18 CFR 154.403 - Periodic rate adjustments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Periodic rate adjustments. 154.403 Section 154.403 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Changes § 154.403 Periodic rate adjustments. (a) This section applies to the passthrough, on a periodic...

18 CFR 154.403 - Periodic rate adjustments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Periodic rate adjustments. 154.403 Section 154.403 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Changes § 154.403 Periodic rate adjustments. (a) This section applies to the passthrough, on a periodic...

Difficulties with Regression Analysis of Age-Adjusted Rates.

DTIC Science & Technology

1982-09-01

variables used in those analyses, such as death rates in various states, have been age adjusted, whereas the predictor variables have not been age adjusted...The use of crude state death rates as the outcome variable with crude covariates and age as predictors can avoid the problem, at least under some...should be regressed on age-adjusted exposure Z+B+ Although age-specific death rates , Yas+’ may be available, it is often difficult to obtain age

39 CFR 3010.14 - Contents of notice of rate adjustment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Contents of notice of rate adjustment. 3010.14... Adjustments) § 3010.14 Contents of notice of rate adjustment. (a) General. The Postal Service notice of rate... sources; (4) The amount of new unused rate authority, if any, that will be generated by the rate...

7 CFR 1421.102 - Adjustment of basic loan rates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... be adjusted or not adjusted as follows: (1) For farm-stored commodities, except for peanuts, that... rate. (3) With respect to commodities harvested, excluding silage or hay, as other than grain and... basic county loan rate shall not be adjusted to reflect the protein content. (5) With respect to...

5 CFR 536.305 - Adjusting an employee's retained rate when a pay schedule is adjusted.

Code of Federal Regulations, 2010 CFR

2010-01-01

... conversion under § 536.303(b) or any other simultaneous pay action. The retained rate adjustment under... new retained rate must be determined under the geographic conversion rule in § 536.303(b). (4... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Adjusting an employee's retained rate...

Enhancing the Accuracy of Platelet to Lymphocyte Ratio after Adjustment for Large Platelet Count: A Pilot Study in Breast Cancer Patients

PubMed Central

Seretis, Charalampos; Seretis, Fotios; Lagoudianakis, Emmanuel; Politou, Marianna; Gemenetzis, George; Salemis, Nikolaos S.

2012-01-01

Background. The objective of our study is to investigate the potential effect of adjusting preoperative platelet to lymphocyte ratio, an emerging biomarker of survival in cancer patients, for the fraction of large platelets. Methods. A total of 79 patients with breast neoplasias, 44 with fibroadenomas, and 35 with invasive ductal carcinoma were included in the study. Both conventional platelet to lymphocyte ratio (PLR) and the adjusted marker, large platelet to lymphocyte ratio (LPLR), were correlated with laboratory and histopathological parameters of the study sample. Results. LPLR elevation was significantly correlated with the presence of malignancy, advanced tumor stage, metastatic spread in the axillary nodes and HER2/neu overexpression, while PLR was only correlated with the number of infiltrated lymph nodes. Conclusions. This is the first study evaluating the effect of adjustment for large platelet count on improving PLR accuracy, when correlated with the basic independent markers of survival in a sample of breast cancer patients. Further studies are needed in order to assess the possibility of applying our adjustment as standard in terms of predicting survival rates in cancer. PMID:23304480

Enhancing the accuracy of platelet to lymphocyte ratio after adjustment for large platelet count: a pilot study in breast cancer patients.

PubMed

Seretis, Charalampos; Seretis, Fotios; Lagoudianakis, Emmanuel; Politou, Marianna; Gemenetzis, George; Salemis, Nikolaos S

2012-01-01

Background. The objective of our study is to investigate the potential effect of adjusting preoperative platelet to lymphocyte ratio, an emerging biomarker of survival in cancer patients, for the fraction of large platelets. Methods. A total of 79 patients with breast neoplasias, 44 with fibroadenomas, and 35 with invasive ductal carcinoma were included in the study. Both conventional platelet to lymphocyte ratio (PLR) and the adjusted marker, large platelet to lymphocyte ratio (LPLR), were correlated with laboratory and histopathological parameters of the study sample. Results. LPLR elevation was significantly correlated with the presence of malignancy, advanced tumor stage, metastatic spread in the axillary nodes and HER2/neu overexpression, while PLR was only correlated with the number of infiltrated lymph nodes. Conclusions. This is the first study evaluating the effect of adjustment for large platelet count on improving PLR accuracy, when correlated with the basic independent markers of survival in a sample of breast cancer patients. Further studies are needed in order to assess the possibility of applying our adjustment as standard in terms of predicting survival rates in cancer.

Shuttle bit rate synchronizer. [signal to noise ratios and error analysis

NASA Technical Reports Server (NTRS)

Huey, D. C.; Fultz, G. L.

1974-01-01

A shuttle bit rate synchronizer brassboard unit was designed, fabricated, and tested, which meets or exceeds the contractual specifications. The bit rate synchronizer operates at signal-to-noise ratios (in a bit rate bandwidth) down to -5 dB while exhibiting less than 0.6 dB bit error rate degradation. The mean acquisition time was measured to be less than 2 seconds. The synchronizer is designed around a digital data transition tracking loop whose phase and data detectors are integrate-and-dump filters matched to the Manchester encoded bits specified. It meets the reliability (no adjustments or tweaking) and versatility (multiple bit rates) of the shuttle S-band communication system through an implementation which is all digital after the initial stage of analog AGC and A/D conversion.

Alternatives for using multivariate regression to adjust prospective payment rates

PubMed Central

Sheingold, Steven H.

1990-01-01

Multivariate regression analysis has been used in structuring three of the adjustments to Medicare's prospective payment rates. Because the indirect-teaching adjustment, the disproportionate-share adjustment, and the adjustment for large cities are responsible for distributing approximately $3 billion in payments each year, the specification of regression models for these adjustments is of critical importance. In this article, the application of regression for adjusting Medicare's prospective rates is discussed, and the implications that differing specifications could have for these adjustments are demonstrated. PMID:10113271

10 CFR 436.22 - Adjusted internal rate of return.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... yearly net savings in energy or water and non-fuel or non-water operation and maintenance costs...

Adjusting Expected Mortality Rates Using Information From a Control Population: An Example Using Socioeconomic Status.

PubMed

Bower, Hannah; Andersson, Therese M-L; Crowther, Michael J; Dickman, Paul W; Lambe, Mats; Lambert, Paul C

2018-04-01

Expected or reference mortality rates are commonly used in the calculation of measures such as relative survival in population-based cancer survival studies and standardized mortality ratios. These expected rates are usually presented according to age, sex, and calendar year. In certain situations, stratification of expected rates by other factors is required to avoid potential bias if interest lies in quantifying measures according to such factors as, for example, socioeconomic status. If data are not available on a population level, information from a control population could be used to adjust expected rates. We have presented two approaches for adjusting expected mortality rates using information from a control population: a Poisson generalized linear model and a flexible parametric survival model. We used a control group from BCBaSe-a register-based, matched breast cancer cohort in Sweden with diagnoses between 1992 and 2012-to illustrate the two methods using socioeconomic status as a risk factor of interest. Results showed that Poisson and flexible parametric survival approaches estimate similar adjusted mortality rates according to socioeconomic status. Additional uncertainty involved in the methods to estimate stratified, expected mortality rates described in this study can be accounted for using a parametric bootstrap, but this might make little difference if using a large control population.

Deprivation index and dependency ratio are key determinants of emergency medical admission rates.

PubMed

Conway, Richard; Byrne, Declan; O'Riordan, Deirdre; Cournane, Seán; Coveney, Seamus; Silke, Bernard

2015-11-01

Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; there has been debate as to the extent to which deprivation and population structure influences hospital admission rate. All emergency medical admissions to an Irish hospital over a 12-year period (2002-2013) categorized by quintile of Deprivation Index and Dependency Ratio (proportion of population <15 or ≥ 65 years) from small area population statistics (SAPS), were evaluated against hospital admission rates. Univariate and multivariable risk estimates (Odds Ratios (OR) or Incidence Rate Ratios (IRR)) were calculated, using logistic or zero truncated Poisson regression as appropriate. 66,861 admissions in 36,214 patients occured during the study period. The Deprivation Index quintile independently predicted the admission rate/1000 population, Q1 9.4 (95%CI 9.2 to 9.7), Q2 16.8 (95%CI 16.6 to 17.0), Q3 33.8 (95%CI 33.5 to 34.1), Q4 29.6 (95%CI 29.3 to 29.8) and Q5 45.4 (95%CI 44.5 to 46.2). Similarly the population Dependency Ratio was an independent predictor of the admission rate with adjusted predicted rates of Q1 20.8 (95%CI 20.5 to 21.1), Q2 19.2 (95%CI 19.0 to 19.4), Q3 27.6 (95%CI 27.3 to 27.9), Q4 43.9 (95%CI 43.5 to 44.4) and Q5 34.4 (95%CI 34.1 to 34.7). A high concurrent Deprivation Index and Dependency Ratio were associated with very high admission rates. Deprivation Index and population Dependency Ratio are key determinants of the rate of emergency medical admissions. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

18 CFR 154.403 - Periodic rate adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Changes § 154.403 Periodic rate adjustments. (a) This section applies to the passthrough, on a periodic... its rates to reflect changes in transportation and compression costs paid to others: (i) The changes... pre-dating the effectiveness of the tariff language setting forth the periodic rate change mechanism...

Compression Ratio Adjuster

NASA Technical Reports Server (NTRS)

Akkerman, J. W.

1982-01-01

New mechanism alters compression ratio of internal-combustion engine according to load so that engine operates at top fuel efficiency. Ordinary gasoline, diesel and gas engines with their fixed compression ratios are inefficient at partial load and at low-speed full load. Mechanism ensures engines operate as efficiently under these conditions as they do at highload and high speed.

Adjusting Permittivity by Blending Varying Ratios of SWNTs

NASA Technical Reports Server (NTRS)

Tour, James M.; Stephenson, Jason J.; Higginbotham, Amanda

2012-01-01

A new composite material of singlewalled carbon nanotubes (SWNTs) displays radio frequency (0 to 1 GHz) permittivity properties that can be adjusted based upon the nanotube composition. When varying ratios of raw to functionalized SWNTs are blended into the silicone elastomer matrix at a total loading of 0.5 percent by weight, a target real permittivity value can be obtained between 70 and 3. This has particular use for designing materials for microwave lenses, microstrips, filters, resonators, high-strength/low-weight electromagnetic interference (EMI) shielding, antennas, waveguides, and low-loss magneto-dielectric products for applications like radome construction.

10 CFR 903.17 - Informal public meetings for minor rate adjustments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Informal public meetings for minor rate adjustments. 903..., Southwestern, and Western Area Power Administrations § 903.17 Informal public meetings for minor rate adjustments. In lieu of public information or comment forums in conjunction with a minor rate adjustment...

10 CFR 903.17 - Informal public meetings for minor rate adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Informal public meetings for minor rate adjustments. 903..., Southwestern, and Western Area Power Administrations § 903.17 Informal public meetings for minor rate adjustments. In lieu of public information or comment forums in conjunction with a minor rate adjustment...

43 CFR 38.3 - Administration of adjusted rates of pay.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Administration of adjusted rates of pay. 38.3 Section 38.3 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.3 Administration of adjusted rates of pay. (a) An employee is...

Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Hospital Readmission Rates Following Hip and Knee Arthroplasty.

PubMed

Martsolf, Grant R; Barrett, Marguerite L; Weiss, Audrey J; Kandrack, Ryan; Washington, Raynard; Steiner, Claudia A; Mehrotra, Ateev; SooHoo, Nelson F; Coffey, Rosanna

2016-08-17

Readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are increasingly used to measure hospital performance. Readmission rates that are not adjusted for race/ethnicity and socioeconomic status, patient risk factors beyond a hospital's control, may not accurately reflect a hospital's performance. In this study, we examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following THA and TKA. We calculated 2 sets of risk-adjusted readmission rates by (1) using the Centers for Medicare & Medicaid Services standard risk-adjustment algorithm that incorporates patient age, sex, comorbidities, and hospital effects and (2) adding race/ethnicity and socioeconomic status to the model. Using data from the Healthcare Cost and Utilization Project, 2011 State Inpatient Databases, we compared the relative performances of 1,194 hospitals across the 2 methods. Addition of race/ethnicity and socioeconomic status to the risk-adjustment algorithm resulted in (1) little or no change in the risk-adjusted readmission rates at nearly all hospitals; (2) no change in the designation of the readmission rate as better, worse, or not different from the population mean at >99% of the hospitals; and (3) no change in the excess readmission ratio at >97% of the hospitals. Inclusion of race/ethnicity and socioeconomic status in the risk-adjustment algorithm led to a relative-performance change in readmission rates following THA and TKA at <3% of the hospitals. We believe that policymakers and payers should consider this result when deciding whether to include race/ethnicity and socioeconomic status in risk-adjusted THA and TKA readmission rates used for hospital accountability, payment, and public reporting. Prognostic Level III. See instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery

39 CFR 3010.26 - Calculation of unused rate adjustment authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Calculation of unused rate adjustment authority. 3010.26 Section 3010.26 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.26 Calculation of unused rate adjustment...

Evaluation of trauma care using TRISS method: the role of adjusted misclassification rate and adjusted w-statistic.

PubMed

Llullaku, Sadik S; Hyseni, Nexhmi Sh; Bytyçi, Cen I; Rexhepi, Sylejman K

2009-01-15

Major trauma is a leading cause of death worldwide. Evaluation of trauma care using Trauma Injury and Injury Severity Score (TRISS) method is focused in trauma outcome (deaths and survivors). For testing TRISS method TRISS misclassification rate is used. Calculating w-statistic, as a difference between observed and TRISS expected survivors, we compare our trauma care results with the TRISS standard. The aim of this study is to analyze interaction between misclassification rate and w-statistic and to adjust these parameters to be closer to the truth. Analysis of components of TRISS misclassification rate and w-statistic and actual trauma outcome. The component of false negative (FN) (by TRISS method unexpected deaths) has two parts: preventable (Pd) and non-preventable (nonPd) trauma deaths. Pd represents inappropriate trauma care of an institution; otherwise nonpreventable trauma deaths represents errors in TRISS method. Removing patients with preventable trauma deaths we get an Adjusted misclassification rate: (FP + FN - Pd)/N or (b+c-Pd)/N. Substracting nonPd from FN value in w-statistic formula we get an Adjusted w-statistic: [FP-(FN - nonPd)]/N, respectively (FP-Pd)/N, or (b-Pd)/N). Because adjusted formulas clean method from inappropriate trauma care, and clean trauma care from the methods error, TRISS adjusted misclassification rate and adjusted w-statistic gives more realistic results and may be used in researches of trauma outcome.

25 CFR 175.12 - Procedures for adjusting electric power rates except for adjustments due to changes in the cost...

Code of Federal Regulations, 2010 CFR

2010-04-01

... adjustments due to changes in the cost of purchased power or energy. 175.12 Section 175.12 Indians BUREAU OF... adjustments due to changes in the cost of purchased power or energy. Except for adjustments to rates due to changes in the cost of purchased power or energy, the Area Director shall adjust electric power rates...

Risk-adjusted sequential probability ratio tests: applications to Bristol, Shipman and adult cardiac surgery.

PubMed

Spiegelhalter, David; Grigg, Olivia; Kinsman, Robin; Treasure, Tom

2003-02-01

To investigate the use of the risk-adjusted sequential probability ratio test in monitoring the cumulative occurrence of adverse clinical outcomes. Retrospective analysis of three longitudinal datasets. Patients aged 65 years and over under the care of Harold Shipman between 1979 and 1997, patients under 1 year of age undergoing paediatric heart surgery in Bristol Royal Infirmary between 1984 and 1995, adult patients receiving cardiac surgery from a team of cardiac surgeons in London,UK. Annual and 30-day mortality rates. Using reasonable boundaries, the procedure could have indicated an 'alarm' in Bristol after publication of the 1991 Cardiac Surgical Register, and in 1985 or 1997 for Harold Shipman depending on the data source and the comparator. The cardiac surgeons showed no significant deviation from expected performance. The risk-adjusted sequential probability test is simple to implement, can be applied in a variety of contexts, and might have been useful to detect specific instances of past divergent performance. The use of this and related techniques deserves further attention in the context of prospectively monitoring adverse clinical outcomes.

Female starlings adjust primary sex ratio in response to aromatic plants in the nest.

PubMed

Polo, Vicente; Veiga, José P; Cordero, Pedro J; Viñuela, Javier; Monaghan, Pat

2004-09-22

Adjustment of offspring sex ratios should be favoured by natural selection when parents are capable of facultatively altering brood sex ratios and of recognizing the circumstances that predict the probable fitness benefit of producing sons and daughters. Although experimental studies have shown that female birds may adjust offspring sex ratios in response to changes in their own condition and in the external appearance of their mate, and male attributes other than his external morphology are also thought to act as signals of male quality, it is not known whether females will respond to changes in such signals, in the absence of any change in the appearance of the male himself. Here, we experimentally manipulated a male courtship display, the green plants carried to the nest by male spotless starlings (Sturnus unicolor), without changing any physical attributes of the male himself, and examined whether this influenced female decisions on offspring sex ratio. We found that in an environment in which female starlings were producing more daughters than sons, experimental enhancement of the green nesting material caused females to significantly increase the number of male eggs produced and thereby removed the female bias. This effect was consistent in 2 years and at two localities. This demonstrates that the green material, whose function has long puzzled biologists, conveys important information to the female and that she facultatively adjusts offspring production accordingly.

On-demand Reporting of Risk-adjusted and Smoothed Rates for Quality Profiling in ACS NSQIP.

PubMed

Cohen, Mark E; Liu, Yaoming; Huffman, Kristopher M; Ko, Clifford Y; Hall, Bruce L

2016-12-01

Surgical quality improvement depends on hospitals having accurate and timely information about comparative performance. Profiling accuracy is improved by risk adjustment and shrinkage adjustment to stabilize estimates. These adjustments are included in ACS NSQIP reports, where hospital odds ratios (OR) are estimated using hierarchical models built on contemporaneous data. However, the timeliness of feedback remains an issue. We describe an alternative, nonhierarchical approach, which yields risk- and shrinkage-adjusted rates. In contrast to our "Traditional" NSQIP method, this approach uses preexisting equations, built on historical data, which permits hospitals to have near immediate access to profiling results. We compared our traditional method to this new "on-demand" approach with respect to outlier determinations, kappa statistics, and correlations between logged OR and standardized rates, for 12 models (4 surgical groups by 3 outcomes). When both methods used the same contemporaneous data, there were similar numbers of hospital outliers and correlations between logged OR and standardized rates were high. However, larger differences were observed when the effect of contemporaneous versus historical data was added to differences in statistical methodology. The on-demand, nonhierarchical approach provides results similar to the traditional hierarchical method and offers immediacy, an "over-time" perspective, application to a broader range of models and data subsets, and reporting of more easily understood rates. Although the nonhierarchical method results are now available "on-demand" in a web-based application, the hierarchical approach has advantages, which support its continued periodic publication as the gold standard for hospital profiling in the program.

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...

5 CFR 9701.322 - Setting and adjusting rate ranges.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges... operational reasons, these adjustments will become effective on or about the date of the annual General...

Break-even analysis revisited: the need to adjust for profitability, the collection rate and autonomous income.

PubMed

Broyles, R W; Narine, L; Khaliq, A

2003-08-01

This paper modifies traditional break-even analysis and develops a model that reflects the influence of variation in payer mix, the collection rate, profitability and autonomous income on the desired volume alternative. The augmented model indicates that a failure to adjust for uncollectibles and the net surplus results in a systematic understatement of the desired volume alternative. Conversely, a failure to adjust for autonomous income derived from the operation of cafeterias, gift shops or an organization's investment in marketable securities produces an overstatement of the desired volume. In addition, this paper uses Microsoft Excel to develop a spreadsheet that constructs a pro forma income statement, expressed in terms of the contribution margin. The spreadsheet also relies on the percentage of sales or revenue approach to prepare a balance sheet from which indicators of fiscal performance are calculated. Hence, the analysis enables the organization to perform a sensitivity analysis of potential changes in the desired volume, the operating margin, the current ratio, the debt: equity ratio and the amount of cash derived from operations that are associated with expected variation in payer mix, the collection rate, grouped by payer, the net surplus and autonomous income.

10 CFR 903.11 - Advance announcement of rate adjustment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern, and... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design and...

10 CFR 903.11 - Advance announcement of rate adjustment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern, and... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design and...

10 CFR 903.11 - Advance announcement of rate adjustment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern, and... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design and...

10 CFR 903.11 - Advance announcement of rate adjustment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in Power and Transmission Rate Adjustments and Extensions for the Alaska, Southeastern, Southwestern, and... advertisement, and/or by Federal Register publication. Written comments relevant to rate policy and design and...

5 CFR 530.307 - OPM review and adjustment of special rate schedules.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... 5305(d), special rate schedule adjustments made by OPM have the force and effect of statute. (d)(1) For... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false OPM review and adjustment of special rate... REGULATIONS PAY RATES AND SYSTEMS (GENERAL) Special Rate Schedules for Recruitment and Retention General...

Risk Adjustment for a Children's Capitation Rate

PubMed Central

Newhouse, Joseph P.; Sloss, Elizabeth M.; Manning, Willard G.; Keeler, Emmett B.

1993-01-01

Few capitation arrangements vary premiums by a child's health characteristics, yielding an incentive to discriminate against children with predictably high expenditures from chronic diseases. In this article, we explore risk adjusters for the 35 percent of the variance in annual outpatient expenditure we find to be potentially predictable. Demographic factors such as age and gender only explain 5 percent of such variance; health status measures explain 25 percent, prior use and health status measures together explain 65 to 70 percent. The profit from risk selection falls less than proportionately with improved ability to adjust for risk. Partial capitation rates may be necessary to mitigate skimming and dumping. PMID:10133708

Risk adjustment for a children's capitation rate.

PubMed

Newhouse, J P; Sloss, E M; Manning, W G; Keeler, E B

1993-01-01

Few capitation arrangements vary premiums by a child's health characteristics, yielding an incentive to discriminate against children with predictably high expenditures from chronic diseases. In this article, we explore risk adjusters for the 35 percent of the variance in annual out-patient expenditure we find to be potentially predictable. Demographic factors such as age and gender only explain 5 percent of such variance; health status measures explain 25 percent, prior use and health status measures together explain 65 to 70 percent. The profit from risk selection falls less than proportionately with improved ability to adjust for risk. Partial capitation rates may be necessary to mitigate skimming and dumping.

39 CFR 3010.26 - Calculation of unused rate adjustment authority.

Code of Federal Regulations, 2011 CFR

2011-07-01

... authority for each class is equal to the difference between the maximum allowable percentage change in rates under the applicable rate limitation and the actual percentage change in rates for that class. (c) When... rate adjustment leading to its computation. ...

Speech perception at positive signal-to-noise ratios using adaptive adjustment of time compression.

PubMed

Schlueter, Anne; Brand, Thomas; Lemke, Ulrike; Nitzschner, Stefan; Kollmeier, Birger; Holube, Inga

2015-11-01

Positive signal-to-noise ratios (SNRs) characterize listening situations most relevant for hearing-impaired listeners in daily life and should therefore be considered when evaluating hearing aid algorithms. For this, a speech-in-noise test was developed and evaluated, in which the background noise is presented at fixed positive SNRs and the speech rate (i.e., the time compression of the speech material) is adaptively adjusted. In total, 29 younger and 12 older normal-hearing, as well as 24 older hearing-impaired listeners took part in repeated measurements. Younger normal-hearing and older hearing-impaired listeners conducted one of two adaptive methods which differed in adaptive procedure and step size. Analysis of the measurements with regard to list length and estimation strategy for thresholds resulted in a practical method measuring the time compression for 50% recognition. This method uses time-compression adjustment and step sizes according to Versfeld and Dreschler [(2002). J. Acoust. Soc. Am. 111, 401-408], with sentence scoring, lists of 30 sentences, and a maximum likelihood method for threshold estimation. Evaluation of the procedure showed that older participants obtained higher test-retest reliability compared to younger participants. Depending on the group of listeners, one or two lists are required for training prior to data collection.

Male sexual strategies modify ratings of female models with specific waist-to-hip ratios.

PubMed

Brase, Gary L; Walker, Gary

2004-06-01

Female waist-to-hip ratio (WHR) has generally been an important general predictor of ratings of physical attractiveness and related characteristics. Individual differences in ratings do exist, however, and may be related to differences in the reproductive tactics of the male raters such as pursuit of short-term or long-term relationships and adjustments based on perceptions of one's own quality as a mate. Forty males, categorized according to sociosexual orientation and physical qualities (WHR, Body Mass Index, and self-rated desirability), rated female models on both attractiveness and likelihood they would approach them. Sociosexually restricted males were less likely to approach females rated as most attractive (with 0.68-0.72 WHR), as compared with unrestricted males. Males with lower scores in terms of physical qualities gave ratings indicating more favorable evaluations of female models with lower WHR. The results indicate that attractiveness and willingness to approach are overlapping but distinguishable constructs, both of which are influenced by variations in characteristics of the raters.

10 CFR 903.11 - Advance announcement of rate adjustment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Advance announcement of rate adjustment. 903.11 Section 903.11 Energy DEPARTMENT OF ENERGY POWER AND TRANSMISSION RATES Procedures for Public Participation in... announcement may be through direct contact with customers, at public meetings, by press release, by newspaper...

76 FR 80191 - Adjustments of Certain Rates of Pay

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... Order 13594 of December 19, 2011 Adjustments of Certain Rates of Pay By the authority vested in me as... Appropriations and Surface Transportation Extensions Act, 2011 (Public Law 111-322), which freezes certain pay... full applicable locality pay rates in non-foreign areas pursuant to the Non-Foreign Area Retirement...

75 FR 81817 - Adjustments of Certain Rates of Pay

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... Order 13561 of December 22, 2010 Adjustments of Certain Rates of Pay By the authority vested in me as..., it is hereby ordered as follows: Section 1. Statutory Pay Systems. Pursuant to the Continuing... ``Continuing Appropriations Act''), the rates of basic pay or salaries of the statutory pay systems (as defined...

5 CFR 9901.312 - Maximum rates of base salary and adjusted salary.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Maximum rates of base salary and adjusted salary. 9901.312 Section 9901.312 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES....312 Maximum rates of base salary and adjusted salary. (a) Subject to § 9901.105, the Secretary may...

39 CFR 3010.27 - Application of unused rate adjustment authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MARKET DOMINANT PRODUCTS Rules for Applying the Price Cap § 3010.27 Application of unused rate adjustment..., then the difference between the percentage change in rates for the class and the price cap shall be...

5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

Code of Federal Regulations, 2011 CFR

2011-01-01

... falls below the minimum adjusted rate of their band. 9701.337 Section 9701.337 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay falls... (including a locality or special rate supplement) falls below the minimum adjusted rate of his or her band as...

5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

Code of Federal Regulations, 2012 CFR

2012-01-01

... falls below the minimum adjusted rate of their band. 9701.337 Section 9701.337 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay falls... (including a locality or special rate supplement) falls below the minimum adjusted rate of his or her band as...

5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

Code of Federal Regulations, 2014 CFR

2014-01-01

... falls below the minimum adjusted rate of their band. 9701.337 Section 9701.337 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay falls... (including a locality or special rate supplement) falls below the minimum adjusted rate of his or her band as...

5 CFR 9701.337 - Treatment of employees whose rate of pay falls below the minimum adjusted rate of their band.

Code of Federal Regulations, 2013 CFR

2013-01-01

... falls below the minimum adjusted rate of their band. 9701.337 Section 9701.337 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.337 Treatment of employees whose rate of pay falls... (including a locality or special rate supplement) falls below the minimum adjusted rate of his or her band as...

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.

12 CFR 567.8 - Leverage ratio.

Code of Federal Regulations, 2011 CFR

2011-01-01

... a composite rating of 1, as defined in § 516.3 of this chapter, shall consist of a ratio of core... capital requirement shall consist of a ratio of core capital to adjusted total assets of 4 percent. Higher...

45 CFR 800.203 - Medical loss ratio.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Medical loss ratio. 800.203 Section 800.203 Public... PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment § 800.203 Medical loss ratio. (a) Required medical loss ratio. An MSPP issuer must attain: (1) The medical loss ratio (MLR...

45 CFR 800.203 - Medical loss ratio.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Medical loss ratio. 800.203 Section 800.203 Public... PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment § 800.203 Medical loss ratio. (a) Required medical loss ratio. An MSPP issuer must attain: (1) The medical loss ratio (MLR...

A 5-trial adjusting delay discounting task: Accurate discount rates in less than 60 seconds

PubMed Central

Koffarnus, Mikhail N.; Bickel, Warren K.

2014-01-01

Individuals who discount delayed rewards at a high rate are more likely to engage in substance abuse, overeating, or problem gambling. Findings such as these suggest the value of methods to obtain an accurate and fast measurement of discount rate that can be easily deployed in variety of settings. In the present study, we developed and evaluated the 5-trial adjusting delay task, a novel method of obtaining discount rate in less than one minute. We hypothesized that discount rates from the 5-trial adjusting delay task would be similar and correlated with discount rates from a lengthier task we have used previously, and that four known effects relating to delay discounting would be replicable with this novel task. To test these hypotheses, the 5-trial adjusting delay task was administered to 111 college students six times to obtain discount rates for six different commodities, along with a lengthier adjusting amount discounting task. We found that discount rates were similar and correlated between the 5-trial adjusting delay task and the adjusting amount task. Each of the four known effects relating to delay discounting was replicated with the 5-trial adjusting delay task to varying degrees. First, discount rates were inversely correlated with amount. Second, discount rates between past and future outcomes were correlated. Third, discount rates were greater for consumable rewards than with money, although we did not control for amount in this comparison. Fourth, discount rates were lower when zero amounts opposing the chosen time point were explicitly described. Results indicate that the 5-trial adjusting delay task is a viable, rapid method to assess discount rate. PMID:24708144

A 5-trial adjusting delay discounting task: accurate discount rates in less than one minute.

PubMed

Koffarnus, Mikhail N; Bickel, Warren K

2014-06-01

Individuals who discount delayed rewards at a high rate are more likely to engage in substance abuse, overeating, or problem gambling. Such findings suggest the value of methods to obtain an accurate and fast measurement of discount rate that can be easily deployed in variety of settings. In the present study, we developed and evaluated the 5-trial adjusting delay task, a novel method of obtaining a discount rate in less than 1 min. We hypothesized that discount rates from the 5-trial adjusting delay task would be similar and would correlate with discount rates from a lengthier task we have used previously, and that 4 known effects relating to delay discounting would be replicable with this novel task. To test these hypotheses, the 5-trial adjusting delay task was administered to 111 college students 6 times to obtain discount rates for 6 different commodities, along with a lengthier adjusting amount discounting task. We found that discount rates were similar and correlated between the 5-trial adjusting delay task and the adjusting amount task. Each of the 4 known effects relating to delay discounting was replicated with the 5-trial adjusting delay task to varying degrees. First, discount rates were inversely correlated with amount. Second, discount rates between past and future outcomes were correlated. Third, discount rates were greater for consumable rewards than with money, although we did not control for amount in this comparison. Fourth, discount rates were lower when $0 amounts opposing the chosen time point were explicitly described. Results indicate that the 5-trial adjusting delay task is a viable, rapid method to assess discount rate. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Peer- and Self-Rated Correlates of a Teacher-Rated Typology of Child Adjustment

ERIC Educational Resources Information Center

Lindstrom, William A., Jr.; Lease, A. Michele; Kamphaus, Randy W.

2007-01-01

External correlates of a teacher-rated typology of child adjustment developed using the Behavior Assessment System for Children were examined. Participants included 377 elementary school children recruited from 26 classrooms in the southeastern United States. Multivariate analyses of variance and planned comparisons were used to determine whether…

Using sightability-adjusted brood-pair ratios to estimate waterfowl productivity

USGS Publications Warehouse

Pagano, Anthony M.; Amundson, Courtney L.; Pieron, Matthew R.; Arnold, Todd W.; Kimmel, Timothy C.

2014-01-01

Historically, biologists used brood-pair ratios (BPRs) as an index to waterfowl productivity to help guide management decisions and evaluate conservation practices. However, BPRs are biased by imperfect detection probabilities, especially for broods. We conducted roadside surveys for breeding waterfowl pairs on 7–8 study sites in the springs of 2006–2008 in northeastern North Dakota, USA. Later each year, we conducted replicate counts of broods on the same wetlands and used mark–recapture methods to estimate sightability-adjusted BPRs (SA-BPRs). Traditional roadside brood surveys detected only 30–45% of the available broods, depending on species. We explored the potential for using SA-BPRs to measure hen success (i.e., the probability a female hatches ≥1 egg across all nesting attempts) for mallards (Anas platyrhynchos) and other upland-nesting dabbling ducks (Anas spp.). We found that SA-BPRs explained 40% of the variation in hen success over 5 species of dabbling ducks, and we were able to detect an effect of predator reduction on hen success in combined dabblers, but not in mallards alone. However, we found no relationship between SA-BPRs and mallard fledging rates (hen success × initial brood size × duckling survival). Our results suggest that SA-BPRs can provide a cost-effective alternative to traditional measures of productivity such as nesting success, but not to measures of duckling survival. Nevertheless, SA-BPRs may be useful in areas where traditional measures of waterfowl productivity are logistically or financially challenging.

An Adjusted Likelihood Ratio Approach Analysing Distribution of Food Products to Assist the Investigation of Foodborne Outbreaks

PubMed Central

Norström, Madelaine; Kristoffersen, Anja Bråthen; Görlach, Franziska Sophie; Nygård, Karin; Hopp, Petter

2015-01-01

In order to facilitate foodborne outbreak investigations there is a need to improve the methods for identifying the food products that should be sampled for laboratory analysis. The aim of this study was to examine the applicability of a likelihood ratio approach previously developed on simulated data, to real outbreak data. We used human case and food product distribution data from the Norwegian enterohaemorrhagic Escherichia coli outbreak in 2006. The approach was adjusted to include time, space smoothing and to handle missing or misclassified information. The performance of the adjusted likelihood ratio approach on the data originating from the HUS outbreak and control data indicates that the adjusted approach is promising and indicates that the adjusted approach could be a useful tool to assist and facilitate the investigation of food borne outbreaks in the future if good traceability are available and implemented in the distribution chain. However, the approach needs to be further validated on other outbreak data and also including other food products than meat products in order to make a more general conclusion of the applicability of the developed approach. PMID:26237468

Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

PubMed

Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

2018-06-01

A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (<1500 g) infants among live births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the <500 g birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of <500 g. The birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

75 FR 53198 - Rate Adjustment for the Satellite Carrier Compulsory License

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 386 [Docket No. 2010-4 CRB Satellite Rate] Rate Adjustment for the Satellite Carrier Compulsory License AGENCY: Copyright Royalty Board, Library... last day of a given month. (2) In the case of a station engaged in digital multicasting, the rates set...

12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Adjustment of civil money penalties by the rate... civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil Penalties... adjust the maximum amount of each civil money penalty within its jurisdiction by the rate of inflation...

12 CFR 747.1001 - Adjustment of civil money penalties by the rate of inflation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Adjustment of civil money penalties by the rate... civil money penalties by the rate of inflation. (a) NCUA is required by the Federal Civil Penalties... adjust the maximum amount of each civil money penalty within its jurisdiction by the rate of inflation...

Are elderly dependency ratios associated with general population suicide rates?

PubMed

Shah, Ajit

2011-05-01

The elderly population size is increasing worldwide due to falling birth rates and increasing life expectancy. It has been hypothesized that as the elderly dependency ratio (the ratio of those over the age of 65 years to those under 65) increases, there will be fewer younger people available to care for older people and this, in turn, will increase the burden on younger carers with increased levels of psychiatric morbidity leading to an increase in general population suicide rates. A cross-national study examining the relationship between elderly dependency ratios and general population suicide rates was conducted using data from the World Health Organization and the United Nations websites. The main findings were of a significant and independent positive correlation between elderly dependency ratios and general population suicide rates in both genders. The contribution of cross-national differences in psychiatric morbidity in younger carers on general population suicide rates requires further study. The prevalence of psychiatric morbidity in younger carers of older people should be examined by: (i) cross-national studies using standardized measures of psychiatric morbidity that are education-free, culture-fair and language-fair; and (ii) within-country longitudinal studies with changing elderly dependency ratios over time.

78 FR 21503 - Adjustments of Certain Rates of Pay

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

... Order 13641 of April 5, 2013 Adjustments of Certain Rates of Pay By the authority vested in me as... Consolidated and Further Continuing Appropriations Act, 2013 (Public Law 113-6), which requires certain pay... follows: Section 1. Statutory Pay Systems. Pursuant to the Consolidated and Further Continuing...

Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing.

PubMed

Matheny, Michael E; Normand, Sharon-Lise T; Gross, Thomas P; Marinac-Dabic, Danica; Loyo-Berrios, Nilsa; Vidi, Venkatesan D; Donnelly, Sharon; Resnic, Frederic S

2011-12-14

Automated adverse outcome surveillance tools and methods have potential utility in quality improvement and medical product surveillance activities. Their use for assessing hospital performance on the basis of patient outcomes has received little attention. We compared risk-adjusted sequential probability ratio testing (RA-SPRT) implemented in an automated tool to Massachusetts public reports of 30-day mortality after isolated coronary artery bypass graft surgery. A total of 23,020 isolated adult coronary artery bypass surgery admissions performed in Massachusetts hospitals between January 1, 2002 and September 30, 2007 were retrospectively re-evaluated. The RA-SPRT method was implemented within an automated surveillance tool to identify hospital outliers in yearly increments. We used an overall type I error rate of 0.05, an overall type II error rate of 0.10, and a threshold that signaled if the odds of dying 30-days after surgery was at least twice than expected. Annual hospital outlier status, based on the state-reported classification, was considered the gold standard. An event was defined as at least one occurrence of a higher-than-expected hospital mortality rate during a given year. We examined a total of 83 hospital-year observations. The RA-SPRT method alerted 6 events among three hospitals for 30-day mortality compared with 5 events among two hospitals using the state public reports, yielding a sensitivity of 100% (5/5) and specificity of 98.8% (79/80). The automated RA-SPRT method performed well, detecting all of the true institutional outliers with a small false positive alerting rate. Such a system could provide confidential automated notification to local institutions in advance of public reporting providing opportunities for earlier quality improvement interventions.

Inappropriate use of payment weights to risk adjust readmission rates.

PubMed

Fuller, Richard L; Goldfield, Norbert I; Averill, Richard F; Hughes, John S

2012-01-01

In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.

Rating long-term care facilities on pressure ulcer development: importance of case-mix adjustment.

PubMed

Berlowitz, D R; Ash, A S; Brandeis, G H; Brand, H K; Halpern, J L; Moskowitz, M A

1996-03-15

To determine the importance of case-mix adjustment in interpreting differences in rates of pressure ulcer development in Department of Veterans Affairs long- term care facilities. A sample assembled from the Patient Assessment File, a Veterans Affairs administrative database, was used to derive predictors of pressure ulcer development; the resulting model was validated in a separate sample. Facility-level rates of pressure ulcer development, both unadjusted and adjusted for case mix using the predictive model, were compared. Department of Veterans Affairs long-term care facilities. The derivation sample consisted of 31 150 intermediate medicine and nursing home residents who were initially free of pressure ulcers and were institutionalized between October 1991 and April 1993. The validation sample consisted of 17 946 residents institutionalized from April 1993 to October 1993. Development of a stage 2 or greater pressure ulcer. 11 factors predicted pressure ulcer development. Validated performance properties of the resulting model were good. Model-predicted rates of pressure ulcer development at individual long-term care facilities varied from 1.9% to 6.3%, and observed rates ranged from 0% to 10.9%. Case-mix-adjusted rates and ranks of facilities differed considerably from unadjusted ratings. For example, among five facilities that were identified as high outliers on the basis of unadjusted rates, two remained as outliers after adjustment for case mix. Long-term care facilities differ in case mix. Adjustments for case mix result in different judgments about facility performance and should be used when facility incidence rates are compared.

75 FR 39891 - Rate Adjustment for the Satellite Carrier Compulsory License

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 386 [Docket No. 2010-4 CRB Satellite Rate] Rate Adjustment for the Satellite Carrier Compulsory License AGENCY: Copyright Royalty Board, Library..., objections must be brought to the Copyright Office Public Information Office, Library of Congress, James...

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...

Three methods to construct predictive models using logistic regression and likelihood ratios to facilitate adjustment for pretest probability give similar results.

PubMed

Chan, Siew Foong; Deeks, Jonathan J; Macaskill, Petra; Irwig, Les

2008-01-01

To compare three predictive models based on logistic regression to estimate adjusted likelihood ratios allowing for interdependency between diagnostic variables (tests). This study was a review of the theoretical basis, assumptions, and limitations of published models; and a statistical extension of methods and application to a case study of the diagnosis of obstructive airways disease based on history and clinical examination. Albert's method includes an offset term to estimate an adjusted likelihood ratio for combinations of tests. Spiegelhalter and Knill-Jones method uses the unadjusted likelihood ratio for each test as a predictor and computes shrinkage factors to allow for interdependence. Knottnerus' method differs from the other methods because it requires sequencing of tests, which limits its application to situations where there are few tests and substantial data. Although parameter estimates differed between the models, predicted "posttest" probabilities were generally similar. Construction of predictive models using logistic regression is preferred to the independence Bayes' approach when it is important to adjust for dependency of tests errors. Methods to estimate adjusted likelihood ratios from predictive models should be considered in preference to a standard logistic regression model to facilitate ease of interpretation and application. Albert's method provides the most straightforward approach.

State infant mortality: an ecologic study to determine modifiable risks and adjusted infant mortality rates.

PubMed

Paul, David A; Mackley, Amy; Locke, Robert G; Stefano, John L; Kroelinger, Charlan

2009-05-01

To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization procedures. Final risk adjusted IMR's were standardized and states were compared with the United States adjusted rates. Models for IMR in individual states in 2001 (r2 = 0.66, P < 0.01) and 2002 (r2 = 0.81, P < 0.01) were tested. African-American race, teen birth rate, and smoking during pregnancy remained independently associated with state infant mortality rates for 2001 and 2002. Ninety five percent confidence intervals (CI) were calculated around the regression lines to model the expected IMR. After adjustment, some states maintained a consistent IMR; for instance, Vermont and New Hampshire remained low, while Delaware and Louisiana remained high. However, other states such as Mississippi, which have traditionally high infant mortality rates, remained within the expected 95% CI for IMR after adjustment indicating confounding affected the initial unadjusted rates. Non-modifiable demographic variables, including the percentage of non-Hispanic African-American and Hispanic populations of the state are major factors contributing to individual variation in state IMR. Race and ethnicity may confound or modify the IMR in states that shifted inside or outside the 95% CI following adjustment. Other factors including smoking during pregnancy and teen birth rate, which are

78 FR 649 - Adjustments of Certain Rates of Pay

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

... Adjustments of Certain Rates of Pay By the authority vested in me as President by the Constitution and the... certain pay schedules for civilian Federal employees may take effect on the first day of the first applicable pay period beginning after the date specified in section 106(3) of Public Law 112-175, it is...

78 FR 80451 - Adjustments of Certain Rates of Pay

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... of Pay By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows: Section 1. Statutory Pay Systems. The rates of basic pay or salaries of the statutory pay systems (as defined in 5 U.S.C. 5302(1)), as adjusted under 5 U.S...

International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.

PubMed

Lisonkova, S; Sabr, Y; Butler, B; Joseph, K S

2012-12-01

To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. Ecological study. Canada, USA and 26 countries in Europe. All deliveries in 2004. Information on preterm birth (<37, 32-36, 28-31 and 24-27 weeks of gestation) and perinatal deaths was obtained for 28 countries. Data sources included files and publications from Statistics Canada, the EURO-PERISTAT project and the National Center for Health Statistics. Pearson correlation coefficients and random-intercept Poisson regression were used to examine the association between preterm birth rates and gestational age-specific stillbirth and neonatal death rates. Rate ratios with 95% confidence intervals were estimated after adjustment for maternal age, parity and multiple births. Stillbirths and neonatal deaths ≥ 32 and ≥ 37 weeks of gestation. International rates of preterm birth (<37 weeks) ranged between 5.3 and 11.4 per 100 live births. Preterm birth rates at 32-36 weeks were inversely associated with stillbirths at ≥ 32 weeks (adjusted rate ratio 0.94, 95% CI 0.92-0.96) and ≥ 37 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) of gestation and inversely associated with neonatal deaths at ≥ 32 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) and ≥ 37 weeks (adjusted rate ratio 0.82, 95% CI 0.78-0.86) of gestation. Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

39 CFR 3010.2 - Types of rate adjustments for market dominant products.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., authorized under 39 U.S.C. 3622(d)(1)(E), is based on exigent circumstances. (b) Upon the establishment of... adjustment, authorized under 39 U.S.C. 3622(d)(1)(D), is based on the statutory annual limitation. A Type 1-B rate adjustment, authorized under 39 U.S.C. 3622(d)(2)(C), is based on an exception to the annual...

The Impact of Financial Sophistication on Adjustable Rate Mortgage Ownership

ERIC Educational Resources Information Center

Smith, Hyrum; Finke, Michael S.; Huston, Sandra J.

2011-01-01

The influence of a financial sophistication scale on adjustable-rate mortgage (ARM) borrowing is explored. Descriptive statistics and regression analysis using recent data from the Survey of Consumer Finances reveal that ARM borrowing is driven by both the least and most financially sophisticated households but for different reasons. Less…

Study of device use adjusted rates in health care-associated infections after implementation of "bundles" in a closed-model medical intensive care unit.

