by the USGS. This finding was attributed to the comparatively large numbers and biomass of fish collected by the OEPA. By combining the two indices and viewing them in terms of the percentage attainment of Ohio Warmwater Habitat criteria, the two agencies? data seemed comparable, although the Index of Biotic Integrity scores were more similar than the Modified Index of Well-Being scores.

Psoas and paraspinous muscle index as a predictor of mortality in African American men with type 2 diabetes mellitus.

PubMed

Murea, Mariana; Lenchik, Leon; Register, Thomas C; Russell, Gregory B; Xu, Jianzhao; Smith, S Carrie; Bowden, Donald W; Divers, Jasmin; Freedman, Barry I

2018-06-01

Recent studies revealed a correlation between skeletal muscle mass index and density with longevity; these studies largely evaluated appendicular skeletal muscles in older Caucasians. This retrospective cohort study assessed the association between axial skeletal muscles size and density with survival in African Americans with type 2 diabetes mellitus. Psoas and paraspinous muscle mass index (cross sectional area/height 2 ) and radiographic density (in Hounsfield Units) were measured using computed tomography in African American-Diabetes Heart Study participants, 314 women and 256 men, with median (25th, 75th quartile) age 55.0(48.0, 62.0) and 57.0(50.0, 64.0) years, respectively. Covariates in fully-adjusted model included age, sex, BMI, smoking, hormone replacement therapy (women), cardiovascular disease, hypertension, coronary artery calcified plaque mass, carotid artery calcified plaque mass, and African ancestry proportion. After median of 7.1(5.9, 8.2) years follow-up, 30(9.6%) of women and 49(19.1%) of men were deceased. In fully-adjusted models, psoas muscle mass index and paraspinous muscle mass index were inversely associated with mortality in men (psoas muscle mass index, hazard ratio [HR] = 0.61, P = 0.004; paraspinous muscle mass index, HR = 0.64, P = 0.004), but not in women. Psoas and paraspinous muscle densities did not associate with all-cause mortality. A penalized Cox regression that involved all covariates and predictors associated with mortality showed that only paraspinous muscle mass index remained a significant predictor of mortality (HR = 0.65, P = 0.02). Independent from established risk factors for mortality, higher psoas and paraspinous muscle index associate with reduced all-cause mortality in middle-aged African American men with type 2 diabetes mellitus. Copyright © 2018 Elsevier Inc. All rights reserved.

Is weight-based adjustment of automatic exposure control necessary for the reduction of chest CT radiation dose?

PubMed

Prakash, Priyanka; Kalra, Mannudeep K; Gilman, Matthew D; Shepard, Jo-Anne O; Digumarthy, Subba R

2010-01-01

To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 +/- 3.1) and weight-adjusted (16.1 +/- 5.6) AEC techniques (p > 0.05). The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT.

"Weekend effect" on stroke mortality revisited: Application of a claims-based stroke severity index in a population-based cohort study.

PubMed

Hsieh, Cheng-Yang; Lin, Huey-Juan; Chen, Chih-Hung; Li, Chung-Yi; Chiu, Meng-Jun; Sung, Sheng-Feng

2016-06-01

Previous studies have yielded inconsistent results on whether weekend admission is associated with increased mortality after stroke, partly because of differences in case mix. Claims-based studies generally lack sufficient information on disease severity and, thus, suffer from inadequate case-mix adjustment. In this study, we examined the effect of weekend admission on 30-day mortality in patients with ischemic stroke by using a claims-based stroke severity index.This was an observational study using a representative sample of the National Health Insurance claims data linked to the National Death Registry. We identified patients hospitalized for ischemic stroke, and examined the effect of weekend admission on 30-day mortality with vs without adjustment for stroke severity by using multilevel logistic regression analysis adjusting for patient-, physician-, and hospital-related factors. We analyzed 46,007 ischemic stroke admissions, in which weekend admissions accounted for 23.0%. Patients admitted on weekends had significantly higher 30-day mortality (4.9% vs 4.0%, P < 0.001) and stroke severity index (7.8 vs 7.4, P < 0.001) than those admitted on weekdays. In multivariate analysis without adjustment for stroke severity, weekend admission was associated with increased 30-day mortality (odds ratio (OR), 1.20; 95% confidence interval [CI], 1.08-1.34). This association became null after adjustment for stroke severity (OR, 1.07; 95% CI, 0.95-1.20).The "weekend effect" on stroke mortality might be attributed to higher stroke severity in weekend patients. While claims data are useful for examining stroke outcomes, adequate adjustment for stroke severity is warranted.

Calibration of the physiological equivalent temperature index for three different climatic regions

NASA Astrophysics Data System (ADS)

Krüger, E.; Rossi, F.; Drach, P.

2017-07-01

In human biometeorology, the integration of several microclimatic variables as a combined index facilitates the understanding of how users perceive thermal environments. Indices, such as the physiological equivalent temperature (PET) index, translate the combined effects of meteorological variables on humans in terms of thermal stress or comfort and serve as important aids to climate-responsive urban and regional planning as well as heat stress and thermal comfort analyses. However, there is a need for adjusting proposed comfort/stress ranges of a given index when using it in different climatic contexts. The purpose of this study is to present a preliminary calibration procedure for the PET index for three different climatic regions: Curitiba, Brazil, a subtropical location; Rio de Janeiro, Brazil, a tropical city; and Glasgow, UK, a high-latitude location. Field studies have been carried out by the authors according to a similar protocol and using similar equipment, yielding actual thermal sensation votes and microclimate data, post-processed as PET data. The calibration procedure uses exclusively thermal sensation data as reported by pedestrians during outdoor comfort campaigns and concurrent microclimatic data recorded during the interviews. PET comfort/stress classes differ among the three locations and, in general, are less restrictive as in the original ranges proposed by the index developers.

Promoting International Energy Security. Volume 3: Sea-Lanes to Asia

DTIC Science & Technology

2012-01-01

commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under...copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use . For...trademark. © Copyright 2012 RAND Corporation Permission is given to duplicate this document for personal use only, as long as it is unaltered and

Assessment of the Content, Design, and Dissemination of the Real Warriors Campaign

DTIC Science & Technology

2012-01-01

by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non...commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under...copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For

Assessment of Beddown Alternatives for the F-35

DTIC Science & Technology

2013-01-01

For More Information Visit RAND at www.rand.org Explore the RAND Corporation View document details Support RAND Purchase this document Browse Reports...copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information ...HOMELAND SECURITY Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to

Adjustable link for kinematic mounting systems

DOEpatents

Hale, Layton C.

1997-01-01

An adjustable link for kinematic mounting systems. The adjustable link is a low-cost, passive device that provides backlash-free adjustment along its single constraint direction and flexural freedom in all other directions. The adjustable link comprises two spheres, two sockets in which the spheres are adjustable retain, and a connection link threadly connected at each end to the spheres, to provide a single direction of restraint and to adjust the length or distance between the sockets. Six such adjustable links provide for six degrees of freedom for mounting an instrument on a support. The adjustable link has applications in any machine or instrument requiring precision adjustment in six degrees of freedom, isolation from deformations of the supporting platform, and/or additional structural damping. The damping is accomplished by using a hollow connection link that contains an inner rod and a viscoelastic separation layer between the two.

Adjustable link for kinematic mounting systems

DOEpatents

Hale, L.C.

1997-07-01

An adjustable link for kinematic mounting systems is disclosed. The adjustable link is a low-cost, passive device that provides backlash-free adjustment along its single constraint direction and flexural freedom in all other directions. The adjustable link comprises two spheres, two sockets in which the spheres are adjustable retain, and a connection link threadly connected at each end to the spheres, to provide a single direction of restraint and to adjust the length or distance between the sockets. Six such adjustable links provide for six degrees of freedom for mounting an instrument on a support. The adjustable link has applications in any machine or instrument requiring precision adjustment in six degrees of freedom, isolation from deformations of the supporting platform, and/or additional structural damping. The damping is accomplished by using a hollow connection link that contains an inner rod and a viscoelastic separation layer between the two. 3 figs.

Assessment of Differential Item Functioning in the Experiences of Discrimination Index

PubMed Central

Cunningham, Timothy J.; Berkman, Lisa F.; Gortmaker, Steven L.; Kiefe, Catarina I.; Jacobs, David R.; Seeman, Teresa E.; Kawachi, Ichiro

2011-01-01

The psychometric properties of instruments used to measure self-reported experiences of discrimination in epidemiologic studies are rarely assessed, especially regarding construct validity. The authors used 2000–2001 data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study to examine differential item functioning (DIF) in 2 versions of the Experiences of Discrimination (EOD) Index, an index measuring self-reported experiences of racial/ethnic and gender discrimination. DIF may confound interpretation of subgroup differences. Large DIF was observed for 2 of 7 racial/ethnic discrimination items: White participants reported more racial/ethnic discrimination for the “at school” item, and black participants reported more racial/ethnic discrimination for the “getting housing” item. The large DIF by race/ethnicity in the index for racial/ethnic discrimination probably reflects item impact and is the result of valid group differences between blacks and whites regarding their respective experiences of discrimination. The authors also observed large DIF by race/ethnicity for 3 of 7 gender discrimination items. This is more likely to have been due to item bias. Users of the EOD Index must consider the advantages and disadvantages of DIF adjustment (omitting items, constructing separate measures, and retaining items). The EOD Index has substantial usefulness as an instrument that can assess self-reported experiences of discrimination. PMID:22038104

A Refractive Index Sensor Based on the Resonant Coupling to Cladding Modes in a Fiber Loop

PubMed Central

Reyes, Mauricio; Monzón-Hernández, David; Martínez-Ríos, Alejandro; Silvestre, Enrique; Díez, Antonio; Cruz, José Luis; Andrés, Miguel V.

2013-01-01

We report an easy-to-build, compact, and low-cost optical fiber refractive index sensor. It consists of a single fiber loop whose transmission spectra exhibit a series of notches produced by the resonant coupling between the fundamental mode and the cladding modes in a uniformly bent fiber. The wavelength of the notches, distributed in a wavelength span from 1,400 to 1,700 nm, can be tuned by adjusting the diameter of the fiber loop and are sensitive to refractive index changes of the external medium. Sensitivities of 170 and 800 nm per refractive index unit for water solutions and for the refractive index interval 1.40–1.442, respectively, are demonstrated. We estimate a long range resolution of 3 × 10−4 and a short range resolution of 2 × 10−5 for water solutions. PMID:23979478

Secukinumab Versus Adalimumab for Psoriatic Arthritis: Comparative Effectiveness up to 48 Weeks Using a Matching-Adjusted Indirect Comparison.

PubMed

Nash, Peter; McInnes, Iain B; Mease, Philip J; Thom, Howard; Hunger, Matthias; Karabis, Andreas; Gandhi, Kunal; Mpofu, Shephard; Jugl, Steffen M

2018-06-01

Secukinumab and adalimumab are approved for adults with active psoriatic arthritis (PsA). In the absence of direct randomized controlled trial (RCT) data, matching-adjusted indirect comparison can estimate the comparative effectiveness in anti-tumor necrosis factor (TNF)-naïve populations. Individual patient data from the FUTURE 2 RCT (secukinumab vs. placebo; N = 299) were adjusted to match baseline characteristics of the ADEPT RCT (adalimumab vs. placebo; N = 313). Logistic regression determined adjustment weights for age, body weight, sex, race, methotrexate use, psoriasis affecting ≥ 3% of body surface area, Psoriasis Area and Severity Index score, Health Assessment Questionnaire Disability Index score, presence of dactylitis and enthesitis, and previous anti-TNF therapy. Recalculated secukinumab outcomes were compared with adalimumab outcomes at weeks 12 (placebo-adjusted), 16, 24, and 48 (nonplacebo-adjusted). After matching, the effective sample size for FUTURE 2 was 101. Week 12 American College of Rheumatology (ACR) response rates were not significantly different between secukinumab and adalimumab. Week 16 ACR 20 and 50 response rates were higher for secukinumab 150 mg than for adalimumab (P = 0.017, P = 0.033), as was ACR 50 for secukinumab 300 mg (P = 0.030). Week 24 ACR 20 and 50 were higher for secukinumab 150 mg than for adalimumab (P = 0.001, P = 0.019), as was ACR 20 for secukinumab 300 mg (P = 0.048). Week 48 ACR 20 was higher for secukinumab 150 and 300 mg than for adalimumab (P = 0.002, P = 0.027), as was ACR 50 for secukinumab 300 mg (P = 0.032). In our analysis, patients with PsA receiving secukinumab were more likely to achieve higher ACR responses through 1 year (weeks 16-48) than those treated with adalimumab. Although informative, these observations rely on a subgroup of patients from FUTURE 2 and thus should be considered interim until the ongoing head-to-head RCT EXCEED can

26 CFR 1.9001-3 - Basis adjustments for taxable years between changeover date and 1956 adjustment date.

Code of Federal Regulations, 2010 CFR

2010-04-01

... changeover date and 1956 adjustment date. 1.9001-3 Section 1.9001-3 Internal Revenue INTERNAL REVENUE SERVICE....9001-3 Basis adjustments for taxable years between changeover date and 1956 adjustment date. (a) In... before the taxpayer's 1956 adjustment date. This adjusted basis shall be used for all purposes of the...

Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen.

PubMed

von Bonsdorff, Mikaela Birgitta; Strandberg, Arto; von Bonsdorff, Monika; Törmäkangas, Timo; Pitkälä, Kaisu H; Strandberg, Timo E

2017-01-25

Long working hours and short sleep duration are associated with a range of adverse health consequences. However, the combined effect of these two exposures on health-related quality of life (HRQoL) has not been investigated. We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3,490). Data on clinical variables, self-rated health (SRH), working hours and sleep duration in 1974, and RAND-36 (SF-36) HRQoL survey in the year 2000 were available for 1,527 men. Follow-up time was 26 years. By combining working hours and sleep duration, four categories were formed: (i) normal work (≤50 hours/week) and normal sleep (>47 hours/week); (ii) long work (>50 hours/week) and normal sleep; (iii) normal work and short sleep (≤47 hours/week); and (iv) long work and short sleep. The association with RAND-36 domains was examined using multiple linear regression models adjusted for age, smoking and SRH. Compared to those with normal work and sleep in midlife, men with long work and short sleep had poorer RAND-36 scores for physical functioning, vitality and general health, and those with long work and normal sleep had poorer scores for physical functioning in old age. Adjustment for midlife smoking and SRH attenuated the associations, but the one for long work and short sleep and physical functioning remained significant (difference in mean physical functioning score −4.58, 95% confidence interval −9.00 to −0.15). Businessmen who had long working hours coupled with short sleep duration in midlife had poorer physical health in old age. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

ERP evidence for flexible adjustment of retrieval orientation and its influence on familiarity.

