Science.gov

Sample records for airway costs allocation

  1. 45 CFR 98.55 - Cost allocation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Cost allocation. 98.55 Section 98.55 Public... of Child Care and Development Funds § 98.55 Cost allocation. (a) The Lead Agency and subgrantees shall keep on file cost allocation plans or indirect cost agreements, as appropriate, that have...

  2. 45 CFR 98.55 - Cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Cost allocation. 98.55 Section 98.55 Public... of Child Care and Development Funds § 98.55 Cost allocation. (a) The Lead Agency and subgrantees shall keep on file cost allocation plans or indirect cost agreements, as appropriate, that have...

  3. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Cost allocation. 1355.57 Section 1355.57 Public... MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL § 1355.57 Cost allocation. (a... maintenance payments or adoption assistance payments may be made under the State plan. (b) Cost allocation...

  4. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Cost allocation. 1355.57 Section 1355.57 Public... MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL § 1355.57 Cost allocation. (a... maintenance payments or adoption assistance payments may be made under the State plan. (b) Cost allocation...

  5. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Cost allocation. 1355.57 Section 1355.57 Public... MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL § 1355.57 Cost allocation. (a...) Cost allocation and distribution for the planning, design, development, installation and operation...

  6. 45 CFR 400.13 - Cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cost allocation. 400.13 Section 400.13 Public... for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must allocate... management of the State's refugee program (e.g., development of the State plan, overall program...

  7. 45 CFR 400.13 - Cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 2 2011-10-01 2011-10-01 false Cost allocation. 400.13 Section 400.13 Public... for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must allocate... management of the State's refugee program (e.g., development of the State plan, overall program...

  8. 45 CFR 400.13 - Cost allocation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 2 2013-10-01 2012-10-01 true Cost allocation. 400.13 Section 400.13 Public... for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must allocate... management of the State's refugee program (e.g., development of the State plan, overall program...

  9. 45 CFR 400.13 - Cost allocation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 2 2012-10-01 2012-10-01 false Cost allocation. 400.13 Section 400.13 Public... for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must allocate... management of the State's refugee program (e.g., development of the State plan, overall program...

  10. What Does it Really Cost? Allocating Indirect Costs.

    ERIC Educational Resources Information Center

    Snyder, Herbert; Davenport, Elisabeth

    1997-01-01

    Better managerial control in terms of decision making and understanding the costs of a system/service result from allocating indirect costs. Allocation requires a three-step process: selecting cost objectives, pooling related overhead costs, and selecting costs bases to connect the objectives to the pooled costs. Argues that activity-based costing…

  11. Projected 1999-2000 Cost Allocation Summary.

    ERIC Educational Resources Information Center

    Wisconsin Technical Coll. System Board, Madison.

    Information contained in this summary was derived from data submitted by Wisconsin technical colleges on their 1999-2000 projected cost allocation schedules. Cost allocation information is used to calculate the distribution of state aids to each college, and prepare financial and enrollment reports including state statistical summaries and reports…

  12. 45 CFR 205.150 - Cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ASSISTANCE PROGRAMS § 205.150 Cost allocation. A State plan under title I, IV-A, X, XIV, or XVI (AABD) of the Social Security Act must provide that the State agency will have an approved cost allocation plan on file with the Department in accordance with the requirements contained in subpart E of 45 CFR part...

  13. 45 CFR 205.150 - Cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ASSISTANCE PROGRAMS § 205.150 Cost allocation. A State plan under title I, IV-A, X, XIV, or XVI (AABD) of the Social Security Act must provide that the State agency will have an approved cost allocation plan on file with the Department in accordance with the requirements contained in subpart E of 45 CFR part...

  14. 42 CFR 433.34 - Cost allocation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets... 42 Public Health 4 2013-10-01 2013-10-01 false Cost allocation. 433.34 Section 433.34 Public... Provisions § 433.34 Cost allocation. A State plan under Title XIX of the Social Security Act must...

  15. 42 CFR 433.34 - Cost allocation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets... 42 Public Health 4 2012-10-01 2012-10-01 false Cost allocation. 433.34 Section 433.34 Public... Provisions § 433.34 Cost allocation. A State plan under Title XIX of the Social Security Act must...

  16. 42 CFR 433.34 - Cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets... 42 Public Health 4 2011-10-01 2011-10-01 false Cost allocation. 433.34 Section 433.34 Public... Provisions § 433.34 Cost allocation. A State plan under Title XIX of the Social Security Act must...

  17. 45 CFR 98.55 - Cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost allocation. 98.55 Section 98.55 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Use of Child Care and Development Funds § 98.55 Cost allocation. (a) The Lead Agency and...

  18. 2 CFR 200.405 - Allocable costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GUIDANCE Reserved UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS Cost Principles Basic Considerations § 200.405 Allocable costs. (a) A cost...

  19. 42 CFR 457.228 - Cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... or appropriate CHIP Agency will have an approved cost allocation plan on file with the Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets forth...

  20. 47 CFR 64.903 - Cost allocation manuals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Cost allocation manuals. 64.903 Section 64.903... RULES RELATING TO COMMON CARRIERS Allocation of Costs § 64.903 Cost allocation manuals. (a) Each... mid-sized incumbent local exchange carriers is required to file a cost allocation manual...

  1. 45 CFR 304.15 - Cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Department in accordance with the requirements contained in Subpart E of 45 CFR part 95. Subpart E also sets... Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT... FEDERAL FINANCIAL PARTICIPATION § 304.15 Cost allocation. A State agency in support of its claims...

  2. 45 CFR 400.13 - Cost allocation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must...

  3. 42 CFR 457.228 - Cost allocation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... or appropriate CHIP Agency will have an approved cost allocation plan on file with the Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets forth the... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  4. 42 CFR 457.228 - Cost allocation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Cost allocation. 457.228 Section 457.228 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES General Administration-Reviews and Audits; Withholding for...

  5. 42 CFR 457.228 - Cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... or appropriate CHIP Agency will have an approved cost allocation plan on file with the Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets forth the... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  6. 42 CFR 457.228 - Cost allocation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... or appropriate CHIP Agency will have an approved cost allocation plan on file with the Department in accordance with the requirements contained in subpart E of 45 CFR part 95. Subpart E also sets forth the... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  7. 28 CFR 100.14 - Directly allocable costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 100.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) COST RECOVERY REGULATIONS, COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.14 Directly allocable costs. (a) A cost is directly allocable to the CALEA compliance effort: (1) If it is a plant cost incurred specifically to...

  8. 28 CFR 100.14 - Directly allocable costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 100.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) COST RECOVERY REGULATIONS, COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.14 Directly allocable costs. (a) A cost is directly allocable to the CALEA compliance effort: (1) If it is a plant cost incurred specifically to...

  9. 28 CFR 100.14 - Directly allocable costs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 100.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) COST RECOVERY REGULATIONS, COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.14 Directly allocable costs. (a) A cost is directly allocable to the CALEA compliance effort: (1) If it is a plant cost incurred specifically to...

  10. 28 CFR 100.14 - Directly allocable costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 100.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) COST RECOVERY REGULATIONS, COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.14 Directly allocable costs. (a) A cost is directly allocable to the CALEA compliance effort: (1) If it is a plant cost incurred specifically to...

  11. 28 CFR 100.14 - Directly allocable costs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 100.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) COST RECOVERY REGULATIONS, COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.14 Directly allocable costs. (a) A cost is directly allocable to the CALEA compliance effort: (1) If it is a plant cost incurred specifically to...

  12. 26 CFR 1.460-5 - Cost allocation rules.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 6 2011-04-01 2011-04-01 false Cost allocation rules. 1.460-5 Section 1.460-5...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-5 Cost allocation...-contract method described in § 1.460-4(d) (CCM), or the percentage-of-completion/capitalized-cost...

  13. 26 CFR 1.460-5 - Cost allocation rules.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 6 2014-04-01 2014-04-01 false Cost allocation rules. 1.460-5 Section 1.460-5...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-5 Cost allocation...-contract method described in § 1.460-4(d) (CCM), or the percentage-of-completion/capitalized-cost...

  14. 26 CFR 1.460-5 - Cost allocation rules.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 6 2013-04-01 2013-04-01 false Cost allocation rules. 1.460-5 Section 1.460-5...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-5 Cost allocation...-contract method described in § 1.460-4(d) (CCM), or the percentage-of-completion/capitalized-cost...

  15. 26 CFR 1.460-5 - Cost allocation rules.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 6 2012-04-01 2012-04-01 false Cost allocation rules. 1.460-5 Section 1.460-5...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-5 Cost allocation...-contract method described in § 1.460-4(d) (CCM), or the percentage-of-completion/capitalized-cost...

  16. 47 CFR 1.1417 - Allocation of Unusable Space Costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Allocation of Unusable Space Costs. 1.1417... Attachment Complaint Procedures § 1.1417 Allocation of Unusable Space Costs. (a) With respect to the formula referenced in § 1.1409(e)(2), a utility shall apportion the cost of providing unusable space on a pole...

  17. 47 CFR 1.1417 - Allocation of Unusable Space Costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Allocation of Unusable Space Costs. 1.1417... by Random Selection Pole Attachment Complaint Procedures § 1.1417 Allocation of Unusable Space Costs... providing unusable space on a pole so that such apportionment equals two-thirds of the costs of...

  18. Survey of Transmission Cost Allocation Methodologies for Regional Transmission Organizations

    SciTech Connect

    Fink, S.; Porter, K.; Mudd, C.; Rogers, J.

    2011-02-01

    The report presents transmission cost allocation methodologies for reliability transmission projects, generation interconnection, and economic transmission projects for all Regional Transmission Organizations.

  19. 26 CFR 1.460-5 - Cost allocation rules.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 6 2010-04-01 2010-04-01 false Cost allocation rules. 1.460-5 Section 1.460-5...) INCOME TAXES Taxable Year for Which Items of Gross Income Included § 1.460-5 Cost allocation rules. (a... described in § 1.460-4(d) (CCM), or the percentage-of-completion/capitalized-cost method described in §...

  20. 77 FR 54482 - Allocation of Costs Under the Simplified Methods

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-05

    ... section 263A costs, raw material costs on hand at year end include unprocessed raw materials and raw... materials that a taxpayer purchases during its current taxable year. Raw material section 471 costs incurred... incurred in the production process and how the cost was allocated to raw materials, work-in-process,...

  1. 42 CFR 415.60 - Allocation of physician compensation costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Physician Services § 415.60 Allocation of physician compensation costs. (a) Definition. For purposes of this... or the carrier. (2) Report the information on which the physician compensation allocation is based to the intermediary or the carrier on an annual basis and promptly notify the intermediary or carrier...

  2. controlling retained insurance costs through an allocation.

    PubMed

    Frese, Richard C

    2015-06-01

    An insurance allocation may help a hospital or health system achieve the following goals for its professional liability and workers' compensation self-insurance or large-deductible programs: Loss-control incentive. Stability. Equity. Comprehension. Ease of administration. PMID:26665334

  3. 47 CFR 1.1417 - Allocation of Unusable Space Costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Allocation of Unusable Space Costs. 1.1417 Section 1.1417 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Pole... Management and Budget....

  4. Transmission Cost Allocation Methodologies for Regional Transmission Organizations

    SciTech Connect

    Fink, S.; Rogers, J.; Porter, K.

    2010-07-01

    This report describes transmission cost allocation methodologies for transmission projects developed to maintain or enhance reliability, to interconnect new generators, or to access new resources and enhance competitive bulk power markets, otherwise known as economic transmission projects.

  5. Report on Transmission Cost Allocation for RTOs and Others (Presentation)

    SciTech Connect

    Coles, L.

    2011-06-01

    Presented at the MARC 2011 Annual Conference, 6 June 2011, Rapid City, South Dakota. This presentation provides an overview of the latest research findings and policy developments pertaining to cost allocation and new variable generation resources on the power grid.

  6. 47 CFR 76.924 - Allocation to service cost categories.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation § 76.924 Allocation to service cost... Premises Equipment Construction/Maintenance Facilities and Equipment Programming Production Facilities and... Production and Office Facilities, Furniture and Equipment Other Tangible Assets Accumulated...

  7. 47 CFR 64.901 - Allocation of costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hierarchy: (i) Whenever possible, common cost categories are to be allocated based upon direct analysis of the origin of the cost themselves. (ii) When direct analysis is not possible, common cost categories... competitive to subsidize services subject to competition. Services included in the definition of...

  8. Adaptive function allocation reduces performance costs of static automation

    NASA Technical Reports Server (NTRS)

    Parasuraman, Raja; Mouloua, Mustapha; Molloy, Robert; Hilburn, Brian

    1993-01-01

    Adaptive automation offers the option of flexible function allocation between the pilot and on-board computer systems. One of the important claims for the superiority of adaptive over static automation is that such systems do not suffer from some of the drawbacks associated with conventional function allocation. Several experiments designed to test this claim are reported in this article. The efficacy of adaptive function allocation was examined using a laboratory flight-simulation task involving multiple functions of tracking, fuel-management, and systems monitoring. The results show that monitoring inefficiency represents one of the performance costs of static automation. Adaptive function allocation can reduce the performance cost associated with long-term static automation.

  9. Demand response compensation, net Benefits and cost allocation: comments

    SciTech Connect

    Hogan, William W.

    2010-11-15

    FERC's Supplemental Notice of Public Rulemaking addresses the question of proper compensation for demand response in organized wholesale electricity markets. Assuming that the Commission would proceed with the proposal ''to require tariff provisions allowing demand response resources to participate in wholesale energy markets by reducing consumption of electricity from expected levels in response to price signals, to pay those demand response resources, in all hours, the market price of energy for such reductions,'' the Commission posed questions about applying a net benefits test and rules for cost allocation. This article summarizes critical points and poses implications for the issues of net benefit tests and cost allocation. (author)

  10. 2 CFR 200.416 - Cost allocation plans and indirect cost proposals.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... agencies (governmental department or agency), normally charge Federal awards for indirect costs through an... necessary to claim indirect costs under Federal awards. Indirect costs include: (1) The indirect costs... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Cost allocation plans and indirect...

  11. ACARA - AVAILABILITY, COST AND RESOURCE ALLOCATION

    NASA Technical Reports Server (NTRS)

    Viterna, L. A.

    1994-01-01

    ACARA is a program for analyzing availability, lifecycle cost, and resource scheduling. It uses a statistical Monte Carlo method to simulate a system's capacity states as well as component failure and repair. Component failures are modelled using a combination of exponential and Weibull probability distributions. ACARA schedules component replacement to achieve optimum system performance. The scheduling will comply with any constraints on component production, resupply vehicle capacity, on-site spares, or crew manpower and equipment. ACARA is capable of many types of analyses and trade studies because of its integrated approach. It characterizes the system performance in terms of both state availability and equivalent availability (a weighted average of state availability). It can determine the probability of exceeding a capacity state to assess reliability and loss of load probability. It can also evaluate the effect of resource constraints on system availability and lifecycle cost. ACARA interprets the results of a simulation and displays tables and charts for: (1) performance, i.e., availability and reliability of capacity states, (2) frequency of failure and repair, (3) lifecycle cost, including hardware, transportation, and maintenance, and (4) usage of available resources, including mass, volume, and maintenance man-hours. ACARA incorporates a user-friendly, menu-driven interface with full screen data entry. It provides a file management system to store and retrieve input and output datasets for system simulation scenarios. ACARA is written in APL2 using the APL2 interpreter for IBM PC compatible systems running MS-DOS. Hardware requirements for the APL2 system include 640K of RAM, 2Mb of extended memory, and an 80386 or 80486 processor with an 80x87 math co-processor. A dot matrix printer is required if the user wishes to print a graph from a results table. A sample MS-DOS executable is provided on the distribution medium. The executable contains licensed

  12. Using Excel's Matrix Operations to Facilitate Reciprocal Cost Allocations

    ERIC Educational Resources Information Center

    Leese, Wallace R.; Kizirian, Tim

    2009-01-01

    The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated direct or step-down methods. Here is a short example demonstrating how Excel's sometimes unknown matrix…

  13. Cognitive cost as dynamic allocation of energetic resources

    PubMed Central

    Christie, S. Thomas; Schrater, Paul

    2015-01-01

    While it is widely recognized that thinking is somehow costly, involving cognitive effort and producing mental fatigue, these costs have alternatively been assumed to exist, treated as the brain's assessment of lost opportunities, or suggested to be metabolic but with implausible biological bases. We present a model of cognitive cost based on the novel idea that the brain senses and plans for longer-term allocation of metabolic resources by purposively conserving brain activity. We identify several distinct ways the brain might control its metabolic output, and show how a control-theoretic model that models decision-making with an energy budget can explain cognitive effort avoidance in terms of an optimal allocation of limited energetic resources. The model accounts for both subject responsiveness to reward and the detrimental effects of hypoglycemia on cognitive function. A critical component of the model is using astrocytic glycogen as a plausible basis for limited energetic reserves. Glycogen acts as an energy buffer that can temporarily support high neural activity beyond the rate supported by blood glucose supply. The published dynamics of glycogen depletion and repletion are consonant with a broad array of phenomena associated with cognitive cost. Our model thus subsumes both the “cost/benefit” and “limited resource” models of cognitive cost while retaining valuable contributions of each. We discuss how the rational control of metabolic resources could underpin the control of attention, working memory, cognitive look ahead, and model-free vs. model-based policy learning. PMID:26379482

  14. Cognitive cost as dynamic allocation of energetic resources.

    PubMed

    Christie, S Thomas; Schrater, Paul

    2015-01-01

    While it is widely recognized that thinking is somehow costly, involving cognitive effort and producing mental fatigue, these costs have alternatively been assumed to exist, treated as the brain's assessment of lost opportunities, or suggested to be metabolic but with implausible biological bases. We present a model of cognitive cost based on the novel idea that the brain senses and plans for longer-term allocation of metabolic resources by purposively conserving brain activity. We identify several distinct ways the brain might control its metabolic output, and show how a control-theoretic model that models decision-making with an energy budget can explain cognitive effort avoidance in terms of an optimal allocation of limited energetic resources. The model accounts for both subject responsiveness to reward and the detrimental effects of hypoglycemia on cognitive function. A critical component of the model is using astrocytic glycogen as a plausible basis for limited energetic reserves. Glycogen acts as an energy buffer that can temporarily support high neural activity beyond the rate supported by blood glucose supply. The published dynamics of glycogen depletion and repletion are consonant with a broad array of phenomena associated with cognitive cost. Our model thus subsumes both the "cost/benefit" and "limited resource" models of cognitive cost while retaining valuable contributions of each. We discuss how the rational control of metabolic resources could underpin the control of attention, working memory, cognitive look ahead, and model-free vs. model-based policy learning. PMID:26379482

  15. 48 CFR 9904.413 - Adjustment and allocation of pension cost.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of pension cost. 9904.413 Section 9904.413 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.413 Adjustment and allocation of pension cost....

  16. 48 CFR 9904.413 - Adjustment and allocation of pension cost.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of pension cost. 9904.413 Section 9904.413 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.413 Adjustment and allocation of pension cost....

  17. 48 CFR 9904.413 - Adjustment and allocation of pension cost.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of pension cost. 9904.413 Section 9904.413 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.413 Adjustment and allocation of pension cost....

  18. 48 CFR 9904.418 - Allocation of direct and indirect costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Allocation of direct and indirect costs. 9904.418 Section 9904.418 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS... COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.418 Allocation of direct and indirect costs....

  19. 48 CFR 9904.418 - Allocation of direct and indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Allocation of direct and indirect costs. 9904.418 Section 9904.418 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS... COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.418 Allocation of direct and indirect costs....

  20. 48 CFR 9904.418 - Allocation of direct and indirect costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Allocation of direct and indirect costs. 9904.418 Section 9904.418 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS... COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.418 Allocation of direct and indirect costs....

  1. 48 CFR 9904.418 - Allocation of direct and indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Allocation of direct and indirect costs. 9904.418 Section 9904.418 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS... COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.418 Allocation of direct and indirect costs....

  2. An Approach for Transmission Loss and Cost Allocation by Loss Allocation Index and Co-operative Game Theory

    NASA Astrophysics Data System (ADS)

    Khan, Baseem; Agnihotri, Ganga; Mishra, Anuprita S.

    2016-03-01

    In the present work authors proposed a novel method for transmission loss and cost allocation to users (generators and loads). In the developed methodology transmission losses are allocated to users based on their usage of the transmission line. After usage allocation, particular loss allocation indices (PLAI) are evaluated for loads and generators. Also Cooperative game theory approach is applied for comparison of results. The proposed method is simple and easy to implement on the practical power system. Sample 6 bus and IEEE 14 bus system is used for showing the effectiveness of proposed method.

  3. Accurate charge capture and cost allocation: cost justification for bedside computing.

    PubMed Central

    Grewal, R.; Reed, R. L.

    1993-01-01

    This paper shows that cost justification for bedside clinical computing can be made by recouping charges with accurate charge capture. Twelve months worth of professional charges for a sixteen bed surgical intensive care unit are computed from charted data in a bedside clinical database and are compared to the professional charges actually billed by the unit. A substantial difference in predicted charges and billed charges was found. This paper also discusses the concept of appropriate cost allocation in the inpatient environment and the feasibility of appropriate allocation as a by-product of bedside computing. PMID:8130444

  4. 50 CFR 80.64 - How does an agency allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.64 How does an agency allocate costs... project or facility. The agency must describe the method used to allocate costs in multipurpose...

  5. 50 CFR 80.64 - How does an agency allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.64 How does an agency allocate costs... project or facility. The agency must describe the method used to allocate costs in multipurpose...

  6. 50 CFR 80.64 - How does an agency allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.64 How does an agency allocate costs... project or facility. The agency must describe the method used to allocate costs in multipurpose...

  7. 50 CFR 80.64 - How does an agency allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.64 How does an agency allocate costs... project or facility. The agency must describe the method used to allocate costs in multipurpose...

  8. 45 CFR 263.14 - What methodology shall States use to allocate TANF costs?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...? § 263.14 What methodology shall States use to allocate TANF costs? States shall use a benefiting program cost allocation methodology consistent with the general requirements of OMB Circular A-87 (2 CFR part... 45 Public Welfare 2 2011-10-01 2011-10-01 false What methodology shall States use to allocate...

  9. 45 CFR 263.14 - What methodology shall States use to allocate TANF costs?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...? § 263.14 What methodology shall States use to allocate TANF costs? States shall use a benefiting program cost allocation methodology consistent with the general requirements of OMB Circular A-87 (2 CFR part... 45 Public Welfare 2 2010-10-01 2010-10-01 false What methodology shall States use to allocate...

  10. 48 CFR 9904.413 - Adjustment and allocation of pension cost.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Adjustment and allocation of pension cost. 9904.413 Section 9904.413 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.413 Adjustment and allocation of...

  11. 30 CFR 1220.014 - Allocation of joint costs and credits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CONTINENTAL SHELF OIL AND GAS LEASES § 1220.014 Allocation of joint costs and credits. (a) Joint costs shall be grouped in cost pools for allocation to NPSL and non-NPSL operations in reasonable proportion to the beneficial or causal relationships which exist between a specific cost pool and the...

  12. 30 CFR 1220.014 - Allocation of joint costs and credits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... OIL AND GAS LEASES § 1220.014 Allocation of joint costs and credits. (a) Joint costs shall be grouped in cost pools for allocation to NPSL and non-NPSL operations in reasonable proportion to the beneficial or causal relationships which exist between a specific cost pool and the operations. That...

  13. 30 CFR 1220.014 - Allocation of joint costs and credits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... OIL AND GAS LEASES § 1220.014 Allocation of joint costs and credits. (a) Joint costs shall be grouped in cost pools for allocation to NPSL and non-NPSL operations in reasonable proportion to the beneficial or causal relationships which exist between a specific cost pool and the operations. That...

  14. 45 CFR 95.509 - Cost allocation plan amendments and certifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DCA if any of the following events occur: (1) The procedures shown in the existing cost allocation...) A material defect is discovered in the cost allocation plan by the Director, DCA or the State. (3... annual statement shall be submitted to the Director, DCA certifying that its approved cost...

  15. 45 CFR 95.509 - Cost allocation plan amendments and certifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DCA if any of the following events occur: (1) The procedures shown in the existing cost allocation...) A material defect is discovered in the cost allocation plan by the Director, DCA or the State. (3... annual statement shall be submitted to the Director, DCA certifying that its approved cost...

  16. 26 CFR 1.162-28 - Allocation of costs to lobbying activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... activities for 1996, as follows: ER21JY95.003 (f) Section 263A cost allocation methods—(1) In general. A... forth cost allocation methods available under section 263A; and § 1.263A-1(g)(4), which provides methods... Taxpayer Y, a manufacturing concern. They each engage in lobbying activities and nonlobbying activities....

  17. 26 CFR 1.162-28 - Allocation of costs to lobbying activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... activities for 1996, as follows: ER21JY95.003 (f) Section 263A cost allocation methods—(1) In general. A... forth cost allocation methods available under section 263A; and § 1.263A-1(g)(4), which provides methods... Taxpayer Y, a manufacturing concern. They each engage in lobbying activities and nonlobbying activities....

  18. 26 CFR 1.199-4 - Costs allocable to domestic production gross receipts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 3 2011-04-01 2011-04-01 false Costs allocable to domestic production gross... Corporations (continued) § 1.199-4 Costs allocable to domestic production gross receipts. (a) In general. The... determine its qualified production activities income (QPAI) (as defined in § 1.199-1(c)) for a taxable...

  19. 26 CFR 1.199-4 - Costs allocable to domestic production gross receipts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Costs allocable to domestic production gross... (continued) § 1.199-4 Costs allocable to domestic production gross receipts. (a) In general. The provisions... determine its qualified production activities income (QPAI) (as defined in § 1.199-1(c)) for a taxable...

  20. 45 CFR 95.515 - Effective date of a cost allocation plan amendment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... general rule, the effective date of a cost allocation plan amendment shall be the first day of the... the defect. (c) It is impractical for the State to implement the amendment on the first day of the... 45 Public Welfare 1 2014-10-01 2014-10-01 false Effective date of a cost allocation plan...

  1. 45 CFR 95.515 - Effective date of a cost allocation plan amendment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... general rule, the effective date of a cost allocation plan amendment shall be the first day of the... the defect. (c) It is impractical for the State to implement the amendment on the first day of the... 45 Public Welfare 1 2012-10-01 2012-10-01 false Effective date of a cost allocation plan...

  2. 45 CFR 95.515 - Effective date of a cost allocation plan amendment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... general rule, the effective date of a cost allocation plan amendment shall be the first day of the... the defect. (c) It is impractical for the State to implement the amendment on the first day of the... 45 Public Welfare 1 2011-10-01 2011-10-01 false Effective date of a cost allocation plan...

  3. 45 CFR 95.515 - Effective date of a cost allocation plan amendment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... general rule, the effective date of a cost allocation plan amendment shall be the first day of the... the defect. (c) It is impractical for the State to implement the amendment on the first day of the... 45 Public Welfare 1 2010-10-01 2010-10-01 false Effective date of a cost allocation plan...

  4. 45 CFR 95.515 - Effective date of a cost allocation plan amendment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... general rule, the effective date of a cost allocation plan amendment shall be the first day of the... the defect. (c) It is impractical for the State to implement the amendment on the first day of the... 45 Public Welfare 1 2013-10-01 2013-10-01 false Effective date of a cost allocation plan...

  5. Allocating the Materials Funds Using Total Cost of Materials.

    ERIC Educational Resources Information Center

    Cubberley, Carol

    1993-01-01

    Discusses the need at the University of Southern Mississippi library to review resource allocations among serials, monographs and standing orders, and to select an allocation formula. The supply and demand formula used, its implementation, and results in departmental purchasing power are described. (four references) (EA)

  6. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cost allocations or billings for are allowable in accordance with the requirements of 2 CFR Part 225... motor pools, computer centers, purchasing, accounting, etc., to operating agencies on a centralized... include computer services, transportation services, insurance, and fringe benefits. 2. “Allocated...

  7. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-consistency in allocating costs incurred for the same purpose. 9904.402 Section 9904.402 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET...

  8. 48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-consistency in allocating costs incurred for the same purpose by educational institutions. 9905.502 Section 9905.502 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF...

  9. Allocation of Transaction Cost to Market Participants Using an Analytical Method in Deregulated Market

    NASA Astrophysics Data System (ADS)

    Jeyasankari, S.; Jeslin Drusila Nesamalar, J.; Charles Raja, S.; Venkatesh, P.

    2014-04-01

    Transmission cost allocation is one of the major challenges in transmission open access faced by the electric power sector. The purpose of this work is to provide an analytical method for allocating transmission transaction cost in deregulated market. This research work provides a usage based transaction cost allocation method based on line-flow impact factor (LIF) which relates the power flow in each line with respect to transacted power for the given transaction. This method provides the impact of line flows without running iterative power flow solution and is well suited for real time applications. The proposed method is compared with the Newton-Raphson (NR) method of cost allocation on sample six bus and practical Indian utility 69 bus systems by considering multilateral transaction.

  10. Sex allocation theory reveals a hidden cost of neonicotinoid exposure in a parasitoid wasp

    PubMed Central

    Whitehorn, Penelope R.; Cook, Nicola; Blackburn, Charlotte V.; Gill, Sophie M.; Green, Jade; Shuker, David M.

    2015-01-01

    Sex allocation theory has proved to be one the most successful theories in evolutionary ecology. However, its role in more applied aspects of ecology has been limited. Here we show how sex allocation theory helps uncover an otherwise hidden cost of neonicotinoid exposure in the parasitoid wasp Nasonia vitripennis. Female N. vitripennis allocate the sex of their offspring in line with Local Mate Competition (LMC) theory. Neonicotinoids are an economically important class of insecticides, but their deployment remains controversial, with evidence linking them to the decline of beneficial species. We demonstrate for the first time to our knowledge, that neonicotinoids disrupt the crucial reproductive behaviour of facultative sex allocation at sub-lethal, field-relevant doses in N. vitripennis. The quantitative predictions we can make from LMC theory show that females exposed to neonicotinoids are less able to allocate sex optimally and that this failure imposes a significant fitness cost. Our work highlights that understanding the ecological consequences of neonicotinoid deployment requires not just measures of mortality or even fecundity reduction among non-target species, but also measures that capture broader fitness costs, in this case offspring sex allocation. Our work also highlights new avenues for exploring how females obtain information when allocating sex under LMC. PMID:25925105

  11. Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany

    PubMed Central

    2012-01-01

    The purpose of this paper is to analyze the German diagnosis related groups (G-DRG) cost accounting scheme by assessing its resource allocation at hospital level and its tariff calculation at national level. First, the paper reviews and assesses the three steps in the G-DRG resource allocation scheme at hospital level: (1) the groundwork; (2) cost-center accounting; and (3) patient-level costing. Second, the paper reviews and assesses the three steps in G-DRG national tariff calculation: (1) plausibility checks; (2) inlier calculation; and (3) the “one hospital” approach. The assessment is based on the two main goals of G-DRG introduction: improving transparency and efficiency. A further empirical assessment attests high costing quality. The G-DRG cost accounting scheme shows high system quality in resource allocation at hospital level, with limitations concerning a managerially relevant full cost approach and limitations in terms of advanced activity-based costing at patient-level. However, the scheme has serious flaws in national tariff calculation: inlier calculation is normative, and the “one hospital” model causes cost bias, adjustment and representativeness issues. The G-DRG system was designed for reimbursement calculation, but developed to a standard with strategic management implications, generalized by the idea of adapting a hospital’s cost structures to DRG revenues. This combination causes problems in actual hospital financing, although resource allocation is advanced at hospital level. PMID:22935314

  12. Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany.

    PubMed

    Vogl, Matthias

    2012-01-01

    The purpose of this paper is to analyze the German diagnosis related groups (G-DRG) cost accounting scheme by assessing its resource allocation at hospital level and its tariff calculation at national level. First, the paper reviews and assesses the three steps in the G-DRG resource allocation scheme at hospital level: (1) the groundwork; (2) cost-center accounting; and (3) patient-level costing. Second, the paper reviews and assesses the three steps in G-DRG national tariff calculation: (1) plausibility checks; (2) inlier calculation; and (3) the "one hospital" approach. The assessment is based on the two main goals of G-DRG introduction: improving transparency and efficiency. A further empirical assessment attests high costing quality. The G-DRG cost accounting scheme shows high system quality in resource allocation at hospital level, with limitations concerning a managerially relevant full cost approach and limitations in terms of advanced activity-based costing at patient-level. However, the scheme has serious flaws in national tariff calculation: inlier calculation is normative, and the "one hospital" model causes cost bias, adjustment and representativeness issues. The G-DRG system was designed for reimbursement calculation, but developed to a standard with strategic management implications, generalized by the idea of adapting a hospital's cost structures to DRG revenues. This combination causes problems in actual hospital financing, although resource allocation is advanced at hospital level. PMID:22935314

  13. 20 CFR 633.304 - Section 402 cost allocation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., equipment, office-space costs, and staff training. (i) Also included are salaries and fringe benefits of... project directors. Additionally, all costs of clerical personnel, materials, supplies, equipment, space... (including classroom training in conjunction with Vocational Exploration or Job Readiness or...

  14. 20 CFR 633.304 - Section 402 cost allocation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., equipment, office-space costs, and staff training. (i) Also included are salaries and fringe benefits of... project directors. Additionally, all costs of clerical personnel, materials, supplies, equipment, space... (including classroom training in conjunction with Vocational Exploration or Job Readiness or...

  15. 20 CFR 633.304 - Section 402 cost allocation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., equipment, office-space costs, and staff training. (i) Also included are salaries and fringe benefits of... project directors. Additionally, all costs of clerical personnel, materials, supplies, equipment, space... (including classroom training in conjunction with Vocational Exploration or Job Readiness or...

  16. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2 Grants and Agreements 1 2013-01-01 2013-01-01 false State/Local-Wide Central Service Cost Allocation Plans C Appendix C to Part 225 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved COST PRINCIPLES FOR STATE, LOCAL, AND INDIAN...

  17. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... cost allocations or billings for are allowable in accordance with the requirements of 2 CFR Part 225... Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved COST PRINCIPLES FOR STATE, LOCAL, AND INDIAN TRIBAL GOVERNMENTS (OMB CIRCULAR A-87) Pt. 225, App. C Appendix C to Part...

  18. 2 CFR Appendix D to Part 225 - Public Assistance Cost Allocation Plans

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... agency 2. State public assistance agency costs C. Policy D. Submission, Documentation, and Approval of... approval of public assistance cost allocation plans in Subpart E of 45 CFR part 95. All administrative... program recipients. C. Policy. State public assistance agencies will develop, document and implement,...

  19. 2 CFR Appendix D to Part 225 - Public Assistance Cost Allocation Plans

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... Definitions 1. State public assistance agency 2. State public assistance agency costs C. Policy D. Submission..., submission, negotiation, and approval of public assistance cost allocation plans in Subpart E of 45 CFR part... services and goods provided directly to program recipients. C. Policy. State public assistance...

  20. Strategic costs and preferences revelation in the allocation of resources for health care.

    PubMed

    Levaggi, Laura; Levaggi, Rosella

    2010-09-01

    This article examines the resources allocation process in the internal market for health care in an environment characterised by asymmetry of information. We analyse the strategic behaviour of the provider and show how, by misreporting its cost function and reservation utility, it might shift the allocation of resources away from the purchaser's objectives. Although the fundamental importance of equity, efficiency and risk aversion considerations which have been the traditional focus of the literature on allocation of resources should not be denied, this paper shows that contracts and internal markets are not neutral instruments and more research should be devoted to studying their effects. PMID:20309636

  1. Minimum cost maximum flow algorithm for upstream bandwidth allocation in OFDMA passive optical networks

    NASA Astrophysics Data System (ADS)

    Wu, Yating; Kuang, Bin; Wang, Tao; Zhang, Qianwu; Wang, Min

    2015-12-01

    This paper presents a minimum cost maximum flow (MCMF) based upstream bandwidth allocation algorithm, which supports differentiated QoS for orthogonal frequency division multiple access passive optical networks (OFDMA-PONs). We define a utility function as the metric to characterize the satisfaction degree of an ONU on the obtained bandwidth. The bandwidth allocation problem is then formulated as maximizing the sum of the weighted total utility functions of all ONUs. By constructing a flow network graph, we obtain the optimized bandwidth allocation using the MCMF algorithm. Simulation results show that the proposed scheme improves the performance in terms of mean packet delay, packet loss ratio and throughput.

  2. 47 CFR 76.924 - Allocation to service cost categories.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... all applicable valuation reserves, or their fair market value. (2) The proceeds from assets sold or... cost less all applicable valuation reserves, or estimated fair market value of the asset. (3) Charges... Equipment Business Offices Facilities and Equipment Other Tangible Assets Accumulated Depreciation...

  3. 47 CFR 76.924 - Allocation to service cost categories.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... are not included the basic service or a cable programming services cost categories as defined in... the basic service tier is regulated by local franchising authorities or the Commission, or, with respect to a cable programming services tier, for which a complaint has been filed with the...

  4. 47 CFR 76.924 - Allocation to service cost categories.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... are not included the basic service or a cable programming services cost categories as defined in... the basic service tier is regulated by local franchising authorities or the Commission, or, with respect to a cable programming services tier, for which a complaint has been filed with the...

  5. 47 CFR 76.924 - Allocation to service cost categories.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... are not included the basic service or a cable programming services cost categories as defined in... the basic service tier is regulated by local franchising authorities or the Commission, or, with respect to a cable programming services tier, for which a complaint has been filed with the...

  6. Cost-Effective Allocation of Agricultural Best Management Practices

    NASA Astrophysics Data System (ADS)

    Arabi, M.; Govindaraju, R. S.; Engel, B. A.