PubMed

Venkatram, Sindhaghatta; Rachmale, Sonal; Kanna, Balavenkatesh

2010-03-01

"Bundles" strategies improve health care-associated infection (HCAI) rates in medical intensive care units (MICUs). However, few studies have analyzed HCAI rates adjusted for the device removal component of the bundles. An observational study of adult MICU patients while using bundles to prevent HCAIs associated with endovascular catheters, mechanical ventilation, and urinary tract catheters was conducted. The HCAI rates, unadjusted and adjusted for device use, were calculated using incidence rate ratios (unadjusted IRRs [uIRR] and adjusted IRRs [aIRR], respectively). Among 4550 study patients, HCAIs declined from 47 in 2004 to 10 in 2005, 8 in 2006, and 3 in 2007. Catheter-related blood stream infection (CRBSI) rates decreased from 10.77 to 1.67 per 1000 central line days (uIRR, 0.155; 95% confidence interval [CI], 0.13-0.18; P < .0001). Foley-related urinary tract infections (CA-UTI) decreased from 6.23 to 0.63 per 1000 device days (uIRR, 0.1; 95% CI, 0.08-0.19; P < .0001). Ventilator-associated pneumonia (VAP) per 1000 ventilator days diminished from 2.17 to 0.62 (uIRR, 0.29; 95% CI, 0.21-0.38; P < .0001). After adjustment for device use, aIRRs of CRBSI (0.14; 95% CI, 0.11-0.18), UTI (0.09; 95% CI, 0.06-0.12), and VAP (0.33; 95% CI, 0.22-0.47) declined significantly (P < .00001). Implementing comprehensive bundle strategies reduces HCAI beyond the impact of device removal. Copyright 2010. Published by Elsevier Inc.

Limiting options: Sex ratios, incarceration rates and sexual risk behavior among people on probation and parole

PubMed Central

Green, Traci C.; Pouget, Enrique R.; Harrington, Magdalena; Taxman, Faye S.; Rhodes, Anne G.; O’Connell, Daniel; Martin, Steven S.; Prendergast, Michael; Friedmann, Peter D.

2012-01-01

Background To investigate how incarceration may affect risk of acquiring HIV and other sexually transmitted infections, we tested associations of ex-offenders’ sexual risk behavior with the male-female sex ratio and the male incarceration rate. Methods Longitudinal data from 1287 drug-involved persons on probation and parole as part of the Criminal Justice Drug Abuse Treatment Studies were matched by county of residence with population factors, and stratified by race/ethnicity and gender. Generalized estimating equations assessed associations of having unprotected sex with a partner who had HIV risk factors, and having more than 1 sex partner in the past month. Results Among non-Hispanic Black men and women, low sex ratios were associated with greater risk of having unprotected sex with a risky partner (Adjusted relative risk (ARR) = 1.76, 95% confidence interval (CI) = 1.29, 2.42; ARR = 2.48, 95% CI = 1.31, 4.73, respectively). Among non-Hispanic Black and non-Hispanic White women, low sex ratios were associated with having more than 1 sex partner (ARR = 2.00, 95% CI = 1.02, 3.94; ARR = 1.71, 95% CI = 1.06, 2.75, respectively). High incarceration rates were associated with greater risk of having a risky partner for all men (non-Hispanic Black: ARR= 2.14, 95% CI=1.39, 3.30; non-Hispanic White: ARR= 1.39, 95% CI: 1.05, 1.85; Hispanic: ARR = 3.99, 95% CI =1.55, 10.26) and having more than one partner among non-Hispanic White men (ARR= 1.92, 95% CI = 1.40, 2.64). Conclusions Low sex ratios and high incarceration rates may influence the number and risk characteristics of sex partners of ex-offenders. HIV-prevention policies and programs for ex-offenders could be improved by addressing structural barriers to safer sexual behavior. PMID:22592827

Comparison of crude and adjusted mortality rates from leading causes of death in northeastern Brazil.

PubMed

França, Elisabeth; Rao, Chalapati; Abreu, Daisy Maria Xavier de; Souza, Maria de Fátima Marinho de; Lopez, Alan D

2012-04-01

To present how the adjustment of incompleteness and misclassification of causes of death in the vital registration (VR) system can contribute to more accurate estimates of the risk of mortality from leading causes of death in northeastern Brazil. After estimating the total numbers of deaths by age and sex in Brazil's Northeast region in 2002-2004 by correcting for undercount in the VR data, adjustment algorithms were applied to the reported cause-of-death structure. Average annual age-standardized mortality rates were computed by cause, with and without the corrections, and compared to death rates for Brazil's South region after adjustments for potential misdiagnosis. Death rates from ischemic heart disease, lower respiratory infections, chronic obstructive pulmonary disease, and perinatal conditions were more than 100% higher for both sexes than what was suggested by the routine VR data. Corrected cause-specific mortality rates were higher in the Northeast region versus the South region for the majority of causes of death, including several noncommunicable conditions. Failure to adjust VR data for undercount of cases reported and misdiagnoses will cause underestimation of mortality risks for the populations of the Northeast region, which are more vulnerable than those in other regions of the country. In order to more reliably understand the pattern of disease, all cause-specific mortality rates in poor populations should be adjusted.

Gaming in risk-adjusted mortality rates: effect of misclassification of risk factors in the benchmarking of cardiac surgery risk-adjusted mortality rates.

PubMed

Siregar, Sabrina; Groenwold, Rolf H H; Versteegh, Michel I M; Noyez, Luc; ter Burg, Willem Jan P P; Bots, Michiel L; van der Graaf, Yolanda; van Herwerden, Lex A

2013-03-01

Upcoding or undercoding of risk factors could affect the benchmarking of risk-adjusted mortality rates. The aim was to investigate the effect of misclassification of risk factors on the benchmarking of mortality rates after cardiac surgery. A prospective cohort was used comprising all adult cardiac surgery patients in all 16 cardiothoracic centers in The Netherlands from January 1, 2007, to December 31, 2009. A random effects model, including the logistic European system for cardiac operative risk evaluation (EuroSCORE) was used to benchmark the in-hospital mortality rates. We simulated upcoding and undercoding of 5 selected variables in the patients from 1 center. These patients were selected randomly (nondifferential misclassification) or by the EuroSCORE (differential misclassification). In the random patients, substantial misclassification was required to affect benchmarking: a 1.8-fold increase in prevalence of the 4 risk factors changed an underperforming center into an average performing one. Upcoding of 1 variable required even more. When patients with the greatest EuroSCORE were upcoded (ie, differential misclassification), a 1.1-fold increase was sufficient: moderate left ventricular function from 14.2% to 15.7%, poor left ventricular function from 8.4% to 9.3%, recent myocardial infarction from 7.9% to 8.6%, and extracardiac arteriopathy from 9.0% to 9.8%. Benchmarking using risk-adjusted mortality rates can be manipulated by misclassification of the EuroSCORE risk factors. Misclassification of random patients or of single variables will have little effect. However, limited upcoding of multiple risk factors in high-risk patients can greatly influence benchmarking. To minimize "gaming," the prevalence of all risk factors should be carefully monitored. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

48 CFR 52.222-32 - Construction Wage Rate Requirements-Price Adjustment (Actual Method).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Construction Wage Rate... CLAUSES Text of Provisions and Clauses 52.222-32 Construction Wage Rate Requirements—Price Adjustment (Actual Method). As prescribed in 22.407(g), insert the following clause: Construction Wage Rate...

Age-Adjustment and Related Epidemiology Rates in Education and Research

ERIC Educational Resources Information Center

Baker, John D.; Kruckman, Laurence; George, Joyce

2006-01-01

A quick review of introductory textbooks reveals that while gerontology authors and instructors introduce some aspect of demography and epidemiology data, there is limited focus on age adjustment or other important epidemiology rates. The goal of this paper is to reintroduce a variety of basic epidemiology strategies such as incidence, prevalence,…

39 CFR 3010.13 - Proceedings for Type 1-A and Type 1-B rate adjustment filings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Proceedings for Type 1-A and Type 1-B rate... (Type 1-A and 1-B Rate Adjustments) § 3010.13 Proceedings for Type 1-A and Type 1-B rate adjustment... include: (1) The general nature of the proceeding; (2) A reference to legal authority to which the...

[Adjusting Platelet Counts for Platelet Aggregation Tests].

PubMed

Ling, Li-Qin; Yang, Xin-Chun; Chen, Hao; Liu, Chao-Nan; Chen, Si; Jiang, Hong; Jin, Ya-Xiong; Zhou, Jing

2018-03-01

To explore a better method to adjust platelet counts for light transmission aggregometry (LTA). Blood samples from 36 healthy participants aged from 18 to 50 yr. were collected.Platelet-rich plasma (PRP) was diluted using platelet-poor plasma (PPP) and physiological saline (PS),respectively,in a ratio of 1.5,2,2.5 and 3 times. Platelet aggregation was induced by adenosine diphosphate (ADP),arachidonic acid (ARA),collagen (COL), epinephrine (EPI),or ristocetin (RIS). The maximal aggregation rates (MAs) of different approaches were compared. We also compared the MAs induced by RIS between PRP-obtained-PPP and whole blood-obtained-PPP (2 100× g, 5 min). Compared with the original PRP,the MAs induced by ADP,ARA,and EPI decreased in PPP-adjusted PRP (significant at 2-3 times dilution ratio, P <0.05),but not in PS-adjusted PRP ( P >0.05). The MA induced by RIS decreased in PS-adjusted PRP (significant at all dilution ratios, P <0.05),but not in PPP-adjusted PRP ( P >0.05). No changes in the MA induced by COL were found in PS-adjusted PRP and PPP-adjusted PRP ( P >0.05). Whole blood-obtained-PPP (2 100× g, 5 min) had the same MA induced by ristocetin compared with PRP-obtained-PPP ( P >0.05). PS is recommended for adjusting platelets counts for platelet aggregation induced by ADP,ARA,COL and EPI. Whole blood-obtained-PPP (2 100 × g, 5 min) is recommended for RIS-induced aggregation as a matter of convenience. Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

Solar radiation increases suicide rate after adjusting for other climate factors in South Korea.

PubMed

Jee, Hee-Jung; Cho, Chul-Hyun; Lee, Yu Jin; Choi, Nari; An, Hyonggin; Lee, Heon-Jeong

2017-03-01

Previous studies have indicated that suicide rates have significant seasonal variations. There is seasonal discordance between temperature and solar radiation due to the monsoon season in South Korea. We investigated the seasonality of suicide and assessed its association with climate variables in South Korea. Suicide rates were obtained from the National Statistical Office of South Korea, and climatic data were obtained from the Korea Meteorological Administration for the period of 1992-2010. We conducted analyses using a generalized additive model (GAM). First, we explored the seasonality of suicide and climate variables such as mean temperature, daily temperature range, solar radiation, and relative humidity. Next, we identified confounding climate variables associated with suicide rate. To estimate the adjusted effect of solar radiation on the suicide rate, we investigated the confounding variables using a multivariable GAM. Suicide rate showed seasonality with a pattern similar to that of solar radiation. We found that the suicide rate increased 1.008 times when solar radiation increased by 1 MJ/m 2 after adjusting for other confounding climate factors (P < 0.001). Solar radiation has a significant linear relationship with suicide after adjusting for region, other climate variables, and time trends. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Adjustment of the ratio of Ca/P in the ceramic coating on Mg alloy by plasma electrolytic oxidation

NASA Astrophysics Data System (ADS)

Yao, Zhongping; Li, Liangliang; Jiang, Zhaohua

2009-04-01

The ceramic coatings containing Ca and P were prepared on AZ91D Mg alloy by plasma electrolytic oxidation technique in NaOH system and Na 2SiO 3 system, respectively. The phase composition, morphology and the element distribution of the coatings was studied by X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy. The corrosion resistance of the coatings was examined by polarizing curve methods in a 0.9% NaCl solution. In NaOH system, there were a large number of micro-holes distributing evenly on the surface of the coating, and the coating was mainly composed of Mg, Al, P and Ca. In Na 2SiO 3 system, the micro-holes in the coatings were reduced greatly in number and the distribution of the micro-holes was uneven, and the coating was mainly composed of Mg, Al, Si, P and Ca. The ratio of Ca/P in the coating can be controlled by the adjustment of the technique parameters to a certain extent. The adjustment of the concentration of Ca 2+ in the electrolyte was an effective method to change the ratio of Ca/P in the coating in both systems; the reaction time and the working voltage for the adjustment of the ratio of Ca/P in the coating was more suitable for the NaSi 2O 3 system than the NaOH system. The polarizing curve tests showed the coatings improved the corrosion resistance of the AZ91D Mg alloy in 0.9% NaCl solution by nearly two orders of magnitude.

Understanding heart rate alarm adjustment in the intensive care units through an analytical approach.

PubMed

Fidler, Richard L; Pelter, Michele M; Drew, Barbara J; Palacios, Jorge Arroyo; Bai, Yong; Stannard, Daphne; Aldrich, J Matt; Hu, Xiao

2017-01-01

Heart rate (HR) alarms are prevalent in ICU, and these parameters are configurable. Not much is known about nursing behavior associated with tailoring HR alarm parameters to individual patients to reduce clinical alarm fatigue. To understand the relationship between heart rate (HR) alarms and adjustments to reduce unnecessary heart rate alarms. Retrospective, quantitative analysis of an adjudicated database using analytical approaches to understand behaviors surrounding parameter HR alarm adjustments. Patients were sampled from five adult ICUs (77 beds) over one month at a quaternary care university medical center. A total of 337 of 461 ICU patients had HR alarms with 53.7% male, mean age 60.3 years, and 39% non-Caucasian. Default HR alarm parameters were 50 and 130 beats per minute (bpm). The occurrence of each alarm, vital signs, and physiologic waveforms was stored in a relational database (SQL server). There were 23,624 HR alarms for analysis, with 65.4% exceeding the upper heart rate limit. Only 51% of patients with HR alarms had parameters adjusted, with a median upper limit change of +5 bpm and -1 bpm lower limit. The median time to first HR parameter adjustment was 17.9 hours, without reduction in alarms occurrence (p = 0.57). HR alarms are prevalent in ICU, and half of HR alarm settings remain at default. There is a long delay between HR alarms and parameters changes, with insufficient changes to decrease HR alarms. Increasing frequency of HR alarms shortens the time to first adjustment. Best practice guidelines for HR alarm limits are needed to reduce alarm fatigue and improve monitoring precision.

Understanding heart rate alarm adjustment in the intensive care units through an analytical approach

PubMed Central

Pelter, Michele M.; Drew, Barbara J.; Palacios, Jorge Arroyo; Bai, Yong; Stannard, Daphne; Aldrich, J. Matt; Hu, Xiao

2017-01-01

Background Heart rate (HR) alarms are prevalent in ICU, and these parameters are configurable. Not much is known about nursing behavior associated with tailoring HR alarm parameters to individual patients to reduce clinical alarm fatigue. Objectives To understand the relationship between heart rate (HR) alarms and adjustments to reduce unnecessary heart rate alarms. Methods Retrospective, quantitative analysis of an adjudicated database using analytical approaches to understand behaviors surrounding parameter HR alarm adjustments. Patients were sampled from five adult ICUs (77 beds) over one month at a quaternary care university medical center. A total of 337 of 461 ICU patients had HR alarms with 53.7% male, mean age 60.3 years, and 39% non-Caucasian. Default HR alarm parameters were 50 and 130 beats per minute (bpm). The occurrence of each alarm, vital signs, and physiologic waveforms was stored in a relational database (SQL server). Results There were 23,624 HR alarms for analysis, with 65.4% exceeding the upper heart rate limit. Only 51% of patients with HR alarms had parameters adjusted, with a median upper limit change of +5 bpm and -1 bpm lower limit. The median time to first HR parameter adjustment was 17.9 hours, without reduction in alarms occurrence (p = 0.57). Conclusions HR alarms are prevalent in ICU, and half of HR alarm settings remain at default. There is a long delay between HR alarms and parameters changes, with insufficient changes to decrease HR alarms. Increasing frequency of HR alarms shortens the time to first adjustment. Best practice guidelines for HR alarm limits are needed to reduce alarm fatigue and improve monitoring precision. PMID:29176776

Use of age-adjusted rates of suicide in time series studies in Israel.

PubMed

Bridges, F Stephen; Tankersley, William B

2009-01-01

Durkheim's modified theory of suicide was examined to explore how consistent it was in predicting Israeli rates of suicide from 1965 to 1997 when using age-adjusted rates rather than crude ones. In this time-series study, Israeli male and female rates of suicide increased and decreased, respectively, between 1965 and 1997. Conforming to Durkheim's modified theory, the Israeli male rate of suicide was lower in years when rates of marriage and birth are higher, while rates of suicide are higher in years when rates of divorce are higher, the opposite to that of Israeli women. The corrected regression coefficients suggest that the Israeli female rate of suicide remained lower in years when rate of divorce is higher, again the opposite suggested by Durkheim's modified theory. These results may indicate that divorce affects the mental health of Israeli women as suggested by their lower rate of suicide. Perhaps the "multiple roles held by Israeli females creates suicidogenic stress" and divorce provides some sense of stress relief, mentally speaking. The results were not as consistent with predictions suggested by Durkheim's modified theory of suicide as were rates from the United States for the same period nor were they consistent with rates based on "crude" suicide data. Thus, using age-adjusted rates of suicide had an influence on the prediction of the Israeli rate of suicide during this period.

[Do laymen understand information about hospital quality? An empirical verification using risk-adjusted mortality rates as an example].

PubMed

Sander, Uwe; Kolb, Benjamin; Taheri, Fatemeh; Patzelt, Christiane; Emmert, Martin

2017-11-01

The effect of public reporting to improve quality in healthcare is reduced by the limited intelligibility of information about the quality of healthcare providers. This may result in worse health-related choices especially for older people and those with lower levels of education. There is, as yet, little information as to whether laymen understand the concepts behind quality comparisons and if this comprehension is correlated with hospital choices. An instrument with 20 items was developed to analyze the intelligibility of five technical terms which were used in German hospital report cards to explain risk-adjusted death rates. Two online presentations of risk-adjusted death rates for five hospitals in the style of hospital report cards were developed. An online survey of 353 volunteers tested the comprehension of the risk-adjusted mortality rates and included an experimental hospital choice. The intelligibility of five technical terms was tested: risk-adjusted, actual and expected death rate, reference range and national average. The percentages of correct answers for the five technical terms were in the range of 75.0-60.2%. Between 23.8% and 5.1% of the respondents were not able to answer the question about the technical term itself. The least comprehensible technical terms were "risk-adjusted death rate" and "reference range". The intelligibility of the 20 items that were used to test the comprehension of the risk-adjusted mortality was between 89.5% and 14.2%. The two items that proved to be least comprehensible were related to the technical terms "risk-adjusted death rate" and "reference range". For all five technical terms it was found that a better comprehension correlated significantly with better hospital choices. We found a better than average intelligibility for the technical terms "actual and expected death rate" and for "national average". The least understandable were "risk-adjusted death rate" and "reference range". Since the self

Recent tobacco tax rate adjustment and its potential impact on tobacco control in China.

PubMed

Hu, Teh-Wei; Mao, Zhengzhong; Shi, Jian

2010-02-01

To compare the new tobacco tax structure effective from May 2009 with the tax structure before May 2009 and to analyse its potential impact. Published government statistics and estimated price elasticities of the demand for cigarettes are used to estimate the impact of the new tax rate adjustment on cigarette consumption and population health. The new adjustment increased the tax rate by 11.7% points at the producer price level. Converting this 11.7% point increase to the retail price level would mean an increase of 3.4% points in the retail price tax rate. Thus, China's new cigarette tax rate at the retail level would be 43.4% instead of the previous 40%. The primary motivation for the recent Chinese government tobacco tax adjustment is to raise additional government revenue. Because the additional ad valorem tax has not yet been transferred to smokers, there is no public health benefit. It is hoped that the Chinese government will pass along these taxes to the retail price level, which would result in between 640,000 and two million smokers quitting smoking and between 210,000 and 700,000 quitters avoiding smoking-related premature death.

A review of terrorism and its reduction of the gender ratio at birth after seasonal adjustment.

PubMed

Grech, Victor; Zammit, Dorota

2017-12-01

Males are born in excess of females, a ratio expressed as M/T (males:total births). The ratio exhibits seasonal variation. Furthermore, acute stressful events may result in a transient dip in male births due to excess foetal losses, reducing M/T. This study was carried out in order to identify significant M/T dips after adjusting for seasonality. Live births by gender and month were sought for acute stressful events. After seasonal correction (where appropriate), M/T dips were sought. Live births. M/T dips. This paper studied 112,226,306 live births. The following events showed dips ≤5th percentile 3-5months after these acute episodes: the Brooklyn Bridge protests, Katrina Hurricane for all 4 states and for each individual state (Alabama, Florida, Louisiana, Mississippi), the Battle in Seattle, the London bombings, The Madrid bombings (for Madrid and for Spain), the Breivik shooting, the Oklahoma City bombing and the Sandy Hook Elementary School shooting. The Virginia Polytechnic Institute and State University shooting the Fukushima Daiichi nuclear disaster also showed dips albeit slightly later. Seasonal adjustments should be taken into consideration in order to avoid Type 1 or 2 error pitfalls. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparing potentially avoidable hospitalization rates related to ambulatory care sensitive conditions in Switzerland: the need to refine the definition of health conditions and to adjust for population health status.

PubMed

Eggli, Yves; Desquins, Béatrice; Seker, Erol; Halfon, Patricia

2014-01-20

Regional rates of hospitalization for ambulatory care sensitive conditions (ACSC) are used to compare the availability and quality of ambulatory care but the risk adjustment for population health status is often minimal. The objectives of the study was to examine the impact of more extensive risk adjustment on regional comparisons and to investigate the relationship between various area-level factors and the properly adjusted rates. Our study is an observational study based on routine data of 2 million anonymous insured in 26 Swiss cantons followed over one or two years. A binomial negative regression was modeled with increasingly detailed information on health status (age and gender only, inpatient diagnoses, outpatient conditions inferred from dispensed drugs and frequency of physician visits). Hospitalizations for ACSC were identified from principal diagnoses detecting 19 conditions, with an updated list of ICD-10 diagnostic codes. Co-morbidities and surgical procedures were used as exclusion criteria to improve the specificity of the detection of potentially avoidable hospitalizations. The impact of the adjustment approaches was measured by changes in the standardized ratios calculated with and without other data besides age and gender. 25% of cases identified by inpatient main diagnoses were removed by applying exclusion criteria. Cantonal ACSC hospitalizations rates varied from to 1.4 to 8.9 per 1,000 insured, per year. Morbidity inferred from diagnoses and drugs dramatically increased the predictive performance, the greatest effect found for conditions linked to an ACSC. More visits were associated with fewer PAH although very high users were at greater risk and subjects who had not consulted at negligible risk. By maximizing health status adjustment, two thirds of the cantons changed their adjusted ratio by more than 10 percent. Cantonal variations remained substantial but unexplained by supply or demand. Additional adjustment for health status is required

76 FR 590 - Adjustment or Determination of Compulsory License Rates for Making and Distributing Phonorecords

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... LIBRARY OF CONGRESS Copyright Royalty Board [Docket No. 2011-3 CRB Phonorecords II] Adjustment or... Board, Library of Congress. ACTION: Notice announcing commencement of proceeding with request for... proceeding was captioned as ``DPRA'' (which stands for ``Digital Phonorecord Rate Adjustment''). Hereinafter...

Adjustable flow rate controller for polymer solutions

DOEpatents

Jackson, Kenneth M.

1981-01-01

An adjustable device for controlling the flow rate of polymer solutions which results in only little shearing of the polymer molecules, said device comprising an inlet manifold, an outlet manifold, a plurality of tubes capable of providing communication between said inlet and outlet manifolds, said tubes each having an internal diameter that is smaller than that of the inlet manifold and large enough to insure that viscosity of the polymer solution passing through each said tube will not be reduced more than about 25 percent, and a valve associated with each tube, said valve being capable of opening or closing communication in that tube between the inlet and outlet manifolds, each said valve when fully open having a diameter that is substantially at least as great as that of the tube with which it is associated.

Estimating risk and rate levels, ratios and differences in case-control studies.

PubMed

King, Gary; Zeng, Langche

2002-05-30

Classic (or 'cumulative') case-control sampling designs do not admit inferences about quantities of interest other than risk ratios, and then only by making the rare events assumption. Probabilities, risk differences and other quantities cannot be computed without knowledge of the population incidence fraction. Similarly, density (or 'risk set') case-control sampling designs do not allow inferences about quantities other than the rate ratio. Rates, rate differences, cumulative rates, risks, and other quantities cannot be estimated unless auxiliary information about the underlying cohort such as the number of controls in each full risk set is available. Most scholars who have considered the issue recommend reporting more than just risk and rate ratios, but auxiliary population information needed to do this is not usually available. We address this problem by developing methods that allow valid inferences about all relevant quantities of interest from either type of case-control study when completely ignorant of or only partially knowledgeable about relevant auxiliary population information.

7 CFR 1810.2 - Adjustment of interest rates for certain loans involving use of or construction on prime or...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Adjustment of interest rates for certain loans... INTEREST RATES, TERMS, CONDITIONS, AND APPROVAL AUTHORITY Interest Rates, Amortization, Guarantee Fee, Annual Charge, and Fixed Period § 1810.2 Adjustment of interest rates for certain loans involving use of...

Predicting prey population dynamics from kill rate, predation rate and predator-prey ratios in three wolf-ungulate systems.

PubMed

Vucetich, John A; Hebblewhite, Mark; Smith, Douglas W; Peterson, Rolf O

2011-11-01

1. Predation rate (PR) and kill rate are both fundamental statistics for understanding predation. However, relatively little is known about how these statistics relate to one another and how they relate to prey population dynamics. We assess these relationships across three systems where wolf-prey dynamics have been observed for 41 years (Isle Royale), 19 years (Banff) and 12 years (Yellowstone). 2. To provide context for this empirical assessment, we developed theoretical predictions of the relationship between kill rate and PR under a broad range of predator-prey models including predator-dependent, ratio-dependent and Lotka-Volterra dynamics. 3. The theoretical predictions indicate that kill rate can be related to PR in a variety of diverse ways (e.g. positive, negative, unrelated) that depend on the nature of predator-prey dynamics (e.g. structure of the functional response). These simulations also suggested that the ratio of predator-to-prey is a good predictor of prey growth rate. That result motivated us to assess the empirical relationship between the ratio and prey growth rate for each of the three study sites. 4. The empirical relationships indicate that PR is not well predicted by kill rate, but is better predicted by the ratio of predator-to-prey. Kill rate is also a poor predictor of prey growth rate. However, PR and ratio of predator-to-prey each explained significant portions of variation in prey growth rate for two of the three study sites. 5. Our analyses offer two general insights. First, Isle Royale, Banff and Yellowstone are similar insomuch as they all include wolves preying on large ungulates. However, they also differ in species diversity of predator and prey communities, exploitation by humans and the role of dispersal. Even with the benefit of our analysis, it remains difficult to judge whether to be more impressed by the similarities or differences. This difficulty nicely illustrates a fundamental property of ecological

Serum Free Light Chain Assay and κ/λ Ratio: Performance in Patients With Monoclonal Gammopathy-High False Negative Rate for κ/λ Ratio

PubMed Central

Singh, Gurmukh

2017-01-01

Background Serum free light chain assay (SFLCA) and κ/λ ratio, and protein electrophoretic methods are used in the diagnosis and monitoring of monoclonal gammopathies. Methods Results for serum free light chains, serum and urine protein electrophoreses and immunofixation electrophoreses in 468 patients with a diagnosis of monoclonal gammopathy were compared. The results of the two methods were graded as concordant, non-concordant or discordant with the established diagnoses to assess the relative performance of the methods. Results of κ/λ ratio in samples with monoclonal protein detectable by electrophoretic methods were also analyzed. Results Protein electrophoreses results were concordant with the established diagnoses significantly more often than κ/λ ratio. The false negative rate for κ/λ ratio was higher than that for electrophoretic methods. κ/λ ratio was falsely negative in about 27% of the 1,860 samples with detectable monoclonal immunoglobulin. The false negative rate was higher in lesions with lambda chains (32%) than those with kappa chains (24%). The false negative rate for κ/λ ratio was over 55% in samples with monoclonal gammopathy of undetermined significance. Even at first encounter, the false negative rates for κ/λ ratios for monoclonal gammopathy of undetermined significance, smoldering myeloma and multiple myeloma were 66.98%, 23.08%, and 30.15%, respectively, with false negative rate for lambda chain lesions being higher. Conclusions Electrophoretic studies of serum and urine are superior to SFLCA and κ/λ ratio. Abnormal κ/λ ratio, per se, is not diagnostic of monoclonal gammopathy. A normal κ/λ ratio does not exclude monoclonal gammopathy. False negative rates for lesions with lambda chain are higher than those for lesions with kappa chains. Electrophoretic studies of urine are underutilized. Clinical usefulness and medical necessity of SFLCA and κ/λ ratio is of questionable value in routine clinical testing. PMID:27924175

Serum Free Light Chain Assay and κ/λ Ratio: Performance in Patients With Monoclonal Gammopathy-High False Negative Rate for κ/λ Ratio.

PubMed

Singh, Gurmukh

2017-01-01

Serum free light chain assay (SFLCA) and κ/λ ratio, and protein electrophoretic methods are used in the diagnosis and monitoring of monoclonal gammopathies. Results for serum free light chains, serum and urine protein electrophoreses and immunofixation electrophoreses in 468 patients with a diagnosis of monoclonal gammopathy were compared. The results of the two methods were graded as concordant, non-concordant or discordant with the established diagnoses to assess the relative performance of the methods. Results of κ/λ ratio in samples with monoclonal protein detectable by electrophoretic methods were also analyzed. Protein electrophoreses results were concordant with the established diagnoses significantly more often than κ/λ ratio. The false negative rate for κ/λ ratio was higher than that for electrophoretic methods. κ/λ ratio was falsely negative in about 27% of the 1,860 samples with detectable monoclonal immunoglobulin. The false negative rate was higher in lesions with lambda chains (32%) than those with kappa chains (24%). The false negative rate for κ/λ ratio was over 55% in samples with monoclonal gammopathy of undetermined significance. Even at first encounter, the false negative rates for κ/λ ratios for monoclonal gammopathy of undetermined significance, smoldering myeloma and multiple myeloma were 66.98%, 23.08%, and 30.15%, respectively, with false negative rate for lambda chain lesions being higher. Electrophoretic studies of serum and urine are superior to SFLCA and κ/λ ratio. Abnormal κ/λ ratio, per se , is not diagnostic of monoclonal gammopathy. A normal κ/λ ratio does not exclude monoclonal gammopathy. False negative rates for lesions with lambda chain are higher than those for lesions with kappa chains. Electrophoretic studies of urine are underutilized. Clinical usefulness and medical necessity of SFLCA and κ/λ ratio is of questionable value in routine clinical testing.

78 FR 67951 - Price Cap Rules for Certain Postal Rate Adjustments; Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... POSTAL REGULATORY COMMISSION 39 CFR Part 3010 [Docket No. RM2013-2; Order No. 1786] Price Cap Rules for Certain Postal Rate Adjustments; Corrections AGENCY: Postal Regulatory Commission. ACTION: Correcting amendments. SUMMARY: The Postal Regulatory Commission published a document in the Federal Register...

Delayed heart rate recovery after exercise as a risk factor of incident type 2 diabetes mellitus after adjusting for glycometabolic parameters in men.

PubMed

Yu, Tae Yang; Jee, Jae Hwan; Bae, Ji Cheol; Hong, Won-Jung; Jin, Sang-Man; Kim, Jae Hyeon; Lee, Moon-Kyu

2016-10-15

Some studies have reported that delayed heart rate recovery (HRR) after exercise is associated with incident type 2 diabetes mellitus (T2DM). This study aimed to investigate the longitudinal association of delayed HRR following a graded exercise treadmill test (GTX) with the development of T2DM including glucose-associated parameters as an adjusting factor in healthy Korean men. Analyses including fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c as confounding factors and known confounders were performed. HRR was calculated as peak heart rate minus heart rate after a 1-min rest (HRR 1). Cox proportional hazards model was used to quantify the independent association between HRR and incident T2DM. During 9082 person-years of follow-up between 2006 and 2012, there were 180 (10.1%) incident cases of T2DM. After adjustment for age, BMI, systolic BP, diastolic BP, smoking status, peak heart rate, peak oxygen uptake, TG, LDL-C, HDL-C, fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c, the hazard ratios (HRs) [95% confidence interval (CI)] of incident T2DM comparing the second and third tertiles to the first tertile of HRR 1 were 0.867 (0.609-1.235) and 0.624 (0.426-0.915), respectively (p for trend=0.017). As a continuous variable, in the fully-adjusted model, the HR (95% CI) of incident T2DM associated with each 1 beat increase in HRR 1 was 0.980 (0.960-1.000) (p=0.048). This study demonstrated that delayed HRR after exercise predicts incident T2DM in men, even after adjusting for fasting glucose, HOMA-IR, HOMA-β, and HbA1c. However, only HRR 1 had clinical significance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

77 FR 13663 - Order Making Fiscal Year 2012 Mid-Year Adjustments to Transaction Fee Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... the Exchange Act establish a new method for annually adjusting the fee rates applicable under Sections... 31(j)(2) specifies the method for determining the mid-year adjustment for fiscal 2012. Specifically... the month ($4,797,592,302,406). Repeat the method to generate forecasts for subsequent months. \\14...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

An Efficient Implementation of Fixed Failure-Rate Ratio Test for GNSS Ambiguity Resolution.

PubMed

Hou, Yanqing; Verhagen, Sandra; Wu, Jie

2016-06-23

Ambiguity Resolution (AR) plays a vital role in precise GNSS positioning. Correctly-fixed integer ambiguities can significantly improve the positioning solution, while incorrectly-fixed integer ambiguities can bring large positioning errors and, therefore, should be avoided. The ratio test is an extensively used test to validate the fixed integer ambiguities. To choose proper critical values of the ratio test, the Fixed Failure-rate Ratio Test (FFRT) has been proposed, which generates critical values according to user-defined tolerable failure rates. This contribution provides easy-to-implement fitting functions to calculate the critical values. With a massive Monte Carlo simulation, the functions for many different tolerable failure rates are provided, which enriches the choices of critical values for users. Moreover, the fitting functions for the fix rate are also provided, which for the first time allows users to evaluate the conditional success rate, i.e., the success rate once the integer candidates are accepted by FFRT. The superiority of FFRT over the traditional ratio test regarding controlling the failure rate and preventing unnecessary false alarms is shown by a simulation and a real data experiment. In the real data experiment with a baseline of 182.7 km, FFRT achieved much higher fix rates (up to 30% higher) and the same level of positioning accuracy from fixed solutions as compared to the traditional critical value.

The impact of sex ratio and economic status on local birth rates.

PubMed

Chipman, A; Morrison, E

2013-04-23

Human mating and reproductive behaviour can vary depending on various mechanisms, including the local sex ratio. Previous research shows that as sex ratios become female-biased, women from economically deprived areas are less likely to delay reproductive opportunities to wait for a high-investing mate but instead begin their reproductive careers sooner. Here, we show that the local sex ratio also has an impact on female fertility schedules. At young ages, a female-biased ratio is associated with higher birth rates in the poorest areas, whereas the opposite is true for the richest areas. At older ages, a female-biased ratio is associated with higher birth rates in the richest, but not the poorest areas. These patterns suggest that female-female competition encourages poorer women to adopt a fast life-history strategy and give birth early, and richer women to adopt a slow life-history strategy and delay reproduction.

The impact of sex ratio and economic status on local birth rates

PubMed Central

Chipman, A.; Morrison, E.

2013-01-01

Human mating and reproductive behaviour can vary depending on various mechanisms, including the local sex ratio. Previous research shows that as sex ratios become female-biased, women from economically deprived areas are less likely to delay reproductive opportunities to wait for a high-investing mate but instead begin their reproductive careers sooner. Here, we show that the local sex ratio also has an impact on female fertility schedules. At young ages, a female-biased ratio is associated with higher birth rates in the poorest areas, whereas the opposite is true for the richest areas. At older ages, a female-biased ratio is associated with higher birth rates in the richest, but not the poorest areas. These patterns suggest that female–female competition encourages poorer women to adopt a fast life-history strategy and give birth early, and richer women to adopt a slow life-history strategy and delay reproduction. PMID:23407502

75 FR 66271 - Assessment Dividends, Assessment Rates and Designated Reserve Ratio

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... has recovered to pre-crisis levels, and the long term, when the reserve ratio is sufficiently large... detail below, concludes that a moderate, long-term average industry assessment rate, combined with an... and earnings of IDIs. Long Term To increase the probability that the fund reserve ratio will reach a...

75 FR 51191 - Great Lakes Pilotage Rates-2011 Annual Review and Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

...-AB48 Great Lakes Pilotage Rates--2011 Annual Review and Adjustment AGENCY: Coast Guard, DHS. ACTION... the Great Lakes to generate sufficient revenue to cover allowable expenses, target pilot compensation..., Chief, Great Lakes Pilotage Division, Commandant (CG-5522), U.S. Coast Guard, at 202-372-1535, by fax...

43 CFR 38.2 - Computation of hourly, daily, weekly, and biweekly adjusted rates of pay.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Computation of hourly, daily, weekly, and biweekly adjusted rates of pay. 38.2 Section 38.2 Public Lands: Interior Office of the Secretary of the Interior PAY OF U.S. PARK POLICE-INTERIM GEOGRAPHIC ADJUSTMENTS § 38.2 Computation of hourly, daily, weekly...

Indirect medical education and disproportionate share adjustments to Medicare inpatient payment rates.

PubMed

Nguyen, Nguyen Xuan; Sheingold, Steven H

2011-11-04

The indirect medical education (IME) and disproportionate share hospital (DSH) adjustments to Medicare's prospective payment rates for inpatient services are generally intended to compensate hospitals for patient care costs related to teaching activities and care of low income populations. These adjustments were originally established based on the statistical relationships between IME and DSH and hospital costs. Due to a variety of policy considerations, the legislated levels of these adjustments may have deviated over time from these "empirically justified levels," or simply, "empirical levels." In this paper, we estimate the empirical levels of IME and DSH using 2006 hospital data and 2009 Medicare final payment rules. Our analyses suggest that the empirical level for IME would be much smaller than under current law-about one-third to one-half. Our analyses also support the DSH adjustment prescribed by the Affordable Care Act of 2010 (ACA)--about one-quarter of the pre-ACA level. For IME, the estimates imply an increase in costs of 1.88% for each 10% increase in teaching intensity. For DSH, the estimates imply that costs would rise by 0.52% for each 10% increase in the low-income patient share for large urban hospitals. Public Domain.

Adjustable repetition-rate multiplication of optical pulses using fractional temporal Talbot effect with preceded binary intensity modulation

NASA Astrophysics Data System (ADS)

Xie, Qijie; Zheng, Bofang; Shu, Chester

2017-05-01

We demonstrate a simple approach for adjustable multiplication of optical pulses in a fiber using the temporal Talbot effect. Binary electrical patterns are used to control the multiplication factor in our approach. The input 10 GHz picosecond pulses are pedestal-free and are shaped directly from a CW laser. The pulses are then intensity modulated by different sets of binary patterns prior to entering a fiber of fixed dispersion. Tunable repetition-rate multiplication by different factors of 2, 4, and 8 have been achieved and up to 80 GHz pulse train has been experimentally generated. We also evaluate numerically the influence of the extinction ratio of the intensity modulator on the performance of the multiplied pulse train. In addition, the impact of the modulator bias on the uniformity of the output pulses has also been analyzed through simulation and experiment and a good agreement is reached. Last, we perform numerical simulation on the RF spectral characteristics of the output pulses. The insensitivity of the signal-to-subharmonic noise ratio (SSNR) to the laser linewidth shows that our multiplication scheme is highly tolerant to the incoherence of the input optical pulses.

The effect of acquiring life skills through humor on social adjustment rate of the female students.

PubMed

Maghsoudi, Jahangir; Sabour, Nazanin Hashemi; Yazdani, Mohsen; Mehrabi, Tayebeh

2010-01-01

Life skills have different effects on various aspects of the mental health. Social adjustment prepares adolescents for entering to the adulthood. On the other hand, humor and joking in the education is considered as a stress reducer and learning increaser. Therefore, the present study conducted aimed to determine the effect of acquiring life skills through humor on the social adjustment rate of the high school girls. This was a two-group semi-experimental study including three phases. The study population included 69 first year high school female students of Isfahan Department of Education district 3 who were selected in simple random sampling. First of all, the social adjustment rate was measured using California Personality Inventory. Thereafter, life skills education was conducted using humor during five sessions. Finally, a test was taken in order to assess the acquisition of the life skills in which passing score was required for re-completing the questionnaire. The data were analyzed using software SPSS(10) and independent and paired t-tests. The findings of the study indicated that the mean score of the social adjustment statistically had a significant difference in the intervention group before and after the intervention. Furthermore, statistically, there was a significant difference between mean score of the social adjustment in the control group and test group after conducting the intervention. The findings of the study indicated that life skills education has been increased through humor on the social adjustment rate of the high school girl students. Considering the efficacy of learning life skills on the social adjustment and results of the other studies which were in accordance with the present study, implementing such trainings with a new method comprehensively is recommended in the schools.

A replication of the relationship between elderly suicides rates and elderly dependency ratios: cross-national study

PubMed Central

Shah, Ajit

2010-01-01

Abstract: Background: A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. Methods: A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. Results: The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). Conclusions: The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. PMID:21483194

5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

Code of Federal Regulations, 2012 CFR

2012-01-01

... fall below the minimum adjusted rate of their band. 9701.336 Section 9701.336 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not fall... or special rate supplement) does not fall below the minimum adjusted rate of his or her band as a...

5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

Code of Federal Regulations, 2013 CFR

2013-01-01

... fall below the minimum adjusted rate of their band. 9701.336 Section 9701.336 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not fall... or special rate supplement) does not fall below the minimum adjusted rate of his or her band as a...

5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

Code of Federal Regulations, 2014 CFR

2014-01-01

... fall below the minimum adjusted rate of their band. 9701.336 Section 9701.336 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not fall... or special rate supplement) does not fall below the minimum adjusted rate of his or her band as a...

5 CFR 9701.336 - Treatment of employees whose pay does not fall below the minimum adjusted rate of their band.

Code of Federal Regulations, 2011 CFR

2011-01-01

... fall below the minimum adjusted rate of their band. 9701.336 Section 9701.336 Administrative Personnel... Administration Locality and Special Rate Supplements § 9701.336 Treatment of employees whose pay does not fall... or special rate supplement) does not fall below the minimum adjusted rate of his or her band as a...

Persistent sex-by-environment effects on offspring fitness and sex-ratio adjustment in a wild bird population.

PubMed

Bowers, E Keith; Thompson, Charles F; Sakaluk, Scott K

2015-03-01

A major component of sex-allocation theory, the Trivers-Willard model (TWM), posits that sons and daughters are differentially affected by variation in the rearing environment. In many species, the amount of parental care received is expected to have differing effects on the fitness of males and females. When this occurs, the TWM predicts that selection should favour adjustment of the offspring sex ratio in relation to the expected fitness return from offspring. However, evidence for sex-by-environment effects is mixed, and little is known about the adaptive significance of producing either sex. Here, we test whether offspring sex ratios vary according to predictions of the TWM in the house wren (Troglodytes aedon, Vieillot). We also test the assumption of a sex-by-environment effect on offspring using two experiments, one in which we manipulated age differences among nestlings within broods, and another in which we held nestling age constant but manipulated brood size. As predicted, females with high investment ability overproduced sons relative to those with lower ability. Males were also overproduced early within breeding seasons. In our experiments, the body mass of sons was more strongly affected by the sibling-competitive environment and resource availability than that of daughters: males grew heavier than females when reared in good conditions but were lighter than females when in poor conditions. Parents rearing broods with 1:1 sex ratios were more productive than parents rearing broods biased more strongly towards sons or daughters, suggesting that selection favours the production of mixed-sex broods. However, differences in the condition of offspring as neonates persisted to adulthood, and their reproductive success as adults varied with the body mass of sons, but not daughters, prior to independence from parental care. Thus, selection should favour slight but predictable variations in the sex ratio in relation to the quality of offspring that parents are

75 FR 78690 - Fiscal Year (FY) 2012-2013 Proposed Transmission Rate Adjustments Public Hearing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... DEPARTMENT OF ENERGY Bonneville Power Administration [BPA File No.: BP-12] Fiscal Year (FY) 2012... Comment AGENCY: Bonneville Power Administration (BPA), Department of Energy (DOE). ACTION: Notice of FY 2012-2013 proposed transmission rate adjustments. SUMMARY: BPA is holding a consolidated rate...

12 CFR 622.61 - Adjustment of civil money penalties by the rate of inflation under the Federal Civil Penalties...

Code of Federal Regulations, 2010 CFR

2010-01-01

... of inflation under the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended. 622.61... civil money penalties by the rate of inflation under the Federal Civil Penalties Inflation Adjustment... is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990, as...

Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

PubMed

Pollmanns, Johannes; Romano, Patrick S; Weyermann, Maria; Geraedts, Max; Drösler, Saskia E

2018-04-01

To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. A retrospective cross-sectional study using in- and outpatient secondary data was performed. Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care. Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment. Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. © Health Research and Educational Trust.