PubMed

Ecker, Ullrich K H; Zimmer, Hubert D

2009-10-01

The assumption was tested that familiarity memory as indexed by a mid-frontal ERP old-new effect is modulated by retrieval orientation. A randomly cued category-based versus exemplar-specific recognition memory test, requiring flexible adjustment of retrieval orientation, was conducted. Results show that the mid-frontal ERP old-new effect is sensitive to the manipulation of study-test congruency-that is, whether the same object is repeated identically or a different category exemplar is presented at test. Importantly, the effect pattern depends on subjects' retrieval orientation. With a specific orientation, only same items elicited an early old-new effect (same > different = new), whereas in the general condition, the old-new effect was graded (same > different > new). This supports the view that both perceptual and conceptual processes can contribute to familiarity memory and demonstrates that the rather automatic process of familiarity is not only data driven but influenced by top-down retrieval orientation, which subjects are able to adjust on a flexible basis.

Tunable Liquid Gradient Refractive Index (L-GRIN) lens with two degrees of freedom.

PubMed

Mao, Xiaole; Lin, Sz-Chin Steven; Lapsley, Michael Ian; Shi, Jinjie; Juluri, Bala Krishna; Huang, Tony Jun

2009-07-21

We report a tunable optofluidic microlens configuration named the Liquid Gradient Refractive Index (L-GRIN) lens for focusing light within a microfluidic device. The focusing of light was achieved through the gradient refractive index (GRIN) within the liquid medium, rather than via curved refractive lens surfaces. The diffusion of solute (CaCl(2)) between side-by-side co-injected microfluidic laminar flows was utilized to establish a hyperbolic secant (HS) refractive index profile to focus light. Tailoring the refractive index profile by adjusting the flow conditions enables not only tuning of the focal distance (translation mode), but also shifting of the output light direction (swing mode), a second degree of freedom that to our knowledge has yet to be accomplished for in-plane tunable microlenses. Advantages of the L-GRIN lens also include a low fluid consumption rate, competitive focusing performance, and high compatibility with existing microfluidic devices. This work provides a new strategy for developing integrative tunable microlenses for a variety of lab-on-a-chip applications.

Risk-adjusted models for adverse obstetric outcomes and variation in risk-adjusted outcomes across hospitals.

PubMed

Bailit, Jennifer L; Grobman, William A; Rice, Madeline Murguia; Spong, Catherine Y; Wapner, Ronald J; Varner, Michael W; Thorp, John M; Leveno, Kenneth J; Caritis, Steve N; Shubert, Phillip J; Tita, Alan T; Saade, George; Sorokin, Yoram; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E; Van Dorsten, J Peter

2013-11-01

Regulatory bodies and insurers evaluate hospital quality using obstetrical outcomes, however meaningful comparisons should take preexisting patient characteristics into account. Furthermore, if risk-adjusted outcomes are consistent within a hospital, fewer measures and resources would be needed to assess obstetrical quality. Our objective was to establish risk-adjusted models for 5 obstetric outcomes and assess hospital performance across these outcomes. We studied a cohort of 115,502 women and their neonates born in 25 hospitals in the United States from March 2008 through February 2011. Hospitals were ranked according to their unadjusted and risk-adjusted frequency of venous thromboembolism, postpartum hemorrhage, peripartum infection, severe perineal laceration, and a composite neonatal adverse outcome. Correlations between hospital risk-adjusted outcome frequencies were assessed. Venous thromboembolism occurred too infrequently (0.03%; 95% confidence interval [CI], 0.02-0.04%) for meaningful assessment. Other outcomes occurred frequently enough for assessment (postpartum hemorrhage, 2.29%; 95% CI, 2.20-2.38, peripartum infection, 5.06%; 95% CI, 4.93-5.19, severe perineal laceration at spontaneous vaginal delivery, 2.16%; 95% CI, 2.06-2.27, neonatal composite, 2.73%; 95% CI, 2.63-2.84). Although there was high concordance between unadjusted and adjusted hospital rankings, several individual hospitals had an adjusted rank that was substantially different (as much as 12 rank tiers) than their unadjusted rank. None of the correlations between hospital-adjusted outcome frequencies was significant. For example, the hospital with the lowest adjusted frequency of peripartum infection had the highest adjusted frequency of severe perineal laceration. Evaluations based on a single risk-adjusted outcome cannot be generalized to overall hospital obstetric performance. Copyright © 2013 Mosby, Inc. All rights reserved.

Comparison between Hardy-Rand-Rittler 4th edition and Ishihara color plate tests for detection of dyschromatopsia in optic neuropathy.

PubMed

Huna-Baron, Ruth; Glovinsky, Yoseph; Habot-Wilner, Zohar

2013-02-01

The aim of this work was to compare the specificity-sensitivity balance of the Hardy-Rand-Rittler (HRR) 4th edition with the Ishihara color plate tests for color-vision defects in patients with optic neuropathy. This is a prospective case-control study. The study group included 43 patients (48 eyes) with newly diagnosed optic neuropathy, and the control group included 33 patients (33 right eyes) who were referred to the eye clinic for conditions other than optic nerve or retinal macular disorders. Individuals with visual acuity of less than 20/70 (0.54 Log MAR) were excluded. All patients underwent comprehensive eye examination and color-vision evaluation with both tests in a random order under standardized lighting conditions. The scores of the Ishihara and HRR tests were set as the number of plates identified out of 12 and six respectively. The receiver operating characteristics (ROC) curve was statistically significantly better when using the HRR test (area under curve [AUC] = 0.93 ± 0.03) than for the Ishihara test (AUC = 0.77 ± 0.05) (P = 0.0006). The best specificity-sensitivity balance for the HRR was 100 % and 79 % respectively, and for the Ishihara test 100 % and 48 % respectively. The HRR 4th edition test proved to be superior to the Ishihara test in detecting acquired dyschromatopsia due to optic neuropathy. We recommend using the HRR 4th edition test as a screening method for detection of color-vision defects in patients with optic neuropathy.

H-index of Collective Health professors in Brazil.

PubMed

Pereira, Julio Cesar Rodrigues; Bronhara, Bruna

2011-06-01

To estimate reference values and the hierarchy function of professors engaged in Collective Health in Brazil by analyzing the distribution of the h-index. From the Portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Portal of Coordination for the Improvement of Higher Education Personnel ), 934 authors were identified in 2008, of whom 819 were analyzed. The h-index of each professor was obtained through the Web of Science using search algorithms controlling for namesakes and alternative spellings of their names. For each Brazilian region and for the country as a whole, we adjusted an exponential probability density function to provide the population parameters and rate of decline by region. Ranking measures were identified using the complement of the cumulative probability function and the hierarchy function among authors according to the h-index by region. Among the professors analyzed, 29.8% had no citation record in Web of Science (h=0). The mean h for the country was 3.1, and the region with greatest mean was the southern region (h=4.7). The median h for the country was 3.1, and the greatest median was for the southern region (3.2). Standardizing populations to one hundred, the first rank in the country was h=16, but stratification by region shows that, within the northeastern, southeastern and southern regions, a greater value is necessary for achieving the first rank. In the southern region, the index needed to achieve the first rank was h=24. Most of the Brazilian Collective Health authors, if assessed on the basis of the Web of Science h-index, did not exceed h=5. Regional differences exist, with the southeastern and northeastern regions being similar and the southern region being outstanding.

Adjustable Pitot Probe

NASA Technical Reports Server (NTRS)

Ashby, George C., Jr.; Robbins, W. Eugene; Horsley, Lewis A.

1991-01-01

Probe readily positionable in core of uniform flow in hypersonic wind tunnel. Formed of pair of mating cylindrical housings: transducer housing and pitot-tube housing. Pitot tube supported by adjustable wedge fairing attached to top of pitot-tube housing with semicircular foot. Probe adjusted both radially and circumferentially. In addition, pressure-sensing transducer cooled internally by water or other cooling fluid passing through annulus of cooling system.

The Consonant-Weighted Envelope Difference Index (cEDI): A Proposed Technique for Quantifying Envelope Distortion

ERIC Educational Resources Information Center

Hoover, Eric C.; Souza, Pamela E.; Gallun, Frederick J.

2012-01-01

Purpose: The benefits of amplitude compression in hearing aids may be limited by distortion resulting from rapid gain adjustment. To evaluate this, it is convenient to quantify distortion by using a metric that is sensitive to the changes in the processed signal that decrease consonant recognition, such as the Envelope Difference Index (EDI;…

Supporting Air and Space Expeditionary Forces: Analysis of Combat Support Basing Options

DTIC Science & Technology

2004-01-01

Brooke et al., 2003. 13 For more information on Set Covering models, see Daskin , 1995. Analysis Methodology 43 Transportation Model. A detailed...This PDF document was made available from www.rand.org as a public service of the RAND Corporation. 6Jump down to document Visit RAND at...www.rand.org Explore RAND Project AIR FORCE View document details This document and trademark(s) contained herein are protected by law as indicated in a

Managing Technological Change: The Process is Key

DTIC Science & Technology

1989-01-01

research results. The RAND Note reports other outputs of sponsored research for general distri- bution. Publications of The RAND Corporation do not...necessarily reflect the opinions or policies of the sponsors of RAND research. Published by The RAND Corporation 1700 Main Street, P.O. Box 2138, Santa...Procedures in Office Settings: Influences and Outcomes, The RAND Corporation , R-3077-NSF/IRIS, October 1987. Bikson, T.K., C. Stasz, and D. A. Mankin, Computer

Developing Headquarters Guidance for Army Installation Sustainability Plans in 2007

DTIC Science & Technology

2009-01-01

Make a charitable contribution Support RAND This PDF document was made available from www.rand.org as a public service of the RAND Corporation . Jump...down to document The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the...6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) RAND Corporation ,1776 Main

Improving Interagency Information Sharing Using Technology Demonstrations: The Legal Basis for Using New Sensor Technologies for Counterdrug Operations Along the U.S. Border

DTIC Science & Technology

2014-01-01

herein are protected by law as indicated in a notice appearing later in this work . This electronic representation of RAND intellectual property is...commercial use. For information on reprint and linking permissions, please see RAND Permissions. Skip all front matter: Jump to Page 16 The RAND Corporation ...from www.rand.org as a public service of the RAND Corporation . CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH

The impact of primary Sjögren's syndrome on female sexual function.

PubMed

van Nimwegen, Jolien F; Arends, Suzanne; van Zuiden, Greetje S; Vissink, Arjan; Kroese, Frans G M; Bootsma, Hendrika

2015-07-01

Prevalence of vaginal dryness and dyspareunia is high in women with primary SS (pSS). Our aim was to compare sexual function and sexual distress in women with pSS with healthy controls, as well as to assess parameters that are associated with sexual dysfunction and distress in pSS. Forty-six women fulfilling the American-European Consensus Group criteria for pSS [mean age 46.3 years (s.d. 10.5)] and 43 age-matched healthy controls were included. Participants completed self-administered questionnaires, namely the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), Maudsley Marital Questionnaire (MMQ) and RAND 36-item Health Survey (RAND-36). In addition, the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) and Patient Reported Index (ESSPRI) were recorded in patients. Women with pSS had impaired sexual function compared with healthy controls (median FSFI 20.6 vs 30.3, P < 0.001), as reflected by significantly lower scores in the domains of desire, arousal, orgasm, lubrication and pain. Furthermore, pSS patients experienced more sexual distress (median FSDS 7 vs 4, P < 0.05) and were sexually active less frequently than controls (76% vs 93%, P < 0.05). Sexual dysfunction correlated significantly with patient-reported symptoms of pSS (ESSPRI), symptoms of fatigue (MFI), depressive symptoms (HADS), relationship dissatisfaction (MMQ) and lower mental quality of life (RAND-36), but not with systemic disease activity (ESSDAI). Women with pSS have impaired sexual function and more sexual distress compared with healthy controls. Sexual function and distress are influenced by vaginal dryness and patient-reported symptoms of pSS as well as psychosocial factors. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Performance Assessment of Kernel Density Clustering for Gene Expression Profile Data

PubMed Central

Zeng, Beiyan; Chen, Yiping P.; Smith, Oscar H.

2003-01-01

Kernel density smoothing techniques have been used in classification or supervised learning of gene expression profile (GEP) data, but their applications to clustering or unsupervised learning of those data have not been explored and assessed. Here we report a kernel density clustering method for analysing GEP data and compare its performance with the three most widely-used clustering methods: hierarchical clustering, K-means clustering, and multivariate mixture model-based clustering. Using several methods to measure agreement, between-cluster isolation, and withincluster coherence, such as the Adjusted Rand Index, the Pseudo F test, the r2 test, and the profile plot, we have assessed the effectiveness of kernel density clustering for recovering clusters, and its robustness against noise on clustering both simulated and real GEP data. Our results show that the kernel density clustering method has excellent performance in recovering clusters from simulated data and in grouping large real expression profile data sets into compact and well-isolated clusters, and that it is the most robust clustering method for analysing noisy expression profile data compared to the other three methods assessed. PMID:18629292

Transparent, immiscible, surrogate liquids with matchable refractive indexes: Increased range of density and viscosity ratios

NASA Astrophysics Data System (ADS)

Cadillon, Jérémy; Saksena, Rajat; Pearlstein, Arne J.

2016-12-01

By replacing the "heavy" silicone oil used in the oil phase of Saksena, Christensen, and Pearlstein ["Surrogate immiscible liquid pairs with refractive indexes matchable over a wide range of density and viscosity ratios," Phys. Fluids 27, 087103 (2015)] by one with a twentyfold higher viscosity, and replacing the "light" silicone oil in that work by one with a viscosity fivefold lower and a density about 10% lower, we have greatly extended the range of viscosity ratio accessible by index-matching the adjustable-composition oil phase to an adjustable-composition 1,2-propanediol + CsBr + H2O aqueous phase and have also extended the range of accessible density ratios. The new system of index-matchable surrogate immiscible liquids is capable of achieving the density and viscosity ratios for liquid/liquid systems consisting of water with the entire range of light or medium crude oils over the temperature range from 40 °F (4.44 °C) to 200 °F (93.3 °C) and can access the density and viscosity ratios for water with some heavy crude oils over part of the same temperature range. It also provides a room-temperature, atmospheric-pressure surrogate for the liquid CO2 + H2O system at 0 °C over almost all of the pressure range of interest in sub-seabed CO2 sequestration.

Bayes linear covariance matrix adjustment

NASA Astrophysics Data System (ADS)

Wilkinson, Darren J.

1995-12-01

In this thesis, a Bayes linear methodology for the adjustment of covariance matrices is presented and discussed. A geometric framework for quantifying uncertainties about covariance matrices is set up, and an inner-product for spaces of random matrices is motivated and constructed. The inner-product on this space captures aspects of our beliefs about the relationship between covariance matrices of interest to us, providing a structure rich enough for us to adjust beliefs about unknown matrices in the light of data such as sample covariance matrices, exploiting second-order exchangeability and related specifications to obtain representations allowing analysis. Adjustment is associated with orthogonal projection, and illustrated with examples of adjustments for some common problems. The problem of adjusting the covariance matrices underlying exchangeable random vectors is tackled and discussed. Learning about the covariance matrices associated with multivariate time series dynamic linear models is shown to be amenable to a similar approach. Diagnostics for matrix adjustments are also discussed.