    2007-12-01

    Implementation of conservation programs is perceived as being crucial for restoring and protecting waters and watersheds from nonpoint source pollution. Success of these programs depends to a great extent on planning tools that can assist the watershed management process. Herein, a novel optimization methodology is presented for deriving watershed-scale sediment and nutrient control plans that incorporate multiple, and often conflicting, objectives. The method combines the use of a watershed model (SWAT), representation of best management practices, an economic component, and a genetic algorithm-based spatial search procedure. For a small watershed in Indiana located in the Midwestern portion of the United States, selection and placement of best management practices by optimization was found to be nearly three times more cost-effective than targeting strategies for the same level of protection specified in terms of maximum monthly sediment, phosphorus, and nitrogen loads. Conversely, for the same cost, the optimization plan reduced the maximum monthly loads by a factor of two when compared to the targeting plan. The optimization methodology developed in this paper can facilitate attaining water quality goals at significantly lower costs than commonly used cost-share and targeting strategies.

  7. Cost drivers and resource allocation in military health care systems.

    PubMed

    Fulton, Larry; Lasdon, Leon S; McDaniel, Reuben R

    2007-03-01

    This study illustrates the feasibility of incorporating technical efficiency considerations in the funding of military hospitals and identifies the primary drivers for hospital costs. Secondary data collected for 24 U.S.-based Army hospitals and medical centers for the years 2001 to 2003 are the basis for this analysis. Technical efficiency was measured by using data envelopment analysis; subsequently, efficiency estimates were included in logarithmic-linear cost models that specified cost as a function of volume, complexity, efficiency, time, and facility type. These logarithmic-linear models were compared against stochastic frontier analysis models. A parsimonious, three-variable, logarithmic-linear model composed of volume, complexity, and efficiency variables exhibited a strong linear relationship with observed costs (R(2) = 0.98). This model also proved reliable in forecasting (R(2) = 0.96). Based on our analysis, as much as $120 million might be reallocated to improve the United States-based Army hospital performance evaluated in this study. PMID:17436766

  8. Risk informed resource allocation policy: safety can save costs.

    PubMed

    Pasman, H J

    2000-01-01

    During economic doldrums, decision making on investments for safety is even more difficult than it already is when funds are abundant. This paper attempts to offer some guidance. After stating the present challenge to prevention of losses in the process industries, the systematic approach of quantified risk assessment is briefly reviewed and improvements in the methodology are mentioned. In addition, attention is given to the use of a risk matrix to survey a plant and to derive a plan of action. Subsequently, the reduction of risk is reviewed. Measures for prevention, protection, and mitigation are discussed. The organization of safety has become at least as important as technical safety of equipment and standards. It is reflected in the introduction of a safety management system. Furthermore, the design process in a pro-active approach is described and the concept of inherent safety is briefly addressed. The concept of Layer of Protection Analysis is explained and also the reason why it is relevant to provide a cost-benefit analysis. Finally, after comments regarding the cost of accidents, the basics of costing and profitability are summarized and a way is suggested to apply this approach to risk-reducing measures. An example is provided on how a selection can be made from a number of alternatives. PMID:10677670

  9. A Study on Cost Allocation in Nuclear Power Coupled with Desalination

    SciTech Connect

    Lee, ManKi; Kim, SeungSu; Moon, KeeHwan; Lim, ChaeYoung

    2004-07-01

    As for a single-purpose desalination plant, there is no particular difficulty in computing the unit cost of the water, which is obtained by dividing the annual total costs by the output of fresh water. When it comes to a dual-purpose plant, cost allocation is needed between the two products. No cost allocation is needed in some cases where two alternatives producing the same water and electricity output are to be compared. In these cases, the consideration of the total cost is then sufficient. This study assumes MED (Multi-Effect Distillation) technology is adopted when nuclear power is coupled with desalination. The total production cost of the two commodities in dual-purpose plant can easily be obtained by using costing methods, if the necessary raw data are available. However, it is not easy to calculate a separate cost for each product, because high-pressure steam plant costs cannot be allocated to one or the other without adopting arbitrary methods. Investigation on power credit method is carried out focusing on the cost allocation of combined benefits due to dual production, electricity and water. The illustrative calculation is taken from Preliminary Economic Feasibility Study of Nuclear Desalination in Madura Island, Indonesia. The study is being performed by BATAN (National Nuclear Energy Agency), KAERI (Korean Atomic Energy Research Institute) and under support of the IAEA (International Atomic Energy Agency) started in the year 2002 in order to perform a preliminary economic feasibility in providing the Madurese with sufficient power and potable water for the public and to support industrialization and tourism in Madura Region. The SMART reactor coupled with MED is considered to be an option to produce electricity and potable water. This study indicates that the correct recognition of combined benefits attributable to dual production is important in carrying out economics of desalination coupled with nuclear power. (authors)

  10. 77 FR 32183 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-31

    ...The Federal Energy Regulatory Commission affirms its basic determinations in Order No. 1000, amending the transmission planning and cost allocation requirements established in Order No. 890 to ensure that Commission-jurisdictional services are provided at just and reasonable rates and on a basis that is just and reasonable and not unduly discriminatory or preferential. This order affirms the......

  11. 76 FR 53450 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... Transmission Owning and Operating Public Utilities, Order No. 1000, 76 FR 49,842 (Aug. 11, 2011), 136 FERC ] 61... Energy Regulatory Commission Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities; Notice of Staff Informational Conferences Take notice that Commission staff...

  12. 18 CFR 366.5 - Allocation of costs for non-power goods and services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Allocation of costs for non-power goods and services. 366.5 Section 366.5 Conservation of Power and Water Resources FEDERAL... ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT BOOKS AND RECORDS Definitions and Provisions...

  13. 30 CFR 220.014 - Allocation of joint costs and credits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Allocation of joint costs and credits. 220.014 Section 220.014 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT ACCOUNTING PROCEDURES FOR DETERMINING NET PROFIT SHARE PAYMENT FOR OUTER CONTINENTAL SHELF OIL...

  14. 30 CFR 1220.014 - Allocation of joint costs and credits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Allocation of joint costs and credits. 1220.014 Section 1220.014 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE ACCOUNTING PROCEDURES FOR DETERMINING NET PROFIT SHARE PAYMENT FOR OUTER CONTINENTAL...

  15. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... cost allocations or billings for are allowable in accordance with the requirements of 2 CFR Part 225... Plans A. General. 1. Most governmental units provide certain services, such as motor pools, computer... basis. Typical examples of billed central services include computer services, transportation...

  16. 5 CFR 734.503 - Allocation and reimbursement of costs associated with political activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... associated with political activities. 734.503 Section 734.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES... Executive Office of the President § 734.503 Allocation and reimbursement of costs associated with...

  17. 5 CFR 734.503 - Allocation and reimbursement of costs associated with political activities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... associated with political activities. 734.503 Section 734.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES... Executive Office of the President § 734.503 Allocation and reimbursement of costs associated with...

  18. 5 CFR 734.503 - Allocation and reimbursement of costs associated with political activities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... associated with political activities. 734.503 Section 734.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES... Executive Office of the President § 734.503 Allocation and reimbursement of costs associated with...

  19. 5 CFR 734.503 - Allocation and reimbursement of costs associated with political activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... associated with political activities. 734.503 Section 734.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES... Executive Office of the President § 734.503 Allocation and reimbursement of costs associated with...

  20. 5 CFR 734.503 - Allocation and reimbursement of costs associated with political activities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... associated with political activities. 734.503 Section 734.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES... Executive Office of the President § 734.503 Allocation and reimbursement of costs associated with...

  1. 26 CFR 1.199-4 - Costs allocable to domestic production gross receipts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 3 2014-04-01 2014-04-01 false Costs allocable to domestic production gross receipts. 1.199-4 Section 1.199-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-4...

  2. 26 CFR 1.199-4 - Costs allocable to domestic production gross receipts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 3 2012-04-01 2012-04-01 false Costs allocable to domestic production gross receipts. 1.199-4 Section 1.199-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-4...

  3. 26 CFR 1.199-4 - Costs allocable to domestic production gross receipts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 3 2013-04-01 2013-04-01 false Costs allocable to domestic production gross receipts. 1.199-4 Section 1.199-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-4...

  4. 7 CFR 1737.61 - Cost allocation for rural and nonrural areas.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... (a) Pursuant to the requirements in 7 CFR part 1735, if loan funds are proposed for facilities to... a nonrural community will have an extended area of service (EAS) with other exchanges of the... all exchanges connected by EAS. (b) If RUS determines that costs cannot be adequately allocated...

  5. 7 CFR 1737.61 - Cost allocation for rural and nonrural areas.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... (a) Pursuant to the requirements in 7 CFR part 1735, if loan funds are proposed for facilities to... a nonrural community will have an extended area of service (EAS) with other exchanges of the... all exchanges connected by EAS. (b) If RUS determines that costs cannot be adequately allocated...

  6. 7 CFR 1737.61 - Cost allocation for rural and nonrural areas.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... (a) Pursuant to the requirements in 7 CFR part 1735, if loan funds are proposed for facilities to... a nonrural community will have an extended area of service (EAS) with other exchanges of the... all exchanges connected by EAS. (b) If RUS determines that costs cannot be adequately allocated...

  7. 7 CFR 1737.61 - Cost allocation for rural and nonrural areas.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... (a) Pursuant to the requirements in 7 CFR part 1735, if loan funds are proposed for facilities to... a nonrural community will have an extended area of service (EAS) with other exchanges of the... all exchanges connected by EAS. (b) If RUS determines that costs cannot be adequately allocated...

  8. 7 CFR 1737.61 - Cost allocation for rural and nonrural areas.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... (a) Pursuant to the requirements in 7 CFR part 1735, if loan funds are proposed for facilities to... a nonrural community will have an extended area of service (EAS) with other exchanges of the... all exchanges connected by EAS. (b) If RUS determines that costs cannot be adequately allocated...

  9. 2 CFR Appendix D to Part 225 - Public Assistance Cost Allocation Plans

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... provisions of Subpart E of 45 CFR part 95. D. Submission, Documentation, and Approval of Public Assistance..., AND INDIAN TRIBAL GOVERNMENTS (OMB CIRCULAR A-87) Pt. 225, App. D Appendix D to Part 225—Public... approval of public assistance cost allocation plans in Subpart E of 45 CFR part 95. All...

  10. Using Excel's Solver Function to Facilitate Reciprocal Service Department Cost Allocations

    ERIC Educational Resources Information Center

    Leese, Wallace R.

    2013-01-01

    The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated and theoretically incorrect direct or step-down methods. This article illustrates how Excel's Solver…

  11. 75 FR 62023 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... Commission issued a Notice of proposed rulemaking (75 FR 37884) proposing to amend the transmission planning... proposed rule published June 30, 2010 (75 FR 37884) are due November 12, 2010. ADDRESSES: You may submit... Energy Regulatory Commission 18 CFR Part 35 Transmission Planning and Cost Allocation by...

  12. 2 CFR Appendix D to Part 225 - Public Assistance Cost Allocation Plans

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... provisions of Subpart E of 45 CFR part 95. D. Submission, Documentation, and Approval of Public Assistance... approval of public assistance cost allocation plans in Subpart E of 45 CFR part 95. All administrative... in Subpart E of 45 CFR part 95. For the purpose of this appendix, these programs include all...

  13. 77 FR 73965 - Allocation of Costs Under the Simplified Methods; Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-12

    ...) that was published in the Federal Register on Wednesday, September 5, 2012 (77 FR 54482). The rules of... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 RIN 1545-BG07 Allocation of Costs Under the Simplified...

  14. 2 CFR Appendix Vi to Part 200 - Public Assistance Cost Allocation Plans

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., submission, negotiation, and approval of public assistance cost allocation plans in Subpart E of 45 CFR Part... services and goods provided directly to program recipients. C. Policy State public assistance agencies will... assistance agencies are funded predominately by the Department of Health and Human Services (HHS). In...

  15. 18 CFR 366.5 - Allocation of costs for non-power goods and services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT BOOKS AND RECORDS Definitions and Provisions Under PUHCA 2005, the Federal Power Act and the Natural Gas Act § 366.5 Allocation of costs for non-power... non-power goods and services. 366.5 Section 366.5 Conservation of Power and Water Resources...

  16. 18 CFR 366.5 - Allocation of costs for non-power goods and services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT BOOKS AND RECORDS Definitions and Provisions Under PUHCA 2005, the Federal Power Act and the Natural Gas Act § 366.5 Allocation of costs for non-power... non-power goods and services. 366.5 Section 366.5 Conservation of Power and Water Resources...

  17. 18 CFR 366.5 - Allocation of costs for non-power goods and services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Allocation of costs for non-power goods and services. 366.5 Section 366.5 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND...

  18. 18 CFR 366.5 - Allocation of costs for non-power goods and services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT BOOKS AND RECORDS Definitions and Provisions Under PUHCA 2005, the Federal Power Act and the Natural Gas Act § 366.5 Allocation of costs for non-power... non-power goods and services. 366.5 Section 366.5 Conservation of Power and Water Resources...

  19. Encouraging energy conservation in multifamily housing: RUBS and other methods of allocating energy costs to residents

    SciTech Connect

    McClelland, L

    1980-10-01

    Methods of encouraging energy conservation in multifamily housing by allocating energy costs to residents are discussed; specifically, methods appropriate for use in master metered buildings without equipment to monitor energy consumption in individual apartments are examined. Several devices available for monitoring individual energy consumption are also discussed plus methods of comparing the energy savings and cost effectiveness of monitoring devices with those of other means of promoting conservation. Specific information in Volume I includes a comparison study on energy use in master and individually metered buildings; types of appropriate conservation programs for master metered buildings; a description of the Resident Utility Billing System (RUBS); energy savings associated with RUBS; Resident reactions to RUBS; cost effectiveness of RUBS for property owners; potential abuses, factors limiting widespread use, and legal status of RUBS. Part I of Volume II contains a cost allocation decision guide and Part II in Volume II presents the RUBS Operations Manual. Pertinent appendices to some chapters are attached. (MCW)

  20. Rational allocation of resources available for healthcare: understanding cost effectiveness analyst.

    PubMed

    Briggs, Andrew

    2014-01-01

    Health systems around the world are grappling with the difficult issue of how to allocate scare healthcare resources. Within Europe many different approaches to healthcare resource allocation exist, but it is clear that the formal techniques of cost-effectiveness analysis are becoming increasingly important. This presentation will first address the fundamental economic principles of scarcity and opportunity cost, before looking at how different European systems are attempting to address the economic challenge of providing healthcare for their population from a limited budget. The presentation will go on to consider general issues in health economic evaluation that are likely important for clinical community focused on HIV treatment: appropriate comparator treatments for defining opportunity cost, patient heterogeneity and the potential for personalized/stratified medicine to control costs and target treatment appropriately. PMID:25394001

  1. An integrated framework for cost allocation in a multi-owned transmission system

    SciTech Connect

    Marangon Lima, J.W.; Pereira, J.L.R. |

    1995-05-01

    This paper describes a methodology for allocating transmission costs among users of a centralized transmission service. In the proposed approach, the share of each participant is proportional to its impact on system transmission investment requirements. This allocation rule provides incentives for all participants to remain in the pool and ensures revenue reconciliation. It is shown that, under some simplifying assumptions, the proposed scheme reduces to a modified MW-mile rule, thus providing some insight on that method`s economic basis. Other issues such as credits for counterflows and distortions due to economies of scale are also addressed. The methodology is illustrated in case studies with the Brazilian system.

  2. Cost of equity in homeland security resource allocation in the face of a strategic attacker.

    PubMed

    Shan, Xiaojun; Zhuang, Jun

    2013-06-01

    Hundreds of billions of dollars have been spent in homeland security since September 11, 2001. Many mathematical models have been developed to study strategic interactions between governments (defenders) and terrorists (attackers). However, few studies have considered the tradeoff between equity and efficiency in homeland security resource allocation. In this article, we fill this gap by developing a novel model in which a government allocates defensive resources among multiple potential targets, while reserving a portion of defensive resources (represented by the equity coefficient) for equal distribution (according to geographical areas, population, density, etc.). Such a way to model equity is one of many alternatives, but was directly inspired by homeland security resource allocation practice. The government is faced with a strategic terrorist (adaptive adversary) whose attack probabilities are endogenously determined in the model. We study the effect of the equity coefficient on the optimal defensive resource allocations and the corresponding expected loss. We find that the cost of equity (in terms of increased expected loss) increases convexly in the equity coefficient. Furthermore, such cost is lower when: (a) government uses per-valuation equity; (b) the cost-effectiveness coefficient of defense increases; and (c) the total defense budget increases. Our model, results, and insights could be used to assist policy making. PMID:23256552

  3. Accounting for enforcement costs in the spatial allocation of marine zones.

    PubMed

    Davis, Katrina; Kragt, Marit; Gelcich, Stefan; Schilizzi, Steven; Pannell, David

    2015-02-01

    Marine fish stocks are in many cases extracted above sustainable levels, but they may be protected through restricted-use zoning systems. The effectiveness of these systems typically depends on support from coastal fishing communities. High management costs including those of enforcement may, however, deter fishers from supporting marine management. We incorporated enforcement costs into a spatial optimization model that identified how conservation targets can be met while maximizing fishers' revenue. Our model identified the optimal allocation of the study area among different zones: no-take, territorial user rights for fisheries (TURFs), or open access. The analysis demonstrated that enforcing no-take and TURF zones incurs a cost, but results in higher species abundance by preventing poaching and overfishing. We analyzed how different enforcement scenarios affected fishers' revenue. Fisher revenue was approximately 50% higher when territorial user rights were enforced than when they were not. The model preferentially allocated area to the enforced-TURF zone over other zones, demonstrating that the financial benefits of enforcement (derived from higher species abundance) exceeded the costs. These findings were robust to increases in enforcement costs but sensitive to changes in species' market price. We also found that revenue under the existing zoning regime in the study area was 13-30% lower than under an optimal solution. Our results highlight the importance of accounting for both the benefits and costs of enforcement in marine conservation, particularly when incurred by fishers. PMID:25103090

  4. Allocation Costs Associated with Induced Defense in Phaeocystis globosa (Prymnesiophyceae): the Effects of Nutrient Availability

    NASA Astrophysics Data System (ADS)

    Wang, Xiaodong; Wang, Yan; Ou, Linjian; He, Xuejia; Chen, Da

    2015-06-01

    Colony enlargement in Phaeocystis globosa has been considered as an induced defense strategy that reduces its susceptibility to grazers, but allocation costs inflicted by this plastic morphological defense are poorly understood. We conducted experiments in which P. globosa cultures were exposed to chemical cues from copepods, ciliates and heterotrophic dinoflagellates, respectively, under nutrient sufficient and deficient conditions to evaluate allocation costs associated with induced defense. Phaeocystis globosa responded to chemical cues from grazers by increasing colony diameter irrespective of nutrient conditions. We did not find trade-offs between induced defense and growth rate under nutrient sufficient conditions. Instead, induced defensive P. globosa had higher growth rates than non-induced P. globosa. When nutrient became limited, P. globosa exposed to grazing cues from copepods and dinoflagellates had significantly decreased growth rates when compared with non-induced P. globosa. We suggested that the decreased growth revealed allocation costs associated with induced defense that may influence on the trophic interactions between Phaeocystis and consumers.

  5. Allocation Costs Associated with Induced Defense in Phaeocystis globosa (Prymnesiophyceae): the Effects of Nutrient Availability.

    PubMed

    Wang, Xiaodong; Wang, Yan; Ou, Linjian; He, Xuejia; Chen, Da

    2015-01-01

    Colony enlargement in Phaeocystis globosa has been considered as an induced defense strategy that reduces its susceptibility to grazers, but allocation costs inflicted by this plastic morphological defense are poorly understood. We conducted experiments in which P. globosa cultures were exposed to chemical cues from copepods, ciliates and heterotrophic dinoflagellates, respectively, under nutrient sufficient and deficient conditions to evaluate allocation costs associated with induced defense. Phaeocystis globosa responded to chemical cues from grazers by increasing colony diameter irrespective of nutrient conditions. We did not find trade-offs between induced defense and growth rate under nutrient sufficient conditions. Instead, induced defensive P. globosa had higher growth rates than non-induced P. globosa. When nutrient became limited, P. globosa exposed to grazing cues from copepods and dinoflagellates had significantly decreased growth rates when compared with non-induced P. globosa. We suggested that the decreased growth revealed allocation costs associated with induced defense that may influence on the trophic interactions between Phaeocystis and consumers. PMID:26040243

  6. Lifetime-Aware Battery Allocation for Wireless Sensor Network under Cost Constraints

    NASA Astrophysics Data System (ADS)

    Liu, Yongpan; Wang, Yiqun; Long, Hengyu; Yang, Huazhong

    Battery-powered wireless sensor networks are prone to premature failures because some nodes deplete their batteries more rapidly than others due to workload variations, the many-to-one traffic pattern, and heterogeneous hardware. Most previous sensor network lifetime enhancement techniques focused on balancing the power distribution, assuming the usage of the identical battery. This paper proposes a novel fine-grained cost-constrained lifetime-aware battery allocation solution for sensor networks with arbitrary topologies and heterogeneous power distributions. Based on an energy-cost battery pack model and optimal node partitioning algorithm, a rapid battery pack selection heuristic is developed and its deviation from optimality is quantified. Furthermore, we investigate the impacts of the power variations on the lifetime extension by battery allocation. We prove a theorem to show that power variations of nodes are more likely to reduce the lifetime than to increase it. Experimental results indicate that the proposed technique achieves network lifetime improvements ranging from 4-13× over the uniform battery allocation, with no more than 10 battery pack levels and 2-5 orders of magnitudes speedup compared with a standard integer nonlinear program solver (INLP).

  7. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Allocation of business... Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  8. Distributed Bees Algorithm Parameters Optimization for a Cost Efficient Target Allocation in Swarms of Robots

    PubMed Central

    Jevtić, Aleksandar; Gutiérrez, Álvaro

    2011-01-01

    Swarms of robots can use their sensing abilities to explore unknown environments and deploy on sites of interest. In this task, a large number of robots is more effective than a single unit because of their ability to quickly cover the area. However, the coordination of large teams of robots is not an easy problem, especially when the resources for the deployment are limited. In this paper, the Distributed Bees Algorithm (DBA), previously proposed by the authors, is optimized and applied to distributed target allocation in swarms of robots. Improved target allocation in terms of deployment cost efficiency is achieved through optimization of the DBA’s control parameters by means of a Genetic Algorithm. Experimental results show that with the optimized set of parameters, the deployment cost measured as the average distance traveled by the robots is reduced. The cost-efficient deployment is in some cases achieved at the expense of increased robots’ distribution error. Nevertheless, the proposed approach allows the swarm to adapt to the operating conditions when available resources are scarce. PMID:22346677

  9. Distributed bees algorithm parameters optimization for a cost efficient target allocation in swarms of robots.

    PubMed

    Jevtić, Aleksandar; Gutiérrez, Alvaro

    2011-01-01

    Swarms of robots can use their sensing abilities to explore unknown environments and deploy on sites of interest. In this task, a large number of robots is more effective than a single unit because of their ability to quickly cover the area. However, the coordination of large teams of robots is not an easy problem, especially when the resources for the deployment are limited. In this paper, the distributed bees algorithm (DBA), previously proposed by the authors, is optimized and applied to distributed target allocation in swarms of robots. Improved target allocation in terms of deployment cost efficiency is achieved through optimization of the DBA's control parameters by means of a genetic algorithm. Experimental results show that with the optimized set of parameters, the deployment cost measured as the average distance traveled by the robots is reduced. The cost-efficient deployment is in some cases achieved at the expense of increased robots' distribution error. Nevertheless, the proposed approach allows the swarm to adapt to the operating conditions when available resources are scarce. PMID:22346677

  10. Cost-effectiveness of Out-of-Hospital Continuous Positive Airway Pressure for Acute Respiratory Failure

    PubMed Central

    Thokala, Praveen; Goodacre, Steve; Ward, Matt; Penn-Ashman, Jerry; Perkins, Gavin D.

    2015-01-01

    Study objective We determine the cost-effectiveness of out-of-hospital continuous positive airway pressure (CPAP) compared with standard care for adults presenting to emergency medical services with acute respiratory failure. Methods We developed an economic model using a United Kingdom health care system perspective to compare the costs and health outcomes of out-of-hospital CPAP to standard care (inhospital noninvasive ventilation) when applied to a hypothetical cohort of patients with acute respiratory failure. The model assigned each patient a probability of intubation or death, depending on the patient’s characteristics and whether he or she had out-of-hospital CPAP or standard care. The patients who survived accrued lifetime quality-adjusted life-years (QALYs) and health care costs according to their age and sex. Costs were accrued through intervention and hospital treatment costs, which depended on patient outcomes. All results were converted into US dollars, using the Organisation for Economic Co-operation and Development purchasing power parities rates. Results Out-of-hospital CPAP was more effective than standard care but was also more expensive, with an incremental cost-effectiveness ratio of £20,514 per QALY ($29,720/QALY) and a 49.5% probability of being cost-effective at the £20,000 per QALY ($29,000/QALY) threshold. The probability of out-of-hospital CPAP’s being cost-effective at the £20,000 per QALY ($29,000/QALY) threshold depended on the incidence of eligible patients and varied from 35.4% when a low estimate of incidence was used to 93.8% with a high estimate. Variation in the incidence of eligible patients also had a marked influence on the expected value of sample information for a future randomized trial. Conclusion The cost-effectiveness of out-of-hospital CPAP is uncertain. The incidence of patients eligible for out-of-hospital CPAP appears to be the key determinant of cost-effectiveness. PMID:25737210

  11. The dynamics of resource allocation and costs of reproduction in a sexually dimorphic, wind-pollinated dioecious plant.

    PubMed

    Teitel, Z; Pickup, M; Field, D L; Barrett, S C H

    2016-01-01

    Sexual dimorphism in resource allocation is expected to change during the life cycle of dioecious plants because of temporal differences between the sexes in reproductive investment. Given the potential for sex-specific differences in reproductive costs, resource availability may contribute to variation in reproductive allocation in females and males. Here, we used Rumex hastatulus, a dioecious, wind-pollinated annual plant, to investigate whether sexual dimorphism varies with life-history stage and nutrient availability, and determine whether allocation patterns differ depending on reproductive commitment. To examine if the costs of reproduction varied between the sexes, reproduction was either allowed or prevented through bud removal, and biomass allocation was measured at maturity. In a second experiment to assess variation in sexual dimorphism across the life cycle, and whether this varied with resource availability, plants were grown in high and low nutrients and allocation to roots, aboveground vegetative growth and reproduction were measured at three developmental stages. Males prevented from reproducing compensated with increased above- and belowground allocation to a much larger degree than females, suggesting that male reproductive costs reduce vegetative growth. The proportional allocation to roots, reproductive structures and aboveground vegetative growth varied between the sexes and among life-cycle stages, but not with nutrient treatment. Females allocated proportionally more resources to roots than males at peak flowering, but this pattern was reversed at reproductive maturity under low-nutrient conditions. Our study illustrates the importance of temporal dynamics in sex-specific resource allocation and provides support for high male reproductive costs in wind-pollinated plants. PMID:25865555

  12. Price allocation guidelines January 1980: Low-cost solar array project

    SciTech Connect

    Aster, R.W.

    1980-01-15

    The price allocation guidelines (PAG) are an integrated set of specific cost targets for several task areas within the Low-cost Solar Array (LSA) Project. PAG is a working tool of LSA Project management designed to provide consistent and meaningful guidelines for costs of polycrystalline silicon material, sheet, cells, encapsulants, and module manufacturing. It is expected that advanced photovoltaic concepts derived from industry and the research community can be developed so that it will be possible by the end of 1982 to demonstrate production processes, all process steps, and prototype equipment required to manufacture flat-plate photovoltaic modules. This demonstration would incorporate production rates and product quality consistent with a specific market price determined by the program. This stage of development has been referred to as Technical Readiness. A goal of $0.70 per peak watt (1980 dollars) has been established for the cost of electricity generated by photovoltaic modules. The processes for producing modules demonstrated to be technically ready must be amenable to scale-up so that this price goal can eventually be achieved in the marketplace. The guidelines described in this document allocate portions of that goal to each module component. Sheet materials derived from the following five technologies are considered: Czochralski, heat exchanger method (HEM), edge-defined film growth (EFG), dendritic web, and silicon on ceramic (SOC). Each type of material provides a unique combination of projected silicon yield, cell efficiency, and module packing efficiency. Also included are tables describing actual inflation rates from 1975 to 1979, and projected inflation rate to mid-1980. Project goals are now expressed in 1980 dollars rather than 1975 dollars, and these tables enable conversion of dollar amounts from prior years (1974 to 1980) to their 1980 or 1975 equivalents.

  13. Determination of cost coefficients of a priority-based water allocation linear programming model - a network flow approach

    NASA Astrophysics Data System (ADS)

    Chou, F. N.-F.; Wu, C.-W.

    2014-05-01

    This paper presents a method to establish the objective function of a network flow programming model for simulating river-reservoir system operations and associated water allocation, with an emphasis on situations when the links other than demand or storage have to be assigned with nonzero cost coefficients. The method preserves the priorities defined by rule curves of reservoir, operational preferences for conveying water, allocation of storage among multiple reservoirs, and transbasin water diversions. Path enumeration analysis transforms these water allocation rules into linear constraints that can be solved to determine link cost coefficients. An approach to prune the original system into a reduced network is proposed to establish the precise constraints of nonzero cost coefficients, which can then be efficiently solved. The cost coefficients for the water allocation in the Feitsui and Shihmen reservoirs' joint operating system of northern Taiwan was adequately assigned by the proposed method. This case study demonstrates how practitioners can correctly utilize network-flow-based models to allocate water supply throughout complex systems that are subject to strict operating rules.

  14. Determination of cost coefficients of priority-based water allocation linear programming model - a network flow approach

    NASA Astrophysics Data System (ADS)

    Chou, F. N.-F.; Wu, C.-W.

    2013-12-01

    This paper presents a method to establish the objective function of a network flow programming model for simulating river/reservoir system operations and associated water allocation, with an emphasis on situations when the links other than demand or storage have to be assigned with nonzero cost coefficients. The method preserves the priorities defined by rule curves of reservoir, operational preferences for conveying water, allocation of storage among multiple reservoirs, and trans-basin water diversions. Path enumeration analysis transforms these water allocation rules into linear constraints that can be solved to determine link cost coefficients. An approach to prune the original system into a reduced network is proposed to establish the precise constraints of nonzero cost coefficients which can then be efficiently solved. The cost coefficients for the water allocation in the Feitsui and Shihmen Reservoirs joint operating system of northern Taiwan was adequately assigned by the proposed method. This case study demonstrates how practitioners can correctly utilize network-flow-based models to allocate water supply throughout complex systems that are subject to strict operating rules.

  15. Coevolutionary Feedbacks between Female Mating Interval and Male Allocation to Competing Sperm Traits Can Drive Evolution of Costly Polyandry.

    PubMed

    Bocedi, Greta; Reid, Jane M

    2016-03-01

    Complex coevolutionary feedbacks between female mating interval and male sperm traits have been hypothesized to explain the evolution and persistence of costly polyandry. Such feedbacks could potentially arise because polyandry creates sperm competition and consequent selection on male allocation to sperm traits, while the emerging sperm traits could create female sperm limitation and, hence, impose selection for increased polyandry. However, the hypothesis that costly polyandry could coevolve with male sperm dynamics has not been tested. We built a genetically explicit individual-based model to simulate simultaneous evolution of female mating interval and male allocation to sperm number versus longevity, where these two sperm traits trade off. We show that evolution of competing sperm traits under polyandry can indeed cause female sperm limitation and, hence, promote further evolution and persistence of costly polyandry, particularly when sperm are costly relative to the degree of female sperm limitation. These feedbacks were stronger, and greater polyandry evolved, when postcopulatory competition for paternity followed a loaded rather than fair raffle and when sperm traits had realistically low heritability. We therefore demonstrate that the evolution of allocation to sperm traits driven by sperm competition can prevent males from overcoming female sperm limitation, thereby driving ongoing evolution of costly polyandry. PMID:26913946

  16. Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach

    PubMed Central

    2013-01-01

    Background There is a paucity of knowledge on the cost of health care services in Ghana. This poses a challenge in the economic evaluation of programmes and inhibits policy makers in making decisions about allocation of resources to improve health care. This study analysed the overall cost of providing health services in selected primary health centres and how much of the cost is attributed to the provision of antenatal and delivery services. Methods The study has a cross-sectional design and quantitative data was collected between July and December 2010. Twelve government run primary health centres in the Kassena-Nankana and Builsa districts of Ghana were randomly selected for the study. All health-care related costs for the year 2010 were collected from a public service provider’s perspective. The step-down allocation approach recommended by World Health Organization was used for the analysis. Results The average annual cost of operating a health centre was $136,014 US. The mean costs attributable to ANC and delivery services were $23,063 US and $11,543 US respectively. Personnel accounted for the largest proportion of cost (45%). Overall, ANC (17%) and delivery (8%) were responsible for less than a quarter of the total cost of operating the health centres. By disaggregating the costs, the average recurrent cost was estimated at $127,475 US, representing 93.7% of the total cost. Even though maternal health services are free, utilization of these services at the health centres were low, particularly for delivery (49%), leading to high unit costs. The mean unit costs were $18 US for an ANC visit and $63 US for spontaneous delivery. Conclusion The high unit costs reflect underutilization of the existing capacities of health centres and indicate the need to encourage patients to use health centres .The study provides useful information that could be used for cost effectiveness analyses of maternal and neonatal care interventions, as well as for policy makers to

  17. Pollution control costs of a transboundary river basin: Empirical tests of the fairness and stability of cost allocation mechanisms using game theory.

    PubMed

    Shi, Guang-Ming; Wang, Jin-Nan; Zhang, Bing; Zhang, Zhe; Zhang, Yong-Liang

    2016-07-15

    With rapid economic growth, transboundary river basin pollution in China has become a very serious problem. Based on practical experience in other countries, cooperation among regions is an economic way to control the emission of pollutants. This study develops a game theoretic simulation model to analyze the cost effectiveness of reducing water pollutant emissions in four regions of the Jialu River basin while considering the stability and fairness of four cost allocation schemes. Different schemes (the nucleolus, the weak nucleolus, the Shapley value and the Separable Cost Remaining Benefit (SCRB) principle) are used to allocate regionally agreed-upon water pollutant abatement costs. The main results show that the fully cooperative coalition yielded the highest incremental gain for regions willing to cooperate if each region agreed to negotiate by transferring part of the incremental gain obtained from the cooperation to cover the losses of other regions. In addition, these allocation schemes produce different outcomes in terms of their fairness to the players and in terms of their derived stability, as measured by the Shapley-Shubik Power Index and the Propensity to Disrupt. Although the Shapley value and the SCRB principle exhibit superior fairness and stabilization to the other methods, only the SCRB principle may maintains full cooperation among regions over the long term. The results provide clear empirical evidence that regional gain allocation may affect the sustainability of cooperation. Therefore, it is implied that not only the cost-effectiveness but also the long-term sustainability should be considered while formulating and implementing environmental policies. PMID:27088211

  18. Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series.

    PubMed

    Culme-Seymour, Emily J; Mason, Katrina; Vallejo-Torres, Laura; Carvalho, Carla; Partington, Leanne; Crowley, Claire; Hamilton, Nick J; Toll, Ed C; Butler, Colin R; Elliott, Martin J; Birchall, Martin A; Lowdell, Mark W; Mason, Chris

    2016-02-01

    Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations. PMID:26559535

  19. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402 Cost... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting...

  20. The influence of metal source uncertainty on cost-effective allocation of mine water pollution abatement in catchments.

    PubMed

    Baresel, Christian; Destouni, Georgia; Gren, Ing-Marie

    2006-01-01

    In mine water pollution abatement, it is commonly assumed that known mine waste sites are the major pollution sources, thus neglecting the possibility of significant contribution from other old and diffuse sources within a catchment. We investigate the influence of different types of pollution source uncertainty on cost-effective allocation of abatement measures for mine water pollution. A catchment-scale cost-minimization model is developed and applied to the catchment of the river Dalälven, Sweden, in order to exemplify important effects of such source uncertainty. Results indicate that, if the pollution distribution between point and diffuse sources is partly unknown, downstream abatement measures, such as constructed wetlands, at given compliance boundaries are often cost-effective. If downstream abatement measures are not practically feasible, the pollution source distribution between point and diffuse mine water sources is critical for cost-effective solutions to abatement measure allocation in catchments. In contrast, cost-effective solutions are relatively insensitive to uncertainty in total pollutant discharge from mine water sources. PMID:16095805

  1. A variation reduction allocation model for quality improvement to minimize investment and quality costs by considering suppliers’ learning curve

    NASA Astrophysics Data System (ADS)

    Rosyidi, C. N.; Jauhari, WA; Suhardi, B.; Hamada, K.

    2016-02-01

    Quality improvement must be performed in a company to maintain its product competitiveness in the market. The goal of such improvement is to increase the customer satisfaction and the profitability of the company. In current practice, a company needs several suppliers to provide the components in assembly process of a final product. Hence quality improvement of the final product must involve the suppliers. In this paper, an optimization model to allocate the variance reduction is developed. Variation reduction is an important term in quality improvement for both manufacturer and suppliers. To improve suppliers’ components quality, the manufacturer must invest an amount of their financial resources in learning process of the suppliers. The objective function of the model is to minimize the total cost consists of investment cost, and quality costs for both internal and external quality costs. The Learning curve will determine how the employee of the suppliers will respond to the learning processes in reducing the variance of the component.