High Altitude Remains Associated with Elevated Suicide Rates after Adjusting for Socioeconomic Status: A Study from South Korea

PubMed Central

Kim, Jaelim; Choi, Nari; Lee, Yu-Jin; An, Hyonggin; Kim, Namkug; Yoon, Ho-Kyoung

2014-01-01

There have been several studies supporting a possible relationship between high suicide rate and high altitude. However socioeconomic status may confound this association because low socioeconomic status, which is known to be related to a high suicide rate, is also associated with living at high altitude. This study aims to explore whether the relationship between high altitude and high suicide rate remains after adjusting for socioeconomic status in South Korea. We collected demographic data of completed suicides, the mean altitude of the district where each suicide took place, and the mean income of each district. We analyzed the data using regression analysis before and after adjustment for mean income. We found that there is a positive correlation between altitude and suicide rate, even after adjustment for mean income. Thus, altitude appears to be an independent risk factor for suicide. PMID:25395983

Essays in applied macroeconomics: Asymmetric price adjustment, exchange rate and treatment effect

NASA Astrophysics Data System (ADS)

Gu, Jingping

This dissertation consists of three essays. Chapter II examines the possible asymmetric response of gasoline prices to crude oil price changes using an error correction model with GARCH errors. Recent papers have looked at this issue. Some of these papers estimate a form of error correction model, but none of them accounts for autoregressive heteroskedasticity in estimation and testing for asymmetry and none of them takes the response of crude oil price into consideration. We find that time-varying volatility of gasoline price disturbances is an important feature of the data, and when we allow for asymmetric GARCH errors and investigate the system wide impulse response function, we find evidence of asymmetric adjustment to crude oil price changes in weekly retail gasoline prices. Chapter III discusses the relationship between fiscal deficit and exchange rate. Economic theory predicts that fiscal deficits can significantly affect real exchange rate movements, but existing empirical evidence reports only a weak impact of fiscal deficits on exchange rates. Based on US dollar-based real exchange rates in G5 countries and a flexible varying coefficient model, we show that the previously documented weak relationship between fiscal deficits and exchange rates may be the result of additive specifications, and that the relationship is stronger if we allow fiscal deficits to impact real exchange rates non-additively as well as nonlinearly. We find that the speed of exchange rate adjustment toward equilibrium depends on the state of the fiscal deficit; a fiscal contraction in the US can lead to less persistence in the deviation of exchange rates from fundamentals, and faster mean reversion to the equilibrium. Chapter IV proposes a kernel method to deal with the nonparametric regression model with only discrete covariates as regressors. This new approach is based on recently developed least squares cross-validation kernel smoothing method. It can not only automatically smooth

Association of heart rate at hospital discharge with mortality and hospitalizations in patients with heart failure.

PubMed

Habal, Marlena V; Liu, Peter P; Austin, Peter C; Ross, Heather J; Newton, Gary E; Wang, Xuesong; Tu, Jack V; Lee, Douglas S

2014-01-01

Heart failure (HF) is associated with a high burden of morbidity and mortality. Hospital discharge is an opportunity for identification of modifiable prognostic factors in the transition to chronic HF. We examined the association of discharge heart rate with 30-day and 1-year mortality and hospitalization outcomes in a cohort of 9097 patients with HF discharged from hospital. Discharge heart rate was categorized into predefined groups: 40 to 60 (n=1333), 61 to 70 (n=2170), 71 to 80 (n=2631), 81 to 90 (n=1700), and >90 bpm (n=1263). There was a significant increase in all-cause 30-day mortality with adjusted odds ratios of 1.59 (95% confidence interval [CI], 1.18-2.14; P=0.003) for discharge heart rates 81 to 90 bpm and 1.56 (95% CI, 1.13-2.16; P=0.007) for heart rates>90 bpm when compared with the reference group (heart rates, 61-70 bpm). Cardiovascular death risk at 30 days was also higher with adjusted odds ratio 1.59 (discharge heart rates, 81-90 bpm; 95% CI, 1.09-2.33; P=0.017) and 1.65 (discharge heart rates, >90 bpm; 95% CI, 1.09-2.48; P=0.017). One-year all-cause mortality (adjusted odds ratio, 1.41; 95% CI, 1.16-1.72; P<0.001) and cardiovascular death (adjusted odds ratio, 1.47; 95% CI, 1.12-1.92; P=0.005) were higher with discharge heart rates>90 bpm when compared with the reference group (heart rates, 40-60 bpm). Readmissions for HF (adjusted hazard ratio, 1.26; 95% CI, 1.04-1.54; P=0.021) and cardiovascular disease (adjusted hazard ratio, 1.29; 95% CI, 1.08-1.54; P=0.004) within 30 days were also higher with discharge heart rates>90 bpm. Higher discharge heart rates were associated with greater risk of all-cause and cardiovascular mortality≤1-year follow-up and an elevated risk of 30-day readmission for HF and cardiovascular disease.

77 FR 47582 - Great Lakes Pilotage Rates-2013 Annual Review and Adjust; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... DEPARTMENT OF HOMELAND SECURITY Coast Guard 46 CFR Part 401 [Docket No. USCG-2012-0409] RIN 1625-AB89 Great Lakes Pilotage Rates--2013 Annual Review and Adjust; Correction AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking; correction. SUMMARY: The Coast Guard published a Notice of...

High Peak Estradiol/Mature Oocyte Ratio Predicts Lower Clinical Pregnancy, Ongoing Pregnancy, and Live Birth Rates in GnRH Antagonist Intracytoplasmic Sperm Injection Cycles.

PubMed

Sandoval, Juan S; Steward, Ryan G; Chen, Chen; Li, Yi-Ju; Price, Thomas M; Muasher, Suheil J

2016-01-01

To define the relationship between peak estradiol (E2)/mature oocyte ratio and pregnancy outcomes in gonadotropin-releasing hormone (GnRH) antagonist intracytoplasmic sperm injection (ICSI) cycles. Retrospective cohort study in the setting of an academic reproductive medicine practice. Records from 162 fresh, autologous, GnRH antagonist ICSI cycles performed between 2009 and 2012 .were analyzed. The main outcome measures were rates of clinical pregnancy (CPR), ongoing pregnancy (OPR), and live birth (LBR). For the primary analysis, 4 groups were created based on peak E2/mature oocyte ratio (group 1: <200, group 2: 200-300, group 3: 300-400, and group 4: >400 pg/mL/oocyte). After adjusting for age, basal FSH, and the number of mature oocytes, a significantly lower OPR was seen in group 4 as compared to group I (OR 0.15, 95% CI 0.03-0.86; p=0.032) and group 3 (OR 0.17, 95% CI 0.03-0.98; p=0.048), respectively. The adjusted LBR was also significantly lower in group 4 as compared to group 1 (OR 0.15, 95% CI 0.03-0.83; p=0.030). In a secondary analysis, 3 ranges of peak E2/ mature oocyte ratio (<200, 200-400, and >400 pg/ mL/oocyte) were compared between low, normal, and high responders (<6, 6-15, and >15 mature oocytes, respectively). Clinical pregnancy rate, OPR, and LBR were all lower in normal responders when the E2/oocyte ratio exceeded 400 pg/mL/oocyte as compared to <200 pg/mL/oocyte and 200-300 pg/mL/oocyte (CPR 1% vs. 16% and 32%, respectively, p=0.017; OPR 0 vs. 15% and 27%, respectively, p=0.011; and LBR 0 vs. 13% and 26%, respectively, p=0.018). Very elevated peak E2/mature oocyte ratio is associated with a lower CPR, OPR, and LBR in fresh, autologous, GnRH antagonist ICSI cycles.

An evaluation of bias in propensity score-adjusted non-linear regression models.

PubMed

Wan, Fei; Mitra, Nandita

2018-03-01

Propensity score methods are commonly used to adjust for observed confounding when estimating the conditional treatment effect in observational studies. One popular method, covariate adjustment of the propensity score in a regression model, has been empirically shown to be biased in non-linear models. However, no compelling underlying theoretical reason has been presented. We propose a new framework to investigate bias and consistency of propensity score-adjusted treatment effects in non-linear models that uses a simple geometric approach to forge a link between the consistency of the propensity score estimator and the collapsibility of non-linear models. Under this framework, we demonstrate that adjustment of the propensity score in an outcome model results in the decomposition of observed covariates into the propensity score and a remainder term. Omission of this remainder term from a non-collapsible regression model leads to biased estimates of the conditional odds ratio and conditional hazard ratio, but not for the conditional rate ratio. We further show, via simulation studies, that the bias in these propensity score-adjusted estimators increases with larger treatment effect size, larger covariate effects, and increasing dissimilarity between the coefficients of the covariates in the treatment model versus the outcome model.

A replication of the relationship between elderly suicides rates and elderly dependency ratios: a cross-national study.

PubMed

Shah, Ajit

2010-01-01

A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. ‎

Financial ratios in diagnostic radiology practices: variability and trends.

PubMed

Hogan, Christopher; Sunshine, Jonathan H

2004-03-01

To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive

Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content.

PubMed

Zhang, Bo; Ding, Fang; Chen, Tian; Xia, Liang-Hua; Qian, Juan; Lv, Guo-Yi

2014-12-21

To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease (NAFLD) based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate. A total of 170 subjects were enrolled in this study. All subjects were examined by ultrasound and (1)H-magnetic resonance spectroscopy ((1)H-MRS) on the same day. The ultrasound hepatic/renal echo-intensity ratio and ultrasound hepatic echo-intensity attenuation rate were obtained from ordinary ultrasound images using the MATLAB program. Correlation analysis revealed that the ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate were significantly correlated with (1)H-MRS liver fat content (ultrasound hepatic/renal ratio: r = 0.952, P = 0.000; hepatic echo-intensity attenuation r = 0.850, P = 0.000). The equation for predicting liver fat content by ultrasound (quantitative ultrasound model) is: liver fat content (%) = 61.519 × ultrasound hepatic/renal ratio + 167.701 × hepatic echo-intensity attenuation rate -26.736. Spearman correlation analysis revealed that the liver fat content ratio of the quantitative ultrasound model was positively correlated with serum alanine aminotransferase, aspartate aminotransferase, and triglyceride, but negatively correlated with high density lipoprotein cholesterol. Receiver operating characteristic curve analysis revealed that the optimal point for diagnosing fatty liver was 9.15% in the quantitative ultrasound model. Furthermore, in the quantitative ultrasound model, fatty liver diagnostic sensitivity and specificity were 94.7% and 100.0%, respectively, showing that the quantitative ultrasound model was better than conventional ultrasound methods or the combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate. If the (1)H-MRS liver fat content had a value < 15%, the sensitivity and specificity of the ultrasound quantitative model would be 81.4% and 100%, which still shows that using

Measurement and risk adjustment of prelabor cesarean rates in a large sample of California hospitals.

PubMed

Huesch, Marco D; Currid-Halkett, Elizabeth; Doctor, Jason N

2014-05-01

Prelabor cesareans in women without a prior cesarean is an important quality measure, yet one that is seldom tracked. We estimated patient-level risks and calculated how sensitive hospital rankings on this proposed quality metric were to risk adjustment. This retrospective cohort study linked Californian patient data from the Agency for Healthcare Research and Quality with hospital-level operational and financial data. Using the outcome of primary prelabor cesarean, we estimated patient-level logistic regressions in progressively more detailed models. We assessed incremental fit and discrimination, and aggregated the predicted patient-level event probabilities to construct hospital-level rankings. Of 408,355 deliveries by women without prior cesareans at 254 hospitals, 11.0% were prelabor cesareans. Including age, ethnicity, race, insurance, weekend and unscheduled admission, and 12 well-known patient risk factors yielded a model c-statistic of 0.83. Further maternal comorbidities, and hospital and obstetric unit characteristics only marginally improved fit. Risk adjusting hospital rankings led to a median absolute change in rank of 44 places compared to rankings based on observed rates. Of the 48 (49) hospitals identified as in the best (worst) quintile on observed rates, only 23 (18) were so identified by the risk-adjusted model. Models predict primary prelabor cesareans with good discrimination. Systematic hospital-level variation in patient risk factors requires risk adjustment to avoid considerably different classification of hospitals by outcome performance. An opportunity exists to define this metric and report such risk-adjusted outcomes to stakeholders. Copyright © 2014 Mosby, Inc. All rights reserved.

Medicare spending by state: the border-crossing adjustment.

PubMed

Basu, J; Lazenby, H C; Levit, K R

1995-01-01

As the first step in a pioneering effort by the Health Care Financing Administration (HCFA) to measure interstate border crossing for services used by both Medicare and non-Medicare beneficiaries, the authors study the spending behavior of Medicare beneficiaries for 10 Medicare-covered services. Based on interstate flow-of-expenditure data developed for calendar year 1991, the authors analyze the spending patterns of State residents by studying the inflow and outflow rates and the netflow ratios of expenditures incurred by Medicare patients. The report also provides per capita expenditure estimates with residence-based adjustments and evaluates the impact of the border-crossing adjustment for individual services and States.

The Association of State Rate Review Authority with Health Insurance Premiums.

PubMed

Ticse, Caroline

2015-10-01

Key findings. (1) Adjusted premiums in the individual market in states with prior approval authority combined with loss ratio requirements were lower in 2010-2013 than premiums in states with no rate review authority or file-and-use regulations only. (2) Adjusted premiums declined modestly in prior approval states while premiums increased in states with no rate review authority or with file-and-use regulations only. (3) The findings suggest that states with prior approval authority and loss ratio requirements constrained increases in health insurance premiums.

Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models

PubMed Central

2013-01-01

Background Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as “practically impossible”, and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Methods Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Results Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Conclusions Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons. PMID:24168424

Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models.

PubMed

Nicholl, Jon; Jacques, Richard M; Campbell, Michael J

2013-10-29

Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as "practically impossible", and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons.

Marital status, social capital, material conditions and self-rated health: a population-based study.

PubMed

Lindström, Martin

2009-12-01

Associations between marital status and self-rated health were investigated, adjusting for material conditions and trust (social capital). The 2004 public-health survey in Skåne is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate associations between marital status and self-rated health, adjusting for economic problems and trust. The prevalence of poor self-rated health was 28.7% among men and 33.2% among women. Older respondents, respondents born abroad, with medium/low education, low emotional support, low instrumental support, economic problems, low trust, never married and divorced had significantly higher odds ratios of poor self-rated health than their respective reference group. Low trust was significantly higher among the divorced and unmarried compared to the married/cohabitating. Adjustment for economic problems but not for trust reduced the odds ratios of poor self-rated health among the divorced, which became not significant among men. Never married and the divorced have significantly higher age-adjusted odds ratios of poor self-rated health than the married/cohabitating group. Economic problems but not trust seem to affect the association between marital status and poor self-rated health.

Leaky polarizing beam splitter with adjustable leak ratio for operation in the wavelength range of 440-690 nm.

PubMed

Cheng, L; Bartlett, C L; Erwin, J K; Mansuripur, M

1997-07-01

We discuss the optomechanical design and fabrication of a novel wideband (440-690-nm), leaky polarizing beam splitter with an adjustable leak ratio. This beam splitter is an important component of a multiwavelength dynamic testbed that we have constructed for testing optical disks. The multilayer thin-film structure of the beam splitter is essentially a stacked pair of narrow-band dielectric reflectors that have been fine tuned for optimal performance. The characteristics of the fabricated device are in good agreement with our theoretical calculations.

A statistical method for the conservative adjustment of false discovery rate (q-value).

PubMed

Lai, Yinglei

2017-03-14

q-value is a widely used statistical method for estimating false discovery rate (FDR), which is a conventional significance measure in the analysis of genome-wide expression data. q-value is a random variable and it may underestimate FDR in practice. An underestimated FDR can lead to unexpected false discoveries in the follow-up validation experiments. This issue has not been well addressed in literature, especially in the situation when the permutation procedure is necessary for p-value calculation. We proposed a statistical method for the conservative adjustment of q-value. In practice, it is usually necessary to calculate p-value by a permutation procedure. This was also considered in our adjustment method. We used simulation data as well as experimental microarray or sequencing data to illustrate the usefulness of our method. The conservativeness of our approach has been mathematically confirmed in this study. We have demonstrated the importance of conservative adjustment of q-value, particularly in the situation that the proportion of differentially expressed genes is small or the overall differential expression signal is weak.

Testing the non-unity of rate ratio under inverse sampling.

PubMed

Tang, Man-Lai; Liao, Yi Jie; Ng, Hong Keung Tony; Chan, Ping Shing

2007-08-01

Inverse sampling is considered to be a more appropriate sampling scheme than the usual binomial sampling scheme when subjects arrive sequentially, when the underlying response of interest is acute, and when maximum likelihood estimators of some epidemiologic indices are undefined. In this article, we study various statistics for testing non-unity rate ratios in case-control studies under inverse sampling. These include the Wald, unconditional score, likelihood ratio and conditional score statistics. Three methods (the asymptotic, conditional exact, and Mid-P methods) are adopted for P-value calculation. We evaluate the performance of different combinations of test statistics and P-value calculation methods in terms of their empirical sizes and powers via Monte Carlo simulation. In general, asymptotic score and conditional score tests are preferable for their actual type I error rates are well controlled around the pre-chosen nominal level, and their powers are comparatively the largest. The exact version of Wald test is recommended if one wants to control the actual type I error rate at or below the pre-chosen nominal level. If larger power is expected and fluctuation of sizes around the pre-chosen nominal level are allowed, then the Mid-P version of Wald test is a desirable alternative. We illustrate the methodologies with a real example from a heart disease study. (c) 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Video-rate scanning two-photon excitation fluorescence microscopy and ratio imaging with cameleons.

PubMed Central

Fan, G Y; Fujisaki, H; Miyawaki, A; Tsay, R K; Tsien, R Y; Ellisman, M H

1999-01-01

A video-rate (30 frames/s) scanning two-photon excitation microscope has been successfully tested. The microscope, based on a Nikon RCM 8000, incorporates a femtosecond pulsed laser with wavelength tunable from 690 to 1050 nm, prechirper optics for laser pulse-width compression, resonant galvanometer for video-rate point scanning, and a pair of nonconfocal detectors for fast emission ratioing. An increase in fluorescent emission of 1.75-fold is consistently obtained with the use of the prechirper optics. The nonconfocal detectors provide another 2.25-fold increase in detection efficiency. Ratio imaging and optical sectioning can therefore be performed more efficiently without confocal optics. Faster frame rates, at 60, 120, and 240 frames/s, can be achieved with proportionally reduced scan lines per frame. Useful two-photon images can be acquired at video rate with a laser power as low as 2.7 mW at specimen with the genetically modified green fluorescent proteins. Preliminary results obtained using this system confirm that the yellow "cameleons" exhibit similar optical properties as under one-photon excitation conditions. Dynamic two-photon images of cardiac myocytes and ratio images of yellow cameleon-2.1, -3.1, and -3.1nu are also presented. PMID:10233058

75 FR 70744 - Fiscal Year (FY) 2012-2013 Proposed Power Rate Adjustments Public Hearing and Opportunities for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-18

... DEPARTMENT OF ENERGY Bonneville Power Administration [BPA File No.: BP-12] Fiscal Year (FY) 2012... AGENCY: Bonneville Power Administration (BPA), Department of Energy (DOE). ACTIONS: Notice of FY 2012-2013 Proposed Power Rate Adjustments. SUMMARY: BPA is holding a consolidated rate proceeding, Docket No...

Magnesite Step Growth Rates as a Function of the Aqueous Magnesium:Carbonate Ratio

DOE PAGES

Bracco, Jacquelyn N.; Stack, Andrew G.; Higgins, Steven R.

2014-10-01

Step velocities of monolayer-height steps on the (101 ⁻4) magnesite surface have been measured as functions of the aqueous magnesium-to-carbonate ratio and saturation index (SI) using a hydrothermal atomic force microscope (HAFM). At SI ≤ 1.9 and 80-90 °C, step velocities were found to be invariant with changes in the magnesium-to-carbonate ratio, an observation in contrast with standard models for growth and dissolution of ionically-bonded, multi-component crystals. However, at high saturation indices (SI = 2.15), step velocities displayed a ratio dependence, maximized at magnesium-to-carbonate ratios slightly greater than 1:1. Traditional affinity-based models were unable to describe growth rates at themore » higher saturation index. Step velocities also could not be modeled solely through nucleation of kink sites, in contrast to other minerals whose bonding between constituent ions is also dominantly ionic in nature, such as calcite and barite. Instead, they could be described only by a model that incorporates both kink nucleation and propagation. Based on observed step morphological changes at these higher saturation indices, the step velocity maximum at SI = 2.15 is likely due to the rate of attachment to propagating kink sites overcoming the rate of detachment from kink sites as the latter becomes less significant under far from equilibrium conditions.« less

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.

Assessment of chloroethene degradation rates based on ratios of daughter/parent compounds in groundwater plumes

NASA Astrophysics Data System (ADS)

Höhener, Patrick

2014-05-01

Chlorinated solvent spills at industrial and urban sites create groundwater plumes where tetrachloro- and trichloroethene may degrade to their daughter compounds, dichloroethenes, vinyl chloride and ethane. The assessment of degradation and natural attenuation at such sites may be based on the analysis and inverse modelling of concentration data, on the calculation of mass fluxes in transsects, and/or on the analysis of stable isotope ratios in the ethenes. Relatively few work has investigated the possibility of using ratio of concentrations for gaining information on degradation rates. The use of ratios bears the advantage that dilution of a single sample with contaminant-free water does not matter. It will be shown that molar ratios of daughter to parent compounds measured along a plume streamline are a rapid and robust mean of determining whether degradation rates increase or decrease along the degradation chain, and allow furthermore a quantitation of the relative magnitude of degradation rates compared to the rate of the parent compound. Furthermore, ratios of concentration will become constant in zones where degradation is absent, and this allows to sketching the extension of actively degrading zones. The assessment is possible for pure sources and also for mixed sources. A quantification method is proposed in order to estimate first-order degradation rates in zones of constant degradation activity. This quantification method includes corrections that are needed due to longitudinal and transversal dispersivity. The method was tested on a number of real field sites from literature. At the majority of these sites, the first-order degradation rates were decreasing along the degradation chain from tetrachloroethene to vinyl chloride, meaning that the latter was often reaching important concentrations. This is bad news for site owners due to the increased toxicity of vinyl chloride compared to its parent compounds.

Sex inequality in kidney transplantation rates.

PubMed

Schaubel, D E; Stewart, D E; Morrison, H I; Zimmerman, D L; Cameron, J I; Jeffery, J J; Fenton, S S

Men in the United States undergoing renal replacement therapy are more likely than women to receive a kidney transplant. However, the ability to pay may, in part, be responsible for this finding. To compare adult male and female transplantation rates in a setting in which equal access to medical treatment is assumed. Using data from the Canadian Organ Replacement Register, the rate of first transplantations was computed for the 20, 131 men and the 13,458 women aged 20 years or older who initiated renal replacement therapy between January 1, 1981, and December 31, 1996. Poisson regression analysis was used to estimate the male-female transplantation rate ratio, adjusting for age, race, province, calendar period, underlying disease leading to renal failure, and dialytic modality. Actuarial survival methods were used to compare transplantation probability for covariable-matched cohorts of men and women. Men experienced 20% greater covariable-adjusted kidney transplantation rates relative to women (rate ratio, 1.20; 95% confidence interval, 1.13-1.27). The sex disparity was stronger for cadaveric transplants (rate ratio, 1.23) compared with those from living donors (rate ratio, 1.10). The 5-year probability of receiving a transplant was 47% for men and 39% for women within covariable-matched cohorts (P<.001). The sex disparity in transplantation rates increased with increasing age. The sex effect was weaker among whites and Oriental persons (Chinese, Japanese, Vietnamese, Cambodian, Laotian, Filipino, Malaysian, Indonesian, and Korean) and stronger among blacks, Asian Indians (Indian, Pakistani, and Sri Lankan), and North American Indians (aboriginal). Since survival probability and quality of life are superior for patients who undergo transplantation relative to those who undergo dialysis, an increased effort should be made to distribute kidneys available for transplantation more equitably by sex among patients undergoing renal replacement therapy.

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.

ADJUSTABLE OUTPUT RATE CHEMICAL FEEDING EQUIPMENT FOR SWIMMING POOLS. NATIONAL SANITATION FOUNDATION STANDARD NUMBER 19.

ERIC Educational Resources Information Center

National Sanitation Foundation, Ann Arbor, MI.

THE SCOPE OF THIS STANDARD COVERS ADJUSTABLE OUTPUT RATE CHEMICAL FEEDERS, WHETHER USED FOR SOLUTIONS, SLURRIES OR SOLIDS. IT ALSO INCLUDES AUXILIARY EQUIPMENT SUCH AS PUMPS, STRAINERS, TUBING CONNECTIONS, TANKS, INJECTION FITTINGS AND OTHER REQUIRED COMPONENTS. THE FEEDERS DESCRIBED ARE INTENDED TO BE DESIGNED AND USED SPECIFICALLY FOR CHEMICAL…

DataView: Medicare Spending by State: The Border-Crossing Adjustment

PubMed Central

Basu, Joy; Lazenby, Helen C.; Levit, Katharine R.

1995-01-01

As the first step in a pioneering effort by the Health Care Financing Administration (HCFA) to measure interstate border crossing for services used by both Medicare and non-Medicare beneficiaries, the authors study the spending behavior of Medicare beneficiaries for 10 Medicare-covered services. Based on interstate flow-of-expenditure data developed for calendar year 1991, the authors analyze the spending patterns of State residents by studying the inflow and outflow rates and the net flow ratios of expenditures incurred by Medicare patients. The report also provides per capita expenditure estimates with residence-based adjustments and evaluates the impact of the border-crossing adjustment for individual services and States. PMID:10157375

Risk-adjusted cesarean section rates for the assessment of physician performance in Taiwan: a population-based study.

PubMed

Tang, Chao-Hsiun; Wang, Han-I; Hsu, Chun-Sen; Su, Hung-Wen; Chen, Mei-Ju; Lin, Herng-Ching

2006-10-09

Over the past decade, about one-third of all births nationwide in Taiwan were delivered by cesarean section (CS). Previous studies in the US and Europe have documented the need for risk adjustment for fairer comparisons among providers. In this study, we set out to determine the impact that adjustment for patient-specific risk factors has on CS among different physicians in Taiwan. There were 172,511 live births which occurred in either hospitals or obstetrics/gynecology clinics between 1 January and 31 December 2003, and for whom birth certificate data could be linked with National Health Insurance (NHI) claims data, available as the sample for this study. Physicians were divided into four equivalent groups based upon the quartile distribution of their crude (actual) CS rates. Stepwise logistic regressions were conducted to develop a predictive model and to determine the expected (risk-adjusted) CS rate and 95% confidence interval (CI) for each physician. The actual rates were then compared with the expected CS rates to see the proportion of physicians whose actual rates were below, within, or above the predicted CI in each quartile. The proportion of physicians whose CS rates were above the predicted CI increased as the quartile moved to the higher level. However, more than half of the physicians whose actual rates were higher than the predicted CI were not in the highest quartile. Conversely, there were some physicians (40 of 258 physicians) in the highest quartile who were actually providing obstetric care that was appropriate to the risk. When a stricter standard was applied to the assessment of physician performance by excluding physicians in quartile 4 for predicting CS rates, as many as 60% of physicians were found to have higher CS rates than the predicted CI, and indeed, the CS rates of no physicians in either quartile 3 or quartile 4 were below the predicted CI. Overall, our study found that the comparison of unadjusted CS rates might not provide a valid

2007 Wholesale Power Rate Adjustment Proceeding (WP-07) : Administrator's Final Record of Decision.

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

United States. Bonneville Power Administration.

2006-07-01

This Record of Decision (ROD) contains the decisions of the Bonneville Power Administration (BPA), based on the record compiled in this rate proceeding, with respect to the adoption of power rates for the three-year rate period commencing October 1, 2006, through September 30, 2009. This ''2007 Wholesale Power Rate Adjustment Proceeding'' is designed to establish replacement rate schedules and General Rate Schedule Provisions (GRSPs) for those that expire on September 30, 2006. This power rate case also establishes the General Transfer Agreement (GTA) Delivery Charge for the period of October 1, 2007, through September 30, 2009. BPA's Power Subscription Strategymore » and Record of Decision (Subscription Strategy), as well as other Agency processes, provide much of the policy context for this rate case and are described in Section 2. This ROD follows a full evidentiary hearing and briefing, including an Oral Argument before the BPA Administrator. Sections 3 through 18, including any appendices or attachments, present the issues raised by parties in this proceeding, the parties positions, BPA staff positions on the issues, BPA's evaluations of the positions, and the Administrator's decisions. Parties had the opportunity to file briefs on exceptions to the Draft ROD, before issuance of this Final Record of Decision.« less

Effect of lift-to-drag ratio in pilot rating of the HL-20 landing task

NASA Technical Reports Server (NTRS)

Jackson, E. B.; Rivers, Robert A.; Bailey, Melvin L.

1993-01-01

A man-in-the-loop simulation study of the handling qualities of the HL-20 lifting-body vehicle was made in a fixed-base simulation cockpit at NASA Langley Research Center. The purpose of the study was to identify and substantiate opportunities for improving the original design of the vehicle from a handling qualities and landing performance perspective. Using preliminary wind-tunnel data, a subsonic aerodynamic model of the HL-20 was developed. This model was adequate to simulate the last 75-90 s of the approach and landing. A simple flight-control system was designed and implemented. Using this aerodynamic model as a baseline, visual approaches and landings were made at several vehicle lift-to-drag ratios. Pilots rated the handling characteristics of each configuration using a conventional numerical pilot-rating scale. Results from the study showed a high degree of correlation between the lift-to-drag ratio and pilot rating. Level 1 pilot ratings were obtained when the L/D ratio was approximately 3.8 or higher.

Effect of lift-to-drag ratio in pilot rating of the HL-20 landing task

NASA Astrophysics Data System (ADS)

Jackson, E. B.; Rivers, Robert A.; Bailey, Melvin L.

1993-10-01

A man-in-the-loop simulation study of the handling qualities of the HL-20 lifting-body vehicle was made in a fixed-base simulation cockpit at NASA Langley Research Center. The purpose of the study was to identify and substantiate opportunities for improving the original design of the vehicle from a handling qualities and landing performance perspective. Using preliminary wind-tunnel data, a subsonic aerodynamic model of the HL-20 was developed. This model was adequate to simulate the last 75-90 s of the approach and landing. A simple flight-control system was designed and implemented. Using this aerodynamic model as a baseline, visual approaches and landings were made at several vehicle lift-to-drag ratios. Pilots rated the handling characteristics of each configuration using a conventional numerical pilot-rating scale. Results from the study showed a high degree of correlation between the lift-to-drag ratio and pilot rating. Level 1 pilot ratings were obtained when the L/D ratio was approximately 3.8 or higher.

Risk adjustment for case mix and the effect of surgeon volume on morbidity.

PubMed

Maas, Matthew B; Jaff, Michael R; Rordorf, Guy A

2013-06-01

Retrospective studies of large administrative databases have shown higher mortality for procedures performed by low-volume surgeons, but the adequacy of risk adjustment in those studies is in doubt. To determine whether the relationship between surgeon volume and outcomes is an artifact of case mix using a prospective sample of carotid endarterectomy cases. Observational cohort study from January 1, 2008, through December 31, 2010, with preoperative, immediate postoperative, and 30-day postoperative assessments acquired by independent monitors. Urban, tertiary academic medical center. All 841 patients who underwent carotid endarterectomy performed by a vascular surgeon or cerebrovascular neurosurgeon at the institution. Carotid endarterectomy without another concurrent surgery. Stroke, death, and other surgical complications occurring within 30 days of surgery along with other case data. A low-volume surgeon performed 40 or fewer cases per year. Variables used in a comparison administrative database study, as well as variables identified by our univariate analysis, were used for adjusted analyses to assess for an association between low-volume surgeons and the rate of stroke and death as well as other complications. RESULTS The rate of stroke and death was 6.9% for low-volume surgeons and 2.0% for high-volume surgeons (P = .001). Complications were similarly higher (13.4% vs 7.2%, P = .008). Low-volume surgeons performed more nonelective cases. Low-volume surgeons were significantly associated with stroke and death in the unadjusted analysis as well as after adjustment with variables used in the administrative database study (odds ratio, 3.61; 95% CI, 1.70-7.67, and odds ratio, 3.68; 95% CI, 1.72-7.89, respectively). However, adjusting for the significant disparity of American Society of Anesthesiologists Physical Status classification in case mix eliminated the effect of surgeon volume on the rate of stroke and death (odds ratio, 1.65; 95% CI, 0.59-4.64) and other

Facultative adjustment of the offspring sex ratio and male attractiveness: a systematic review and meta-analysis.

PubMed

Booksmythe, Isobel; Mautz, Brian; Davis, Jacqueline; Nakagawa, Shinichi; Jennions, Michael D

2017-02-01

Females can benefit from mate choice for male traits (e.g. sexual ornaments or body condition) that reliably signal the effect that mating will have on mean offspring fitness. These male-derived benefits can be due to material and/or genetic effects. The latter include an increase in the attractiveness, hence likely mating success, of sons. Females can potentially enhance any sex-biased benefits of mating with certain males by adjusting the offspring sex ratio depending on their mate's phenotype. One hypothesis is that females should produce mainly sons when mating with more attractive or higher quality males. Here we perform a meta-analysis of the empirical literature that has accumulated to test this hypothesis. The mean effect size was small (r = 0.064-0.095; i.e. explaining <1% of variation in offspring sex ratios) but statistically significant in the predicted direction. It was, however, not robust to correction for an apparent publication bias towards significantly positive results. We also examined the strength of the relationship using different indices of male attractiveness/quality that have been invoked by researchers (ornaments, behavioural displays, female preference scores, body condition, male age, body size, and whether a male is a within-pair or extra-pair mate). Only ornamentation and body size significantly predicted the proportion of sons produced. We obtained similar results regardless of whether we ran a standard random-effects meta-analysis, or a multi-level, Bayesian model that included a correction for phylogenetic non-independence. A moderate proportion of the variance in effect sizes (51.6-56.2%) was due to variation that was not attributable to sampling error (i.e. sample size). Much of this non-sampling error variance was not attributable to phylogenetic effects or high repeatability of effect sizes among species. It was approximately equally attributable to differences (occurring for unknown reasons) in effect sizes among and within

QuickStats: Age-Adjusted Death Rates,* by Race/Ethnicity† - National Vital Statistics System, United States, 2014-2015.

PubMed

2017-04-07

From 2014 to 2015, the age-adjusted death rate for the total U.S. population increased 1.2% from 724.6 to 733.1 per 100,000 population. The rate increased 0.6% from 870.7 to 876.1 for non-Hispanic blacks and 1.4% from 742.8 to 753.2 for non-Hispanic whites. The rate for Hispanic persons did not change significantly. The highest rate was recorded for the non-Hispanic black population, followed by the non-Hispanic white and Hispanic populations.

Secondary Students' Quantification of Ratio and Rate: A Framework for Reasoning about Change in Covarying Quantities

ERIC Educational Resources Information Center

Johnson, Heather Lynn

2015-01-01

Contributing to a growing body of research addressing secondary students' quantitative and covariational reasoning, the multiple case study reported in this article investigated secondary students' quantification of ratio and rate. This article reports results from a study investigating students' quantification of rate and ratio as…

34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false General requirements for adjusting official cohort default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF...

34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false General requirements for adjusting official cohort default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF...

Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

PubMed

Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

2015-08-01

When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using a detailed uncertainty analysis to adjust mapped rates of forest disturbance derived from Landsat time series data (Invited)

NASA Astrophysics Data System (ADS)

Cohen, W. B.; Yang, Z.; Stehman, S.; Huang, C.; Healey, S. P.

2013-12-01

Forest ecosystem process models require spatially and temporally detailed disturbance data to accurately predict fluxes of carbon or changes in biodiversity over time. A variety of new mapping algorithms using dense Landsat time series show great promise for providing disturbance characterizations at an annual time step. These algorithms provide unprecedented detail with respect to timing, magnitude, and duration of individual disturbance events, and causal agent. But all maps have error and disturbance maps in particular can have significant omission error because many disturbances are relatively subtle. Because disturbance, although ubiquitous, can be a relatively rare event spatially in any given year, omission errors can have a great impact on mapped rates. Using a high quality reference disturbance dataset, it is possible to not only characterize map errors but also to adjust mapped disturbance rates to provide unbiased rate estimates with confidence intervals. We present results from a national-level disturbance mapping project (the North American Forest Dynamics project) based on the Vegetation Change Tracker (VCT) with annual Landsat time series and uncertainty analyses that consist of three basic components: response design, statistical design, and analyses. The response design describes the reference data collection, in terms of the tool used (TimeSync), a formal description of interpretations, and the approach for data collection. The statistical design defines the selection of plot samples to be interpreted, whether stratification is used, and the sample size. Analyses involve derivation of standard agreement matrices between the map and the reference data, and use of inclusion probabilities and post-stratification to adjust mapped disturbance rates. Because for NAFD we use annual time series, both mapped and adjusted rates are provided at an annual time step from ~1985-present. Preliminary evaluations indicate that VCT captures most of the higher

Assessing the Efficacy of Adjustable Moving Averages Using ASEAN-5 Currencies.

PubMed

Chan Phooi M'ng, Jacinta; Zainudin, Rozaimah

2016-01-01

The objective of this research is to examine the trends in the exchange rate markets of the ASEAN-5 countries (Indonesia (IDR), Malaysia (MYR), the Philippines (PHP), Singapore (SGD), and Thailand (THB)) through the application of dynamic moving average trading systems. This research offers evidence of the usefulness of the time-varying volatility technical analysis indicator, Adjustable Moving Average (AMA') in deciphering trends in these ASEAN-5 exchange rate markets. This time-varying volatility factor, referred to as the Efficacy Ratio in this paper, is embedded in AMA'. The Efficacy Ratio adjusts the AMA' to the prevailing market conditions by avoiding whipsaws (losses due, in part, to acting on wrong trading signals, which generally occur when there is no general direction in the market) in range trading and by entering early into new trends in trend trading. The efficacy of AMA' is assessed against other popular moving-average rules. Based on the January 2005 to December 2014 dataset, our findings show that the moving averages and AMA' are superior to the passive buy-and-hold strategy. Specifically, AMA' outperforms the other models for the United States Dollar against PHP (USD/PHP) and USD/THB currency pairs. The results show that different length moving averages perform better in different periods for the five currencies. This is consistent with our hypothesis that a dynamic adjustable technical indicator is needed to cater for different periods in different markets.

Assessing the Efficacy of Adjustable Moving Averages Using ASEAN-5 Currencies

PubMed Central

2016-01-01

The objective of this research is to examine the trends in the exchange rate markets of the ASEAN-5 countries (Indonesia (IDR), Malaysia (MYR), the Philippines (PHP), Singapore (SGD), and Thailand (THB)) through the application of dynamic moving average trading systems. This research offers evidence of the usefulness of the time-varying volatility technical analysis indicator, Adjustable Moving Average (AMA′) in deciphering trends in these ASEAN-5 exchange rate markets. This time-varying volatility factor, referred to as the Efficacy Ratio in this paper, is embedded in AMA′. The Efficacy Ratio adjusts the AMA′ to the prevailing market conditions by avoiding whipsaws (losses due, in part, to acting on wrong trading signals, which generally occur when there is no general direction in the market) in range trading and by entering early into new trends in trend trading. The efficacy of AMA′ is assessed against other popular moving-average rules. Based on the January 2005 to December 2014 dataset, our findings show that the moving averages and AMA′ are superior to the passive buy-and-hold strategy. Specifically, AMA′ outperforms the other models for the United States Dollar against PHP (USD/PHP) and USD/THB currency pairs. The results show that different length moving averages perform better in different periods for the five currencies. This is consistent with our hypothesis that a dynamic adjustable technical indicator is needed to cater for different periods in different markets. PMID:27574972

75 FR 12740 - Proposed Rate Adjustment, Public Forum, and Opportunities for Public Review and Comment for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-17

... DEPARTMENT OF ENERGY Southeastern Power Administration Proposed Rate Adjustment, Public Forum, and... participate in a public forum, and to submit written comments. Southeastern will evaluate all comments... and comment forum will be held in Atlanta, Georgia, at 10 a.m., on April 29, 2010. Persons desiring to...

Stress Ratio Effects on Crack Opening Loads and Crack Growth Rates in Aluminum Alloy 2024

NASA Technical Reports Server (NTRS)

Riddell, William T.; Piascik, Robert S.

1998-01-01

The effects of stress ratio (R) and crack opening behavior on fatigue crack growth rates (da/dN) for aluminum alloy (AA) 2024-T3 were investigated using constant-delta K testing, closure measurements, and fractography. Fatigue crack growth rates were obtained for a range of delta K and stress ratios. Results show that constant delta K fatigue crack growth for R ranging from near 0 to 1 is divided into three regions. In Region 1, at low R, da/dN increases with increasing R. In Region 2, at intermediate R, fatigue crack growth rates are relatively independent of R. In Region 3, at high R, further increases in da/dN are observed with increasing R.

Fructose-maltodextrin ratio in a carbohydrate-electrolyte solution differentially affects exogenous carbohydrate oxidation rate, gut comfort, and performance.

PubMed

O'Brien, Wendy J; Rowlands, David S

2011-01-01

Solutions containing multiple carbohydrates utilizing different intestinal transporters (glucose and fructose) show enhanced absorption, oxidation, and performance compared with single-carbohydrate solutions, but the impact of the ratio of these carbohydrates on outcomes is unknown. In a randomized double-blind crossover, 10 cyclists rode 150 min at 50% peak power, then performed an incremental test to exhaustion, while ingesting artificially sweetened water or one of three carbohydrate-salt solutions comprising fructose and maltodextrin in the respective following concentrations: 4.5 and 9% (0.5-Ratio), 6 and 7.5% (0.8-Ratio), and 7.5 and 6% (1.25-Ratio). The carbohydrates were ingested at 1.8 g/min and naturally (13)C-enriched to permit evaluation of oxidation rate by mass spectrometry and indirect calorimetry. Mean exogenous carbohydrate oxidation rates were 1.04, 1.14, and 1.05 g/min (coefficient of variation 20%) in 0.5-, 0.8-, and 1.25-Ratios, respectively, representing likely small increases in 0.8-Ratio of 11% (90% confidence limits; ± 4%) and 10% (± 4%) relative to 0.5- and 1.25-Ratios, respectively. Comparisons of fat and total and endogenous carbohydrate oxidation rates between solutions were unclear. Relative to 0.5-Ratio, there were moderate improvements to peak power with 0.8- (3.6%; 99% confidence limits ± 3.5%) and 1.25-Ratio (3.0%; ± 3.7%) but unclear with water (0.4%; ± 4.4%). Increases in stomach fullness, abdominal cramping, and nausea were lowest with the 0.8- followed by the 1.25-Ratio solution. At high carbohydrate-ingestion rate, greater benefits to endurance performance may result from ingestion of 0.8- to 1.25-Ratio fructose-maltodextrin solutions. Small perceptible improvements in gut comfort favor the 0.8-Ratio and provide a clearer suggestion of mechanism than the relationship with exogenous carbohydrate oxidation.

Negative Control Outcomes and the Analysis of Standardized Mortality Ratios

PubMed Central

Richardson, DB; Keil, A; Tchetgen, Tchetgen E; Cooper, GS

2016-01-01

In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to non-comparability of the occupational cohort and reference population. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for bias due to unmeasured differences between the occupational cohort and the reference population. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR=1.90; 1.27, 2.72) but not among monthly-paid males (SMR=0.96; 0.67, 1.33). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR=2.22; 1.52, 3.24; and, aSMR=1.99; 1.43, 2.76, respectively). The proposed adjusted SMR offers a complement to typical standardized mortality ratio analyses. PMID:26172862

Choice with frequently changing food rates and food ratios.

PubMed

Baum, William M; Davison, Michael

2014-03-01

In studies of operant choice, when one schedule of a concurrent pair is varied while the other is held constant, the constancy of the constant schedule may exert discriminative control over performance. In our earlier experiments, schedules varied reciprocally across components within sessions, so that while food ratio varied food rate remained constant. In the present experiment, we held one variable-interval (VI) schedule constant while varying the concurrent VI schedule within sessions. We studied five conditions, each with a different constant left VI schedule. On the right key, seven different VI schedules were presented in seven different unsignaled components. We analyzed performances at several different time scales. At the longest time scale, across conditions, behavior ratios varied with food ratios as would be expected from the generalized matching law. At shorter time scales, effects due to holding the left VI constant became more and more apparent, the shorter the time scale. In choice relations across components, preference for the left key leveled off as the right key became leaner. Interfood choice approximated strict matching for the varied right key, whereas interfood choice hardly varied at all for the constant left key. At the shortest time scale, visit patterns differed for the left and right keys. Much evidence indicated the development of a fix-and-sample pattern. In sum, the procedural difference made a large difference to performance, except for choice at the longest time scale and the fix-and-sample pattern at the shortest time scale. © Society for the Experimental Analysis of Behavior.

A Distributed Transmission Rate Adjustment Algorithm in Heterogeneous CSMA/CA Networks

PubMed Central

Xie, Shuanglong; Low, Kay Soon; Gunawan, Erry

2015-01-01

Distributed transmission rate tuning is important for a wide variety of IEEE 802.15.4 network applications such as industrial network control systems. Such systems often require each node to sustain certain throughput demand in order to guarantee the system performance. It is thus essential to determine a proper transmission rate that can meet the application requirement and compensate for network imperfections (e.g., packet loss). Such a tuning in a heterogeneous network is difficult due to the lack of modeling techniques that can deal with the heterogeneity of the network as well as the network traffic changes. In this paper, a distributed transmission rate tuning algorithm in a heterogeneous IEEE 802.15.4 CSMA/CA network is proposed. Each node uses the results of clear channel assessment (CCA) to estimate the busy channel probability. Then a mathematical framework is developed to estimate the on-going heterogeneous traffics using the busy channel probability at runtime. Finally a distributed algorithm is derived to tune the transmission rate of each node to accurately meet the throughput requirement. The algorithm does not require modifications on IEEE 802.15.4 MAC layer and it has been experimentally implemented and extensively tested using TelosB nodes with the TinyOS protocol stack. The results reveal that the algorithm is accurate and can satisfy the throughput demand. Compared with existing techniques, the algorithm is fully distributed and thus does not require any central coordination. With this property, it is able to adapt to traffic changes and re-adjust the transmission rate to the desired level, which cannot be achieved using the traditional modeling techniques. PMID:25822140

Physiological adjustment to salt stress in Jatropha curcas is associated with accumulation of salt ions, transport and selectivity of K+, osmotic adjustment and K+/Na+ homeostasis.