Price adjustment for traditional Chinese medicine procedures: Based on a standardized value parity model.

PubMed

Wang, Haiyin; Jin, Chunlin; Jiang, Qingwu

2017-11-20

Traditional Chinese medicine (TCM) is an important part of China's medical system. Due to the prolonged low price of TCM procedures and the lack of an effective mechanism for dynamic price adjustment, the development of TCM has markedly lagged behind Western medicine. The World Health Organization (WHO) has emphasized the need to enhance the development of alternative and traditional medicine when creating national health care systems. The establishment of scientific and appropriate mechanisms to adjust the price of medical procedures in TCM is crucial to promoting the development of TCM. This study has examined incorporating value indicators and data on basic manpower expended, time spent, technical difficulty, and the degree of risk in the latest standards for the price of medical procedures in China, and this study also offers a price adjustment model with the relative price ratio as a key index. This study examined 144 TCM procedures and found that prices of TCM procedures were mainly based on the value of medical care provided; on average, medical care provided accounted for 89% of the price. Current price levels were generally low and the current price accounted for 56% of the standardized value of a procedure, on average. Current price levels accounted for a markedly lower standardized value of acupuncture, moxibustion, special treatment with TCM, and comprehensive TCM procedures. This study selected a total of 79 procedures and adjusted them by priority. The relationship between the price of TCM procedures and the suggested price was significantly optimized (p < 0.01). This study suggests that adjustment of the price of medical procedures based on a standardized value parity model is a scientific and suitable method of price adjustment that can serve as a reference for other provinces and municipalities in China and other countries and regions that mainly have fee-for-service (FFS) medical care.

Dyadic sexual communication in pre-menopausal women with self-reported dyspareunia and their partners: associations with sexual function, sexual distress and dyadic adjustment.

PubMed

Pazmany, Els; Bergeron, Sophie; Verhaeghe, Johan; Van Oudenhove, Lukas; Enzlin, Paul

2015-02-01

While there is increasing interest in studying aspects of communication processes in sex research, the association between dyadic sexual communication and relationship and sexuality outcomes has not yet been examined in pre-menopausal women with dyspareunia. To examine the associations between dyadic sexual communication and pain, sexual distress, sexual function and dyadic adjustment in women with self-reported dyspareunia and their male partners. Pre-menopausal women (n=38; M age=24.92, SD=6.12) with self-reported dyspareunia from a community sample and their partners (n=38; M age=26.71, SD=6.59) completed an online survey. The Actor-Partner Interdependence Model was used in order to investigate both actor and partner effects. Both members of the couple completed: (i) the Dyadic Sexual Communication Scale and (ii) the Dyadic Adjustment Scale; women also completed (iii) the Female Sexual Function Index, (iv) the Female Sexual Distress Scale, and (v) a Visual Analogue Scale on pain during intercourse; and men also completed (vi) the International Index of Erectile Functioning. Controlling for relationship duration, women's better dyadic sexual communication was significantly associated with their higher levels of sexual function (P=0.028), lower levels of sexual distress (P=0.003) and higher levels of dyadic adjustment (P=0.005), but not with their pain or men's sexual function or dyadic adjustment. Controlling for relationship duration, men's better dyadic sexual communication was associated with their higher levels of dyadic adjustment (P=0.027) but not with their sexual function, nor with women's sexual function or dyadic adjustment. These findings contribute to the theoretical knowledge on interaction processes in couples with dyspareunia and suggest that it may be important to enhance open and direct communication about sexual matters in couples with dyspareunia. © 2014 International Society for Sexual Medicine.

Slow light effect with high group index and wideband by saddle-like mode in PC-CROW

NASA Astrophysics Data System (ADS)

Wan, Yong; Jiang, Li-Jun; Xu, Sheng; Li, Meng-Xue; Liu, Meng-Nan; Jiang, Cheng-Yi; Yuan, Feng

2018-04-01

Slow light with high group index and wideband is achieved in photonic crystal coupled-resonator optical waveguides (PC-CROWs). According to the eye-shaped scatterers and various microcavities, saddle-like curves between the normalized frequency f and wave number k can be obtained by adjusting the parameters of the scatterers, parameters of the coupling microcavities, and positions of the scatterers. Slow light with decent flat band and group index can then be achieved by optimizing the parameters. Simulations prove that the maximal value of the group index is > 104, and the normalized delay bandwidth product within a new varying range of n g > 102 or n g > 103 can be a new and effective criterion of evaluation for the slow light in PC-CROWs.

39 CFR 3010.25 - Limitation on unused rate adjustment authority rate adjustments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Limitation on unused rate adjustment authority rate adjustments. 3010.25 Section 3010.25 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.25 Limitation on...

Carbohydrate, glycemic index, and glycemic load and colorectal adenomas in the Prostate, Lung, Colorectal, and Ovarian Screening Study.

PubMed

Flood, Andrew; Peters, Ulrike; Jenkins, David J A; Chatterjee, Nilanjan; Subar, Amy F; Church, Timothy R; Bresalier, Robert; Weissfeld, Joel L; Hayes, Richard B; Schatzkin, Arthur

2006-11-01

It is possible that high-glycemic-load diets, through their hyperinsulinemic effects, can increase the risk of colorectal cancer. We analyzed data from a cancer screening study to determine whether persons with high-glycemic-load diets would be at an increased risk of distal adenomas. We included subjects with no prior adenoma or cancer from the Prostate, Lung, Colorectal, and Ovarian screening trial and whose results from flexible sigmoidoscopy exams indicated either no lesions (n = 34 817) or >/=1 distal adenoma (n = 3696). We used a 137-item food-frequency questionnaire to assess usual dietary intake over the preceding 12 mo. Using logistic regression analysis, we calculated, separately for men and women, prevalence odds ratios (ORs) and 95% CIs of sigmoidoscopy-detected, distal adenomas for quintiles of energy-adjusted dietary carbohydrate, glycemic index, and glycemic load. ORs decreased with increasing intakes of carbohydrate for both the men and the women in unadjusted models, but these associations were attenuated in multivariate-adjusted models. Among the men, the association remained significant after adjustment (OR: 0.71; 95% CI 0.60, 0.84; P for trend < 0.0001), but in the women it did not (OR: 0.89; 95% CI: 0.73, 1.10; P for trend = 0.30). The results for glycemic index showed no associations in either men or women. Results for glycemic load closely mirrored those for carbohydrate. Despite expectations that increasing glycemic load and glycemic index would increase the risk of adenoma, we observed no association in women and even an inverse association in men.

The Cost of a Military Person-Year. A Method for Computing Savings from Force Reductions

DTIC Science & Technology

2007-01-01

personnel FASAB Federal Accounting Standards Advisory Board FASB Financial Accounting Standards Board FERS Federal Employee Retirement System FG federal...an average prescribed SMCR of only $61,393, which is clearly problematic: Using the Comptroller’s own methods as mandated by DoD financial man... financial commitment the Figure 4.2 Probability-Adjusted Present Values of Retirement Benefits for Current Members by YOS RAND MG598-4.2 1,400 $ th o u

Optimizing UV Index determination from broadband irradiances

NASA Astrophysics Data System (ADS)

Tereszchuk, Keith A.; Rochon, Yves J.; McLinden, Chris A.; Vaillancourt, Paul A.

2018-03-01

A study was undertaken to improve upon the prognosticative capability of Environment and Climate Change Canada's (ECCC) UV Index forecast model. An aspect of that work, and the topic of this communication, was to investigate the use of the four UV broadband surface irradiance fields generated by ECCC's Global Environmental Multiscale (GEM) numerical prediction model to determine the UV Index. The basis of the investigation involves the creation of a suite of routines which employ high-spectral-resolution radiative transfer code developed to calculate UV Index fields from GEM forecasts. These routines employ a modified version of the Cloud-J v7.4 radiative transfer model, which integrates GEM output to produce high-spectral-resolution surface irradiance fields. The output generated using the high-resolution radiative transfer code served to verify and calibrate GEM broadband surface irradiances under clear-sky conditions and their use in providing the UV Index. A subsequent comparison of irradiances and UV Index under cloudy conditions was also performed. Linear correlation agreement of surface irradiances from the two models for each of the two higher UV bands covering 310.70-330.0 and 330.03-400.00 nm is typically greater than 95 % for clear-sky conditions with associated root-mean-square relative errors of 6.4 and 4.0 %. However, underestimations of clear-sky GEM irradiances were found on the order of ˜ 30-50 % for the 294.12-310.70 nm band and by a factor of ˜ 30 for the 280.11-294.12 nm band. This underestimation can be significant for UV Index determination but would not impact weather forecasting. Corresponding empirical adjustments were applied to the broadband irradiances now giving a correlation coefficient of unity. From these, a least-squares fitting was derived for the calculation of the UV Index. The resultant differences in UV indices from the high-spectral-resolution irradiances and the resultant GEM broadband irradiances are typically within 0

Parental Divorce and Children's Adjustment.

PubMed

Lansford, Jennifer E

2009-03-01

This article reviews the research literature on links between parental divorce and children's short-term and long-term adjustment. First, I consider evidence regarding how divorce relates to children's externalizing behaviors, internalizing problems, academic achievement, and social relationships. Second, I examine timing of the divorce, demographic characteristics, children's adjustment prior to the divorce, and stigmatization as moderators of the links between divorce and children's adjustment. Third, I examine income, interparental conflict, parenting, and parents well-being as mediators of relations between divorce and children's adjustment. Fourth, I note the caveats and limitations of the research literature. Finally, I consider notable policies related to grounds for divorce, child support, and child custody in light of how they might affect children s adjustment to their parents divorce. © 2009 Association for Psychological Science.

Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations

USDA-ARS?s Scientific Manuscript database

Introduction: Meal or dietary glycemic index (GI) and glycemic load (GL) values from dietary questionnaires are calculated using GI values of individual foods and for GL after adjusting for serving size. Partially unaddressed is the potential confounding effect of different amounts and proportions o...

A needs index for mental health care.

PubMed

Glover, G R; Robin, E; Emami, J; Arabscheibani, G R

1998-02-01

The study aimed to develop a mental illness needs index to help local managers, district purchasers and national policy makers in allocating resources. Formulae were developed by regression analysis using 1991 census data to predict the period prevalence of acute psychiatric admission from electoral wards. Census variables used were chosen on the basis of an established association with mental illness rates. Data from one English Health Service region were analysed for patterns common to wards at hospital catchment area level and patterns common to district health authorities at regional level. The North East Thames region was chosen as the setting for the study, with 7096 patients being admitted during 1991. In most, but not all, catchment areas reasonable prediction of the pattern of admission prevalence was possible using the variables chosen. However, different population characteristics predicted admission prevalence in rural and urban areas. Prediction methods based on one or two variables are thus unlikely to work in both settings. A Mental Illness Needs Index (MINI) based on social isolation, poverty, unemployment, permanent sickness and temporary and insecure housing predicted differences in admission prevalence between wards at catchment area level better than Jarman's Underprivileged Area (UPA) score [1] and between districts at regional level better than the UPA score and comparably to the York Psychiatric Index [2] (adjusted r2 at regional level (MINI 0.82, UPA 0.53, York index 0.70). District admission prevalence rates vary by a factor of three between rural and inner city areas; this difference may not fully reflect the variation in the cost of providing care. It did not prove possible to incorporate factors related to bed availability in the models used; reasons for this are discussed. Data covering other aspects of mental health care in addition to hospital admission are needed for more satisfactory modelling.

Association of Body Mass Index with Timing of Death during Tuberculosis Treatment

PubMed Central

Lai, Yun-Ju; Yen, Yung-Feng

2017-01-01

Background The association between body mass index and mortality in patients with tuberculosis has not been extensively studied, and the existing evidence is inconsistent. This study aimed to investigate the impact of body mass index on timing of death in patients with tuberculosis. Methods All Taiwanese adults with tuberculosis in Taipei, Taiwan, were included in a retrospective cohort study in 2011–2012. Multinomial logistic regression was used to evaluate the association between body mass index and timing of death in patients with tuberculosis. Results Among 1557 eligible patients, 84.1% (1310), 8.2% (128), and 7.6% (119) underwent successful treatment, early death, and late death, respectively. The mean age of the patients with tuberculosis was 64.2 years old, and 67.7% were male. After controlling for potential confounding variables, underweight with body mass index less than 18.5 kg/ m2 was significantly associated with elevated risk of all-cause mortality [Adjusted odds ratio (AOR), 1.64; 95% confidence interval (CI), 1.17–2.30]. Considering timing of death, underweight with body mass index less than 18.5 was significantly associated only with elevated risk of early mortality within the first 8 weeks of treatment onset (AOR, 2.22; 95% CI, 1.45–3.40) Conclusions For patients with tuberculosis infection, underweight with body mass index less than 18.5 kg/ m2 is an independent predictor for early mortality within the first 8 weeks of treatment. PMID:28085951

Influence of stromal refractive index and hydration on corneal laser refractive surgery.

PubMed

de Ortueta, Diego; von Rüden, Dennis; Magnago, Thomas; Arba Mosquera, Samuel

2014-06-01

To evaluate the influence of the stromal refractive index and hydration on postoperative outcomes in eyes that had corneal laser refractive surgery using the Amaris laser system. Augenzentrum Recklinghausen, Recklinghausen, Germany. Comparative case series. At the 6-month follow-up, right eyes were retrospectively analyzed. The effect of the stromal refractive index and hydration on refractive outcomes was assessed using univariate linear and multilinear correlations. Sixty eyes were analyzed. Univariate linear analyses showed that the stromal refractive index and hydration were correlated with the thickness of the preoperative exposed stroma and was statistically different for laser in situ keratomileusis and laser-assisted subepithelial keratectomy treatments. Univariate multilinear analyses showed that the spherical equivalent (SE) was correlated with the attempted SE and stromal refractive index (or hydration). Analyses suggest overcorrections for higher stromal refractive index values and for lower hydration values. The stromal refractive index and hydration affected postoperative outcomes in a subtle, yet significant manner. An adjustment toward greater attempted correction in highly hydrated corneas and less intended correction in low hydrated corneas might help optimize refractive outcomes. Mr. Magnago and Dr. Arba-Mosquera are employees of and Dr. Diego de Ortueta is a consultant to Schwind eye-tech-solutions GmbH & Co. KG. Mr. Rüden has no financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

42 CFR 422.310 - Risk adjustment data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... risk adjustment factors used to adjust payments, as required under §§ 422.304(a) and (c). CMS also may... submission of risk adjustment data. Risk adjustment factors for each payment year are based on risk... factors for affected individuals to determine if adjustments to payments are necessary. Risk adjustment...

42 CFR 422.310 - Risk adjustment data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... risk adjustment factors used to adjust payments, as required under §§ 422.304(a) and (c). CMS also may... submission of risk adjustment data. Risk adjustment factors for each payment year are based on risk... factors for affected individuals to determine if adjustments to payments are necessary. Risk adjustment...

Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents.

PubMed

Bacopoulou, Flora; Foskolos, Elizabeth; Stefanaki, Charikleia; Tsitsami, Eleni; Vousoura, Eleni

2017-11-30

The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship. Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires. Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05). Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects. Level V, cross-sectional descriptive study.

The U.S.-Soviet Strategic Balance in the 1980s: Can We Meet the Challenge,

DTIC Science & Technology

1981-08-01

34 ; ’ 085 The Rand Paper Series Papers are issued by The Rand Corporation as a service to its professional Staff, Theis purpose is to tacilitate the...exchange of ideas among those who share the author’s research interests; Papers are not reports prepared in fulfillment of Rand’s contracts or grants...Views expressed in a Paper are the author’s own, and are not necessarily shared by Rand or its research sponsors. The Rand Corporation Santa Monica

Post implantation adjustable intraocular lenses.

PubMed

Schwartz, D M; Jethmalani, J M; Sandstedt, C A; Kornfield, J A; Grubbs, R H

2001-06-01

To eliminate persistent refractive errors after cataract and phakic IOL surgery, photosensitive silicone IOLs have been developed. These IOL formulations enable precise laser adjustment of IOL power to correct spherical and toric errors post-operatively, after wound and IOL stabilization. Initial experience with these laser adjustable IOLs indicate excellent biocompatability and adjustability of more than five diopters.

Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

PubMed Central

Martínez-González, Miguel A.; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J. Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

2014-01-01

Background Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78–1.34), 1.30 (0.97–1.75) and 1.55 (1.06–2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88–1.59), 1.02 (0.74–1.41) and 1.57 (1.19–2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Trial

Population-Adjusted Street Connectivity, Urbanicity and Risk of Obesity in the U.S

PubMed Central

Wang, Fahui; Wen, Ming; Xu, Yanqing

2013-01-01

Street connectivity, defined as the number of (3-way or more) intersections per area unit, is an important index of built environments as a proxy for walkability in a neighborhood. This paper examines its geographic variations across the rural-urban continuum (urbanicity), major racial-ethnic groups and various poverty levels. The population-adjusted street connectivity index is proposed as a better measure than the regular index for a large area such as county due to likely concentration of population in limited space within the large area. Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS), this paper uses multilevel modeling to analyze its association with physical activity and obesity while controlling for various individual and county-level variables. Analysis of data subsets indicates that the influences of individual and county-level variables on obesity risk vary across areas of different urbanization levels. The positive influence of street connectivity on obesity control is limited to the more but not the mostly urbanized areas. This demonstrates the value of obesogenic environment research in different geographic settings, helps us reconcile and synthesize some seemingly contradictory results reported in different studies, and also promotes that effective policies need to be highly sensitive to the diversity of demographic groups and geographically adaptable. PMID:23667278

[Validity of adjusted morbidity groups with respect to clinical risk groups in the field of primary care].

PubMed

Monterde, David; Vela, Emili; Clèries, Montse; García Eroles, Luis; Pérez Sust, Pol

2018-02-09

To compare the performance in terms of goodness of fit and explanatory power of 2morbidity groupers in primary care (PC): adjusted morbidity groups (AMG) and clinical risk groups (CRG). Cross-sectional study. PC in the Catalan Institute for the Health (CIH), Catalonia, Spain. Population allocated in primary care centers of the CIH for the year 2014. Three indicators of interest are analyzed such as urgent hospitalization, number of visits and spending in pharmacy. A stratified analysis by centers is applied adjusting generalized lineal models from the variables age, sex and morbidity grouping to explain each one of the 3variables of interest. The statistical measures to analyze the performance of the different models applied are the Akaike index, the Bayes index and the pseudo-variability explained by deviance change. The results show that in the area of the primary care the explanatory power of the AMGs is higher to that offered by the CRGs, especially for the case of the visits and the pharmacy. The performance of GMAs in the area of the CIH PC is higher than that shown by the CRGs. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Explaining prescription drug use and expenditures using the adjusted clinical groups case-mix system in the population of British Columbia, Canada.

PubMed

Hanley, Gillian E; Morgan, Steve; Reid, Robert J

2010-05-01

Given that prescription drugs have become a major financial component of health care, there is an increased need to explain variations in the use of and expenditure on medicines. Case-mix systems built from existing administrative datasets may prove very useful for such prediction. We estimated the concurrent and prospective predictive validity of the adjusted clinical groups (ACG) system in pharmaceutical research and compared the ACG system with the Charlson index of comorbidity. We ran a generalized linear models to examine the predictive validity of the ACG system and the Charlson index and report the correlation between the predicted and observed expenditures. We reported mean predictive ratios across medical condition and cost-defined groups. When predicting use of medicines, we used C-statistics to summarize the area under the receiver operating characteristic curve. The 3,908,533 British Columbia residents who were registered for the universal health care plan for 275+ days in the calendar years 2004 and 2005. Outcomes were total pharmaceutical expenditures, use of any medicines, and use of medicines from 4+ different therapeutic categories. The ACG case mix system predicted drug expenditures better than the Charlson index. The mean predictive ratios for the ACG system models were all within 4% of the actual costs when examining medical condition group and the C-stats for the 2 dichotomous outcomes were between 0.82 and 0.89. ACG case-mix adjusters are a valuable predictor of pharmaceutical use and expenditures with much higher predictive power than age, sex, and the Charlson index of comorbidity.

12 CFR 19.240 - Inflation adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b) The...

Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan.

PubMed

Kikuya, Masahiro; Staessen, Jan A; Ohkubo, Takayoshi; Thijs, Lutgarde; Metoki, Hirohito; Asayama, Kei; Obara, Taku; Inoue, Ryusuke; Li, Yan; Dolan, Eamon; Hoshi, Haruhisa; Hashimoto, Junichiro; Totsune, Kazuhito; Satoh, Hiroshi; Wang, Ji-Guang; O'Brien, Eoin; Imai, Yutaka

2007-04-01

Ambulatory arterial stiffness index (AASI) and pulse pressure (PP) are indexes of arterial stiffness and can be computed from 24-hour blood pressure recordings. We investigated the prognostic value of AASI and PP in relation to fatal outcomes. In 1542 Ohasama residents (baseline age, 40 to 93 years; 63.4% women), we applied Cox regression to relate mortality to AASI and PP while adjusting for sex, age, BMI, 24-hour MAP, smoking and drinking habits, diabetes mellitus, and a history of cardiovascular disease. During 13.3 years (median), 126 cardiovascular and 63 stroke deaths occurred. The sex- and age-standardized incidence rates of cardiovascular and stroke mortality across quartiles were U-shaped for AASI and J-shaped for PP. Across quartiles, the multivariate-adjusted hazard ratios for cardiovascular and stroke death significantly deviated from those in the whole population in a U-shaped fashion for AASI, whereas for PP, none of the HRs departed from the overall risk. The hazard ratios for cardiovascular mortality across ascending AASI quartiles were 1.40 (P=0.04), 0.82 (P=0.25), 0.64 (P=0.01), and 1.35 (P=0.03). Additional adjustment of AASI for PP and sensitivity analyses by sex, excluding patients on antihypertensive treatment or with a history of cardiovascular disease, or censoring deaths occurring within 2 years of enrollment, produced confirmatory results. In a Japanese population, AASI predicted cardiovascular and stroke mortality over and beyond PP and other risk factors, whereas in adjusted analyses, PP did not carry any prognostic information.

78 FR 79286 - Truth in Lending (Regulation Z): Adjustment to Asset-Size Exemption Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

...The Bureau is amending the official commentary that interprets the requirements of the Bureau's Regulation Z (Truth in Lending) to reflect a change in the asset size threshold for certain creditors to qualify for an exemption to the requirement to establish an escrow account for a higher-priced mortgage loan based on the annual percentage change in the average of the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) for the 12-month period ending in November. The exemption threshold is adjusted to increase to $2.028 billion from $2 billion. The adjustment is based on the 1.4 percent increase in the average of the CPI-W for the 12-month period ending in November 2013. Therefore, creditors with assets of $2.028 billion or less as of December 31, 2013, are exempt, if other requirements of Regulation Z also are met, from establishing escrow accounts for higher-priced mortgage loans in 2014.

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

PubMed Central

Prakash, Priyanka; Gilman, Matthew D.; Shepard, Jo-Anne O.; Digumarthy, Subba R.

2010-01-01

Objective To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. Materials and Methods With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Results Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 ± 3.1) and weight-adjusted (16.1 ± 5.6) AEC techniques (p > 0.05). Conclusion The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT. PMID:20046494

Augmentation index (AI) in a dose–response relationship with smoking habits in males

PubMed Central

Tsuru, Tomoko; Adachi, Hisashi; Enomoto, Mika; Fukami, Ako; Kumagai, Eita; Nakamura, Sachiko; Nohara, Yume; Kono, Shoko; Nakao, Erika; Sakaue, Akiko; Morikawa, Nagisa; Fukumoto, Yoshihiro

2016-01-01

Abstract We investigated the relationship between augmentation index (AI) and smoking habits in community-dwelling Japanese. This cross-sectional study enrolled 1926 subjects (769 males and 1157 females) aged 40 to 95 years who underwent a health check-up in a Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town in Kyushu Island in 2009. The subjects’ medical history, alcohol intake, smoking habit, and current medications for hypertension, dyslipidemia, and diabetes were ascertained by questionnaire. Radial arterial pressure wave analysis was used to obtain AI. We analyzed the data stratified by gender. Age-adjusted means of AI in males showed a clear dose–response relationship in 4 categories of smoking habits (P = 0.010). There was no significant relationship between AI and smoking habits in females (P = 0.127). The significant dose–response relationship (P = 0.036) in males between AI and 4 categories of smoking habits still remained even after adjustment for age, body mass index, systolic blood pressure, estimated glomerular filtration rate, glucose, hypertensive medication, and alcohol intake. The present study demonstrated that AI values were significantly associated with smoking habits in a dose-dependent manner in Japanese males. PMID:28002323

26 CFR 1.9001-2 - Basis adjustments for taxable years beginning on or after 1956 adjustment date.

Code of Federal Regulations, 2010 CFR

2010-04-01

... on or after 1956 adjustment date. 1.9001-2 Section 1.9001-2 Internal Revenue INTERNAL REVENUE SERVICE....9001-2 Basis adjustments for taxable years beginning on or after 1956 adjustment date. (a) In general. Subsection (d) of the Act provides the basis adjustments required to be made by the taxpayer as of the 1956...

Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method.

PubMed

Ueda, Kayo; Ohtera, Shosuke; Kaso, Misato; Nakayama, Takeo

2017-09-22

In childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, "something can go wrong at any minute." There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan. We used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1-3) were held between July and December 2012. The assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively. We established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.

44 CFR 62.21 - Claims adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program SALE OF INSURANCE AND ADJUSTMENT OF CLAIMS Claims Adjustment, Claims Appeals, and Judicial Review § 62.21 Claims adjustment. (a) In...

RAND’s Portfolio Analysis Tool (PAT): Theory, Methods, and Reference Manual

DTIC Science & Technology

2009-01-01

language , such as Analytica® (a product of Lumina Decision Systems, Inc., [www.lumina.com]). We used such a connection approach in our work for MDA...with $ signs ) so that the formulas will be automatically adjusted if they change PAT’s structure by, e.g., adding a column or row. Checking is...year, in real (inflation-protected) dollars. The sign is positive or negative, depending on whether one is receiving or paying and on the syntax of

The Mediating Role of Psychological Adjustment between Peer Victimization and Social Adjustment in Adolescence

PubMed Central

Romera, Eva M.; Gómez-Ortiz, Olga; Ortega-Ruiz, Rosario

2016-01-01

There is extensive scientific evidence of the serious psychological and social effects that peer victimization may have on students, among them internalizing problems such as anxiety or negative self-esteem, difficulties related to low self-efficacy and lower levels of social adjustment. Although a direct relationship has been observed between victimization and these effects, it has not yet been analyzed whether there is a relationship of interdependence between all these measures of psychosocial adjustment. The aim of this study was to examine the relationship between victimization and difficulties related to social adjustment among high school students. To do so, various explanatory models were tested to determine whether psychological adjustment (negative self-esteem, social anxiety and social self-efficacy) could play a mediating role in this relationship, as suggested by other studies on academic adjustment. The sample comprised 2060 Spanish high school students (47.9% girls; mean age = 14.34). The instruments used were the scale of victimization from European Bullying Intervention Project Questionnaire, the negative scale from Rosenberg Self-Esteem Scale, Social Anxiety Scale for Adolescents and a general item about social self-efficacy, all of them self-reports. Structural equation modeling was used to analyze the data. The results confirmed the partial mediating role of negative self-esteem, social anxiety and social self-efficacy between peer victimization and social adjustment and highlight the importance of empowering victimized students to improve their self-esteem and self-efficacy and prevent social anxiety. Such problems lead to the avoidance of social interactions and social reinforcement, thus making it difficult for these students to achieve adequate social adjustment. PMID:27891108

The Mediating Role of Psychological Adjustment between Peer Victimization and Social Adjustment in Adolescence.

PubMed

Romera, Eva M; Gómez-Ortiz, Olga; Ortega-Ruiz, Rosario

2016-01-01

There is extensive scientific evidence of the serious psychological and social effects that peer victimization may have on students, among them internalizing problems such as anxiety or negative self-esteem, difficulties related to low self-efficacy and lower levels of social adjustment. Although a direct relationship has been observed between victimization and these effects, it has not yet been analyzed whether there is a relationship of interdependence between all these measures of psychosocial adjustment. The aim of this study was to examine the relationship between victimization and difficulties related to social adjustment among high school students. To do so, various explanatory models were tested to determine whether psychological adjustment (negative self-esteem, social anxiety and social self-efficacy) could play a mediating role in this relationship, as suggested by other studies on academic adjustment. The sample comprised 2060 Spanish high school students (47.9% girls; mean age = 14.34). The instruments used were the scale of victimization from European Bullying Intervention Project Questionnaire , the negative scale from Rosenberg Self-Esteem Scale, Social Anxiety Scale for Adolescents and a general item about social self-efficacy, all of them self-reports. Structural equation modeling was used to analyze the data. The results confirmed the partial mediating role of negative self-esteem, social anxiety and social self-efficacy between peer victimization and social adjustment and highlight the importance of empowering victimized students to improve their self-esteem and self-efficacy and prevent social anxiety. Such problems lead to the avoidance of social interactions and social reinforcement, thus making it difficult for these students to achieve adequate social adjustment.

[Self-esteem, self-centeredness and social-emotional adjustment of gifted children and adolescents].