  2. The interplay between shifts in biomass allocation and costs of reproduction in four grassland perennials under simulated successional change.

    PubMed

    Jongejans, Eelke; de Kroon, Hans; Berendse, Frank

    2006-03-01

    When perennial herbs face the risk of being outcompeted in the course of succession, they are hypothesized to either increase their biomass allocation to flowers and seeds or to invest more in vegetative growth. We tested these hypotheses in a 3-year garden experiment with four perennials (Hypochaeris radicata, Cirsium dissectum, Succisa pratensis and Centaurea jacea) by growing them in the midst of a tall tussock-forming grass (Molinia caerulea) that may successionally replace them in their natural habitat. In all species except for the short-lived H. radicata, costs of sexual reproduction were significant over the 3 years, since continuous bud removal enhanced total biomass or rosette number. To mimic succession we added nutrients, which resulted in a tripled grass biomass and higher death rates in the shorter-lived species. The simulated succession resulted also in a number of coupled growth responses in the survivors: enhanced plant size as well as elevated seed production. The latter was partly due to larger plant sizes, but mostly due to higher reproductive allocation, which in turn could be partly explained by lower relative somatic costs and by lower root-shoot ratios in the high-nutrient plots. Our results suggest that perennial plants can increase both their persistence and their colonization ability by simultaneously increasing their vegetative size and reproductive allocation in response to enhanced competition and nutrient influxes. These responses can be very important for the survival of a species in a metapopulation context. PMID:16400509

  3. 48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 9905.502 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting...

  4. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402...

  5. 48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402...

  6. 78 FR 15615 - Practice and Procedure; Pole Attachment Complaint Procedures; Allocation of Unusable Space Costs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-12

    ... COMMISSION 47 CFR Part 1 Practice and Procedure; Pole Attachment Complaint Procedures; Allocation of Unusable... date. SUMMARY: This document announces the approval by the Office of Management and Budget (OMB) on... 63 FR 12026, March 12, 1998, has been approved by OMB and is effective March 12, 2013....

  7. 11 CFR 300.33 - Allocation of costs of Federal election activity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... forth in 11 CFR 100.24(a)(1) or paragraph (a) of this section must allocate the following minimum.... Subject to the conditions of 11 CFR 300.32(c), State, district, and local party committees and... Federal funds and Levin funds for voter registration activity, as defined in 11 CFR 100.24(a)(2),...

  8. A Guide to Cost Allocation Procedures: Implementing Strategies for Universal Pre-Kindergarten.

    ERIC Educational Resources Information Center

    Russell-Browne, Acquenetta; Lederman, Nancy

    This guide is intended to assist community-based providers in New York City who intend to blend universal pre-kindergarten funds with public child care funds, Head Start, preschool special education, or other funds to provide full or extended day early education programs for children. The guide provides information on how to allocate a programs…

  9. 48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard... 9905.502 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS...

  10. 48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard... 9905.502 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS...

  11. Make or buy analysis model based on tolerance allocation to minimize manufacturing cost and fuzzy quality loss

    NASA Astrophysics Data System (ADS)

    Rosyidi, C. N.; Puspitoingrum, W.; Jauhari, W. A.; Suhardi, B.; Hamada, K.

    2016-02-01

    The specification of tolerances has a significant impact on the quality of product and final production cost. The company should carefully pay attention to the component or product tolerance so they can produce a good quality product at the lowest cost. Tolerance allocation has been widely used to solve problem in selecting particular process or supplier. But before merely getting into the selection process, the company must first make a plan to analyse whether the component must be made in house (make), to be purchased from a supplier (buy), or used the combination of both. This paper discusses an optimization model of process and supplier selection in order to minimize the manufacturing costs and the fuzzy quality loss. This model can also be used to determine the allocation of components to the selected processes or suppliers. Tolerance, process capability and production capacity are three important constraints that affect the decision. Fuzzy quality loss function is used in this paper to describe the semantic of the quality, in which the product quality level is divided into several grades. The implementation of the proposed model has been demonstrated by solving a numerical example problem that used a simple assembly product which consists of three components. The metaheuristic approach were implemented to OptQuest software from Oracle Crystal Ball in order to obtain the optimal solution of the numerical example.

  12. High-capacity and low-cost long-reach OFDMA PON based on distance-adaptive bandwidth allocation.

    PubMed

    Hu, Xiaofeng; Cao, Pan; Wu, Jiayang; Mao, Junming; Lv, Jianxin; Jiang, Yuling; Qiu, Ciyuan; Tremblay, Christine; Su, Yikai

    2015-01-26

    We propose and experimentally demonstrate a distance-adaptive bandwidth allocation scheme to realize high-capacity long-reach orthogonal frequency division multiple access passive optical network (OFDMA PON) with cost-effective electro-absorption modulator (EAM). In our scheme, the subcarriers in downstream OFDM signal are properly allocated to the optical network units (ONUs) with different fiber transmission lengths. By this means, the detrimental influence of power fading induced by dispersion and chirp can be avoided, thus all OFDM subcarriers can be modulated with high-order quadrature amplitude modulation (QAM) format, leading to a high transmission capacity. A proof-of-concept experiment is performed, in which three ONUs with transmission distances of 25, 50, and 100 km are assigned with different subcarriers, respectively. By using distance-adaptive bandwidth allocation technique, an OFDM signal of 34.5 Gb/s is successfully delivered to the ONUs with a bit error ratio (BER) lower than 2 × 10(-3). PMID:25835883

  13. Improving resource allocation decisions for health and HIV programmes in South Africa: Bioethical, cost-effectiveness and health diplomacy considerations.

    PubMed

    Kevany, Sebastian; Benatar, Solomon R; Fleischer, Theodore

    2013-01-01

    The escalating expenditure on patients with HIV/AIDS within an inadequately funded public health system is tending towards crowding out care for patients with non-HIV illnesses. Priority-setting decisions are thus required and should increasingly be based on an explicit, transparent and accountable process to facilitate sustainability. South Africa's public health system is eroding, even though the government has received extensive donor financing for specific conditions, such as HIV/AIDS. The South African government's 2007 HIV plan anticipated costs exceeding 20% of the annual health budget with a strong focus on treatment interventions, while the recently announced 2012-2016 National Strategic HIV plan could cost up to US$16 billion. Conversely, the total non-HIV health budget has remained static in recent years, effectively reducing the supply of health care for other diseases. While the South African government cannot meet all demands for health care simultaneously, health funders should attempt to allocate health resources in a fair, efficient, transparent and accountable manner, in order to ensure that publicly funded health care is delivered in a reasonable and non-discriminatory fashion. We recommend a process for resource allocation that includes ethical, economic, legal and policy considerations. This process, adapted for use by South Africa's policy-makers, could bring health, political, economic and ethical gains, whilst allaying a social crisis as mounting treatment commitments generated by HIV have the potential to overwhelm the health system. PMID:23651436

  14. An approach for optimal allocation of safety resources: using the knapsack problem to take aggregated cost-efficient preventive measures.

    PubMed

    Reniers, Genserik L L; Sörensen, Kenneth

    2013-11-01

    On the basis of the combination of the well-known knapsack problem and a widely used risk management technique in organizations (that is, the risk matrix), an approach was developed to carry out a cost-benefits analysis to efficiently take prevention investment decisions. Using the knapsack problem as a model and combining it with a well-known technique to solve this problem, bundles of prevention measures are prioritized based on their costs and benefits within a predefined prevention budget. Those bundles showing the highest efficiencies, and within a given budget, are identified from a wide variety of possible alternatives. Hence, the approach allows for an optimal allocation of safety resources, does not require any highly specialized information, and can therefore easily be applied by any organization using the risk matrix as a risk ranking tool. PMID:23551066

  15. Activity-based resource allocation: a system for predicting nursing costs.

    PubMed

    Crockett, M J; DiBlasi, M; Flaherty, P; Sampson, K

    1997-01-01

    As hospital-based managers are being confronted with changing patterns of reimbursement, ranging from revenue generating to cost management, it is imperative that hospitals know the exact nursing costs associated with the actual care delivered to specific patients. Nursing care has traditionally been bundled into the room rate for patients. This approach is extremely limiting when facilities are negotiating per diem rates and capitated rate contracts. At Braintree Hospital Rehabilitation Network, the nursing department has developed and implemented an activity-based management system to determine the actual cost of nursing care provided to each patient. This approach, which differentiates nursing costs accurately by diagnostic group and by intensity of nursing care, has contributed to the hospital's success in negotiating individual patient contracts with insurers in the managed care environment that increasingly focuses on costs and outcomes. Another result has been to enhance the accuracy of the network's cost accounting system. PMID:9416189

  16. An Innovative Time-Cost-Quality Tradeoff Modeling of Building Construction Project Based on Resource Allocation

    PubMed Central

    2014-01-01

    The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated. PMID:24672351

  17. 42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.564... providing medical care. Enrollment, marketing, and other administrative and general costs that benefit the total enrollment of the HMO or CMP and are not directly associated with furnishing medical care must...

  18. 42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417... associated with providing medical care. Enrollment, marketing, and other administrative and general costs... medical care must be apportioned on the basis of a ratio of Medicare enrollees to the total HMO or...

  19. 42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417... associated with providing medical care. Enrollment, marketing, and other administrative and general costs... medical care must be apportioned on the basis of a ratio of Medicare enrollees to the total HMO or...

  20. 42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.564... providing medical care. Enrollment, marketing, and other administrative and general costs that benefit the total enrollment of the HMO or CMP and are not directly associated with furnishing medical care must...

  1. 76 FR 53377 - Cost Accounting Standards; Allocation of Home Office Expenses to Segments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... FR 8260). C. Public Comments Three respondents submitted comments in response to the SDP. Two... Rulemaking. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS) Board... CAS 403 thresholds at 48 CFR 9904.403-40(c)(2) that require use of the three factor formula...

  2. Analysis of the Children's Hospital Graduate Medical Education Program Fund Allocations for Indirect Medical Education Costs.

    ERIC Educational Resources Information Center

    Wynn, Barbara O.; Kawata, Jennifer

    This study analyzed issues related to estimating indirect medical education costs specific to pediatric discharges. The Children's Hospital Graduate Medical Education (CHGNE) program was established to support graduate medical education in children's hospitals. This provision authorizes payments for both direct and indirect medical education…

  3. Understanding the Uncertainty of an Effectiveness-Cost Ratio in Educational Resource Allocation: A Bayesian Approach

    ERIC Educational Resources Information Center

    Pan, Yilin

    2016-01-01

    Given the necessity to bridge the gap between what happened and what is likely to happen, this paper aims to explore how to apply Bayesian inference to cost-effectiveness analysis so as to capture the uncertainty of a ratio-type efficiency measure. The first part of the paper summarizes the characteristics of the evaluation data that are commonly…

  4. 30 CFR 1220.011 - Schedule of allowable direct and allocable joint costs and credits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... event of oil spills or other environmental damage are allowable. The costs of actual control and cleanup of oil spills and resulting responsibilities required by applicable laws and regulations are... PAYMENT FOR OUTER CONTINENTAL SHELF OIL AND GAS LEASES § 1220.011 Schedule of allowable direct...

  5. 30 CFR 1220.011 - Schedule of allowable direct and allocable joint costs and credits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... event of oil spills or other environmental damage are allowable. The costs of actual control and cleanup of oil spills and resulting responsibilities required by applicable laws and regulations are... PAYMENT FOR OUTER CONTINENTAL SHELF OIL AND GAS LEASES § 1220.011 Schedule of allowable direct...

  6. 30 CFR 1220.011 - Schedule of allowable direct and allocable joint costs and credits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... event of oil spills or other environmental damage are allowable. The costs of actual control and cleanup of oil spills and resulting responsibilities required by applicable laws and regulations are... PAYMENT FOR OUTER CONTINENTAL SHELF OIL AND GAS LEASES § 1220.011 Schedule of allowable direct...

  7. 30 CFR 220.011 - Schedule of allowable direct and allocable joint costs and credits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... event of oil spills or other environmental damage are allowable. The costs of actual control and cleanup of oil spills and resulting responsibilities required by applicable laws and regulations are... PAYMENT FOR OUTER CONTINENTAL SHELF OIL AND GAS LEASES § 220.011 Schedule of allowable direct...

  8. 30 CFR 1220.011 - Schedule of allowable direct and allocable joint costs and credits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... event of oil spills or other environmental damage are allowable. The costs of actual control and cleanup of oil spills and resulting responsibilities required by applicable laws and regulations are... DETERMINING NET PROFIT SHARE PAYMENT FOR OUTER CONTINENTAL SHELF OIL AND GAS LEASES § 1220.011 Schedule...

  9. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  10. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  11. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  12. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  13. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3. ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR...

  14. The Impact of Proposed Changes in Liver Allocation Policy on Cold Ischemia Times and Organ Transportation Costs

    PubMed Central

    DuBay, D. A.; MacLennan, P. A.; Reed, R. D.; Fouad, M.; Martin, M.; Meeks, C. B.; Taylor, G.; Kilgore, M. L.; Tankersley, M.; Gray, S. H.; White, J. A.; Eckhoff, D. E.; Locke, J. E.

    2015-01-01

    Changes to the liver allocation system have been proposed to decrease regional variation in access to liver transplant. It is unclear what impact these changes will have on cold ischemia times (CITs) and donor transportation costs. Therefore, we performed a retrospective single center study (2008–2012) measuring liver procurement CIT and transportation costs. Four groups were defined: Local-within driving distance (Local-D, n = 262), Local-flight (Local-F, n = 105), Regional-flight <3 h (Regional <3h, n = 61) and Regional-Flight >3 h (Regional >3h, n = 53). The median travel distance increased in each group, varying from zero miles (Local-D), 196 miles (Local-F), 384 miles (Regional <3 h), to 1647 miles (Regional >3 h). Increasing travel distances did not significantly increase CIT until the flight time was >3 h. The average CIT ranged from 5.0 to 6.0 h for Local-D, Local-F and Regional <3h, but increased to 10 h for Regional >3h (p < 0.0001). Transportation costs increased with greater distance traveled: Local-D $101, Local-F $1993, Regional <3h $8324 and Regional >3 h $27 810 (p < 0.0001). With proposed redistricting, local financial modeling suggests that the average liver donor procurement transportation variable direct costs will increase from $2415 to $7547/liver donor, an increase of 313%. These findings suggest that further discussion among transplant centers and insurance providers is needed prior to policy implementation. PMID:25612501

  15. 2 CFR Appendix V to Part 200 - State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans V Appendix V to Part 200 Grants and Agreements Office of Management..., App. V Appendix V to Part 200—State/Local Government and Indian Tribe-Wide Central Service...

  16. Linking Costs to Health Outcomes for Allocating Scarce Public Health Resources

    PubMed Central

    Corso, Phaedra S.; Ingels, Justin B.; Taylor, Nathaniel; Desai, Samir

    2014-01-01

    Introduction: Resources for public health (PH) are scarce and policymakers face tough decisions in determining their funding priorities. The difficulty of making these decisions is compounded by current PH accounting systems, which are ill-equipped to link fiscal resources to PH outcomes. This paper examines the types of revenues and expenditures, health services, and health outcomes that are being tracked at the local and state PH levels. The authors provide recommendations for strengthening the ability of local and state governments to link expenditures to PH outcomes, both within and across jurisdictions. Framework and Next Steps: The source of revenue data for most local jurisdictions is the accounting systems used for the budgeting and auditing of fiscal activities, and these are primarily linked to specific PH programs. In contrast, expenditure data are mostly generic and typically span multiple PH programs with no link to specific PH activities. Many challenges exist to then link PH activities to health outcomes data, which are often collected through separate reporting systems at the local, state, and national levels. Policy change at the state level and implementation strategies that are standardized across local health departments are required to assess the costs and health outcomes of PH activities. Conclusion: Information linking PH expenditures to health outcomes of PH services could greatly inform the decision-making process. This information will allow investments in PH to be better understood and will provide a strong foundation for the PH services and systems research community to understand variation and drive improvement. Ultimately, these data could be used to improve accountability at the local and state PH department levels. PMID:25848629

  17. 50 CFR 80.63 - Does an agency have to allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.63 Does an agency have to allocate... in multipurpose projects and facilities. A grant-funded project or facility is multipurpose if...

  18. 50 CFR 80.63 - Does an agency have to allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.63 Does an agency have to allocate... in multipurpose projects and facilities. A grant-funded project or facility is multipurpose if...

  19. 50 CFR 80.63 - Does an agency have to allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.63 Does an agency have to allocate... in multipurpose projects and facilities. A grant-funded project or facility is multipurpose if...

  20. 50 CFR 80.63 - Does an agency have to allocate costs in multipurpose projects and facilities?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS Allocation of Funds by an Agency § 80.63 Does an agency have to allocate... in multipurpose projects and facilities. A grant-funded project or facility is multipurpose if...

  1. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  2. 45 CFR 156.470 - Allocation of rates and claims costs for advance payments of cost-sharing reductions and the...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... fair health insurance premium standards described at 45 CFR 147.102, the single risk pool standards described at 45 CFR 156.80, and the same premium rate standards described at 45 CFR 156.255. (d) Allocation... market on the Exchange, a dollar allocation of the expected premium for the plan, to: (1) The...

  3. PPD-QALY-an index for cost-effectiveness in orthopedics: providing essential information to both physicians and health care policy makers for appropriate allocation of medical resources.

    PubMed

    Dougherty, Christopher P; Howard, Timothy

    2013-09-01

    Because of the increasing health care costs and the need for proper allocation of resources, it is important to ensure the best use of health benefits for sick and injured people of the population. An index or indicator is needed to help us quantify what is being spent so that comparisons with other options can be implemented. Cost-effective analysis seems to be well suited to provide this essential information to health care policy makers and those charged with distributing disability funds so that the proper allocation of resources can be achieved. There is currently no such index to show whether the benefits paid out are the most cost-effective. By comparing the quality-adjusted life year (QALY) of a treatment method to the disability an individual would experience, on the basis of lost wages as measure of disability, we provide decision makers more information for the basis of cost allocation in health care. To accomplish this, we describe a new term, the PPD-QALY (permanent partial disability-quality of life year). This term was developed to establish an index to which musculoskeletal care can be compared, to evaluate the cost-effectiveness of a treatment on the basis of the monetary value of the disability. This term serves to standardize the monetary value of an injury. Cost-effective analysis in arthroscopic surgery may prove to be a valuable asset in this role and to provide decision makers the information needed to determine the societal benefit from new arthroscopic procedures as they are developed and implemented. PMID:23924750

  4. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  5. Towards an equitable allocation of the cost of a global change adaptation plan at the river basin scale: going beyond the perfect cooperation assumption

    NASA Astrophysics Data System (ADS)

    Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velázquez, Manuel

    2015-04-01

    Adaptation to global change is a key issue in the planning of water resource systems in a changing world. Adaptation has to be efficient, but also equitable in the share of the costs of joint adaptation at the river basin scale. Least-cost hydro-economic optimization models have been helpful at defining efficient adaptation strategies. However, they often rely on the assumption of a "perfect cooperation" among the stakeholders, required for reaching the optimal solution. Nowadays, most adaptation decisions have to be agreed among the different actors in charge of their implementation, thus challenging the validity of a perfect command-and-control solution. As a first attempt to over-pass this limitation, our work presents a method to allocate the cost of an efficient adaptation programme of measures among the different stakeholders at the river basin scale. Principles of equity are used to define cost allocation scenarios from different perspectives, combining elements from cooperative game theory and axioms from social justice to bring some "food for thought" in the decision making process of adaptation. To illustrate the type of interactions between stakeholders in a river basin, the method has been applied in a French case study, the Orb river basin. Located on the northern rim of the Mediterranean Sea, this river basin is experiencing changes in demand patterns, and its water resources will be impacted by climate change, calling for the design of an adaptation plan. A least-cost river basin optimization model (LCRBOM) has been developed under GAMS to select the combination of demand- and supply-side adaptation measures that allows meeting quantitative water management targets at the river basin scale in a global change context. The optimal adaptation plan encompasses measures in both agricultural and urban sectors, up-stream and down-stream of the basin, disregarding the individual interests of the stakeholders. In order to ensure equity in the cost allocation

  6. Influence of atmospheric [CO2] on growth, carbon allocation and cost of plant tissues on leaf nitrogen concentration maintenance in nodulated Medicago sativa

    NASA Astrophysics Data System (ADS)

    Pereyra, Gabriela; Hartmann, Henrik; Ziegler, Waldemar; Michalzik, Beate; Gonzalez-Meler, Miquel; Trumbore, Susan

    2015-04-01

    Plant carbon (C) allocation and plant metabolic processes (i.e. photosynthesis and respiration) can be affected by changes in C availability, for example from changing atmospheric [CO2]. In nodulated plants, C availability may also influence nitrogen (N) fixation by bacteriods. But C allocation and N fixation are often studied independently and hence do not allow elucidating interactive effects. We investigated how different atmospheric [CO2] (Pleistocene: 170 ppm, ambient: 400 ppm and projected future: 700 ppm) influence plant growth, allocation to nodules, and the ratio of photosynthesis-to-respiration (R:A) as an indicator of C cost in Medicago sativa inoculated with Ensifer meliloti. M. sativa grew c. 38% more nodules at 400 ppm and 700 ppm than at 170 ppm. However, ratios of above- and belowground plant biomass to nodule biomass were constant over time and independent of atmospheric [CO2]. Total non-structural carbohydrate concentrations were not significantly different between plants grown at 400 and 700 ppm, but were four to five-fold higher than in 170 ppm plants. Leaf level N concentration was similar across treatments, but N-based photosynthetic rates were 82% and 93% higher in leaves of plants grown at 400 and 700 ppm, respectively, than plants grown at 170 ppm. In addition, leaf R:A was greater (48% or 55%) in plants grown at 170 ppm than plants grown at 400 and 700 ppm. Similarly, the greatest proportion of assimilated CO2 released by root respiration occurred in rhizobial plants growing at 170 ppm. Our results suggest that C limitation in nodulated Medicago sativa plants did not influence C allocation to nodule biomass but caused a proportionally greater allocation of C to belowground respiration, most likely to bacteriods. This suggests that N tissue concentration was maintained at low [CO2] by revving up bacteriod metabolism and at the expense of non-structural carbohydrate reserves.

  7. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  8. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

  9. A High-Value, Low-Cost Bubble Continuous Positive Airway Pressure System for Low-Resource Settings: Technical Assessment and Initial Case Reports

    PubMed Central

    Brown, Jocelyn; Machen, Heather; Kawaza, Kondwani; Mwanza, Zondiwe; Iniguez, Suzanne; Lang, Hans; Gest, Alfred; Kennedy, Neil; Miros, Robert; Richards-Kortum, Rebecca; Molyneux, Elizabeth; Oden, Maria

    2013-01-01

    Acute respiratory infections are the leading cause of global child mortality. In the developing world, nasal oxygen therapy is often the only treatment option for babies who are suffering from respiratory distress. Without the added pressure of bubble Continuous Positive Airway Pressure (bCPAP) which helps maintain alveoli open, babies struggle to breathe and can suffer serious complications, and frequently death. A stand-alone bCPAP device can cost $6,000, too expensive for most developing world hospitals. Here, we describe the design and technical evaluation of a new, rugged bCPAP system that can be made in small volume for a cost-of-goods of approximately $350. Moreover, because of its simple design—consumer-grade pumps, medical tubing, and regulators—it requires only the simple replacement of a <$1 diaphragm approximately every 2 years for maintenance. The low-cost bCPAP device delivers pressure and flow equivalent to those of a reference bCPAP system used in the developed world. We describe the initial clinical cases of a child with bronchiolitis and a neonate with respiratory distress who were treated successfully with the new bCPAP device. PMID:23372661

  10. Summary of the technical report on estimating the impact of key programmatic risk allocation decisions on Phase 1 bids and U.S. Department of Energy costs

    SciTech Connect

    Keisler, J.M.; Buehring, W.A.

    1996-05-01

    The US Department of Energy (DOE) is privatizing the processing of hazardous and radioactive tank waste at the Hanford Site in Washington State. As part of the privatization process, a request for proposals describing the conditions and DOE`s expectations for contractor performance and responsibilities was issued. Argonne National Laboratory and Pacific Northwest National Laboratory collaborated to analyze programmatic risks and costs associated with privatization. They examined nine major risks to determine financial impacts on the prospective vendors and DOE for three alternative risk allocations: (1) DOE bears the risk, (2) the vendor bears the risk, or (3) the risk is shared. With the help of a subject-matter expert, each risk was characterized by estimating potential consequences and likelihood of occurrence. A financial risk model was developed to estimate the total cost to DOE for a given risk allocation strategy covering all nine risks. Results showed that it is financially advantageous to DOE to bear some risks, share some others, and assign some to the vendor.

  11. Allocation without locking

    SciTech Connect

    Appel, A.W.

    1988-01-01

    In a programming environment with both concurrency and automatic garbage collection, the allocation and initialization of a new record is a sensitive matter: if it is interrupted halfway through, the allocating process may be in a state that the garbage collector can't understand. In particular, the collector won't know which words of the new record have been initialized and which are meaningless (and unsafe to transverse). For this reason, parallel implementations usually use a locking or semaphore mechanism to ensure that allocation is an atomic operation. The locking significantly adds to the cost of allocation. This paper shows that allocation can run extremely quickly even in a multi-thread environment: open-coded, without locking.

  12. A Guide for State Government Agencies: Establishing Cost Allocation Plans and Indirect Cost Rates for Grants and Contracts with the Department of Health, Education, and Welfare.

    ERIC Educational Resources Information Center

    Department of Health, Education, and Welfare, Washington, DC.

    This brochure provides guidelines for State governments seeking to recover the costs of services provided by central service-type activities to grantee State departments and the indirect cost of grantee State departments. As a prerequisite to such recovery, States must develop and submit to the Department of Health, Education, and Welfare a formal…

  13. Solution of resource allocation problem for identification of cost-effective measures to reduce nuclear proliferation risks

    SciTech Connect

    Andrianov, A.; Kuptsov, I.

    2013-07-01

    This report presents a methodology of selection of cost-effective measures to reduce nuclear proliferation risks. The methodology relies on a graded security model used in practice in different applications. The method is based on the controlled finite Markov chain approach set in combination with discrete dynamic programming and MCDM (Multi Criteria Decision Making) techniques that enables the expert to select the cost-effective measures to reduce nuclear proliferation risks depending on availability of resources. The analysis performed with different number of possible measures confirms the conclusions that the implementation of extra-large costs may not produce the required effect, and the increase in resources above a certain level does not appear sensitive. Diversification in improving the effectiveness of other measures seems more rational and efficient for the whole system than the unlimited improvement of the effectiveness of only one measure.

  14. 77 FR 43184 - Allocation of Capacity on New Merchant Transmission Projects and New Cost-Based, Participant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Utilities; Recovery of Stranded Costs by Public Utilities and Transmitting Utilities, Order No. 888, 61 FR 21540 (May 10, 1996), FERC Stats. & Regs. ] 31,036 (1996), order on reh'g, Order No. 888-A, 62 FR 12274... customers may be another appropriate vehicle for new merchant transmission projects and new...

  15. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    PubMed Central

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V.; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    Background: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. Methods: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Results: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). Conclusion: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level. PMID:24688915

  16. Emergency airway puncture

    MedlinePlus

    Emergency airway puncture is the placement of a hollow needle through the throat into the airway. It ... Emergency airway puncture is done in an emergency situation, when someone is choking and all other efforts ...

  17. Blockage of upper airway

    MedlinePlus

    ... Airway obstruction - acute upper Images Throat anatomy Choking Respiratory system References Cukor J, Manno M. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Marx ...

  18. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    PubMed Central

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    or current tracheostomy. Twenty-three patients (6%) required emergent surgical airways. Sixty-two patients (17%) were stabilized and transported to the operating room for definitive airway management. There were no airway management-related deaths, sentinel events, or malpractice claims in adult patients managed by DART. Five in situ simulations conducted in the first program year improved DART's teamwork, communication, and response times and increased the functionality of the difficult airway carts. Over the 5-year period, we conducted 18 airway courses, through which more than 200 providers were trained. Conclusions DART is a comprehensive program for improving difficult airway management. Future studies will examine the comparative effectiveness of the DART program and evaluate how DART has impacted patient outcomes, operational efficiency, and costs of care. PMID:26086513

  19. 17 CFR 256.01-11 - Methods of allocation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... HOLDING COMPANY ACT OF 1935 General Instructions § 256.01-11 Methods of allocation. Indirect costs and... indirect costs of work orders for two or more associate companies shall be allocated among such...

  20. Upper airway test (image)

    MedlinePlus

    An upper airway biopsy is obtained by using a flexible scope called a bronchoscope. The scope is passed down through ... may be performed when an abnormality of the upper airway is suspected. It may also be performed as ...

  1. Careers in Airway Science.

    ERIC Educational Resources Information Center

    Federal Aviation Administration (DOT), Washington, DC.

    The Federal Aviation Administration (FAA) has initiated the Airway Science curriculum as a method of preparing the next generation of aviation technicians and managers. This document: (1) discusses the FAA's role in the Airway Science program; (2) describes some of the career fields that FAA offers to Airway Science graduates (air traffic control…

  2. The Physiologically Difficult Airway.

    PubMed

    Mosier, Jarrod M; Joshi, Raj; Hypes, Cameron; Pacheco, Garrett; Valenzuela, Terence; Sakles, John C

    2015-12-01

    Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management. The four physiologically difficult airways described include hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure. The emergency physician should account for these physiologic derangements with airway management in critically ill patients regardless of the predicted anatomic difficulty of the intubation. PMID:26759664

  3. The Physiologically Difficult Airway

    PubMed Central

    Mosier, Jarrod M.; Joshi, Raj; Hypes, Cameron; Pacheco, Garrett; Valenzuela, Terence; Sakles, John C.

    2015-01-01

    Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management. The four physiologically difficult airways described include hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure. The emergency physician should account for these physiologic derangements with airway management in critically ill patients regardless of the predicted anatomic difficulty of the intubation. PMID:26759664

  4. Integrated care pathways for airway diseases (AIRWAYS-ICPs).

    PubMed

    Bousquet, J; Addis, A; Adcock, I; Agache, I; Agusti, A; Alonso, A; Annesi-Maesano, I; Anto, J M; Bachert, C; Baena-Cagnani, C E; Bai, C; Baigenzhin, A; Barbara, C; Barnes, P J; Bateman, E D; Beck, L; Bedbrook, A; Bel, E H; Benezet, O; Bennoor, K S; Benson, M; Bernabeu-Wittel, M; Bewick, M; Bindslev-Jensen, C; Blain, H; Blasi, F; Bonini, M; Bonini, S; Boulet, L P; Bourdin, A; Bourret, R; Bousquet, P J; Brightling, C E; Briggs, A; Brozek, J; Buhl, R; Bush, A; Caimmi, D; Calderon, M; Calverley, P; Camargos, P A; Camuzat, T; Canonica, G W; Carlsen, K H; Casale, T B; Cazzola, M; Cepeda Sarabia, A M; Cesario, A; Chen, Y Z; Chkhartishvili, E; Chavannes, N H; Chiron, R; Chuchalin, A; Chung, K F; Cox, L; Crooks, G; Crooks, M G; Cruz, A A; Custovic, A; Dahl, R; Dahlen, S E; De Blay, F; Dedeu, T; Deleanu, D; Demoly, P; Devillier, P; Didier, A; Dinh-Xuan, A T; Djukanovic, R; Dokic, D; Douagui, H; Dubakiene, R; Eglin, S; Elliot, F; Emuzyte, R; Fabbri, L; Fink Wagner, A; Fletcher, M; Fokkens, W J; Fonseca, J; Franco, A; Frith, P; Furber, A; Gaga, M; Garcés, J; Garcia-Aymerich, J; Gamkrelidze, A; Gonzales-Diaz, S; Gouzi, F; Guzmán, M A; Haahtela, T; Harrison, D; Hayot, M; Heaney, L G; Heinrich, J; Hellings, P W; Hooper, J; Humbert, M; Hyland, M; Iaccarino, G; Jakovenko, D; Jardim, J R; Jeandel, C; Jenkins, C; Johnston, S L; Jonquet, O; Joos, G; Jung, K S; Kalayci, O; Karunanithi, S; Keil, T; Khaltaev, N; Kolek, V; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Le, L T; Lodrup Carlsen, K C; Louis, R; MacNee, W; Mair, A; Majer, I; Manning, P; de Manuel Keenoy, E; Masjedi, M R; Melen, E; Melo-Gomes, E; Menzies-Gow, A; Mercier, G; Mercier, J; Michel, J P; Miculinic, N; Mihaltan, F; Milenkovic, B; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Morgan, M; N'Diaye, M; Nafti, S; Nekam, K; Neou, A; Nicod, L; O'Hehir, R; Ohta, K; Paggiaro, P; Palkonen, S; Palmer, S; Papadopoulos, N G; Papi, A; Passalacqua, G; Pavord, I; Pigearias, B; Plavec, D; Postma, D S; Price, D; Rabe, K F; Radier Pontal, F; Redon, J; Rennard, S; Roberts, J; Robine, J M; Roca, J; Roche, N; Rodenas, F; Roggeri, A; Rolland, C; Rosado-Pinto, J; Ryan, D; Samolinski, B; Sanchez-Borges, M; Schünemann, H J; Sheikh, A; Shields, M; Siafakas, N; Sibille, Y; Similowski, T; Small, I; Sola-Morales, O; Sooronbaev, T; Stelmach, R; Sterk, P J; Stiris, T; Sud, P; Tellier, V; To, T; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; Valiulis, A; Valovirta, E; Van Ganse, E; Vandenplas, O; Vasankari, T; Vestbo, J; Vezzani, G; Viegi, G; Visier, L; Vogelmeier, C; Vontetsianos, T; Wagstaff, R; Wahn, U; Wallaert, B; Whalley, B; Wickman, M; Williams, D M; Wilson, N; Yawn, B P; Yiallouros, P K; Yorgancioglu, A; Yusuf, O M; Zar, H J; Zhong, N; Zidarn, M; Zuberbier, T

    2014-08-01

    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers). PMID:24925919

  5. Attribution of Library Costs

    ERIC Educational Resources Information Center

    Drake, Miriam A.

    1977-01-01

    Universities conduct a variety of cost-allocation studies that require the collection and analysis of the library cost-data. Cost accounting methods are used in most studies; however, costs are attributed to library user groups in a variety of ways. Cost accounting studies are reviewed and allocation methods are discussed. (Author)

  6. Engineering Airway Epithelium

    PubMed Central

    Soleas, John P.; Paz, Ana; Marcus, Paula; McGuigan, Alison; Waddell, Thomas K.

    2012-01-01

    Airway epithelium is constantly presented with injurious signals, yet under healthy circumstances, the epithelium maintains its innate immune barrier and mucociliary elevator function. This suggests that airway epithelium has regenerative potential (I. R. Telford and C. F. Bridgman, 1990). In practice, however, airway regeneration is problematic because of slow turnover and dedifferentiation of epithelium thereby hindering regeneration and increasing time necessary for full maturation and function. Based on the anatomy and biology of the airway epithelium, a variety of tissue engineering tools available could be utilized to overcome the barriers currently seen in airway epithelial generation. This paper describes the structure, function, and repair mechanisms in native epithelium and highlights specific and manipulatable tissue engineering signals that could be of great use in the creation of artificial airway epithelium. PMID:22523471

  7. Cost Accounting for Decision Makers.

    ERIC Educational Resources Information Center

    Kaneklides, Ann L.

    1985-01-01

    Underscores the importance of informed decision making through accurate anticipation of cost incurrence in light of changing economic and environmental conditions. Explains the concepts of cost accounting, full allocation of costs, the selection of an allocation base, the allocation of indirect costs, depreciation, and implications for community…

  8. Conquering the difficult airway.

    PubMed

    Gandy, William E

    2008-01-01

    Every medic should practice regularly for the inevitable difficult airway case. Practice should include review of the causes of difficult airways, as well as skill practice. Having a preassembled airway kit can make your response to an unexpected difficult situation easier. Of all the devices mentioned, the bougie is the airway practitioner's best friend. Using the BURP technique, if not contraindicated, together with the bougie will enable you to intubate many difficult patients with confidence. Remember, "If your patient cannot breathe, nothing else matters. PMID:18251307

  9. Brachycephalic airway syndrome: management.

    PubMed

    Lodato, Dena L; Hedlund, Cheryl S

    2012-08-01

    Brachycephalic airway syndrome (BAS) is a group of primary and secondary abnormalities that result in upper airway obstruction. Several of these abnormalities can be addressed medically and/or surgically to improve quality of life. This article reviews potential complications, anesthetic considerations, recovery strategies, and outcomes associated with medical and surgical management of BAS. PMID:22935992

  10. Simvastatin Inhibits Airway Hyperreactivity

    PubMed Central

    Zeki, Amir A.; Franzi, Lisa; Last, Jerold; Kenyon, Nicholas J.