PubMed

Silva, E N; Silveira, J A G; Rodrigues, C R F; Viégas, R A

2015-09-01

This study assessed the capacity of Jatropha curcas to physiologically adjust to salinity. Seedlings were exposed to increasing NaCl concentrations (25, 50, 75 and 100 mm) for 15 days. Treatment without NaCl was adopted as control. Shoot dry weight was strongly reduced by NaCl, reaching values of 35% to 65% with 25 to 100 mm NaCl. The shoot/root ratio was only affected with 100 mm NaCl. Relative water content (RWC) increased only with 100 mm NaCl, while electrolyte leakage (EL) was much enhanced with 50 mm NaCl. The Na(+) transport rate to the shoot was more affected with 50 and 100 mm NaCl. In parallel, Cl(-) transport rate increased with 75 and 100 mm NaCl, while K(+) transport rate fell from 50 mm to 100 mm NaCl. In roots, Na(+) and Cl(-) transport rates fell slightly only in 50 mm (to Na(+)) and 50 and 100 mm (to Cl(-)) NaCl, while K(+) transport rate fell significantly with increasing NaCl. In general, our data demonstrate that J. curcas seedlings present changes in key physiological processes that allow this species to adjust to salinity. These responses are related to accumulation of Na(+) and Cl(-) in leaves and roots, K(+)/Na(+) homeostasis, transport of K(+) and selectivity (K-Na) in roots, and accumulation of organic solutes contributing to osmotic adjustment of the species. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

Adaptive upstream rate adjustment by RSOA-ONU depending on different injection power of seeding light in standard-reach and long-reach PON systems

NASA Astrophysics Data System (ADS)

Yeh, C. H.; Chow, C. W.; Shih, F. Y.; Pan, C. L.

2012-08-01

The wavelength division multiplexing-time division multiplexing (WDM-TDM) passive optical network (PON) using reflective semiconductor optical amplifier (RSOA)-based colorless optical networking units (ONUs) is considered as a promising candidate for the realization of fiber-to-the-home (FTTH). And this architecture is actively considered by Industrial Technology Research Institute (ITRI) for the realization of FTTH in Taiwan. However, different fiber distances and optical components would introduce different power budgets to different ONUs in the PON. Besides, due to the aging of optical transmitter (Tx), the power decay of the distributed optical carrier from the central office (CO) could also reduce the injection power into each ONU. The situation will be more severe in the long-reach (LR) PON, which is considered as an option for the future access. In this work, we investigate a WDM-TDM PON using RSOA-based ONU for upstream data rate adjustment depending on different continuous wave (CW) injection powers. Both standard-reach (25 km) and LR (100 km) transmissions are evaluated. Moreover, a detail analysis of the upstream signal bit-error rate (BER) performances at different injection powers, upstream data rates, PON split-ratios under stand-reach and long-reach is presented.

Use of GRACE determined secular gravity rates for glacial isostatic adjustment studies in North-America

NASA Astrophysics Data System (ADS)

van der Wal, Wouter; Wu, Patrick; Sideris, Michael G.; Shum, C. K.

2008-10-01

Monthly geopotential spherical harmonic coefficients from the GRACE satellite mission are used to determine their usefulness and limitations for studying glacial isostatic adjustment (GIA) in North-America. Secular gravity rates are estimated by unweighted least-squares estimation using release 4 coefficients from August 2002 to August 2007 provided by the Center for Space Research (CSR), University of Texas. Smoothing is required to suppress short wavelength noise, in addition to filtering to diminish geographically correlated errors, as shown in previous studies. Optimal cut-off degrees and orders are determined for the destriping filter to maximize the signal to noise ratio. The halfwidth of the Gaussian filter is shown to significantly affect the sensitivity of the GRACE data (with respect to upper mantle viscosity and ice loading history). Therefore, the halfwidth should be selected based on the desired sensitivity. It is shown that increase in water storage in an area south west of Hudson Bay, from the summer of 2003 to the summer of 2006, contributes up to half of the maximum estimated gravity rate. Hydrology models differ in the predictions of the secular change in water storage, therefore even 4-year trend estimates are influenced by the uncertainty in water storage changes. Land ice melting in Greenland and Alaska has a non-negligible contribution, up to one-fourth of the maximum gravity rate. The estimated secular gravity rate shows two distinct peaks that can possibly be due to two domes in the former Pleistocene ice cover: west and south east of Hudson Bay. With a limited number of models, a better fit is obtained with models that use the ICE-3G model compared to the ICE-5G model. However, the uncertainty in interannual variations in hydrology models is too large to constrain the ice loading history with the current data span. For future work in which GRACE will be used to constrain ice loading history and the Earth's radial viscosity profile, it is

Collateral consequences: implications of male incarceration rates, imbalanced sex ratios and partner availability for heterosexual Black women.

PubMed

Dauria, Emily F; Oakley, Lisa; Arriola, Kimberly Jacob; Elifson, Kirk; Wingood, Gina; Cooper, Hannah L F

2015-01-01

While studies have found correlations between rates of incarceration and sexually transmitted infections (STIs), few studies have explored the mechanisms linking these phenomena. This qualitative study examines how male incarceration rates and sex ratios influence perceived partner availability and sexual partnerships for heterosexual Black women. Semi-structured interviews were conducted with 33 Black women living in two US neighbourhoods, one with a high male incarceration rate and an imbalanced sex ratio (referred to as 'Allentown') and one with a low male incarceration rate and an equitable sex ratio (referred to as 'Blackrock'). Data were analysed using grounded theory. In Allentown, male incarceration reduced the number of available men, and participants largely viewed men available for partnerships as being of an undesirable quality. The number and desirability of men impacted on the nature of partnerships such that they were shorter, focused on sexual activity and may be with higher-risk sexual partners (e.g. transactional sex partners). In Blackrock, marriage rates contributed to the shortage of desirable male partners. By highlighting the role that the quantity and quality of male partners has on shaping sexual partnerships, this study advances current understandings of how incarceration and sex ratios shape HIV- and STI-related risk.

Compensation of power drops in reflective semiconductor optical amplifier-based passive optical network with upstream data rate adjustment

NASA Astrophysics Data System (ADS)

Yeh, Chien-Hung; Chow, Chi-Wai; Chiang, Ming-Feng; Shih, Fu-Yuan; Pan, Ci-Ling

2011-09-01

In a wavelength division multiplexed-passive optical network (WDM-PON), different fiber lengths and optical components would introduce different power budgets to different optical networking units (ONUs). Besides, the power decay of the distributed optical carrier from the optical line terminal owing to aging of the optical transmitter could also reduce the injected power into the ONU. In this work, we propose and demonstrate a carrier distributed WDM-PON using a reflective semiconductor optical amplifier-based ONU that can adjust its upstream data rate to accommodate different injected optical powers. The WDM-PON is evaluated at standard-reach (25 km) and long-reach (100 km). Bit-error rate measurements at different injected optical powers and transmission lengths show that by adjusting the upstream data rate of the system (622 Mb/s, 1.25 and 2.5 Gb/s), error-free (<10-9) operation can still be achieved when the power budget drops.

45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

Testing-adjusted chlamydia notification trends in New South Wales, Australia, 2000 to 2010.

PubMed

Cretikos, Michelle; Mayne, Darren; Reynolds, Roderick; Spokes, Paula; Madeddu, Daniel

2014-01-01

Between 2005 and 2010, Australian notification rates for chlamydia infection increased by 64% from 203 to 333 per 100 000 population. Interpreting this trend is difficult without examining rates and local patterns of testing. We examined the effect of adjusting for local testing rates on chlamydia notification trends in New South Wales (NSW), Australia from 2000 to 2010. We used testing data for NSW residents for Medicare Benefits Schedule items for chlamydia from 1 July 1999 to 30 June 2005 and 1 July 2007 to 30 June 2010. This data set excluded testing by public sector laboratories. We also obtained laboratory-confirmed genital chlamydia notifications in NSW residents for 1 July 1999 to 30 June 2010 and excluded notifications from public laboratories. We used negative binomial regression to assess trends in chlamydia notification rates by age and sex after adjusting for local government area (LGA)-level Medicare-funded testing rates, socioeconomic disadvantage, remoteness and Medicare provider density. Testing-adjusted rates of chlamydia notifications declined by 5.2% per annum (rate ratio [RR] = 0.95, 95% confidence interval (CI) = 0.93-0.96) for women overall, and 2.3% (RR = 0.98, 95% CI = 0.96-1.00) and 5.0% per annum (RR = 0.95, 95% CI = 0.93-0.98) for men in LGAs with moderate and high densities of Medicare providers, respectively. Notification rates remained stable for men in low Medicare provider density LGAs (RR = 1.01, 95% CI = 0.96-1.07). It is likely that increased testing for chlamydia has driven increases in chlamydia notification in NSW over the last decade. Notification data provide no evidence for a general increase in the prevalence of chlamydia in the NSW community for this period. Notification-based chlamydia surveillance should be routinely adjusted for local testing rates.

Dust release rates and dust-to-gas mass ratios of eight comets

NASA Technical Reports Server (NTRS)

Singh, P. D.; De Almeida, A. A.; Huebner, W. F.

1992-01-01

Mass release rates of dust and mass ratios of dust-to-gas release rates of Comets Thiele (1985m), Wilson (1986l), P/Borrelly (1987p), Liller (1988a), Bradfield (1987s), Hartley-Good (1985l), P/Giacobini-Zinner (1984e), and P/Halley (1982i) are estimated from the analysis of continuum flux measurements at optical wavelengths. An attempt is made to estimate the size of each comet nucleus on the basis of water-ice sublimation (vaporization), assuming that the nucleus is spherical and only a fraction of its surface area is active. Where possible, the dust mass release rates are compared with those obtained by other investigators in the optical and IR wavelength regions. Good agreement with results based on IR observations is found.

A study on the optimal hydraulic loading rate and plant ratios in recirculation aquaponic system.

PubMed

Endut, Azizah; Jusoh, A; Ali, N; Wan Nik, W B; Hassan, A

2010-03-01

The growths of the African catfish (Clarias gariepinus) and water spinach (Ipomoea aquatica) were evaluated in recirculation aquaponic system (RAS). Fish production performance, plant growth and nutrient removal were measured and their dependence on hydraulic loading rate (HLR) was assessed. Fish production did not differ significantly between hydraulic loading rates. In contrast to the fish production, the water spinach yield was significantly higher in the lower hydraulic loading rate. Fish production, plant growth and percentage nutrient removal were highest at hydraulic loading rate of 1.28 m/day. The ratio of fish to plant production has been calculated to balance nutrient generation from fish with nutrient removal by plants and the optimum ratio was 15-42 gram of fish feed/m(2) of plant growing area. Each unit in RAS was evaluated in terms of oxygen demand. Using specified feeding regime, mass balance equations were applied to quantify the waste discharges from rearing tanks and treatment units. The waste discharged was found to be strongly dependent on hydraulic loading rate. 2009 Elsevier Ltd. All rights reserved.

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...

QuickStats: Age-Adjusted Death Rates* for Top Five Causes of Cancer Death,(†) by Race/Hispanic Ethnicity - United States, 2014.

PubMed

2016-09-16

In 2014, the top five causes of cancer deaths for the total population were lung, colorectal, female breast, pancreatic, and prostate cancer. The non-Hispanic black population had the highest age-adjusted death rates for each of these five cancers, followed by non-Hispanic white and Hispanic groups. The age-adjusted death rate for lung cancer, the leading cause of cancer death in all groups, was 42.1 per 100,000 standard population for the total population, 45.4 for non-Hispanic white, 45.7 for non-Hispanic black, and 18.3 for Hispanic populations.

The relations of Arab Jordanian adolescents' perceived maternal parenting to teacher-rated adjustment and problems: the intervening role of perceived need satisfaction.

PubMed

Ahmad, Ikhlas; Vansteenkiste, Maarten; Soenens, Bart

2013-01-01

Although the effects of important parenting dimensions, such as responsiveness and psychological control, are well documented among Western populations, research has only recently begun to systematically identify psychological processes that may account for the cross-cultural generalization of these effects. A first aim of this study was to examine whether perceived maternal responsiveness and psychological control would relate differentially to teacher ratings of adolescent adjustment in a vertical-collectivist society (i.e., Jordan). The most important aim of this study was to examine, on the basis of self-determination theory, whether these associations would be accounted for by perceived satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Results in a large sample of Jordanian adolescents (N = 545) showed that perceived maternal psychological control and responsiveness yielded, respectively, a positive and negative association with teacher-rated problems, whereas psychological control was negatively related to teacher-rated adjustment. Further, these 2 parenting dimensions related to adjustment and problems via perceived satisfaction of the basic psychological needs for autonomy and competence (but not relatedness). The findings are discussed in light of the ongoing debate between universalistic and relativistic perspectives on parenting and adolescent adjustment.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

... address changes to the case-mix that are a result of changes in the coding or classification of different...-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...

Trends of and factors associated with live-birth and abortion rates among HIV-positive and HIV-negative women.

PubMed

Haddad, Lisa B; Wall, Kristin M; Mehta, C Christina; Golub, Elizabeth T; Rahangdale, Lisa; Kempf, Mirjam-Colette; Karim, Roksana; Wright, Rodney; Minkoff, Howard; Cohen, Mardge; Kassaye, Seble; Cohan, Deborah; Ofotokun, Igho; Cohn, Susan E

2017-01-01

Little is known about fertility choices and pregnancy outcome rates among HIV-infected women in the current combination antiretroviral treatment era. We sought to describe trends and factors associated with live-birth and abortion rates among HIV-positive and high-risk HIV-negative women enrolled in the Women's Interagency HIV Study in the United States. We analyzed longitudinal data collected from Oct. 1, 1994, through Sept. 30, 2012, through the Women's Interagency HIV Study. Age-adjusted rates per 100 person-years live births and induced abortions were calculated by HIV serostatus over 4 time periods. Poisson mixed effects models containing variables associated with live births and abortions in bivariable analyses (P < .05) generated adjusted incidence rate ratios and 95% confidence intervals. There were 1356 pregnancies among 2414 women. Among HIV-positive women, age-adjusted rates of live birth increased from 1994 through 1997 to 2006 through 2012 (2.85-7.27/100 person-years, P trend < .0001). Age-adjusted rates of abortion in HIV-positive women remained stable over these time periods (4.03-4.29/100 person-years, P trend = .09). Significantly lower live-birth rates occurred among HIV-positive compared to HIV-negative women in 1994 through 1997 and 1997 through 2001, however rates were similar during 2002 through 2005 and 2006 through 2012. Higher CD4 + T cells/mm 3 (≥350 adjusted incidence rate ratio, 1.39 [95% CI 1.03-1.89] vs <350) were significantly associated with increased live-birth rates, while combination antiretroviral treatment use (adjusted incidence rate ratio, 1.35 [95% CI 0.99-1.83]) was marginally associated with increased live-birth rates. Younger age, having a prior abortion, condom use, and increased parity were associated with increased abortion rates among both HIV-positive and HIV-negative women. CD4 + T-cell count, combination antiretroviral treatment use, and viral load were not associated with abortion rates. Unlike earlier periods

Frequency-dependent population dynamics: effect of sex ratio and mating system on the elasticity of population growth rate.

PubMed

Haridas, C V; Eager, Eric Alan; Rebarber, Richard; Tenhumberg, Brigitte

2014-11-01

When vital rates depend on population structure (e.g., relative frequencies of males or females), an important question is how the long-term population growth rate λ responds to changes in rates. For instance, availability of mates may depend on the sex ratio of the population and hence reproductive rates could be frequency-dependent. In such cases change in any vital rate alters the structure, which in turn, affect frequency-dependent rates. We show that the elasticity of λ to a rate is the sum of (i) the effect of the linear change in the rate and (ii) the effect of nonlinear changes in frequency-dependent rates. The first component is always positive and is the classical elasticity in density-independent models obtained directly from the population projection matrix. The second component can be positive or negative and is absent in density-independent models. We explicitly express each component of the elasticity as a function of vital rates, eigenvalues and eigenvectors of the population projection matrix. We apply this result to a two-sex model, where male and female fertilities depend on adult sex ratio α (ratio of females to males) and the mating system (e.g., polygyny) through a harmonic mating function. We show that the nonlinear component of elasticity to a survival rate is negligible only when the average number of mates (per male) is close to α. In a strictly monogamous species, elasticity to female survival is larger than elasticity to male survival when α<1 (less females). In a polygynous species, elasticity to female survival can be larger than that of male survival even when sex ratio is female biased. Our results show how demography and mating system together determine the response to selection on sex-specific vital rates. Copyright © 2014 Elsevier Inc. All rights reserved.

Co/Ni ratios at taenite/kamacite interfaces and relative cooling rates in iron meteorites

NASA Astrophysics Data System (ADS)

Wasson, John T.; Hoppe, Peter

2012-05-01

We report a pilot study of a new technique to use the distribution of Co between kamacite and taenite to infer relative cooling rates of iron meteorites; data of Widge and Goldstein (1977) showed that the distribution is temperature dependent. A plot of the logarithm of the double ratio [(Co/Ni)kamacite/(Co/Ni)taenite] (abbreviated Rαγ) against inverse temperature yields a linear equation showing that the ratio ranges from ˜2.5 at 1080 K to ˜30 at 710 K. Thus, a measurement of Rαγ in the kamacite and taenite near the interface offers information about relative cooling rates; the higher Rαγ, the lower the cooling rate. A major advantage of this technique is that it is mainly affected by the final (low-temperature) cooling rate, just before the sample cooled to the blocking temperature where diffusion became insignificant. To test this method we used the NanoSIMS ion probe to measure Rαγ in two IVA and two IIIAB irons; members of each pair differ by large factors in elemental composition and in published metallographic cooling rates (Yang and Goldstein, 2006; Yang et al., 2008). Despite differing by a factor of 25 in estimated metallographic cooling rate, the two IVA irons showed similar Rαγ values of ˜22. If experimental uncertainties are considered this implies that, at low temperatures, their cooling rates differ by less than a factor of 5 with 95% confidence, i.e., significantly less than the range in metallographic cooling rates. In contrast, the IIIAB irons have different ratios; Rαγ in Haig is 29 whereas that in Cumpas, with a reported cooling rate 4.5 times lower, is 22, the opposite of that expected from the published cooling rates. A reevaluation of the Yang-Goldstein IIIAB data set shows that Haig has anomalous metallographic properties. We suggest that both the high Rαγ in Haig and the systematically low taenite central Ni contents are the result of impact-produced fractures in the taenite that allowed equilibration with kamacite down to

QuickStats: Age-Adjusted Death Rates* for Males Aged 15-44 Years, by the Five Leading Causes of Death(†) - United States, 1999 and 2014.

PubMed

2016-08-12

The age-adjusted death rate for males aged 15-44 years was 10% lower in 2014 (156.6 per 100,000 population) than in 1999 (174.1). Among the five leading causes of death, the age-adjusted rates for three were lower in 2014 than in 1999: cancer (from 17.1 to 12.8; 25% decline), heart disease (20.1 to 17.0; 15% decline), and homicide (15.7 to 13.8; 12% decline). The age-adjusted death rates for two of the five causes were higher in 2014 than in 1999: suicide (20.1 to 22.5; 12% increase), and unintentional injuries (from 48.7 to 51.0; 5% increase).

37 CFR 255.3 - Adjustment of royalty rate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... fraction thereof, whichever amount is larger, subject to further adjustment pursuant to paragraphs (b....85 cent per minute of playing time or fraction thereof, whichever amount is larger, subject to... embodied in the phonorecord shall be either 5.0 cents, or 0.95 cent per minute of playing time or fraction...

A likelihood ratio test for evolutionary rate shifts and functional divergence among proteins

PubMed Central

Knudsen, Bjarne; Miyamoto, Michael M.

2001-01-01

Changes in protein function can lead to changes in the selection acting on specific residues. This can often be detected as evolutionary rate changes at the sites in question. A maximum-likelihood method for detecting evolutionary rate shifts at specific protein positions is presented. The method determines significance values of the rate differences to give a sound statistical foundation for the conclusions drawn from the analyses. A statistical test for detecting slowly evolving sites is also described. The methods are applied to a set of Myc proteins for the identification of both conserved sites and those with changing evolutionary rates. Those positions with conserved and changing rates are related to the structures and functions of their proteins. The results are compared with an earlier Bayesian method, thereby highlighting the advantages of the new likelihood ratio tests. PMID:11734650

Assessing the adequacy of contribution rates towards employees' provident fund in Malaysia

NASA Astrophysics Data System (ADS)

Saidi, Nurul Athirah Nabila; Yusuf, Mazlynda Md; Basah, Mohamad Yazis Ali

2017-04-01

The vital role of Malaysian Employees' Provident Fund (EPF) is to provide financial support for its participants during retirement years. However, the issues of inadequacy have risen and EPF has been through various improvements in order to cope with current living situations, including making adjustment in the contribution rates. This study intends to provide the projection of EPF accumulations for three different types of contribution rates namely contribution rates at current fixed rate, increasing and decreasing proportion. Then, the replacement ratio is calculated and is used as an indicator to determine the adequacy of retirement income delivered by EPF. The ideal replacement ratio recommended by financial advisors is at 70%. Based on the findings in this study, contribution rates following a decreasing proportion gives replacement ratio that exceeds or nearest to the ideal replacement ratio, while contribution rates at current fixed rate gives replacement rates that fall far from 70%. Therefore, this study shows that the accumulated amount in the fund with contribution rates following a decreasing proportion gives higher replacement ratio and is recommended to be applied by the Malaysian EPF.

Leptin to adiponectin ratio in preeclampsia.

PubMed

Khosrowbeygi, A; Ahmadvand, H

2013-04-01

The aim of the present study was to assess leptin/adiponectin ratio in preeclamptic patients compared with normal pregnant women. A cross-sectional study was designed. The study population consisted of 30 preeclamptic patients and 30 healthy pregnant women. Serum levels of total leptin and adiponectin were assessed using commercially available enzyme-linked immunosorbent assay methods. The one-way ANOVA and Student's t tests and Pearson's correlation analysis were used for statistical calculations. Levels of leptin and adiponectin were also adjusted for BMI. A p-value < 0.05 was considered statistically significant. The leptin/adiponectin ratio was increased significantly in preeclamptic patients. The leptin/adiponectin ratio was significantly higher in severe preeclamptic patient than in mild preeclampsia. Adjusted leptin/adiponectin ratio was also significantly increased in preeclamptic patients than in normal pregnant women. The findings of the present study suggest that the leptin/adiponectin ratio was increased in preeclamsia and imbalance between the adipocytokines could be involved in the pathogenesis of preeclampsia.

Serum Free Light Chain Assay and κ/λ Ratio Performance in Patients Without Monoclonal Gammopathies:  High False-Positive Rate.

PubMed

Singh, Gurmukh

2016-08-01

Serum free light chain assay is a recommended screening test for monoclonal gammopathies. Anecdotal observations indicated a high rate of false-positive abnormal κ/λ ratios. This study was undertaken to ascertain the magnitude of the false-positive rate and factors contributing to the error rate. Results of serum protein electrophoresis, serum free light chains, and related tests, usually done for investigation of suspected monoclonal gammopathy, were reviewed retrospectively for 270 patients and 297 observations. Using the conventional κ/λ ratio, 36.4% of the ratios were abnormal, in the absence of monoclonal gammopathy. When the renal κ/λ ratio was used, the rate of abnormal κ/λ ratios was 30.1%. In patients with a γ-globulin concentration of 1.6 g/dL or more, the usual κ/λ ratio was abnormal in 54.8% of the patients. Urine protein electrophoresis was used in 53 (19.6%) instances, whereas bone marrow examination was done in 65 (24.1%) cases. Usual κ/λ ratio was abnormal in 36.4% of the observations in patients without evidence of monoclonal gammopathy, and an abnormal κ/λ ratio should not be used as the sole indicator for diagnosis of neoplastic proliferation of the lympho-plasmacytic system. Hypergammaglobulinemia is associated with a higher rate of false-positive abnormal κ/λ ratios. Examination of urine for monoclonal immunoglobulins may be underused, and recommendations by some to use serum free light chain assay in place of, rather than as an adjunct to, urine electrophoresis are not warranted. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Radial and tangential gravity rates from GRACE in areas of glacial isostatic adjustment

NASA Astrophysics Data System (ADS)

van der Wal, Wouter; Kurtenbach, Enrico; Kusche, Jürgen; Vermeersen, Bert

2011-11-01

In areas dominated by Glacial Isostatic Adjustment (GIA), the free-air gravity anomaly rate can be converted to uplift rate to good approximation by using a simple spectral relation. We provide quantitative comparisons between gravity rates derived from monthly gravity field solutions (GFZ Potsdam, CSR Texas, IGG Bonn) from the Gravity Recovery and Climate Experiment (GRACE) satellite mission with uplift rates measured by GPS in these areas. The band-limited gravity data from the GRACE satellite mission can be brought to very good agreement with the point data from GPS by using scaling factors derived from a GIA model (the root-mean-square of differences is 0.55 mm yr-1 for a maximum uplift rate signal of 10 mm yr-1). The root-mean-square of the differences between GRACE derived uplift rates and GPS derived uplift rates decreases with increasing GRACE time period to a level below the uncertainty that is expected from GRACE observations, GPS measurements and the conversion from gravity rate to uplift rate. With the current length of time-series (more than 8 yr) applying filters and a hydrology correction to the GRACE data does not reduce the root-mean-square of differences significantly. The smallest root-mean-square was obtained with the GFZ solution in Fennoscandia and with the CSR solution in North America. With radial gravity rates in excellent agreement with GPS uplift rates, more information on the GIA process can be extracted from GRACE gravity field solutions in the form of tangential gravity rates, which are equivalent to a rate of change in the deflection of the vertical scaled by the magnitude of gravity rate vector. Tangential gravity rates derived from GRACE point towards the centre of the previously glaciated area, and are largest in a location close to the centre of the former ice sheet. Forward modelling showed that present day tangential gravity rates have maximum sensitivity between the centre and edge of the former ice sheet, while radial gravity

30 CFR 36.44 - Maximum allowable fuel : air ratio.

Code of Federal Regulations, 2012 CFR

2012-07-01

... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Maximum allowable fuel : air ratio. 36.44...

30 CFR 36.44 - Maximum allowable fuel : air ratio.

Code of Federal Regulations, 2013 CFR

2013-07-01

... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Maximum allowable fuel : air ratio. 36.44...

30 CFR 36.44 - Maximum allowable fuel : air ratio.

Code of Federal Regulations, 2010 CFR

2010-07-01

... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Maximum allowable fuel : air ratio. 36.44...

30 CFR 36.44 - Maximum allowable fuel : air ratio.

Code of Federal Regulations, 2011 CFR

2011-07-01

... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Maximum allowable fuel : air ratio. 36.44...

The relationship between elderly suicide rates and elderly dependency ratios: a cross-national study using data from the WHO data bank.

PubMed

Shah, Ajit; Padayatchi, Mellisha; Das, Kavita

2008-06-01

Cultural factors may influence cross-national variations in elderly suicide rates. A cross-national study examining the relationship between elderly suicide rates and elderly dependency ratios was conducted with the a priori unidirectional hypothesis that lower elderly dependency ratios (ratio of people over the age of 65 years to people under the age of 65 years) may imply a greater number of younger people being potentially available to provide support and respect to the elderly and to hold them in high esteem, and this would lead to a reduction in elderly suicide rates. Data on elderly suicide rates, and the total number of elderly and young people were ascertained from the World Health Organization website. Significant positive correlations were found between the natural logarithm of suicide rates, in both sexes in two elderly age-bands (65-74 years and 75+ years), and the elderly dependency ratio for males, females and both sexes combined. The impact of elderly dependency ratios on elderly suicide rates may interact with and be modified and mediated through cultural factors. The contribution of cross-national differences in cultural factors on elderly suicide rates require further study by formally measuring cultural factors with validated instruments.

Sociosexual orientation and 2D:4D ratios in women: Relationship to men's desirability ratings as a long-term pair bond.

PubMed

DeLecce, Tara L; Polheber, John P; Matchock, Robert L

2014-02-01

The current study examined whether men's ratings of women's desirability as a long-term pairbond, based on static photographs, were related to the women's second-to-fourth digit (2D:4D) ratio and their sexual attitudes and behavior. The 2D:4D ratio was measured in 164 women and facial photographs were taken of 55 of these women. All women completed the Sociosexual Orientation Inventory (SOI). Male participants (n = 89), masked to this information, rated the 55 female participants on their desirability as a long-term sexual partner, specifically along dimensions of faithfulness, youthfulness, and attractiveness. Ten independent judges rated women's photographed faces on masculinity. Results indicated a significant negative relationship between women's SOI scores and men's faithfulness ratings (more unrestricted sociosexuality was associated with lower faithfulness ratings). There was also a significant positive relationship between right (but not left) 2D:4D ratio and faithfulness ratings (women with female-like ratios were rated as being more faithful). The SOI scores of the women were not related to 2D:4D ratios. These results suggest that the potential for sexual infidelity can be gleaned from static facial cues.

Calcium carbonate precipitation rate as a function of ion ratio in the presence & absence of Sr2+

NASA Astrophysics Data System (ADS)

Gebrehiwet, T.; Beig, M. S.; Fujita, Y.; Redden, G. D.; Smith, R. W.

2010-12-01

Tsigabu Gebrehiwet 1*, Mikala Beig 2, Yoshiko Fujita 3, George Redden 3 and Robert W. Smith 1 1University of Idaho, 1776 Science Center Dr, Idaho Falls,ID, 83402 (*tgebrehiwet@uidaho.edu; smithbob@uidaho.edu ) 27963 Grasmere Dr.Boulder, CO 80301(mbeig@alumni.rice.edu) 3Idaho National Laboratory, MS 2208, Idaho Falls, ID 83415 (Yoshiko.Fujita@inl.gov; George.Redden@inl.gov) Engineered in situ precipitation of calcium carbonate is a proposed strategy for remediating toxic or radioactive metals (e.g., Sr2+)in subsurface environments as well as for modifying the physical properties (e.g., stiffness, permeability) of geomedia. Inducing the precipitation reaction will likely involve manipulating the geochemical conditions by adding calcium, (bi)carbonate, or both, and relying on mixing of the two reactants. Under these conditions, the ratio of Ca2+ to CO32- will vary with distance from the mixing interface, and for most or all of the porous medium, a 1:1 stoichiometry between calcium and carbonate is unlikely to be achieved. Indeed, in engineered systems where rapid treatment is an important objective, very steep ion concentration gradients may be generated, which would result in local reactant ratios varying from very small to very large over short distances, depending on the mixing geometry and particular chemical composition of the mixing fluids. This in turn has an impact on the rate of mineral precipitation. Typically, the rate of calcium carbonate precipitation is expressed with an affinity-based rate law of the type: Rate = k(Ω-1)n, where k is a rate constant, Ω is the saturation state for the mineral (e.g., calcite), and n is an empirical reaction order. The saturation state Ω is defined as the ratio of the ion activity product to the mineral solubility product. In this expression, the rate is simply dependent on the value of Ω; the actual activities of the individual ions (Ca2+ and CO32-) do not appear in the expression. In support of the development of

30 CFR 36.44 - Maximum allowable fuel:air ratio.

Code of Federal Regulations, 2014 CFR

2014-07-01

... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel:air ratio determined from the... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Maximum allowable fuel:air ratio. 36.44 Section...

Influence of ceramic dental crown coating substrate thickness ratio on strain energy release rate

NASA Astrophysics Data System (ADS)

Khasnulhadi, K.; Daud, R.; Mat, F.; Noor, S. N. F. M.; Basaruddin, K. S.; Sulaiman, M. H.

2017-10-01

This paper presents the analysis of coating substrate thickness ratio effect on the crown coating fracture behaviour. The bi-layer material is examined under four point bending with pre-crack at the bottom of the core material by using finite element. Three different coating thickness of core/substrate was tested which is 1:1, 1:2 and 2:1. The fracture parameters are analysed based on bilayer and homogenous elastic interaction. The result shows that the ratio thickness of core/veneer provided a significant effect on energy release rate.

Flow control for a paper-based microfluidic device by adjusting permeability of paper

NASA Astrophysics Data System (ADS)

Jang, Ilhoon; Kim, Gangjune; Song, Simon

2014-11-01

The paper-based microfluidics has attracted intensive attention as a prospective substitute for conventional microfluidic substrates used for a point-of-care diagnostics due to its superior advantages such as the cost effectiveness and production simplicity. Generally, a paper-based microfluidic device utilizes capillary force to drive a flow. Recent studies on flow control in such a device aimed at obtaining accurate and quantitative results by varying a channel geometry like width and length. According to the Darcy's law describing a flow in a porous media like paper, a flow rate can be adjusted the permeability of paper. In this study, we investigate a flow control method by adjusting the permeability of paper. We utilize the wax printing for the adjustment and the fabrication of paper channels. A rectangular wax pattern was printed on one inlet channel of a Y-channel geometry. By varying the brightness of the wax pattern, a relationship between the flow rate and permeability changes due to the wax was investigated. As a result, we obtained an effective permeability contour with respect to the wax pattern length and brightness. In addition, we developed a paper-based micromixer of which the mixing ratio was controlled precisely by adjusting the permeability.

Quantitative chemical exchange saturation transfer (qCEST) MRI - omega plot analysis of RF-spillover-corrected inverse CEST ratio asymmetry for simultaneous determination of labile proton ratio and exchange rate.

PubMed

Wu, Renhua; Xiao, Gang; Zhou, Iris Yuwen; Ran, Chongzhao; Sun, Phillip Zhe

2015-03-01

Chemical exchange saturation transfer (CEST) MRI is sensitive to labile proton concentration and exchange rate, thus allowing measurement of dilute CEST agent and microenvironmental properties. However, CEST measurement depends not only on the CEST agent properties but also on the experimental conditions. Quantitative CEST (qCEST) analysis has been proposed to address the limitation of the commonly used simplistic CEST-weighted calculation. Recent research has shown that the concomitant direct RF saturation (spillover) effect can be corrected using an inverse CEST ratio calculation. We postulated that a simplified qCEST analysis is feasible with omega plot analysis of the inverse CEST asymmetry calculation. Specifically, simulations showed that the numerically derived labile proton ratio and exchange rate were in good agreement with input values. In addition, the qCEST analysis was confirmed experimentally in a phantom with concurrent variation in CEST agent concentration and pH. Also, we demonstrated that the derived labile proton ratio increased linearly with creatine concentration (P < 0.01) while the pH-dependent exchange rate followed a dominantly base-catalyzed exchange relationship (P < 0.01). In summary, our study verified that a simplified qCEST analysis can simultaneously determine labile proton ratio and exchange rate in a relatively complex in vitro CEST system. Copyright © 2015 John Wiley & Sons, Ltd.

The Effect of Compression Ratio, Fuel Octane Rating, and Ethanol Content on Spark-Ignition Engine Efficiency.

PubMed

Leone, Thomas G; Anderson, James E; Davis, Richard S; Iqbal, Asim; Reese, Ronald A; Shelby, Michael H; Studzinski, William M

2015-09-15

Light-duty vehicles (LDVs) in the United States and elsewhere are required to meet increasingly challenging regulations on fuel economy and greenhouse gas (GHG) emissions as well as criteria pollutant emissions. New vehicle trends to improve efficiency include higher compression ratio, downsizing, turbocharging, downspeeding, and hybridization, each involving greater operation of spark-ignited (SI) engines under higher-load, knock-limited conditions. Higher octane ratings for regular-grade gasoline (with greater knock resistance) are an enabler for these technologies. This literature review discusses both fuel and engine factors affecting knock resistance and their contribution to higher engine efficiency and lower tailpipe CO2 emissions. Increasing compression ratios for future SI engines would be the primary response to a significant increase in fuel octane ratings. Existing LDVs would see more advanced spark timing and more efficient combustion phasing. Higher ethanol content is one available option for increasing the octane ratings of gasoline and would provide additional engine efficiency benefits for part and full load operation. An empirical calculation method is provided that allows estimation of expected vehicle efficiency, volumetric fuel economy, and CO2 emission benefits for future LDVs through higher compression ratios for different assumptions on fuel properties and engine types. Accurate "tank-to-wheel" estimates of this type are necessary for "well-to-wheel" analyses of increased gasoline octane ratings in the context of light duty vehicle transportation.

Effects of diets supplemented by fish oil on sex ratio of pups in bitch.

PubMed

Gharagozlou, Faramarz; Youssefi, Reza; Akbarinejad, Vahid

2016-01-01

The present study was conducted to evaluate the effect of fish oil supplementation prior to mating on secondary sex ratio of pups (the proportion of males at birth) in bitches. Sixty five bitches (German Shepherd, n = 35; Husky, n = 30) were enrolled in the study. Bitches (140-150 days post-estrus) were given 2% per dry matter intake palm oil and fish oil in the control (n = 33) and treatment (n = 32) groups, respectively. To induce estrus, bitches were received equine chorionic gonadotropin (eCG) administration (50 IU kg(-1)) 30 days after nutritional supplementation followed by human chorionic gonadotropin (hCG) administration (500 IU per dog) seven days later. Bitches were introduced to dogs of the same breed after hCG administration. The weight of bitches was increased over time (p < 0.05), but their weight change was not different between two groups (p > 0.05). The mating rate, pregnancy rate and litter size were not influenced by treatment and breed. Secondary sex ratio was higher in the treatment (105/164; 64.00%) than in the control (68/147; 46.30%) group (p < 0.05; adjusted odds ratio = 2.068). Moreover, secondary sex ratio was higher in Husky bitches (88/141; 62.40%) compared to German Shepherd (85/170; 50.00%; p < 0.05; adjusted odds ratio = 1.661). In conclusion, the present study showed that inclusion of fish oil in the diet of bitches prior to mating could increase the proportion of male pups at birth. In addition, it appears that there might be variation among dog breeds with regard to the sex ratio of offspring.

Effects of diets supplemented by fish oil on sex ratio of pups in bitch

PubMed Central

Gharagozlou, Faramarz; Youssefi, Reza; Akbarinejad, Vahid

2016-01-01

The present study was conducted to evaluate the effect of fish oil supplementation prior to mating on secondary sex ratio of pups (the proportion of males at birth) in bitches. Sixty five bitches (German Shepherd, n = 35; Husky, n = 30) were enrolled in the study. Bitches (140-150 days post-estrus) were given 2% per dry matter intake palm oil and fish oil in the control (n = 33) and treatment (n = 32) groups, respectively. To induce estrus, bitches were received equine chorionic gonadotropin (eCG) administration (50 IU kg-1) 30 days after nutritional supplementation followed by human chorionic gonadotropin (hCG) administration (500 IU per dog) seven days later. Bitches were introduced to dogs of the same breed after hCG administration. The weight of bitches was increased over time (p < 0.05), but their weight change was not different between two groups (p > 0.05). The mating rate, pregnancy rate and litter size were not influenced by treatment and breed. Secondary sex ratio was higher in the treatment (105/164; 64.00%) than in the control (68/147; 46.30%) group (p < 0.05; adjusted odds ratio = 2.068). Moreover, secondary sex ratio was higher in Husky bitches (88/141; 62.40%) compared to German Shepherd (85/170; 50.00%; p < 0.05; adjusted odds ratio = 1.661). In conclusion, the present study showed that inclusion of fish oil in the diet of bitches prior to mating could increase the proportion of male pups at birth. In addition, it appears that there might be variation among dog breeds with regard to the sex ratio of offspring. PMID:27482354

Determination of rate constants and branching ratios for TCE degradation by zero-valent iron using a chain decay multispecies model.

PubMed

Hwang, Hyoun-Tae; Jeen, Sung-Wook; Sudicky, Edward A; Illman, Walter A

2015-01-01

The applicability of a newly-developed chain-decay multispecies model (CMM) was validated by obtaining kinetic rate constants and branching ratios along the reaction pathways of trichloroethene (TCE) reduction by zero-valent iron (ZVI) from column experiments. Changes in rate constants and branching ratios for individual reactions for degradation products over time for two columns under different geochemical conditions were examined to provide ranges of those parameters expected over the long-term. As compared to the column receiving deionized water, the column receiving dissolved CaCO3 showed higher mean degradation rates for TCE and all of its degradation products. However, the column experienced faster reactivity loss toward TCE degradation due to precipitation of secondary carbonate minerals, as indicated by a higher value for the ratio of maximum to minimum TCE degradation rate observed over time. From the calculated branching ratios, it was found that TCE and cis-dichloroethene (cis-DCE) were dominantly dechlorinated to chloroacetylene and acetylene, respectively, through reductive elimination for both columns. The CMM model, validated by the column test data in this study, provides a convenient tool to determine simultaneously the critical design parameters for permeable reactive barriers and natural attenuation such as rate constants and branching ratios. Copyright © 2015 Elsevier B.V. All rights reserved.

Calibrating recruitment estimates for mourning doves from harvest age ratios

USGS Publications Warehouse

Miller, David A.; Otis, David L.

2010-01-01

We examined results from the first national-scale effort to estimate mourning dove (Zenaida macroura) age ratios and developed a simple, efficient, and generalizable methodology for calibrating estimates. Our method predicted age classes of unknown-age wings based on backward projection of molt distributions from fall harvest collections to preseason banding. We estimated 1) the proportion of late-molt individuals in each age class, and 2) the molt rates of juvenile and adult birds. Monte Carlo simulations demonstrated our estimator was minimally biased. We estimated model parameters using 96,811 wings collected from hunters and 42,189 birds banded during preseason from 68 collection blocks in 22 states during the 2005–2007 hunting seasons. We also used estimates to derive a correction factor, based on latitude and longitude of samples, which can be applied to future surveys. We estimated differential vulnerability of age classes to harvest using data from banded birds and applied that to harvest age ratios to estimate population age ratios. Average, uncorrected age ratio of known-age wings for states that allow hunting was 2.25 (SD 0.85) juveniles:adult, and average, corrected ratio was 1.91 (SD 0.68), as determined from harvest age ratios from an independent sample of 41,084 wings collected from random hunters in 2007 and 2008. We used an independent estimate of differential vulnerability to adjust corrected harvest age ratios and estimated the average population age ratio as 1.45 (SD 0.52), a direct measure of recruitment rates. Average annual recruitment rates were highest east of the Mississippi River and in the northwestern United States, with lower rates between. Our results demonstrate a robust methodology for calibrating recruitment estimates for mourning doves and represent the first large-scale estimates of recruitment for the species. Our methods can be used by managers to correct future harvest survey data to generate recruitment estimates for use in

Temporal patterns in capture rate and sex ratio of forest bats in Arkansas

Treesearch

Roger W. Perry; S. Andrew Carter; Ronald E. Thill

2010-01-01

We quantified changes in capture rates and sex ratios from May to Sept. for eight species of bats, derived from 8 y of extensive mist netting in forests of the Ouachita Mountains, Arkansas. Our primary goal was to determine patterns of relative abundance for each species of bat captured over forest streams and to determine if these patterns were similar to patterns of...

Requirement for specific gravity and creatinine adjustments for urinary steroids and luteinizing hormone concentrations in adolescents.

PubMed

Singh, Gurmeet K S; Balzer, Ben W R; Desai, Reena; Jimenez, Mark; Steinbeck, Katharine S; Handelsman, David J

2015-11-01

Urinary hormone concentrations are often adjusted to correct for hydration status. We aimed to determine whether first morning void urine hormones in growing adolescents require adjustments and, if so, whether urinary creatinine or specific gravity are better adjustments. The study population was adolescents aged 10.1 to 14.3 years initially who provided fasting morning blood samples at 0 and 12 months (n = 343) and first morning urine every three months (n = 644). Unadjusted, creatinine and specific gravity-adjusted hormonal concentrations were compared by Deming regression and Bland-Altman analysis and grouped according to self-rated Tanner stage or chronological age. F-ratios for self-rated Tanner stages and age groups were used to compare unadjusted and adjusted hormonal changes in growing young adolescents. Correlations of paired serum and urinary hormonal concentration of unadjusted and creatinine and specific gravity-adjusted were also compared. Fasting first morning void hormone concentrations correlated well and were unbiased between unadjusted or adjusted by either creatinine or specific gravity. Urine creatinine concentration increases with Tanner stages, age and male gender whereas urine specific gravity was not influenced by Tanner stage, age or gender. Adjustment by creatinine or specific gravity of urinary luteinizing hormone, estradiol, testosterone, dihydrotestosterone and dehydroepiandrosterone concentrations did not improve correlation with paired serum concentrations. Urine steroid and luteinizing hormone concentrations in first morning void samples of adolescents are not significantly influenced by hydration status and may not require adjustments; however, if desired, both creatinine and specific gravity adjustments are equally suitable. © The Author(s) 2015.

Negative Control Outcomes and the Analysis of Standardized Mortality Ratios.

PubMed

Richardson, David B; Keil, Alexander P; Tchetgen Tchetgen, Eric; Cooper, Glinda

2015-09-01

In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to noncomparability of the occupational cohort and reference population with respect to unmeasured risk factors for the outcome of interest. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for such bias. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR = 1.9; 95% confidence interval [CI] = 1.3, 2.7) but not among monthly-paid males (SMR = 1.0; 95% CI = 0.67, 1.3). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR = 2.2; 95% CI = 1.5, 3.2; and, aSMR = 2.0; 95% CI = 1.4, 2.8, respectively). The proposed adjusted SMR offers a complement to typical SMR analyses.

Preparation of hydrophilic interaction/ion-exchange mixed-mode chromatographic stationary phase with adjustable selectivity by controlling different ratios of the co-monomers.