PubMed

Kostogianni, N; Andronikof, A

2009-10-01

There is an ongoing debate of how giftedness affects social-emotional adjustment. Self-esteem may be an indicator of social-emotional adjustment but insufficient in its explanatory capacity, especially high self-esteem which tends to produce opposite responses in regards to adjustment. A distinction between defensive and genuine high self-esteem could account for these results. In order to understand how self-esteem operates on social-emotional adjustment, it should be associated with other measurements relating to self-concern. In the Rorschach comprehensive system (CS), egocentricity index measures self-centeredness, which can be defined as the balance between self-concern and concern for others. High self-concern is associated with a neglect of the others. Operationalized here, as the interaction of high self-esteem and excessive self-concern, defensive high self-esteem should predict maladaptive outcomes. Participants were aged from 9 to 15 years old, with an IQ greater or equal to 130 on the WISC-III. They were attending regular classes and were not in counseling or psychotherapy. Children and adolescents were administrated the Rorschach CS and the Coopersmith self-esteem inventory. Parents completed the child behaviour checklist (CBCL) which assesses general psychopathology. Seventy-eight subjects' data satisfy the conditions of validity of the instruments used. Gifted boys present more behavior and emotional problems than gifted girls in this study. Self-esteem predicts social-emotional adjustment. There is an interaction between self-esteem and self-concern on psychopathology only for high values of self-esteem. Gifted with high self-esteem associated with high self-concern are more vulnerable to maladjustment than high self-esteem associated with low self-concern. Gifted children and adolescents with low self-esteem experience more problems anyhow. These findings reinforce the view that the gifted are a diverse group in terms of social-emotional adjustment

Site Index Tables for Shortleaf Pine In the Ozark Highlands of Northern Arkansas and Southern Missouri

Treesearch

Edwin R. Ferguson; David L. Graney

1975-01-01

Field guides are presented for estimating site index on each of the three major soil groups in the Ozark Highland Province: limestone-dolomite, sandstone, and fragipan soils. Factors utilized vary by soil groups but include aspect, township, slope shape and depth to pan, with adjustments for hardwood competition. Tabular predictions were within ± 3 feet of measured...

Analysis of dynamic thresholds for the normalized difference water index

USGS Publications Warehouse

Ji, Lei; Zhang, Li; Wylie, Bruce K.

2009-01-01

The normalized difference water index (NDWI) has been successfully used to delineate surface water features. However, two major problems have been often encountered: (a) NDWIs calculated from different band combinations [visible, nearinfrared, or shortwave-infrared (SWIR)] can generate different results, and (b) NDWI thresholds vary depending on the proportions of subpixel water/non-water components. We need to evaluate all the NDWIS for determining the best performing index and to establish appropriate thresholds for clearly identifying water features. We used the spectral data obtained from a spectral library to simulate the satellite sensors Landsat ETM+, SPOT-5, ASTER, and MODIS, and calculated the simulated NDWI in different forms. We found that the NDWI calculated from (green - swm)/(green + SWIR), where SWIR is the shorter wavelength region (1.2 to 1.8 ??m), has the most stable threshold. We recommend this NDWI be employed for mapping water, but adjustment of the threshold based on actual situations is necessary. ?? 2009 American Society for Photogrammetry and Remote Sensing.

Birth-Order Complementarity and Marital Adjustment.

ERIC Educational Resources Information Center

Vos, Cornelia J. Vanderkooy; Hayden, Delbert J.

1985-01-01

Tested the influence of birth-order complementarity on marital adjustment among 327 married women using the Spanier Dyadic Adjustment Scale (1976). Birth-order complementarity was found to be unassociated with marital adjustment. (Author/BL)

Measuring coronary calcium on CT images adjusted for attenuation differences.

PubMed

Nelson, Jennifer Clark; Kronmal, Richard A; Carr, J Jeffrey; McNitt-Gray, Michael F; Wong, Nathan D; Loria, Catherine M; Goldin, Jonathan G; Williams, O Dale; Detrano, Robert

2005-05-01

To quantify scanner and participant variability in attenuation values for computed tomographic (CT) images assessed for coronary calcium and define a method for standardizing attenuation values and calibrating calcium measurements. Institutional review board approval and participant informed consent were obtained at all study sites. An image attenuation adjustment method involving the use of available calibration phantom data to define standard attenuation values was developed. The method was applied to images from two population-based multicenter studies: the Coronary Artery Risk Development in Young Adults study (3041 participants) and the Multi-Ethnic Study of Atherosclerosis (6814 participants). To quantify the variability in attenuation, analysis of variance techniques were used to compare the CT numbers of standardized torso phantom regions across study sites, and multivariate linear regression models of participant-specific calibration phantom attenuation values that included participant age, race, sex, body mass index (BMI), smoking status, and site as covariates were developed. To assess the effect of the calibration method on calcium measurements, Pearson correlation coefficients between unadjusted and attenuation-adjusted calcium measurements were computed. Multivariate models were used to examine the effect of sex, race, BMI, smoking status, unadjusted score, and site on Agatston score adjustments. Mean attenuation values (CT numbers) of a standard calibration phantom scanned beneath participants varied significantly according to scanner and participant BMI (P < .001 for both). Values were lowest for Siemens multi-detector row CT scanners (110.0 HU), followed by GE-Imatron electron-beam (116.0 HU) and GE LightSpeed multi-detector row scanners (121.5 HU). Values were also lower for morbidly obese (BMI, > or =40.0 kg/m(2)) participants (108.9 HU), followed by obese (BMI, 30.0-39.9 kg/m(2)) (114.8 HU), overweight (BMI, 25.0-29.9 kg/m(2)) (118.5 HU), and

SIM_ADJUST -- A computer code that adjusts simulated equivalents for observations or predictions

USGS Publications Warehouse

Poeter, Eileen P.; Hill, Mary C.

2008-01-01

This report documents the SIM_ADJUST computer code. SIM_ADJUST surmounts an obstacle that is sometimes encountered when using universal model analysis computer codes such as UCODE_2005 (Poeter and others, 2005), PEST (Doherty, 2004), and OSTRICH (Matott, 2005; Fredrick and others (2007). These codes often read simulated equivalents from a list in a file produced by a process model such as MODFLOW that represents a system of interest. At times values needed by the universal code are missing or assigned default values because the process model could not produce a useful solution. SIM_ADJUST can be used to (1) read a file that lists expected observation or prediction names and possible alternatives for the simulated values; (2) read a file produced by a process model that contains space or tab delimited columns, including a column of simulated values and a column of related observation or prediction names; (3) identify observations or predictions that have been omitted or assigned a default value by the process model; and (4) produce an adjusted file that contains a column of simulated values and a column of associated observation or prediction names. The user may provide alternatives that are constant values or that are alternative simulated values. The user may also provide a sequence of alternatives. For example, the heads from a series of cells may be specified to ensure that a meaningful value is available to compare with an observation located in a cell that may become dry. SIM_ADJUST is constructed using modules from the JUPITER API, and is intended for use on any computer operating system. SIM_ADJUST consists of algorithms programmed in Fortran90, which efficiently performs numerical calculations.

Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

PubMed

Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

2015-04-01

Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, p<0.05). The skeletal muscle index was negatively correlated with most cardiometabolic risk factors, including fasting glucose and cholesterol levels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Generalized adjustment by least squares ( GALS).

USGS Publications Warehouse

Elassal, A.A.

1983-01-01

The least-squares principle is universally accepted as the basis for adjustment procedures in the allied fields of geodesy, photogrammetry and surveying. A prototype software package for Generalized Adjustment by Least Squares (GALS) is described. The package is designed to perform all least-squares-related functions in a typical adjustment program. GALS is capable of supporting development of adjustment programs of any size or degree of complexity. -Author

39 CFR 3010.28 - Maximum size of unused rate adjustment authority rate adjustments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Maximum size of unused rate adjustment authority rate adjustments. 3010.28 Section 3010.28 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.28 Maximum size of...

Comparison of clinical probability-adjusted D-dimer and age-adjusted D-dimer interpretation to exclude venous thromboembolism.

PubMed

Takach Lapner, Sarah; Julian, Jim A; Linkins, Lori-Ann; Bates, Shannon; Kearon, Clive

2017-10-05

Two new strategies for interpreting D-dimer results have been proposed: i) using a progressively higher D-dimer threshold with increasing age (age-adjusted strategy) and ii) using a D-dimer threshold in patients with low clinical probability that is twice the threshold used in patients with moderate clinical probability (clinical probability-adjusted strategy). Our objective was to compare the diagnostic accuracy of age-adjusted and clinical probability-adjusted D-dimer interpretation in patients with a low or moderate clinical probability of venous thromboembolism (VTE). We performed a retrospective analysis of clinical data and blood samples from two prospective studies. We compared the negative predictive value (NPV) for VTE, and the proportion of patients with a negative D-dimer result, using two D-dimer interpretation strategies: the age-adjusted strategy, which uses a progressively higher D-dimer threshold with increasing age over 50 years (age in years × 10 µg/L FEU); and the clinical probability-adjusted strategy which uses a D-dimer threshold of 1000 µg/L FEU in patients with low clinical probability and 500 µg/L FEU in patients with moderate clinical probability. A total of 1649 outpatients with low or moderate clinical probability for a first suspected deep vein thrombosis or pulmonary embolism were included. The NPV of both the clinical probability-adjusted strategy (99.7 %) and the age-adjusted strategy (99.6 %) were similar. However, the proportion of patients with a negative result was greater with the clinical probability-adjusted strategy (56.1 % vs, 50.9 %; difference 5.2 %; 95 % CI 3.5 % to 6.8 %). These findings suggest that clinical probability-adjusted D-dimer interpretation is a better way of interpreting D-dimer results compared to age-adjusted interpretation.

New index of social deprivation during pregnancy: results from a national study in France.

PubMed

Opatowski, Marion; Blondel, Béatrice; Khoshnood, Babak; Saurel-Cubizolles, Marie-Josèphe

2016-04-05

To identify precariousness markers in pregnant women that differ from the usual socioeconomic variables. Data were obtained from the National Perinatal Survey, a representative sample of women giving birth in France in 2010. From six indicators of social vulnerability, four were selected by multiple correspondence analysis. The first axis of this analysis was used, characterised by the following contributory variables: receiving RSA (Revenu de Solidarité Active) allowance; benefitting from the CMU (Couverture Maladie Universelle) system (French social security) or not being insured; not living in own accommodation; and not living with a partner. These four variables were summed to create a deprivation index. This index was strongly associated with social maternal characteristics and correctly identified women who were socially vulnerable. Furthermore, it was highly related to the psychosocial context, access to care, behaviours during pregnancy, and pregnancy outcomes. These associations remained significant after adjustment for social variables: compared with no deprivation (no factors), a high level of deprivation (≥3 factors) was associated with late prenatal care (OR 5.8, 95% CI 4.6 to 7.2) and small for gestational age (OR 1.5, 95% CI 1.1 to 1.9). This index of social deprivation was associated with health issues and behaviours during pregnancy, even after adjustment for social variables, revealing a dimension not measured by the usual variables. Moreover, it is simple to use and easily reproducible. 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/

Environmental Quality Index - Overview Report | Science ...

EPA Pesticide Factsheets

A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and humanhealth. Described in this report is the effort to construct an environmental quality index representing multiple domains of the ambient environment, includingair, water, land, built and sociodemographic for all counties in the U.S. for the time period including the years 2000-2005. The EQI was created for two mainpurposes: a.) as an indicator of ambient conditions/exposure in environmental health modeling and b.) as a covariate to adjust for ambient conditions inenvironmental models. However, as detailed in the discussion of this report, the EQI can be adapted and used for other objectives. The EQI was developedin four parts: domain identification; data source identification and review; variable construction; and data reduction. Each of these four areas represents achapter in the report where detailed information is provided on the development of the EQI. The methods applied provide a reproducible approach thatcapitalizes almost exclusively on publically-available data sources.This report is written as an overview to the companion technical document. A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) was developed for all counties in the U.S. using indicators from the

Statistics, Adjusted Statistics, and Maladjusted Statistics.

PubMed

Kaufman, Jay S

2017-05-01

Statistical adjustment is a ubiquitous practice in all quantitative fields that is meant to correct for improprieties or limitations in observed data, to remove the influence of nuisance variables or to turn observed correlations into causal inferences. These adjustments proceed by reporting not what was observed in the real world, but instead modeling what would have been observed in an imaginary world in which specific nuisances and improprieties are absent. These techniques are powerful and useful inferential tools, but their application can be hazardous or deleterious if consumers of the adjusted results mistake the imaginary world of models for the real world of data. Adjustments require decisions about which factors are of primary interest and which are imagined away, and yet many adjusted results are presented without any explanation or justification for these decisions. Adjustments can be harmful if poorly motivated, and are frequently misinterpreted in the media's reporting of scientific studies. Adjustment procedures have become so routinized that many scientists and readers lose the habit of relating the reported findings back to the real world in which we live.

Adjustable-Torque Truss-Joint Mechanism

NASA Technical Reports Server (NTRS)

Bush, Harold G.; Wallsom, Richard E.

1993-01-01

Threaded pin tightened or loosened; tedious trial-and-error procedure shortened. Mechanism joining strut and node in truss structure preloaded to desired stress to ensure tight, compressive fit preventing motion of strut during loading or vibration. Preload stress on stack of Belleville spring washers adjusted by tightening or loosening threaded Belleville-washer-alignment pin. Pin turned, by use of allen wrench, to adjust compression preload on Belleville washers and adjusts joint-operating torque.

Refractive index modulation of Sb70Te30 phase-change thin films by multiple femtosecond laser pulses

NASA Astrophysics Data System (ADS)

Lei, Kai; Wang, Yang; Jiang, Minghui; Wu, Yiqun

2016-05-01

In this study, the controllable effective refractive index modulation of Sb70Te30 phase-change thin films between amorphous and crystalline states was achieved experimentally by multiple femtosecond laser pulses. The modulation mechanism was analyzed comprehensively by a spectral ellipsometer measurement, surface morphology observation, and two-temperature model calculations. We numerically demonstrate the application of the optically modulated refractive index of the phase-change thin films in a precisely adjustable color display. These results may provide further insights into ultrafast phase-transition mechanics and are useful in the design of programmable photonic and opto-electrical devices based on phase-change memory materials.

Optimizing ACS NSQIP modeling for evaluation of surgical quality and risk: patient risk adjustment, procedure mix adjustment, shrinkage adjustment, and surgical focus.