    2009-01-01

    Rationale: Statin use has been linked to improved lung health in asthma and chronic obstructive pulmonary disease. We hypothesize that statins inhibit allergic airway inflammation and reduce airway hyperreactivity via a mevalonate-dependent mechanism. Objectives: To determine whether simvastatin attenuates airway inflammation and improves lung physiology by mevalonate pathway inhibition. Methods: BALB/c mice were sensitized to ovalbumin over 4 weeks and exposed to 1% ovalbumin aerosol over 2 weeks. Simvastatin (40 mg/kg) or simvastatin plus mevalonate (20 mg/kg) was injected intraperitoneally before each ovalbumin exposure. Measurements and Main Results: Simvastatin reduced total lung lavage leukocytes, eosinophils, and macrophages (P < 0.05) in the ovalbumin-exposed mice. Cotreatment with mevalonate, in addition to simvastatin, reversed the antiinflammatory effects seen with simvastatin alone (P < 0.05). Lung lavage IL-4, IL-13, and tumor necrosis factor-α levels were all reduced by treatment with simvastatin (P < 0.05). Simvastatin treatment before methacholine bronchial challenge increased lung compliance and reduced airway hyperreactivity (P = 0.0001). Conclusions: Simvastatin attenuates allergic airway inflammation, inhibits key helper T cell type 1 and 2 chemokines, and improves lung physiology in a mouse model of asthma. The mevalonate pathway appears to modulate allergic airway inflammation, while the beneficial effects of simvastatin on lung compliance and airway hyperreactivity may be independent of the mevalonate pathway. Simvastatin and similar agents that modulate the mevalonate pathway may prove to be treatments for inflammatory airway diseases, such as asthma. PMID:19608720

  11. Controversies in Pediatric Perioperative Airways

    PubMed Central

    Klučka, Jozef; Štourač, Petr; Štoudek, Roman; Ťoukálková, Michaela; Harazim, Hana; Kosinová, Martina

    2015-01-01

    Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient. PMID:26759809

  12. 14 CFR 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Allocation of risk/liability. 1260.61... AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk/Liability..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  13. 14 CFR 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Allocation of risk/liability. 1260.61... AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk/Liability..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  14. 14 CFR 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Allocation of risk/liability. 1260.61... AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk/Liability..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  15. 17 CFR 256.01-11 - Methods of allocation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... compensation for use of capital shall be allocated to work orders in accordance with the service company's... indirect costs of work orders for two or more associate companies shall be allocated among such companies in the same manner. Each work order should identify the methods of allocation to associate...

  16. 18 CFR 367.28 - Methods of allocation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Methods of allocation... Instructions § 367.28 Methods of allocation. Indirect costs and compensation for use of capital must be allocated to projects in accordance with the service company's applicable and currently effective methods...

  17. 18 CFR 367.28 - Methods of allocation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Methods of allocation... Instructions § 367.28 Methods of allocation. Indirect costs and compensation for use of capital must be allocated to projects in accordance with the service company's applicable and currently effective methods...

  18. Airway dysfunction in swimmers.

    PubMed

    Bougault, Valérie; Boulet, Louis-Philippe

    2012-05-01

    Elite competitive swimmers are particularly affected by airway disorders that are probably related to regular and intense training sessions in a chlorinated environment. Upper and lower airway respiratory symptoms, rhinitis, airway hyper-responsiveness, and exercise-induced bronchoconstriction are highly prevalent in these athletes, but their influence on athletic performance is still unclear. The authors reviewed the main upper and lower respiratory ailments observed in competitive swimmers who train in indoor swimming pools, their pathophysiology, clinical significance and possible effects on performance. Issues regarding the screening of these disorders, their management and preventive measures are addressed. PMID:22247299

  19. Meteorological conditions along airways

    NASA Technical Reports Server (NTRS)

    Gregg, W R

    1927-01-01

    This report is an attempt to show the kind of meteorological information that is needed, and is in part available, for the purpose of determining operating conditions along airways. In general, the same factors affect these operating conditions along all airways though in varying degree, depending upon their topographic, geographic, and other characteristics; but in order to bring out as clearly as possible the nature of the data available, a specific example is taken, that of the Chicago-Dallas airway on which regular flying begins this year (1926).

  20. Computer Processor Allocator

    2004-03-01

    The Compute Processor Allocator (CPA) provides an efficient and reliable mechanism for managing and allotting processors in a massively parallel (MP) computer. It maintains information in a database on the health. configuration and allocation of each processor. This persistent information is factored in to each allocation decision. The CPA runs in a distributed fashion to avoid a single point of failure.

  1. Airway management in trauma.

    PubMed

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration. PMID:19412149

  2. Medicare and Medicaid programs; Home Health Prospective Payment System rate update for CY 2014, home health quality reporting requirements, and cost allocation of home health survey expenses. Final rule.

    PubMed

    2013-12-01

    This final rule will update the Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, the low-utilization payment adjustment (LUPA) add-on, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective January 1, 2014. As required by the Affordable Care Act, this rule establishes rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode payment rates; the national per-visit rates; and the NRS conversion factor. In addition, this final rule will remove 170 diagnosis codes from assignment to diagnosis groups within the HH PPS Grouper, effective January 1, 2014. Finally, this rule will establish home health quality reporting requirements for CY 2014 payment and subsequent years and will clarify that a state Medicaid program must provide that, in certifying HHAs, the state's designated survey agency carry out certain other responsibilities that already apply to surveys of nursing facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), including sharing in the cost of HHA surveys. For that portion of costs attributable to Medicare and Medicaid, we will assign 50 percent to Medicare and 50 percent to Medicaid, the standard method that CMS and states use in the allocation of expenses related to surveys of nursing homes. PMID:24294635

  3. Role of upper airway ultrasound in airway management.

    PubMed

    Osman, Adi; Sum, Kok Meng

    2016-01-01

    Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enables us to identify important sonoanatomy of the upper airway such as thyroid cartilage, epiglottis, cricoid cartilage, cricothyroid membrane, tracheal cartilages, and esophagus. Understanding this applied sonoanatomy facilitates clinician to use ultrasound in assessment of airway anatomy for difficult intubation, ETT and LMA placement and depth, assessment of airway size, ultrasound-guided invasive procedures such as percutaneous needle cricothyroidotomy and tracheostomy, prediction of postextubation stridor and left double-lumen bronchial tube size, and detecting upper airway pathologies. Widespread POCUS awareness, better technological advancements, portability, and availability of ultrasound in most critical areas facilitate upper airway ultrasound to become the potential first-line non-invasive airway assessment tool in the future. PMID:27529028

  4. 26 CFR 1.42-17 - Qualified allocation plan.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Qualified allocation plan. 1.42-17 Section 1.42... Credits Against Tax § 1.42-17 Qualified allocation plan. (a) Requirements—(1) In general. (2) Selection..., rent-up and marketing costs, accounting and auditing costs, working capital and operating...

  5. 26 CFR 1.42-17 - Qualified allocation plan.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Qualified allocation plan. 1.42-17 Section 1.42... Credits Against Tax § 1.42-17 Qualified allocation plan. (a) Requirements—(1) In general. (2) Selection..., rent-up and marketing costs, accounting and auditing costs, working capital and operating...

  6. 26 CFR 1.42-17 - Qualified allocation plan.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Qualified allocation plan. 1.42-17 Section 1.42... Credits Against Tax § 1.42-17 Qualified allocation plan. (a) Requirements—(1) In general. (2) Selection..., rent-up and marketing costs, accounting and auditing costs, working capital and operating...

  7. 26 CFR 1.42-17 - Qualified allocation plan.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Qualified allocation plan. 1.42-17 Section 1.42... Credits Against Tax § 1.42-17 Qualified allocation plan. (a) Requirements—(1) In general. (2) Selection..., rent-up and marketing costs, accounting and auditing costs, working capital and operating...

  8. 26 CFR 1.42-17 - Qualified allocation plan.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Qualified allocation plan. 1.42-17 Section 1.42... Credits Against Tax § 1.42-17 Qualified allocation plan. (a) Requirements—(1) In general. (2) Selection..., rent-up and marketing costs, accounting and auditing costs, working capital and operating...

  9. Clinical effectiveness and cost-effectiveness results from the randomised controlled Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea-hypopnoea (TOMADO) and long-term economic analysis of oral devices and continuous positive airway pressure.

    PubMed Central

    Sharples, Linda; Glover, Matthew; Clutterbuck-James, Abigail; Bennett, Maxine; Jordan, Jake; Chadwick, Rebecca; Pittman, Marcus; East, Clare; Cameron, Malcolm; Davies, Mike; Oscroft, Nick; Smith, Ian; Morrell, Mary; Fox-Rushby, Julia; Quinnell, Timothy

    2014-01-01

    BACKGROUND Obstructive sleep apnoea-hypopnoea (OSAH) causes excessive daytime sleepiness (EDS), impairs quality of life (QoL) and increases cardiovascular disease and road traffic accident risks. Continuous positive airway pressure (CPAP) treatment is clinically effective but undermined by intolerance, and its cost-effectiveness is borderline in milder cases. Mandibular advancement devices (MADs) are another option, but evidence is lacking regarding their clinical effectiveness and cost-effectiveness in milder disease. OBJECTIVES (1) Conduct a randomised controlled trial (RCT) examining the clinical effectiveness and cost-effectiveness of MADs against no treatment in mild to moderate OSAH. (2) Update systematic reviews and an existing health economic decision model with data from the Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea-hypopnoea (TOMADO) and newly published results to better inform long-term clinical effectiveness and cost-effectiveness of MADs and CPAP in mild to moderate OSAH. TOMADO A crossover RCT comparing clinical effectiveness and cost-effectiveness of three MADs: self-moulded [SleepPro 1™ (SP1); Meditas Ltd, Winchester, UK]; semibespoke [SleepPro 2™ (SP2); Meditas Ltd, Winchester, UK]; and fully bespoke [bespoke MAD (bMAD); NHS Oral-Maxillofacial Laboratory, Addenbrooke's Hospital, Cambridge, UK] against no treatment, in 90 adults with mild to moderate OSAH. All devices improved primary outcome [apnoea-hypopnoea index (AHI)] compared with no treatment: relative risk 0.74 [95% confidence interval (CI) 0.62 to 0.89] for SP1; relative risk 0.67 (95% CI 0.59 to 0.76) for SP2; and relative risk 0.64 (95% CI 0.55 to 0.76) for bMAD (p < 0.001). Differences between MADs were not significant. Sleepiness [as measured by the Epworth Sleepiness Scale (ESS)] was scored 1.51 [95% CI 0.73 to 2.29 (SP1)] to 2.37 [95% CI 1.53 to 3.22 (bMAD)] lower than no treatment (p < 0.001), with SP2 and bMAD significantly better than SP1

  10. Supraglottic airway devices.

    PubMed

    Ramachandran, Satya Krishna; Kumar, Anjana M

    2014-06-01

    Supraglottic airway devices (SADs) are used to keep the upper airway open to provide unobstructed ventilation. Early (first-generation) SADs rapidly replaced endotracheal intubation and face masks in > 40% of general anesthesia cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes. Individual second-generation SADs have allowed more dependable positive-pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement, and have reduced risk of pulmonary aspiration of gastric contents. SADs now provide successful rescue ventilation in > 90% of patients in whom mask ventilation or tracheal intubation is found to be impossible. However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. Careful patient selection and excellent technical skills are necessary for successful use of these devices. PMID:24891199

  11. Issues of critical airway management (Which anesthesia; which surgical airway?).

    PubMed

    Bonanno, Fabrizio Giuseppe

    2012-10-01

    Which anesthesia for patients with critical airway? Safe and effective analgesia and anesthesia in critical airway is a skilled task especially after severe maxillofacial injury combined with head injury and hemorrhagic shock. If on one side sedation is wanted, on the other hand it may worsen the airway and hemodynamic situation to a point where hypoventilation and decrease of blood pressure, common side-effect of many opioids, may prejudice the patient's level of consciousness and hemodynamic compensation, compounding an already critical situation. What to do when endotracheal intubation fails and blood is trickling down the airways in an unconscious patient or when a conscious patient has to sit up to breathe? Which surgical airway in critical airway? Comparative studies among the various methods of emergency surgical airway would be unethical; furthermore, operator's training and experience is relevant for indications and performance. PMID:23248494

  12. Allocation Games: Addressing the Ill-Posed Nature of Allocation in Life-Cycle Inventories.

    PubMed

    Hanes, Rebecca J; Cruze, Nathan B; Goel, Prem K; Bakshi, Bhavik R

    2015-07-01

    Allocation is required when a life cycle contains multi-functional processes. One approach to allocation is to partition the embodied resources in proportion to a criterion, such as product mass or cost. Many practitioners apply multiple partitioning criteria to avoid choosing one arbitrarily. However, life cycle results from different allocation methods frequently contradict each other, making it difficult or impossible for the practitioner to draw any meaningful conclusions from the study. Using the matrix notation for life-cycle inventory data, we show that an inventory that requires allocation leads to an ill-posed problem: an inventory based on allocation is one of an infinite number of inventories that are highly dependent upon allocation methods. This insight is applied to comparative life-cycle assessment (LCA), in which products with the same function but different life cycles are compared. Recently, there have been several studies that applied multiple allocation methods and found that different products were preferred under different methods. We develop the Comprehensive Allocation Investigation Strategy (CAIS) to examine any given inventory under all possible allocation decisions, enabling us to detect comparisons that are not robust to allocation, even when the comparison appears robust under conventional partitioning methods. While CAIS does not solve the ill-posed problem, it provides a systematic way to parametrize and examine the effects of partitioning allocation. The practical usefulness of this approach is demonstrated with two case studies. The first compares ethanol produced from corn stover hydrolysis, corn stover gasification, and corn grain fermentation. This comparison was not robust to allocation. The second case study compares 1,3-propanediol (PDO) produced from fossil fuels and from biomass, which was found to be a robust comparison. PMID:26061700

  13. Quantitative analysis of airway abnormalities in CT

    NASA Astrophysics Data System (ADS)

    Petersen, Jens; Lo, Pechin; Nielsen, Mads; Edula, Goutham; Ashraf, Haseem; Dirksen, Asger; de Bruijne, Marleen

    2010-03-01

    A coupled surface graph cut algorithm for airway wall segmentation from Computed Tomography (CT) images is presented. Using cost functions that highlight both inner and outer wall borders, the method combines the search for both borders into one graph cut. The proposed method is evaluated on 173 manually segmented images extracted from 15 different subjects and shown to give accurate results, with 37% less errors than the Full Width at Half Maximum (FWHM) algorithm and 62% less than a similar graph cut method without coupled surfaces. Common measures of airway wall thickness such as the Interior Area (IA) and Wall Area percentage (WA%) was measured by the proposed method on a total of 723 CT scans from a lung cancer screening study. These measures were significantly different for participants with Chronic Obstructive Pulmonary Disease (COPD) compared to asymptomatic participants. Furthermore, reproducibility was good as confirmed by repeat scans and the measures correlated well with the outcomes of pulmonary function tests, demonstrating the use of the algorithm as a COPD diagnostic tool. Additionally, a new measure of airway wall thickness is proposed, Normalized Wall Intensity Sum (NWIS). NWIS is shown to correlate better with lung function test values and to be more reproducible than previous measures IA, WA% and airway wall thickness at a lumen perimeter of 10 mm (PI10).

  14. Total airway reconstruction.

    PubMed

    Connor, Matthew P; Barrera, Jose E; Eller, Robert; McCusker, Scott; O'Connor, Peter

    2013-02-01

    We present a case of obstructive sleep apnea (OSA) that required multilevel surgical correction of the airway and literature review and discuss the role supraglottic laryngeal collapse can have in OSA. A 34-year-old man presented to a tertiary otolaryngology clinic for treatment of OSA. He previously had nasal and palate surgeries and a Repose tongue suspension. His residual apnea hypopnea index (AHI) was 67. He had a dysphonia associated with a true vocal cord paralysis following resection of a benign neck mass in childhood. He also complained of inspiratory stridor with exercise and intolerance to continuous positive airway pressure. Physical examination revealed craniofacial hypoplasia, full base of tongue, and residual nasal airway obstruction. On laryngoscopy, the paretic aryepiglottic fold arytenoid complex prolapsed into the laryngeal inlet with each breath. This was more pronounced with greater respiratory effort. Surgical correction required a series of operations including awake tracheostomy, supraglottoplasty, midline glossectomy, genial tubercle advancement, maxillomandibular advancement, and reconstructive rhinoplasty. His final AHI was 1.9. Our patient's supraglottic laryngeal collapse constituted an area of obstruction not typically evaluated in OSA surgery. In conjunction with treating nasal, palatal, and hypopharyngeal subsites, our patient's supraglottoplasty represented a key component of his success. This case illustrates the need to evaluate the entire upper airway in a complicated case of OSA. PMID:22965285

  15. Epithelial hyperplasia, airways

    Cancer.gov

    Number of respiratory epithelial cells is increased diffusely or focally. Frequently luminal protrusions are observed, sometimes forming papillae. Mucous (goblet) cell metaplastic hyperplasia is a variant, in which the respiratory epithelium of conducting airways is replaced by mucous cells either as a single or a pseudostratified layer.

  16. Patterns of recruitment and injury in a heterogeneous airway network model.

    PubMed

    Stewart, Peter S; Jensen, Oliver E

    2015-10-01

    In respiratory distress, lung airways become flooded with liquid and may collapse due to surface-tension forces acting on air-liquid interfaces, inhibiting gas exchange. This paper proposes a mathematical multiscale model for the mechanical ventilation of a network of occluded airways, where air is forced into the network at a fixed tidal volume, allowing investigation of optimal recruitment strategies. The temporal response is derived from mechanistic models of individual airway reopening, incorporating feedback on the airway pressure due to recruitment. The model accounts for stochastic variability in airway diameter and stiffness across and between generations. For weak heterogeneity, the network is completely ventilated via one or more avalanches of recruitment (with airways recruited in quick succession), each characterized by a transient decrease in the airway pressure; avalanches become more erratic for airways that are initially more flooded. However, the time taken for complete ventilation of the network increases significantly as the network becomes more heterogeneous, leading to increased stresses on airway walls. The model predicts that the most peripheral airways are most at risk of ventilation-induced damage. A positive-end-expiratory pressure reduces the total recruitment time but at the cost of larger stresses exerted on airway walls. PMID:26423440

  17. CT based computerized identification and analysis of human airways: A review

    PubMed Central

    Pu, Jiantao; Gu, Suicheng; Liu, Shusen; Zhu, Shaocheng; Wilson, David; Siegfried, Jill M.; Gur, David

    2012-01-01

    As one of the most prevalent chronic disorders, airway disease is a major cause of morbidity and mortality worldwide. In order to understand its underlying mechanisms and to enable assessment of therapeutic efficacy of a variety of possible interventions, noninvasive investigation of the airways in a large number of subjects is of great research interest. Due to its high resolution in temporal and spatial domains, computed tomography (CT) has been widely used in clinical practices for studying the normal and abnormal manifestations of lung diseases, albeit there is a need to clearly demonstrate the benefits in light of the cost and radiation dose associated with CT examinations performed for the purpose of airway analysis. Whereas a single CT examination consists of a large number of images, manually identifying airway morphological characteristics and computing features to enable thorough investigations of airway and other lung diseases is very time-consuming and susceptible to errors. Hence, automated and semiautomated computerized analysis of human airways is becoming an important research area in medical imaging. A number of computerized techniques have been developed to date for the analysis of lung airways. In this review, we present a summary of the primary methods developed for computerized analysis of human airways, including airway segmentation, airway labeling, and airway morphometry, as well as a number of computer-aided clinical applications, such as virtual bronchoscopy. Both successes and underlying limitations of these approaches are discussed, while highlighting areas that may require additional work. PMID:22559631

  18. CT based computerized identification and analysis of human airways: A review

    SciTech Connect

    Pu Jiantao; Gu Suicheng; Liu Shusen; Zhu Shaocheng; Wilson, David; Siegfried, Jill M.; Gur, David

    2012-05-15

    As one of the most prevalent chronic disorders, airway disease is a major cause of morbidity and mortality worldwide. In order to understand its underlying mechanisms and to enable assessment of therapeutic efficacy of a variety of possible interventions, noninvasive investigation of the airways in a large number of subjects is of great research interest. Due to its high resolution in temporal and spatial domains, computed tomography (CT) has been widely used in clinical practices for studying the normal and abnormal manifestations of lung diseases, albeit there is a need to clearly demonstrate the benefits in light of the cost and radiation dose associated with CT examinations performed for the purpose of airway analysis. Whereas a single CT examination consists of a large number of images, manually identifying airway morphological characteristics and computing features to enable thorough investigations of airway and other lung diseases is very time-consuming and susceptible to errors. Hence, automated and semiautomated computerized analysis of human airways is becoming an important research area in medical imaging. A number of computerized techniques have been developed to date for the analysis of lung airways. In this review, we present a summary of the primary methods developed for computerized analysis of human airways, including airway segmentation, airway labeling, and airway morphometry, as well as a number of computer-aided clinical applications, such as virtual bronchoscopy. Both successes and underlying limitations of these approaches are discussed, while highlighting areas that may require additional work.

  19. Advances in prehospital airway management

    PubMed Central

    Jacobs, PE; Grabinsky, A

    2014-01-01

    Prehospital airway management is a key component of emergency responders and remains an important task of Emergency Medical Service (EMS) systems worldwide. The most advanced airway management techniques involving placement of oropharyngeal airways such as the Laryngeal Mask Airway or endotracheal tube. Endotracheal tube placement success is a common measure of out-of-hospital airway management quality. Regional variation in regard to training, education, and procedural exposure may be the major contributor to the findings in success and patient outcome. In studies demonstrating poor outcomes related to prehospital-attempted endotracheal intubation (ETI), both training and skill level of the provider are usually often low. Research supports a relationship between the number of intubation experiences and ETI success. National standards for certification of emergency medicine provider are in general too low to guarantee good success rate in emergency airway management by paramedics and physicians. Some paramedic training programs require more intense airway training above the national standard and some EMS systems in Europe staff their system with anesthesia providers instead. ETI remains the cornerstone of definitive prehospital airway management, However, ETI is not without risk and outcomes data remains controversial. Many systems may benefit from more input and guidance by the anesthesia department, which have higher volumes of airway management procedures and extensive training and experience not just with training of airway management but also with different airway management techniques and adjuncts. PMID:24741499

  20. Methods of airway resistance assessment.

    PubMed

    Urbankowski, Tomasz; Przybyłowski, Tadeusz

    2016-01-01

    Airway resistance is the ratio of driving pressure to the rate of the airflow in the airways. The most frequent methods used to measure airway resistance are whole-body plethysmography, the interrupter technique and the forced oscillation technique. All these methods allow to measure resistance during respiration at the level close to tidal volume, they do not require forced breathing manoeuvres or deep breathing during measurement. The most popular method for measuring airway resistance is whole-body plethysmography. The results of plethysmography include among others the following parameters: airway resistance (Raw), airway conductance (Gaw), specific airway resistance (sRaw) and specific airway conductance (sGaw). The interrupter technique is based on the assumption that at the moment of airway occlusion, air pressure in the mouth is equal to the alveolar pressure . In the forced oscillation technique (FOT), airway resistance is calculated basing on the changes in pressure and flow caused by air vibration. The methods for measurement of airway resistance that are described in the present paper seem to be a useful alternative to the most common lung function test - spirometry. The target group in which these methods may be widely used are particularly the patients who are unable to perform spirometry. PMID:27238174

  1. Supraglottic airway devices in children

    PubMed Central

    Ramesh, S; Jayanthi, R

    2011-01-01

    Modern anaesthesia practice in children was made possible by the invention of the endotracheal tube (ET), which made lengthy and complex surgical procedures feasible without the disastrous complications of airway obstruction, aspiration of gastric contents or asphyxia. For decades, endotracheal intubation or bag-and-mask ventilation were the mainstays of airway management. In 1983, this changed with the invention of the laryngeal mask airway (LMA), the first supraglottic airway device that blended features of the facemask with those of the ET, providing ease of placement and hands-free maintenance along with a relatively secure airway. The invention and development of the LMA by Dr. Archie Brain has had a significant impact on the practice of anaesthesia, management of the difficult airway and cardiopulmonary resuscitation in children and neonates. This review article will be a brief about the clinical applications of supraglottic airways in children. PMID:22174464

  2. Management of the Traumatized Airway.

    PubMed

    Jain, Uday; McCunn, Maureen; Smith, Charles E; Pittet, Jean-Francois

    2016-01-01

    There is a lack of evidence-based approach regarding the best practice for airway management in patients with a traumatized airway. General recommendations for the management of the traumatized airway are summarized in table 5. Airway trauma may not be readily apparent, and its evaluation requires a high level of suspicion for airway disruption and compression. For patients with facial trauma, control of the airway may be significantly impacted by edema, bleeding, inability to clear secretions, loss of bony support, and difficulty with face mask ventilation. With the airway compression from neck swelling or hematoma, intubation attempts can further compromise the airway due to expanding hematoma. For patients with airway disruption, the goal is to pass the tube across the injured area without disrupting it or to insert the airway distal to the injury using a surgical approach. If airway injury is extensive, a surgical airway distal to the site of injury may be the best initial approach. Alternatively, if orotracheal intubation is chosen, spontaneous ventilation may be maintained or RSI may be performed. RSI is a common approach. Thus, some of the patients intubated may subsequently require tracheostomy. A stable patient with limited injuries may not require intubation but should be watched carefully for at least several hours. Because of a paucity of evidence-based data, the choice between these approaches and the techniques utilized is a clinical decision depending on the patient's condition, clinical setting, injuries to airway and other organs, and available personnel, expertise, and equipment. Inability to obtain a definitive airway is always an absolute indication for an emergency cricothyroidotomy or surgical tracheostomy. PMID:26517857

  3. Fair Water Allocation in Complex International River Systems

    NASA Astrophysics Data System (ADS)

    Beck, L.; Bernauer, T.

    2011-12-01

    Conflicts over water allocation in international freshwater systems are recurring phenomena, and climatic changes are likely to make existing problems worse in many parts of the world. Science-based proposals for water allocation frequently focus on allocating water to the economically most efficient purposes. In reality, allocation outcomes are often shaped by political and economic power, rather than considerations of economic efficiency. This paper develops a new approach to fair international water allocation in complex international freshwater systems. This approach covers both needs-based criteria - if acute water scarcity is present - and criteria for fair water allocation pertaining to relative gains in water-abundant situations. The usefulness of the approach is illustrated with a case study on the Zambezi River Basin (ZRB). Based on a hydrological model, and scenarios for water availability and demand in the ZRB until 2050, the paper shows how the waters of the ZRB could be allocated in a way that fairly distributes costs and benefits.

  4. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... collection and information retrieval system described in § 1355.53 of this part shall be treated as necessary... includes functions, processing, information collection and management, equipment or services that are...

  5. 45 CFR 1355.57 - Cost allocation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... collection and information retrieval system described in § 1355.53 of this part shall be treated as necessary... includes functions, processing, information collection and management, equipment or services that are...

  6. 48 CFR 1631.203-70 - Allocation techniques.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... among cost centers at the initial entry into the cost accounting system shall be made in compliance with... FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST...) Carriers shall use the following methods for allocating groupings of business unit indirect costs....

  7. Upper Airway Mechanics

    PubMed Central

    Verbraecken, Johan A.; De Backer, Wilfried A.

    2009-01-01

    This review discusses the pathophysiological aspects of sleep-disordered breathing, with focus on upper airway mechanics in obstructive and central sleep apnoea, Cheyne-Stokes respiration and obesity hypoventilation syndrome. These disorders constitute the end points of a spectrum with distinct yet interrelated mechanisms that lead to substantial pathology, i.e. increased upper airway collapsibility, control of breathing instability, increased work of breathing, disturbed ventilatory system mechanics and neurohormonal changes. Concepts are changing. Although sleep apnoea is considered more and more to be an increased loop gain disorder, the central type of apnoea is now considered as an obstructive event, because it causes pharyngeal narrowing, associated with prolonged expiration. Although a unifying concept for the pathogenesis is lacking, it seems that these patients are in a vicious circle. Knowledge of common patterns of sleep-disordered breathing may help to identify these patients and guide therapy. PMID:19478479

  8. Brachycephalic airway syndrome.

    PubMed

    Meola, Stacy D

    2013-08-01

    Brachycephalic airway syndrome is a common finding in brachycephalic breeds. A combination of primary and secondary changes can progress to life-threatening laryngeal collapse. Early recognition of primary anatomic abnormalities that include stenotic nares, elongated soft palate, and hypoplastic trachea would allow the clinician to make early recommendations for medical and surgical management, which can improve the quality of life in affected animals. PMID:24182996

  9. Fairness in children's resource allocation depends on the recipient.

    PubMed

    Moore, Chris

    2009-08-01

    Sixty-six children between 4.5 and 6 years of age were tested in a resource-allocation game with three different recipients. When the recipient was a friend, children made equitable decisions and shared as much when there was a cost to themselves as when there was no cost. When the recipient was another familiar child who was not a friend, children were less likely to allocate resources to that child. When the recipient was a stranger, children allocated resources as much as with a friend and more than with a nonfriend when there was no cost to themselves. However, when there was a cost to themselves, children treated strangers like nonfriends. These results show that resource-allocation decisions made by young children depend on the recipient. Young children prefer equitable division of resources with friends, treat nonfriends less well, and make prosocial moves with strangers when the cost to self is not high. PMID:19515118

  10. Upper airway resistance syndrome.

    PubMed

    Hasan, N; Fletcher, E C

    1998-07-01

    Many clinicians are familiar with the clinical symptoms and signs of obstructive sleep apnea (OSA). In its most blatant form, OSA is complete airway obstruction with repetitive, prolonged pauses in breathing, arterial oxyhemoglobin desaturation; followed by arousal with resumption of breathing. Daytime symptoms of this disorder include excessive daytime somnolence, intellectual dysfunction, and cardiovascular effects such as systemic hypertension, angina, myocardial infarction, and stroke. It has been recently recognized that increased pharyngeal resistance with incomplete obstruction can lead to a constellation of symptoms identical to OSA called "upper airway resistance syndrome" (UARS). The typical findings of UARS on sleep study are: (1) repetitive arousals from EEG sleep coinciding with a (2) waxing and waning of the respiratory airflow pattern and (3) increased respiratory effort as measured by esophageal pressure monitoring. There may be few, if any, obvious apneas or hypopneas with desaturation, but snoring may be a very prominent finding. Treatment with nasal positive airway pressure (NCPAP) eliminates the symptoms and confirms the diagnosis. Herein we describe two typical cases of UARS. PMID:9676067

  11. Airway closure in microgravity.

    PubMed

    Dutrieue, Brigitte; Verbanck, Sylvia; Darquenne, Chantal; Prisk, G Kim

    2005-08-25

    Recent single breath washout (SBW) studies in microgravity and on the ground have suggested an important effect of airway closure on gas mixing in the human lung, reflected particularly in the phase III slope of vital capacity SBW and bolus tests. In order to explore this effect, we designed a SBW in which subjects inspired 2-l from residual volume (RV) starting with a 150 ml bolus of He and SF6. In an attempt to vary the pattern of airways closure configuration before the test, the experiments were conducted in 1G and in microgravity during parabolic flight allowing the pre-test expiration to RV to be either in microgravity or at 1.8 G, with the actual test gas inhalation performed entirely in microgravity. Contrary to our expectations, the measured phase III slope and phase IV height and volume obtained from seven subjects in microgravity were essentially identical irrespective of the gravity level during the pre-test expiration to RV. The results suggest that airway closure configuration at RV before the test inspiration has no apparent impact on phases III and IV generation. PMID:15979418

  12. The Unobtrusive Memory Allocator

    2003-03-31

    This library implements a memory allocator/manager which ask its host program or library for memory refions to manage rather than requesting them from the operating system. This allocator supports multiple distinct heaps within a single executable, each of which may grow either upward or downward in memory. The GNU mmalloc library has been modified in such a way that its allocation algorithms have been preserved, but the manner in which it obtains regions to managemore » has been changed to request memory from the host program or library. Additional modifications allow the allocator to manage each heap as either upward or downward-growing. By allowing the hosting program or library to determine what memory is managed, this package allows a greater degree of control than other memory allocation/management libraries. Additional distinguishing features include the ability to manage multiple distinct heaps with in a single executable, each of which may grow either upward or downward in memory. The most common use of this library is in conjunction with the Berkeley Unified Parallel C (UPC) Runtime Library. This package is a modified version of the LGPL-licensed "mmalloc" allocator from release 5.2 of the "gdb" debugger's source code.« less

  13. Constrained Allocation Flux Balance Analysis.

    PubMed

    Mori, Matteo; Hwa, Terence; Martin, Olivier C; De Martino, Andrea; Marinari, Enzo

    2016-06-01

    New experimental results on bacterial growth inspire a novel top-down approach to study cell metabolism, combining mass balance and proteomic constraints to extend and complement Flux Balance Analysis. We introduce here Constrained Allocation Flux Balance Analysis, CAFBA, in which the biosynthetic costs associated to growth are accounted for in an effective way through a single additional genome-wide constraint. Its roots lie in the experimentally observed pattern of proteome allocation for metabolic functions, allowing to bridge regulation and metabolism in a transparent way under the principle of growth-rate maximization. We provide a simple method to solve CAFBA efficiently and propose an "ensemble averaging" procedure to account for unknown protein costs. Applying this approach to modeling E. coli metabolism, we find that, as the growth rate increases, CAFBA solutions cross over from respiratory, growth-yield maximizing states (preferred at slow growth) to fermentative states with carbon overflow (preferred at fast growth). In addition, CAFBA allows for quantitatively accurate predictions on the rate of acetate excretion and growth yield based on only 3 parameters determined by empirical growth laws. PMID:27355325

  14. Constrained Allocation Flux Balance Analysis

    PubMed Central

    Mori, Matteo; Hwa, Terence; Martin, Olivier C.

    2016-01-01

    New experimental results on bacterial growth inspire a novel top-down approach to study cell metabolism, combining mass balance and proteomic constraints to extend and complement Flux Balance Analysis. We introduce here Constrained Allocation Flux Balance Analysis, CAFBA, in which the biosynthetic costs associated to growth are accounted for in an effective way through a single additional genome-wide constraint. Its roots lie in the experimentally observed pattern of proteome allocation for metabolic functions, allowing to bridge regulation and metabolism in a transparent way under the principle of growth-rate maximization. We provide a simple method to solve CAFBA efficiently and propose an “ensemble averaging” procedure to account for unknown protein costs. Applying this approach to modeling E. coli metabolism, we find that, as the growth rate increases, CAFBA solutions cross over from respiratory, growth-yield maximizing states (preferred at slow growth) to fermentative states with carbon overflow (preferred at fast growth). In addition, CAFBA allows for quantitatively accurate predictions on the rate of acetate excretion and growth yield based on only 3 parameters determined by empirical growth laws. PMID:27355325

  15. Management of the artificial airway.

    PubMed

    Branson, Richard D; Gomaa, Dina; Rodriquez, Dario

    2014-06-01

    Management of the artificial airway includes securing the tube to prevent dislodgement or migration as well as removal of secretions. Preventive measures include adequate humidification and appropriate airway suctioning. Monitoring airway patency and removing obstruction are potentially life-saving components of airway management. Cuff pressure management is important for preventing aspiration and mucosal damage as well as assuring adequate ventilation. A number of new monitoring techniques have been introduced, and automated cuff pressure control is becoming more common. The respiratory therapist should be adept with all these devices and understand the appropriate application and management. PMID:24891202

  16. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway. (a... provide a patent airway. (b) Classification. Class I (general controls). The device is exempt from...

  17. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway. (a... provide a patent airway. (b) Classification. Class I (general controls). The device is exempt from...

  18. Limits on linearity of missile allocation optimization

    SciTech Connect

    Canavan, G.H.

    1997-12-01

    Optimizations of missile allocation based on linearized exchange equations produce accurate allocations, but the limits of validity of the linearization are not known. These limits are explored in the context of the upload of weapons by one side to initially small, equal forces of vulnerable and survivable weapons. The analysis compares analytic and numerical optimizations and stability induces based on aggregated interactions of the two missile forces, the first and second strikes they could deliver, and they resulting costs. This note discusses the costs and stability indices induced by unilateral uploading of weapons to an initially symmetrical low force configuration. These limits are quantified for forces with a few hundred missiles by comparing analytic and numerical optimizations of first strike costs. For forces of 100 vulnerable and 100 survivable missiles on each side, the analytic optimization agrees closely with the numerical solution. For 200 vulnerable and 200 survivable missiles on each side, the analytic optimization agrees with the induces to within about 10%, but disagrees with the allocation of the side with more weapons by about 50%. The disagreement comes from the interaction of the possession of more weapons with the shift of allocation from missiles to value that they induce.

  19. Brachycephalic airway obstructive syndrome.

    PubMed

    Wykes, P M

    1991-06-01

    This is a complex condition, recognized primarily in brachycephalic breeds, that results in varying degrees of upper airway obstruction. The signs consist of respiratory distress, stridor, reduced exercise tolerance, and in more severe cases, cyanosis and collapse. The inherent anatomy of the brachycephalic skull contributes to the development of these signs. Such anatomic features include: a shortened and distorted nasopharynx, stenotic nares, an elongated soft palate, and everted laryngeal saccules. The increased negative pressure created in the pharyngolaryngeal region, as a result of these obstructing structures, ultimately results in distortion and collapse of the arytenoid cartilages of the larynx. PMID:1802247

  20. Particle Deposition During Airway Closure

    NASA Astrophysics Data System (ADS)

    Tai, Cheng-Feng; Halpern, David; Grotberg, James B.

    2011-11-01

    Inhaled aerosol particles deposit in the lung and may be from environmental, toxic, or medical therapy sources. While much research focuses on inspiratory deposition, primarily at airway bifurcations due to inertial impaction, there are other mechanisms that allow the particles to reach the airway surface, such as gravitational settling and diffusion depending on particle size. We introduce a new mechanism not previously studied, i.e. aerosol deposition from airway closure. The airways are lined with a liquid layer. Due to the surface tension driven instability, a liquid plug can form from this layer which blocks the airway. This process of airway closure tends to occur toward the end of expiration. In this study, the efficiency of the impaction of the particles during airway closure will be investigated. The particles will be released from the upstream of the airway and convected by the air flow and deposited onto the closing liquid layer. We solve the governing equations using a finite volume approach in conjunction with a sharp interface method for the interfaces. Once the velocity field of the gas flow is obtained, the path of the particles will be calculated and the efficiency of the deposition can be estimated. We acknowledge support from the National Institutes of Health grant number NIH HL85156.