PubMed

Bo, Chunmiao; Wang, Xiaomeng; Wang, Chaozhan; Wei, Yinmao

2017-03-03

Development of mixed-mode chromatography (MMC) stationary phase with adjustable selectivity is beneficial to meet the needs of complex samples. In this work, surface-initiated atom transfer radical polymerization (SI-ATRP) using the mixture of two functional monomers was proposed as a new preparation strategy for MMC stationary phase with adjustable selectivity. The mixture of sodium 4-styrenesulfonate (NASS) and dimethylaminoethyl methacrylate (DMAEMA) underwent SI-ATRP to bond poly(NASS-co-DMAEMA) on the surface of silica to prepare hydrophilic interaction/ion-exchange mixed-mode stationary phase. Various analytes (neutral, acidic, basic analytes and strong polar nucleosides) were employed to investigate the retention behaviors. The influences of water content and pH of the mobile phase on the retention validated the mixed-mode retention mechanisms of HILIC and ion-exchange. The charge and polarity of stationary phase as well as the separation selectivity were conveniently manipulated by the ratio of NASS to DMAEMA monomer, and the use of DMAEMA in the mixture additionally endowed the column with the temperature-responsive characteristics. Moreover, the application of the developed column was demonstrated by the successful separation of nucleosides, β-agonists and safflower injection. In a word, the proposed strategy can be potentially applied in the controllable preparation of MMC stationary phase with adjustable selectivity. Copyright © 2017 Elsevier B.V. All rights reserved.

Modeling whole-tree carbon assimilation rate using observed transpiration rates and needle sugar carbon isotope ratios.

PubMed

Hu, Jia; Moore, David J P; Riveros-Iregui, Diego A; Burns, Sean P; Monson, Russell K

2010-03-01

*Understanding controls over plant-atmosphere CO(2) exchange is important for quantifying carbon budgets across a range of spatial and temporal scales. In this study, we used a simple approach to estimate whole-tree CO(2) assimilation rate (A(Tree)) in a subalpine forest ecosystem. *We analysed the carbon isotope ratio (delta(13)C) of extracted needle sugars and combined it with the daytime leaf-to-air vapor pressure deficit to estimate tree water-use efficiency (WUE). The estimated WUE was then combined with observations of tree transpiration rate (E) using sap flow techniques to estimate A(Tree). Estimates of A(Tree) for the three dominant tree species in the forest were combined with species distribution and tree size to estimate and gross primary productivity (GPP) using an ecosystem process model. *A sensitivity analysis showed that estimates of A(Tree) were more sensitive to dynamics in E than delta(13)C. At the ecosystem scale, the abundance of lodgepole pine trees influenced seasonal dynamics in GPP considerably more than Engelmann spruce and subalpine fir because of its greater sensitivity of E to seasonal climate variation. *The results provide the framework for a nondestructive method for estimating whole-tree carbon assimilation rate and ecosystem GPP over daily-to weekly time scales.

Examining the Relationship between Trace Lithium in Drinking Water and the Rising Rates of Age-Adjusted Alzheimer's Disease Mortality in Texas.

PubMed

Fajardo, Val Andrew; Fajardo, Val Andrei; LeBlanc, Paul J; MacPherson, Rebecca E K

2018-01-01

Alzheimer's disease (AD) mortality rates have steadily increased over time. Lithium, the current gold standard treatment for bipolar disorder, can exert neuroprotective effects against AD. We examined the relationship between trace levels of lithium in drinking water and changes in AD mortality across several Texas counties. 6,180 water samples from public wells since 2007 were obtained and averaged for 234 of 254 Texas counties. Changes in AD mortality rates were calculated by subtracting aggregated age-adjusted mortality rates obtained between 2000-2006 from those obtained between 2009-2015. Using aggregated rates maximized the number of counties with reliable mortality data. Correlational analyses between average lithium concentrations and changes in AD mortality were performed while also adjusting for gender, race, education, rural living, air pollution, physical inactivity, obesity, and type 2 diabetes. Age-adjusted AD mortality rate was significantly increased over time (+27%, p < 0.001). Changes in AD mortality were negatively correlated with trace lithium levels (p = 0.01, r = -0.20), and statistical significance was maintained after controlling for most risk factors except for physical inactivity, obesity, and type 2 diabetes. Furthermore, the prevalence of obesity and type 2 diabetes positively correlated with changes in AD mortality (p = 0.01 and 0.03, respectively), but also negatively correlated with trace lithium in drinking water (p = 0.05 and <0.0001, respectively). Trace lithium in water is negatively linked with changes in AD mortality, as well as obesity and type 2 diabetes, which are important risk factors for AD.

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.…

QuickStats: Age-Adjusted Death Rates* for Females Aged 15-44 Years, by the Five Leading Causes of Death(†) - United States, 1999 and 2014.

PubMed

2016-07-01

The age-adjusted death rate for females aged 15-44 years was 5% lower in 2014 (82.1 per 100,000 population) than in 1999 (86.5). Among the five leading causes of death, the age-adjusted rates of three were lower in 2014 than in 1999: cancer (from 19.6 to 15.3, a 22% decline), heart disease (8.9 to 8.2, an 8% decline), and homicide (4.2 to 2.8, a 33% decline). The age-adjusted death rates for two of the five causes were higher in 2014 than in 1999: unintentional injuries (from 17.0 to 20.1, an 18% increase) and suicide (4.8 to 6.5, a 35% increase). Unintentional injuries replaced cancer as the leading cause of death in this demographic group.

Adjusting the Adjusted X[superscript 2]/df Ratio Statistic for Dichotomous Item Response Theory Analyses: Does the Model Fit?

ERIC Educational Resources Information Center

Tay, Louis; Drasgow, Fritz

2012-01-01

Two Monte Carlo simulation studies investigated the effectiveness of the mean adjusted X[superscript 2]/df statistic proposed by Drasgow and colleagues and, because of problems with the method, a new approach for assessing the goodness of fit of an item response theory model was developed. It has been previously recommended that mean adjusted…

Projection of incidence rates to a larger population using ecologic variables.

PubMed

Frey, C M; Feuer, E J; Timmel, M J

1994-09-15

There is wide acceptance of direct standardization of vital rates to adjust for differing age distributions according to the representation within age categories of some referent population. One can use a similar process to standardize, and subsequently project vital rates with respect to continuous, or ratio scale ecologic variables. We obtained from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) programme, a 10 per cent subset of the total U.S. population, country-level breast cancer incidence during 1987-1989 for white women aged 50 and over. We applied regression coefficients that relate ecologic factors to SEER incidence to the full national complement of county-level information to produce an age and ecologic factor adjusted rate that may be more representative of the U.S. than the simple age-adjusted SEER incidence. We conducted a validation study using breast cancer mortality data available for the entire U.S. and which supports the appropriateness of this method for projecting rates.

Association between resting heart rate and arterial stiffness in Korean adults.

PubMed

Park, Byoung-Jin; Lee, Hye-Ree; Shim, Jae-Yong; Lee, Jung-Hyun; Jung, Dong-Hyuk; Lee, Yong-Jae

2010-04-01

Higher resting heart rate, a simple and useful indicator of autonomic balance and metabolic rate, has emerged as an independent predictor for atherosclerotic cardiovascular disease. To determine the association between resting heart rate and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). We examined the association between resting heart rate and baPWV in 641 Korean adults (366 men, 275 women) in a health examination program. A high baPWV was defined as greater than 1450 cm/s (>75th percentile). The odds ratios for high baPWVs were calculated using multivariable logistic regression analysis after adjusting for confounding variables across heart rate quartiles (Q1or=69 beats/min). Age-adjusted baPWV mean values increased gradually with heart rate quartile (Q1=1281, Q2=1285, Q3=1354, Q4=1416 cm/s). The odds ratios (95% confidence intervals) for high baPWVs in each heart rate quartile were 1.00, 1.28 (0.57-2.86), 2.63 (1.20-5.79) and 3.66 (1.66-8.05), respectively, after adjusting for age, sex, smoking status, alcohol intake, exercise, body mass index, hypertension medication, diabetes medication, hyperlipidaemia medication, mean arterial blood pressure, fasting plasma glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, white blood cell count, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase and uric acid. These findings indicate that a higher resting heart rate is independently associated with arterial stiffness. Accordingly, early detection of increased resting heart rate is important for preservation of arterial function and assessment of cardiovascular risk. Copyright 2010 Elsevier Masson SAS. All rights reserved.

26 CFR 1.803-2 - Adjusted reserves.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) INCOME TAXES Life Insurance Companies § 1.803-2 Adjusted reserves. For the purpose of determining... insurance, no adjustment is to be made. The reserves are thus adjusted, and the rate of interest on which...

26 CFR 1.803-2 - Adjusted reserves.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-2 Adjusted reserves. For the purpose of... or paid-up insurance, no adjustment is to be made. The reserves are thus adjusted, and the rate of...

26 CFR 1.803-2 - Adjusted reserves.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-2 Adjusted reserves. For the purpose of... or paid-up insurance, no adjustment is to be made. The reserves are thus adjusted, and the rate of...

26 CFR 1.803-2 - Adjusted reserves.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-2 Adjusted reserves. For the purpose of... or paid-up insurance, no adjustment is to be made. The reserves are thus adjusted, and the rate of...

26 CFR 1.803-2 - Adjusted reserves.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-2 Adjusted reserves. For the purpose of... or paid-up insurance, no adjustment is to be made. The reserves are thus adjusted, and the rate of...

Perinatal mortality in twin pregnancy: an analysis of birth weight-specific mortality rates and adjusted mortality rates for birth weight distributions.

PubMed

Fabre, E; González de Agüero, R; de Agustin, J L; Pérez-Hiraldo, M P; Bescos, J L

1988-01-01

The objective of this study is to compare the fetal mortality rate (FMR), early neonatal mortality rate (ENMR) and perinatal mortality rate (PMR) of twin and single births. It is based on a survey which was carried out in 22 Hospital Centers in Spain in 1980, and covered 1,956 twins born and 110,734 singletons born. The FMR in twins was 36.3/1000 and 8.8/1000 for singletons. The ENMR in twins was 36.1/1000 and 5.7/1000 for singletons. The PMR in twins was 71.1/1000 and 14.4/1000 for singletons. When birthweight-specific PMR in twin and singletons births are compared, there were no differences between the rates for groups 500-999 g and 1000-1499 g. For birthweight groups of 1500-1999 g (124.4 vs 283.8/1000) and 2000-2999 g (29.6 vs 73.2/1000) the rates for twins were about twice lower than those for single births. The PMR for 2500 g and over birthweight was about twice higher in twins than in singletons (12.5 vs 5.5/1000). After we adjusted for birthweight there was a difference in the FMR (12.6 vs 9.8/1000) and the PMR (19.1 vs 16.0/1000, and no difference in the ENMR between twins and singletons (5.9 vs 6.4/1000), indicating that most of the differences among crude rates are due to differences in distribution of birthweight.

Adjustable release of mitomycin C for inhibition of scar tissue formation after filtration surgery.

PubMed

Merritt, Sonia R; Velasquez, Gia; von Recum, Horst A

2013-11-01

The aim of this study is to demonstrate a drug delivery system with the capacity to adjust the release of mitomycin C (MMC), based on polymer composition, and inhibit fibroblast proliferation to a better effect than is currently used in glaucoma filtration surgery. The polymer used in this work is made from the oligosaccharide cyclodextrin, from which others and we have demonstrated adjustable release of small molecule drugs due to specific molecular interactions or "affinity" between drug and the cyclodextrin polymer. To adjust release rate, cyclodextrin polymers were synthesized in either dimethylformamide (DMF) or dimethyl sulfoxide, (DMSO) at a crosslinking ratio of 1:0.16 or 1:0:32 (molecule of glucose: molecule of crosslinker). The polymers were then loaded with mitomycin C, dried, and release evaluated in a physiological environment. Drug release was determined by visible spectroscopy. Released aliquots of mitomycin C were incubated with 3T3 fibroblast cells to determine cytotoxic or inhibitory effect through a cell proliferation assay. We show that by using affinity between drug and polymer, we can adjust MMC release rates to be slower and more sustained than from conventional, diffusion-only polymers, for both the DMF polymers (p = 0.00526) and the DMSO polymers (p = 0.0113). The incorporated and released MMC maintains inhibition of fibroblast proliferation much longer than is possible with a one-time application. Affinity polymers with 1:0.16 and 1:0.32 crosslink ratio showed significant inhibition of proliferation for up to 100 h (p = 0.018 and p = 0.014 respectively). The use of our controlled drug delivery technology applied after surgery could have a greater therapeutic impact than the current one-time applications of MMC. Copyright © 2013 Elsevier Ltd. All rights reserved.

Adjustable release of mitomycin C for inhibition of scar tissue formation after filtration surgery

PubMed Central

Merritt, Sonia R.; Velasquez, Gia; von Recum, Horst A.

2016-01-01

The aim of this study is to demonstrate a drug delivery system with the capacity to adjust the release of mitomycin C (MMC), based on polymer composition, and inhibit fibroblast proliferation to a better effect than is currently used in glaucoma filtration surgery. The polymer used in this work is made from the oligosaccharide cyclodextrin, from which others and we have demonstrated adjustable release of small molecule drugs due to specific molecular interactions or “affinity” between drug and the cyclodextrin polymer. To adjust release rate, cyclodextrin polymers were synthesized in either dimethylformamide (DMF) or dimethyl sulfoxide, (DMSO) at a crosslinking ratio of 1:0.16 or 1:0:32 (molecule of glucose: molecule of crosslinker). The polymers were then loaded with mitomycin C, dried, and release evaluated in a physiological environment. Drug release was determined by visible spectroscopy. Released aliquots of mitomycin C were incubated with 3T3 fibroblast cells to determine cytotoxic or inhibitory effect through a cell proliferation assay. We show that by using affinity between drug and polymer, we can adjust MMC release rates to be slower and more sustained than from conventional, diffusion-only polymers, for both the DMF polymers (p = 0.00526) and the DMSO polymers (p = 0.0113). The incorporated and released MMC maintains inhibition of fibroblast proliferation much longer than is possible with a one-time application. Affinity polymers with 1:0.16 and 1:0.32 crosslink ratio showed significant inhibition of proliferation for up to 100 h (p = 0.018 and p = 0.014 respectively). The use of our controlled drug delivery technology applied after surgery could have a greater therapeutic impact than the current one-time applications of MMC. PMID:23911951

Effect of urine urea nitrogen and protein intake adjusted by using the estimated urine creatinine excretion rate on the antiproteinuric effect of angiotensin II type I receptor blockers.

PubMed

Chin, Ho Jun; Kim, Dong Ki; Park, Jung Hwan; Shin, Sung Joon; Lee, Sang Ho; Choi, Bum Soon; Kim, Suhnggwon; Lim, Chun Soo

2015-01-01

The aim of this study was to determine the role of protein intake on proteinuria in chronic kidney disease (CKD), as it is presently not conclusive. This is a subanalysis of data from an open-label, case-controlled, randomized clinical trial on education about low-salt diets (NCT01552954). We estimated the urine excretion rate of parameters in a day, adjusted by using the equation for estimating urine creatinine excretion, and analyzed the effect of urine urea nitrogen (UUN), as well as estimating protein intake on the level of albuminuria in hypertensive patients with chronic kidney disease. Among 174 participants from whom complete 24-h urine specimens were collected, the estimates from the Tanaka equation resulted in the highest accuracy for the urinary excretion rate of creatinine, sodium, albumin, and UUN. Among 227 participants, the baseline value of estimated urine albumin excretion (eUalb) was positively correlated with the estimated UUN (eUUN) or protein intake according to eUUN (P = 0.012 and P = 0.038, respectively). We were able to calculate the ratios of eUalb and eUUN in 221 participants and grouped them according to the ratio of eUUN during 16-wk trial period. The proportion of patients that achieved a decrement of eUalb ≥25% during 16 wk with an angiotensin II type I receptor blocker (ARB) medication was 80% (24 of 30) in group 1, with eUUN ratio ≤-25%; 82.2% (111 of 135) in group 2, with eUUN ratio between -25% and 25%; and 66.1% (37 and 56) in group 3, with eUUN ratio ≥25% (P = 0.048). The probability of a decrease in albuminuria with ARB treatment was lower in patients with an increase of eUUN or protein intake during the 16 wk of ARB treatment, as observed in multiple logistic regression analysis as well. The estimated urine urea excretion rate showed a positive association with the level of albuminuria in hypertensive patients with chronic kidney disease. The increase of eUUN excretion ameliorated the antiproteinuric effect of ARB

Comparing the Effects of Unknown-Known Ratios on Word Reading Learning versus Learning Rates

ERIC Educational Resources Information Center

Joseph, Laurice M.; Nist, Lindsay M.

2006-01-01

An extension of G. L. Cates et al. (2003) investigation was conducted to determine if students' cumulative learning rates would be superior for words read under a traditional drill and practice condition (as they were for spelling in the previous study) than under interspersal conditions of varying ratios of unknown to known words. Participants…

Adjusting the HIV prevalence for non-respondents using mortality rates in an open cohort in northwest Tanzania.

PubMed

Tenu, Filemon; Isingo, Raphael; Zaba, Basia; Urassa, Mark; Todd, Jim

2014-06-01

To estimate HIV prevalence in adults who have not tested for HIV using age-specific mortality rates and to adjust the overall population HIV prevalence to include both tested and untested adults. An open cohort study was established since 1994 with demographic surveillance system (DSS) and five serological surveys conducted. Deaths from Kisesa DSS were used to estimate mortality rates and 95% confidence intervals by HIV status for 3- 5-year periods (1995-1999, 2000-2004, and 2005-2009). Assuming that mortality rates in individuals who did not test for HIV are similar to those in tested individuals, and dependent on age, sex and HIV status and HIV, prevalence was estimated. In 1995-1999, mortality rates (per 1000 person years) were 43.7 (95% CI 35.7-53.4) for HIV positive, 2.6 (95% CI 2.1-3.2) in HIV negative and 16.4 (95% CI 14.4-18.7) in untested. In 2000-2004, mortality rates were 43.3 (95% CI 36.2-51.9) in HIV positive, 3.3 (95% CI 2.8-4.0) in HIV negative and 11.9 (95% CI 10.5-13.6) in untested. In 2005-2009, mortality rates were 30.7 (95% CI 24.8-38.0) in HIV positive, 4.1 (95% CI 3.5-4.9) in HIV negative and 5.7 (95% CI 5.0-6.6) in untested residents. In the three survey periods (1995-1999, 2000-2004, 2005-2009), the adjusted period prevalences of HIV, including the untested, were 13.5%, 11.6% and 7.1%, compared with the observed prevalence in the tested of 6.0%, 6.8 and 8.0%. The estimated prevalence in the untested was 33.4%, 21.6% and 6.1% in the three survey periods. The simple model was able to estimate HIV prevalence where a DSS provided mortality data for untested residents. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... equivalence. CMS may add to, modify, or substitute for risk adjustment factors if those changes will improve... adjust for health status, CMS applies a risk factor based on data obtained in accordance with § 422.310. (ii) Implementation. CMS applies a risk factor that incorporates inpatient hospital and ambulatory...

Office and 24-hour heart rate and target organ damage in hypertensive patients

PubMed Central

2012-01-01

Background We investigated the association between heart rate and its variability with the parameters that assess vascular, renal and cardiac target organ damage. Methods A cross-sectional study was performed including a consecutive sample of 360 hypertensive patients without heart rate lowering drugs (aged 56 ± 11 years, 64.2% male). Heart rate (HR) and its standard deviation (HRV) in clinical and 24-hour ambulatory monitoring were evaluated. Renal damage was assessed by glomerular filtration rate and albumin/creatinine ratio; vascular damage by carotid intima-media thickness and ankle/brachial index; and cardiac damage by the Cornell voltage-duration product and left ventricular mass index. Results There was a positive correlation between ambulatory, but not clinical, heart rate and its standard deviation with glomerular filtration rate, and a negative correlation with carotid intima-media thickness, and night/day ratio of systolic and diastolic blood pressure. There was no correlation with albumin/creatinine ratio, ankle/brachial index, Cornell voltage-duration product or left ventricular mass index. In the multiple linear regression analysis, after adjusting for age, the association of glomerular filtration rate and intima-media thickness with ambulatory heart rate and its standard deviation was lost. According to the logistic regression analysis, the predictors of any target organ damage were age (OR = 1.034 and 1.033) and night/day systolic blood pressure ratio (OR = 1.425 and 1.512). Neither 24 HR nor 24 HRV reached statistical significance. Conclusions High ambulatory heart rate and its variability, but not clinical HR, are associated with decreased carotid intima-media thickness and a higher glomerular filtration rate, although this is lost after adjusting for age. Trial Registration ClinicalTrials.gov: NCT01325064 PMID:22439900

Mortality, fertility, and the OY ratio in a model hunter-gatherer system.

PubMed

White, Andrew A

2014-06-01

An agent-based model (ABM) is used to explore how the ratio of old to young adults (the OY ratio) in a sample of dead individuals is related to aspects of mortality, fertility, and longevity experienced by the living population from which the sample was drawn. The ABM features representations of rules, behaviors, and constraints that affect person- and household-level decisions about marriage, reproduction, and infant mortality in hunter-gatherer systems. The demographic characteristics of the larger model system emerge through human-level interactions playing out in the context of "global" parameters that can be adjusted to produce a range of mortality and fertility conditions. Model data show a relationship between the OY ratios of living populations (the living OY ratio) and assemblages of dead individuals drawn from those populations (the dead OY ratio) that is consistent with that from empirically known ethnographic hunter-gatherer cases. The dead OY ratio is clearly related to the mean ages, mean adult mortality rates, and mean total fertility rates experienced by living populations in the model. Sample size exerts a strong effect on the accuracy with which the calculated dead OY ratio reflects the actual dead OY ratio of the complete assemblage. These results demonstrate that the dead OY ratio is a potentially useful metric for paleodemographic analysis of changes in mortality and mean age, and suggest that, in general, hunter-gatherer populations with higher mortality, higher fertility, and lower mean ages are characterized by lower dead OY ratios. Copyright © 2014 Wiley Periodicals, Inc.

The College Adjustment Questionnaire: A Measure of Students' Educational, Relational, and Psychological Adjustment to the College Environment

ERIC Educational Resources Information Center

O'Donnell, Maeve B.; Shirley, Lauren A.; Park, Stacey S.; Nolen, Julian P.; Gibbons, Alyssa M.; Rosén, Lee A.

2018-01-01

Several instruments exist to measure college adjustment: the Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1989), the College Adjustment Rating Scale (Zitzow, 1984), and the College Adjustment Scales (Anton & Reed, 1991). Of these, the SACQ is the most widely used and takes a multifaceted approach to measuring college…

States with stronger health insurance rate review authority experienced lower premiums in the individual market in 2010-13.

PubMed

Karaca-Mandic, Pinar; Fulton, Brent D; Hollingshead, Ann; Scheffler, Richard M

2015-08-01

States have varying degrees of review authority over health insurance carriers' rates, including prior approval authority over proposed rates and requirements for loss ratios, the proportion of premium revenues spent on medical claims. The Affordable Care Act (ACA) requires carriers in certain categories of health insurance to provide public justification for rate increases of 10 percent or more. We collected data on how states changed their rate review authority and requirements during 2010-13, the years immediately after enactment of the ACA, and we combined these data with carrier filings. We found that adjusted premiums in the individual market in states that had prior-approval authority combined with loss ratio requirements were lower in 2010-13 ($3,489) than premiums in states with no rate review authority or that had only file-and-use regulations, which gave the states no authority to block rate increases ($3,617). Adjusted premiums declined modestly in prior-approval states with loss ratio requirements, from $3,526 in 2010 to $3,452 in 2013, while premiums increased from $3,422 to $3,683 in states with no rate review authority or file-and-use regulations only. Our findings suggest that states with prior approval authority and loss ratio requirements constrained health insurance premium increases. Project HOPE—The People-to-People Health Foundation, Inc.

39 CFR 3010.21 - Calculation of annual limitation when notices of rate adjustment are 12 or more months apart.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the Postal Service files its notice of rate adjustment and dividing the sum by 12 (Recent Average... values immediately preceding the Recent Average and dividing the sum by 12 (Base Average). Finally, the full year limitation is calculated by dividing the Recent Average by the Base Average and subtracting 1...

39 CFR 3010.22 - Calculation of annual limitation when notices of rate adjustment are less than 12 months apart.

Code of Federal Regulations, 2014 CFR

2014-07-01

... dividing the sum by 12 (Recent Average). The partial year limitation is then calculated by dividing the Recent Average by the Recent Average from the most recent previous notice of rate adjustment (Previous Recent Average) applicable to each affected class of mail and subtracting 1 from the quotient. The result...

High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure.

PubMed

Kindel, Tammy; Martin, Emily; Hungness, Eric; Nagle, Alex

2014-01-01

Determinants of success of a bariatric procedure are many but paramount is the ability to durably produce significant and reliable weight loss. We sought to determine the primary success of the laparoscopic adjustable gastric band (LAGB) by defining failure as clinical weight loss failure with an intact band (excess weight loss [EWL]<20%) or band removal (terminal removal or conversion to a secondary bariatric procedure). A retrospective chart review was performed on patients who underwent an LAGB as a primary bariatric procedure between January 2003 and December 2007. Data collected included body mass index (BMI), weight, postoperative follow-up length, EWL, and adjustment number, as well as complications of the LAGB. Sixteen of 120 patients had the band removed. Nine were terminally removed for unmanageable symptoms, and 7 were converted to an alternative bariatric procedure. The average follow-up for the 104 patients with an intact band was 4.8 years. The average EWL for successful intact bands was 44.9±19.4%; however, an additional 35.6% of patients had an EWL<20%. Patients with an EWL<20% had a significantly higher preoperative BMI and fewer band adjustments. In total, 44% of patients had band failure because of clinical weight loss failure (31%) or eventual band removal (13%). This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients because of either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients because of its high failure rate. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

The State Sets the Rate: The Relationship Among State-Specific College Binge Drinking, State Binge Drinking Rates, and Selected State Alcohol Control Policies

PubMed Central

Nelson, Toben F.; Naimi, Timothy S.; Brewer, Robert D.; Wechsler, Henry

2005-01-01

Objectives. We assessed the relationship between college binge drinking, binge drinking in the general population, and selected alcohol control policies. Methods. We analyzed binge drinking rates from 2 national surveys, the Har-vard School of Public Health College Alcohol Study and the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. Binge drinking data were linked to a summary measure of 7 salient alcohol control policies and a rating of resources devoted to law enforcement. Results. State-level college and adult binge drinking rates were strongly correlated (Pearson correlation coefficient=0.43; P<.01). Attending college in states with the lowest binge drinking rates (adjusted odds ratio [OR]=0.63; 95% confidence interval [CI]=0.41, 0.97) and presence of more stringent alcohol control policies (adjusted OR=0.57; 95% CI=0.33, 0.97) were independent predictors of student binge drinking, after adjusting for state law enforcement and individual-, college-, and state-level covariates. Conclusions. State of residence is a predictor of binge drinking by college students. State-level alcohol control policies may help reduce binge drinking among college students and in the general population. PMID:15727974

Differences in Interaction Patterns of Families with First or Second Grade Sons Rated High or Low in Classroom Adjustment.

ERIC Educational Resources Information Center

St. Pierre, Susan; And Others

This study attempts to determine whether families with a son rated by his teacher as either "high" or "low" on classroom adjustment (behavior indicative of social maturity and achievement motivation) could be differentiated on the basis of their communicative patterns. It was questioned if significant differences existed in the amount of positive…

Decreased Surgical Site Infection Rate in Hysterectomy: Effect of a Gynecology-Specific Bundle.

PubMed

Andiman, Sarah E; Xu, Xiao; Boyce, John M; Ludwig, Elizabeth M; Rillstone, Heidi R W; Desai, Vrunda B; Fan, Linda L

2018-06-01

We implemented a hysterectomy-specific surgical site infection prevention bundle after a higher-than-expected surgical site infection rate was identified at our institution. We evaluate how this bundle affected the surgical site infection rate, length of hospital stay, and 30-day postoperative readmission rate. This is a quality improvement study featuring retrospective analysis of a prospectively implemented, multidisciplinary team-designed surgical site infection prevention bundle that consisted of chlorhexidine-impregnated preoperative wipes, standardized aseptic surgical preparation, standardized antibiotic dosing, perioperative normothermia, surgical dressing maintenance, and direct feedback to clinicians when the protocol was breached. There were 2,099 hysterectomies completed during the 33-month study period. There were 61 surgical site infections (4.51%) in the pre-full bundle implementation period and 14 (1.87%) in the post-full bundle implementation period; we found a sustained reduction in the proportion of patients experiencing surgical site infection during the last 8 months of the study period. After adjusting for clinical characteristics, patients who underwent surgery after full implementation were less likely to develop a surgical site infection (adjusted odds ratio [OR] 0.46, P=.01) than those undergoing surgery before full implementation. Multivariable regression analysis showed no statistically significant difference in postoperative days of hospital stay (adjusted mean ratio 0.95, P=.09) or rate of readmission for surgical site infection-specific indication (adjusted OR 2.65, P=.08) between the before and after full-bundle implementation periods. The multidisciplinary implementation of a gynecologic perioperative surgical site infection prevention bundle was associated with a significant reduction in surgical site infection rate in patients undergoing hysterectomy.

Contact angle adjustment in equation-of-state-based pseudopotential model

NASA Astrophysics Data System (ADS)

Hu, Anjie; Li, Longjian; Uddin, Rizwan; Liu, Dong

2016-05-01

The single component pseudopotential lattice Boltzmann model has been widely applied in multiphase simulation due to its simplicity and stability. In many studies, it has been claimed that this model can be stable for density ratios larger than 1000. However, the application of the model is still limited to small density ratios when the contact angle is considered. The reason is that the original contact angle adjustment method influences the stability of the model. Moreover, simulation results in the present work show that, by applying the original contact angle adjustment method, the density distribution near the wall is artificially changed, and the contact angle is dependent on the surface tension. Hence, it is very inconvenient to apply this method with a fixed contact angle, and the accuracy of the model cannot be guaranteed. To solve these problems, a contact angle adjustment method based on the geometry analysis is proposed and numerically compared with the original method. Simulation results show that, with our contact angle adjustment method, the stability of the model is highly improved when the density ratio is relatively large, and it is independent of the surface tension.

Contact angle adjustment in equation-of-state-based pseudopotential model.

PubMed

Hu, Anjie; Li, Longjian; Uddin, Rizwan; Liu, Dong

2016-05-01

The single component pseudopotential lattice Boltzmann model has been widely applied in multiphase simulation due to its simplicity and stability. In many studies, it has been claimed that this model can be stable for density ratios larger than 1000. However, the application of the model is still limited to small density ratios when the contact angle is considered. The reason is that the original contact angle adjustment method influences the stability of the model. Moreover, simulation results in the present work show that, by applying the original contact angle adjustment method, the density distribution near the wall is artificially changed, and the contact angle is dependent on the surface tension. Hence, it is very inconvenient to apply this method with a fixed contact angle, and the accuracy of the model cannot be guaranteed. To solve these problems, a contact angle adjustment method based on the geometry analysis is proposed and numerically compared with the original method. Simulation results show that, with our contact angle adjustment method, the stability of the model is highly improved when the density ratio is relatively large, and it is independent of the surface tension.

[Effect of elastic strain rate ratio method and virtual touch tissue quantification on the diagnosis of breast masses].

PubMed

Gong, LiJie; He, Yan; Tian, Peng; Yan, Yan

2016-07-01

To determine the effect of elastic strain rate ratio method and virtual touch tissue quantification (VTQ) on the diagnosis of breast masses.
 Sixty female patients with breast cancer, who received surgical treatment in Daqing Oilfield General Hospital, were enrolled. All patients signed the informed consent paperwork and they were treated by routine ultrasound examination, compression elastography (CE) examination, and VTQ examination in turn. Strain ratio (SR) was checked by CE and shear wave velocity (SWV) value was measured by VTQ. The diagnostic values of different methods were evaluated by receiver operating characteristic (ROC) curves in the diagnosis of benign and malignant breast tumors.
 The maximum diameter and SWV value of the benign tumors were lower than those of the malignant tumors, and the SR ratio of benign masses was higher than that of malignant tumors (P<0.01). The AUC, sensitivity and specificity for elastic strain rate and VTQ for single or combined use were higher than those of conventional ultrasound (0.904, 97.5%, 69.2%; 0.946, 87.5%, 87.2%; 0.976, 90%, 97.4% vs 0.783, 85%, 61.5%). The AUC and specificity of VTQ were higher than those of the elastic strain rate (0.946, 87.2% vs 0.904, 69.2%), but the sensitivity of VTQ was higher than that of the latter (87.5% vs 97.5%). The AUC and specificity for combination of both methods were higher than those of single method, but the sensitivity was lower than that of the elastic strain rate. 
 Combination of elastic strain rate ratio method with VTQ possesses the best diagnostic value and the highest diagnostic accuracy in the diagnosis of breast mass than that used alone.

39 CFR 3010.6 - Type 3 adjustment-in general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... extraordinary circumstances. (b) An exigency-based rate adjustment is not subject to the inflation-based....6 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS General Provisions § 3010.6 Type 3 adjustment—in general. (a) A Type 3 rate adjustment is a...

25 CFR 175.13 - Procedures for adjusting electric power rates to reflect changes in the cost of purchased power...

Code of Federal Regulations, 2010 CFR

2010-04-01

... changes in the cost of purchased power or energy. 175.13 Section 175.13 Indians BUREAU OF INDIAN AFFAIRS... purchased power or energy. Whenever the cost of purchased power or energy changes, the effect of the change... accordingly. Rate adjustments due to the change in cost of purchased power or energy shall become effective...

Excitation rate coefficients and line ratios for the optical and ultraviolet transitions in S II

NASA Technical Reports Server (NTRS)

Cai, Wei; Pradhan, Anil K.

1993-01-01

New calculations are reported for electron excitation collision strengths, rate coefficients, transition probabilities, and line ratios for the astrophysically important optical and UV lines in S II. The collision strengths are calculated in the close coupling approximation using the R-matrix method. The present calculations are more extensive than previous ones, including all transitions among the 12 lowest LS terms and the corresponding 28 fine-structure levels in the collisional-radiative model for S II. While the present rate coefficients for electron impact excitation are within 10-30 percent of the previous values for the low-lying optical transitions employed as density diagnostics of H II regions and nebulae, the excitation rates for the UV transitions 4S super 0 sub 3/2 - 4Psub 1/2,3/2,5/2 differ significantly from earlier calculations, by up to factor of 2. We describe temperature and density sensitive flux ratios for a number of UV lines. The present UV results are likely to be of interest in a more accurate interpretation of S II emission from the Io plasma torus in the magnetosphere of Jupiter, as well as other UV sources observed from the IUE, ASTRO 1, and the HST.

True gender ratios and stereotype rating norms

PubMed Central

Garnham, Alan; Doehren, Sam; Gygax, Pascal

2015-01-01

We present a study comparing, in English, perceived distributions of men and women in 422 named occupations with actual real world distributions. The first set of data was obtained from previous a large-scale norming study, whereas the second set was mostly drawn from UK governmental sources. In total, real world ratios for 290 occupations were obtained for our perceive vs. real world comparison, of which 205 were deemed to be unproblematic. The means for the two sources were similar and the correlation between them was high, suggesting that people are generally accurate at judging real gender ratios, though there were some notable exceptions. Beside this correlation, some interesting patterns emerged from the two sources, suggesting some response strategies when people complete norming studies. We discuss these patterns in terms of the way real world data might complement norming studies in determining gender stereotypicality. PMID:26257681

Is outdoor work associated with elevated rates of cerebrovascular disease mortality? A cohort study based on iron-ore mining.

PubMed

Björ, Ove; Jonsson, Håkan; Damber, Lena; Burström, Lage; Nilsson, Tohr

2016-01-01

A cohort study that examined iron ore mining found negative associations between cumulative working time employed underground and several outcomes, including mortality of cerebrovascular diseases. In this cohort study, and using the same group of miners, we examined whether work in an outdoor environment could explain elevated cerebrovascular disease rates. This study was based on a Swedish iron ore mining cohort consisting of 13,000 workers. Poisson regression models were used to generate smoothed estimates of standardized mortality ratios and adjusted rate ratios, both models by cumulative exposure time in outdoor work. The adjusted rate ratio between employment classified as outdoor work ≥25 years and outdoor work 0-4 years was 1.62 (95 % CI 1.07-2.42). The subgroup underground work ≥15 years deviated most in occurrence of cerebrovascular disease mortality compared with the external reference population: SMR (0.70 (95 % CI 0.56-0.85)). Employment in outdoor environments was associated with elevated rates of cerebrovascular disease mortality. In contrast, work in tempered underground employment was associated with a protecting effect.

Association between neutrophil-to-lymphocyte ratio and survival rate patient hemodialysis in Adam Malik general hospital in 2016

NASA Astrophysics Data System (ADS)

Sibarani, H.; Muzasti, R. A.; Lubis, H. R.

2018-03-01

Hemodialysis patients’ survival rate is influenced by many factors. Some study showed anassociation between theneutrophil-to-lymphocyte ratio (NLR)with anincidentof CKD and the progression to ESRD. The aim of this study was to find the role of Neutrophil-to- Lymphocyte ratio in hemodialysis patients’ survival rate. It was a cohort retrospective with survival analysis to all patients undergoing dialysis in HAM hospital in January 2016. Patients were followed until December 2016 to find out whether they are dead or alive. Survival rate was as the time when theblood samplewas from January 2016 until the patients die or the study stopped. The patients were mostly male (58%) with amean ageof 48 ± 13 yo, mean dialysis was 9.6 ± 3.7 months. Patients who were still alive until the study stopped were 68 persons (61%). There was an association between NLR and patients’ survival rate with a p-value of 0.001, HR: 1.168, 95%CI: 1.092-1.249.

Mothers adjust offspring sex to match the quality of the rearing environment

PubMed Central

Pryke, Sarah R.; Rollins, Lee A.

2012-01-01

Theory predicts that mothers should adjust offspring sex ratios when the expected fitness gains or rearing costs differ between sons and daughters. Recent empirical work has linked biased offspring sex ratios to environmental quality via changes in relative maternal condition. It is unclear, however, whether females can manipulate offspring sex ratios in response to environmental quality alone (i.e. independent of maternal condition). We used a balanced within-female experimental design (i.e. females bred on both low- and high-quality diets) to show that female parrot finches (Erythrura trichroa) manipulate primary offspring sex ratios to the quality of the rearing environment, and not to their own body condition and health. Individual females produced an unbiased sex ratio on high-quality diets, but over-produced sons in poor dietary conditions, even though they maintained similar condition between diet treatments. Despite the lack of sexual size dimorphism, such sex ratio adjustment is in line with predictions from sex allocation theory because nutritionally stressed foster sons were healthier, grew faster and were more likely to survive than daughters. These findings suggest that mothers may adaptively adjust offspring sex ratios to optimally match their offspring to the expected quality of the rearing environment. PMID:22859597

Mothers adjust offspring sex to match the quality of the rearing environment.

PubMed

Pryke, Sarah R; Rollins, Lee A

2012-10-07

Theory predicts that mothers should adjust offspring sex ratios when the expected fitness gains or rearing costs differ between sons and daughters. Recent empirical work has linked biased offspring sex ratios to environmental quality via changes in relative maternal condition. It is unclear, however, whether females can manipulate offspring sex ratios in response to environmental quality alone (i.e. independent of maternal condition). We used a balanced within-female experimental design (i.e. females bred on both low- and high-quality diets) to show that female parrot finches (Erythrura trichroa) manipulate primary offspring sex ratios to the quality of the rearing environment, and not to their own body condition and health. Individual females produced an unbiased sex ratio on high-quality diets, but over-produced sons in poor dietary conditions, even though they maintained similar condition between diet treatments. Despite the lack of sexual size dimorphism, such sex ratio adjustment is in line with predictions from sex allocation theory because nutritionally stressed foster sons were healthier, grew faster and were more likely to survive than daughters. These findings suggest that mothers may adaptively adjust offspring sex ratios to optimally match their offspring to the expected quality of the rearing environment.

Evaluation of the product ratio coherent model in forecasting mortality rates and life expectancy at births by States

NASA Astrophysics Data System (ADS)

Shair, Syazreen Niza; Yusof, Aida Yuzi; Asmuni, Nurin Haniah

2017-05-01

Coherent mortality forecasting models have recently received increasing attention particularly in their application to sub-populations. The advantage of coherent models over independent models is the ability to forecast a non-divergent mortality for two or more sub-populations. One of the coherent models was recently developed by [1] known as the product-ratio model. This model is an extension version of the functional independent model from [2]. The product-ratio model has been applied in a developed country, Australia [1] and has been extended in a developing nation, Malaysia [3]. While [3] accounted for coherency of mortality rates between gender and ethnic group, the coherency between states in Malaysia has never been explored. This paper will forecast the mortality rates of Malaysian sub-populations according to states using the product ratio coherent model and its independent version— the functional independent model. The forecast accuracies of two different models are evaluated using the out-of-sample error measurements— the mean absolute forecast error (MAFE) for age-specific death rates and the mean forecast error (MFE) for the life expectancy at birth. We employ Malaysian mortality time series data from 1991 to 2014, segregated by age, gender and states.

42 CFR 413.232 - Low-volume adjustment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Low-volume adjustment. 413.232 Section 413.232... Disease (ESRD) Services and Organ Procurement Costs § 413.232 Low-volume adjustment. (a) CMS adjusts the base rate for low-volume ESRD facilities, as defined in paragraph (b) of this section. (b) Definition...

42 CFR 413.232 - Low-volume adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Low-volume adjustment. 413.232 Section 413.232... Disease (ESRD) Services and Organ Procurement Costs § 413.232 Low-volume adjustment. (a) CMS adjusts the base rate for low-volume ESRD facilities, as defined in paragraph (b) of this section. (b) Definition...

Crude and intrinsic birth rates for Asian countries.

PubMed

Rele, J R

1978-01-01

An attempt to estimate birth rates for Asian countries. The main sources of information in developing countries has been census age-sex distribution, although inaccuracies in the basic data have made it difficult to reach a high degree of accuracy. Different methods bring widely varying results. The methodology presented here is based on the use of the conventional child-woman ratio from the census age-sex distribution, with a rough estimate of the expectation of life at birth. From the established relationships between child-woman ratio and the intrinsic birth rate of the nature y = a + bx + cx(2) at each level of life expectation, the intrinsic birth rate is first computed using coefficients already computed. The crude birth rate is obtained using the adjustment based on the census age-sex distribution. An advantage to this methodology is that the intrinsic birth rate, normally an involved computation, can be obtained relatively easily as a biproduct of the crude birth rates and the bases for the calculations for each of 33 Asian countries, in some cases over several time periods.

External Validation of a Case-Mix Adjustment Model for the Standardized Reporting of 30-Day Stroke Mortality Rates in China

PubMed Central

Yu, Ping; Pan, Yuesong; Wang, Yongjun; Wang, Xianwei; Liu, Liping; Ji, Ruijun; Meng, Xia; Jing, Jing; Tong, Xu; Guo, Li; Wang, Yilong

2016-01-01

Background and Purpose A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke. Methods The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson’s correlation coefficient. Results The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79–0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81–0.84). Excellent calibration was reported in the two models with Pearson’s correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). Conclusions The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke. PMID:27846282

External Validation of a Case-Mix Adjustment Model for the Standardized Reporting of 30-Day Stroke Mortality Rates in China.

PubMed

Yu, Ping; Pan, Yuesong; Wang, Yongjun; Wang, Xianwei; Liu, Liping; Ji, Ruijun; Meng, Xia; Jing, Jing; Tong, Xu; Guo, Li; Wang, Yilong

2016-01-01

A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke. The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson's correlation coefficient. The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79-0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81-0.84). Excellent calibration was reported in the two models with Pearson's correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke.

Age dependent sex disproportion in US asthma hospitalization rates, 2000-2010.

PubMed

Lin, Robert Yao-wen; Ji, Rong; Liao, William

2013-09-01

Age-stratified sex differences in asthma hospitalizations rates have been reported to be most marked between the ages of 40 and 54 years in New York. It is not known whether age-dependent sex differences in asthma hospitalization rates also exist for the entire United States. To compare sex-specific hospitalization rates for asthma in adults in the United States and to describe the adjusted associations between female sex and age in the fifth to sixth decades of life. The National Inpatient Sample databases for 2000-2010 were queried for a principal diagnosis of asthma to calculate the ratio of female to male hospitalization rates for different decades of adult life. Logistic regression modeling was used to determine whether age in the fifth to sixth decades of life had associations with female sex that remained significant after adjusting for comorbidities and demographic features. For all years of the study, there was a distinct peaking in female to male ratio most manifested in the fifth to sixth decades of life. This age grouping was significantly associated with female sex. Models revealed that female sex was significantly associated with this age grouping, even after adjustment for obesity, chronic obstructive pulmonary disease, race, insurance status, discharge year, and smoking. Excluding identifiable repeat admissions also did not abrogate the age grouping association. There is a striking propensity of women in their fifth to sixth decades of life to be admitted for asthma, which appears to be independent of many known comorbidities. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

12 CFR 615.5330 - Minimum surplus ratios.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) and weighted on the basis of risk in accordance with § 615.5210. (b) Core surplus. (1) Each institution shall achieve and at all times maintain a ratio of core surplus to the risk-adjusted asset base of... otherwise includible pursuant to § 615.5301(b). (2) Each association shall compute its core surplus ratio by...

Projecting School Psychology Staffing Needs Using a Risk-Adjusted Model.

ERIC Educational Resources Information Center

Stellwagen, Kurt

A model is proposed to project optimal school psychology service ratios based upon the percentages of at risk students enrolled within a given school population. Using the standard 1:1,000 service ratio advocated by The National Association of School Psychologists (NASP) as a starting point, ratios are then adjusted based upon the size of three…

Solid-state YVO4/Nd:YVO4/KTP green laser system for the generation of subnanosecond pulses with adjustable kilohertz repetition rate.