PubMed

Cohen, Mark E; Ko, Clifford Y; Bilimoria, Karl Y; Zhou, Lynn; Huffman, Kristopher; Wang, Xue; Liu, Yaoming; Kraemer, Kari; Meng, Xiangju; Merkow, Ryan; Chow, Warren; Matel, Brian; Richards, Karen; Hart, Amy J; Dimick, Justin B; Hall, Bruce L

2013-08-01

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) collects detailed clinical data from participating hospitals using standardized data definitions, analyzes these data, and provides participating hospitals with reports that permit risk-adjusted comparisons with a surgical quality standard. Since its inception, the ACS NSQIP has worked to refine surgical outcomes measurements and enhance statistical methods to improve the reliability and validity of this hospital profiling. From an original focus on controlling for between-hospital differences in patient risk factors with logistic regression, ACS NSQIP has added a variable to better adjust for the complexity and risk profile of surgical procedures (procedure mix adjustment) and stabilized estimates derived from small samples by using a hierarchical model with shrinkage adjustment. New models have been developed focusing on specific surgical procedures (eg, "Procedure Targeted" models), which provide opportunities to incorporate indication and other procedure-specific variables and outcomes to improve risk adjustment. In addition, comparative benchmark reports given to participating hospitals have been expanded considerably to allow more detailed evaluations of performance. Finally, procedures have been developed to estimate surgical risk for individual patients. This article describes the development of, and justification for, these new statistical methods and reporting strategies in ACS NSQIP. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults.

PubMed

Kim, Min Kyung; Ahn, Chul Woo; Kang, Shinae; Nam, Ji Sun; Kim, Kyung Rae; Park, Jong Suk

2017-08-23

The triglyceride glucose (TyG) index has been considered a simple surrogate marker of insulin resistance. However, few studies have investigated the relationship between the TyG index and coronary artery calcification (CAC). Thus, we investigated the relationship between the TyG index and CAC in healthy Korean adults. In total, 4319 participants who underwent cardiac computed tomography (CT) in a health promotion center were enrolled. Anthropometric profiles and multiple cardiovascular risk factors were measured. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2], and the insulin resistance index of homeostasis model assessment (HOMA-IR) was estimated. The CAC was measured using multidetector CT, and CAC presence was defined as an Agatston score of >0. All subjects were stratified into four groups based on their TyG indices. Significant differences were observed in cardiovascular parameters among the groups, and the prevalence of CAC significantly increased with increasing TyG index. In the logistic regression analysis after adjustment for multiple risk factors, the odds ratio for the prevalence of CAC, when comparing the highest and lowest quartiles of the TyG index was 1.95 (95% CI 1.23-3.11; P for trend = 0.01); the odds ratio for the prevalence of CAC, when comparing the highest and lowest quartiles of HOMA-IR was 1.64 (95% CI 1.12-2.40; P for trend = 0.04). In the receiver operating characteristics analysis, the TyG index was superior to HOMA-IR in predicting CAC. The TyG index is more independently associated with the presence of coronary artery atherosclerosis than is HOMA-IR in healthy Korean adults.

Chiropractic Adjustment

MedlinePlus

... physical function. Why it's done Low back pain, neck pain and headache are the most common problems for ... headaches and other spine-related conditions, such as neck pain. Not everyone responds to chiropractic adjustments. A lot ...

One-way acoustic mirror based on anisotropic zero-index media

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

Gu, Zhong-ming; Liang, Bin, E-mail: liangbin@nju.edu.cn, E-mail: jccheng@nju.edu.cn; Yang, Jing

2015-11-23

We have designed a one-way acoustic mirror comprising anisotropic zero-index media. For acoustic beam incident at a particular angle, the designed structure behaves like a high-efficient mirror that redirects almost all the incident energy into another direction predicted by the Snell's law, while becoming virtually transparent to beams propagating reversely along this output path. Furthermore, the mirror can be tailored to work at arbitrary incident angle by simply adjusting its geometry. Our design, with undirectional reflection functionality and flexible working angle, may offer possibilities in space isolations and have deep implication in various scenarios like ultrasound imaging or noise control.

Modeling and Computing of Stock Index Forecasting Based on Neural Network and Markov Chain

PubMed Central

Dai, Yonghui; Han, Dongmei; Dai, Weihui

2014-01-01

The stock index reflects the fluctuation of the stock market. For a long time, there have been a lot of researches on the forecast of stock index. However, the traditional method is limited to achieving an ideal precision in the dynamic market due to the influences of many factors such as the economic situation, policy changes, and emergency events. Therefore, the approach based on adaptive modeling and conditional probability transfer causes the new attention of researchers. This paper presents a new forecast method by the combination of improved back-propagation (BP) neural network and Markov chain, as well as its modeling and computing technology. This method includes initial forecasting by improved BP neural network, division of Markov state region, computing of the state transition probability matrix, and the prediction adjustment. Results of the empirical study show that this method can achieve high accuracy in the stock index prediction, and it could provide a good reference for the investment in stock market. PMID:24782659

Beyond Body Mass Index. Is the Body Cell Mass Index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?: Body Cell Mass Index links in elderly.

PubMed

Rondanelli, Mariangela; Talluri, Jacopo; Peroni, Gabriella; Donelli, Chiara; Guerriero, Fabio; Ferrini, Krizia; Riggi, Emilia; Sauta, Elisabetta; Perna, Simone; Guido, Davide

2018-06-01

The aim of this study was to establish the effectiveness of Body Cell Mass Index (BCMI) as a prognostic index of (mal)nutrition, inflammation and muscle mass status in the elderly. A cross-sectional observational study has been conducted on 114 elderly patients (80 women and 34 men), with mean age equal to 81.07 ± 6.18 years. We performed a multivariate regression model by Structural Equation Modelling (SEM) framework. We detected the effects over a Mini Nutritional Assessment (MNA) stratification, by performing a multi-group multivariate regression model (via SEM) in two MNA nutritional strata, less and bigger (or equal) than 17. BCMI had a significant effect on albumin (β = +0.062, P = 0.001), adjusting for the other predictors of the model as Body Mass Index (BMI), age, sex, fat mass and cognitive condition. An analogous result is maintained in MNA<17 stratum. BMI has confirmed to be a solid prognostic factor for both free fat mass (FFM) (β = +0.480, P < 0.001) and Skeletal Muscle Index (SMI) (β = +0.265, P < 0.001), assessed by DXA. BCMI also returned suggestive evidences (0.05 < P < 0.10) for both the effect on FFM and on SMI in overall sample. The main result of this study is that the BCMI, compared to BMI, proved to be significantly related to an important marker as albumin in geriatric population. Then, assessing the BCMI could be a valuable, inexpensive, easy to perform tool to investigate the inflammation status of elderly patients. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Predictors of adults' body mass index and the association with index child's infant birth weight, in the Lifeways Cross-Generation Cohort Study of a thousand families in the Republic of Ireland.

PubMed

McKey, S; Heinen, M; Mehegan, J; Somerville, R; Khalil, H; Segurado, R; Murrin, C; Kelleher, C C

2017-12-01

The Lifeways study is novel in having information on three generations of the same families. It is well established that infant birth weight (IBW) predicts individuals' risk of adult chronic disease and more recently studies report cross-generation transmission of risk patterns. The aims of this analysis were to examine whether adults' birth weights were associated with measures of own health status or social position and to relate adults' birth weights to that of the index child's IBW. Finally, we assessed whether birth weight of either adults or children was associated with adult body mass index (BMI) of parents and grandparents. We included 1075 children whose IBW was recorded at recruitment from hospital records and 2546 adult cohort members followed from 2001 until 2014. At baseline, a sub-group of 920 adults had reported own birth weight (RBW). Results showed male adults' RBW were significantly higher than females' (P=0.001). Mothers' RBW was significantly correlated with IBW (r=0.178, P<0.001). In mixed effects linear models with BMI as the outcome variable, of all adults, and in sub-groups of adults with RBW and of mothers only, the IBW was associated with adult BMI adjusting for other predictors. Adults' BMI was positively associated with age (P=0.013), index child's IBW (P=0.001), gender (P<0.001) but not own RBW, adjusting for family identification number. When mothers were removed from the adult models however, IBW ceased to be associated with BMI, a final model showed RBW being associated with adult BMI (P=0.04). There are cross-generational associations in the Lifeways cohort, the maternal association being stronger.

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2012 CFR

2012-04-01

... small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Adjustment § 39.145 Can a school receive both a small school adjustment and a small high school adjustment? A school that meets the criteria in § 39.140 can receive both a small school adjustment and a small high...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2014 CFR

2014-04-01

... small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Adjustment § 39.145 Can a school receive both a small school adjustment and a small high school adjustment? A school that meets the criteria in § 39.140 can receive both a small school adjustment and a small high...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2013 CFR

2013-04-01

... small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Adjustment § 39.145 Can a school receive both a small school adjustment and a small high school adjustment? A school that meets the criteria in § 39.140 can receive both a small school adjustment and a small high...

75 FR 82397 - Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

............ NA........ RAND Schizophrenia 2: ........ Annual assessment of weight/BMI, glycemic control, lipids. 41......... NA........ RAND Schizophrenia B: ........ Proportion of schizophrenia patients with long- term utilization of antipsychotic medications. 42......... NA........ RAND Schizophrenia C...

Expanding the Use of Time/Frequency Difference of Arrival Geolocation in the Department of Defense

DTIC Science & Technology

2012-01-01

next decade. Military acquisition and research , development, test , and evaluation will likely be the hardest hit by spending cuts (Eaglen and Nguyen...Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under copyright law...Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information on reprint

Analysis of the Air Force Logistics Enterprise: Evaluation of Global Repair Network Options for Supporting the C-130

DTIC Science & Technology

2011-01-01

for each of the target shops. The primary maintenance function would be at the flightline to aid sortie generation. However, on observing that...law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non ...commercial use only. Unauthorized posting of RAND electronic documents to a non -RAND website is prohibited. RAND electronic documents are protected under

Correlates of household seismic hazard adjustment adoption.

PubMed

Lindell, M K; Whitney, D J

2000-02-01

This study examined the relationships of self-reported adoption of 12 seismic hazard adjustments (pre-impact actions to reduce danger to persons and property) with respondents' demographic characteristics, perceived risk, perceived hazard knowledge, perceived protection responsibility, and perceived attributes of the hazard adjustments. Consistent with theoretical predictions, perceived attributes of the hazard adjustments differentiated among the adjustments and had stronger correlations with adoption than any of the other predictors. These results identify the adjustments and attributes that emergency managers should address to have the greatest impact on improving household adjustment to earthquake hazard.

Establishment of key grid-connected performance index system for integrated PV-ES system

NASA Astrophysics Data System (ADS)

Li, Q.; Yuan, X. D.; Qi, Q.; Liu, H. M.

2016-08-01

In order to further promote integrated optimization operation of distributed new energy/ energy storage/ active load, this paper studies the integrated photovoltaic-energy storage (PV-ES) system which is connected with the distribution network, and analyzes typical structure and configuration selection for integrated PV-ES generation system. By combining practical grid- connected characteristics requirements and technology standard specification of photovoltaic generation system, this paper takes full account of energy storage system, and then proposes several new grid-connected performance indexes such as paralleled current sharing characteristic, parallel response consistency, adjusting characteristic, virtual moment of inertia characteristic, on- grid/off-grid switch characteristic, and so on. A comprehensive and feasible grid-connected performance index system is then established to support grid-connected performance testing on integrated PV-ES system.

Parenting and adolescents’ psychological adjustment: Longitudinal moderation by adolescents’ genetic sensitivity

PubMed Central

Stocker, Clare M.; Masarik, April S.; Widaman, Keith F.; Reeb, Ben T.; Boardman, Jason D.; Smolen, Andrew; Neppl, Tricia K.; Conger, Katherine J.

2017-01-01

We examined whether adolescents’ genetic sensitivity, measured by a polygenic index score, moderated the longitudinal associations between parenting and adolescents’ internalizing and externalizing problems. The sample included 323 mothers, fathers, and adolescents (177 female, 146 male; Time 1 [T1] average age = 12.61 [SD = 0.54] years, Time 2 [T2] average age = 13.59 [SD = 0.59] years). Parents’ warmth and hostility were rated by trained, independent observers using videotapes of family discussions. Adolescents reported their symptoms of anxiety, depressed mood, and hostility at T1 and T2. Results from autoregressive linear regression models showed that adolescents’ genetic sensitivity moderated associations between observations of mothers’ T1 parenting and adolescents’ T2 symptoms of depression, anxiety, and hostility. For fathers, the same pattern was found for adolescents’ anxiety and hostility, but not for depressed mood. Compared to adolescents with low genetic sensitivity, adolescents with high genetic sensitivity had worse adjustment outcomes when parenting was low on warmth and high on hostility. When parenting was characterized by high warmth and low hostility, adolescents with high genetic sensitivity had better adjustment outcomes than their counterparts with low genetic sensitivity. Results support the differential susceptibility model and highlight the complex ways that genes and environment interact to influence development. PMID:28027713

13 CFR 315.16 - Adjustment proposal requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF COMMERCE TRADE ADJUSTMENT ASSISTANCE FOR FIRMS Adjustment Proposals § 315.16 Adjustment proposal... reasonably calculated to contribute materially to the economic adjustment of the Firm (i.e., that such... generally consists of knowledge-based services such as market penetration studies, customized business...

Adjustable Autonomy Testbed

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schrenkenghost, Debra K.

2001-01-01

The Adjustable Autonomy Testbed (AAT) is a simulation-based testbed located in the Intelligent Systems Laboratory in the Automation, Robotics and Simulation Division at NASA Johnson Space Center. The purpose of the testbed is to support evaluation and validation of prototypes of adjustable autonomous agent software for control and fault management for complex systems. The AA T project has developed prototype adjustable autonomous agent software and human interfaces for cooperative fault management. This software builds on current autonomous agent technology by altering the architecture, components and interfaces for effective teamwork between autonomous systems and human experts. Autonomous agents include a planner, flexible executive, low level control and deductive model-based fault isolation. Adjustable autonomy is intended to increase the flexibility and effectiveness of fault management with an autonomous system. The test domain for this work is control of advanced life support systems for habitats for planetary exploration. The CONFIG hybrid discrete event simulation environment provides flexible and dynamically reconfigurable models of the behavior of components and fluids in the life support systems. Both discrete event and continuous (discrete time) simulation are supported, and flows and pressures are computed globally. This provides fast dynamic simulations of interacting hardware systems in closed loops that can be reconfigured during operations scenarios, producing complex cascading effects of operations and failures. Current object-oriented model libraries support modeling of fluid systems, and models have been developed of physico-chemical and biological subsystems for processing advanced life support gases. In FY01, water recovery system models will be developed.

AE Geomagnetic Index Predictability for High Speed Solar Wind Streams: A Wavelet Decomposition Technique

NASA Technical Reports Server (NTRS)

Guarnieri, Fernando L.; Tsurutani, Bruce T.; Hajra, Rajkumar; Echer, Ezequiel; Gonzalez, Walter D.; Mannucci, Anthony J.

2014-01-01

High speed solar wind streams cause geomagnetic activity at Earth. In this study we have applied a wavelet interactive filtering and reconstruction technique on the solar wind magnetic field components and AE index series to allowed us to investigate the relationship between the two. The IMF Bz component was found as the most significant solar wind parameter responsible by the control of the AE activity. Assuming magnetic reconnection associated to southward directed Bz is the main mechanism transferring energy into the magnetosphere, we adjust parameters to forecast the AE index. The adjusted routine is able to forecast AE, based only on the Bz measured at the L1 Lagrangian point. This gives a prediction approximately 30-70 minutes in advance of the actual geomagnetic activity. The correlation coefficient between the observed AE data and the forecasted series reached values higher than 0.90. In some cases the forecast reproduced particularities observed in the signal very well.The high correlation values observed and the high efficacy of the forecasting can be taken as a confirmation that reconnection is the main physical mechanism responsible for the energy transfer during HILDCAAs. The study also shows that the IMF Bz component low frequencies are most important for AE prediction.