  1. Operative endoscopy of the airway

    PubMed Central

    Walters, Dustin M.

    2016-01-01

    Airway endoscopy has long been an important and useful tool in the management of thoracic diseases. As thoracic specialists have gained experience with both flexible and rigid bronchoscopic techniques, the technology has continued to evolve so that bronchoscopy is currently the foundation for diagnosis and treatment of many thoracic ailments. Airway endoscopy plays a significant role in the biopsy of tumors within the airways, mediastinum, and lung parenchyma. Endoscopic methods have been developed to treat benign and malignant airway stenoses and tracheomalacia. And more recently, techniques have been conceived to treat end-stage emphysema and prolonged air leaks in select patients. This review describes the abundant uses of airway endoscopy, as well as technical considerations and limitations of the current technologies. PMID:26981263

  2. Reference allocations and use of a disparity measure to inform the design of allocation funding formulas in public health programs.

    PubMed

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

    2012-01-01

    Funding formulas are commonly used by federal agencies to allocate program funds to states. As one approach to evaluating differences in allocations resulting from alternative formula calculations, we propose the use of a measure derived from the Gini index to summarize differences in allocations relative to 2 referent allocations: one based on equal per-capita funding across states and another based on equal funding per person living in poverty, which we define as the "proportionality of allocation" (PA). These referents reflect underlying values that often shape formula-based allocations for public health programs. The size of state populations serves as a general proxy for the amount of funding needed to support programs across states. While the size of state populations living in poverty is correlated with overall population size, allocations based on states' shares of the national population living in poverty reflect variations in funding need shaped by the association between poverty and multiple adverse health outcomes. The PA measure is a summary of the degree of dispersion in state-specific allocations relative to the referent allocations and provides a quick assessment of the impact of selecting alternative funding formula designs. We illustrate the PA values by adjusting a sample allocation, using various measures of the salary costs and in-state wealth, which might modulate states' needs for federal funding. PMID:22635187

  3. 48 CFR 9904.403 - Allocation of home office expenses to segments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Allocation of home office expenses to segments. 9904.403 Section 9904.403 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.403 Allocation of home office expenses...

  4. 48 CFR 9904.403 - Allocation of home office expenses to segments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Allocation of home office expenses to segments. 9904.403 Section 9904.403 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.403 Allocation of home office expenses...

  5. 48 CFR 9904.403 - Allocation of home office expenses to segments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Allocation of home office expenses to segments. 9904.403 Section 9904.403 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.403 Allocation of home office expenses...

  6. 7 CFR 3015.196 - Costs allowable with approval.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... government-wide cost allocation plan or when treated as indirect costs, acceptance of the costs as part of the indirect cost rate or cost allocation plan shall constitute approval. (b)(1) All direct costs must... OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Cost Principles § 3015.196...

  7. 7 CFR 3015.196 - Costs allowable with approval.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... government-wide cost allocation plan or when treated as indirect costs, acceptance of the costs as part of the indirect cost rate or cost allocation plan shall constitute approval. (b)(1) All direct costs must... OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Cost Principles § 3015.196...

  8. 7 CFR 3015.196 - Costs allowable with approval.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... government-wide cost allocation plan or when treated as indirect costs, acceptance of the costs as part of the indirect cost rate or cost allocation plan shall constitute approval. (b)(1) All direct costs must... OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Cost Principles § 3015.196...

  9. 14 CFR § 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Allocation of risk/liability. § 1260.61... COOPERATIVE AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  10. Putting the Squeeze on Airway Epithelia.

    PubMed

    Park, Jin-Ah; Fredberg, Jeffrey J; Drazen, Jeffrey M

    2015-07-01

    Asthma is characterized by chronic inflammation, airway hyperresponsiveness, and progressive airway remodeling. The airway epithelium is known to play a critical role in the initiation and perpetuation of these processes. Here, we review how excessive epithelial stress generated by bronchoconstriction is sufficient to induce airway remodeling, even in the absence of inflammatory cells. PMID:26136543

  11. Putting the Squeeze on Airway Epithelia

    PubMed Central

    Park, Jin-Ah; Fredberg, Jeffrey J.

    2015-01-01

    Asthma is characterized by chronic inflammation, airway hyperresponsiveness, and progressive airway remodeling. The airway epithelium is known to play a critical role in the initiation and perpetuation of these processes. Here, we review how excessive epithelial stress generated by bronchoconstriction is sufficient to induce airway remodeling, even in the absence of inflammatory cells. PMID:26136543

  12. Airway clearance in neuromuscular weakness.

    PubMed

    Gauld, Leanne Maree

    2009-05-01

    Impaired airway clearance leads to recurrent chest infections and respiratory deterioration in neuromuscular weakness. It is frequently the cause of death. Cough is the major mechanism of airway clearance. Cough has several components, and assessment tools are available to measure the different components of cough. These include measuring peak cough flow, respiratory muscle strength, and inspiratory capacity. Each is useful in assessing the ability to generate an effective cough, and can be used to guide when techniques of assisting airway clearance may be effective for the individual and which are most effective. Techniques to assist airway clearance include augmenting inspiration by air stacking, augmenting expiration by assisting the cough, and augmenting both inspiration and expiration with the mechanical insufflator-exsufflator or by direct suctioning via a tracheostomy. Physiotherapists are invaluable in assisting airway clearance, and in teaching patients and their families how to use these techniques. Use of the mechanical insufflator-exsufflator has gained popularity in recent times, but several simpler, more economical methods are available to assist airway clearance that can be used effectively alone or in combination. This review examines the literature available on the assessment and management of impaired airway clearance in neuromuscular weakness. PMID:19379290

  13. The allocation of cargo to channel missions

    SciTech Connect

    Liu, Cheng; Harrison, G.

    1992-01-01

    Each month the armed services provide a forecast of tons of cargo by channel to MAC. The purpose of the Channels Allocation Algorithm is to allocate cargo requirements to specific Channel Missions. The objective of the allocation is algorithm is to minimize frequency and cargo requirements shortfall. The constraints on the allocation model include flying hours, channel frequencies, mission structure, mission operation days, and aircraft capacity. Cargo requirements shortfall is defined as the tonnage of cargo not moved from the airfields in the United States that are channel staging points to overseas locations. Channel frequencies are defined by the number of times a destination is served by an origin in one month. The mission structures are defined as sets of missions usually in the form of circuit. Mission operating days are determined by the operating day rules for the month, or they can be input by the user for an individual month. One of the assumptions in this model is that there is only one transshipment allowed between any origin and a destination if there is no mission that actually connects the stations. The transshipment stations are also restricted in that only certain stations can serve as transshipment stations. The Channels Allocation Algorithm consists of two linear programs that incorporate three objectives. The objectives are: (1) to minimize that number of frequency channels not met. (2) to minimize cargo shortfall, and (3) to minimize operating cost. The first linear program minimizes frequency channels not met, subject to the mission structure, number of times the mission operates, and total flying hours available. The second linear program minimizes the fleet operating cost cargo handling cost, and cargo shortfall, subject to frequency channels met by the first linear program, aircraft capacity, and total flying hours available. This document is comprised of viewgraphs.

  14. The allocation of cargo to channel missions

    SciTech Connect

    Liu, Cheng; Harrison, G.

    1992-06-01

    Each month the armed services provide a forecast of tons of cargo by channel to MAC. The purpose of the Channels Allocation Algorithm is to allocate cargo requirements to specific Channel Missions. The objective of the allocation is algorithm is to minimize frequency and cargo requirements shortfall. The constraints on the allocation model include flying hours, channel frequencies, mission structure, mission operation days, and aircraft capacity. Cargo requirements shortfall is defined as the tonnage of cargo not moved from the airfields in the United States that are channel staging points to overseas locations. Channel frequencies are defined by the number of times a destination is served by an origin in one month. The mission structures are defined as sets of missions usually in the form of circuit. Mission operating days are determined by the operating day rules for the month, or they can be input by the user for an individual month. One of the assumptions in this model is that there is only one transshipment allowed between any origin and a destination if there is no mission that actually connects the stations. The transshipment stations are also restricted in that only certain stations can serve as transshipment stations. The Channels Allocation Algorithm consists of two linear programs that incorporate three objectives. The objectives are: (1) to minimize that number of frequency channels not met. (2) to minimize cargo shortfall, and (3) to minimize operating cost. The first linear program minimizes frequency channels not met, subject to the mission structure, number of times the mission operates, and total flying hours available. The second linear program minimizes the fleet operating cost cargo handling cost, and cargo shortfall, subject to frequency channels met by the first linear program, aircraft capacity, and total flying hours available. This document is comprised of viewgraphs.

  15. Irritant-induced airway disorders.

    PubMed

    Brooks, Stuart M; Bernstein, I Leonard

    2011-11-01

    Thousands of persons experience accidental high-level irritant exposures each year but most recover and few die. Irritants function differently than allergens because their actions proceed nonspecifically and by nonimmunologic mechanisms. For some individuals, the consequence of a single massive exposure to an irritant, gas, vapor or fume is persistent airway hyperresponsiveness and the clinical picture of asthma, referred to as reactive airways dysfunction syndrome (RADS). Repeated irritant exposures may lead to chronic cough and continual airway hyperresponsiveness. Cases of asthma attributed to repeated irritant-exposures may be the result of genetic and/or host factors. PMID:21978855

  16. Increased airway glucose increases airway bacterial load in hyperglycaemia

    PubMed Central

    Gill, Simren K.; Hui, Kailyn; Farne, Hugo; Garnett, James P.; Baines, Deborah L.; Moore, Luke S.P.; Holmes, Alison H.; Filloux, Alain; Tregoning, John S.

    2016-01-01

    Diabetes is associated with increased frequency of hospitalization due to bacterial lung infection. We hypothesize that increased airway glucose caused by hyperglycaemia leads to increased bacterial loads. In critical care patients, we observed that respiratory tract bacterial colonisation is significantly more likely when blood glucose is high. We engineered mutants in genes affecting glucose uptake and metabolism (oprB, gltK, gtrS and glk) in Pseudomonas aeruginosa, strain PAO1. These mutants displayed attenuated growth in minimal medium supplemented with glucose as the sole carbon source. The effect of glucose on growth in vivo was tested using streptozocin-induced, hyperglycaemic mice, which have significantly greater airway glucose. Bacterial burden in hyperglycaemic animals was greater than control animals when infected with wild type but not mutant PAO1. Metformin pre-treatment of hyperglycaemic animals reduced both airway glucose and bacterial load. These data support airway glucose as a critical determinant of increased bacterial load during diabetes. PMID:27273266

  17. Increased airway glucose increases airway bacterial load in hyperglycaemia.

    PubMed

    Gill, Simren K; Hui, Kailyn; Farne, Hugo; Garnett, James P; Baines, Deborah L; Moore, Luke S P; Holmes, Alison H; Filloux, Alain; Tregoning, John S

    2016-01-01

    Diabetes is associated with increased frequency of hospitalization due to bacterial lung infection. We hypothesize that increased airway glucose caused by hyperglycaemia leads to increased bacterial loads. In critical care patients, we observed that respiratory tract bacterial colonisation is significantly more likely when blood glucose is high. We engineered mutants in genes affecting glucose uptake and metabolism (oprB, gltK, gtrS and glk) in Pseudomonas aeruginosa, strain PAO1. These mutants displayed attenuated growth in minimal medium supplemented with glucose as the sole carbon source. The effect of glucose on growth in vivo was tested using streptozocin-induced, hyperglycaemic mice, which have significantly greater airway glucose. Bacterial burden in hyperglycaemic animals was greater than control animals when infected with wild type but not mutant PAO1. Metformin pre-treatment of hyperglycaemic animals reduced both airway glucose and bacterial load. These data support airway glucose as a critical determinant of increased bacterial load during diabetes. PMID:27273266

  18. Rare Upper Airway Anomalies.

    PubMed

    Windsor, Alanna; Clemmens, Clarice; Jacobs, Ian N

    2016-01-01

    A broad spectrum of congenital upper airway anomalies can occur as a result of errors during embryologic development. In this review, we will describe the clinical presentation, diagnosis, and management strategies for a few select, rare congenital malformations of this system. The diagnostic tools used in workup of these disorders range from prenatal tests to radiological imaging, swallowing evaluations, indirect or direct laryngoscopy, and rigid bronchoscopy. While these congenital defects can occur in isolation, they are often associated with disorders of other organ systems or may present as part of a syndrome. Therefore workup and treatment planning for patients with these disorders often involves a team of multiple specialists, including paediatricians, otolaryngologists, pulmonologists, speech pathologists, gastroenterologists, and geneticists. PMID:26277452

  19. [Reactive airways dysfunction syndrome].

    PubMed

    Costa, R; Orriols, R

    2005-01-01

    Reactive airways dysfunction syndrome, better known as RADS, was described as a clinical entity consisting in the appearance of bronchial asthma due to massive toxic inhalation. The term was coined and recognised for the first time in 1985. Since then different publications have verified new cases as well as different causal agents. It usually arises from an accident at the work place and in closed or poorly ventilated spaces, where high concentrations of irritant products are inhaled in the form of gas, smoke or vapour. In the following minutes or hours symptoms of bronchial obstruction appear in an acute form, with bronchial hyperresponsiveness persisting for months or years. The affected patients do not show a recurrence of symptoms following exposure to non-toxic doses of the same agent that started the symptoms. This is why diagnosis is based on clinical manifestations as it is not reproducible through a provocation test. PMID:15915173

  20. 24 CFR 578.63 - Indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Indirect costs. 578.63 Section 578... Indirect costs. (a) In general. Continuum of Care funds may be used to pay indirect costs in accordance with OMB Circulars A-87 or A-122, as applicable. (b) Allocation. Indirect costs may be allocated...

  1. 24 CFR 578.63 - Indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Indirect costs. 578.63 Section 578... Indirect costs. (a) In general. Continuum of Care funds may be used to pay indirect costs in accordance with OMB Circulars A-87 or A-122, as applicable. (b) Allocation. Indirect costs may be allocated...

  2. Spectrum allocations above 40 GHz

    NASA Technical Reports Server (NTRS)

    Katzenstein, W. E.; Moore, R. P.; Kimball, H. G.

    1981-01-01

    The 1979 World Administrative Radio Conference (WARC-79) revised the International Table of Frequency Allocations to reflect increased interest and activity in the region of the EM spectrum above 40 GHz. The total width of the spectrum allocated (235 GHz) in the region above 40 GHz indicates the extent of this new spectrum resource, made accessible by advances in the state-of-the-art of telecommunications equipment. There are some striking differences between the approach to allocation above and below 40 GHz. For example, there are not bands allocated exclusively. This reflects the characteristics of propagation and the small antenna beamwidths achievable at these frequencies. Attention is given to atmospheric window and absorption band limits, allocations to satellite services, allocations to scientific services, allocations to terrestrial services, the future refinement of the radio regulations above 40 GHz, and allocations of WARC-79 and frequency management.

  3. High-frequency oscillation of the airway and chest wall.

    PubMed

    Fink, James B; Mahlmeister, Michael J

    2002-07-01

    High-frequency oscillation (HFO), applied to either the airway or chest wall, has been associated with changes in sputum attributes and clearance. The evolution of evidence, both in vitro and in vivo, supporting the use of HFO is reviewed. Devices that apply HFO to the airway range from the relatively simple mechanical Flutter and Acapella devices to the more complex Percussionaire Intrapercussive Ventilators. and the Hayek Oscillator are designed to provide high-frequency chest wall compression. Operation and use of these devices are described with examples of differentiation of device types by characterization of flows, and airway and esophageal pressures. Although HFO devices span a broad range of costs, they provide a reasonable therapeutic option to support secretion clearance for patients with cystic fibrosis. PMID:12088550

  4. Economics of spectrum allocation

    NASA Astrophysics Data System (ADS)

    Melody, W. H.

    The effective and efficient allocation and use of the spectrum can be ensured only by a set of sharing rules that will reflect the interests, values, and power of all affected parties. What is now happening is that the new interests and different values of the developing countries are pressing to change the international sharing rules established by a small group of high-technology nations. It is noted that the latter have established a massive telecommunications infrastructure on the basis of inherited sharing rules that reflect only their interests and a much simplified scarcity problem. Once long-term goals and underlying principles of allocation are established, communication technologies and markets can be directed, through a series of adjustment policies, to achieve them. A crucial first step in the creation of an international information environment in which 'free' flows will be balanced flows is the establishment of a balanced and equitable set of sharing rules for the radio spectrum.

  5. Apoptosis and the Airway Epithelium

    PubMed Central

    White, Steven R.

    2011-01-01

    The airway epithelium functions as a barrier and front line of host defense in the lung. Apoptosis or programmed cell death can be elicited in the epithelium as a response to viral infection, exposure to allergen or to environmental toxins, or to drugs. While apoptosis can be induced via activation of death receptors on the cell surface or by disruption of mitochondrial polarity, epithelial cells compared to inflammatory cells are more resistant to apoptotic stimuli. This paper focuses on the response of airway epithelium to apoptosis in the normal state, apoptosis as a potential regulator of the number and types of epithelial cells in the airway, and the contribution of epithelial cell apoptosis in important airways diseases. PMID:22203854

  6. Extraglottic airway devices: A review

    PubMed Central

    Ramaiah, Ramesh; Das, Debasmita; Bhananker, Sanjay M; Joffe, Aaron M

    2014-01-01

    Extraglottic airway devices (EAD) have become an integral part of anesthetic care since their introduction into clinical practice 25 years ago and have been used safely hundreds of millions of times, worldwide. They are an important first option for difficult ventilation during both in-hospital and out-of-hospital difficult airway management and can be utilized as a conduit for tracheal intubation either blindly or assisted by another technology (fiberoptic endoscopy, lightwand). Thus, the EAD may be the most versatile single airway technique in the airway management toolbox. However, despite their utility, knowledge regarding specific devices and the supporting data for their use is of paramount importance to patient's safety. In this review, number of commercially available EADs are discussed and the reported benefits and potential pitfalls are highlighted. PMID:24741502

  7. United airway disease: current perspectives

    PubMed Central

    Giavina-Bianchi, Pedro; Aun, Marcelo Vivolo; Takejima, Priscila; Kalil, Jorge; Agondi, Rosana Câmara

    2016-01-01

    Upper and lower airways are considered a unified morphological and functional unit, and the connection existing between them has been observed for many years, both in health and in disease. There is strong epidemiologic, pathophysiologic, and clinical evidence supporting an integrated view of rhinitis and asthma: united airway disease in the present review. The term “united airway disease” is opportune, because rhinitis and asthma are chronic inflammatory diseases of the upper and lower airways, which can be induced by allergic or nonallergic reproducible mechanisms, and present several phenotypes. Management of rhinitis and asthma must be jointly carried out, leading to better control of both diseases, and the lessons of the Allergic Rhinitis and Its Impact on Asthma initiative cannot be forgotten. PMID:27257389

  8. Tachykinin receptors and airway pathophysiology.

    PubMed

    Maggi, C A

    1993-05-01

    The mammalian tachykinins (TKs), substance P and neurokinin A, are present in sensory nerve fibres in the upper and lower airways of various mammalian species, including humans. TKs are released from these afferent nerves in an "efferent" mode at peripheral level, especially in response to irritant stimuli. TKs exert a variety of biological effects (bronchoconstriction, plasma protein extravasation, stimulation of mucus secretion), collectively known as "neurogenic inflammation", and this process is thought to be of potential pathogenic relevance for various airway diseases. The recent development of potent and selective TK receptor antagonists on the one hand provides important new tools for the understanding of basic airway physiology and pathophysiology and, on the other, opens new possibilities for therapy of airway diseases. PMID:8390944

  9. Eosinophilic phenotypes of airway disease.

    PubMed

    Pavord, Ian D

    2013-12-01

    Our understanding of the clinical implications of eosinophilic airway inflammation has increased significantly over the last 20 years, aided by the development of noninvasive means to assess it. This pattern of airway inflammation can occur in a diverse range of airway diseases. It is associated with a positive response to corticosteroids and a high risk of preventable exacerbations. Our new understanding of the role of eosinophilic airway inflammation has paved the way for the clinical development of a number of more specific inhibitors that may become new treatment options. Different definitions, ideas of disease, and adoption of biomarkers that are not well known are necessary to fully realize the potential of these treatments. PMID:24313765

  10. Imaging of the Distal Airways

    PubMed Central

    Tashkin, Donald P.; de Lange, Eduard E.

    2009-01-01

    Imaging techniques of the lung continues to advance with improving ability to image the more distal airways. Two imaging techniques are reviewed, computerized tomography and magnetic resonance with hyperpolarized helium-3. PMID:19962040

  11. The Virtual Pediatric Airways Workbench.

    PubMed

    Quammen, Cory W; Taylor Ii, Russell M; Krajcevski, Pavel; Mitran, Sorin; Enquobahrie, Andinet; Superfine, Richard; Davis, Brad; Davis, Stephanie; Zdanski, Carlton

    2016-01-01

    The Virtual Pediatric Airways Workbench (VPAW) is a patient-centered surgical planning software system targeted to pediatric patients with airway obstruction. VPAW provides an intuitive surgical planning interface for clinicians and supports quantitative analysis regarding prospective surgeries to aid clinicians deciding on potential surgical intervention. VPAW enables a full surgical planning pipeline, including importing DICOM images, segmenting the airway, interactive 3D editing of airway geometries to express potential surgical treatment planning options, and creating input files for offline geometric analysis and computational fluid dynamics simulations for evaluation of surgical outcomes. In this paper, we describe the VPAW system and its use in one case study with a clinician to successfully describe an intended surgery outcome. PMID:27046595

  12. Myrmics Memory Allocator

    2011-09-23

    MMA is a stand-alone memory management system for MPI clusters. It implements a shared Partitioned Global Address Space, where multiple MPI processes request objects from the allocator and the latter provides them with system-wide unique memory addresses for each object. It provides applications with an intuitive way of managing the memory system in a unified way, thus enabling easier writing of irregular application code.

  13. Attention allocation before antisaccades.

    PubMed

    Klapetek, Anna; Jonikaitis, Donatas; Deubel, Heiner

    2016-01-01

    In the present study, we investigated the distribution of attention before antisaccades. We used a dual task paradigm, in which participants made prosaccades or antisaccades and discriminated the orientation of a visual probe shown at the saccade goal, the visual cue location (antisaccade condition), or a neutral location. Moreover, participants indicated whether they had made a correct antisaccade or an erroneous prosaccade. We observed that, while spatial attention in the prosaccade task was allocated only to the saccade goal, attention in the antisaccade task was allocated both to the cued location and to the antisaccade goal. This suggests parallel attentional selection of the cued and antisaccade locations. We further observed that in error trials--in which participants made an incorrect prosaccade instead of an antisaccade--spatial attention was biased towards the prosaccade goal. These erroneous prosaccades were mostly unnoticed and were often followed by corrective antisaccades with very short latencies (<100 ms). Data from error trials therefore provide further evidence for the parallel programming of the reflexive prosaccade to the cue and the antisaccade to the intended location. Taken together, our results suggest that attention allocation and saccade goal selection in the antisaccade task are mediated by a common competitive process. PMID:26790843

  14. 20 CFR 627.435 - Cost principles and allowable costs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... OMB Circulars identified in DOL's regulations at 29 CFR 97.22(b). (c) Costs allocable to another... unforeseen events; (7) Costs prohibited by 29 CFR part 93 (Lobbying Restrictions) or costs of any salaries or... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Cost principles and allowable costs....

  15. 20 CFR 627.435 - Cost principles and allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... OMB Circulars identified in DOL's regulations at 29 CFR 97.22(b). (c) Costs allocable to another... unforeseen events; (7) Costs prohibited by 29 CFR part 93 (Lobbying Restrictions) or costs of any salaries or... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Cost principles and allowable costs....

  16. Airway Surface Mycosis in Chronic Th2-Associated Airway Disease

    PubMed Central

    Porter, Paul; Lim, Dae Jun; Maskatia, Zahida Khan; Mak, Garbo; Tsai, Chu-Lin; Citardi, Martin J; Fakhri, Samer; Shaw, Joanne L.; Fothergil, Annette; Kheradmand, Farrah; Corry, David B; Luong, Amber

    2014-01-01

    Background Environmental fungi have been linked to T helper type 2 (Th2) cell-related airway inflammation and the Th2-associated chronic airway diseases asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and allergic fungal rhinosinusitis (AFRS), but whether these organisms participate directly or indirectly in disease pathology remains unknown. Objective To determine the frequency of fungus isolation and fungus-specific immunity in Th2-associated and non-associated airway disease patients. Methods Sinus lavage fluid and blood were collected from sinus surgery patients (n=118) including CRS patients with and without nasal polyps and AFRS and non-CRS/non-asthmatic control patients. Asthma status was deteremined from medical history. Sinus lavage fluids were cultured and directly examined for evidence of viable fungi. Peripheral blood mononuclear cells were restimulated with fungal antigens in an enzyme linked immunocell spot (ELISpot) assay to determine total memory fungus-specific IL-4-secreting cells. These data were compared to fungus-specific IgE levels measured from plasma by ELISA. Results Filamentous fungi were significantly more commonly cultured from Th2-associated airway disease subjects (asthma, CRSwNP, or AFRS: n=68) compared to non-Th2-associated control patients (n=31); 74% vs 16% respectively, p<0.001. Both fungus-specific IL-4 ELISpot (n=48) and specific IgE (n=70) data correlated with Th2-associated diseases (sensitivity 73% and specificity 100% vs. 50% and 77%, respectively). Conclusions The frequent isolation of fungi growing directly within the airways accompanied by specific immunity to these organisms only in patients with Th2-associated chronic airway diseases suggests that fungi participate directly in the pathogenesis of these conditions. Efforts to eradicate airway fungi from the airways should be considered in selected patients. Clinical Implications Airway fungi may contribute to the expression of sinusitis with nasal polyps and

  17. Airway obstruction with cricoid pressure.

    PubMed

    Hartsilver, E L; Vanner, R G

    2000-03-01

    Cricoid pressure may cause airway obstruction. We investigated whether this is related to the force applied and to the technique of application. We recorded expired tidal volumes and inflation pressures during ventilation via a face-mask and oral airway in 52 female patients who were anaesthetised and about to undergo elective surgery. An inspired tidal volume of 900 ml was delivered using a ventilator. Ventilation was assessed under five different conditions: no cricoid pressure, backwards cricoid pressure applied with a force of 30 N, cricoid pressure applied in an upward and backward direction with a force of 30 N, backwards cricoid pressure with a force of 44 N and through a tracheal tube. An expired tidal volume of < 200 ml was taken to indicate airway obstruction. Airway obstruction did not occur without cricoid pressure, but did occur in one patient (2%) with cricoid pressure at 30 N, in 29 patients (56%) with 30 N applied in an upward and backward direction and in 18 (35%) patients with cricoid pressure at 44 N. Cricoid pressure applied with a force of 44 N can cause airway obstruction but if cricoid pressure is applied with a force of 30 N, airway obstruction occurs less frequently (p = 0.0001) unless the force is applied in an upward and backward direction. PMID:10671836

  18. Tachykinin antagonists and the airways.

    PubMed

    Joos, G F; Kips, J C; Peleman, R A; Pauwels, R A

    1995-01-01

    There is now convincing evidence for the presence of substance P (SP) and neurokinin A (NKA) in human airway nerves. Studies on autopsy tissue, on bronchoalveolar lavage fluid and on sputum suggest that SP may be present in increased amounts in the asthmatic airway. Substance P and NKA are potent bronchoconstrictors of human airways, asthmatics being more sensitive than normal persons. The major enzyme responsible for the degradation of the tachykinins, the neutral endopeptidase, is present in the airways and is involved in the breakdown of exogenously administered SP and NKA, both in normal and asthmatic persons. Other, less well documented airway effects of SP and NKA include mucus secretion, vasodilation and plasma extravasation, as well as the chemoattraction and stimulation of various cells presumed to be involved in asthmatic airway inflammation. NK2 receptors and, to a lesser extent, NK1 receptors have been shown to be involved in bronchoconstriction, whereas NK1 receptors were found to be involved in mucus secretion, microvascular leakage and vasodilatation, and in most of the effects on inflammatory cells. The first clinical trial with FK224, a peptide NK1 and NK2 receptor antagonist, and CP99994, a nonpeptide NK1 receptor antagonist, are negative. However, FK224 failed to block the bronchoconstrictor effect of NKA in asthmatics and the dose of CP99994, needed to antagonize tachykinin effects in man, remains to be determined. PMID:7543746

  19. Surfactant and allergic airway inflammation.

    PubMed

    Winkler, Carla; Hohlfeld, Jens M

    2013-01-01

    Pulmonary surfactant is a complex mixture of unique proteins and lipids that covers the airway lumen. Surfactant prevents alveolar collapse and maintains airway patency by reducing surface tension at the air-liquid interface. Furthermore, it provides a defence against antigen uptake by binding foreign particles and enhancing cellular immune responses. Allergic asthma is associated with chronic airway inflammation and presents with episodes of airway narrowing. The pulmonary inflammation and bronchoconstriction can be triggered by exposure to allergens or pathogens present in the inhaled air. Pulmonary surfactant has the potential to interact with various immune cells which orchestrate allergen- or pathogen-driven episodes of airway inflammation. The complex nature of surfactant allows multiple sites of interaction, but also makes it susceptible to external alterations, which potentially impair its function. This duality of modulating airway physiology and immunology during inflammatory conditions, while at the same time being prone to alterations accompanied by restricted function, has stimulated numerous studies in recent decades, which are reviewed in this article. PMID:23896983

  20. Synaptic Tagging During Memory Allocation

    PubMed Central

    Rogerson, Thomas; Cai, Denise; Frank, Adam; Sano, Yoshitake; Shobe, Justin; Aranda, Manuel L.; Silva, Alcino J.

    2014-01-01

    There is now compelling evidence that the allocation of memory to specific neurons (neuronal allocation) and synapses (synaptic allocation) in a neurocircuit is not random and that instead specific mechanisms, such as increases in neuronal excitability and synaptic tagging and capture, determine the exact sites where memories are stored. We propose an integrated view of these processes, such that neuronal allocation, synaptic tagging and capture, spine clustering and metaplasticity reflect related aspects of memory allocation mechanisms. Importantly, the properties of these mechanisms suggest a set of rules that profoundly affect how memories are stored and recalled. PMID:24496410

  1. 50 CFR 660.323 - Pacific whiting allocations, allocation attainment, and inseason allocation reapportionment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Pacific whiting allocations, allocation...) FISHERIES OFF WEST COAST STATES West Coast Groundfish Fisheries § 660.323 Pacific whiting allocations... amounts that will be harvested, or a combination of the two. Estimates of the amount of Pacific...

  2. Comparing the Laryngeal Mask Airway, Cobra Perilaryngeal Airway and Face Mask in Children Airway Management

    PubMed Central

    Tekin, Beyza; Hatipoğlu, Zehra; Türktan, Mediha; Özcengiz, Dilek

    2016-01-01

    Objective We compared the effects of the laryngeal mask airway (LMA), face mask and Cobra perilaryngeal airway (PLA) in the airway management of spontaneously breathing paediatric patients undergoing elective inguinal surgery. Methods In this study, 90 cases of 1–14-year-old children undergoing elective inguinal surgery were scheduled. The patients were randomly divided into three groups. Anaesthesia was provided with sevoflurane and 50%–50% nitrous oxide and oxygen. After providing an adequate depth of anaesthesia, supraglottic airway devices were inserted in the group I and II patients. The duration and number of insertion, haemodynamic parameters, plateau and peak inspiratory pressure and positive end-expiratory pressure of the patients were recorded preoperatively, after induction and at 5, 10, 15 and 30 min peroperatively. Results There were no statistical differences between the groups in terms of haemodynamic parameters (p>0.05). In group II, instrumentation success was higher and instrumentation time was shorter than group II. The positive end-expiratory pressure and plateau and peak inspiratory pressure values were statistically lower in group II (p<0.05). Conclusion We concluded that for airway safety and to avoid possible complications, LMA and Cobra PLA could be alternatives to face mask and that the Cobra PLA provided lower airway pressure and had a faster and more easy placement than LMA. PMID:27366563

  3. Human airway ciliary dynamics

    PubMed Central

    Thompson, Kristin; Knowles, Michael R.; Davis, C. William

    2013-01-01

    Airway cilia depend on precise changes in shape to transport the mucus gel overlying mucosal surfaces. The ciliary motion can be recorded in several planes using video microscopy. However, cilia are densely packed, and automated computerized systems are not available to convert these ciliary shape changes into forms that are useful for testing theoretical models of ciliary function. We developed a system for converting planar ciliary motions recorded by video microscopy into an empirical quantitative model, which is easy to use in validating mathematical models, or in examining ciliary function, e.g., in primary ciliary dyskinesia (PCD). The system we developed allows the manipulation of a model cilium superimposed over a video of beating cilia. Data were analyzed to determine shear angles and velocity vectors of points along the cilium. Extracted waveforms were used to construct a composite waveform, which could be used as a standard. Variability was measured as the mean difference in position of points on individual waveforms and the standard. The shapes analyzed were the end-recovery, end-effective, and fastest moving effective and recovery with mean (± SE) differences of 0.31(0.04), 0.25(0.06), 0.50(0.12), 0.50(0.10), μm, respectively. In contrast, the same measures for three different PCD waveforms had values far outside this range. PMID:23144323

  4. Role of Small Airways in Asthma.

    PubMed

    Finkas, Lindsay K; Martin, Richard

    2016-08-01

    Asthma is an inflammatory condition of both the small and large airways. Recently the small airways have gained attention as studies have shown significant inflammation in the small airways in all severities of asthma. This inflammation has correlated with peripheral airway resistance and as a result, noninvasive methods to reliably measure small airways have been pursued. In addition, recent changes in asthma inhalers have led to alterations in drug formulations and the development of extrafine particle inhalers that improve delivery to the distal airways. PMID:27401620

  5. A model for analysis of TDA budget allocation

    NASA Technical Reports Server (NTRS)

    Remer, D. S.; Buchanan, H. R.

    1994-01-01

    There is an ever-increasing need to achieve greater efficiency in the operation of the Deep Space Network (DSN), i.e., increased productivity at reduced cost. One of the tools used in the course of a planning workshop on this subject was a methodology for budget allocation applicable to long-range planning. This article presents a model for analysis of the TDA budget allocation. For the 1994 through 1999 period, the percentage of the total TDA budget allocated to capacity and capability is being cut in half, whereas the percentage spent on efficiency of delivery will be increasing.

  6. 30 CFR 725.21 - Allowable costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... shall determine costs which may be reimbursed according to Office of Management and Budget Circular No... attributable to the period covered by the grant. (d) Costs must not be allocated to or included as a cost...

  7. 30 CFR 725.21 - Allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... shall determine costs which may be reimbursed according to Office of Management and Budget Circular No... attributable to the period covered by the grant. (d) Costs must not be allocated to or included as a cost...

  8. 30 CFR 725.21 - Allowable costs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... shall determine costs which may be reimbursed according to Office of Management and Budget Circular No... attributable to the period covered by the grant. (d) Costs must not be allocated to or included as a cost...

  9. 30 CFR 725.21 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... shall determine costs which may be reimbursed according to Office of Management and Budget Circular No... attributable to the period covered by the grant. (d) Costs must not be allocated to or included as a cost...

  10. 30 CFR 725.21 - Allowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... shall determine costs which may be reimbursed according to Office of Management and Budget Circular No... attributable to the period covered by the grant. (d) Costs must not be allocated to or included as a cost...

  11. Telescope Time Allocation Tool

    NASA Astrophysics Data System (ADS)

    Alves, J.

    2005-03-01

    TaToo is ESO's new Time Allocation Tool. This software scheduler is a combination of a user-friendly graphical user interface and an intelligent constraint-programming engine fine-tuned to ESO's scheduling problem. TaToo is able to produce a high quality and reliable schedule taking into consideration all constraints of the recommended programs for all telescopes in about 15 minutes. This performance allows schedulers at ESO-VISAS to simulate and evaluate different scenarios, optimize the scheduling of engineering activities at the observatories, and in the end construct the most science efficient schedule possible.

  12. [Organ allocation. Ethical issues].

    PubMed

    Cattorini, P

    2010-01-01

    The criteria for allocating organs are one of the most debated ethical issue in the transplantation programs. The article examines some rules and principles followed by "Nord Italia Transplant program", summarized in its Principles' Charter and explained in a recent interdisciplinary book. General theories of justice and their application to individual clinical cases are commented and evaluated, in order to foster a public, democratic, transparent debate among professionals and citizens, scientific associations and customers' organizations. Some specific moral dilemmas are focused regarding the concepts of proportionate treatment, unselfish donation by living persons, promotion of local institutions efficiency. PMID:20677677

  13. Computationally efficient control allocation

    NASA Technical Reports Server (NTRS)

    Durham, Wayne (Inventor)

    2001-01-01

    A computationally efficient method for calculating near-optimal solutions to the three-objective, linear control allocation problem is disclosed. The control allocation problem is that of distributing the effort of redundant control effectors to achieve some desired set of objectives. The problem is deemed linear if control effectiveness is affine with respect to the individual control effectors. The optimal solution is that which exploits the collective maximum capability of the effectors within their individual physical limits. Computational efficiency is measured by the number of floating-point operations required for solution. The method presented returned optimal solutions in more than 90% of the cases examined; non-optimal solutions returned by the method were typically much less than 1% different from optimal and the errors tended to become smaller than 0.01% as the number of controls was increased. The magnitude of the errors returned by the present method was much smaller than those that resulted from either pseudo inverse or cascaded generalized inverse solutions. The computational complexity of the method presented varied linearly with increasing numbers of controls; the number of required floating point operations increased from 5.5 i, to seven times faster than did the minimum-norm solution (the pseudoinverse), and at about the same rate as did the cascaded generalized inverse solution. The computational requirements of the method presented were much better than that of previously described facet-searching methods which increase in proportion to the square of the number of controls.