PubMed

Zhang, Haijuan; Zhao, Shengzhi; Yang, Kejian; Li, Guiqiu; Li, Dechun; Zhao, Jia; Wang, Yonggang

2013-09-20

A solid-state green laser generating subnanosecond pulses with adjustable kilohertz repetition rate is presented. This pulse laser system is composed of a Q-switched and mode-locked YVO(4)/Nd:YVO(4)/KTP laser simultaneously modulated by an electro-optic (EO) modulator and a central semiconductor saturable absorption mirror. Because the repetition rate of the Q-switched envelope in this laser depends on the modulation frequency of the EO modulator, so long as the pulsewidth of the Q-switched envelope is shorter than the cavity roundtrip transmit time, i.e., the time interval of two neighboring mode-locking pulses, only one mode-locking pulse exists underneath a Q-switched envelope, resulting in the generation of subnanosecond pulses with kilohertz repetition rate. The experimental results show that the pulsewidth of subnanosecond pulses decreases with increasing pump power and the shortest pulse generated at 1 kHz was 450 ps with pulse energy as high as 252 μJ, corresponding to a peak power of 560 kW. In addition, this laser was confirmed to have high stability, and the pulse repetition rate could be freely adjusted from 1 to 4 kHz.

Approaches of aroma extraction dilution analysis (AEDA) for headspace solid phase microextraction and gas chromatography-olfactometry (HS-SPME-GC-O): Altering sample amount, diluting the sample or adjusting split ratio?

PubMed

Feng, Yunzi; Cai, Yu; Sun-Waterhouse, Dongxiao; Cui, Chun; Su, Guowan; Lin, Lianzhu; Zhao, Mouming

2015-11-15

Aroma extract dilution analysis (AEDA) is widely used for the screening of aroma-active compounds in gas chromatography-olfactometry (GC-O). In this study, three aroma dilution methods, (I) using different test sample volumes, (II) diluting samples, and (III) adjusting the GC injector split ratio, were compared for the analysis of volatiles by using HS-SPME-AEDA. Results showed that adjusting the GC injector split ratio (III) was the most desirable approach, based on the linearity relationships between Ln (normalised peak area) and Ln (normalised flavour dilution factors). Thereafter this dilution method was applied in the analysis of aroma-active compounds in Japanese soy sauce and 36 key odorants were found in this study. The most intense aroma-active components in Japanese soy sauce were: ethyl 2-methylpropanoate, ethyl 2-methylbutanoate, ethyl 3-methylbutanoate, ethyl 4-methylpentanoate, 3-(methylthio)propanal, 1-octen-3-ol, 2-methoxyphenol, 4-ethyl-2-methoxyphenol, 2-methoxy-4-vinylphenol, 2-phenylethanol, and 4-hydroxy-5-ethyl-2-methyl-3(2H)-furanone. Copyright © 2015. Published by Elsevier Ltd.

Seamless Data-Rate Change Using Punctured Convolutional Codes for Time-Varying Signal-to-Noise Ratios

NASA Astrophysics Data System (ADS)

Feria, Y.; Cheung, K.-M.

1994-10-01

In a time-varying signal-to-noise ratio (SNR) environment, symbol rate is often changed to maximize data return. However, the symbol-rate change has some undesirable effects, such as changing the transmission bandwidth and perhaps causing the receiver symbol loop to lose lock temporarily, thus losing some data. In this article, we are proposing an alternate way of varying the data rate without changing the symbol rate and, therefore, the transmission bandwidth. The data rate change is achieved in a seamless fashion by puncturing the convolutionally encoded symbol stream to adapt to the changing SNR environment. We have also derived an exact expression to enumerate the number of distinct puncturing patterns. To demonstrate this seamless rate-change capability, we searched for good puncturing patterns for the Galileo (14,1/4) convolutional code and changed the data rates by using the punctured codes to match the Galileo SNR profile of November 9, 1997. We show that this scheme reduces the symbol-rate changes from nine to two and provides a comparable data return in a day and a higher symbol SNR during most of the day.

Epidemiology of perforated peptic ulcer: Age- and gender-adjusted analysis of incidence and mortality

PubMed Central

Thorsen, Kenneth; Søreide, Jon Arne; Kvaløy, Jan Terje; Glomsaker, Tom; Søreide, Kjetil

2013-01-01

AIM: To investigate the epidemiological trends in incidence and mortality of perforated peptic ulcer (PPU) in a well-defined Norwegian population. METHODS: A retrospective, population-based, single-center, consecutive cohort study of all patients diagnosed with benign perforated peptic ulcer. Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010. Ulcers with a malignant neoplasia diagnosis, verified by histology after biopsy or resection, were excluded. Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes (K25.1, K25.2, K25.5, K25.6, K26.1, K26.2, K26.5, K26.6). Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures (e.g., JDA 60, JDA 61, JDH 70 and JDH 71) were performed to enable a complete identification of all patients. Patient demographics, presentation patterns and clinical data were retrieved from hospital records and surgical notes. Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. RESULTS: In the study period, a total of 172 patients with PPU were identified. The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year (95%CI: 5.6-7.6) and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year (95%CI: 0.7-1.6). A non-significant decline in adjusted incidence rate from 9.7 to 5.6 occurred during the decade. The standardized mortality ratio for the whole study period was 5.7 (95%CI: 3.9-8.2), while the total 30-d mortality was 16.3%. No difference in incidence or mortality was found between genders. However, for patients ≥ 60 years, the incidence increased over 10-fold, and mortality more than 50-fold, compared to younger ages. The admission rates outside office hours were high with almost two out of three (63%) admissions seen at evening

Epidemiology of perforated peptic ulcer: age- and gender-adjusted analysis of incidence and mortality.

PubMed

Thorsen, Kenneth; Søreide, Jon Arne; Kvaløy, Jan Terje; Glomsaker, Tom; Søreide, Kjetil

2013-01-21

To investigate the epidemiological trends in incidence and mortality of perforated peptic ulcer (PPU) in a well-defined Norwegian population. A retrospective, population-based, single-center, consecutive cohort study of all patients diagnosed with benign perforated peptic ulcer. Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010. Ulcers with a malignant neoplasia diagnosis, verified by histology after biopsy or resection, were excluded. Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes (K25.1, K25.2, K25.5, K25.6, K26.1, K26.2, K26.5, K26.6). Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures (e.g., JDA 60, JDA 61, JDH 70 and JDH 71) were performed to enable a complete identification of all patients. Patient demographics, presentation patterns and clinical data were retrieved from hospital records and surgical notes. Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. In the study period, a total of 172 patients with PPU were identified. The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year (95%CI: 5.6-7.6) and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year (95%CI: 0.7-1.6). A non-significant decline in adjusted incidence rate from 9.7 to 5.6 occurred during the decade. The standardized mortality ratio for the whole study period was 5.7 (95%CI: 3.9-8.2), while the total 30-d mortality was 16.3%. No difference in incidence or mortality was found between genders. However, for patients ≥ 60 years, the incidence increased over 10-fold, and mortality more than 50-fold, compared to younger ages. The admission rates outside office hours were high with almost two out of three (63%) admissions seen at evening/night time shifts and/or during

[The mechanical properties and moisture permeability of eudragit L100/S100 free films affected by plasticizers and membrane materials ratio].

PubMed

Zhang, Guo-song; Feng, Chuan-hua; Jiang, Wei; Hu, Peng-yi; Deng, Ping; Zhang, Yao; Luo, Xiao-jian

2011-09-01

The free membrane of Eudragit L100/S100 which is pH-sensitive, colon-specific was prepared by plane casting films. The film humidity, species and amount of plasticizers, the ratio of membrane material was investigated. The rate of membrane permeability and mechanical properties were used as indicators of orthogonal experiment, and its related properties were studied. The results show that the mechanical properties of the membrane and phragmoid capacity are the best when 30% TEC was used as plasticizer; the ratio of membrane material have little effect on the rate of membrane permeability and mechanical properties. By adjusting the species and amount of plasticizers, the ratio of Eudragit L100/S100, the free membrane which is colon-specific can be obtained.

Sexual orientation and self-rated health: the role of social capital, offence, threat of violence, and violence.

PubMed

Axelsson, Jakob; Modén, Birgit; Rosvall, Maria; Lindström, Martin

2013-07-01

To study the association between sexual orientation and self-rated health, including trust, offence, threat of violence, and violence. DESIGN/SETTING/PARTICIPANTS/MEASUREMENT: The 2008 Public Health Survey in Skåne is a cross-sectional postal questionnaire study. A total of 28,198 persons aged 18-80 years responded (55%). Logistic regressions analysed the association between sexual orientation and self-rated health. 27.4% of all men and 30.0% of all women rated their health as poor. Poor self-rated health was significantly more prevalent in higher age, among immigrants, people with lower education, low social support, low trust, experience of being offended, experience of threat of violence and violence, and bisexual and other orientation. Homosexual and bisexual men and women had higher age-adjusted odds ratios of having felt offended compared to heterosexual respondents. The odds ratios of low trust, threat of violence (men), and experience of violence (women) were significant for respondents with bisexual orientation but not for respondents with homosexual orientation. In the age-adjusted model, no significant association was observed between homosexual orientation and poor self-rated health among women. All other associations between sexual orientation and health were significant in the age-adjusted model but non-significant in the multiple models. Associations between sexual orientation and health disappear after multiple adjustments including trust and experience of offence, threat of violence, and violence. The study suggests that the group with bisexual orientation seems to be more exposed to low social capital (trust), threat of violence, and violence than the group with homosexual orientation.

Structural adjustments in resprouting trees drive differences in post-fire transpiration.

PubMed

Nolan, Rachael H; Mitchell, Patrick J; Bradstock, Ross A; Lane, Patrick N J

2014-02-01

Following disturbance many woody species are capable of resprouting new foliage, resulting in a reduced leaf-to-sapwood area ratio and altered canopy structure. We hypothesized that such changes would promote adjustments in leaf physiology, resulting in higher rates of transpiration per unit leaf area, consistent with the mechanistic framework proposed by Whitehead et al. (Whitehead D, Jarvis PG, Waring RH (1984) Stomatal conductance, transpiration and resistance to water uptake in a Pinus sylvestris spacing experiment. Can J For Res 14:692-700). We tested this in Eucalyptus obliqua L'Hér following a wildfire by comparing trees with unburnt canopies with trees that had been subject to 100% canopy scorch and were recovering their leaf area via resprouting. In resprouting trees, foliage was distributed along the trunk and on lateral branches, resulting in shorter hydraulic path lengths. We evaluated measurements of whole-tree transpiration and structural and physiological traits expected to drive any changes in transpiration. We used these structural and physiological measurements to parameterize the Whitehead et al. equation, and found that the expected ratio of transpiration per unit leaf area between resprouting and unburnt trees was 3.41. This is similar to the observed ratio of transpiration per unit leaf area, measured from sapflow observations, which was 2.89 (i.e., resprouting trees had 188% higher transpiration per unit leaf area). Foliage at low heights (<2 m) was found to be significantly different to foliage in the tree crown (14-18 m) in a number of traits, including higher specific leaf area, midday leaf water potential and higher rates of stomatal conductance and photosynthesis. We conclude that these post-fire adjustments in resprouting trees help to drive increased stomatal conductance and hydraulic efficiency, promoting the rapid return of tree-scale transpiration towards pre-disturbance levels. These transient patterns in canopy transpiration have

Postmyelography headache rates with Whitacre versus Quincke 22-gauge spinal needles.

PubMed

Peterman, S B

1996-09-01

To compare the postdural puncture headache (PDPH) rates after myelography with use of 22-gauge Whitacre (blunt tip) versus standard 22-gauge Quincke (bevel-tip) spinal needles. At myelography, 340 patients were randomly assigned to one of two groups in which either the Whitacre (167 patients) or the Quincke (173 patients) needle was used. Follow-up was at 48 hours and at 4 days after the procedure. Crude and adjusted Whitacre/PDPH odds ratios and risk ratios were calculated. The crude Whitacre needle PDPH risk was 9.6%, and the crude Quincke needle PDPH risk was 15.6%. The absolute risk difference was 6.0% with a 95% confidence interval of -0.98% and 13.04%. The adjusted Whitacre/PDPH odds ratio was 0.492 with a 95% confidence interval of 0.241 and 1.003. The Whitacre needle group had a statistically significantly lower PDPH severity grade (P = .0151), similar PDPH duration, and more technical difficulty with the needle. The Whitacre needle is associated with an equal or lower PDPH risk; the lack of statistical significance is most likely related to sample size. Further study is necessary to determine whether the decreased PDPH rate justifies the added difficulty associated with use of the Whitacre needle.

A poly(glycerol sebacate)-coated mesoporous bioactive glass scaffold with adjustable mechanical strength, degradation rate, controlled-release and cell behavior for bone tissue engineering.

PubMed

Lin, Dan; Yang, Kai; Tang, Wei; Liu, Yutong; Yuan, Yuan; Liu, Changsheng

2015-07-01

Various requirements in the field of tissue engineering have motivated the development of three-dimensional scaffold with adjustable physicochemical properties and biological functions. A series of multiparameter-adjustable mesoporous bioactive glass (MBG) scaffolds with uncrosslinked poly(glycerol sebacate) (PGS) coating was prepared in this article. MBG scaffold was prepared by a modified F127/PU co-templating process and then PGS was coated by a simple adsorption and lyophilization process. Through controlling macropore parameters and PGS coating amount, the mechanical strength, degradation rate, controlled-release and cell behavior of the composite scaffold could be modulated in a wide range. PGS coating successfully endowed MBG scaffold with improved toughness and adjustable mechanical strength covering the bearing range of trabecular bone (2-12MPa). Multilevel degradation rate of the scaffold and controlled-release rate of protein from mesopore could be achieved, with little impact on the protein activity owing to an "ultralow-solvent" coating and "nano-cavity entrapment" immobilization method. In vitro studies indicated that PGS coating promoted cell attachment and proliferation in a dose-dependent manner, without affecting the osteogenic induction capacity of MBG substrate. These results first provide strong evidence that uncrosslinked PGS might also yield extraordinary achievements in traditional MBG scaffold. With the multiparameter adjustability, the composite MBG/PGS scaffolds would have a hopeful prospect in bone tissue engineering. The design considerations and coating method of this study can also be extended to other ceramic-based artificial scaffolds and are expected to provide new thoughts on development of future tissue engineering materials. Copyright © 2015 Elsevier B.V. All rights reserved.

Demonization of Divorce: Prevalence Rates and Links to Postdivorce Adjustment

ERIC Educational Resources Information Center

Krumrei, Elizabeth J.; Mahoney, Annette; Pargament, Kenneth I.

2011-01-01

The meaning-making process can be crucial to individuals as they adjust to their divorce. Demonization is a negative coping response (also known as spiritual struggle) that involves appraising someone or something as related to demonic forces. Individuals may cognitively frame a divorce as the work of Satan in order to understand suffering while…

Comparison of Physician-, Biomarker-, and Symptom-Based Strategies for Adjustment of Inhaled Corticosteroid Therapy in Adults With Asthma

PubMed Central

Calhoun, William J.; Ameredes, Bill T.; King, Tonya S.; Icitovic, Nikolina; Bleecker, Eugene R.; Castro, Mario; Cherniack, Reuben M.; Chinchilli, Vernon M.; Craig, Timothy; Denlinger, Loren; DiMango, Emily A.; Engle, Linda L.; Fahy, John V.; Grant, J. Andrew; Israel, Elliot; Jarjour, Nizar; Kazani, Shamsah D.; Kraft, Monica; Kunselman, Susan J.; Lazarus, Stephen C.; Lemanske, Robert F.; Lugogo, Njira; Martin, Richard J.; Meyers, Deborah A.; Moore, Wendy C.; Pascual, Rodolfo; Peters, Stephen P.; Ramsdell, Joe; Sorkness, Christine A.; Sutherland, E. Rand; Szefler, Stanley J.; Wasserman, Stephen I.; Walter, Michael J.; Wechsler, Michael E.; Boushey, Homer A.

2013-01-01

Context No consensus exists for adjusting inhaled corticosteroid therapy in patients with asthma. Approaches include adjustment at outpatient visits guided by physician assessment of asthma control (symptoms, rescue therapy, pulmonary function), based on exhaled nitric oxide, or on a day-to-day basis guided by symptoms. Objective To determine if adjustment of inhaled corticosteroid therapy based on exhaled nitric oxide or day-to-day symptoms is superior to guideline-informed, physician assessment–based adjustment in preventing treatment failure in adults with mild to moderate asthma. Design, Setting, and Participants A randomized, parallel, 3-group, placebo-controlled, multiply-blinded trial of 342 adults with mild to moderate asthma controlled by low-dose inhaled corticosteroid therapy (n=114 assigned to physician assessment–based adjustment [101 completed], n=115 to biomarker-based [exhaled nitric oxide] adjustment [92 completed], and n=113 to symptom-based adjustment [97 completed]), the Best Adjustment Strategy for Asthma in the Long Term (BASALT) trial was conducted by the Asthma Clinical Research Network at 10 academic medical centers in the United States for 9 months between June 2007 and July 2010. Interventions For physician assessment–based adjustment and biomarker-based (exhaled nitric oxide) adjustment, the dose of inhaled corticosteroids was adjusted every 6 weeks; for symptom-based adjustment, inhaled corticosteroids were taken with each albuterol rescue use. Main Outcome Measure The primary outcome was time to treatment failure. Results There were no significant differences in time to treatment failure. The 9-month Kaplan-Meier failure rates were 22% (97.5% CI, 14%-33%; 24 events) for physician assessment–based adjustment, 20% (97.5% CI, 13%-30%; 21 events) for biomarker-based adjustment, and 15% (97.5% CI, 9%-25%; 16 events) for symptom-based adjustment. The hazard ratio for physician assessment–based adjustment vs biomarker

Long-chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery calcification in Japanese in Japan and United States whites – population-based prospective cohort study

PubMed Central

Sekikawa, Akira; Miura, Katsuyuki; Lee, Sunghee; Fujiyoshi, Akira; Edmundowicz, Daniel; Kadowaki, Takashi; Evans, Rhobert W.; Kadowaki, Sayaka; Sutton-Tyrrell, Kim; Okamura, Tomonori; Bertolet, Marnie; Masaki, Kamal H.; Nakamura, Yasuyuki; Barinas-Mitchell, Emma J. M.; Willcox, Bradley J.; Kadota, Aya; Seto, Todd B.; Maegawa, Hiroshi; Kuller, Lewis H.; Ueshima, Hirotsugu

2014-01-01

Objective To determine whether serum levels of long-chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in incidence rate of coronary artery calcification (CAC) between Japanese in Japan and U.S. whites. Methods In a population-based prospective-cohort study, 214 Japanese and 152 white men aged 40–49 years at baseline (2002–2006) with coronary calcium score (CCS) = 0 were reexamined for CAC in 2007–2010. Among these, 175 Japanese and 113 whites participated in the follow-up exam. Incident cases were defined as participants with CCS ≥ 10 at follow-up. A relative risk regression analysis was used to model incidence rate ratio between Japanese and whites. The incidence rate ratio was first adjusted for potential confounders at baseline and then further adjusted for serum LCn3PUFAs at baseline. Results Mean (standard deviation) serum percentage of LCn3PUFA was > 100% higher in Japanese than in whites (9.08 (2.49) versus 3.84 (1.79), respectively, p<0.01). Japanese had a significantly lower incidence rate of CAC compared to whites (0.9 versus 2.9/100 person-years, respectively, p < 0.01). Incidence rate ratio of CAC taking follow-up time into account between Japanese and white men was 0.321 (95% confidence interval (CI) 0.150, 0.690: p<0.01). After adjusting for age, systolic-blood pressure, low-density-lipoprotein cholesterol, diabetes, and other potential confounders, the ratio remained significant: 0.262 (95% CI: 0.094, 0.731, p=0.01). After further adjusting for LCn3PUFAs, however, the ratio was attenuated and became non-significant (0.376 (95% CI: 0.090, 1.572, p=0.18). Conclusions LCn3PUFAs significantly contributed to the difference in CAC incidence between Japanese and white men. PMID:24352736

Rates of Atrial Fibrillation in Black Versus White Patients With Pacemakers.

PubMed

Kamel, Hooman; Kleindorfer, Dawn O; Bhave, Prashant D; Cushman, Mary; Levitan, Emily B; Howard, George; Soliman, Elsayed Z

2016-02-12

Black US residents experience higher rates of ischemic stroke than white residents but have lower rates of clinically apparent atrial fibrillation (AF), a strong risk factor for stroke. It is unclear whether black persons truly have less AF or simply more undiagnosed AF. We obtained administrative claims data from state health agencies regarding all emergency department visits and hospitalizations in California, Florida, and New York. We identified a cohort of patients with pacemakers, the regular interrogation of which reduces the likelihood of undiagnosed AF. We compared rates of documented AF or atrial flutter at follow-up visits using Kaplan-Meier survival statistics and Cox proportional hazards models adjusted for demographic characteristics and vascular risk factors. We identified 10 393 black and 91 380 white patients without documented AF or atrial flutter before or at the index visit for pacemaker implantation. During 3.7 (±1.8) years of follow-up, black patients had a significantly lower rate of AF (21.4%; 95% CI 19.8-23.2) than white patients (25.5%; 95% CI 24.9-26.0). After adjustment for demographic characteristics and comorbidities, black patients had a lower hazard of AF (hazard ratio 0.91; 95% CI 0.86-0.96), a higher hazard of atrial flutter (hazard ratio 1.29; 95% CI 1.11-1.49), and a lower hazard of the composite of AF or atrial flutter (hazard ratio 0.94; 95% CI 0.88-99). In a population-based sample of patients with pacemakers, black patients had a lower rate of AF compared with white patients. These findings indicate that the persistent racial disparities in rates of ischemic stroke are likely to be related to factors other than undiagnosed AF. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Applying the compound Poisson process model to the reporting of injury-related mortality rates.

PubMed

Kegler, Scott R

2007-02-16

Injury-related mortality rate estimates are often analyzed under the assumption that case counts follow a Poisson distribution. Certain types of injury incidents occasionally involve multiple fatalities, however, resulting in dependencies between cases that are not reflected in the simple Poisson model and which can affect even basic statistical analyses. This paper explores the compound Poisson process model as an alternative, emphasizing adjustments to some commonly used interval estimators for population-based rates and rate ratios. The adjusted estimators involve relatively simple closed-form computations, which in the absence of multiple-case incidents reduce to familiar estimators based on the simpler Poisson model. Summary data from the National Violent Death Reporting System are referenced in several examples demonstrating application of the proposed methodology.

Simulating the impact of case-mix adjusted hospice rates.

PubMed

Mor, V; Laliberte, L

1986-01-01

The Medicare hospice benefit prospectively reimburses hospices based on the inpatient status of the patient, whether or not the patient is at home, and whether the patient is receiving round-the-clock nursing. Using national Hospice Study data, two case-mix adjusters based on patient functioning and living arrangement were found to be significantly related to per diem cost. These were tested by simulating their impact on hospice revenues. Increasing per diem reimbursements 35 percent for nonambulatory patients living alone only increases hospice revenues by 4 percent; hospices with sicker patients benefit the most.

Performance of high-area-ratio annular dump diffuser using suction-stabilized-vortex flow control

NASA Technical Reports Server (NTRS)

Juhasz, A. J.; Smith, J. M.

1977-01-01

A short annular dump diffuser having a geometry conductive to formation of suction stabilized toroidal vortices in the region of abrupt area change was tested. The overall diffuser area ratio was 4.0 and the length to inlet height ratio was 2.0. Performance data were obtained at near ambient temperature and pressure for inlet Mach numbers of 0.18 and 0.30 with suction rates ranging from 0 to 18 percent of total inlet mass flowrate. Results show that the exit velocity profile could be readily biased toward either wall by adjustment of inner and outer wall suction rates. Symmetric exit velocity profiles were inherently unstable with a tendency to revert to a hub or tip bias. Diffuser effectiveness was increased from about 38 percent without suction to over 85 percent at a total suction rate of 10 to 12 percent. At the same time diffuser total pressure loss was reduced from 3.1 percent to 1.1 percent at an inlet Mach number of 0.3.

Readmission Rates and Long-Term Hospital Costs Among Survivors of In-Hospital Cardiac Arrest

PubMed Central

Chan, Paul S.; Nallamothu, Brahmajee K.; Krumholz, Harlan M.; Curtis, Lesley H.; Li, Yan; Hammill, Bradley G.; Spertus, John A.

2014-01-01

Background Although in-hospital cardiac arrest is common, little is known about readmission patterns and inpatient resource use among survivors of in-hospital cardiac arrest. Methods and Results Within a large national registry, we examined long-term inpatient utilization among 6972 adults ≥65 years who survived an in-hospital cardiac arrest. We examined 30-day and 1-year readmission rates and inpatient costs, overall and by patient demographics, hospital disposition (discharge destination), and neurological status at discharge. The mean age was 75.8 ± 7.0 years, 56% were men, and 12% were black. There were a total of 2005 readmissions during the first 30 days (cumulative incidence rate: 35 readmissions/100 patients [95% CI: 33–37]) and 8751 readmissions at 1 year (cumulative incidence rate: 185 readmissions/100 patients [95% CI: 177–190]). Overall, mean inpatient costs were $7,741 ± $2323 at 30 days and $18,629 ± $9411 at 1 year. Thirty-day inpatient costs were higher in patients of younger age (≥85 years: $6052 [reference]; 75–84 years: $7444 [adjusted cost ratio, 1.23 [1.06–1.42]; 65–74 years: $8291 [adjusted cost ratio, 1.37 [1.19–1.59]; both P<0.001]) and black race (whites: $7413; blacks: $9044; adjusted cost ratio, 1.22 [1.05–1.42]; P<0.001), as well as those discharged with severe neurological disability or to skilled nursing or rehabilitation facilities. These differences in resource use persisted at 1 year and were largely due to higher readmission rates. Conclusion Survivors of in-hospital cardiac arrest have frequent readmissions and high follow-up inpatient costs. Readmissions and inpatient costs were higher in certain subgroups, including patients of younger age and black race. PMID:25351479

75 FR 4592 - January 2010 Pay Adjustments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... OFFICE OF PERSONNEL MANAGEMENT January 2010 Pay Adjustments AGENCY: U.S. Office of Personnel Management. ACTION: Notice. SUMMARY: The President adjusted the rates of basic pay and locality payments for certain categories of Federal employees effective in January 2010. This notice documents those pay...

Survival After Rate-Responsive Programming in Patients With Cardiac Resynchronization Therapy-Defibrillator Implants Is Associated With a Novel Parameter: The Heart Rate Score.

PubMed

Olshansky, Brian; Richards, Mark; Sharma, Arjun; Wold, Nicholas; Jones, Paul; Perschbacher, David; Wilkoff, Bruce L

2016-08-01

Rate-responsive pacing (DDDR) versus nonrate-responsive pacing (DDD) has shown no survival benefit for patients undergoing cardiac resynchronization therapy defibrillator (CRT-D) implants. The heart rate score (HRSc), an indicator of heart rate variation, may predict survival. We hypothesized that high-risk HRSc CRT-D patients will have improved survival with DDDR versus DDD alone. All CRT-D patients in LATITUDE remote monitoring (2006-2011), programmed DDD, had HRSc calculated at first data upload after implant (median 1.4 months). Patients subsequently reprogrammed to DDDR 7.6 median months later were compared with a propensity-matched DDD group and followed for 21.4 median months by remote monitoring. Data were adjusted for age, sex, lower rate limit, percent atrial pacing, percent biventricular pacing, and implant year. The social security death index was used to identify deaths. Remote monitoring provided programming and histogram data. DDDR programming in CRT-D patients was associated with improved survival (adjusted hazard ratio =0.77; P<0.001). However, only those with baseline HRSc ≥70% (2308/6164) had improved HRSc with DDDR (from 88±9% to 78±15%; P<0.001) and improved survival (hazard ratio =0.74; P<0.001). Patients with a high baseline HRSc and significant improvement over time were more likely to survive (hazard ratio =0.63; P=0.006). For patients with HRSc <70%, DDDR reprogramming increased the HRSc from 46±11% to 50±15% (P<0.001); survival did not change. The HRSc did not change with DDD pacing over time. In CRT-D patients with HRSc ≥70%, DDDR reprogramming improved the HRSc and was associated with survival. Patients with lower HRSc had no change in survival with DDDR programming. © 2016 American Heart Association, Inc.

A comparative study of adjustable and non-adjustable sutures in primary horizontal muscle surgery in children

PubMed Central

Kamal, A M; Abozeid, D; Seif, Y; Hassan, M

2016-01-01

Purpose To compare the results of using adjustable and non-adjustable sutures in primary horizontal strabismus surgeries in children. Methods This randomized control trial included 60 cases of primary horizontal deviation. The adjustable suture (AS) group included 30 patients, and the non-adjustable suture (NAS) group included 30 patients. The follow-up period was at least 6 months. A successful motor outcome was defined as orthophoria or a horizontal tropia of 8 PD or less at both near and far distances. The success rate and ocular drift were recorded and analysed. Results The mean age in the AS group was 3.48±2.37 years at the time of surgery. The mean age in the NAS group was 3.55±2.64 years at the time of surgery. The success rate at the end of 6 months was 86.67% in the AS group and 73.33% in the NAS group (P=0.197). In exotropic patients, there was a mean undercorrection drift of 2.86 PD in the AS group and a mean undercorrection drift of 2.17 PD in the NAS group. In esotropic patients, there was a mean undercorrection drift of 0.26 PD in the AS group and a mean undercorrection drift of 1.83 PD in the NAS group. Conclusion There was no significant difference between the groups. However, the success rate was clinically higher in the AS group than in the NAS group. PMID:27419838

Use of Prolonged Travel to Improve Pediatric Risk-Adjustment Models

PubMed Central

Lorch, Scott A; Silber, Jeffrey H; Even-Shoshan, Orit; Millman, Andrea

2009-01-01

Objective To determine whether travel variables could explain previously reported differences in lengths of stay (LOS), readmission, or death at children's hospitals versus other hospital types. Data Source Hospital discharge data from Pennsylvania between 1996 and 1998. Study Design A population cohort of children aged 1–17 years with one of 19 common pediatric conditions was created (N=51,855). Regression models were constructed to determine difference for LOS, readmission, or death between children's hospitals and other types of hospitals after including five types of additional illness severity variables to a traditional risk-adjustment model. Principal Findings With the traditional risk-adjustment model, children traveling longer to children's or rural hospitals had longer adjusted LOS and higher readmission rates. Inclusion of either a geocoded travel time variable or a nongeocoded travel distance variable provided the largest reduction in adjusted LOS, adjusted readmission rates, and adjusted mortality rates for children's hospitals and rural hospitals compared with other types of hospitals. Conclusions Adding a travel variable to traditional severity adjustment models may improve the assessment of an individual hospital's pediatric care by reducing systematic differences between different types of hospitals. PMID:19207591

[Relationship between assertiveness including consideration for others and adjustment in children].

PubMed

Eguchi, Megumi; Hamaguchi, Yoshikazu

2012-06-01

The relationship between assertiveness and internal and external adjustment was investigated. Elementary school children in grades four to six (n=207) and their classroom teachers (n=8) participated in the study. Internal and external adjustments were measured by using self-ratings, and self- and other- ratings respectively. The children responded to a questionnaires inquiring about assertiveness that included two components of assessment: "self expression" and "consideration for others". Then, the children were divided into 4 groups according to their scores on these two components of assertiveness. The results indicated that children scoring high on both components of assertiveness had higher self-rating scores than those scoring low on both components. Moreover, children that scored high on "consideration for others" tended to have high external adjustment. Also, boys that scored low on "self expression" had lower external adjustment as indicated by the negative ratings of teachers. Furthermore, girls that scored high on "consideration for others" had high external adjustment as indicated by positive ratings of teachers and same-sexed classmates.

Challenges in assessing hospital-level stroke mortality as a quality measure: comparison of ischemic, intracerebral hemorrhage, and total stroke mortality rates.

PubMed

Xian, Ying; Holloway, Robert G; Pan, Wenqin; Peterson, Eric D

2012-06-01

Public reporting efforts currently profile hospitals based on overall stroke mortality rates, yet the "mix" of hemorrhagic and ischemic stroke cases may impact this rate. Using the 2005 to 2006 New York state data, we examined the degree to which hospital stroke mortality rankings varied regarding ischemic versus hemorrhagic versus total stroke. Observed/expected ratio was calculated using the Agency for Healthcare Research and Quality Inpatient Quality Indicator software. The observed/expected ratio and outlier status based on stroke types across hospitals were examined using Pearson correlation coefficients (r) and weighted κ. Overall 30-day stroke mortality rates were 15.2% and varied from 11.3% for ischemic stroke and 37.3% for intracerebral hemorrhage. Hospital risk-adjusted ischemic stroke observed/expected ratio was weakly correlated with its own intracerebral hemorrhage observed/expected ratio (r=0.38). When examining hospital performance group (mortality better, worse, or no different than average), disagreement was observed in 35 of 81 hospitals (κ=0.23). Total stroke mortality observed/expected ratio and rankings were correlated with intracerebral hemorrhage (r=0.61 and κ=0.36) and ischemic stroke (r=0.94 and κ=0.71), but many hospitals still switched classification depending on mortality metrics. However, hospitals treating a higher percent of hemorrhagic stroke did not have a statistically significant higher total stroke mortality rate relative to those treating fewer hemorrhagic strokes. Hospital stroke mortality ratings varied considerably depending on whether ischemic, hemorrhagic, or total stroke mortality rates were used. Public reporting of stroke mortality measures should consider providing risk-adjusted outcome on separate stroke types.

Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis.

PubMed

Nitsch, Dorothea; Grams, Morgan; Sang, Yingying; Black, Corri; Cirillo, Massimo; Djurdjev, Ognjenka; Iseki, Kunitoshi; Jassal, Simerjot K; Kimm, Heejin; Kronenberg, Florian; Oien, Cecilia M; Levey, Andrew S; Levin, Adeera; Woodward, Mark; Hemmelgarn, Brenda R

2013-01-29

To assess for the presence of a sex interaction in the associations of estimated glomerular filtration rate and albuminuria with all-cause mortality, cardiovascular mortality, and end stage renal disease. Random effects meta-analysis using pooled individual participant data. 46 cohorts from Europe, North and South America, Asia, and Australasia. 2,051,158 participants (54% women) from general population cohorts (n=1,861,052), high risk cohorts (n=151,494), and chronic kidney disease cohorts (n=38,612). Eligible cohorts (except chronic kidney disease cohorts) had at least 1000 participants, outcomes of either mortality or end stage renal disease of ≥ 50 events, and baseline measurements of estimated glomerular filtration rate according to the Chronic Kidney Disease Epidemiology Collaboration equation (mL/min/1.73 m(2)) and urinary albumin-creatinine ratio (mg/g). Risks of all-cause mortality and cardiovascular mortality were higher in men at all levels of estimated glomerular filtration rate and albumin-creatinine ratio. While higher risk was associated with lower estimated glomerular filtration rate and higher albumin-creatinine ratio in both sexes, the slope of the risk relationship for all-cause mortality and for cardiovascular mortality were steeper in women than in men. Compared with an estimated glomerular filtration rate of 95, the adjusted hazard ratio for all-cause mortality at estimated glomerular filtration rate 45 was 1.32 (95% CI 1.08 to 1.61) in women and 1.22 (1.00 to 1.48) in men (P(interaction)<0.01). Compared with a urinary albumin-creatinine ratio of 5, the adjusted hazard ratio for all-cause mortality at urinary albumin-creatinine ratio 30 was 1.69 (1.54 to 1.84) in women and 1.43 (1.31 to 1.57) in men (P(interaction)<0.01). Conversely, there was no evidence of a sex difference in associations of estimated glomerular filtration rate and urinary albumin-creatinine ratio with end stage renal disease risk. Both sexes face increased risk of all

Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis

PubMed Central

Nitsch, Dorothea; Grams, Morgan; Sang, Yingying; Black, Corri; Cirillo, Massimo; Djurdjev, Ognjenka; Iseki, Kunitoshi; Jassal, Simerjot K; Kimm, Heejin; Kronenberg, Florian; Øien, Cecilia M; Levin, Adeera; Woodward, Mark; Hemmelgarn, Brenda R

2013-01-01

Objective To assess for the presence of a sex interaction in the associations of estimated glomerular filtration rate and albuminuria with all-cause mortality, cardiovascular mortality, and end stage renal disease. Design Random effects meta-analysis using pooled individual participant data. Setting 46 cohorts from Europe, North and South America, Asia, and Australasia. Participants 2 051 158 participants (54% women) from general population cohorts (n=1 861 052), high risk cohorts (n=151 494), and chronic kidney disease cohorts (n=38 612). Eligible cohorts (except chronic kidney disease cohorts) had at least 1000 participants, outcomes of either mortality or end stage renal disease of ≥50 events, and baseline measurements of estimated glomerular filtration rate according to the Chronic Kidney Disease Epidemiology Collaboration equation (mL/min/1.73 m2) and urinary albumin-creatinine ratio (mg/g). Results Risks of all-cause mortality and cardiovascular mortality were higher in men at all levels of estimated glomerular filtration rate and albumin-creatinine ratio. While higher risk was associated with lower estimated glomerular filtration rate and higher albumin-creatinine ratio in both sexes, the slope of the risk relationship for all-cause mortality and for cardiovascular mortality were steeper in women than in men. Compared with an estimated glomerular filtration rate of 95, the adjusted hazard ratio for all-cause mortality at estimated glomerular filtration rate 45 was 1.32 (95% CI 1.08 to 1.61) in women and 1.22 (1.00 to 1.48) in men (Pinteraction<0.01). Compared with a urinary albumin-creatinine ratio of 5, the adjusted hazard ratio for all-cause mortality at urinary albumin-creatinine ratio 30 was 1.69 (1.54 to 1.84) in women and 1.43 (1.31 to 1.57) in men (Pinteraction<0.01). Conversely, there was no evidence of a sex difference in associations of estimated glomerular filtration rate and urinary albumin-creatinine ratio with end stage renal

Real time ablation rate measurement during high aspect-ratio hole drilling with a 120-ps fiber laser.

PubMed

Mezzapesa, Francesco P; Sibillano, Teresa; Di Niso, Francesca; Ancona, Antonio; Lugarà, Pietro M; Dabbicco, Maurizio; Scamarcio, Gaetano

2012-01-02

We report on the instantaneous detection of the ablation rate as a function of depth during ultrafast microdrilling of metal targets. The displacement of the ablation front has been measured with a sub-wavelength resolution using an all-optical sensor based on the laser diode self-mixing interferometry. The time dependence of the laser ablation process within the depth of aluminum and stainless steel targets has been investigated to study the evolution of the material removal rate in high aspect-ratio micromachined holes.

The Effect of Adding Comorbidities to Current Centers for Disease Control and Prevention Central-Line-Associated Bloodstream Infection Risk-Adjustment Methodology.

PubMed

Jackson, Sarah S; Leekha, Surbhi; Magder, Laurence S; Pineles, Lisa; Anderson, Deverick J; Trick, William E; Woeltje, Keith F; Kaye, Keith S; Stafford, Kristen; Thom, Kerri; Lowe, Timothy J; Harris, Anthony D

2017-09-01

BACKGROUND Risk adjustment is needed to fairly compare central-line-associated bloodstream infection (CLABSI) rates between hospitals. Until 2017, the Centers for Disease Control and Prevention (CDC) methodology adjusted CLABSI rates only by type of intensive care unit (ICU). The 2017 CDC models also adjust for hospital size and medical school affiliation. We hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes. METHODS Using a cohort design across 22 hospitals, we analyzed data from ICU patients admitted between January 2012 and December 2013. Demographics and International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) discharge codes were obtained for each patient, and CLABSIs were identified by trained infection preventionists. Models adjusting only for ICU type and for ICU type plus patient case mix were built and compared using discrimination and standardized infection ratio (SIR). Hospitals were ranked by SIR for each model to examine and compare the changes in rank. RESULTS Overall, 85,849 ICU patients were analyzed and 162 (0.2%) developed CLABSI. The significant variables added to the ICU model were coagulopathy, paralysis, renal failure, malnutrition, and age. The C statistics were 0.55 (95% CI, 0.51-0.59) for the ICU-type model and 0.64 (95% CI, 0.60-0.69) for the ICU-type plus patient case-mix model. When the hospitals were ranked by adjusted SIRs, 10 hospitals (45%) changed rank when comorbidity was added to the ICU-type model. CONCLUSIONS Our risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model. The CDC should strongly consider comorbidity-based risk adjustment to more accurately compare CLABSI rates across hospitals. Infect Control Hosp Epidemiol 2017;38:1019-1024.

Simulating the impact of case-mix adjusted hospice rates

PubMed Central

Mor, Vincent; Laliberte, Linda

1986-01-01

The Medicare hospice benefit prospectively reimburses hospices based on the inpatient status of the patient, whether or not the patient is at home, and whether the patient is receiving round-the-clock nursing. Using National Hospice Study data, two case-mix adjusters based on patient functioning and living arrangement were found to be significantly related to per diem cost. These were tested by simulating their impact on hospice revenues. Increasing per diem reimbursements 35 percent for nonambulatory patients living alone only increases hospice revenues by 4 percent; hospices with sicker patients benefit the most. PMID:10312012

Effect of C/N ratio, aeration rate and moisture content on ammonia and greenhouse gas emission during the composting.

PubMed

Jiang, Tao; Schuchardt, Frank; Li, Guoxue; Guo, Rui; Zhao, Yuanqiu

2011-01-01

Gaseous emission (N2O, CH4 and NH3) from composting can be an important source of anthropogenic greenhouse gas and air pollution. A laboratory scale orthogonal experiment was conducted to estimate the effects of C/N ratio, aeration rate and initial moisture content on gaseous emission during the composting of pig faeces from Chinese Ganqinfen system. The results showed that about 23.9% to 45.6% of total organic carbon (TOC) was lost in the form of CO2 and 0.8% to 7.5% of TOC emitted as CH4. Most of the nitrogen was lost in the form of NH3, which account for 9.6% to 32.4% of initial nitrogen. N2O was also an important way of nitrogen losses and 1.5% to 7.3% of initial total nitrogen was lost as it. Statistic analysis showed that the aeration rate is the most important factor which could affect the NH3 (p = 0.0189), CH4 (p = 0.0113) and N2O (p = 0.0493) emissions significantly. Higher aeration rates reduce the CH4 emission but increase the NH3 and N2O losses. C/N ratio could affect the NH3 (p = 0.0442) and CH4 (p = 0.0246) emissions significantly, but not the N2O. Lower C/N ratio caused higher NH3 and CH4 emissions. The initial moisture content can not influence the gaseous emission significantly. Most treatments were matured after 37 days, except a trial with high moisture content and a low C/N ratio.

Increased Ratio of Electron Transport to Net Assimilation Rate Supports Elevated Isoprenoid Emission Rate in Eucalypts under Drought1[W][OPEN

PubMed Central

Dani, Kaidala Ganesha Srikanta; Jamie, Ian McLeod; Prentice, Iain Colin; Atwell, Brian James

2014-01-01

Plants undergoing heat and low-CO2 stresses emit large amounts of volatile isoprenoids compared with those in stress-free conditions. One hypothesis posits that the balance between reducing power availability and its use in carbon assimilation determines constitutive isoprenoid emission rates in plants and potentially even their maximum emission capacity under brief periods of stress. To test this, we used abiotic stresses to manipulate the availability of reducing power. Specifically, we examined the effects of mild to severe drought on photosynthetic electron transport rate (ETR) and net carbon assimilation rate (NAR) and the relationship between estimated energy pools and constitutive volatile isoprenoid emission rates in two species of eucalypts: Eucalyptus occidentalis (drought tolerant) and Eucalyptus camaldulensis (drought sensitive). Isoprenoid emission rates were insensitive to mild drought, and the rates increased when the decline in NAR reached a certain species-specific threshold. ETR was sustained under drought and the ETR-NAR ratio increased, driving constitutive isoprenoid emission until severe drought caused carbon limitation of the methylerythritol phosphate pathway. The estimated residual reducing power unused for carbon assimilation, based on the energetic status model, significantly correlated with constitutive isoprenoid emission rates across gradients of drought (r2 > 0.8) and photorespiratory stress (r2 > 0.9). Carbon availability could critically limit emission rates under severe drought and photorespiratory stresses. Under most instances of moderate abiotic stress levels, increased isoprenoid emission rates compete with photorespiration for the residual reducing power not invested in carbon assimilation. A similar mechanism also explains the individual positive effects of low-CO2, heat, and drought stresses on isoprenoid emission. PMID:25139160

Chest compression rates and survival following out-of-hospital cardiac arrest.

PubMed

Idris, Ahamed H; Guffey, Danielle; Pepe, Paul E; Brown, Siobhan P; Brooks, Steven C; Callaway, Clifton W; Christenson, Jim; Davis, Daniel P; Daya, Mohamud R; Gray, Randal; Kudenchuk, Peter J; Larsen, Jonathan; Lin, Steve; Menegazzi, James J; Sheehan, Kellie; Sopko, George; Stiell, Ian; Nichol, Graham; Aufderheide, Tom P

2015-04-01

Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions/min. A recent clinical study reported optimal return of spontaneous circulation with rates between 100 and 120/min during cardiopulmonary resuscitation for out-of-hospital cardiac arrest. However, the relationship between compression rate and survival is still undetermined. Prospective, observational study. Data is from the Resuscitation Outcomes Consortium Prehospital Resuscitation IMpedance threshold device and Early versus Delayed analysis clinical trial. Adults with out-of-hospital cardiac arrest treated by emergency medical service providers. None. Data were abstracted from monitor-defibrillator recordings for the first five minutes of emergency medical service cardiopulmonary resuscitation. Multiple logistic regression assessed odds ratio for survival by compression rate categories (<80, 80-99, 100-119, 120-139, ≥140), both unadjusted and adjusted for sex, age, witnessed status, attempted bystander cardiopulmonary resuscitation, location of arrest, chest compression fraction and depth, first rhythm, and study site. Compression rate data were available for 10,371 patients; 6,399 also had chest compression fraction and depth data. Age (mean±SD) was 67±16 years. Chest compression rate was 111±19 per minute, compression fraction was 0.70±0.17, and compression depth was 42±12 mm. Circulation was restored in 34%; 9% survived to hospital discharge. After adjustment for covariates without chest compression depth and fraction (n=10,371), a global test found no significant relationship between compression rate and survival (p=0.19). However, after adjustment for covariates including chest compression depth and fraction (n=6,399), the global test found a significant relationship between compression rate and survival (p=0.02), with the reference group (100-119 compressions/min) having the greatest likelihood for survival. After adjustment for chest

Effect of fertility on secondary sex ratio and twinning rate in Sweden, 1749-1870.