Adjustment Problems of Korean American Elderly.

ERIC Educational Resources Information Center

Kiefer, Christie W.; And Others

1985-01-01

Interviewed 50 elderly Korean immigrants to identify adjustment problems. Ratings of overall stress and adjustment were made in five areas of functioning: social, cultural, economic, health, and emotional/cognitive. Adjustment was positively related to education, length of residence in the United States, and multigenerational household structure.…

Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

PubMed

Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

2006-08-01

We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

An Outcome Study of the M.I.C.A.S. Summer '84 School: Adaptation and Adjustment of Khmer Refugee Children in the United States.

ERIC Educational Resources Information Center

Stephen, Lynn; And Others

This study evaluated the adaptation and adjustment processes of 28 Khmer children (aged 10 to 15 years) in the Boston (Massachusetts) area in a summer school setting provided by the Metropolitan Indochinese Children and Adolescent Services (MICAS). Using the Children's Acculturation Problem Index and the Children's Alienation Scale, supplemented…

45 CFR 153.610 - Risk adjustment issuer requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HHS on behalf of the State. (b) Risk adjustment data storage. An issuer that offers risk adjustment... adjustment issuer requirements. (a) Data requirements. An issuer that offers risk adjustment covered plans must submit or make accessible all required risk adjustment data for those risk adjustment covered...

45 CFR 153.610 - Risk adjustment issuer requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HHS on behalf of the State. (b) Risk adjustment data storage. An issuer that offers risk adjustment... adjustment issuer requirements. (a) Data requirements. An issuer that offers risk adjustment covered plans must submit or make accessible all required risk adjustment data for those risk adjustment covered...

45 CFR 153.610 - Risk adjustment issuer requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HHS on behalf of the State. (b) Risk adjustment data storage. An issuer that offers risk adjustment... adjustment issuer requirements. (a) Data requirements. An issuer that offers risk adjustment covered plans must submit or make accessible all required risk adjustment data for those risk adjustment covered...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

29 CFR 785.42 - Adjusting grievances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Adjusting Grievances, Medical Attention, Civic and Charitable Work, and Suggestion Systems § 785.42 Adjusting grievances. Time spent in adjusting grievances between an employer and employees during the time the employees are required to be on the premises is hours worked, but in the event a bona fide union...

24 CFR 5.611 - Adjusted income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income (as...

12 CFR 313.55 - Salary adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay arising...

Rand Corporation

MedlinePlus

... Posts America Is Great at Fighting Terrorism, but Terror Is Alive and Well Can Vaping Help Smokers ... Commentary: America Is Great at Fighting Terrorism, but Terror Is Alive and Well William Shadel @william_shadel ...

Walkability Index

EPA Pesticide Factsheets

The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

Comparison of Topographic Effects between the Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI)

NASA Astrophysics Data System (ADS)

Matsushita, B.; Yang, W.; Chen, J.; Onda, Y.

2007-12-01

Vegetation indices play an important role in monitoring variations in vegetation. The Enhanced Vegetation Index (EVI) proposed by the MODIS Land Discipline Group and the Normalized Difference Vegetation Index (NDVI) are both global-based vegetation indices aimed at providing consistent spatial and temporal information regarding global vegetation. However, many environmental factors such as atmospheric conditions and soil background may produce errors in these indices. The topographic effect is another very important factor, especially when the indices are used in areas of rough terrain. In this paper, we analyzed differences in the topographic effect between the EVI and the NDVI based on a non-Lambertian model and using two airborne-based images with a spatial resolution of 1.5m acquired from a mountainous area covered by a homogeneous Japanese cypress plantation. The results indicate that the soil adjustment factor "L" in the EVI makes it more sensitive to topographic conditions than is the NDVI. Based on these results, we strongly recommend that the topographic effect be removed from the EVI--as well as from other vegetation indices that similarly include a term without a band ratio format (e.g., the PVI and SAVI)--when these indices are used in conjunction with a high spatial resolution image of an area of rough terrain, where the topographic effect on the vegetarian indices having only a band ratio format (e.g., the NDVI) can usually be ignored.

Intratheater Airlift Functional Solution Analysis (FSA)

DTIC Science & Technology

2011-01-01

law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non ...commercial use only. Unauthorized posting of RAND electronic documents to a non -RAND website is prohibited. RAND electronic documents are protected under...1. REPORT DATE 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Intratheater Airlift Functional Solution

Air Power Against Terror: America’s Conduct of Operation Enduring Freedom

DTIC Science & Technology

2005-01-01

Institute View document details For More Information This PDF document was made available from www.rand.org as a public service of the RAND Corporation ...WORKFORCE AND WORKPLACE The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Rand Corporation ,1776 Main Street,PO Box 2138,Santa Monica,CA,90407-2138 8

A Framework to Assess Programs for Building Partnerships

DTIC Science & Technology

2009-01-01

available from www.rand.org as a public service of the RAND Corporation . 6Jump down to document THE ARTS CHILD POLICY CIVIL JUSTICE EDUCATION ENERGY...ABUSE TERRORISM AND HOMELAND SECURITY TRANSPORTATION AND INFRASTRUCTURE WORKFORCE AND WORKPLACE The RAND Corporation is a nonprofit research...6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Rand Corporation ,1776

Comparison of the performance of the CMS Hierarchical Condition Category (CMS-HCC) risk adjuster with the Charlson and Elixhauser comorbidity measures in predicting mortality.

PubMed

Li, Pengxiang; Kim, Michelle M; Doshi, Jalpa A

2010-08-20

The Centers for Medicare and Medicaid Services (CMS) has implemented the CMS-Hierarchical Condition Category (CMS-HCC) model to risk adjust Medicare capitation payments. This study intends to assess the performance of the CMS-HCC risk adjustment method and to compare it to the Charlson and Elixhauser comorbidity measures in predicting in-hospital and six-month mortality in Medicare beneficiaries. The study used the 2005-2006 Chronic Condition Data Warehouse (CCW) 5% Medicare files. The primary study sample included all community-dwelling fee-for-service Medicare beneficiaries with a hospital admission between January 1st, 2006 and June 30th, 2006. Additionally, four disease-specific samples consisting of subgroups of patients with principal diagnoses of congestive heart failure (CHF), stroke, diabetes mellitus (DM), and acute myocardial infarction (AMI) were also selected. Four analytic files were generated for each sample by extracting inpatient and/or outpatient claims for each patient. Logistic regressions were used to compare the methods. Model performance was assessed using the c-statistic, the Akaike's information criterion (AIC), the Bayesian information criterion (BIC) and their 95% confidence intervals estimated using bootstrapping. The CMS-HCC had statistically significant higher c-statistic and lower AIC and BIC values than the Charlson and Elixhauser methods in predicting in-hospital and six-month mortality across all samples in analytic files that included claims from the index hospitalization. Exclusion of claims for the index hospitalization generally led to drops in model performance across all methods with the highest drops for the CMS-HCC method. However, the CMS-HCC still performed as well or better than the other two methods. The CMS-HCC method demonstrated better performance relative to the Charlson and Elixhauser methods in predicting in-hospital and six-month mortality. The CMS-HCC model is preferred over the Charlson and Elixhauser methods

12 CFR 1780.80 - Inflation adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Inflation adjustments. 1780.80 Section 1780.80... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within OFHEO's...

A "Goldilocks" Approach to Hearing Aid Self-Fitting: Ear-Canal Output and Speech Intelligibility Index.

PubMed

Mackersie, Carol; Boothroyd, Arthur; Lithgow, Alexandra

2018-06-11

The objective was to determine self-adjusted output response and speech intelligibility index (SII) in individuals with mild to moderate hearing loss and to measure the effects of prior hearing aid experience. Thirteen hearing aid users and 13 nonusers, with similar group-mean pure-tone thresholds, listened to prerecorded and preprocessed sentences spoken by a man. Starting with a generic level and spectrum, participants adjusted (1) overall level, (2) high-frequency boost, and (3) low-frequency cut. Participants took a speech perception test after an initial adjustment before making a final adjustment. The three self-selected parameters, along with individual thresholds and real-ear-to-coupler differences, were used to compute output levels and SIIs for the starting and two self-adjusted conditions. The values were compared with an NAL second nonlinear threshold-based prescription (NAL-NL2) and, for the hearing aid users, performance of their existing hearing aids. All participants were able to complete the self-adjustment process. The generic starting condition provided outputs (between 2 and 8 kHz) and SIIs that were significantly below those prescribed by NAL-NL2. Both groups increased SII to values that were not significantly different from prescription. The hearing aid users, but not the nonusers, increased high-frequency output and SII significantly after taking the speech perception test. Seventeen of the 26 participants (65%) met an SII criterion of 60% under the generic starting condition. The proportion increased to 23 out of 26 (88%) after the final self-adjustment. Of the 13 hearing aid users, 8 (62%) met the 60% criterion with their existing hearing aids. With the final self-adjustment, 12 out of 13 (92%) met this criterion. The findings support the conclusion that user self-adjustment of basic amplification characteristics can be both feasible and effective with or without prior hearing aid experience.

28 CFR 85.2 - Calculation of adjustment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 85.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CIVIL MONETARY PENALTIES INFLATION ADJUSTMENT § 85.2 Calculation of adjustment. (a) The inflation adjustments described in § 85.3 were... Inflation Adjustment Act of 1990, Pub. L. 101-410. Any increase so determined was rounded to the nearest— (1...

An evaluation of multiple trauma severity indices created by different index development strategies.

PubMed

Gustafson, D H; Fryback, D G; Rose, J H; Prokop, C T; Detmer, D E; Rossmeissl, J C; Taylor, C M; Alemi, F; Carnazzo, A J

1983-07-01

Evaluation of the effectiveness of emergency trauma care systems is complicated by the need to adjust for the widely variable case mix found in trauma patient populations. Several strategies have been advanced to construct the severity indices that can control for these population differences. This article describes a validity and reliability comparison of trauma severity indices developed under three different approaches: 1) use of a multi-attribute utility (MAU) model; 2) an actuarial approach relying on empirical data bases; and 3) an "ad hoc" approach. Seven criteria were identified to serve as standards of comparison for four different indices. The study's findings indicate that the index developed using the MAU theory approach associates most closely with physician judgments of trauma severity. When correlated with a morbidity outcome measure, the MAU-based index shows higher levels of agreement than the other indices. The index development approach based on the principles of MAU theory has several advantages and it appears to be a powerful tool in the creation of effective severity indices.

Robotics FAQ Index

Science.gov Websites

faqs.org Robotics FAQ Index faqs.org faqs.org - Internet FAQ Archives Robotics FAQ Index [By Updates | Archive Stats | Search | Help] Internet RFC Index Usenet FAQ Index Other FAQs Documents Tools

7 CFR 1744.64 - Budget adjustment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from another...

77 FR 5262 - Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

...] Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment AGENCY... per capita indicator for recommending cost share adjustments for major disasters declared on or after... INFORMATION: Pursuant to 44 CFR 206.47, the statewide per capita indicator that is used to recommend an...

78 FR 9935 - Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

...] Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment AGENCY... per capita indicator for recommending cost share adjustments for major disasters declared on or after... INFORMATION: Pursuant to 44 CFR 206.47, the statewide per capita indicator that is used to recommend an...

19 CFR 351.413 - Disregarding insignificant adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... any group of adjustments having an ad valorem effect of less than 1.0 percent, of the export price, constructed export price, or normal value, as the case may be. Groups of adjustments are adjustments for differences in circumstances of sale under § 351.410, adjustments for differences in the physical...

48 CFR 252.215-7000 - Pricing adjustments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Pricing adjustments. 252... Provisions And Clauses 252.215-7000 Pricing adjustments. As prescribed in 215.408(1), use the following clause: Pricing Adjustments (DEC 1991) The term “pricing adjustment,” as used in paragraph (a) of the...

Augmentation index (AI) in a dose-response relationship with smoking habits in males: The Tanushimaru study.

PubMed

Tsuru, Tomoko; Adachi, Hisashi; Enomoto, Mika; Fukami, Ako; Kumagai, Eita; Nakamura, Sachiko; Nohara, Yume; Kono, Shoko; Nakao, Erika; Sakaue, Akiko; Morikawa, Nagisa; Fukumoto, Yoshihiro

2016-12-01

We investigated the relationship between augmentation index (AI) and smoking habits in community-dwelling Japanese.This cross-sectional study enrolled 1926 subjects (769 males and 1157 females) aged 40 to 95 years who underwent a health check-up in a Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town in Kyushu Island in 2009. The subjects' medical history, alcohol intake, smoking habit, and current medications for hypertension, dyslipidemia, and diabetes were ascertained by questionnaire. Radial arterial pressure wave analysis was used to obtain AI. We analyzed the data stratified by gender.Age-adjusted means of AI in males showed a clear dose-response relationship in 4 categories of smoking habits (P = 0.010). There was no significant relationship between AI and smoking habits in females (P = 0.127). The significant dose-response relationship (P = 0.036) in males between AI and 4 categories of smoking habits still remained even after adjustment for age, body mass index, systolic blood pressure, estimated glomerular filtration rate, glucose, hypertensive medication, and alcohol intake.The present study demonstrated that AI values were significantly associated with smoking habits in a dose-dependent manner in Japanese males.

FIB-4 index is associated with hepatocellular carcinoma risk in HIV-infected patients.

PubMed

Park, Lesley S; Tate, Janet P; Justice, Amy C; Lo Re, Vincent; Lim, Joseph K; Bräu, Norbert; Brown, Sheldon T; Butt, Adeel A; Gibert, Cynthia; Goetz, Matthew Bidwell; Rimland, David; Rodriguez-Barradas, Maria C; Dubrow, Robert

2011-12-01

Chronic inflammation caused by hepatitis B virus infection, hepatitis C virus infection, and/or heavy alcohol use can lead to fibrosis, cirrhosis, and eventually hepatocellular carcinoma (HCC). FIB-4 is an index score calculated from platelet count, alanine transaminase, aspartate transaminase, and age that predicts fibrosis and cirrhosis. We hypothesized that high FIB-4 would be associated with development of HCC in HIV-infected persons, who are at high risk due to high prevalence of viral hepatitis and alcohol consumption, and possibly due to HIV infection itself. Using proportional hazards models, we tested this hypothesis among 22,980 HIV-infected men from the Veterans Aging Cohort Study. We identified incident HCC cases from the Veterans Affairs Central Cancer Registry. During follow-up, there were 112 incident HCC diagnoses. The age- and race/ethnic group-adjusted HR was 4.2 [95% confidence interval (CI), 2.4-7.4] for intermediate FIB-4 and 13.0 (95% CI, 7.2-23.4) for high FIB-4, compared with low FIB-4. After further adjustment for enrollment year, CD4 count, HIV-1 RNA level, antiretroviral therapy use, hepatitis B and C virus infection, alcohol abuse/dependency, and diabetes, FIB-4 remained a strong, significant, independent risk factor for HCC. The multivariate-adjusted HR was 3.6 (95% CI, 2.1-6.4) for intermediate FIB-4 and 9.6 (95% CI, 5.2-17.4) for high FIB-4. Calculated from routine, noninvasive laboratory tests, FIB-4 is a strong, independent HCC risk factor in HIV-infected patients. FIB-4 might prove valuable as an easily measured index to identify those at highest risk for HCC, even prior to development of clinical cirrhosis.