  14. Airway Gland Structure and Function.

    PubMed

    Widdicombe, Jonathan H; Wine, Jeffrey J

    2015-10-01

    Submucosal glands contribute to airway surface liquid (ASL), a film that protects all airway surfaces. Glandular mucus comprises electrolytes, water, the gel-forming mucin MUC5B, and hundreds of different proteins with diverse protective functions. Gland volume per unit area of mucosal surface correlates positively with impaction rate of inhaled particles. In human main bronchi, the volume of the glands is ∼ 50 times that of surface goblet cells, but the glands diminish in size and frequency distally. ASL and its trapped particles are removed from the airways by mucociliary transport. Airway glands have a tubuloacinar structure, with a single terminal duct, a nonciliated collecting duct, then branching secretory tubules lined with mucous cells and ending in serous acini. They allow for a massive increase in numbers of mucus-producing cells without replacing surface ciliated cells. Active secretion of Cl(-) and HCO3 (-) by serous cells produces most of the fluid of gland secretions. Glands are densely innervated by tonically active, mutually excitatory airway intrinsic neurons. Most gland mucus is secreted constitutively in vivo, with large, transient increases produced by emergency reflex drive from the vagus. Elevations of [cAMP]i and [Ca(2+)]i coordinate electrolyte and macromolecular secretion and probably occur together for baseline activity in vivo, with cholinergic elevation of [Ca(2+)]i being mainly responsive for transient increases in secretion. Altered submucosal gland function contributes to the pathology of all obstructive diseases, but is an early stage of pathogenesis only in cystic fibrosis. PMID:26336032

  15. The Airway Microbiome at Birth

    PubMed Central

    Lal, Charitharth Vivek; Travers, Colm; Aghai, Zubair H.; Eipers, Peter; Jilling, Tamas; Halloran, Brian; Carlo, Waldemar A.; Keeley, Jordan; Rezonzew, Gabriel; Kumar, Ranjit; Morrow, Casey; Bhandari, Vineet; Ambalavanan, Namasivayam

    2016-01-01

    Alterations of pulmonary microbiome have been recognized in multiple respiratory disorders. It is critically important to ascertain if an airway microbiome exists at birth and if so, whether it is associated with subsequent lung disease. We found an established diverse and similar airway microbiome at birth in both preterm and term infants, which was more diverse and different from that of older preterm infants with established chronic lung disease (bronchopulmonary dysplasia). Consistent temporal dysbiotic changes in the airway microbiome were seen from birth to the development of bronchopulmonary dysplasia in extremely preterm infants. Genus Lactobacillus was decreased at birth in infants with chorioamnionitis and in preterm infants who subsequently went on to develop lung disease. Our results, taken together with previous literature indicating a placental and amniotic fluid microbiome, suggest fetal acquisition of an airway microbiome. We speculate that the early airway microbiome may prime the developing pulmonary immune system, and dysbiosis in its development may set the stage for subsequent lung disease. PMID:27488092

  16. Allergen-induced airway responses.

    PubMed

    Gauvreau, Gail M; El-Gammal, Amani I; O'Byrne, Paul M

    2015-09-01

    Environmental allergens are an important cause of asthma and can contribute to loss of asthma control and exacerbations. Allergen inhalation challenge has been a useful clinical model to examine the mechanisms of allergen-induced airway responses and inflammation. Allergen bronchoconstrictor responses are the early response, which reaches a maximum within 30 min and resolves by 1-3 h, and late responses, when bronchoconstriction recurs after 3-4 h and reaches a maximum over 6-12 h. Late responses are followed by an increase in airway hyperresponsiveness. These responses occur when IgE on mast cells is cross-linked by an allergen, causing degranulation and the release of histamine, neutral proteases and chemotactic factors, and the production of newly formed mediators, such as cysteinyl leukotrienes and prostaglandin D2. Allergen-induced airway inflammation consists of an increase in airway eosinophils, basophils and, less consistently, neutrophils. These responses are mediated by the trafficking and activation of myeloid dendritic cells into the airways, probably as a result of the release of epithelial cell-derived thymic stromal lymphopoietin, and the release of pro-inflammatory cytokines from type 2 helper T-cells. Allergen inhalation challenge has also been a widely used model to study potential new therapies for asthma and has an excellent negative predictive value for this purpose. PMID:26206871

  17. The Airway Microbiome at Birth.

    PubMed

    Lal, Charitharth Vivek; Travers, Colm; Aghai, Zubair H; Eipers, Peter; Jilling, Tamas; Halloran, Brian; Carlo, Waldemar A; Keeley, Jordan; Rezonzew, Gabriel; Kumar, Ranjit; Morrow, Casey; Bhandari, Vineet; Ambalavanan, Namasivayam

    2016-01-01

    Alterations of pulmonary microbiome have been recognized in multiple respiratory disorders. It is critically important to ascertain if an airway microbiome exists at birth and if so, whether it is associated with subsequent lung disease. We found an established diverse and similar airway microbiome at birth in both preterm and term infants, which was more diverse and different from that of older preterm infants with established chronic lung disease (bronchopulmonary dysplasia). Consistent temporal dysbiotic changes in the airway microbiome were seen from birth to the development of bronchopulmonary dysplasia in extremely preterm infants. Genus Lactobacillus was decreased at birth in infants with chorioamnionitis and in preterm infants who subsequently went on to develop lung disease. Our results, taken together with previous literature indicating a placental and amniotic fluid microbiome, suggest fetal acquisition of an airway microbiome. We speculate that the early airway microbiome may prime the developing pulmonary immune system, and dysbiosis in its development may set the stage for subsequent lung disease. PMID:27488092

  18. 48 CFR 31.203 - Indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... cost of that or any other final cost objective. (c) The contractor shall accumulate indirect costs by... for allocating indirect costs is the cost accounting period during which such costs are incurred and... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Indirect costs....

  19. 48 CFR 31.203 - Indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... cost of that or any other final cost objective. (c) The contractor shall accumulate indirect costs by... for allocating indirect costs is the cost accounting period during which such costs are incurred and... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Indirect costs....

  20. 38 CFR 17.261 - Indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Indirect costs. 17.261... Exchange of Information § 17.261 Indirect costs. The grantee shall allocate expenditures as between direct and indirect costs according to generally accepted accounting procedures. The amount allocated...

  1. 38 CFR 17.261 - Indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Indirect costs. 17.261... Exchange of Information § 17.261 Indirect costs. The grantee shall allocate expenditures as between direct and indirect costs according to generally accepted accounting procedures. The amount allocated...

  2. 38 CFR 17.261 - Indirect costs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Indirect costs. 17.261... Exchange of Information § 17.261 Indirect costs. The grantee shall allocate expenditures as between direct and indirect costs according to generally accepted accounting procedures. The amount allocated...

  3. 38 CFR 17.261 - Indirect costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Indirect costs. 17.261... Exchange of Information § 17.261 Indirect costs. The grantee shall allocate expenditures as between direct and indirect costs according to generally accepted accounting procedures. The amount allocated...

  4. 38 CFR 17.261 - Indirect costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Indirect costs. 17.261... Exchange of Information § 17.261 Indirect costs. The grantee shall allocate expenditures as between direct and indirect costs according to generally accepted accounting procedures. The amount allocated...

  5. [Orthodontics and the upper airway].

    PubMed

    Cobo Plana, J; de Carlos Villafranca, F; Macías Escalada, E

    2004-03-01

    One of the general aims of orthodontic treatment and of the combination of orthodontics and orthognathic surgery is to achieve good occlusion and aesthetic improvement, especially in cases of severe dentoskeletal deformities. However, on many occasions, the parameters of the upper airways are not taken into account when the aims of conventional treatment are fulfilled. Patients with obstructive alterations during sleep represent for the orthodontist a type of patient who differs from the normal; for them, treatment should include the objective of improving oxygen saturation. Here, functional considerations should outweigh purely aesthetic ones. It is important, when making an orthodontic, surgical or combined diagnosis for a patient, to bear in mind the impact that treatment may have on the upper airways. Good aesthetics should never be achieved for some of our patients at the expense of diminishing the capacity of their upper airways. PMID:15301356

  6. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Airway connector. 868.5810 Section 868.5810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5810 Airway connector. (a) Identification. An airway connector is a device intended to...

  7. Chronic effects of mechanical force on airways.

    PubMed

    Tschumperlin, Daniel J; Drazen, Jeffrey M

    2006-01-01

    Airways are embedded in the mechanically dynamic environment of the lung. In utero, this mechanical environment is defined largely by fluid secretion into the developing airway lumen. Clinical, whole lung, and cellular studies demonstrate pivotal roles for mechanical distention in airway morphogenesis and cellular behavior during lung development. In the adult lung, the mechanical environment is defined by a dynamic balance of surface, tissue, and muscle forces. Diseases of the airways modulate both the mechanical stresses to which the airways are exposed as well as the structure and mechanical behavior of the airways. For instance, in asthma, activation of airway smooth muscle abruptly changes the airway size and stress state within the airway wall; asthma also results in profound remodeling of the airway wall. Data now demonstrate that airway epithelial cells, smooth muscle cells, and fibroblasts respond to their mechanical environment. A prominent role has been identified for the epithelium in transducing mechanical stresses, and in both the fetal and mature airways, epithelial cells interact with mesenchymal cells to coordinate remodeling of tissue architecture in response to the mechanical environment. PMID:16460284

  8. Site of Fluid Secretion in Small Airways.

    PubMed

    Flores-Delgado, Guillermo; Lytle, Christian; Quinton, Paul M

    2016-03-01

    The secretion and management of readily transportable airway surface liquid (ASL) along the respiratory tract is crucial for the clearance of debris and pathogens from the lungs. In proximal large airways, submucosal glands (SMGs) can produce ASL. However, in distal small airways, SMGs are absent, although the lumens of these airways are, uniquely, highly plicated. Little is known about the production and maintenance of ASL in small airways, but using electrophysiology, we recently found that native porcine small airways simultaneously secrete and absorb. How these airways can concurrently transport ASL in opposite directions is puzzling. Using high expression of the Na-K-2Cl cotransport (NKCC) 1 protein (SLC12a2) as a phenotypic marker for fluid secretory cells, immunofluorescence microscopy of porcine small airways revealed two morphologically separated sets of luminal epithelial cells. NKCC1 was abundantly expressed by most cells in the contraluminal regions of the pleats but highly expressed very infrequently by cells in the luminal folds of the epithelial plications. In larger proximal airways, the acini of SMGs expressed NKCC1 prominently, but cells expressing NKCC1 in the surface epithelium were sparse. Our findings indicate that, in the small airway, cells in the pleats of the epithelium secrete ASL, whereas, in the larger proximal airways, SMGs mainly secrete ASL. We propose a mechanism in which the locations of secretory cells in the base of pleats and of absorptive cells in luminal folds physically help maintain a constant volume of ASL in small airways. PMID:26562629

  9. Research on allocation efficiency of the daisy chain allocation algorithm

    NASA Astrophysics Data System (ADS)

    Shi, Jingping; Zhang, Weiguo

    2013-03-01

    With the improvement of the aircraft performance in reliability, maneuverability and survivability, the number of the control effectors increases a lot. How to distribute the three-axis moments into the control surfaces reasonably becomes an important problem. Daisy chain method is simple and easy to be carried out in the design of the allocation system. But it can not solve the allocation problem for entire attainable moment subset. For the lateral-directional allocation problem, the allocation efficiency of the daisy chain can be directly measured by the area of its subset of attainable moments. Because of the non-linear allocation characteristic, the subset of attainable moments of daisy-chain method is a complex non-convex polygon, and it is difficult to solve directly. By analyzing the two-dimensional allocation problems with a "micro-element" idea, a numerical calculation algorithm is proposed to compute the area of the non-convex polygon. In order to improve the allocation efficiency of the algorithm, a genetic algorithm with the allocation efficiency chosen as the fitness function is proposed to find the best pseudo-inverse matrix.

  10. Optimal Sensor Allocation for Fault Detection and Isolation

    NASA Technical Reports Server (NTRS)

    Azam, Mohammad; Pattipati, Krishna; Patterson-Hine, Ann

    2004-01-01

    Automatic fault diagnostic schemes rely on various types of sensors (e.g., temperature, pressure, vibration, etc) to measure the system parameters. Efficacy of a diagnostic scheme is largely dependent on the amount and quality of information available from these sensors. The reliability of sensors, as well as the weight, volume, power, and cost constraints, often makes it impractical to monitor a large number of system parameters. An optimized sensor allocation that maximizes the fault diagnosibility, subject to specified weight, volume, power, and cost constraints is required. Use of optimal sensor allocation strategies during the design phase can ensure better diagnostics at a reduced cost for a system incorporating a high degree of built-in testing. In this paper, we propose an approach that employs multiple fault diagnosis (MFD) and optimization techniques for optimal sensor placement for fault detection and isolation (FDI) in complex systems. Keywords: sensor allocation, multiple fault diagnosis, Lagrangian relaxation, approximate belief revision, multidimensional knapsack problem.

  11. Laryngeal mask airway: an alternative for the difficult airway.

    PubMed

    Jones, J R

    1995-10-01

    The laryngeal mask airway (LMA) was invented by Dr. Archie Brain at the London Hospital, Whitechapel, in 1981. Dr. Brain's main objective for the LMA was that it would provide a better method of maintaining a patient's airway than by face mask. Also, the LMA would be less hemodynamically stressful than with insertion of an endotracheal tube. The LMA consists of a silicone rubber tube connected to a miniature silicone mask. The perimeter of the mask consists of an inflatable elliptical cuff, which forms a tip at the distal aspect of the LMA. The aperture bars in the dome of the mask lift the epiglottis away, so the lumen remains unobstructive. The LMA forms a low pressure seal around the larynx. The LMA is contraindicated in any situation where the patient is at risk for pulmonary aspiration. The LMA is not a substitute for a properly placed endotracheal tube in this situation. The American Society of Anesthesiologists' difficult airway algorithm recommends the insertion of an LMA when ventilation and/or intubation are difficult. The distal aperture of the LMA is in close approximation to the vocal cords, so a 6.0-mm internal diameter endotracheal tube can be passed over an intubating stylet or a pediatric fiberoptic bronchoscope to secure a patient's airway. PMID:7502644

  12. [Airway equipment and its maintenance for a non difficult adult airway management (endotracheal intubation and its alternative: face mask, laryngeal mask airway, laryngeal tube)].

    PubMed

    Francon, D; Estèbe, J P; Ecoffey, C

    2003-08-01

    The airway equipment for a non difficult adult airway management are described: endotracheal tubes with a specific discussion on how to inflate the balloon, laryngoscopes and blades, stylets and intubation guides, oral airways, face masks, laryngeal mask airways and laryngeal tubes. Cleaning and disinfections with the maintenance are also discussed for each type of airway management. PMID:12943860

  13. Systematic Task Allocation Evaluation in Distributed Software Development

    NASA Astrophysics Data System (ADS)

    Münch, Jürgen; Lamersdorf, Ansgar

    Systematic task allocation to different development sites in global software development projects can open business and engineering perspectives and help to reduce risks and problems inherent in distributed development. Relying only on a single evaluation criterion such as development cost when distributing tasks to development sites has shown to be very risky and often does not lead to successful solutions in the long run. Task allocation in global software projects is challenging due to a multitude of impact factors and constraints. Systematic allocation decisions require the ability to evaluate and compare task allocation alternatives and to effectively establish customized task allocation practices in an organization. In this article, we present a customizable process for task allocation evaluation that is based on results from a systematic interview study with practitioners. In this process, the relevant criteria for evaluating task allocation alternatives are derived by applying principles from goal-oriented measurement. In addition, the customization of the process is demonstrated, related work and limitations are sketched, and an outlook on future work is given.

  14. Jaw thrust can deteriorate upper airway patency.

    PubMed

    von Ungern-Sternberg, B S; Erb, T O; Frei, F J

    2005-04-01

    Upper airway obstruction is a frequent problem in spontaneously breathing children undergoing anesthesia or sedation procedures. Failure to maintain a patent airway can rapidly result in severe hypoxemia, bradycardia, or asystole, as the oxygen demand of children is high and oxygen reserve is low. We present two children with cervical masses in whom upper airway obstruction exaggerated while the jaw thrust maneuver was applied during induction of anesthesia. This deterioration in airway patency was probably caused by medial displacement of the lateral tumorous tissues which narrowed the pharyngeal airway. PMID:15777312

  15. Activity-Based Costing Systems for Higher Education.

    ERIC Educational Resources Information Center

    Day, Dennis H.

    1993-01-01

    Examines traditional costing models utilized in higher education and pinpoints shortcomings related to proper identification of costs. Describes activity-based costing systems as a superior alternative for cost identification, measurement, and allocation. (MLF)

  16. Sensory neuropeptides and airway function.

    PubMed

    Solway, J; Leff, A R

    1991-12-01

    Sensory nerves synthesize tachykinins and calcitonin-gene related peptide and package these neuropeptides together in synaptic vesicles. Stimulation of these C-fibers by a range of chemical and physical factors results in afferent neuronal conduction that elicits central parasympathetic reflexes and in antidromic conduction that results in local release of neuropeptides through the axon reflex. In the airways, sensory neuropeptides act on bronchial smooth muscle, the mucosal vasculature, and submucosal glands to promote airflow obstruction, hyperemia, microvascular hyperpermeability, and mucus hypersecretion. In addition, tachykinins potentiate cholinergic neurotransmission. Proinflammatory effects of these peptides also promote the recruitment, adherence, and activation of granulocytes that may further exacerbate neurogenic inflammation (i.e., neuropeptide-induced plasma extravasation and vasodilation). Enzymatic degradation limits the physiological effects of tachykinins but may be impaired by respiratory infection or other factors. Given their sensitivity to noxious compounds and physical stimuli and their potent effects on airway function, it is possible that neuropeptide-containing sensory nerves play an important role in mediating airway responses in human disease. Supporting this view are the striking phenomenological similarities between hyperpnea-induced bronchoconstriction (HIB) in guinea pigs and HIB in patients with exercise-induced asthma. Endogenous tachykinins released from airway sensory nerves mediate HIB in guinea pigs and also cause hyperpnea-induced bronchovascular hyperpermeability in these animals. On the basis of these observations, it is reasonable to speculate that sensory neuropeptides participate in the pathogenesis of hyperpnea-induced airflow obstruction in human asthmatic subjects as well. PMID:1663932

  17. Equitable fund allocation, an economical approach for sustainable waste load allocation.

    PubMed

    Ashtiani, Elham Feizi; Niksokhan, Mohammad Hossein; Jamshidi, Shervin

    2015-08-01

    This research aims to study a novel approach for waste load allocation (WLA) to meet environmental, economical, and equity objectives, simultaneously. For this purpose, based on a simulation-optimization model developed for Haraz River in north of Iran, the waste loads are allocated according to discharge permit market. The non-dominated solutions are initially achieved through multiobjective particle swarm optimization (MOPSO). Here, the violation of environmental standards based on dissolved oxygen (DO) versus biochemical oxidation demand (BOD) removal costs is minimized to find economical total maximum daily loads (TMDLs). This can save 41% in total abatement costs in comparison with the conventional command and control policy. The BOD discharge permit market then increases the revenues to 45%. This framework ensures that the environmental limits are fulfilled but the inequity index is rather high (about 4.65). For instance, the discharge permit buyer may not be satisfied about the equity of WLA. Consequently, it is recommended that a third party or institution should be in charge of reallocating the funds. It means that the polluters which gain benefits by unfair discharges should pay taxes (or funds) to compensate the losses of other polluters. This intends to reduce the costs below the required values of the lowest inequity index condition. These compensations of equitable fund allocation (EFA) may help to reduce the dissatisfactions and develop WLA policies. It is concluded that EFA in integration with water quality trading (WQT) is a promising approach to meet the objectives. PMID:26205280

  18. A Persistent and Diverse Airway Microbiota Present during Chronic Obstructive Pulmonary Disease Exacerbations

    PubMed Central

    Huang, Yvonne J.; Kim, Eugenia; Cox, Michael J.; Brodie, Eoin L.; Brown, Ron; Wiener-Kronish, Jeanine P.

    2010-01-01

    Abstract Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a major source of morbidity and contribute significantly to healthcare costs. Although bacterial infections are implicated in nearly 50% of exacerbations, only a handful of pathogens have been consistently identified in COPD airways, primarily by culture-based methods, and the bacterial microbiota in acute exacerbations remains largely uncharacterized. The aim of this study was to comprehensively profile airway bacterial communities using a culture-independent microarray, the 16S rRNA PhyloChip, of a cohort of COPD patients requiring ventilatory support and antibiotic therapy for exacerbation-related respiratory failure. PhyloChip analysis revealed the presence of over 1,200 bacterial taxa representing 140 distinct families, many previously undetected in airway diseases; bacterial community composition was strongly influenced by the duration of intubation. A core community of 75 taxa was detected in all patients, many of which are known pathogens. Bacterial community diversity in COPD airways is substantially greater than previously recognized and includes a number of potential pathogens detected in the setting of antibiotic exposure. Comprehensive assessment of the COPD airway microbiota using high-throughput, culture-independent methods may prove key to understanding the relationships between airway bacterial colonization, acute exacerbation, and clinical outcomes in this and other chronic inflammatory airway diseases. PMID:20141328

  19. Systems-level airway models of bronchoconstriction.

    PubMed

    Donovan, Graham M

    2016-09-01

    Understanding lung and airway behavior presents a number of challenges, both experimental and theoretical, but the potential rewards are great in terms of both potential treatments for disease and interesting biophysical phenomena. This presents an opportunity for modeling to contribute to greater understanding, and here, we focus on modeling efforts that work toward understanding the behavior of airways in vivo, with an emphasis on asthma. We look particularly at those models that address not just isolated airways but many of the important ways in which airways are coupled both with each other and with other structures. This includes both interesting phenomena involving the airways and the layer of airway smooth muscle that surrounds them, and also the emergence of spatial ventilation patterns via dynamic airway interaction. WIREs Syst Biol Med 2016, 8:459-467. doi: 10.1002/wsbm.1349 For further resources related to this article, please visit the WIREs website. PMID:27348217

  20. The Importance of Airway Management in Trauma

    PubMed Central

    Jacobs, Lenworth M.

    1988-01-01

    The airway is the most important priority in the management of the severely injured patient. It is essential to open and clear the airway to allow free access of air to the distal endobronchial tree. Manual methods of opening the airway are described. Numerous methods for establishing definitive control of the airway as well as the associated devices currently available to maintain control are described. Once the airway is maintained, it is important to ensure adequate oxygenation and ventilation through the airway. Modern portable devices that monitor the carbon dioxide in the expired air at the end of each breath are currently available. These devices allow the physician to verify the position of the tube in the airway as well as to continuously monitor the efficacy of ventilation. PMID:3073226

  1. Sarcoidosis of the upper and lower airways.

    PubMed

    Morgenthau, Adam S; Teirstein, Alvin S

    2011-12-01

    Sarcoidosis is a systemic granulomatous disease of undetermined etiology characterized by a variable clinical presentation and disease course. Although clinical granulomatous inflammation may occur within any organ system, more than 90% of sarcoidosis patients have lung disease. Sarcoidosis is considered an interstitial lung disease that is frequently characterized by restrictive physiologic dysfunction on pulmonary function tests. However, sarcoidosis also involves the airways (large and small), causing obstructive airways disease. It is one of a few interstitial lung diseases that affects the entire length of the respiratory tract - from the nose to the terminal bronchioles - and causes a broad spectrum of airways dysfunction. This article examines airway dysfunction in sarcoidosis. The anatomical structure of the airways is the organizational framework for our discussion. We discuss sarcoidosis involving the nose, sinuses, nasal passages, larynx, trachea, bronchi and small airways. Common complications of airways disease, such as, atelectasis, fibrosis, bullous leions, bronchiectasis, cavitary lesions and mycetomas, are also reviewed. PMID:22082167

  2. 48 CFR 31.202 - Direct costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Direct costs. 31.202... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.202 Direct costs. (a) No final cost objective shall have allocated to it as a direct cost any cost, if other...

  3. 48 CFR 31.202 - Direct costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Direct costs. 31.202... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.202 Direct costs. (a) No final cost objective shall have allocated to it as a direct cost any cost, if other...

  4. 48 CFR 31.202 - Direct costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Direct costs. 31.202... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.202 Direct costs. (a) No final cost objective shall have allocated to it as a direct cost any cost, if other...

  5. 48 CFR 31.202 - Direct costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Direct costs. 31.202... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.202 Direct costs. (a) No final cost objective shall have allocated to it as a direct cost any cost, if other...

  6. Allocations for HANDI 2000 business management system

    SciTech Connect

    Wilson, D.

    1998-08-24

    The Data Integration 2000 Project will result in an integrated and comprehensive set of functional applications containing core information necessary to support the Project Hanford Management Contract. It is based on the Commercial-Off-The-Shelf product solution with commercially proven business processes. The COTS product solution set, of PassPort and People Soft software, supports finance, supply and chemical management/Material Safety Data Sheet, human resources. Allocations at Fluor Daniel Hanford are burdens added to base costs using a predetermined rate.

  7. Noninvasive clearance of airway secretions.

    PubMed

    Hardy, K A; Anderson, B D

    1996-06-01

    Airway clearance techniques are indicated for specific diseases that have known clearance abnormalities (Table 2). Murray and others have commented that such techniques are required only for patients with a daily sputum production of greater than 30 mL. The authors have observed that patients with diseases known to cause clearance abnormalities can have sputum clearance with some techniques, such as positive expiratory pressure, autogenic drainage, and active cycle of breathing techniques, when PDPV has not been effective. Hasani et al has shown that use of the forced exhalatory technique in patients with nonproductive cough still resulted in movement of secretions proximally from all regions of the lung in patients with airway obstruction. It is therefore reasonable to consider airway clearance techniques for any patient who has a disease known to alter mucous clearance, including CF, dyskinetic cilia syndromes, and bronchiectasis from any cause. Patients with atelectasis from mucous plugs and hypersecretory states, such as asthma and chronic bronchitis, patients with pain secondary to surgical procedures, and patients with neuromuscular disease, weak cough, and abnormal patency of the airway may also benefit from the application of airway clearance techniques. Infants and children up to 3 years of age with airway clearance problems need to be treated with PDPV. Manual percussion with hands alone or a flexible face mask or cup and small mechanical vibrator/percussors, such as the ultrasonic devices, can be used. The intrapulmonary percussive ventilator shows growing promise in this area. The high-frequency oscillator is not supplied with vests of appropriate sizes for tiny babies and has not been studied in this group. Young patients with neuromuscular disease may require assisted ventilation and airway oscillations can be applied. CPAP alone has been shown to improve achievable flow rates that will increase air-liquid interactions for patients with these diseases

  8. Interaction between haemopoietic regulation and airway inflammation.

    PubMed

    O'Byrne, P M; Gauvreau, G M; Wood, L J

    1999-06-01

    Asthma is characterized by reversible airway narrowing, by airway hyperresponsiveness, and by airway inflammation. Inhaled allergens are the most important of the stimuli known to cause asthma. Methods for studying inhaled allergen in the laboratory have been well standardized and extensively used for the investigation of the pathophysiology and the pharmacological modulation of allergen-induced airway responses. Allergen inhalation by a sensitized subject results in an early asthmatic response, and, in the majority of subjects, a late asthmatic response and airway hyperresponsiveness. The late response and airway hyperresponsiveness are associated with increases in airway eosinophils and metachromatic cells. Allergen-induced airway inflammation in dogs (predominantly neutrophilic) is associated with increased granulocyte-macrophage progenitors in bone marrow, which is dependent on the effects of a circulating serum factor stimulating the bone marrow. The newly formed cells traffic to the airways. These increases in granulocyte-macrophage progenitors are blocked by inhaled corticosteroids. In human subjects, allergen-induced eosinophilic inflammation is associated with increases in Eo/B progenitors, mediated through up-regulation if the IL-5 receptor on progenitors and increases responsiveness to IL-5. Inhaled corticosteroids also attenuate all allergen-induced physiological responses and airway inflammation, an effect possibly mediated, in part, through inhibition of eosinophil and basophil maturation or release from the bone marrow. PMID:10421819

  9. Paediatric airway management: What is new?

    PubMed Central

    Ramesh, S; Jayanthi, R; Archana, SR

    2012-01-01

    Airway management plays a pivotal role in Paediatric Anaesthesia. Over the last two decades many improvements in this area have helped us to overcome this final frontier. From an era where intubation with a conventional laryngoscope or blind nasal intubation was the only tool for airway management, we have come a long way. Today supraglottic airway devices have pride of place in the Operating Room and are becoming important airway devices used in routine procedures. Direct and indirect fibreoptic laryngoscopes and transtracheal devices help us overcome difficult and previously impossible airway situations. These developments mean that we need to update our knowledge on these devices. Also much of our basic understanding of the physiology and anatomy of the paediatric airway has changed. This article attempts to shed light on some of the most important advances/opinions in paediatric airway management like, cuffed endotracheal tubes, supraglottic airway devices, video laryngoscopes, rapid sequence intubation, the newly proposed algorithm for difficult airway management and the role of Ex Utero Intrapartum Treatment (EXIT) procedure in the management of the neonatal airway. PMID:23293383

  10. Collaborative Resource Allocation

    NASA Technical Reports Server (NTRS)

    Wang, Yeou-Fang; Wax, Allan; Lam, Raymond; Baldwin, John; Borden, Chester

    2007-01-01

    Collaborative Resource Allocation Networking Environment (CRANE) Version 0.5 is a prototype created to prove the newest concept of using a distributed environment to schedule Deep Space Network (DSN) antenna times in a collaborative fashion. This program is for all space-flight and terrestrial science project users and DSN schedulers to perform scheduling activities and conflict resolution, both synchronously and asynchronously. Project schedulers can, for the first time, participate directly in scheduling their tracking times into the official DSN schedule, and negotiate directly with other projects in an integrated scheduling system. A master schedule covers long-range, mid-range, near-real-time, and real-time scheduling time frames all in one, rather than the current method of separate functions that are supported by different processes and tools. CRANE also provides private workspaces (both dynamic and static), data sharing, scenario management, user control, rapid messaging (based on Java Message Service), data/time synchronization, workflow management, notification (including emails), conflict checking, and a linkage to a schedule generation engine. The data structure with corresponding database design combines object trees with multiple associated mortal instances and relational database to provide unprecedented traceability and simplify the existing DSN XML schedule representation. These technologies are used to provide traceability, schedule negotiation, conflict resolution, and load forecasting from real-time operations to long-range loading analysis up to 20 years in the future. CRANE includes a database, a stored procedure layer, an agent-based middle tier, a Web service wrapper, a Windows Integrated Analysis Environment (IAE), a Java application, and a Web page interface.

  11. Airway anastomosis for lung transplantation

    PubMed Central

    Diso, Daniele; Rendina, Erino Angelo; Venuta, Federico

    2016-01-01

    Lung transplantation (LT) is the only viable option for a selected group of patients with end stage pulmonary diseases. During the recent years satisfactory results in terms of long-term survival and quality of life have been achieved with improvements in surgical technique, immunosuppression and perioperative management. Since the beginning, the airway anastomosis has been considered crucial and significant efforts have been made to understand the healing process. A number of experimental studies allowed improving the surgical technique by modifying the technique of suturing, the anastomotic protection and type and dose of immunosuppression, reducing the risk of airway complications. Furthermore, a huge progress has been made in the management of such complications. Early diagnosis of bronchial complications and their prompt and correct management are crucial to achieve long-term survival. PMID:26981271

  12. 20 CFR 627.435 - Cost principles and allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... OMB Circulars identified in DOL's regulations at 29 CFR 97.22(b). (c) Costs allocable to another... unforeseen events; (7) Costs prohibited by 29 CFR part 93 (Lobbying Restrictions) or costs of any salaries or expenses related to any activity designed to influence legislation or appropriations pending before...

  13. 44 CFR 302.5 - Allocations and reallocations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (33) percent will be allocated on the basis of the ratio of the State's population to the national... administrative services in that State; that is, whether such costs are considerably above or below the national... are to be released to headquarters for reallocation on a national basis. In addition, the...

  14. 44 CFR 302.5 - Allocations and reallocations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (33) percent will be allocated on the basis of the ratio of the State's population to the national... administrative services in that State; that is, whether such costs are considerably above or below the national... are to be released to headquarters for reallocation on a national basis. In addition, the...

  15. 44 CFR 302.5 - Allocations and reallocations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (33) percent will be allocated on the basis of the ratio of the State's population to the national... administrative services in that State; that is, whether such costs are considerably above or below the national... are to be released to headquarters for reallocation on a national basis. In addition, the...

  16. Partial airway obstruction following manufacturing defect in laryngeal mask airway (Laryngeal Mask Silken™).

    PubMed

    Jangra, Kiran; Malhotra, Surender Kumar; Saini, Vikas

    2014-10-01

    Laryngeal mask (LM) airway is commonly used for securing airway in day-care surgeries. Various problems have been described while using LM airway. Out of those, mechanical obstruction causing airway compromise is most common. Here, we describe a case report of 4-year-old child who had partial upper airway obstruction due to LM manufacturer's defect. There was a silicon band in upper one-third of shaft of LM airway. This band was made up of the same material as that of LM airway so it was not identifiable on external inspection of transparent shaft. We suggest that such as non-transparent laryngeal mask, a transparent LM airway should also be inspected looking inside the lumen with naked eyes or by using a probe to rule out any manufacturing defect before its insertion. PMID:25422617

  17. Airway management in cervical spine injury

    PubMed Central

    Austin, Naola; Krishnamoorthy, Vijay; Dagal, Arman

    2014-01-01

    To minimize risk of spinal cord injury, airway management providers must understand the anatomic and functional relationship between the airway, cervical column, and spinal cord. Patients with known or suspected cervical spine injury may require emergent intubation for airway protection and ventilatory support or elective intubation for surgery with or without rigid neck stabilization (i.e., halo). To provide safe and efficient care in these patients, practitioners must identify high-risk patients, be comfortable with available methods of airway adjuncts, and know how airway maneuvers, neck stabilization, and positioning affect the cervical spine. This review discusses the risks and benefits of various airway management strategies as well as specific concerns that affect patients with known or suspected cervical spine injury. PMID:24741498

  18. Airway injury during high-level exercise.

    PubMed

    Kippelen, Pascale; Anderson, Sandra D

    2012-05-01

    Airway epithelial cells act as a physical barrier against environmental toxins and injury, and modulate inflammation and the immune response. As such, maintenance of their integrity is critical. Evidence is accumulating to suggest that exercise can cause injury to the airway epithelium. This seems the case particularly for competitive athletes performing high-level exercise, or when exercise takes place in extreme environmental conditions such as in cold dry air or in polluted air. Dehydration of the small airways and increased forces exerted on to the airway surface during severe hyperpnoea are thought to be key factors in determining the occurrence of injury of the airway epithelium. The injury-repair process of the airway epithelium may contribute to the development of the bronchial hyper-responsiveness that is documented in many elite athletes. PMID:22247295

  19. Genetic association between male attractiveness and female differential allocation

    PubMed Central

    Head, Megan L; Hunt, John; Brooks, Robert

    2006-01-01

    Differential allocation of reproductive effort towards offspring of attractive mates is a form of post-copulatory mate choice. Although differential allocation has been demonstrated in many taxa, its evolutionary implications have received little attention. Theory predicts that mate choice will lead to a positive genetic correlation between female preference and male attractiveness. This prediction has been upheld for pre-copulatory mate choice, but whether such a relationship between male attractiveness and female differential allocation exists has never been tested. Here, we show that both female pre-copulatory mate choice and post-copulatory differential allocation are genetically associated with male attractiveness in house crickets, Acheta domesticus. Daughters of attractive males mated sooner and laid more eggs when paired with larger males. These forms of mate choice are strongest in large females, suggesting that costs decrease with increasing female size. The genetic association between attractiveness and differential allocation suggests potential for differential allocation to become exaggerated by coevolutionary runaway processes in an analogous manner to pre-copulatory choice. Sexual selection is thus likely to be stronger than predicted by pre-copulatory choice alone. PMID:17148398

  20. Quadratic Programming for Allocating Control Effort

    NASA Technical Reports Server (NTRS)

    Singh, Gurkirpal

    2005-01-01

    A computer program calculates an optimal allocation of control effort in a system that includes redundant control actuators. The program implements an iterative (but otherwise single-stage) algorithm of the quadratic-programming type. In general, in the quadratic-programming problem, one seeks the values of a set of variables that minimize a quadratic cost function, subject to a set of linear equality and inequality constraints. In this program, the cost function combines control effort (typically quantified in terms of energy or fuel consumed) and control residuals (differences between commanded and sensed values of variables to be controlled). In comparison with prior control-allocation software, this program offers approximately equal accuracy but much greater computational efficiency. In addition, this program offers flexibility, robustness to actuation failures, and a capability for selective enforcement of control requirements. The computational efficiency of this program makes it suitable for such complex, real-time applications as controlling redundant aircraft actuators or redundant spacecraft thrusters. The program is written in the C language for execution in a UNIX operating system.