PubMed

Fellman, Johan; Eriksson, Aldur W

2015-02-01

We analyzed the effect of total fertility rate (TFR) and crude birth rate (CBR) on the number of males per 100 females at birth, also called the secondary sex ratio (SR), and on the twinning rate (TWR). Earlier studies have noted regional variations in TWR and racial differences in the SR. Statistical analyses have shown that comparisons between SRs demand large data sets because random fluctuations in moderate data are marked. Consequently, reliable results presuppose national birth data. Here, we analyzed historical demographic data and their regional variations between counties in Sweden. We built spatial models for the TFR in 1860 and the CBR in 1751-1870, and as regressors we used geographical coordinates for the provincial capitals of the counties. For both variables, we obtained significant spatial variations, albeit of different patterns and power. The SR among the live-born in 1749-1869 and the TWR in 1751-1860 showed slight spatial variations. The influence of CBR and TFR on the SR and TWR was examined and statistical significant effects were found.

The Dietary Fructose:Vitamin C Intake Ratio Is Associated with Hyperuricemia in African-American Adults.

PubMed

Zheng, Zihe; Harman, Jane L; Coresh, Josef; Köttgen, Anna; McAdams-DeMarco, Mara A; Correa, Adolfo; Young, Bessie A; Katz, Ronit; Rebholz, Casey M

2018-03-01

A high fructose intake has been shown to be associated with increased serum urate concentration, whereas ascorbate (vitamin C) may lower serum urate by competing with urate for renal reabsorption. We assessed the combined association, as the fructose:vitamin C intake ratio, and the separate associations of dietary fructose and vitamin C intakes on prevalent hyperuricemia. We conducted cross-sectional analyses of dietary intakes of fructose and vitamin C and serum urate concentrations among Jackson Heart Study participants, a cohort of African Americans in Jackson, Mississippi, aged 21-91 y. In the analytic sample (n = 4576), multivariable logistic regression was used to examine the separate associations of dietary intakes of fructose and vitamin C and the fructose:vitamin C intake ratio with prevalent hyperuricemia (serum urate ≥7 mg/dL), after adjusting for age, sex, smoking, waist circumference, systolic blood pressure, estimated glomerular filtration rate, diuretic medication use, vitamin C supplement use, total energy intake, alcohol consumption, and dietary intake of animal protein. Analyses for individual dietary factors (vitamin C, fructose) were adjusted for the other dietary factor. In the fully adjusted model, there were 17% greater odds of hyperuricemia associated with a doubling of the fructose:vitamin C intake ratio (OR: 1.17; 95% CI: 1.08, 1.28), 20% greater odds associated with a doubling of fructose intake (OR: 1.20; 95% CI: 1.08, 1.34), and 13% lower odds associated with a doubling of vitamin C intake (OR: 0.87; 95% CI: 0.78, 0.97). Dietary fructose and the fructose:vitamin C intake ratio were more strongly associated with hyperuricemia among men than women (P-interaction ≤ 0.04). Dietary intakes of fructose and vitamin C are associated with prevalent hyperuricemia in a community-based population of African Americans.

Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States.

PubMed

Chen, Han-Yang; Chauhan, Suneet P; Ananth, Cande V; Vintzileos, Anthony M; Abuhamad, Alfred Z

2011-06-01

To examine the association between electronic fetal heart rate monitoring and neonatal and infant mortality, as well as neonatal morbidity. We used the United States 2004 linked birth and infant death data. Multivariable log-binomial regression models were fitted to estimate risk ratio for association between electronic fetal heart rate monitoring and mortality, while adjusting for potential confounders. In 2004, 89% of singleton pregnancies had electronic fetal heart rate monitoring. Electronic fetal heart rate monitoring was associated with significantly lower infant mortality (adjusted relative risk, 0.75); this was mainly driven by the lower risk of early neonatal mortality (adjusted relative risk, 0.50). In low-risk pregnancies, electronic fetal heart rate monitoring was associated with decreased risk for Apgar scores <4 at 5 minutes (relative risk, 0.54); in high-risk pregnancies, with decreased risk of neonatal seizures (relative risk, 0.65). In the United States, the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality. Copyright © 2011 Mosby, Inc. All rights reserved.

Impaired fasting glucose, ancestry and waist-to-height ratio: main predictors of incident diagnosed diabetes in the Canary Islands.

PubMed

de León, A Cabrera; Coello, S Domínguez; González, D Almeida; Díaz, B Brito; Rodríguez, J C del Castillo; Hernández, A González; Aguirre-Jaime, A; Pérez, M del Cristo Rodríguez

2012-03-01

To estimate the incidence rate and risk factors for diabetes in the Canary Islands. A total of 5521 adults without diabetes were followed for a median of 3.5 years. Incident cases of diabetes were self-declared and validated in medical records. The following factors were assessed by Cox regression to estimate the hazard ratios for diabetes: impaired fasting glucose (5.6 mmol/l ≤ fasting glucose ≤ 6.9 mmol/l), BMI, waist-to-height ratio (≥ 0.55), insulin resistance (defined as triglycerides/HDL cholesterol ≥ 3), familial antecedents of diabetes, Canarian ancestry, smoking, alcohol intake, sedentary lifestyle, Mediterranean diet, social class and the metabolic syndrome. The incidence rate was 7.5/10(3) person-years (95% CI 6.4-8.8). The greatest risks were obtained for impaired fasting glucose (hazard ratio 2.6; 95% CI 1.8-3.8), Canarian ancestry (hazard ratio 1.9; 95% CI 1.0-3.4), waist-to-height ratio (hazard ratio 1.7; 95% CI 1.1-2.5), insulin resistance (hazard ratio 1.5; 95% CI 1.0-2.2) and paternal history of diabetes (hazard ratio 1.5; 95% CI 1.0-2.3). The metabolic syndrome (hazard ratio 1.9; 95% CI 1.3-2.8) and BMI ≥ 30 kg/m(2) (hazard ratio 1.7; 95% CI 1.0-2.7) were significant only when their effects were not adjusted for impaired fasting glucose and waist-to-height ratio, respectively. The incidence of diabetes in the Canary Islands is 1.5-fold higher than that in continental Spain and 1.7-fold higher than in the UK. The main predictors of diabetes were impaired fasting glucose, Canarian ancestry, waist-to-height ratio and insulin resistance. The metabolic syndrome predicted diabetes only when its effect was not adjusted for impaired fasting glucose. In individuals with Canarian ancestry, genetic susceptibility studies may be advisable. In order to propose preventive strategies, impaired fasting glucose, waist-to-height ratio and triglyceride/HDL cholesterol should be used to identify subjects with an increased risk of developing diabetes. �

Effects of mix ratio, moisture content and aeration rate on sulfur odor emissions during pig manure composting.

PubMed

Zang, Bing; Li, Shuyan; Michel, Frederick; Li, Guoxue; Luo, Yuan; Zhang, Difang; Li, Yangyang

2016-10-01

Sulfur compounds in swine manure can cause odor emissions during composting if conditions are not conducive to their rapid oxidation and degradation. In this study, the effects of controllable composting process variables on sulfur odor emissions were investigated. These included pig manure to corn stalk mix ratio (0.7:1, 1.5:1 and 2.2:1dw basis), initial moisture content (60%, 65%, 70% and 75%) and aeration rate (1.0, 2.0, 3.0 and 4.0m(3)m(-3)h(-1)). The compounds measured were carbonyl sulfide, carbon disulfide, hydrogen sulfide, methyl mercaptan, ethyl mercaptan, diethyl sulfide, dimethyl sulfide (Me2S) and dimethyl disulfide (Me2SS). The results showed that total sulfur losses ranged from 3.9% to 18.3% after 26days of composting. Me2S and Me2SS were the primary (>59.61%) sulfur compounds released during this period. After turning, emission rates of both Me2S and Me2SS increased. Emissions of the other six sulfur compounds were low and inconsistent during composting. Within the compost, feedstock mix ratio significantly influenced the concentration of Me2SS, while aeration rate significantly affected Me2S concentration (p<0.05). Moisture content did not have a significant effect on the concentrations of either of these two compounds. Concentrations of sulfur odor compounds were the lowest at the highest aeration rate. Therefore, high aeration rates during the thermophilic phase, especially after turning, are recommended to minimize sulfur odors produced during swine manure composting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Readmission rates and long-term hospital costs among survivors of an in-hospital cardiac arrest.

PubMed

Chan, Paul S; Nallamothu, Brahmajee K; Krumholz, Harlan M; Curtis, Lesley H; Li, Yan; Hammill, Bradley G; Spertus, John A

2014-11-01

Although an in-hospital cardiac arrest is common, little is known about readmission patterns and an inpatient resource use among survivors of an in-hospital cardiac arrest. Within a large national registry, we examined long-term inpatient use among 6972 adults aged ≥65 years who survived an in-hospital cardiac arrest. We examined 30-day and 1-year readmission rates and inpatient costs, overall and by patient demographics, hospital disposition (discharge destination), and neurological status at discharge. The mean age was 75.8±7.0 years, 56% were men, and 12% were black. There were a total of 2005 readmissions during the first 30 days (cumulative incidence rate, 35 readmissions/100 patients; 95% confidence interval, 33-37) and 8751 readmissions at 1 year (cumulative incidence rate, 185 readmissions/100 patients; 95% confidence interval, 177-190). Overall, mean inpatient costs were $7741±$2323 at 30 days and $18 629±$9411 at 1 year. Thirty-day inpatient costs were higher in patients of younger age (≥85 years, $6052 [reference]; 75-84 years, $7444 [adjusted cost ratio, 1.23; 1.06-1.42; 65-74 years, $8291 [adjusted cost ratio, 1.37; 1.19-1.59; both P<0.001) and black race (whites, $7413; blacks, $9044; adjusted cost ratio, 1.22; 1.05-1.42; P<0.001), as well as those discharged with severe neurological disability or to skilled nursing or rehabilitation facilities. These differences in resource use persisted at 1 year and were largely because of higher readmission rates. Survivors of an in-hospital cardiac arrest have frequent readmissions and high follow-up inpatient costs. Readmissions and inpatient costs were higher in certain subgroups, including patients of younger age and black race. © 2014 American Heart Association, Inc.

On the Inference of the Cosmic-ray Ionization Rate ζ from the HCO+-to-DCO+ Abundance Ratio: The Effect of Nuclear Spin

NASA Astrophysics Data System (ADS)

Shingledecker, Christopher N.; Bergner, Jennifer B.; Le Gal, Romane; Öberg, Karin I.; Hincelin, Ugo; Herbst, Eric

2016-10-01

The chemistry of dense interstellar regions was analyzed using a time-dependent gas-grain astrochemical simulation and a new chemical network that incorporates deuterated chemistry, taking into account nuclear spin states for the hydrogen chemistry and its deuterated isotopologues. With this new network, the utility of the [HCO+]/[DCO+] abundance ratio as a probe of the cosmic-ray ionization rate has been re-examined, with special attention paid to the effect of the initial value of the ortho-to-para ratio (OPR) of molecular hydrogen. After discussing the use of the probe for cold cores, we compare our results with previous theoretical and observational results for a molecular cloud close to the supernova remnant W51C, which is thought to have an enhanced cosmic-ray ionization rate ζ caused by the nearby γ-ray source. In addition, we attempt to use our approach to estimate the cosmic-ray ionization rate for L1174, a dense core with an embedded star. Beyond the previously known sensitivity of [HCO+]/[DCO+] to ζ, we demonstrate its additional dependence on the initial OPR and, secondarily, on the age of the source, its temperature, and its density. We conclude that the usefulness of the [HCO+]/[DCO+] abundance ratio in constraining the cosmic-ray ionization rate in dense regions increases with the age of the source and the ionization rate as the ratio becomes far less sensitive to the initial value of the OPR.

IMPACT OF CIGARETTE SMOKING ON RATES AND CLINICAL PROGNOSIS OF PULMONARY TUBERCULOSIS IN SOUTHERN MEXICO

PubMed Central

Bonacci, Robert A.; Cruz-Hervert, Luis Pablo; García-García, Lourdes; Reynales-Shigematsu, Luz Myriam; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Báez-Saldaña, Renata; Téllez-Vázquez, Norma; Mongua-Rodríguez, Norma; Montero-Campos, Rogelio; Delgado-Sánchez, Guadalupe; Martínez-Gamboa, Rosa Areli; Cano-Arellano, Bulmaro; Sifuentes-Osornio, José; de León, Alfredo Ponce

2012-01-01

Objectives To examine the relationship between cigarette smoking and incidence and mortality rates of pulmonary tuberculosis (TB) and treatment outcomes. Materials From 1995-2010, we analyzed data from 1062 patients with TB and from 2001-2004, 2951 contacts in Southern Mexico. Patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and mycobacteriological evaluation and received treatment by the local DOTS program. Results Consumers of 1-10 (LS) or 11 or more (HS) cigarettes per day incidence (1.75 and 11.79) and mortality (HS,17.74) smoker-nonsmoker rate ratios were significantly higher for smokers. Smoker population was more likely to experience unfavorable treatment outcomes (HS, adjusted OR 2.36) and retreatment (LS and HS, adjusted hazard ratio (HR) 2.14 and 2.37). Contacts that smoked had a higher probability of developing active TB (HR 2.38) during follow up. Conclusions Results indicate the need of incorporating smoking prevention and cessation, especially among men, into international TB control strategies. PMID:22982014

Effects of feedstock ratio and organic loading rate on the anaerobic mesophilic co-digestion of rice straw and cow manure.

PubMed

Li, Dong; Liu, Shengchu; Mi, Li; Li, Zhidong; Yuan, Yuexiang; Yan, Zhiying; Liu, Xiaofeng

2015-01-01

In order to investigate the effects of feedstock ratio and organic loading rate (OLR) on the anaerobic mesophilic co-digestion of rice straw (RS) and cow manure (CM), batch tests (2.5L) were carried out at volatile solid (VS) ratios of 0:1, 1:2, 1:1, 2:1, and 1:0 (RS/CM), and continuous bench experiments (40 L) were carried out at OLRs of 3.0, 3.6, 4.2, 4.8, 6.0, 8.0, and 12.0 kg VS/(m(3) d) with optimal VS ratio. The optimal VS ratio was found to be 1:1. Stable and efficient co-digestion with average specific biogas production of 383.5L/kg VS and volumetric biogas production rate of 2.30 m(3)/(m(3) d) was obtained at an OLR of 6 kg VS/(m(3) d). Anaerobic co-digestion was severely inhibited by the accumulation of volatile fatty acids instead of ammonia when the OLR was 12 kg VS/(m(3) d). Further, significant foaming was observed at OLR ⩾ 8 kg VS/(m(3) d). Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of strain rate, mixing ratio, and stress-strain definition on the mechanical behavior of the polydimethylsiloxane (PDMS) material as related to its biological applications.

PubMed

Khanafer, Khalil; Duprey, Ambroise; Schlicht, Marty; Berguer, Ramon

2009-04-01

Tensile tests on Polydimethylsiloxane (PDMS) materials were conducted to illustrate the effects of mixing ratio, definition of the stress-strain curve, and the strain rate on the elastic modulus and stress-strain curve. PDMS specimens were prepared according to the ASTM standards for elastic materials. Our results indicate that the physiological elastic modulus depends strongly on the definition of the stress-strain curve, mixing ratio, and the strain rate. For various mixing ratios and strain rates, true stress-strain definition results in higher stress and elastic modulus compared with engineering stress-strain and true stress-engineering strain definitions. The elastic modulus increases as the mixing ratio increases up-to 9:1 ratio after which the elastic modulus begins to decrease even as the mixing ratio continues to increase. The results presented in this study will be helpful to assist the design of in vitro experiments to mimic blood flow in arteries and to understand the complex interaction between blood flow and the walls of arteries using PDMS elastomer.

Triglyceride to high-density lipoprotein cholesterol ratio predicts cardiovascular outcomes in prevalent dialysis patients.

PubMed

Chen, Hung-Yuan; Tsai, Wan-Chuan; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Peng, Yu-Sen

2015-03-01

Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, an indicator of atherogenic dyslipidemia, is a predictor of cardiovascular (CV) outcomes in the general population and has been correlated with atherosclerotic events. Whether the TG/HDL-C ratio can predict CV outcomes and survival in dialysis patients is unknown. We performed this prospective, observational cohort study and enrolled 602 dialysis patients (539 hemodialysis and 63 peritoneal dialysis) from a single center in Taiwan followed up for a median of 3.9 years. The outcomes were the occurrence of CV events, CV death, and all-cause mortality during follow-up. The association of baseline TG/HDL-C ratio with outcomes was explored with Cox regression models, which were adjusted for demographic parameters and inflammatory/nutritional markers. Overall, 203 of the patients experienced CV events and 169 patients died, of whom 104 died due to CV events. Two hundred fifty-four patients reached the composite CV outcome. Patients with higher TG/HDL-C levels (quintile 5) had a higher incidence of CV events (adjusted hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.19-3.47), CV mortality (adjusted HR 1.91, 95% CI 1.07-3.99), composite CV outcome (adjusted HR 2.2, 95% CI 1.37-3.55), and all-cause mortality (adjusted HR 1.94, 95% CI 1.1-3.39) compared with the patients in quintile 1. However, in diabetic dialysis patients, the TG/HDL-C ratio did not predict the outcomes. The TG/HDL-C ratio is a reliable and easily accessible predictor to evaluate CV outcomes and survival in prevalent nondiabetic dialysis patients. ClinicalTrials.gov: NCT01457625.

Quantifying in situ growth rate of a filamentous bacterial species in activated sludge using rRNA:rDNA ratio.

PubMed

Nguyen, Vivi L; He, Xia; de Los Reyes, Francis L

2016-11-01

If the in situ growth rate of filamentous bacteria in activated sludge can be quantified, researchers can more accurately assess the effect of operating conditions on the growth of filaments and improve the mathematical modeling of filamentous bulking. We developed a method to quantify the in situ specific growth rate of Sphaerotilus natans (a model filament) in activated sludge using the species-specific 16S rRNA:rDNA ratio. Primers targeting the 16S rRNA of S. natans were designed, and real-time PCR and RT-PCR were used to quantify DNA and RNA levels of S. natans, respectively. A positive linear relationship was found between the rRNA:rDNA ratio (from 440 to 4500) and the specific growth rate of S. natans (from 0.036 to 0.172 h -1 ) using chemostat experiments. The in situ growth rates of S. natans in activated sludge samples from three water reclamation facilities were quantified, illustrating how the approach can be applied in a complex environment such as activated sludge. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

20 CFR 10.420 - How are cost-of-living adjustments applied?

Code of Federal Regulations, 2012 CFR

2012-04-01

... of recurrence of disability, where the pay rate for compensation purposes is the pay rate at the time... effective date of that pay rate began more than one year prior to the date the cost-of-living adjustment took effect. (d) In cases of death, entitlement to cost-of-living adjustments under 5 U.S.C. 8146a...

20 CFR 10.420 - How are cost-of-living adjustments applied?

Code of Federal Regulations, 2011 CFR

2011-04-01

... of recurrence of disability, where the pay rate for compensation purposes is the pay rate at the time... effective date of that pay rate began more than one year prior to the date the cost-of living adjustment took effect. (d) In cases of death, entitlement to cost-of-living adjustments under 5 U.S.C. 8146a...

20 CFR 10.420 - How are cost-of-living adjustments applied?

Code of Federal Regulations, 2010 CFR

2010-04-01

... of recurrence of disability, where the pay rate for compensation purposes is the pay rate at the time... effective date of that pay rate began more than one year prior to the date the cost-of living adjustment took effect. (d) In cases of death, entitlement to cost-of-living adjustments under 5 U.S.C. 8146a...

20 CFR 10.420 - How are cost-of-living adjustments applied?

Code of Federal Regulations, 2013 CFR

2013-04-01

... of recurrence of disability, where the pay rate for compensation purposes is the pay rate at the time... effective date of that pay rate began more than one year prior to the date the cost-of-living adjustment took effect. (d) In cases of death, entitlement to cost-of-living adjustments under 5 U.S.C. 8146a...

20 CFR 10.420 - How are cost-of-living adjustments applied?

Code of Federal Regulations, 2014 CFR

2014-04-01

... of recurrence of disability, where the pay rate for compensation purposes is the pay rate at the time... effective date of that pay rate began more than one year prior to the date the cost-of-living adjustment took effect. (d) In cases of death, entitlement to cost-of-living adjustments under 5 U.S.C. 8146a...

Simple and cost-effective fabrication of solid biodegradable polymer microneedle arrays with adjustable aspect ratio for transdermal drug delivery using acupuncture microneedles

NASA Astrophysics Data System (ADS)

Cha, Kyoung Je; Kim, Taewan; Jea Park, Sung; Kim, Dong Sung

2014-11-01

Polymer microneedle arrays (MNAs) have received much attention for their use in transdermal drug delivery and microneedle therapy systems due to the advantages they offer, such as low cost, good mechanical properties, and a versatile choice of materials. Here, we present a simple and cost-effective method for the fabrication of a biodegradable polymer MNA in which the aspect ratio of each microneedle is adjustable using commercially available acupuncture microneedles. In our process, a master template with acupuncture microneedles, whose shape will be the final MNA, was carefully prepared by fixing them onto a plastic substrate with selectively drilled holes which, in turn, determine the aspect ratios of the microneedles. A polylactic acid (PLA; a biodegradable polymer) MNA was fabricated by a micromolding process with a polydimethylsiloxane (PDMS) mold containing the cavity of the microneedles, which was obtained by the PDMS replica molding against the master template. The mechanical force and degradation behavior of the replicated PLA MNA were characterized with the help of a compression test and an accelerated degradation test, respectively. Finally, the transdermal drug delivery performance of the PLA MNA was successfully simulated by two different methods of penetration and staining, using the skin of a pig cadaver. These results indicated that the proposed method can be effectively used for the fabrication of polymer MNAs which can be used in various microneedle applications.

Herschel/SPIRE observations of water production rates and ortho-to-para ratios in comets★

NASA Astrophysics Data System (ADS)

Wilson, Thomas G.; Rawlings, Jonathan M. C.; Swinyard, Bruce M.

2017-04-01

This paper presents Herschel/SPIRE (Spectral and Photometric Imaging Receiver) spectroscopic observations of several fundamental rotational ortho- and para-water transitions seen in three Jupiter-family comets and one Oort-cloud comet. Radiative transfer models that include excitation by collisions with neutrals and electrons, and by solar infrared radiation, were used to produce synthetic emission line profiles originating in the cometary coma. Ortho-to-para ratios (OPRs) were determined and used to derived water production rates for all comets. Comparisons are made with the water production rates derived using an OPR of 3. The OPR of three of the comets in this study is much lower than the statistical equilibrium value of 3; however they agree with observations of comets 1P/Halley and C/2001 A2 (LINEAR), and the protoplanetary disc TW Hydrae. These results provide evidence suggesting that OPR variation is caused by post-sublimation gas-phase nuclear-spin conversion processes. The water production rates of all comets agree with previous work and, in general, decrease with increasing nucleocentric offset. This could be due to a temperature profile, additional water source or OPR variation in the comae, or model inaccuracies.

Metabolic Response of “Candidatus Accumulibacter Phosphatis” Clade II C to Changes in Influent P/C Ratio

PubMed Central

Welles, Laurens; Abbas, Ben; Sorokin, Dimitry Y.; Lopez-Vazquez, Carlos M.; Hooijmans, Christine M.; van Loosdrecht, Mark C. M.; Brdjanovic, Damir

2017-01-01

The objective of this study was to investigate the ability of a culture highly enriched with the polyphosphate-accumulating organism, “Candidatus Accumulibacter phosphatis” clade IIC, to adjust their metabolism to different phosphate availabilities. For this purpose the biomass was cultivated in a sequencing batch reactor with acetate and exposed to different phosphate/carbon influent ratios during six experimental phases. Activity tests were conducted to determine the anaerobic kinetic and stoichiometric parameters as well as the composition of the microbial community. Increasing influent phosphate concentrations led to increased poly-phosphate content and decreased glycogen content of the biomass. In response to higher biomass poly-phosphate content, the biomass showed higher specific phosphate release rates. Together with the phosphate release rates, acetate uptake rates also increased up to an optimal poly-phosphate/glycogen ratio of 0.3 P-mol/C-mol. At higher poly-phosphate/glycogen ratios (obtained at influent P/C ratios above 0.051 P-mol/C-mol), the acetate uptake rates started to decrease. The stoichiometry of the anaerobic conversions clearly demonstrated a metabolic shift from a glycogen dominated to a poly-phosphate dominated metabolism as the biomass poly-phosphate content increased. FISH and DGGE analyses confirmed that no significant changes occurred in the microbial community, suggesting that the changes in the biomass activity were due to different metabolic behavior, allowing the organisms to proliferate under conditions with fluctuating phosphate levels. PMID:28111570

Self-Reported Sleep Duration and Self-Rated Health in Young Adults.

PubMed

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-07-15

This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Approximately 30% of participants slept 7-8 hours, 17.4% were short sleepers (categories < 6 hours and 6-7 hours), and 53.9% were long sleepers (categories 8-10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7-8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6-7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. © 2017 American Academy of Sleep Medicine

Prevalence of self-rated visual impairment among adults with diabetes.

PubMed

Saaddine, J B; Narayan, K M; Engelgau, M M; Aubert, R E; Klein, R; Beckles, G L

1999-08-01

This study estimated the prevalence of self-rated visual impairment among US adults with diabetes and identified correlates of such impairment. Self-reported data from the 1995 Behavioral Risk Factor Surveillance System survey of adults 18 years and older with diabetes were analyzed. Correlates of visual impairment were examined by multiple logistic regression analysis. The prevalence of self-rated visual impairment was 24.8% (95% confidence interval [CI] = 22.3%, 27.3%). Among insulin users, multivariable-adjusted odds ratios were 4.9 (95% CI = 2.6, 9.2) for those who had not completed high school and 1.8 (95% CI = 1.0, 2.8) for those who had completed high school compared with those with higher levels of education. Comparable estimates of odds ratios for nonusers of insulin were 2.2 (95% CI = 1.4, 3.4) and 1.3 (95% CI = 0.9, 2.0), respectively. Among nonusers, the adjusted odds for minority adults were 2.4 (95% CI = 1.0, 3.7) times the odds for non-Hispanic Whites. By these data, 1.6 million US adults with diabetes reported having some degree of visual impairment. Future research on the specific causes of visual impairment may help in estimating the avoidable public health burden.

Validation and Adjustment of the Leipzig-Halifax Acute Aortic Dissection Type A Scorecard.

PubMed

Mejàre-Berggren, Hanna; Olsson, Christian

2017-11-01

The novel Leipzig-Halifax (LH) scorecard for acute aortic dissection type A (AADA) stratifies risk of in-hospital death based on age, malperfusion syndromes, critical preoperative state, and coronary disease. The study aim was to externally validate the LH scorecard performance and, if adequate, propose adjustments. All consecutive AADA patients operated on from 1996 to 2016 (n = 509) were included to generate an external validation cohort. Variables related to in-hospital death were analyzed using univariable and multivariable analysis. The LH scorecard was applied to the validation cohort, compared with the original study, and variable selection was adjusted using validation measures for discrimination and calibration. In-hospital mortality rate was 17.7% (LH cohort 18.7%). Critical preoperative state and Penn class non-Aa were independent predictors (odds ratio [OR] 2.42 and 2.45, respectively) of in-hospital death. The LH scorecard was adjusted to include Penn class non-Aa, critical preoperative state, and coronary disease. Assessing discrimination, area under receiver operator characteristic curve for the LH scorecard was 0.61 versus 0.66 for the new scorecard (p = 0.086). In-hospital mortality rates in low-, medium-, and high-risk groups were 14%, 15%, and 48%, respectively (LH scorecard) versus 11%, 23%, and 43%, respectively (new scorecard), and goodness-of-fit p value was 0.01 versus 0.86, indicating better calibration by the new scorecard. A lower Akaike information criterion value, 464 versus 448, favored the new scorecard. Through adjustment of the LH scorecard after external validation, prognostic performance improved. Further validated, the LH scorecard could be a valuable risk prediction tool. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Defining Rates and Risk Factors for Readmissions Following Emergency General Surgery.

PubMed

Havens, Joaquim M; Olufajo, Olubode A; Cooper, Zara R; Haider, Adil H; Shah, Adil A; Salim, Ali

2016-04-01

Hospital readmission rates following surgery are increasingly being used as a marker of quality of care and are used in pay-for-performance metrics. To our knowledge, comprehensive data on readmissions to the initial hospital or a different hospital after emergency general surgery (EGS) procedures do not exist. To define readmission rates and identify risk factors for readmission after common EGS procedures. Patients undergoing EGS, as defined by the American Association for the Surgery of Trauma, were identified in the California State Inpatient Database (2007-2011) on January 15, 2015. Patients were 18 years and older. We identified the 5 most commonly performed EGS procedures in each of 11 EGS diagnosis groups. Patient demographics (sex, age, race/ethnicity, and insurance type) as well as Charlson Comorbidity Index score, length of stay, complications, and discharge disposition were collected. Factors associated with readmission were determined using multivariate logistic regression models analysis. Thirty-day hospital readmission. Among 177,511 patients meeting inclusion criteria, 57.1% were white, 48.8% were privately insured, and most were 45 years and older (51.3%). Laparoscopic appendectomy (35.2%) and laparoscopic cholecystectomy (19.3%) were the most common procedures. The overall 30-day readmission rate was 5.91%. Readmission rates ranged from 4.1% (upper gastrointestinal) to 16.8% (cardiothoracic). Of readmitted patients, 16.8% were readmitted at a different hospital. Predictors of readmission included Charlson Comorbidity Index score of 2 or greater (adjusted odds ratio: 2.26 [95% CI, 2.14-2.39]), leaving against medical advice (adjusted odds ratio: 2.24 [95% CI, 1.89-2.66]), and public insurance (adjusted odds ratio: 1.55 [95% CI, 1.47-1.64]). The most common reasons for readmission were surgical site infections (16.9%), gastrointestinal complications (11.3%), and pulmonary complications (3.6%). Readmission after EGS procedures is common and varies

Stochastic Endogenous Replication Stress Causes ATR-Triggered Fluctuations in CDK2 Activity that Dynamically Adjust Global DNA Synthesis Rates.

PubMed

Daigh, Leighton H; Liu, Chad; Chung, Mingyu; Cimprich, Karlene A; Meyer, Tobias

2018-06-04

Faithful DNA replication is challenged by stalling of replication forks during S phase. Replication stress is further increased in cancer cells or in response to genotoxic insults. Using live single-cell image analysis, we found that CDK2 activity fluctuates throughout an unperturbed S phase. We show that CDK2 fluctuations result from transient ATR signals triggered by stochastic replication stress events. In turn, fluctuating endogenous CDK2 activity causes corresponding decreases and increases in DNA synthesis rates, linking changes in stochastic replication stress to fluctuating global DNA replication rates throughout S phase. Moreover, cells that re-enter the cell cycle after mitogen stimulation have increased CDK2 fluctuations and prolonged S phase resulting from increased replication stress-induced CDK2 suppression. Thus, our study reveals a dynamic control principle for DNA replication whereby CDK2 activity is suppressed and fluctuates throughout S phase to continually adjust global DNA synthesis rates in response to recurring stochastic replication stress events. Copyright © 2018. Published by Elsevier Inc.

Adjustable suture strabismus surgery in infants and children: a 19-year experience.

PubMed

Kassem, Ahmed; Xue, Gilbert; Gandhi, Niral B; Tian, Jing; Guyton, David L

2018-06-01

To evaluate the success rate of adjustable suture techniques in horizontal eye muscle surgery in children ≤15 years of age over a 19-year period by a single surgeon. The medical records of all consecutive patients in this age group who underwent horizontal eye muscle surgery from 1989 through 2012 were reviewed retrospectively. Patients were divided into two groups: those in whom a nonadjustable suture technique was used and those in whom adjustable sutures were used. The following data were collected: type of strabismus, preoperative measurements, postoperative results, and reoperation rates. A total of 116 cases in the nonadjustable group and 521 cases in the adjustable group were included. In the adjustable group, adjustment was performed in 63% of the cases, because of either an under- (41%) or overcorrection (22%). The adjustment procedure was performed under topical proparacaine in 15% of cases and under intravenous propofol in 85%. For the adjustable group, 3-5 minutes more per muscle intraoperatively and 15-20 minutes for adjustment were required. No complications were encountered during the adjustment procedures. Early success rate, defined as alignment within 8 Δ of straight at 3 to 6 months' postoperative follow-up, was significantly greater in the adjustable group than in the nonadjustable group (77.7% vs 64.6% [P ≤ 0.03]). Of the adjustable patients, 15% required reoperation compared with 21% of the nonadjustable patients. Use of adjustable sutures in horizontal eye muscle surgery in children ≤15 years of age provided an improved success rate and fewer reoperations compared with nonadjustable sutures. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

A simple signaling rule for variable life-adjusted display derived from an equivalent risk-adjusted CUSUM chart.

PubMed

Wittenberg, Philipp; Gan, Fah Fatt; Knoth, Sven

2018-04-17

The variable life-adjusted display (VLAD) is the first risk-adjusted graphical procedure proposed in the literature for monitoring the performance of a surgeon. It displays the cumulative sum of expected minus observed deaths. It has since become highly popular because the statistic plotted is easy to understand. But it is also easy to misinterpret a surgeon's performance by utilizing the VLAD, potentially leading to grave consequences. The problem of misinterpretation is essentially caused by the variance of the VLAD's statistic that increases with sample size. In order for the VLAD to be truly useful, a simple signaling rule is desperately needed. Various forms of signaling rules have been developed, but they are usually quite complicated. Without signaling rules, making inferences using the VLAD alone is difficult if not misleading. In this paper, we establish an equivalence between a VLAD with V-mask and a risk-adjusted cumulative sum (RA-CUSUM) chart based on the difference between the estimated probability of death and surgical outcome. Average run length analysis based on simulation shows that this particular RA-CUSUM chart has similar performance as compared to the established RA-CUSUM chart based on the log-likelihood ratio statistic obtained by testing the odds ratio of death. We provide a simple design procedure for determining the V-mask parameters based on a resampling approach. Resampling from a real data set ensures that these parameters can be estimated appropriately. Finally, we illustrate the monitoring of a real surgeon's performance using VLAD with V-mask. Copyright © 2018 John Wiley & Sons, Ltd.

Triglyceride to High-Density Lipoprotein Cholesterol Ratio Predicts Cardiovascular Outcomes in Prevalent Dialysis Patients

PubMed Central

Chen, Hung-Yuan; Tsai, Wan-Chuan; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Peng, Yu-Sen

2015-01-01

Abstract Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, an indicator of atherogenic dyslipidemia, is a predictor of cardiovascular (CV) outcomes in the general population and has been correlated with atherosclerotic events. Whether the TG/HDL-C ratio can predict CV outcomes and survival in dialysis patients is unknown. We performed this prospective, observational cohort study and enrolled 602 dialysis patients (539 hemodialysis and 63 peritoneal dialysis) from a single center in Taiwan followed up for a median of 3.9 years. The outcomes were the occurrence of CV events, CV death, and all-cause mortality during follow-up. The association of baseline TG/HDL-C ratio with outcomes was explored with Cox regression models, which were adjusted for demographic parameters and inflammatory/nutritional markers. Overall, 203 of the patients experienced CV events and 169 patients died, of whom 104 died due to CV events. Two hundred fifty-four patients reached the composite CV outcome. Patients with higher TG/HDL-C levels (quintile 5) had a higher incidence of CV events (adjusted hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.19–3.47), CV mortality (adjusted HR 1.91, 95% CI 1.07–3.99), composite CV outcome (adjusted HR 2.2, 95% CI 1.37–3.55), and all-cause mortality (adjusted HR 1.94, 95% CI 1.1–3.39) compared with the patients in quintile 1. However, in diabetic dialysis patients, the TG/HDL-C ratio did not predict the outcomes. The TG/HDL-C ratio is a reliable and easily accessible predictor to evaluate CV outcomes and survival in prevalent nondiabetic dialysis patients. ClinicalTrials.gov: NCT01457625 PMID:25761189

Effect of pH and Fe/U ratio on the U(VI) removal rate by the synergistic effect of Fe(II) and O2

NASA Astrophysics Data System (ADS)

Fu, Yukui; Luo, Yingfeng; Fang, Qi; Xie, Yanpei; Wang, Zhihong; Zhu, Xiangyu

2018-02-01

As for the decommissioned uranium deposits of acid in-situ leaching, both of the concentrations of U(VI) and Fe(II) are relatively high in groundwater. In the presence of O2, the oxidation of Fe(II) into Fe(III) that forms Fe-hydroxides could effectively remove U(VI) in the forms of sorption or co-precipitation. In this process, pH condition and Fe content will have a significant effect on the U(VI) removal rate by the synergistic effect of Fe(II) and O2. In the present work, a series of batch experiments were carried out to investigate the effect of pH values and Fe/U mass ratio on the U(VI) removal rate by the synergistic effect of Fe(II) and O2. Experiment results show that the removal rate of U(VI) is mainly controlled by pH and secondly by Fe/U mass ratio. In the neutral conditions with pH at 7 and 8, the removal rate of U(VI) reaches up to 90% for all solutions with different initial Fe(II) concentrations. The optimal pH for the removal rate of U(VI) is above 7. In the acidic conditions with pH below 6, the effect of Fe/U mass ratio on the removal rate of U(VI) becomes more obvious and the optimal Fe/U mass ratio for U(VI) removal is 1:2.

Independent and combined effects of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population: The Henan Rural Cohort study.

PubMed

Zhang, Xia; Li, Yuqian; Wang, Fang; Zang, Jianguo; Liu, Xiaotian; Zhang, Honglei; Yang, Kaili; Zhang, Gongyuan; Wang, Chongjian

2018-06-07

We examined the independent and cumulative associations of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population based on epidemiological research. A total of 38,708 participants were derived from the Henan Rural Cohort study. Restricted cubic splines and logistic regression model were used to estimate the odds ratios and 95% confidence intervals of metabolic syndrome risk in relation to resting heart rate and pulse pressure. After adjusting for potential confounders, the odds ratio (95% confidence intervals) of resting heart rate and pulse pressure in the highest quartile with the risk of metabolic syndrome were 1.59 (1.48-1.70) and1.81 (1.67-1.95), respectively. Simultaneously, the cumulative effect analysis indicated that the adjusted the odd ratio of resting heart rate and pulse pressure in the highest quartile was 2.89 (2.40-3.47). Furthermore, there was a significantly additive interaction between resting heart rate and pulse pressure on the risk of metabolic syndrome. Increased resting heart rate and pulse pressure are associated with the higher risk of metabolic syndrome as well as the influences of resting heart rate with pulse pressure might cumulatively increase the risk of metabolic syndrome. However, the potential clinical application remains to be determined. Copyright © 2018. Published by Elsevier B.V.

Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

PubMed Central

Solevåg, Anne Lee; Schmölzer, Georg M.

2017-01-01

Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider. Thus, provider performance should be taken into account. Neonatal resuscitation guidelines recommend a 3:1 C:V ratio. CCs should be delivered at a rate of 90/min synchronized with ventilations at a rate of 30/min to achieve a total of 120 events/min. Despite a lack of scientific evidence supporting this, the investigation of alternative CC interventions in human neonates is ethically challenging. Also, the infrequent occurrence of extensive CPR measures in the DR make randomized controlled trials difficult to perform. Thus, many biomechanical aspects of CC have been investigated in animal and manikin models. Despite mathematical and physiological rationales that higher rates and uninterrupted CC improve CPR hemodynamics, studies indicate that provider fatigue is more pronounced when CC are performed continuously compared to when a pause is inserted after every third CC as currently recommended. A higher rate (e.g., 120/min) is also more fatiguing, which affects CC quality. In post-transitional piglets with asphyxia-induced cardiac arrest, there was no benefit of performing continuous CC at a rate of 90/min. Not only rate but duty cycle, i.e., the duration of CC/total cycle time, is a known determinant of CC effectiveness. However, duty cycle cannot be controlled with manual CC. Mechanical/automated CC in neonatal CPR has not been explored, and feedback systems are under-investigated in this

Thermal acclimation of photosynthesis: on the importance of adjusting our definitions and accounting for thermal acclimation of respiration.

PubMed

Way, Danielle A; Yamori, Wataru

2014-02-01

While interest in photosynthetic thermal acclimation has been stimulated by climate warming, comparing results across studies requires consistent terminology. We identify five types of photosynthetic adjustments in warming experiments: photosynthesis as measured at the high growth temperature, the growth temperature, and the thermal optimum; the photosynthetic thermal optimum; and leaf-level photosynthetic capacity. Adjustments of any one of these variables need not mean a concurrent adjustment in others, which may resolve apparently contradictory results in papers using different indicators of photosynthetic acclimation. We argue that photosynthetic thermal acclimation (i.e., that benefits a plant in its new growth environment) should include adjustments of both the photosynthetic thermal optimum (T opt) and photosynthetic rates at the growth temperature (A growth), a combination termed constructive adjustment. However, many species show reduced photosynthesis when grown at elevated temperatures, despite adjustment of some photosynthetic variables, a phenomenon we term detractive adjustment. An analysis of 70 studies on 103 species shows that adjustment of T opt and A growth are more common than adjustment of other photosynthetic variables, but only half of the data demonstrate constructive adjustment. No systematic differences in these patterns were found between different plant functional groups. We also discuss the importance of thermal acclimation of respiration for net photosynthesis measurements, as respiratory temperature acclimation can generate apparent acclimation of photosynthetic processes, even if photosynthesis is unaltered. We show that while dark respiration is often used to estimate light respiration, the ratio of light to dark respiration shifts in a non-predictable manner with a change in leaf temperature.

Controlling the nitrite:ammonium ratio in a SHARON reactor in view of its coupling with an Anammox process.

PubMed

Volcke, E I P; van Loosdrecht, M C M; Vanrolleghem, P A

2006-01-01

The combined SHARON-Anammox process for treating wastewater streams with high ammonia load is the focus of this paper. In particular, partial nitritation in the SHARON reactor should be performed to such an extent that a nitrite:ammonium ratio is generated which is optimal for full conversion in an Anammox process. In the simulation studies performed in this contribution, the nitrite:ammonium ratio produced in a SHARON process with fixed volume, as well as its effect on the subsequent Anammox process, is examined for realistic influent conditions and considering both direct and indirect pH effects on the SHARON process. Several possible operating modes for the SHARON reactor, differing in control strategies for O2, pH and the produced nitrite:ammonium ratio and based on regulating the air flow rate and/or acid/base addition, are systematically evaluated. The results are quantified through an operating cost index. Best results are obtained by means of cascade feedback control of the SHARON effluent nitrite:ammonium ratio through setting an O2 set-point that is tracked by adjusting the air flow rate, combined with single loop pH control through acid/base addition.

Impact of Coal Mining on Self-Rated Health among Appalachian Residents

PubMed Central

Woolley, Shannon M.; Bear, Todd M.; Balmert, Lauren C.; Talbott, Evelyn O.; Buchanich, Jeanine M.

2015-01-01

Objective. To determine the impact of coal mining, measured as the number of coal mining-related facilities nearby one's residence or employment in an occupation directly related to coal mining, on self-rated health in Appalachia. Methods. Unadjusted and adjusted ordinal logistic regression models calculated odds ratio estimates and associated 95% confidence intervals for the probability of having an excellent self-rated health response versus another response. Covariates considered in the analyses included number of coal mining-related facilities nearby one's residence and employment in an occupation directly related to coal mining, as well as potential confounders age, sex, BMI, smoking status, income, and education. Results. The number of coal mining facilities near the respondent's residence was not a statistically significant predictor of self-rated health. Employment in a coal-related occupation was a statistically significant predictor of self-rated health univariably; however, after adjusting for potential confounders, it was no longer a significant predictor. Conclusions. Self-rated health does not seem to be associated with residential proximity to coal mining facilities or employment in the coal industry. Future research should consider additional measures for the impact of coal mining. PMID:26240577

Low to high frequency ratio of heart rate variability spectra fails to describe sympatho-vagal balance in cardiac patients.

PubMed

Milicević, Goran

2005-06-01

Heart rate variability (HRV) reflects an influence of autonomic nervous system on heart work. In healthy subjects, ratio between low and high frequency components (LF/HF ratio) of HRV spectra represents a measure of sympatho-vagal balance. The ratio was defined by the authorities as an useful clinical tool, but it seems that it fails to summarise sympatho-vagal balance in a clinical setting. Value of the method was re-evaluated in several categories of cardiac patients. HRV was analysed from 24-hour Holter ECGs in 132 healthy subjects, and 2159 cardiac patients dichotomised by gender, median of age, diagnosis of myocardial infarction or coronary artery surgery, left ventricular systolic function and divided by overall HRV into several categories. In healthy subjects, LF/HF ratio correlated with overall HRV negatively, as expected. The paradoxical finding was obtained in cardiac patients; the lower the overall HRV and the time-domain indices of vagal modulation activity were the lower the LF/HF ratio was. If used as a measure of sympatho-vagal balance, long-term recordings of LF/HF ratio contradict to clinical finding and time-domain HRV indices in cardiac patients. The ratio cannot therefore be used as a reliable marker of autonomic activity in a clinical setting.

Ownership of dwelling affects the sex ratio at birth in Uganda.

PubMed

Wallner, Bernard; Fieder, Martin; Seidler, Horst

2012-01-01

Socio-economic conditions can affect the secondary sex ratio in humans. Mothers under good environmental conditions are predicted to increase the birth rates of sons according to the Trivers-Willard hypothesis (TWH). This study analyzed the effects of ownership and non-ownership of dwellings on the sex ratio at birth (SRB) on a Ugandan sample. Our investigation included 438,640 mothers aged between 12 and 54 years. The overall average SRB was 0.5008. Mothers who live in owned dwellings gave increased births to sons (0.5019) compared to those who live in non-owned dwellings (0.458). Multivariate statistics revealed the strongest effects of dwelling ownership when controlling for demographic and social variables such as marital status, type of marriage, mothers' age, mothers' education, parity and others. The results are discussed in the framework of recent plausible models dealing with the adjustment of the sex ratio. We conclude that the aspect of dwelling status could represent an important socio-economic parameter in relation to SRB variations in humans if further studies are able to analyze it between different countries in a comparative way.