Role of heterogeneous research and development funds in the productivity of the US manufacturing industry

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

Rhee, C.O.

1987-01-01

This paper investigates, in the framework of firm's optimal behavior, the effect of company-funded and federally-funded RandD on productivity in selected US industries. Especially, the role of federal funding RandD in productivity through direct as well as indirect mechanisms is analyzed. Using different model specification, two types of RandD-federal and company, and data of industry level, no support can be found for the blanket statement that federally-funded RandD (FRD) crowds out or pulls in company-funding RandD in productivity growth. Whether crowding-out or pulling-in is shown to be industry-specific as well as based on FRD's time dimension. Hence, the lag effectmore » of heterogeneous RandD funds on productivity is emphasized. The classification of heterogeneous RandD funds into basic research, applied research, and development is adopted to look at the impact of each on productivity. The model of firm's optimal behavior following such classification demonstrates that federally-funded basic research has a tremendous pulling-in impact on company-funded applied research and development, respectively.« less

CENDI Indexing Workshop

NASA Technical Reports Server (NTRS)

1994-01-01

The CENDI Indexing Workshop held at NASA Headquarters, Two Independence Square, 300 E Street, Washington, DC, on September 21-22, 1994 focused on the following topics: machine aided indexing, indexing quality, an indexing pilot project, the MedIndEx Prototype, Department of Energy/Office of Scientific and Technical Information indexing activities, high-tech coding structures, category indexing schemes, and the Government Information Locator Service. This publication consists mostly of viewgraphs related to the above noted topics. In an appendix is a description of the Government Information Locator Service.

Remotely Adjustable Hydraulic Pump

NASA Technical Reports Server (NTRS)

Kouns, H. H.; Gardner, L. D.

1987-01-01

Outlet pressure adjusted to match varying loads. Electrohydraulic servo has positioned sleeve in leftmost position, adjusting outlet pressure to maximum value. Sleeve in equilibrium position, with control land covering control port. For lowest pressure setting, sleeve shifted toward right by increased pressure on sleeve shoulder from servovalve. Pump used in aircraft and robots, where hydraulic actuators repeatedly turned on and off, changing pump load frequently and over wide range.

The relationship between effectiveness and costs measured by a risk-adjusted case-mix system: multicentre study of Catalonian population data bases.

PubMed

Sicras-Mainar, Antoni; Navarro-Artieda, Ruth; Blanca-Tamayo, Milagrosa; Velasco-Velasco, Soledad; Escribano-Herranz, Esperanza; Llopart-López, Josep Ramon; Violan-Fors, Concepción; Vilaseca-Llobet, Josep Maria; Sánchez-Fontcuberta, Encarna; Benavent-Areu, Jaume; Flor-Serra, Ferran; Aguado-Jodar, Alba; Rodríguez-López, Daniel; Prados-Torres, Alejandra; Estelrich-Bennasar, Jose

2009-06-25

The main objective of this study is to measure the relationship between morbidity, direct health care costs and the degree of clinical effectiveness (resolution) of health centres and health professionals by the retrospective application of Adjusted Clinical Groups in a Spanish population setting. The secondary objectives are to determine the factors determining inadequate correlations and the opinion of health professionals on these instruments. We will carry out a multi-centre, retrospective study using patient records from 15 primary health care centres and population data bases. The main measurements will be: general variables (age and sex, centre, service [family medicine, paediatrics], and medical unit), dependent variables (mean number of visits, episodes and direct costs), co-morbidity (Johns Hopkins University Adjusted Clinical Groups Case-Mix System) and effectiveness.The totality of centres/patients will be considered as the standard for comparison. The efficiency index for visits, tests (laboratory, radiology, others), referrals, pharmaceutical prescriptions and total will be calculated as the ratio: observed variables/variables expected by indirect standardization.The model of cost/patient/year will differentiate fixed/semi-fixed (visits) costs of the variables for each patient attended/year (N = 350,000 inhabitants). The mean relative weights of the cost of care will be obtained. The effectiveness will be measured using a set of 50 indicators of process, efficiency and/or health results, and an adjusted synthetic index will be constructed (method: percentile 50).The correlation between the efficiency (relative-weights) and synthetic (by centre and physician) indices will be established using the coefficient of determination. The opinion/degree of acceptance of physicians (N = 1,000) will be measured using a structured questionnaire including various dimensions. multiple regression analysis (procedure: enter), ANCOVA (method: Bonferroni's adjustment

Use of social adaptability index to explain self-care and diabetes outcomes.

PubMed

Campbell, Jennifer A; Walker, Rebekah J; Smalls, Brittany L; Egede, Leonard E

2017-06-20

To examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes. Six hundred fifteen patients were recruited from two primary care settings. A series of multiple linear regression models were run to assess (1) associations between the SAI and diabetes self-care/outcomes, and (2) associations between individual SAI indicator variables and diabetes self-care/outcomes. Separate models were run for each self-care behavior and outcome. Two models were run for each dependent variable to compare associations with the SAI and components of the index. The SAI has a significant association with the mental component of quality of life (0.23, p < 0.01). In adjusted analyses, the SAI score did not have a significant association with any of the self-care behaviors. Individual components from the index had significant associations between self-care and multiple SAI indicator variables. Significant associations also exist between outcomes and the individual SAI indicators for education and employment. In this population, the SAI has low explanatory power and few significant associations with diabetes self-care/outcomes. While the use of a composite index to predict outcomes within a diabetes population would have high utility, particularly for clinical settings, this SAI lacks statistical and clinical significance in a representative diabetes population. Based on these results, the index does not provide a good model fit and masks the relationship of individual components to diabetes self-care and outcomes. These findings suggest that five items alone are not adequate to explain or predict outcomes for patients with type 2 diabetes.

Effect of insulin therapy and dietary adjustments on safety and performance during simulated soccer tests in people with type 1 diabetes: study protocol for a randomized controlled trial.

PubMed

Calvo-Marín, Javier; Torrealba-Acosta, Gabriel; Campbell, Matthew; Gaboury, Jesse; Ali, Ajmol; Chen-Ku, Chih Hao

2017-07-20

Despite the reduction in glycemic derangement in patients with type 1 diabetes mellitus (T1D) through dietary and therapeutic adjustments implemented before, during and after continuous exercise, evidence for its effectiveness with intermittent forms of exercise, such as soccer, is still lacking. We designed a study protocol for a randomized, crossover, double-blinded, controlled trial, for the evaluation of the effect that a strategy of dietary and therapeutic modifications may have on safety and performance of persons with T1D in soccer training sessions and cognitive testing. Inclusion criteria comprise: age older than 18 years, more than 2 years since T1D diagnosis, low C-peptide level, a stable insulin regimen, HbA1c less than 9.0% and regular participation in soccer activities. Our primary outcome evaluates safety regarding hypoglycemia events in patients using dietary and therapeutic adjustments, compared with the performance under the implementation of current American Diabetes Association (ADA) usual recommendations for nutritional and pharmacological adjustments for exercise. Additionally, we will evaluate as secondary outcomes: soccer performance, indexed by performance in well-established soccer skill tests, cognitive functions (indexed by Stroop, digital vigilance test (DVT), Corsi block-tapping task (CBP), and rapid visual information processing (RVIP) tests), and glycemic control measured with a continuous glucose monitor (CGM). Dietary and insulin adjustments standardized under a 4-step method strategy have never been tested in a clinical trial setting with intermittent forms of exercise, such as soccer. We hypothesize that through this strategy we will observe better performance by persons with T1D in soccer and cognitive evaluations, and more stable control of glycemic parameters before, during and after exercise execution, indexed by CGM measurements. ISRCTN, ISRCTN17447843. Registered on 5 January 2017.

Spectral Index and Quasi-Periodic Oscillation Frequency Correlation in Black Hole (BH) Sources: Observational Evidence of Two Phases and Phase Transition in BHs

NASA Technical Reports Server (NTRS)

Titarchuk, Lev; Fiorito, Ralph

2004-01-01

Recent studies have shown that strong correlations are observed between the low frequencies (1-10 Hz) of quasiperiodic oscillations (QPOs) and the spectral power law index of several Black Hole (BH) candidate sources, in low hard states, steep power-law (soft) states and in transition between these states. The observations indicate that the X-ray spectrum of such state (phases) show the presence of a power-law component and are sometimes related to simultaneous radio emission indicated the probable presence of a jet. Strong QPOs (less than 20% rms) are present in the power density spectrum in the spectral range where the power-law component is dominant ( i.e. 60-90% ). This evidence contradicts the dominant long standing interpretation of QPOs as a signature of the thermal accretion disk. We present the data from the literature and our own data to illustrate the dominance of power-law index-QPO frequency correlations. We provide a model, that identifies and explains the origin of the QPOs and how they are imprinted on the properties of power-law flux component. We argue the existence of a bounded compact coronal region which is a natural consequence of the adjustment of Keplerian disk flow to the innermost sub-Keplerian boundary conditions near the central object and that ultimately leads to the formation of a transition layer (TL) between the adjustment radius and the innermost boundary. The model predicts two phases or states dictated by the photon upscattering produced in the TL: (1) hard state, in which the TL is optically thin and very hot (kT approx. greater than 50 keV) producing photon upscattering via thermal Componization; the photon spectrum index Gamma appprox.1.5 for this state is dictated by gravitational energy release and Compton cooling in an optically thin shock near the adjustment radius; (2) a soft state which is optically thick and relatively cold (approx. less than 5 keV); the index for this state, Gamma approx. 2.8 is determined by soft

Spectral Index and Quasi-Periodic Oscillation Frequency Correlation in Black Hole Sources: Observational Evidence of Two Phases and Phase Transition in Black Holes

NASA Technical Reports Server (NTRS)

Titarchuk, Lev; Fiorito, Ralph

2004-01-01

Recent studies have shown that strong correlations are observed between the low frequencies (1-10 Hz) of quasi-periodic oscillations (QPOs) and the spectral power law index of several black hole (BH) candidate sources, in low (hard) states, steep power law (soft) states, and transitions between these states. The observations indicate that the X-ray spectra of such state (phases) show the presence of a power-law component and are sometimes related to simultaneous radio emission, indicating the probable presence of a jet. Strong QPOs (>20% rms) are present in the power density spectrum in the spectral range where the power-law component is dominant (i.e., 60%90%). This evidence contradicts the dominant, long-standing interpretation of QPOs as a signature of the thermal accretion disk. We present the data from the literature and our own data to illustrate the dominance of power-law index-QPO frequency correlations. We provide a model that identifies and explains the origin of the QPOs and how they are imprinted on the properties of the power-law flux component. We argue for the existence of a bounded compact coronal region that is a natural consequence of the adjustment of the Keplerian disk flow to the innermost sub-Keplerian boundary conditions near the central object and that ultimately leads to the formation of a transition layer (TL) between the adjustment radius and the innermost boundary. The model predicts two phases or states dictated by the photon upscattering produced in the TL: (1) a hard state, in which the TL is optically thin and very hot (kT approximately greater than 50 keV), producing photon upscattering via thermal Comptonization (the photon spectrum index Gamma approximates 1.7 for this state is dictated by gravitational energy release and Compton cooling in an optically thin shock near the adjustment radius), and (2) a soft state that is optically thick and relatively cold (kT approximately less than 5 keV the index for this state, Gamma

The eye lens: age-related trends and individual variations in refractive index and shape parameters.

PubMed

Pierscionek, Barbara; Bahrami, Mehdi; Hoshino, Masato; Uesugi, Kentaro; Regini, Justyn; Yagi, Naoto

2015-10-13

The eye lens grows throughout life by cell accrual on its surface and can change shape to adjust the focussing power of the eye. Varying concentrations of proteins in successive cell layers create a refractive index gradient. The continued growth of the lens and age-related changes in proteins render it less able to alter shape with loss of capacity by the end of the sixth decade of life. Growth and protein ageing alter the refractive index but as accurate measurement of this parameter is difficult, the nature of such alterations remains uncertain. The most accurate method to date for measuring refractive index in intact lenses has been developed at the SPring-8 synchrotron. The technique, based on Talbot interferometry, has an X-ray source and was used to measure refractive index in sixty-six human lenses, aged from 16 to 91 years. Height and width were measured for forty-five lenses. Refractive index contours show decentration in some older lenses but individual variations mask age-related trends. Refractive index profiles along the optic axis have relatively flat central sections with distinct micro-fluctuations and a steep gradient in the cortex but do not exhibit an age-related trend. The refractive index profiles in the equatorial aspect show statistical significance with age, particularly for lenses below the age of sixty that had capacity to alter shape in vivo. The maximum refractive index in the lens centre decreases slightly with age with considerable scatter in the data and there are age-related variations in sagittal thickness and equatorial height.

The eye lens: age-related trends and individual variations in refractive index and shape parameters

PubMed Central

Pierscionek, Barbara; Bahrami, Mehdi; Hoshino, Masato; Uesugi, Kentaro; Regini, Justyn; Yagi, Naoto

2015-01-01

The eye lens grows throughout life by cell accrual on its surface and can change shape to adjust the focussing power of the eye. Varying concentrations of proteins in successive cell layers create a refractive index gradient. The continued growth of the lens and age-related changes in proteins render it less able to alter shape with loss of capacity by the end of the sixth decade of life. Growth and protein ageing alter the refractive index but as accurate measurement of this parameter is difficult, the nature of such alterations remains uncertain. The most accurate method to date for measuring refractive index in intact lenses has been developed at the SPring-8 synchrotron. The technique, based on Talbot interferometry, has an X-ray source and was used to measure refractive index in sixty-six human lenses, aged from 16 to 91 years. Height and width were measured for forty-five lenses. Refractive index contours show decentration in some older lenses but individual variations mask age-related trends. Refractive index profiles along the optic axis have relatively flat central sections with distinct micro-fluctuations and a steep gradient in the cortex but do not exhibit an age-related trend. The refractive index profiles in the equatorial aspect show statistical significance with age, particularly for lenses below the age of sixty that had capacity to alter shape in vivo. The maximum refractive index in the lens centre decreases slightly with age with considerable scatter in the data and there are age-related variations in sagittal thickness and equatorial height. PMID:26416418