  1. 42 CFR 417.566 - Other methods of allocation and apportionment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.566 Other methods of allocation... 42 Public Health 3 2011-10-01 2011-10-01 false Other methods of allocation and apportionment. 417.566 Section 417.566 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  2. 42 CFR 417.566 - Other methods of allocation and apportionment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.566 Other methods of allocation... 42 Public Health 3 2010-10-01 2010-10-01 false Other methods of allocation and apportionment. 417.566 Section 417.566 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  3. 78 FR 32296 - Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... Federal Transit Administration Second Allocation of Public Transportation Emergency Relief Funds in... Administration (FTA) announces the allocation of $3.7 billion under the Public Transportation Emergency Relief... costs after an emergency or major disaster that affects public transportation systems. The...

  4. Airway Assessment for Office Sedation/Anesthesia.

    PubMed

    Rosenberg, Morton B; Phero, James C

    2015-01-01

    Whenever a patient is about to receive sedation or general anesthesia, no matter what the technique, the preoperative assessment of the airway is one of the most important steps in ensuring patient safety and positive outcomes. This article, Part III in the series on airway management, is directed at the ambulatory office practice and focuses on predicting the success of advanced airway rescue techniques. PMID:26061578

  5. A bug's view of allergic airways disease.

    PubMed

    Hsu, Peter S; Campbell, Dianne E

    2016-06-01

    The increase in allergic airways disease has been linked to modern urbanization and lifestyle. Recent evidence suggests that the associated reduction in microbial exposure, reduction in dietary fibre intake and increased antibiotic use may cause early dysbiosis in infancy, which predisposes to immune dysregulation and allergic airways disease later in life. This implies that there may be a window of opportunity for primary prevention strategies aimed to protect or restore the microbiome early in life and thereby decrease the risk of developing allergic airways disease. Alternatively, strategies that correct dysbiosis may aid in the treatment of established allergic airways disease. PMID:27012478

  6. Airway vascular damage in elite swimmers.

    PubMed

    Moreira, André; Palmares, Carmo; Lopes, Cristina; Delgado, Luís

    2011-11-01

    We postulated that high level swimming can promote airway inflammation and thus asthma by enhancing local vascular permeability. We aimed to test this hypothesis by a cross-sectional study comparing swimmers (n = 13, 17 ± 3 years, competing 7 ± 4 years, training 18 ± 3 h per week), asthmatic-swimmers (n = 6, 17 ± 2 years, competing 8 ± 3 years, training 16 ± 4 h per week), and asthmatics (n = 19, 14 ± 3 years). Subjects performed induced sputum and had exhaled nitric oxide, lung volumes, and airway responsiveness determined. Airway vascular permeability index was defined as the ratio of albumin in sputum and serum. Results from the multiple linear regression showed each unit change in airway vascular permeability index was associated with an increase of 0.97% (95%CI: 0.02 to 1.92; p = 0.047) in sputum eosinophilis, and of 2.64% (95%CI:0.96 to 4.31; p = 0.006) in sputum neutrophils after adjustment for confounders. In a general linear model no significant differences between airway vascular permeability between index study groups existed, after controlling for sputum eosinophilis and neutrophils. In conclusion, competitive swimmers training in chlorine-rich pools have similar levels of airway vascular permeability than asthmatics. Although competitive swimming has been associated with asthma, airway inflammation and airway hyperesponsiveness do not seem to be dependent on increased airway vascular permeability. PMID:21669516

  7. Automated lobe-based airway labeling.

    PubMed

    Gu, Suicheng; Wang, Zhimin; Siegfried, Jill M; Wilson, David; Bigbee, William L; Pu, Jiantao

    2012-01-01

    Regional quantitative analysis of airway morphological abnormalities is of great interest in lung disease investigation. Considering that pulmonary lobes are relatively independent functional unit, we develop and test a novel and efficient computerized scheme in this study to automatically and robustly classify the airways into different categories in terms of pulmonary lobe. Given an airway tree, which could be obtained using any available airway segmentation scheme, the developed approach consists of four basic steps: (1) airway skeletonization or centerline extraction, (2) individual airway branch identification, (3) initial rule-based airway classification/labeling, and (4) self-correction of labeling errors. In order to assess the performance of this approach, we applied it to a dataset consisting of 300 chest CT examinations in a batch manner and asked an image analyst to subjectively examine the labeled results. Our preliminary experiment showed that the labeling accuracy for the right upper lobe, the right middle lobe, the right lower lobe, the left upper lobe, and the left lower lobe is 100%, 99.3%, 99.3%, 100%, and 100%, respectively. Among these, only two cases are incorrectly labeled due to the failures in airway detection. It takes around 2 minutes to label an airway tree using this algorithm. PMID:23093951

  8. Airway sonography in live models and cadavers.

    PubMed

    Tsui, Ban; Ip, Vivian; Walji, Anil

    2013-06-01

    Sonography using cadavers is beneficial in teaching and learning sonoanatomy, which is particularly important because imaging of the airway can be challenging due to the cartilaginous landmarks and air artifacts. In this exploratory study, we have attempted to compare the airway sonoanatomy of cadavers and live models. Our observations support the use of cadavers as teaching tools for learning airway sonoanatomy and practicing procedures involving airway structures, such as superior laryngeal nerve blocks, transtracheal injections, and needle cricothyroidotomy, before performance on patients in clinical situations. We believe this process will improve patient safety and enhance the competency of trainees and practitioners in rare procedures such as needle cricothyroidotomy. PMID:23716527

  9. Anatomic Optical Coherence Tomography of Upper Airways

    NASA Astrophysics Data System (ADS)

    Chin Loy, Anthony; Jing, Joseph; Zhang, Jun; Wang, Yong; Elghobashi, Said; Chen, Zhongping; Wong, Brian J. F.

    The upper airway is a complex and intricate system responsible for respiration, phonation, and deglutition. Obstruction of the upper airways afflicts an estimated 12-18 million Americans. Pharyngeal size and shape are important factors in the pathogenesis of airway obstructions. In addition, nocturnal loss in pharyngeal muscular tone combined with high pharyngeal resistance can lead to collapse of the airway and periodic partial or complete upper airway obstruction. Anatomical optical coherence tomography (OCT) has the potential to provide high-speed three-dimensional tomographic images of the airway lumen without the use of ionizing radiation. In this chapter we describe the methods behind endoscopic OCT imaging and processing to generate full three dimensional anatomical models of the human airway which can be used in conjunction with numerical simulation methods to assess areas of airway obstruction. Combining this structural information with flow dynamic simulations, we can better estimate the site and causes of airway obstruction and better select and design surgery for patients with obstructive sleep apnea.

  10. Physical principle of airway design in human lungs

    NASA Astrophysics Data System (ADS)

    Park, Keunhwan; Son, Taeho; Kim, Wonjung; Kim, Ho-Young

    2014-11-01

    From an engineering perspective, lungs are natural microfluidic devices that extract oxygen from air. In the bronchial tree, airways branch by dichotomy with a systematic reduction of their diameters. It is generally accepted that in conducting airways, which air passes on the way to the acinar airways from the atmosphere, the reduction ratio of diameter is closely related to the minimization of viscous dissipation. Such a principle is formulated as the Hess-Murray law. However, in acinar airways, where oxygen transfer to alveolae occurs, the diameter reduction with progressive generations is more moderate than in conducting airways. Noting that the dominant transfer mechanism in acinar airways is diffusion rather than advection, unlike conducting airways, we construct a mathematical model for oxygen transfer through a series of acinar airways. Our model allows us to predict the optimal airway reduction ratio that maximizes the oxygen transfer in a finite airway volume, thereby rationalizing the observed airway reduction ratio in acinar airways.

  11. 49 CFR 266.11 - Allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Allowable costs. 266.11 Section 266.11... TRANSPORTATION ACT § 266.11 Allowable costs. Allowable costs include only the following costs which are properly allocable to the work performed: Planning and program operation costs which are allowed under...

  12. 48 CFR 31.203 - Indirect costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... coverage, the contractor shall follow the criteria and guidance in 48 CFR 9904.406 for selecting the cost... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.203 Indirect... final cost objectives. No final cost objective shall have allocated to it as an indirect cost any...

  13. A comparative study on the usefulness of the Glidescope or Macintosh laryngoscope when intubating normal airways

    PubMed Central

    Choi, Guen Seok; Lee, Eun-Ha; Lim, Chae Seong

    2011-01-01

    Background The Glidescope Videolaryngoscope (GVL) is a newly developed video laryngoscope. It offers a significantly improved laryngeal view and facilitates endotracheal intubation in difficult airways, but it is controversial in that it offers an improved laryngeal view in normal airways as well. And the price of GVL is expensive. We hypothesized that intubation carried out by fully experienced anesthesiologists using the GVL with appropriate pre-anesthetic preparations offers an improved laryngeal view and shortened intubation time in normal airways. Therefore, the aim of this study was to compare the GVL with the Macintosh laryngoscope in normal airways and to determine whether GVL can substitute the Macintosh laryngoscope. Methods This study included 60 patients with an ASA physical status of class 1 or 2 requiring tracheal intubation for elective surgery. All patients were randomly allocated into two groups, GVL (group G) or Macintosh (group M). ADS (airway difficulty score) was recorded before induction of anesthesia. The anesthesiologist scored vocal cord visualization using the percentage of glottic opening (POGO) visible and the subjective ease of intubation on a visual analogue scale (VAS). The time required to intubate was recorded by an assistant. Results There was a significant increase in POGO when using the GVL (P < 0.05). However, there was no difference in the time required for a successful tracheal intubation using the GVL compared with the Macintosh laryngoscope. The VAS score on the ease of intubation was significantly lower for the GVL than for the Macintosh laryngoscope (P < 0.05). Conclusions GVL could be a first-line tool in normal airways. PMID:21716906

  14. 24 CFR 92.50 - Formula allocation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Formula allocation. 92.50 Section 92.50 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Allocation Formula § 92.50 Formula allocation. (a) Jurisdictions eligible for a formula allocation. HUD...

  15. Integration and Task Allocation: Evidence from Patient Care*

    PubMed Central

    David, Guy; Rawley, Evan; Polsky, Daniel

    2013-01-01

    Using the universe of patient transitions from inpatient hospital care to skilled nursing facilities and home health care in 2005, we show how integration eliminates task misallocation problems between organizations. We find that vertical integration allows hospitals to shift patient recovery tasks downstream to lower-cost organizations by discharging patients earlier (and in poorer health) and increasing post-hospitalization service intensity. While integration facilitates a shift in the allocation of tasks and resources, health outcomes either improved or were unaffected by integration on average. The evidence suggests that integration solves coordination problems that arise in market exchange through improvements in the allocation of tasks across care settings. PMID:24415893

  16. Collective credit allocation in science

    PubMed Central

    Shen, Hua-Wei; Barabási, Albert-László

    2014-01-01

    Collaboration among researchers is an essential component of the modern scientific enterprise, playing a particularly important role in multidisciplinary research. However, we continue to wrestle with allocating credit to the coauthors of publications with multiple authors, because the relative contribution of each author is difficult to determine. At the same time, the scientific community runs an informal field-dependent credit allocation process that assigns credit in a collective fashion to each work. Here we develop a credit allocation algorithm that captures the coauthors’ contribution to a publication as perceived by the scientific community, reproducing the informal collective credit allocation of science. We validate the method by identifying the authors of Nobel-winning papers that are credited for the discovery, independent of their positions in the author list. The method can also compare the relative impact of researchers working in the same field, even if they did not publish together. The ability to accurately measure the relative credit of researchers could affect many aspects of credit allocation in science, potentially impacting hiring, funding, and promotion decisions. PMID:25114238

  17. 48 CFR 9904.403 - Allocation of home office expenses to segments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Allocation of home office expenses to segments. 9904.403 Section 9904.403 Federal Acquisition Regulations System COST ACCOUNTING... segments....

  18. School District Program Cost Accounting: An Alternative Approach

    ERIC Educational Resources Information Center

    Hentschke, Guilbert C.

    1975-01-01

    Discusses the value for school districts of a program cost accounting system and examines different approaches to generating program cost data, with particular emphasis on the "cost allocation to program system" (CAPS) and the traditional "transaction-based system." (JG)

  19. Effects of tracheal airway occlusion on hyoid muscle length and upper airway volume.

    PubMed

    van Lunteren, E; Haxhiu, M A; Cherniack, N S

    1989-12-01

    Complex relationships exist among electromyograms (EMGs) of the upper airway muscles, respective changes in muscle length, and upper airway volume. To test the effects of preventing lung inflation on these relationships, recordings were made of EMGs and length changes of the geniohyoid (GH) and sternohyoid (SH) muscles as well as of tidal changes in upper airway volume in eight anesthetized cats. During resting breathing, tracheal airway occlusion tended to increase the inspiratory lengthening of GH and SH. In response to progressive hypercapnia, the GH eventually shortened during inspiration in all animals; the extent of muscle shortening was minimally augmented by airway occlusion despite substantial increases in EMGs. SH lengthened during inspiration in six of eight animals under hypercapnic conditions, and in these cats lengthening was greater during airway occlusion even though EMGs increased. Despite the above effects on SH and GH length, upper airway tidal volume was increased significantly by tracheal occlusion under hypercapnic conditions. These data suggest that the thoracic and upper airway muscle reflex effects of preventing lung inflation during inspiration act antagonistically on hyoid muscle length, but, because of the mechanical arrangement of the hyoid muscles relative to the airway and thorax, they act agonistically to augment tidal changes in upper airway volume. The augmentation of upper airway tidal volume may occur in part as a result of the effects of thoracic movements being passively transmitted through the hyoid muscles. PMID:2606835

  20. Airway smooth muscle dynamics: a common pathway of airway obstruction in asthma

    PubMed Central

    An, S.S.; Bai, T.R.; Bates, J.H.T.; Black, J.L.; Brown, R.H.; Brusasco, V.; Chitano, P.; Deng, L.; Dowell, M.; Eidelman, D.H.; Fabry, B.; Fairbank, N.J.; Ford, L.E.; Fredberg, J.J.; Gerthoffer, W.T.; Gilbert, S.H.; Gosens, R.; Gunst, S.J.; Halayko, A.J.; Ingram, R.H.; Irvin, C.G.; James, A.L.; Janssen, L.J.; King, G.G.; Knight, D.A.; Lauzon, A.M.; Lakser, O.J.; Ludwig, M.S.; Lutchen, K.R.; Maksym, G.N.; Martin, J.G.; Mauad, T.; McParland, B.E.; Mijailovich, S.M.; Mitchell, H.W.; Mitchell, R.W.; Mitzner, W.; Murphy, T.M.; Paré, P.D.; Pellegrino, R.; Sanderson, M.J.; Schellenberg, R.R.; Seow, C.Y.; Silveira, P.S.P.; Smith, P.G.; Solway, J.; Stephens, N.L.; Sterk, P.J.; Stewart, A.G.; Tang, D.D.; Tepper, R.S.; Tran, T.; Wang, L.

    2008-01-01

    Excessive airway obstruction is the cause of symptoms and abnormal lung function in asthma. As airway smooth muscle (ASM) is the effecter controlling airway calibre, it is suspected that dysfunction of ASM contributes to the pathophysiology of asthma. However, the precise role of ASM in the series of events leading to asthmatic symptoms is not clear. It is not certain whether, in asthma, there is a change in the intrinsic properties of ASM, a change in the structure and mechanical properties of the noncontractile components of the airway wall, or a change in the interdependence of the airway wall with the surrounding lung parenchyma. All these potential changes could result from acute or chronic airway inflammation and associated tissue repair and remodelling. Anti-inflammatory therapy, however, does not “cure” asthma, and airway hyperresponsiveness can persist in asthmatics, even in the absence of airway inflammation. This is perhaps because the therapy does not directly address a fundamental abnormality of asthma, that of exaggerated airway narrowing due to excessive shortening of ASM. In the present study, a central role for airway smooth muscle in the pathogenesis of airway hyperresponsiveness in asthma is explored. PMID:17470619

  1. Airway surface liquid depth imaged by surface laser reflectance microscopy.

    PubMed

    Thiagarajah, Jay R; Song, Yuanlin; Derichs, Nico; Verkman, A S

    2010-09-01

    The thin layer of liquid at the surface of airway epithelium, the airway surface liquid (ASL), is important in normal airway physiology and in the pathophysiology of cystic fibrosis. At present, the best method to measure ASL depth involves scanning confocal microscopy after staining with an aqueous-phase fluorescent dye. We describe here a simple, noninvasive imaging method to measure ASL depth by reflectance imaging of an epithelial mucosa in which the surface is illuminated at a 45-degree angle by an elongated 13-microm wide rectangular beam produced by a 670-nm micro-focus laser. The principle of the method is that air-liquid, liquid-liquid, and liquid-cell interfaces produce distinct specular or diffuse reflections that can be imaged to give a micron-resolution replica of the mucosal surface. The method was validated using fluid layers of specified thicknesses and applied to measure ASL depth in cell cultures and ex vivo fragments of pig trachea. In addition, the method was adapted to measure transepithelial fluid transport from the dynamics of fluid layer depth. Compared with confocal imaging, ASL depth measurement by surface laser reflectance microscopy does not require dye staining or costly instrumentation, and can potentially be adapted for in vivo measurements using fiberoptics. PMID:20713545

  2. Advances in Positive Airway Pressure Treatment Modalities for Hypoventilation Syndromes

    PubMed Central

    Combs, Dan; Shetty, Safal; Parthasarathy, Sairam

    2014-01-01

    SYNOPSIS Rationale Positive airway pressure therapy for hypoventilation syndromes can significantly improve health-related quality of life (HR-QOL), healthcare costs, and even mortality. The sleep-disordered breathing in such individuals are quite complex and require sophisticated devices with algorithms that are designed to accurately detect and effectively treat respiratory events that includes hypoventilation, upper airway obstruction, lower airway obstruction, central apneas and central hypopneas and reduce the work of breathing while maintaining breathing comfort. Objectives The therapeutic physiological rationale for the various advanced PAP modalities and the details about the principles of operation and technology implementation are provided here. Conclusions The physiological rationale for advanced PAP modalities is sound considering the complexity of sleep-disordered breathing in patients with hypoventilation syndromes. Although such devices are increasingly used in clinical practice, the supporting clinical evidence – specifically comparative-effectiveness studies in real-life conditions -- needs to be performed. Moreover, there is much opportunity for further refining these devices that include the ability of the device to reliably monitor gas-exchange, sleep-wakefulness state, and for reducing variability in device efficacy due to provider-selected device-settings. PMID:25346650

  3. A cuckoo search algorithm by Lévy flights for solving reliability redundancy allocation problems

    NASA Astrophysics Data System (ADS)

    Valian, Ehsan; Valian, Elham

    2013-11-01

    A new metaheuristic optimization algorithm, called cuckoo search (CS), was recently developed by Yang and Deb (2009, 2010). This article uses CS and Lévy flights to solve the reliability redundancy allocation problem. The redundancy allocation problem involves setting reliability objectives for components or subsystems in order to meet the resource consumption constraint, e.g. the total cost. The difficulties facing the redundancy allocation problem are to maintain feasibility with respect to three nonlinear constraints, namely, cost, weight and volume-related constraints. The redundancy allocation problems have been studied in the literature for decades, usually using mathematical programming or metaheuristic optimization algorithms. The performance of the algorithm is tested on five well-known reliability redundancy allocation problems and is compared with several well-known methods. Simulation results demonstrate that the optimal solutions obtained by CS are better than the best solutions obtained by other methods.

  4. Athletic Trainers' Knowledge Regarding Airway Adjuncts

    ERIC Educational Resources Information Center

    Edler, Jessica R.; Eberman, Lindsey E.; Kahanov, Leamor; Roman, Christopher; Mata, Heather Lynne

    2015-01-01

    Context: Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective: To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the…

  5. SUBCHRONIC ENDOTOXIN INHALATION CAUSES PERSISTENT AIRWAY DISEASE

    EPA Science Inventory

    ABSTRACT

    The endotoxin component of organic dusts causes acute reversible airflow obstruction and airway inflammation. To test the hypothesis that endotoxin alone causes airway remodeling, we have compared the response of two inbred mouse strains to subchronic endotoxin ...

  6. Airway and Extracellular Matrix Mechanics in COPD

    PubMed Central

    Bidan, Cécile M.; Veldsink, Annemiek C.; Meurs, Herman; Gosens, Reinoud

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases worldwide, and is characterized by airflow obstruction that is not fully reversible with treatment. Even though airflow obstruction is caused by airway smooth muscle contraction, the extent of airway narrowing depends on a range of other structural and functional determinants that impact on active and passive tissue mechanics. Cells and extracellular matrix in the airway and parenchymal compartments respond both passively and actively to the mechanical stimulation induced by smooth muscle contraction. In this review, we summarize the factors that regulate airway narrowing and provide insight into the relative contributions of different constituents of the extracellular matrix and their biomechanical impact on airway obstruction. We then review the changes in extracellular matrix composition in the airway and parenchymal compartments at different stages of COPD, and finally discuss how these changes impact airway narrowing and the development of airway hyperresponsiveness. Finally, we position these data in the context of therapeutic research focused on defective tissue repair. As a conclusion, we propose that future works should primarily target mild or early COPD, prior to the widespread structural changes in the alveolar compartment that are more characteristic of severe COPD. PMID:26696894

  7. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  8. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  9. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  10. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  11. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  12. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  13. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  14. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  15. Trefoil factor-2 reverses airway remodeling changes in allergic airways disease.

    PubMed

    Royce, Simon G; Lim, Clarice; Muljadi, Ruth C; Samuel, Chrishan S; Ververis, Katherine; Karagiannis, Tom C; Giraud, Andrew S; Tang, Mimi L K

    2013-01-01

    Trefoil factor 2 (TFF2) is a small peptide with an important role in mucosal repair. TFF2 is up-regulated in asthma, suggesting a role in asthma pathogenesis. Given its known biological role in promoting epithelial repair, TFF2 might be expected to exert a protective function in limiting the progression of airway remodeling in asthma. The contribution of TFF2 to airway remodeling in asthma was investigated by examining the expression of TFF2 in the airway and lung, and evaluating the effects of recombinant TFF2 treatment on established airway remodeling in a murine model of chronic allergic airways disease (AAD). BALB/c mice were sensitized and challenged with ovalbumin (OVA) or saline for 9 weeks, whereas mice with established OVA-induced AAD were treated with TFF2 or vehicle control (intranasally for 14 d). Effects on airway remodeling, airway inflammation, and airway hyperresponsiveness were then assessed, whereas TFF2 expression was determined by immunohistochemistry. TFF2 expression was significantly increased in the airways of mice with AAD, compared with expression levels in control mice. TFF2 treatment resulted in reduced epithelial thickening, subepithelial collagen deposition, goblet-cell metaplasia, bronchial epithelium apoptosis, and airway hyperresponsiveness (all P < 0.05, versus vehicle control), but TFF2 treatment did not influence airway inflammation. The increased expression of endogenous TFF2 in response to chronic allergic inflammation is insufficient to prevent the progression of airway inflammation and remodeling in a murine model of chronic AAD. However, exogenous TFF2 treatment is effective in reversing aspects of established airway remodeling. TFF2 has potential as a novel treatment for airway remodeling in asthma. PMID:22652198

  16. 26 CFR 1.42-6 - Buildings qualifying for carryover allocations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...-allocation basis even though C has owned the land since 1985. The $150,000 of costs C has incurred for... property is determined under sections 1012 and 1016, and generally includes the direct and indirect costs of acquiring, constructing, and rehabilitating the property. Costs otherwise includible in...

  17. Great Expectations: An Examination of Section 180c Funding Allocations

    SciTech Connect

    Dilger, F.C.; Halstead, R.J.

    2006-07-01

    As the U.S. Department of Energy (DOE) moves toward milestones in developing a plan to ship high-level radioactive waste to Yucca Mountain, an increasingly difficult issue is the distribution of Federal emergency management funds to mitigate costs of preparing for the shipments. DOE staff and contractors, and state transportation planning groups, have high expectations that some allocation formula based on technical factors can be used to distribute funds effectively and equitably. This paper examines the empirical results of a funding allocation formula proposed by the Western Governors Association among the eleven affected states which are members of the Western Interstate Energy Board. The amount of Federal funds allocated to Western states is also compared to the amount of revenue that would be generated by state-imposed fees on DOE shipments. (authors)

  18. Optimal Allocation of Node Capacity in Cascade-Robustness Networks

    PubMed Central

    Chen, Zhen; Zhang, Jun; Du, Wen-Bo; Lordan, Oriol; Tang, Jiangjun

    2015-01-01

    The robustness of large scale critical infrastructures, which can be modeled as complex networks, is of great significance. One of the most important means to enhance robustness is to optimize the allocation of resources. Traditional allocation of resources is mainly based on the topology information, which is neither realistic nor systematic. In this paper, we try to build a framework for searching for the most favorable pattern of node capacity allocation to reduce the vulnerability to cascading failures at a low cost. A nonlinear and multi-objective optimization model is proposed and tackled using a particle swarm optimization algorithm (PSO). It is found that the network becomes more robust and economical when less capacity is left on the heavily loaded nodes and the optimized network performs better resisting noise. Our work is helpful in designing a robust economical network. PMID:26496705

  19. Optimal Allocation of Node Capacity in Cascade-Robustness Networks.

    PubMed

    Chen, Zhen; Zhang, Jun; Du, Wen-Bo; Lordan, Oriol; Tang, Jiangjun

    2015-01-01

    The robustness of large scale critical infrastructures, which can be modeled as complex networks, is of great significance. One of the most important means to enhance robustness is to optimize the allocation of resources. Traditional allocation of resources is mainly based on the topology information, which is neither realistic nor systematic. In this paper, we try to build a framework for searching for the most favorable pattern of node capacity allocation to reduce the vulnerability to cascading failures at a low cost. A nonlinear and multi-objective optimization model is proposed and tackled using a particle swarm optimization algorithm (PSO). It is found that the network becomes more robust and economical when less capacity is left on the heavily loaded nodes and the optimized network performs better resisting noise. Our work is helpful in designing a robust economical network. PMID:26496705

  20. Airway tissue engineering for congenital laryngotracheal disease.

    PubMed

    Maughan, Elizabeth; Lesage, Flore; Butler, Colin R; Hynds, Robert E; Hewitt, Richard; Janes, Sam M; Deprest, Jan A; Coppi, Paolo De

    2016-06-01

    Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach. Moreover, the international acceptance of the EXIT procedure as a means of securing the precarious neonatal airway, together with the advent of fetal surgery as a method of heading off postnatal co-morbidities, offers the revolutionary possibility of extending the clinical indication for tissue-engineered airway transplantation to infants affected by diverse severe congenital laryngotracheal malformations. This article outlines the necessary basic components for regenerative medicine solutions in this potential clinical niche. PMID:27301606

  1. Regulation of human airway surface liquid.

    PubMed

    Widdicombe, J H; Widdicombe, J G

    1995-01-01

    Human airways are lined with a film of liquid from 5-100 microns in depth, consisting of a periciliary sol around and a mucous gel above the cilia. Microscopical studies have shown the sol to be invariably the same depth as the length of the cilia, and we discuss possible reasons for this. The composition and sources of the airway surface liquid are also described. In addition the forces regulating its volume are analyzed. Several airway diseases are characterised by dramatic changes in the volume and composition of airway liquid. We review recent research suggesting that the accumulation of airway mucous secretions in cystic fibrosis is caused by alterations in active transport of ions and water across both the surface and gland epithelia. PMID:7740210

  2. Awake Craniotomy: A New Airway Approach.

    PubMed

    Sivasankar, Chitra; Schlichter, Rolf A; Baranov, Dimitry; Kofke, W Andrew

    2016-02-01

    Awake craniotomies have been performed regularly at the University of Pennsylvania since 2004. Varying approaches to airway management are described for this procedure, including intubation with an endotracheal tube and use of a laryngeal mask airway, simple facemask, or nasal cannula. In this case series, we describe the successful use (i.e., no need for endotracheal intubation related to inadequate gas exchange) of bilateral nasopharyngeal airways in 90 patients undergoing awake craniotomies. The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway. Our purpose was to describe our experience and report adverse events related to this technique. PMID:26579845

  3. Airway fires during surgery: Management and prevention

    PubMed Central

    Akhtar, Navaid; Ansar, Farrukh; Baig, Mirza Shahzad; Abbas, Akbar

    2016-01-01

    Airway fires pose a serious risk to surgical patients. Fires during surgery have been reported for many years with flammable anesthetic agents being the main culprits in the past. Association of airway fires with laser surgery is well-recognized, but there are reports of endotracheal tube fires ignited by electrocautery during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially grave consequences. While airway fires are relatively uncommon occurrences, they are very serious and can often be fatal. Success in preventing such events requires a thorough understanding of the components leading to a fire (fuel, oxidizer, and ignition source), as well as good communication between all members present to appropriately manage the fire and ensure patient safety. We present a case of fire in the airway during routine adenotonsillectomy. We will review the causes, preventive measures, and brief management for airway fires. PMID:27006554

  4. Anaesthetic management of acute airway obstruction

    PubMed Central

    Wong, Patrick; Wong, Jolin; Mok, May Un Sam

    2016-01-01

    The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the United Kingdom’s 4th National Audit Project on major airway complications in 2011 and the updated American Society of Anesthesiologists’ difficult airway algorithm of 2013, have recently been published. The former contained many reports of adverse events associated with the management of acute airway obstruction. By analysing the data and concepts from these two publications, this review article provides an update on management techniques for the acutely obstructed airway. We discuss the principles and factors relevant to the decision-making process in formulating a logical management plan. PMID:26996162

  5. Anaesthetic management of acute airway obstruction.

    PubMed

    Wong, Patrick; Wong, Jolin; Mok, May Un Sam

    2016-03-01

    The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the United Kingdom's 4th National Audit Project on major airway complications in 2011 and the updated American Society of Anesthesiologists' difficult airway algorithm of 2013, have recently been published. The former contained many reports of adverse events associated with the management of acute airway obstruction. By analysing the data and concepts from these two publications, this review article provides an update on management techniques for the acutely obstructed airway. We discuss the principles and factors relevant to the decision-making process in formulating a logical management plan. PMID:26996162

  6. Investigating the geometry of pig airways using computed tomography

    NASA Astrophysics Data System (ADS)

    Mansy, Hansen A.; Azad, Md Khurshidul; McMurray, Brandon; Henry, Brian; Royston, Thomas J.; Sandler, Richard H.

    2015-03-01

    Numerical modeling of sound propagation in the airways requires accurate knowledge of the airway geometry. These models are often validated using human and animal experiments. While many studies documented the geometric details of the human airways, information about the geometry of pig airways is scarcer. In addition, the morphology of animal airways can be significantly different from that of humans. The objective of this study is to measure the airway diameter, length and bifurcation angles in domestic pigs using computed tomography. After imaging the lungs of 3 pigs, segmentation software tools were used to extract the geometry of the airway lumen. The airway dimensions were then measured from the resulting 3 D models for the first 10 airway generations. Results showed that the size and morphology of the airways of different animals were similar. The measured airway dimensions were compared with those of the human airways. While the trachea diameter was found to be comparable to the adult human, the diameter, length and branching angles of other airways were noticeably different from that of humans. For example, pigs consistently had an early airway branching from the trachea that feeds the superior (top) right lung lobe proximal to the carina. This branch is absent in the human airways. These results suggested that the human geometry may not be a good approximation of the pig airways and may contribute to increasing the errors when the human airway geometric values are used in computational models of the pig chest.

  7. 2 CFR 200.60 - Intermediate cost objective.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... objective. Intermediate cost objective means a cost objective that is used to accumulate indirect costs or service center costs that are subsequently allocated to one or more indirect cost pools or final cost... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Intermediate cost objective. 200.60...

  8. Task allocation among multiple intelligent robots

    NASA Technical Reports Server (NTRS)

    Gasser, L.; Bekey, G.

    1987-01-01

    Researchers describe the design of a decentralized mechanism for allocating assembly tasks in a multiple robot assembly workstation. Currently, the approach focuses on distributed allocation to explore its feasibility and its potential for adaptability to changing circumstances, rather than for optimizing throughput. Individual greedy robots make their own local allocation decisions using both dynamic allocation policies which propagate through a network of allocation goals, and local static and dynamic constraints describing which robots are elibible for which assembly tasks. Global coherence is achieved by proper weighting of allocation pressures propagating through the assembly plan. Deadlock avoidance and synchronization is achieved using periodic reassessments of local allocation decisions, ageing of allocation goals, and short-term allocation locks on goals.

  9. Puberty and Upper Airway Dynamics During Sleep

    PubMed Central

    Bandla, Preetam; Huang, Jingtao; Karamessinis, Laurie; Kelly, Andrea; Pepe, Michelle; Samuel, John; Brooks, Lee; Mason, Thornton. A.; Gallagher, Paul R.; Marcus, Carole L.

    2008-01-01

    Study Objectives: The upper airway compensatory response to subatmospheric pressure loading declines with age. The epidemiology of obstructive sleep apnea suggests that sex hormones play a role in modulating upper airway function. Sex hormones increase gradually during puberty, from minimally detectable to adult levels. We hypothesized that the upper airway response to subatmospheric pressure loading decreased with increasing pubertal Tanner stage in males but remained stable during puberty in females. Design: Upper airway dynamic function during sleep was measured over the course of puberty. Participants: Normal subjects of Tanner stages 1 to 5. Measurements: During sleep, maximal inspiratory airflow was measured while varying the level of nasal pressure. The slope of the upstream pressure-flow relationship (SPF) was measured. Results: The SPF correlated with age and Tanner stage. However, the relationship with Tanner stage became nonsignificant when the correlation due to the mutual association with age was removed. Females had a lower SPF than males. Conclusions: In both sexes, the upper airway compensatory response to subatmospheric pressure loading decreased with age rather than degree of pubertal development. Thus, changes in sex hormones are unlikely to be a primary modulator of upper airway function during the transition from childhood to adulthood. Although further studies of upper airway structural changes during puberty are needed, we speculate that the changes in upper airway function with age are due to the depressant effect of age on ventilatory drive, leading to a decrease in upper airway neuromotor tone. Citation: Bandla P; Huang J; Karamessinis L; Kelly A; Pepe M; Samuel J; Brooks L; Mason TA; Gallagher PR; Marcus CL. Puberty and Upper Airway Dynamics During Sleep. SLEEP 2008;31(4):534-541. PMID:18457241

  10. Intrathoracic airway measurement: ex-vivo validation

    NASA Astrophysics Data System (ADS)

    Reinhardt, Joseph M.; Raab, Stephen A.; D'Souza, Neil D.; Hoffman, Eric A.

    1997-05-01

    High-resolution x-ray CT (HRCT) provides detailed images of the lungs and bronchial tree. HRCT-based imaging and quantitation of peripheral bronchial airway geometry provides a valuable tool for assessing regional airway physiology. Such measurements have been sued to address physiological questions related to the mechanics of airway collapse in sleep apnea, the measurement of airway response to broncho-constriction agents, and to evaluate and track the progression of disease affecting the airways, such as asthma and cystic fibrosis. Significant attention has been paid to the measurements of extra- and intra-thoracic airways in 2D sections from volumetric x-ray CT. A variety of manual and semi-automatic techniques have been proposed for airway geometry measurement, including the use of standardized display window and level settings for caliper measurements, methods based on manual or semi-automatic border tracing, and more objective, quantitative approaches such as the use of the 'half-max' criteria. A recently proposed measurements technique uses a model-based deconvolution to estimate the location of the inner and outer airway walls. Validation using a plexiglass phantom indicates that the model-based method is more accurate than the half-max approach for thin-walled structures. In vivo validation of these airway measurement techniques is difficult because of the problems in identifying a reliable measurement 'gold standard.' In this paper we report on ex vivo validation of the half-max and model-based methods using an excised pig lung. The lung is sliced into thin sections of tissue and scanned using an electron beam CT scanner. Airways of interest are measured from the CT images, and also measured with using a microscope and micrometer to obtain a measurement gold standard. The result show no significant difference between the model-based measurements and the gold standard; while the half-max estimates exhibited a measurement bias and were significantly

  11. Allocating operating room block time using historical caseload variability.

    PubMed

    Hosseini, Narges; Taaffe, Kevin M

    2015-12-01

    Operating room (OR) allocation and planning is one of the most important strategic decisions that OR managers face. The number of ORs that a hospital opens depends on the number of blocks that are allocated to the surgical groups, services, or individual surgeons, combined with the amount of open posting time (i.e., first come, first serve posting) that the hospital wants to provide. By allocating too few ORs, a hospital may turn away surgery demand whereas opening too many ORs could prove to be a costly decision. The traditional method of determining block frequency and size considers the average historical surgery demand for each group. However, given that there are penalties to the system for having too much or too little OR time allocated to a group, demand variability should play a role in determining the real OR requirement. In this paper we present an algorithm that allocates block time based on this demand variability, specifically accounting for both over-utilized time (time used beyond the block) and under-utilized time (time unused within the block). This algorithm provides a solution to the situation in which total caseload demand can be accommodated by the total OR resource set, in other words not in a capacity-constrained situation. We have found this scenario to be common among several regional healthcare providers with large OR suites and excess capacity. This algorithm could be used to adjust existing blocks or to assign new blocks to surgeons that did not previously have a block. We also have studied the effect of turnover time on the number of ORs that needs to be allocated. Numerical experiments based on real data from a large health-care provider indicate the opportunity to achieve over 2,900 hours of OR time savings through improved block allocations. PMID:24590259

  12. Theatre personnel's perception of operating room resource allocation.

    PubMed

    Adejumo, A O; Adejumo, P O

    2009-06-01

    Operating rooms (OR) in hospitals represent big investments and must be utilized efficiently. Inaccurate scheduling of OR resources often results in delays of surgery or cancellations of procedures. These are costly to the patient, surgical team and hospital. Existing literatures in the OR management lack consensus on the method of evaluating management decisions from the perspectives of personnel or those affected by management decision-making processes. Eight key informant interviews were conducted. Also, 50 Operating Theatre Personnel (OTP), i.e., Surgeons, OR Nurses, Anaesthetists, and Executive Officers in the Nigeria's premier University Teaching Hospital were asked to complete a survey questionnaire concerning operating theatre resource allocation in the hospital. Five close-ended and 10 open-ended questions were used. (For example, how are the decisions to allocate OR resources in this hospital made?) Thematic analysis and descriptive statistics were done. The theoretical framework, accountability for reasonableness was applied. Forty-eight percent of the participants were ignorant of the framework guiding OR resource allocation. 54% of the respondents admitted the current mechanism for publicizing management decisions on OR resource allocation is ineffective. Another 50% of the respondents knew little about the mode of appealing against unfavourable allocation decisions. Participants' open ended responses revealed that hospital executives and a few consultant surgeons control the allocation of OR resources, with little recourse to OR personnel's concerns. If operating theatre stake holders are excluded in the planning, allocation and evaluation of OR resources, the efficiency required in surgical services would never be realized irrespective of the dexterity of the surgical team. PMID:20175420

  13. 48 CFR 731.771 - Bid and proposal costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and proposals normally should be treated as indirect costs for allocation to all current activities... and allocated an appropriate share of indirect costs under the conditions described in paragraph B.3... GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With...