The independence of irradiation creep in austenitic alloys of displacement rate and helium to dpa ratio

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

Garner, F.A.; Toloczko, M.B.; Grossbeck, M.L.

1997-04-01

The majority of high fluence data on the void swelling and irradiation creep of austenitic steels were generated at relatively high displacement rates and relatively low helium/dpa levels that are not characteristic of the conditions anticipated in ITER and other anticipated fusion environments. After reanalyzing the available data, this paper shows that irradiation creep is not directly sensitive to either the helium/dpa ratio or the displacement rate, other than through their possible influence on void swelling, since one component of the irradiation creep rate varies with no correlation to the instantaneous swelling rate. Until recently, however, the non-swelling-related creep componentmore » was also thought to exhibit its own strong dependence on displacement rate, increasing at lower fluxes. This perception originally arose from the work of Lewthwaite and Mosedale at temperatures in the 270-350{degrees}C range. More recently this perception was thought to extend to higher irradiation temperatures. It now appears, however, that this interpretation is incorrect, and in fact the steady-state value of the non-swelling component of irradiation creep is actually insensitive to displacement rate. The perceived flux dependence appears to arise from a failure to properly interpret the impact of the transient regime of irradiation creep.« less

77 FR 10767 - Rate Adjustments for Indian Irrigation Projects

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-23

... Irrigation Project on the proposed rates about the following issues: (1) The methodology for O&M rate setting... BIA's responses are provided below. Comment: The BIA's methodology for setting the 2013 O&M assessment rate was unreasonable. Response: The methodology used by the BIA to determine the 2013 O&M assessment...

Simultaneous experimental determination of labile proton fraction ratio and exchange rate with irradiation radio frequency power-dependent quantitative CEST MRI analysis.

PubMed

Sun, Phillip Zhe; Wang, Yu; Xiao, Gang; Wu, Renhua

2013-01-01

Chemical exchange saturation transfer (CEST) imaging is sensitive to dilute proteins/peptides and microenvironmental properties, and has been increasingly evaluated for molecular imaging and in vivo applications. However, the experimentally measured CEST effect depends on the CEST agent concentration, exchange rate and relaxation time. In addition, there may be non-negligible direct radio-frequency (RF) saturation effects, particularly severe for diamagnetic CEST (DIACEST) agents owing to their relatively small chemical shift difference from that of the bulk water resonance. As such, the commonly used asymmetry analysis only provides CEST-weighted information. Recently, it has been shown with numerical simulation that both labile proton concentration and exchange rate can be determined by evaluating the RF power dependence of DIACEST effect. To validate the simulation results, we prepared and imaged two CEST phantoms: a pH phantom of serially titrated pH at a fixed creatine concentration and a concentration phantom of serially varied creatine concentration titrated to the same pH, and solved the labile proton fraction ratio and exchange rate per-pixel. For the concentration phantom, we showed that the labile proton fraction ratio is proportional to the CEST agent concentration with negligible change in the exchange rate. Additionally, we found the exchange rate of the pH phantom is dominantly base-catalyzed with little difference in the labile proton fraction ratio. In summary, our study demonstrated quantitative DIACEST MRI, which remains promising to augment the conventional CEST-weighted MRI analysis. Copyright © 2013 John Wiley & Sons, Ltd.

Social deprivation, population dependency ratio and an extended hospital episode - Insights from acute medicine.

PubMed

Cournane, Seán; Dalton, Ann; Byrne, Declan; Conway, Richard; O'Riordan, Deirdre; Coveney, Seamus; Silke, Bernard

2015-11-01

Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; this study aimed to investigate the extent to which Deprivation status and the population Dependency Ratio influenced extended hospital episodes. All Emergency Medical admissions (75,018 episodes of 41,728 patients) over 12 years (2002-2013) categorized by quintile of Deprivation Index and Population Dependency Rates (proportion of non-working/working) were evaluated against length of stay (LOS). Patients with an Extended LOS (ELOS), >30 days, were investigated, by Deprivation status, Illness Severity and Co-morbidity status. Univariate and multi-variable risk estimates (Odds Rates or Incidence Rate Ratios) were calculated, using truncated Poisson regression. Hospital episodes with ELOS had a frequency of 11.5%; their median LOS (IQR) was 55.0 (38.8, 97.6) days utilizing 57.6% of all bed days by all 75,018 emergency medical admissions. The Deprivation Index independently predicted the rate of such ELOS admissions; these increased approximately five-fold (rate/1000 population) over the Deprivation Quintiles with model adjusted predicted admission rates of for Q1 0.93 (95% CI: 0.86, 0.99), Q22.63 (95% CI: 2.55, 2.71), Q3 3.84 (95% CI: 3.77, 3.91), Q4 3.42 (95% CI: 3.37, 3.48) and Q5 4.38 (95% CI: 4.22, 4.54). Similarly the Population Dependency Ratio Quintiles (dependent to working structure of the population by small area units) independently predicted extended LOS admissions. The admission of patients with an ELOS is strongly influenced by the Deprivation status and the population Dependency Ratio of the catchment area. These factors interact, with both high deprivation and Dependency cohorts having a major influence on the numbers of emergency medical admission patients with an extended hospital episode. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Impact of cigarette smoking on rates and clinical prognosis of pulmonary tuberculosis in Southern Mexico.

PubMed

Bonacci, Robert A; Cruz-Hervert, Luis Pablo; García-García, Lourdes; Reynales-Shigematsu, Luz Myriam; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Báez-Saldaña, Renata; Téllez-Vázquez, Norma; Mongua-Rodríguez, Norma; Montero-Campos, Rogelio; Delgado-Sánchez, Guadalupe; Martínez-Gamboa, Rosa Areli; Cano-Arellano, Bulmaro; Sifuentes-Osornio, José; Ponce de León, Alfredo

2013-04-01

To examine the relationship between cigarette smoking and incidence and mortality rates of pulmonary tuberculosis (TB) and treatment outcomes. From 1995 to 2010, we analyzed data from 1062 patients with TB and from 2001 to 2004, 2951 contacts in Southern Mexico. Patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and mycobacteriological evaluation and received treatment by the local DOTS program. Consumers of 1-10 (LS) or 11 or more (HS) cigarettes per day incidence (1.75 and 11.79) and mortality (HS, 17.74) smoker-non-smoker rate ratios were significantly higher for smokers. Smoker population was more likely to experience unfavorable treatment outcomes (HS, adjusted OR 2.36) and retreatment (LS and HS, adjusted hazard ratio (HR) 2.14 and 2.37). Contacts that smoked had a higher probability of developing active TB (HR 2.38) during follow up. Results indicate the need of incorporating smoking prevention and cessation, especially among men, into international TB control strategies. Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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

42 CFR 412.322 - Indirect medical education adjustment factor.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data. CMS...] Determination of Transition Period Payment Rates for Capital-Related Costs ... 42 Public Health 2 2010-10-01 2010-10-01 false Indirect medical education adjustment factor. 412...

Maternal personal resources and children's socioemotional and behavioral adjustment.

PubMed

Al-Yagon, Michal

2008-09-01

The study examined the role of three maternal personal resources [sense of coherence (SOC), attachment style, and social/emotional feelings of loneliness] in explaining children's socioemotional adjustment (self-rated loneliness and SOC, and mother-rated child behavior) and children's (self-rated) secure attachment. The sample included 58 mother-child dyads (27 boys and 31 girls) aged 8-11 years. Preliminary analyses indicated significant group differences between mothers with high or low scores on the two subscales of the attachment scale (i.e., avoidance and anxiety), on their SOC, and their social/emotional loneliness. Findings revealed that maternal SOC significantly contributed to all child socioemotional adjustment measures and attachment scores. In addition, the current findings demonstrated the role of maternal anxious attachment in explaining children's externalizing behaviors. Discussion focused on the unique value of maternal characteristics for understanding social and emotional adjustment among school-age children.

Psychosocial work characteristics and self rated health in four post-communist countries.

PubMed

Pikhart, H; Bobak, M; Siegrist, J; Pajak, A; Rywik, S; Kyshegyi, J; Gostautas, A; Skodova, Z; Marmot, M

2001-09-01

To examine whether psychosocial factors at work are related to self rated health in post-communist countries. Random samples of men and women in five communities in four countries were sent a postal questionnaire (Poland, Czech Republic and Lithuania) or were invited to an interview (Hungary). Working subjects (n=3941) reported their self rated health in the past 12 months (5 point scale), their socioeconomic circumstances, perceived control over life, and the following aspects of the psychosocial work environment: job control, job demand, job variety, social support, and effort and reward at work (to calculate a ratio of effort/reward imbalance). As the results did not differ by country, pooled analyses were performed. Odds ratios of poor or very poor health ("poor health") were estimated for a 1 SD increase in the scores of work related factors. The overall prevalence of poor health was 6% in men and 7% in women. After controlling for age, sex and community, all work related factors were associated with poor health (p<0.05). After further adjustment for perceived control, only two work related factors remained associated with poor health; the odds ratios (95% confidence intervals) for 1 SD increase in the effort/reward ratio (log transformed) and job variety were 1.51 (1.29, 1.78) and 0.82 (0.73, 1.00), respectively. Further adjustment for all work related factors did not change these estimates. There were no interactions between individual work related factors, but the effects of job control and social support at work differed by marital status, and the odds ratio of job demand increased with increasing education. The continuous measure of effort/reward imbalance at work was a powerful determinant of self rated health in these post-communist populations. Although the cross sectional design does not allow firm conclusions as to causality, this study suggests that the effect of the psychosocial work environment is not confined to Western populations.

Rate equation model of laser induced bias in uranium isotope ratios measured by resonance ionization mass spectrometry

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

Isselhardt, B. H.; Prussin, S. G.; Savina, M. R.

2016-01-01

Resonance Ionization Mass Spectrometry (RIMS) has been developed as a method to measure uranium isotope abundances. In this approach, RIMS is used as an element-selective ionization process between uranium atoms and potential isobars without the aid of chemical purification and separation. The use of broad bandwidth lasers with automated feedback control of wavelength was applied to the measurement of the U-235/U-238 ratio to decrease laser-induced isotopic fractionation. In application, isotope standards are used to identify and correct bias in measured isotope ratios, but understanding laser-induced bias from first-principles can improve the precision and accuracy of experimental measurements. A rate equationmore » model for predicting the relative ionization probability has been developed to study the effect of variations in laser parameters on the measured isotope ratio. The model uses atomic data and empirical descriptions of laser performance to estimate the laser-induced bias expected in experimental measurements of the U-235/U-238 ratio. Empirical corrections are also included to account for ionization processes that are difficult to calculate from first principles with the available atomic data. Development of this model has highlighted several important considerations for properly interpreting experimental results.« less

Rate equation model of laser induced bias in uranium isotope ratios measured by resonance ionization mass spectrometry

DOE PAGES

Isselhardt, B. H.; Prussin, S. G.; Savina, M. R.; ...

2015-12-07

Resonance Ionization Mass Spectrometry (RIMS) has been developed as a method to measure uranium isotope abundances. In this approach, RIMS is used as an element-selective ionization process between uranium atoms and potential isobars without the aid of chemical purification and separation. The use of broad bandwidth lasers with automated feedback control of wavelength was applied to the measurement of the 235U/238U ratio to decrease laser-induced isotopic fractionation. In application, isotope standards are used to identify and correct bias in measured isotope ratios, but understanding laser-induced bias from first-principles can improve the precision and accuracy of experimental measurements. A rate equationmore » model for predicting the relative ionization probability has been developed to study the effect of variations in laser parameters on the measured isotope ratio. The model uses atomic data and empirical descriptions of laser performance to estimate the laser-induced bias expected in experimental measurements of the 235U/ 238U ratio. Empirical corrections are also included to account for ionization processes that are difficult to calculate from first principles with the available atomic data. As a result, development of this model has highlighted several important considerations for properly interpreting experimental results.« less

Husbands’ and Wives’ Alcohol Use Disorders and Marital Interactions as Longitudinal Predictors of Marital Adjustment

PubMed Central

Cranford, James A.; Floyd, Frank J.; Schulenberg, John E.; Zucker, Robert A.

2011-01-01

This longitudinal study tested the hypothesis that marital interactions mediate the associations between wives’ and husbands’ lifetime alcoholism status and their subsequent marital adjustment. Participants were 105 couples from the Michigan Longitudinal Study (MLS), an ongoing multimethod investigation of substance use in a community-based sample of alcoholics, nonalcoholics, and their families. At baseline (T1), husbands and wives completed a series of diagnostic measures and lifetime DSM-IV diagnosis of alcohol use disorder (AUD) was assessed. Couples completed a problem-solving marital interaction task 3 years later at T2, which was coded for the ratio of positive to negative behaviors (P/N) was calculated. Couples also completed the Dyadic Adjustment Scale (DAS; Spanier, 1976) at T4 (9 years after T1 and 6 years after T2). Moderate to strong positive correlations were observed between husbands’ and wives’ lifetime AUD, P/N ratio, and dyadic adjustment. Based on an Actor-Partner Independence Model (APIM) framework, results from structural equation modeling showed that husbands’ lifetime AUD was negatively associated with wives’ P/N ratio at the 3 year point, but was not related to their own or their wives’ marital adjustment 9 years from baseline. However, wives’ lifetime AUD had direct negative associations with their own and their husband’s marital satisfaction 9 years later, and wives’ P/N ratio was positively related to their own and their husband’s marital satisfaction 6 years later. Results indicate that marital adjustment in alcoholic couples may be driven more by the wives’ than the husbands’ AUD and marital behavior. PMID:21133510

RNA:DNA ratios as a proxy of egg production rates of Acartia

NASA Astrophysics Data System (ADS)

Cruz, Joana; Teodósio, M. Alexandra; Ben-Hamadou, Radhouane; Chícharo, Luís; Garrido, Susana; Ré, Pedro; Santos, A. Miguel P.

2017-03-01

Estimates of copepod secondary production are of great importance to infer the global organic matter fluxes in aquatic ecosystems and species-specific responses of zooplankton to hydrologic variability. However, there is still no routine method to determine copepods secondary production in order to eliminate time consuming experimental analyses. Therefore, we determined whether there is a correlation between Egg Production Rates (EPR) and RNA:DNA ratios of Acartia species, by measuring their seasonal and spatial variability and the influence of environmental factors for Acartia sp. collected in the Guadiana river estuary. EPR of Acartia tonsa was positively related with chlorophyll a concentration, freshwater inflow and biomass of dinoflagellates, while Acartia clausi was only related to dinoflagellates. Dinoflagellates seem to be the optimal food item influencing the reproduction of both Acartia species in the studied area. The biochemical index RNA:DNA was positively related to EPR, indicating that it is a good proxy of copepod production and a promising method to use in the future to estimate secondary production.

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.

RECURRENCE RATES OF OCULAR TOXOPLASMOSIS DURING PREGNANCY

PubMed Central

Braakenburg, Arthur M.D.; Crespi, Catherine M.; Holland, Gary N.; Wu, Sheng; Yu, Fei; Rothova, Aniki

2014-01-01

Purpose To investigate whether recurrence rates of ocular toxoplasmosis are higher during pregnancy among women of childbearing age. Design Retrospective longitudinal cohort study. Methods We reviewed medical records of all women seen at a university eye clinic (Utrecht, Netherlands) during episodes of active toxoplasmic retinochoroiditis that occurred while the women were of childbearing age (16–42 years). Each woman was sent a questionnaire requesting information regarding all pregnancies and episodes of ocular toxoplasmosis, whether or not episodes were observed at the eye clinic. Conditional fixed-effects Poisson regression was used to model incident rate ratios of recurrence during pregnant versus non-pregnant intervals, adjusted for potential confounders, including age at time of active toxoplasmic retinochoroiditis and interval since last episode of active disease, which are known to influence risk of recurrence. Results Questionnaires were returned by 50 (58%) of 86 women, 34 of whom had 69 pregnancies during 584 person-years of study. There were 128 episodes of ocular toxoplasmosis during the study period (6 during pregnancy). First episodes of ocular toxoplasmosis occurred between ages 9.6 and 38.5 years. Youngest age at pregnancy was 16.1 years; oldest age at childbirth was 40.9 years. Incident rate ratios for pregnant versus non-pregnant intervals were in the direction of lower recurrence rates during pregnancy, with point estimates of 0.54 and 0.75 under two different approaches, but ratios were not significantly different from the null value (p-values of 0.16 and 0.55). Conclusions Recurrence rates of ocular toxoplasmosis are likely not higher during pregnancy, in contrast to traditional beliefs. PMID:24412127

Recurrence rates of ocular toxoplasmosis during pregnancy.

PubMed

Braakenburg, Arthur M D; Crespi, Catherine M; Holland, Gary N; Wu, Sheng; Yu, Fei; Rothova, Aniki

2014-04-01

To investigate whether recurrence rates of ocular toxoplasmosis are higher during pregnancy in women of childbearing age. Retrospective longitudinal cohort study. We reviewed medical records of all women seen at a university eye clinic (Utrecht, Netherlands) during episodes of active toxoplasmic retinochoroiditis that occurred while the women were of childbearing age (16-42 years). Each woman was sent a questionnaire requesting information regarding all pregnancies and episodes of ocular toxoplasmosis, whether or not episodes were observed at the eye clinic. Conditional fixed-effects Poisson regression was used to model incidence rate ratios of recurrence during pregnant versus nonpregnant intervals, adjusted for potential confounders, including age at time of active toxoplasmic retinochoroiditis and interval since last episode of active disease, which are known to influence risk for recurrence. Questionnaires were returned by 50 (58%) of 86 women, 34 of whom had had 69 pregnancies during 584 person-years of study. There were 128 episodes of ocular toxoplasmosis during the study period (6 during pregnancy). First episodes of ocular toxoplasmosis occurred between ages 9.6 and 38.5 years. The youngest age at pregnancy was 16.1 years; the oldest age at childbirth was 40.9 years. The incidence-rate ratios for pregnant versus nonpregnant intervals were in the direction of lower recurrence rates during pregnancy, with point estimates of 0.54 and 0.75 under 2 different approaches, but the ratios were not significantly different from the null value (P values of 0.16 and 0.55). Recurrence rates of ocular toxoplasmosis are probably not higher during pregnancy, in contrast to traditional beliefs. Copyright © 2014 Elsevier Inc. All rights reserved.

Variation in hospital mortality rates with inpatient cancer surgery.

PubMed

Wong, Sandra L; Revels, ShaʼShonda L; Yin, Huiying; Stewart, Andrew K; McVeigh, Andrea; Banerjee, Mousumi; Birkmeyer, John D

2015-04-01

To elucidate clinical mechanisms underlying variation in hospital mortality after cancer surgery : Thousands of Americans die every year undergoing elective cancer surgery. Wide variation in hospital mortality rates suggest opportunities for improvement, but these efforts are limited by uncertainty about why some hospitals have poorer outcomes than others. Using data from the 2006-2007 National Cancer Data Base, we ranked 1279 hospitals according to a composite measure of perioperative mortality after operations for bladder, esophagus, colon, lung, pancreas, and stomach cancers. We then conducted detailed medical record review of 5632 patients at 1 of 19 hospitals with low mortality rates (2.1%) or 30 hospitals with high mortality rates (9.1%). Hierarchical logistic regression analyses were used to compare risk-adjusted complication incidence and case-fatality rates among patients experiencing serious complications. The 7.0% absolute mortality difference between the 2 hospital groups could be attributed to higher mortality from surgical site, pulmonary, thromboembolic, and other complications. The overall incidence of complications was not different between hospital groups [21.2% vs 17.8%; adjusted odds ratio (OR) = 1.34, 95% confidence interval (CI): 0.93-1.94]. In contrast, case-fatality after complications was more than threefold higher at high mortality hospitals than at low mortality hospitals (25.9% vs 13.6%; adjusted OR = 3.23, 95% CI: 1.56-6.69). Low mortality and high mortality hospitals are distinguished less by their complication rates than by how frequently patients die after a complication. Strategies for ensuring the timely recognition and effective management of postoperative complications will be essential in reducing mortality after cancer surgery.

Relationship Between Post-exercise Heart Rate Recovery and Changing Ratio of Cardiopulmonary Exercise Capacity.

PubMed

Kim, Ji-Hyun; Choe, Yu-Ri; Song, Min-Keun; Choi, In-Sung; Han, Jae-Young

2017-12-01

To determine whether heart rate recovery (HRR) following an exercise tolerance test (ETT) is correlated with a changing ratio of peak oxygen consumption (VO 2 ) and maximal metabolic equivalents (MET max ). A total of 60 acute myocardial infarction (AMI) patients who underwent ETT at both assessment points - 3 weeks (T0) after the AMI attack and 3 months after T0 (T1) were included. After achieving a peak workload, the treadmill was stopped with a 5-minute cooldown period, and the patients recovered in a comfortable and relaxed seated position. HRR was defined as the difference between the maximal heart rate (HR max ) and the HR measured at specific time intervals - immediately after the cool down period (HRR-0) and 3 minutes after the completion of the ETT (HRR-3). HRR-0 and HRR-3 increased over time, whereas VO 2max and MET max did not show significant changes. There was a positive correlation between HRR at T0 and the exercise capacity at T0. HRR at T0 also showed a positive correlation with the exercise capacity at T1. There was no significant correlation between HRR measured at T0 and the change in the ratio of VO 2max and MET max , as calculated by subtracting VO 2max and MET max obtained at T0 from those obtained at T1, divided by VO 2max at T0 and multiplied by 100. Post-exercise HRR measured at 3 weeks after the AMI onset can reflect the exercise capacity 3 months after the first ETT. However, it may be difficult to correlate post-exercise HRR at T0 with the degree of increase in cardiopulmonary exercise capacity in patients with AMI.

Why do four NICUs using identical RBC transfusion guidelines have different gestational age-adjusted RBC transfusion rates?

PubMed

Henry, E; Christensen, R D; Sheffield, M J; Eggert, L D; Carroll, P D; Minton, S D; Lambert, D K; Ilstrup, S J

2015-02-01

To compare neonatal red blood cell (RBC) transfusion rates in four large Intermountain Healthcare NICUs, all of which adhere to the same RBC transfusion guidelines. This retrospective analysis was part of a transfusion-management quality-improvement project. De-identified data included RBC transfusions, clinical and laboratory findings, the anemia-prevention strategies in place in each NICU, and specific costs and outcomes. Of 2389 NICU RBC transfusions given during the 4-year period studied, 98.9 ± 2.1% (mean ± S.D.) were compliant with our transfusion guidelines, with no difference in compliance between any of the four NICUs. However, RBC transfusion rates varied widely between the four, with averages ranging from 4.6 transfusions/1000 NICU days to 21.7/1000 NICU days (P < 0.00001). Gestational age-adjusted transfusion rates were correspondingly discordant (P < 0.00001). The lower-transfusing NICUs had written anemia-preventing guidelines, such as umbilical cord milking at very low birth weight delivery, use of cord blood for admission laboratory studies, and darbepoetin dosing for selected neonates. Rates of Bell stage ⩾ 2 necrotizing enterocolitis and grade ⩾ 3 intraventricular hemorrhage were lowest in the two lower-transfusing NICUs (P < 0.0002 and P < 0.0016). Average pharmacy costs for darbepoetin were $84/dose, with an average pharmacy cost of $269 per transfusion averted. With a cost of $900/RBC transfusion, the anemia-preventing strategies resulted in an estimated cost savings to Intermountain Healthcare of about $6970 per 1000 NICU days, or about $282,300 annually. Using transfusion guidelines has been shown previously to reduce practice variability, lower transfusion rates and diminish transfusion costs. Based on our present findings, we maintain that even when transfusion guidelines are in place and adhered to rigorously, RBC transfusion rates are reduced further if anemia-preventing strategies are also in place.

48 CFR 1652.216-70 - Accounting and price adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Accounting and price... of FEHBP Clauses 1652.216-70 Accounting and price adjustment. As prescribed in section 1616.7001, the... (community rated). Accounting and Price Adjustment (JAN 2003) (a) Annual Accounting Statement. The Carrier...

The self as a mediator between personality and adjustment.

PubMed

Graziano, W G; Jensen-Campbell, L A; Finch, J F

1997-08-01

The self can be conceptualized as a mediating agent that translates personality into situated goal-directed activities and adaptation. This research used a level-of-analysis approach to link personality dimensions (Level I) to self-systems (Level II) and to teacher ratings of adjustment in African American, Mexican American, and European American students (N = 317). The authors hypothesized that links among aspects of self-esteem and teacher ratings of adjustment would be domain specific, and those links to dimensions of the 5-factor model would reflects the domain specificity. Structural equation modeling corroborated hypotheses about domain specificity in links between adjustment and 5-factor dimensions. Results were discussed in terms of levels of analysis for personality structure, personality development, and age-related adaptations to social contexts.

Assessment of Glacial Isostatic Adjustment in Greenland using GPS

NASA Astrophysics Data System (ADS)

Khan, S. A.; Bevis, M. G.; Sasgen, I.; van Dam, T. M.; Wahr, J. M.; Wouters, B.; Bamber, J. L.; Willis, M. J.; Knudsen, P.; Helm, V.; Kuipers Munneke, P.; Muresan, I. S.

2015-12-01

The Greenland GPS network (GNET) was constructed to provide a new means to assess viscoelastic and elastic adjustments driven by past and present-day changes in ice mass. Here we assess existing glacial isostatic adjustments (GIA) predictions by analysing 1995-2015 data from 61 continuous GPS receivers located along the margin of the Greenland ice sheet. Since GPS receivers measure both the GIA and elastic signals, we isolate GIA, by removing the elastic adjustments of the lithosphere due to present-day mass changes using high-resolution fields of ice surface elevation change derived from satellite and airborne altimetry measurements (ERS1/2, ICESat, ATM, ENVISAT, and CryoSat-2). For most GPS stations, our observed GIA rates contradict GIA predictions; particularly, we find huge uplift rates in southeast Greenland of up to 14 mm/yr while models predict rates of 0-2 mm/yr. Our results suggest possible improvements of GIA predictions, and hence of the poorly constrained ice load history and Earth structure models for Greenland.

Poisson sampling - The adjusted and unadjusted estimator revisited

Treesearch

Michael S. Williams; Hans T. Schreuder; Gerardo H. Terrazas

1998-01-01

The prevailing assumption, that for Poisson sampling the adjusted estimator "Y-hat a" is always substantially more efficient than the unadjusted estimator "Y-hat u" , is shown to be incorrect. Some well known theoretical results are applicable since "Y-hat a" is a ratio-of-means estimator and "Y-hat u" a simple unbiased estimator...

Influence of the cooling rate and the blend ratio on the physical stability of co-amorphous naproxen/indomethacin.

PubMed

Beyer, Andreas; Grohganz, Holger; Löbmann, Korbinian; Rades, Thomas; Leopold, Claudia S

2016-12-01

Co-amorphization represents a promising approach to increase the physical stability and dissolution rate of amorphous active pharmaceutical ingredients (APIs) as an alternative to polymer glass solutions. For amorphous and co-amorphous systems, it is reported that the preparation method and the blend ratio play major roles with regard to the resulting physical stability. Therefore, in the present study, co-amorphous naproxen-indomethacin (NAP/IND) was prepared by melt-quenching at three different cooling rates and at ten different NAP/IND blend ratios. The samples were analyzed using XRPD and FTIR, both directly after preparation and during storage to investigate their physical stabilities. All cooling methods led to fully amorphous samples, but with significantly different physical stabilities. Samples prepared by fast cooling had a higher degree of crystallinity after 300d of storage than samples prepared by intermediate cooling and slow cooling. Intermediate cooling was subsequently used to prepare co-amorphous NAP/IND at different blend ratios. In a previous study, it was postulated that the equimolar (0.5:0.5) co-amorphous blend of NAP/IND is most stable. However, in the present study the physically most stable blend was found for a NAP/IND ratio of 0.6:0.4, which also represents the eutectic composition of the crystalline NAP/γ-IND system. This indicates that the eutectic point may be of major importance for the stability of binary co-amorphous systems. Slight deviations from the optimal naproxen molar fraction led to significant recrystallization during storage. Either naproxen or γ-indomethacin recrystallized until a naproxen molar fraction of about 0.6 in the residual co-amorphous phase was reached again. In conclusion, the physical stability of co-amorphous NAP/IND may be significantly improved, if suitable preparation conditions and the optimal phase composition are chosen. Copyright © 2016 Elsevier B.V. All rights reserved.

Increased serum cholesterol esterification rates predict coronary heart disease and sudden death in a general population.

PubMed

Tanaka, Shin-ichiro; Yasuda, Tomoyuki; Ishida, Tatsuro; Fujioka, Yoshio; Tsujino, Takeshi; Miki, Tetsuo; Hirata, Ken-ichi

2013-05-01

Lecithin:cholesterol acyltransferase (LCAT) is thought to be important in reverse cholesterol transport. However, its association with coronary heart disease (CHD) and sudden death is controversial. We prospectively studied 1927 individuals from the general population. Serum concentrations of apolipoprotein A-I, A-II, B, C-II, C-III, E, and LCAT activity measured as a serum cholesterol esterification rate were evaluated. We documented 61 events of CHD and sudden death during 10.9 years of follow-up. After adjustment for age and sex, LCAT activity was significantly associated with the risk of CHD and sudden death (hazard ratio, 3.02; 95% confidence interval, 1.49-6.12; P=0.002). In multivariate analysis adjusted for age, sex, current smoking status, history of diabetes mellitus, body mass index, systolic blood pressure, serum total cholesterol, and serum high-density lipoprotein cholesterol concentrations, the hazard ratio of LCAT activity for the risk of CHD and sudden death remained significant (hazard ratio, 3.07; 95% confidence interval, 1.35-7.01; P=0.008). However, when it was analyzed for men and women separately, this association remained significant only in women. Increased LCAT activity measured as a serum cholesterol esterification rate was a risk for CHD and sudden death in a Japanese general population.

Self-Reported Sleep Duration and Self-Rated Health in Young Adults

PubMed Central

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-01-01

Study Objectives: This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. Methods: In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Results: Approximately 30% of participants slept 7–8 hours, 17.4% were short sleepers (categories < 6 hours and 6–7 hours), and 53.9% were long sleepers (categories 8–10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7–8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6–7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Conclusions: Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. Citation: Štefan L, Juranko D, Prosoli R, Barić R, Sporiš G. Self-reported sleep duration and self-rated health in young adults. J Clin Sleep Med. 2017;13(7):899–904. PMID:28502281

Probing the big five in adolescence: personality and adjustment during a developmental transition.

PubMed

Graziano, W G; Ward, D

1992-06-01

The present study probed the links among Big Five personality differences, self-reported personality differences, and adjustment to school among young adolescents. We used a multimethod converging analysis, with three sources of data: (a) adolescent self-report on standardized personality inventories; (b) classroom teacher trait ratings and evaluations of adjustment; and (c) school guidance counselor evaluations of adjustment. Evaluations of adolescent adjustment were systematically related to Big Five personality differences, as assessed by both classroom teachers' and school counselors' ratings. For classroom teachers, adjustment was closely related to evaluations on the Big Five dimension of Conscientiousness. Adolescent self-report on several standardized measures was not related to adult evaluation of school adjustment. We suggest that the five-factor model may be a useful tool for probing adjustment during the transition to adolescence.

Premorbid adjustment and neuropsychological performance in schizophrenia.

PubMed

Silverstein, Marshall L; Mavrolefteros, George; Close, David

2002-01-01

To examine the relationship between premorbid adjustment and neuropsychological deficit in schizophrenia, this report examined retrospective ratings of social and school adjustment during three age epochs (childhood, early adolescence, and late adolescence) as predictors of neurocognitive performance in 61 clinically and pharmacologically stabilized schizophrenia outpatients. Results indicated greater cognitive deficits when premorbid adjustment was unfavorable, particularly for measures of attention and executive functions. Premorbid number and quality of peer relationships and psychosocial adaptation to the school environment were more closely related to neuropsychological performance during adulthood than were premorbid withdrawal and premorbid academic performance. Early onset of poor premorbid adjustment rather than deterioration from childhood to adolescence was associated with greater neuropsychological disturbance in adulthood. It is suggested that childhood onset of premorbid deficits in selective areas of social and academic adjustment appears to influence the cognitive performance seen in adult schizophrenia. This study is consistent with findings from other related reports; it extends these findings to a larger and clinically stabilized sample.

Stroke and the "stroke belt" in dialysis: contribution of patient characteristics to ischemic stroke rate and its geographic variation.

PubMed

Wetmore, James B; Ellerbeck, Edward F; Mahnken, Jonathan D; Phadnis, Milind A; Rigler, Sally K; Spertus, John A; Zhou, Xinhua; Mukhopadhyay, Purna; Shireman, Theresa I

2013-12-01

Geographic variation in stroke rates is well established in the general population, with higher rates in the South than in other areas of the United States. ESRD is a potent risk factor for stroke, but whether regional variations in stroke risk exist among dialysis patients is unknown. Medicare claims from 2000 to 2005 were used to ascertain ischemic stroke events in a large cohort of 265,685 incident dialysis patients. A Poisson generalized linear mixed model was generated to determine factors associated with stroke and to ascertain state-by-state geographic variability in stroke rates by generating observed-to-expected (O/E) adjusted rate ratios for stroke. Older age, female sex, African American race and Hispanic ethnicity, unemployed status, diabetes, hypertension, history of stroke, and permanent atrial fibrillation were positively associated with ischemic stroke, whereas body mass index >30 kg/m(2) was inversely associated with stroke (P<0.001 for each). After full multivariable adjustment, the three states with O/E rate ratios >1.0 were all in the South: North Carolina, Mississippi, and Oklahoma. Regional efforts to increase primary prevention in the "stroke belt" or to better educate dialysis patients on the signs of stroke so that they may promptly seek care may improve stroke care and outcomes in dialysis patients.

Types of cultural capital and self-rated health among disadvantaged women in outer Beirut, Lebanon.

PubMed

Khawaja, Marwan; Mowafi, Mona

2007-01-01

This study extends research on the social determinants of health by exploring the association between a new, potentially very significant dimension, cultural capital by type, and self-rated health among low-income women living in outer Beirut, Lebanon. Self-rated general health was assessed using household data from a cross-sectional survey of 1869 women, conducted in 2003. Three types of cultural capital were included: watching cultural TV programs, producing art (e.g. drawing, theatre performance), and consuming art or literature (e.g. attending exhibitions, reading literary books). Associations between self-rated health status and types of cultural capital were assessed using odds ratios from binary logistic regression models. With the exception of art production, lack of cultural capital increased the odds of self-perceived poor health status adjusting for sociodemographics and other risk factors. The adjusted odds ratios were 1.86 (95% CI 1.07-3.22) for not watching cultural TV programs and 1.52 (95% CI 1.12-2.06) for not consuming art. As expected, health-risk factors, age, social support, and community of residence were also associated with health status. Two types of cultural capital were strong predictors of self-perceived health status among women living in poor urban communities, regardless of social capital, income, and other relevant risk factors.

14 CFR Appendix - Example of SIFL Adjustment

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Example of SIFL Adjustment Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs Treatment of deferred Federal income taxes for rate purposes. Pt. 399, Subpt. C,...

14 CFR Appendix - Example of SIFL Adjustment

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Example of SIFL Adjustment Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs Treatment of deferred Federal income taxes for rate purposes. Pt. 399, Subpt. C,...

14 CFR Appendix - Example of SIFL Adjustment

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Example of SIFL Adjustment Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs Treatment of deferred Federal income taxes for rate purposes. Pt. 399, Subpt. C,...

Ensemble of trees approaches to risk adjustment for evaluating a hospital's performance.

PubMed

Liu, Yang; Traskin, Mikhail; Lorch, Scott A; George, Edward I; Small, Dylan

2015-03-01

A commonly used method for evaluating a hospital's performance on an outcome is to compare the hospital's observed outcome rate to the hospital's expected outcome rate given its patient (case) mix and service. The process of calculating the hospital's expected outcome rate given its patient mix and service is called risk adjustment (Iezzoni 1997). Risk adjustment is critical for accurately evaluating and comparing hospitals' performances since we would not want to unfairly penalize a hospital just because it treats sicker patients. The key to risk adjustment is accurately estimating the probability of an Outcome given patient characteristics. For cases with binary outcomes, the method that is commonly used in risk adjustment is logistic regression. In this paper, we consider ensemble of trees methods as alternatives for risk adjustment, including random forests and Bayesian additive regression trees (BART). Both random forests and BART are modern machine learning methods that have been shown recently to have excellent performance for prediction of outcomes in many settings. We apply these methods to carry out risk adjustment for the performance of neonatal intensive care units (NICU). We show that these ensemble of trees methods outperform logistic regression in predicting mortality among babies treated in NICU, and provide a superior method of risk adjustment compared to logistic regression.

An empirical model of the phytoplankton chlorophyll : carbon ratio-the conversion factor between productivity and growth rate

USGS Publications Warehouse

Cloern, James E.; Grenz, Christian; Vidergar-Lucas, Lisa

1995-01-01

We present an empirical model that describes the ratio of phytoplankton chlorophyll a to carbon, Chl: C, as a function of temperature, daily irradiance, and nutrient-limited growth rate. Our model is based on 219 published measurements of algal cultures exposed to light-limited or nutrient-limited growth conditions. We illustrate an approach for using this estimator of Chl: C to calculate phytoplankton population growth rate from measured primary productivity. This adaptive Chl: C model gives rise to interactive light-nutrient effects in which growth efficiency increases with nutrient availability under low-light conditions. One implication of this interaction is the enhancement of phytoplankton growth efficiency, in addition to enhancement of biomass yield, as a response to eutrophication.

Effects of Systematic Group Counseling on Work Adjustment Clients

ERIC Educational Resources Information Center

Roessler, Richard; And Others

1977-01-01

When compared with a group of clients who had received work adjustment services and a placebo treatment (personal hygiene training), experimental clients given Personal Achievement Skills (PAS) and work adjustment services reported greater gains on self-ratings of life perspective (optimism), work-related attitudes, and goal attainment. (Author)

Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

PubMed

Campbell, Lauren; Li, Yue

2018-02-01

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

ON THE INFERENCE OF THE COSMIC-RAY IONIZATION RATE ζ FROM THE HCO{sup +}-to-DCO{sup +} ABUNDANCE RATIO: THE EFFECT OF NUCLEAR SPIN

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

Shingledecker, Christopher N.; Le Gal, Romane; Hincelin, Ugo

2016-10-20

The chemistry of dense interstellar regions was analyzed using a time-dependent gas–grain astrochemical simulation and a new chemical network that incorporates deuterated chemistry, taking into account nuclear spin states for the hydrogen chemistry and its deuterated isotopologues. With this new network, the utility of the [HCO{sup +}]/[DCO{sup +}] abundance ratio as a probe of the cosmic-ray ionization rate has been re-examined, with special attention paid to the effect of the initial value of the ortho-to-para ratio (OPR) of molecular hydrogen. After discussing the use of the probe for cold cores, we compare our results with previous theoretical and observational resultsmore » for a molecular cloud close to the supernova remnant W51C, which is thought to have an enhanced cosmic-ray ionization rate ζ caused by the nearby γ -ray source. In addition, we attempt to use our approach to estimate the cosmic-ray ionization rate for L1174, a dense core with an embedded star. Beyond the previously known sensitivity of [HCO{sup +}]/[DCO{sup +}] to ζ , we demonstrate its additional dependence on the initial OPR and, secondarily, on the age of the source, its temperature, and its density. We conclude that the usefulness of the [HCO{sup +}]/[DCO{sup +}] abundance ratio in constraining the cosmic-ray ionization rate in dense regions increases with the age of the source and the ionization rate as the ratio becomes far less sensitive to the initial value of the OPR.« less

Lung Cancer Resection at Hospitals With High vs Low Mortality Rates.

PubMed

Grenda, Tyler R; Revels, Sha'Shonda L; Yin, Huiying; Birkmeyer, John D; Wong, Sandra L

2015-11-01

Wide variations in mortality rates exist across hospitals following lung cancer resection; however, the factors underlying these differences remain unclear. To evaluate perioperative outcomes in patients who underwent lung cancer resection at hospitals with very high and very low mortality rates (high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) to better understand the factors related to differences in mortality rates after lung cancer resection. In this retrospective cohort study, 1279 hospitals that were accredited by the Commission on Cancer were ranked on a composite measure of risk-adjusted mortality following major cancer resections performed from January 1, 2005, through December 31, 2006. We collected data from January 1, 2006, through December 31, 2007, on 645 lung resections in 18 LMHs and 25 HMHs. After adjusting for patient characteristics, we used hierarchical logistic regression to examine differences in the incidence of complications and "failure-to-rescue" rates (defined as death following a complication). Rates of adherence to processes of care, incidence of complications, and failure to rescue following complications. Among 645 patients who received lung resections (441 in LMHs and 204 in HMHs), the overall unadjusted mortality rates were 1.6% (n = 7) vs 10.8% (n = 22; P < .001) for LMHs and HMHs, respectively. Following risk adjustment, the difference in mortality rates was attenuated (1.8% vs 8.1%; P < .001) but remained significant. Overall, complication rates were higher in HMHs (23.3% vs 15.6%; adjusted odds ratio [aOR], 1.79; 95% CI, 0.99-3.21), but this difference was not significant. The likelihood of any surgical (aOR, 0.73; 95% CI, 0.26-2.00) or cardiopulmonary (aOR, 1.23; 95% CI, 0.70-2.16) complications was similar between LMHs and HMHs. However, failure-to-rescue rates were significantly higher in HMHs (25.9% vs 8.7%; aOR, 6.55; 95% CI, 1.44-29.88). Failure-to-rescue rates are higher at HMHs, which may

Case-mix adjustment and the comparison of community health center performance on patient experience measures.

PubMed

Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

2010-06-01

To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

Urinary trace element concentrations in environmental settings: is there a value for systematic creatinine adjustment or do we introduce a bias?

PubMed

Hoet, Perrine; Deumer, Gladys; Bernard, Alfred; Lison, Dominique; Haufroid, Vincent

2016-01-01

Systematic creatinine adjustment of urinary concentrations of biomarkers has been a challenge over the past years because the assumption of a constant creatinine excretion rate appears erroneous and the issue of overadjustment has recently emerged. This study aimed at determining whether systematic creatinine adjustment is to be recommended for urinary concentrations of trace elements (TEs) in environmental settings. Paired 24-h collection and random spot urine samples (spotU) were obtained from 39 volunteers not occupationally exposed to TEs. Four models to express TEs concentration in spotU were tested to predict the 24-h excretion rate of these TEs (TEμg/24h) considered as the gold standard reference: absolute concentration (TEμg/l); ratio to creatinine (TEμg/gcr); TEμg/gcr adjusted to creatinine (TEμg/gcr-adj); and concentration adjusted to specific gravity (TEμg/l-SG). As, Ba, Cd, Co, Cr, Cu, Hg, Li, Mo, Ni, Pb, Sn, Sb, Se, Te, V and Zn were analyzed by inductively coupled argon plasma mass spectrometry. There was no single pattern of relationship between urinary TEs concentrations in spotU and TEμg/24h. TEμg/l predicted TEμg/24h with an explained variance ranging from 0 to 60%. Creatinine adjustment improved the explained variance by an additional 5 to ~60% for many TEs, but with a risk of overadjustment for the most of them. This issue could be addressed by adjusting TE concentrations on the basis of the regression coefficient of the relationship between TEμg/gcr and creatinine concentration. SG adjustment was as suitable as creatinine adjustment to predict TEμg/24h with no SG-overadjustment (except V). Regarding Cd, Cr, Cu, Ni and Te, none of the models were found to reflect TEμg/24h. In the context of environmental exposure, systematic creatinine adjustment is not recommended for urinary concentrations of TEs. SG adjustment appears to be a more reliable alternative. For some TEs, however, neither methods appear suitable.

Licit prescription drug use in a Swedish population according to age, gender and socioeconomic status after adjusting for level of multi-morbidity

PubMed Central

2012-01-01

Background There is a great variability in licit prescription drug use in the population and among patients. Factors other than purely medical ones have proven to be of importance for the prescribing of licit drugs. For example, individuals with a high age, female gender and low socioeconomic status are more likely to use licit prescription drugs. However, these results have not been adjusted for multi-morbidity level. In this study we investigate the odds of using licit prescription drugs among individuals in the population and the rate of licit prescription drug use among patients depending on gender, age and socioeconomic status after adjustment for multi-morbidity level. Methods The study was carried out on the total population aged 20 years or older in Östergötland county with about 400 000 inhabitants in year 2006. The Johns Hopkins ACG Case-mix was used as a proxy for the individual level of multi-morbidity in the population to which we have related the odds ratio for individuals and incidence rate ratio (IRR) for patients of using licit prescription drugs, defined daily doses (DDDs) and total costs of licit prescription drugs after adjusting for age, gender and socioeconomic factors (educational and income level). Results After adjustment for multi-morbidity level male individuals had less than half the odds of using licit prescription drugs (OR 0.41 (95% CI 0.40-0.42)) compared to female individuals. Among the patients, males had higher total costs (IRR 1.14 (95% CI 1.13-1.15)). Individuals above 80 years had nine times the odds of using licit prescription drugs (OR 9.09 (95% CI 8.33-10.00)) despite adjustment for multi-morbidity. Patients in the highest education and income level had the lowest DDDs (IRR 0.78 (95% CI 0.76-0.80), IRR 0.73 (95% CI 0.71-0.74)) after adjustment for multi-morbidity level. Conclusions This paper shows that there is a great variability in licit prescription drug use associated with gender, age and socioeconomic status

The Relationship of Paternal Acceptance and Control to College Females' Personality Adjustment.