  14. Resource Allocation: A Participatory Process.

    ERIC Educational Resources Information Center

    Reid, Alban E.

    Whether a participatory process for resource allocation in a public community college setting occurs depends upon several key factors: (1) the leadership style of the institutional chief executive officer; (2) the administrative organizational structure of the institution; (3) the relationship which exists between and among members of the various…

  15. Report on Tribal Priority Allocations.

    ERIC Educational Resources Information Center

    Bureau of Indian Affairs (Dept. of Interior), Washington, DC.

    As part of Bureau of Indian Affairs (BIA) funding, Tribal Priority Allocations (TPA) are the principal source of funds for tribal governments and agency offices at the reservation level. According to their unique needs and circumstances, tribes may prioritize funding among eight general categories: government, human services, education, public…

  16. Regulating nutrient allocation in plants

    DOEpatents

    Udvardi, Michael; Yang, Jiading; Worley, Eric

    2014-12-09

    The invention provides coding and promoter sequences for a VS-1 and AP-2 gene, which affects the developmental process of senescence in plants. Vectors, transgenic plants, seeds, and host cells comprising heterologous VS-1 and AP-2 genes are also provided. Additionally provided are methods of altering nutrient allocation and composition in a plant using the VS-1 and AP-2 genes.

  17. Administrators' Decisions about Resource Allocation

    ERIC Educational Resources Information Center

    Knight, William E.; Folkins, John W.; Hakel, Milton D.; Kennell, Richard P.

    2011-01-01

    Do academic administrators make decisions about resource allocation differently depending on the discipline receiving the funding? Does an administrator's academic identity influence these decisions? This study explored those questions with a sample of 1,690 academic administrators at doctoral-research universities. Participants used fictional…

  18. Cost Accounting in Higher Education. Simplified Macro- and Micro-Costing Techniques.

    ERIC Educational Resources Information Center

    Jenny, Hans H.

    This manual covers cost accounting applications and techniques as they apply to institutions of higher education, focusing mainly on the different methods of allocating costs. The manual covers four major costing topics: aggregate institution and systemwide costs; major academic and administrative program costs; academic and administrative…

  19. Allergic airways disease develops after an increase in allergen capture and processing in the airway mucosa.

    PubMed

    von Garnier, Christophe; Wikstrom, Matthew E; Zosky, Graeme; Turner, Debra J; Sly, Peter D; Smith, Miranda; Thomas, Jennifer A; Judd, Samantha R; Strickland, Deborah H; Holt, Patrick G; Stumbles, Philip A

    2007-11-01

    Airway mucosal dendritic cells (AMDC) and other airway APCs continuously sample inhaled Ags and regulate the nature of any resulting T cell-mediated immune response. Although immunity develops to harmful pathogens, tolerance arises to nonpathogenic Ags in healthy individuals. This homeostasis is thought to be disrupted in allergic respiratory disorders such as allergic asthma, such that a potentially damaging Th2-biased, CD4(+) T cell-mediated inflammatory response develops against intrinsically nonpathogenic allergens. Using a mouse model of experimental allergic airways disease (EAAD), we have investigated the functional changes occurring in AMDC and other airway APC populations during disease onset. Onset of EAAD was characterized by early and transient activation of airway CD4(+) T cells coinciding with up-regulation of CD40 expression exclusively on CD11b(-) AMDC. Concurrent enhanced allergen uptake and processing occurred within all airway APC populations, including B cells, macrophages, and both CD11b(+) and CD11b(-) AMDC subsets. Immune serum transfer into naive animals recapitulated the enhanced allergen uptake observed in airway APC populations and mediated activation of naive allergen-specific, airway CD4(+) T cells following inhaled allergen challenge. These data suggest that the onset of EAAD is initiated by enhanced allergen capture and processing by a number of airway APC populations and that allergen-specific Igs play a role in the conversion of normally quiescent AMDC subsets into those capable of inducing airway CD4(+) T cell activation. PMID:17947647

  20. On System Engineering a Barter-Based Re-allocation of Space System Key Development Resources

    NASA Astrophysics Data System (ADS)

    Kosmann, William J.

    NASA has had a decades-long problem with cost growth during the development of space science missions. Numerous agency-sponsored studies have produced average mission level development cost growths ranging from 23 to 77%. A new study of 26 historical NASA science instrument set developments using expert judgment to re-allocate key development resources has an average cost growth of 73.77%. Twice in history, during the Cassini and EOS-Terra science instrument developments, a barter-based mechanism has been used to re-allocate key development resources. The mean instrument set development cost growth was -1.55%. Performing a bivariate inference on the means of these two distributions, there is statistical evidence to support the claim that using a barter-based mechanism to re-allocate key instrument development resources will result in a lower expected cost growth than using the expert judgment approach. Agent-based discrete event simulation is the natural way to model a trade environment. A NetLogo agent-based barter-based simulation of science instrument development was created. The agent-based model was validated against the Cassini historical example, as the starting and ending instrument development conditions are available. The resulting validated agent-based barter-based science instrument resource re-allocation simulation was used to perform 300 instrument development simulations, using barter to re-allocate development resources. The mean cost growth was -3.365%. A bivariate inference on the means was performed to determine that additional significant statistical evidence exists to support a claim that using barter-based resource re-allocation will result in lower expected cost growth, with respect to the historical expert judgment approach. Barter-based key development resource re-allocation should work on science spacecraft development as well as it has worked on science instrument development. A new study of 28 historical NASA science spacecraft

  1. 20 CFR 669.550 - How are costs classified under the NFJP?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., Planning and Waiver Provision § 669.550 How are costs classified under the NFJP? (a) Costs are classified as follows: (1) Administrative costs, as defined in 20 CFR 667.220; and (2) Program costs, which are... services, including allocated staff costs; and (2) All other program services, including allocated...

  2. Vaccines: from valuation to resource allocation.

    PubMed

    Bloom, David E; Madhavan, Guruprasad

    2015-06-01

    This review focuses on selected challenges and opportunities concerning broader valuation of vaccines and immunization. The challenges involve conceptualizing and measuring the value of vaccines, while the opportunities relate to the strategic and systematic use of that information in health policy decisions that range from the adoption of particular vaccines in national immunization plans to the allocation of resources to vaccine research, development, and delivery. Clarifying the demonstrable individual, family, and community-level benefits of vaccines will allow the public health community to make better-informed and more meaningful comparisons of the costs of vaccines in relation to their full benefits. Taking advantage of this opportunity will require enhanced data collection and the development of strategic planning tools for transparently assessing trade-offs among the myriad attributes of different vaccines in various social and economic contexts. PMID:26022569

  3. The organ allocation controversy: how did we arrive here?

    PubMed

    Van Meter, C H

    1999-01-01

    The Department of Health and Human Services (HHS) recently issued a final regulation governing the Organ Procurement and Transplantation Network (OPTN) that directs the allocation of organs to the sickest patients first without regard to a host of medical, geographic, and social factors that members of the transplant community view as an essential part of a sound organ allocation policy.Current organ allocation mechanisms are based on policies that reflect a broad consensus of medical experts and provide equal consideration for both the needs of the sickest patients and the efficient use of organs. This system also reduces potential waste of organs by minimizing cold ischemic time, increases access to transplantation for patients in local communities, provides positive incentives for local citizens and medical professionals to support organ donation initiatives, and decreases the cost of organ transplantation.Representatives of the American Society of Transplant Surgeons have testified before Congress that "giving priority to the sickest patients first over broad geographic areas would be wasteful and dangerous, resulting in fewer patients transplanted, increased death rates, increased retransplantation due to poor organ function, and increased overall cost of transplantation." In response, Congress enacted a 1-year moratorium on the implementation of the HHS rule and provided for a study of the current organ allocation policy and HHS regulation by The Institute of Medicine. PMID:21845113

  4. Educating the Educator: Teaching Airway Adjunct Techniques in Athletic Training

    ERIC Educational Resources Information Center

    Berry, David C.; Seitz, S. Robert

    2011-01-01

    The 5th edition of the "Athletic Training Education Competencies" ("Competencies") now requires athletic training educators (ATEs) to introduce into the curriculum various types of airway adjuncts including: (1) oropharyngeal airways (OPA), (2) nasopharyngeal airways (NPA), (3) supraglottic airways (SGA), and (4) suction. The addition of these…

  5. Small particles disrupt postnatal airway development

    PubMed Central

    Lee, DongYoub; Wallis, Chris; Schelegle, Edward S.; Van Winkle, Laura S.; Plopper, Charles G.; Fanucchi, Michelle V.; Kumfer, Ben; Kennedy, Ian M.; Chan, Jackie K. W.

    2010-01-01

    Increasing numbers of epidemiologic studies associate air pollution exposure in children with decreased lung function development. The objective of this study was to examine the effects of exposure to combustion-generated fine [230 and 212 nm number mean aerodynamic particle diameter (NMAD)] to ultrafine (73 nm NMAD) particles differing in elemental (EC) and organic (OC) carbon content on postnatal airway development in rats. Neonatal Sprague-Dawley rats were exposed from postnatal day 7 through 25, and lung function and airway architecture were evaluated 81 days of age. In a separate group of rats, cell proliferation was examined after a single particle exposure at 7 days of age. Early life exposure to 73 nm high OC/EC particles altered distal airway architecture and resulted in subtle changes in lung mechanics. Early life exposure to 212 nm high OC/EC particles did not alter lung architecture but did alter lung mechanics in a manner suggestive of central airway changes. In contrast, early life exposure to 230 nm low OC/EC particles did not alter lung architecture or mechanics. A single 6-h exposure to 73 nm high OC/EC particle decreased airway cell proliferation, whereas 212 nm high OC/EC particles increased it and 230 nm low OC/EC particles did not. The early life exposure to ultrafine, high OC/EC particles results in persistent alterations in distal airway architecture that is characterized by an initial decrease in airway cell proliferation. PMID:20634362

  6. Lung Transplantation: The State of the Airways.

    PubMed

    Husain, Aliya N; Garrity, Edward R

    2016-03-01

    Context .- Lung transplantation has become a viable option for definitive treatment of several end-stage lung diseases for which there are no other options available. However, long-term survival continues to be limited by chronic lung allograft dysfunction, which primarily affects the airways. Objective . -To highlight the complications occurring mainly in the airways of the lung transplant recipient from the early to late posttransplant periods. Data Sources .- Review literature focusing on the airways in patients with lung transplants and clinical experience of the authors. Conclusions .- Postsurgical complications and infections of the airways have decreased because of better techniques and management. Acute cellular rejection of the airways can be distinguished from infection pathologically and on cultures. Separating small from large airways need not be an issue because both are risk factors for bronchiolitis obliterans. Grading of airway rejection needs to be standardized. Chronic lung allograft dysfunction consists of both bronchiolitis obliterans and restrictive allograft syndrome, neither of which can be treated very effectively at present. PMID:26927718

  7. Comparison of analysis methods for airway quantification

    NASA Astrophysics Data System (ADS)

    Odry, Benjamin L.; Kiraly, Atilla P.; Novak, Carol L.; Naidich, David P.

    2012-03-01

    Diseased airways have been known for several years as a possible contributing factor to airflow limitation in Chronic Obstructive Pulmonary Diseases (COPD). Quantification of disease severity through the evaluation of airway dimensions - wall thickness and lumen diameter - has gained increased attention, thanks to the availability of multi-slice computed tomography (CT). Novel approaches have focused on automated methods of measurement as a faster and more objective means that the visual assessment routinely employed in the clinic. Since the Full-Width Half-Maximum (FWHM) method of airway measurement was introduced two decades ago [1], several new techniques for quantifying airways have been detailed in the literature, but no approach has truly become a standard for such analysis. Our own research group has presented two alternative approaches for determining airway dimensions, one involving a minimum path and the other active contours [2, 3]. With an increasing number of techniques dedicated to the same goal, we decided to take a step back and analyze the differences of these methods. We consequently put to the test our two methods of analysis and the FWHM approach. We first measured a set of 5 airways from a phantom of known dimensions. Then we compared measurements from the three methods to those of two independent readers, performed on 35 airways in 5 patients. We elaborate on the differences of each approach and suggest conclusions on which could be defined as the best one.

  8. Breath tests and airway gas exchange.

    PubMed

    Anderson, Joseph C; Hlastala, Michael P

    2007-01-01

    Measuring soluble gas in the exhaled breath is a non-invasive technique used to estimate levels of respiratory, solvent, and metabolic gases. The interpretation of these measurements is based on the assumption that the measured gases exchange in the alveoli. While the respiratory gases have a low blood-solubility and exchange in the alveoli, high blood-soluble gases exchange in the airways. The effect of airway gas exchange on the interpretation of these exhaled breath measurements can be significant. We describe airway gas exchange in relation to exhaled measurements of soluble gases that exchange in the alveoli. The mechanisms of airway gas exchange are reviewed and criteria for determining if a gas exchanges in the airways are provided. The effects of diffusion, perfusion, temperature and breathing maneuver on airway gas exchange and on measurement of exhaled soluble gas are discussed. A method for estimating the impact of airway gas exchange on exhaled breath measurements is presented. We recommend that investigators should carefully control the inspired air conditions and type of exhalation maneuver used in a breath test. Additionally, care should be taken when interpreting breath tests from subjects with pulmonary disease. PMID:16413216

  9. A Cost Analysis Process for Rural Schools.

    ERIC Educational Resources Information Center

    Sparkman, William E.

    Cost analysis involves breaking down operating costs of a school district and allocating those costs to the appropriate unit of analysis so various comparisons can be made and used by school boards in making decisions about whether to continue certain programs or whether to close or consolidate school buildings. A cost analysis does not provide…

  10. 24 CFR 576.109 - Indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Indirect costs. 576.109 Section 576... § 576.109 Indirect costs. (a) In general. ESG grant funds may be used to pay indirect costs in.... Indirect costs may be allocated to each eligible activity under § 576.101 through § 576.108, so long...

  11. 24 CFR 576.109 - Indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Indirect costs. 576.109 Section 576... § 576.109 Indirect costs. (a) In general. ESG grant funds may be used to pay indirect costs in.... Indirect costs may be allocated to each eligible activity under § 576.101 through § 576.108, so long...

  12. Implementing a trustworthy cost-accounting model.

    PubMed

    Spence, Jay; Seargeant, Dan

    2015-03-01

    Hospitals and health systems can develop an effective cost-accounting model and maximize the effectiveness of their cost-accounting teams by focusing on six key areas: Implementing an enhanced data model. Reconciling data efficiently. Accommodating multiple cost-modeling techniques. Improving transparency of cost allocations. Securing department manager participation. Providing essential education and training to staff members and stakeholders. PMID:26492763

  13. Complex Genetic Effects on Early Vegetative Development Shape Resource Allocation Differences Between Arabidopsis lyrata Populations

    PubMed Central

    Remington, David L.; Leinonen, Päivi H.; Leppälä, Johanna; Savolainen, Outi

    2013-01-01

    Costs of reproduction due to resource allocation trade-offs have long been recognized as key forces in life history evolution, but little is known about their functional or genetic basis. Arabidopsis lyrata, a perennial relative of the annual model plant A. thaliana with a wide climatic distribution, has populations that are strongly diverged in resource allocation. In this study, we evaluated the genetic and functional basis for variation in resource allocation in a reciprocal transplant experiment, using four A. lyrata populations and F2 progeny from a cross between North Carolina (NC) and Norway parents, which had the most divergent resource allocation patterns. Local alleles at quantitative trait loci (QTL) at a North Carolina field site increased reproductive output while reducing vegetative growth. These QTL had little overlap with flowering date QTL. Structural equation models incorporating QTL genotypes and traits indicated that resource allocation differences result primarily from QTL effects on early vegetative growth patterns, with cascading effects on later vegetative and reproductive development. At a Norway field site, North Carolina alleles at some of the same QTL regions reduced survival and reproductive output components, but these effects were not associated with resource allocation trade-offs in the Norway environment. Our results indicate that resource allocation in perennial plants may involve important adaptive mechanisms largely independent of flowering time. Moreover, the contributions of resource allocation QTL to local adaptation appear to result from their effects on developmental timing and its interaction with environmental constraints, and not from simple models of reproductive costs. PMID:23979581

  14. Human airway measurement from CT images

    NASA Astrophysics Data System (ADS)

    Lee, Jaesung; Reeves, Anthony P.; Fotin, Sergei; Apanasovich, Tatiyana; Yankelevitz, David

    2008-03-01

    A wide range of pulmonary diseases, including common ones such as COPD, affect the airways. If the dimensions of airway can be measured with high confidence, the clinicians will be able to better diagnose diseases as well as monitor progression and response to treatment. In this paper, we introduce a method to assess the airway dimensions from CT scans, including the airway segments that are not oriented axially. First, the airway lumen is segmented and skeletonized, and subsequently each airway segment is identified. We then represent each airway segment using a segment-centric generalized cylinder model and assess airway lumen diameter (LD) and wall thickness (WT) for each segment by determining inner and outer wall boundaries. The method was evaluated on 14 healthy patients from a Weill Cornell database who had two scans within a 2 month interval. The corresponding airway segments were located in two scans and measured using the automated method. The total number of segments identified in both scans was 131. When 131 segments were considered altogether, the average absolute change over two scans was 0.31 mm for LD and 0.12 mm for WT, with 95% limits of agreement of [-0.85, 0.83] for LD and [-0.32, 0.26] for WT. The results were also analyzed on per-patient basis, and the average absolute change was 0.19 mm for LD and 0.05 mm for WT. 95% limits of agreement for per-patient changes were [-0.57, 0.47] for LD and [-0.16, 0.10] for WT.

  15. Secondary Reverse Slide Tracheoplasty for Airway Rescue.

    PubMed

    Kopelovich, Jonathan C; Wine, Todd M; Rutter, Michael J; Mitchell, Max B; Prager, Jeremy D

    2016-03-01

    Slide tracheoplasty is used in cases of tracheal stenosis or injury. With expanding indications for its use at tertiary centers, salvage techniques for dehiscence or restenosis after slide tracheoplasty are increasingly relevant. We present a case in which slide tracheoplasty was augmented with an anterior costochondral graft that stenosed again and ultimately failed. We salvaged this airway emergency by performing a secondary reverse slide tracheoplasty. Using this technique, we were able to establish a safe and durable airway using only native airway tissue. PMID:26897214

  16. Airways disorders and the swimming pool.

    PubMed

    Bougault, Valérie; Boulet, Louis-Philippe

    2013-08-01

    Concerns have been expressed about the possible detrimental effects of chlorine derivatives in indoor swimming pool environments. Indeed, a controversy has arisen regarding the possibility that chlorine commonly used worldwide as a disinfectant favors the development of asthma and allergic diseases. The effects of swimming in indoor chlorinated pools on the airways in recreational and elite swimmers are presented. Recent studies on the influence of swimming on airway inflammation and remodeling in competitive swimmers, and the phenotypic characteristics of asthma in this population are reviewed. Preventative measures that could potentially reduce the untoward effects of pool environment on airways of swimmers are discussed. PMID:23830132

  17. Brachycephalic airway syndrome: pathophysiology and diagnosis.

    PubMed

    Lodato, Dena L; Hedlund, Cheryl S

    2012-07-01

    Brachycephalic airway syndrome (BAS) is a group of abnormalities that result in upper airway obstruction. Primary malformations include stenotic nares, elongated soft palate, and hypoplastic trachea, which cause an increase in negative pressure within the upper airways that can eventually lead to secondary abnormalities such as everted laryngeal saccules, everted tonsils, and laryngeal and tracheal collapse. Abnormal nasopharyngeal turbinates are also encountered, but have not been classified as primary or secondary. BAS is readily diagnosed, and quality of life is improved with appropriate medical and/or surgical management. PMID:22847322

  18. Airway nitric oxide in microgravity

    NASA Astrophysics Data System (ADS)

    Linnarsson, D.; Gustafsson, L.; Hemmingsson, Tryggve; Frostell, C.; Paiva, M.

    2005-10-01

    Nitric Oxide (NO), a molecule with a wide range of biological effects, is found in exhaled gas. Elevation of expired NO is an early sign of airway inflammation in asthma and dust inhalation. Animal experiments have demonstrated a marked increase of expired NO after venous gas emboli (bubbles, VGE), which may occur after decompression in conjunction with extravehicular activity (EVA). For this MAP project, astronauts will perform a simple inhalation-exhalation procedure weekly during their flights, and before and after EVA. Furthermore, the microgravity environment offers a possibility to gain new insights into how and where NO is formed in the lungs and what local effects NO may have there. The planned experiments have been made possible by recent developments of new techniques by the team's industrial partners; Aerocrine has developed a highly compact and accurate NO analyser, and Linde Gas Theapeutics has developed a highly compact device for NO administration in the inhaled air.

  19. Removal of Laryngeal Mask Airway in Adults Under Target-Controlled, Propofol–Fentanyl Infusion Anesthesia

    PubMed Central

    Huang, Ren-Chih; Hung, Nan-Kai; Lu, Chueng-He; Wu, Zhi-Fu

    2016-01-01

    Abstract After emergence from anesthesia, the incidence and severity of adverse airway effects caused by the laryngeal mask airway (LMA) can vary, depending on when the device was removed; nonetheless, reports differ regarding the exact optimal timing of LMA removal. The purpose of this study was to compare the rate of adverse events between 2 groups: those whose LMA was removed under general anesthesia (“deep” group) or under target-controlled infusion (TCI) of propofol (“awake” group). Institutional Review Board approval and written informed consent were obtained; 124 patients were then randomly allocated into either the “awake” group or the “deep” group. Anesthesia was induced and maintained using TCI of propofol, as well as intravenous fentanyl. In the “deep” group, the LMA was removed after surgery while the patients were deeply anesthetized using a target effect-site propofol concentration of 2 μg/mL, whereas in the “awake” group, the device was removed while the patients followed verbal instructions. The incidence of the following adverse events was recorded: coughing, straining, bronchospasm, laryngospasm, clenching, breath holding, gross purposeful movement, airway obstruction, retching, vomiting, and oxygen desaturation. If any such event occurred, the LMA removal was considered a failure. Airway hyperreactivity was recorded and graded – based on the severity of cough, breath holding, and oxygen desaturation. The failure rate was higher in the “awake” group (15/61; 24.6%) than in the “deep” group (5/60; 8.3%). Airway hyperreactivity was mild (score, <3) in both groups. Removal of the LMA under deep anesthesia using a target-controlled, effect-site propofol concentration of 2 μg/mL may be safer and more successful than removal when patients are fully awake after surgery. PMID:27124034

  20. Comprehensive Airway Management of Patients with Maxillofacial Trauma

    PubMed Central

    Kellman, Robert M.; Losquadro, William D.

    2008-01-01

    Airway management in patients with maxillofacial trauma is complicated by injuries to routes of intubation, and the surgeon is frequently asked to secure the airway. Airway obstruction from hemorrhage, tissue prolapse, or edema may require emergent intervention for which multiple intubation techniques exist. Competing needs for both airway and surgical access create intraoperative conflicts during repair of maxillofacial fractures. Postoperatively, edema and maxillomandibular fixation place the patient at risk for further airway compromise. PMID:22110788

  1. Mechanisms Linking Advanced Airway Management and Cardiac Arrest Outcomes

    PubMed Central

    Benoit, Justin L.; Prince, David K.; Wang, Henry E.

    2015-01-01

    Advanced airway management – such as endotracheal intubation (ETI) or supraglottic airway (SGA) insertion – is one of the most prominent interventions in out-of-hospital cardiac arrest (OHCA) resuscitation. While randomized controlled trials are currently in progress to identify the best advanced airway technique in OHCA, the mechanisms by which airway management may influence OHCA outcomes remain unknown. We provide a conceptual model describing potential mechanisms linking advanced airway management with OHCA outcomes. PMID:26073275

  2. 23 CFR 660.107 - Allocations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Allocations. 660.107 Section 660.107 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS SPECIAL PROGRAMS (DIRECT FEDERAL) Forest Highways § 660.107 Allocations. On October 1 of each fiscal year, the FHWA will allocate 66 percent of Public Lands...

  3. 15 CFR 923.110 - Allocation formula.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Allocation formula. 923.110 Section... Grants § 923.110 Allocation formula. (a) As required by subsection 306(a), the Secretary may make grants...) Allocation formula factors and weighting. Each State eligible to receive a financial assistance award...

  4. 10 CFR 455.31 - Allocation formulas.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Allocation formulas. 455.31 Section 455.31 Energy... § 455.31 Allocation formulas. (a) Financial assistance for conducting technical assistance programs for... this section. (c) The allocation factor (K) shall be determined by the formula: EC14NO91.086 where,...

  5. 24 CFR 574.130 - Formula allocations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Formula allocations. 574.130... URBAN DEVELOPMENT COMMUNITY FACILITIES HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS Formula Entitlements § 574.130 Formula allocations. (a) Data sources. HUD will allocate funds based on the number of cases...

  6. 24 CFR 92.50 - Formula allocation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Formula allocation. 92.50 Section 92.50 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Allocation Formula § 92.50 Formula allocation....

  7. 24 CFR 92.50 - Formula allocation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Formula allocation. 92.50 Section 92.50 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Allocation Formula § 92.50 Formula allocation....

  8. 24 CFR 92.50 - Formula allocation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Formula allocation. 92.50 Section 92.50 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Allocation Formula § 92.50 Formula allocation....

  9. Nasal airway responses to nasal continuous positive airway pressure breathing: An in-vivo pilot study.

    PubMed

    White, David E; Bartley, Jim; Shakeel, Muhammad; Nates, Roy J; Hankin, Robin K S

    2016-06-14

    The nasal cycle, through variation in nasal airflow partitioning, allows the upper airway to accommodate the contrasting demands of air conditioning and removal of entrapped air contaminants. The purpose of this study was to investigate the influence of nasal continuous positive airway pressure (nCPAP) breathing has on both nasal airflow partitioning and nasal geometry. Using a custom-made nasal mask, twenty healthy participants had the airflow in each naris measured during normal nasal breathing followed by nCPAP breathing. Eight participants also underwent magnetic resonance imaging (MRI) of the nasal region during spontaneous nasal breathing, and then nCPAP breathing over a range of air pressures. During nCPAP breathing, a simultaneous reduction in airflow through the patent airway together with a corresponding increase in airway flow within the congested nasal airway were observed in sixteen of the twenty participants. Nasal airflow resistance is inversely proportional to airway cross-sectional area. MRI data analysis during nCPAP breathing confirmed airway cross-sectional area reduced along the patent airway while the congested airway experienced an increase in this parameter. During awake breathing, nCPAP disturbs the normal inter-nasal airflow partitioning. This could partially explain the adverse nasal drying symptoms frequently reported by many users of this therapy. PMID:27173595

  10. Airway registry: a performance improvement surveillance project of emergency department airway management.

    PubMed

    Phelan, Michael P; Glauser, Jonathan; Yuen, Ho-Wang A; Sturges-Smith, Elizabeth; Schrump, Stefanie E

    2010-01-01

    The aim of this study was to determine if use of a standardized airway data collection sheet can survey airway management practices in an emergency department. Success rates and trends from the authors' facility have been benchmarked against the National Emergency Airway Registry (NEAR). This study included all patients requiring invasive airway management during a 21-month period (July 1, 2005, through March 31, 2007). An audit form was developed and implemented to collect data on intubations. During the study period, 224 patients required invasive airway control. Of all airways managed by emergency medicine residents, the intubation success rate was 99% (200/203; 95% confidence interval [CI] = 96%-100%), with 3% of those (6/203; 95% CI = 1%-6%) requiring more than 3 attempts; 3 patients (1%; 95% CI = 0%-4%) could not be intubated and required a surgical airway. Use of an airway registry based on the NEAR registry as a benchmark of rates and types of successful intubation allows comparison of airway practices. PMID:20505111

  11. Communication patterns and allocation strategies.

    SciTech Connect

    Leung, Vitus Joseph; Mache, Jens Wolfgang; Bunde, David P.

    2004-01-01

    Motivated by observations about job runtimes on the CPlant system, we use a trace-driven microsimulator to begin characterizing the performance of different classes of allocation algorithms on jobs with different communication patterns in space-shared parallel systems with mesh topology. We show that relative performance varies considerably with communication pattern. The Paging strategy using the Hilbert space-filling curve and the Best Fit heuristic performed best across several communication patterns.

  12. Minority Transportation Expenditure Allocation Model

    1993-04-12

    MITRAM (Minority TRansportation expenditure Allocation Model) can project various transportation related attributes of minority (Black and Hispanic) and majority (white) populations. The model projects vehicle ownership, vehicle miles of travel, workers, new car and on-road fleet fuel economy, amount and share of household income spent on gasoline, and household expenditures on public transportation and taxis. MITRAM predicts reactions to sustained fuel price changes for up to 10 years after the change.

  13. Therapeutic bronchoscopic interventions for malignant airway obstruction

    PubMed Central

    Dalar, Levent; Özdemir, Cengiz; Abul, Yasin; Karasulu, Levent; Sökücü, Sinem Nedime; Akbaş, Ayşegül; Altın, Sedat

    2016-01-01

    Abstract There is no definitive consensus about the factors affecting the choice of interventional bronchoscopy in the management of malignant airway obstruction. The present study defines the choice of the interventional bronchoscopic modality and analyzes the factors influencing survival in patients with malignant central airway obstruction. Totally, over 7 years, 802 interventional rigid bronchoscopic procedures were applied in 547 patients having malignant airway obstruction. There was a significant association between the type of stent and the site of the lesion in the present study. Patients with tracheal involvement and/or involvement of the main bronchi had the worst prognosis. The sites of the lesion and endobronchial treatment modality were independent predictors of survival in the present study. The selection of different types of airway stents can be considered on the base of site of the lesion. Survival can be estimated based on the site of the lesion and endobronchial brochoscopic modality used. PMID:27281104

  14. BEHAVIOR OF CIGARETTE SMOKE IN HUMAN AIRWAYS

    EPA Science Inventory

    Experimental deposition patterns of cigarette smoke in surrogate human airway systems are very heterogeneous. article deposits are enhanced at predictable, well-defined morphological regions; most specifically, carinal ridges within bifurcation zones, and along posterior sections...

  15. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  16. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  17. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  18. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  19. Diesel exhaust particles and airway inflammation

    EPA Science Inventory

    Purpose of review. Epidemiologic investigation has associated traffic-related air pollution with adverse human health outcomes. The capacity ofdiesel exhaust particles (DEP), a major emission source air pollution particle, to initiate an airway inflammation has subsequently been ...

  20. Role of platelets in allergic airway inflammation.

    PubMed

    Idzko, Marco; Pitchford, Simon; Page, Clive

    2015-06-01

    Increasing evidence suggests an important role for platelets and their products (e.g., platelet factor 4, β-thromboglobulin, RANTES, thromboxane, or serotonin) in the pathogenesis of allergic diseases. A variety of changes in platelet function have been observed in patients with asthma, such as alterations in platelet secretion, expression of surface molecules, aggregation, and adhesion. Moreover, platelets have been found to actively contribute to most of the characteristic features of asthma, including bronchial hyperresponsiveness, bronchoconstriction, airway inflammation, and airway remodeling. This review brings together the current available data from both experimental and clinical studies that have investigated the role of platelets in allergic airway inflammation and asthma. It is anticipated that a better understanding of the role of platelets in the pathogenesis of asthma might lead to novel promising therapeutic approaches in the treatment of allergic airway diseases. PMID:26051948

  1. Virtual Airway Skills Trainer (VAST) Simulator.

    PubMed

    Demirel, Doga; Yu, Alexander; Halic, Tansel; Sankaranarayanan, Ganesh; Ryason, Adam; Spindler, David; Butler, Kathryn L; Cao, Caroline; Petrusa, Emil; Molina, Marcos; Jones, Dan; De, Suvranu; Demoya, Marc; Jones, Stephanie

    2016-01-01

    This paper presents a simulation of Virtual Airway Skill Trainer (VAST) tasks. The simulated tasks are a part of two main airway management techniques; Endotracheal Intubation (ETI) and Cricothyroidotomy (CCT). ETI is a simple nonsurgical airway management technique, while CCT is the extreme surgical alternative to secure the airway of a patient. We developed identification of Mallampati class, finding the optimal angle for positioning pharyngeal/mouth axes tasks for ETI and identification of anatomical landmarks and incision tasks for CCT. Both ETI and CCT simulators were used to get physicians' feedback at Society for Education in Anesthesiology and Association for Surgical Education spring meetings. In this preliminary validation study, total 38 participants for ETI and 48 for CCT performed each simulation task and completed pre and post questionnaires. In this work, we present the details of the simulation for the tasks and also the analysis of the collected data from the validation study. PMID:27046559

  2. Airway management for cervical spine surgery.

    PubMed

    Farag, Ehab

    2016-03-01

    Cervical spine surgery is one of the most commonly performed spine surgeries in the United States, and 90% of the cases are related to degenerative cervical spine disease (the rest to cervical spine trauma and/or instability). The airway management for cervical spine surgery represents a crucial step in the anesthetic management to avoid injury to the cervical cord. The crux for upper airway management for cervical spine surgery is maintaining the neck in a neutral position with minimal neck movement during endotracheal intubation. Therefore, the conventional direct laryngoscopy (DL) can be unsuitable for securing the upper airway in cervical spine surgery, especially in cases of cervical spine instability and myelopathy. This review discusses the most recent evidence-based facts of the main advantages and limitations of different techniques available for upper airway management for cervical spine surgery. PMID:27036600

  3. The Role of Capital Productivity in British Airways' Financial Recovery

    NASA Technical Reports Server (NTRS)

    Morrell, Peter

    1999-01-01

    British Airways (BA) was privatized in 1987, but its financial recovery occurred a number of years earlier, This recovery was sustained throughout the early 1990s economic recession, a period when few major airlines were operating profitably. This paper examines the role of productivity developments at British Airways from the early 1980s through 1996. The emphasis is on capital productivity and investment, but changes in capital intensity and labour productivity are also evaluated. Various measures are considered for both capital and labour productivity: outputs are measured in available tonne-kms (ATKs) and revenue tonne-kms (RTKs), with the former preferred over the latter two measures, after adjustment for work performed by BA for others. Capital inputs are measured in equivalent lease costs adjusted to constant prices with a different treatment of flight and ground equipment or assets. Labour inputs are derived from total payroll costs deflated by a UK wage price index. The airline made considerable capital investments over the period and at the same time went through two major processes of labour restructuring. This resulted in a gradual increase in capital intensity, relative high labour productivity growth, but poor capital productivity performance, However, capital investment played an important role in the airline's sustained labour and total factor productivity over the whole period.

  4. The Role of Capital Productivity in British Airways' Financial Recovery

    NASA Technical Reports Server (NTRS)

    Morrell, Peter

    1999-01-01

    British Airways (BA) was privatised in 1987, but its financial recovery occurred a number of years earlier. This recovery was sustained throughout the early 1990s economic recession, a period when few major airlines were operating profitably. This paper examines the role of productivity developments at British Airways from the early 1980s through 1996. The emphasis is on capital productivity and investment, but changes in capital intensity and labour productivity are also evaluated. Various measures are considered for both capital and labour productivity: outputs are measured in available tonne-kms (ATKS) and revenue tonne-kms (RTKs), with the former preferred over the latter two measures, after adjustment for work performed by BA for others. Capital inputs are measured in equivalent lease costs adjusted to constant prices with a different treatment of flight and ground equipment or assets. Labour inputs are derived from total payroll costs deflated by a UK wage price index. The airline made considerable capital investments over the period and at the same time went through two major processes of labour restructuring. This resulted in a gradual increase in capital intensity, relative high labour productivity growth, but poor capital productivity performance. However, capital investment played an important role in the airline's sustained labour and total factor productivity over the whole period.

  5. Organ Allocation for Liver Transplantation According to the Public Opinion

    PubMed Central

    Danesh, Ahmad; Nedjat, Saharnaz; Asghari, Fariba; Jafarian, Ali; Fotouhi, Akbar

    2012-01-01

    Background Although liver transplantation is the last resort for treating end stage liver diseases, this medical procedure is not available for all needful patients because of inadequate organ supply. Therefore, guidelines have been developed by medical experts to regulate the process. Some professionals believe that medical criteria are inadequate for organ allocation in all situations and may not secure fairness of organ allocation. Objectives The current study has been designed to identify decision criteria about allocation of donated liver to potential recipients from public points of view. Patients and Methods This is a qualitative study that was conducted through individual interviews and Focus Group Discussions. Individual interviews were conducted among patients’ companions and nurses in one of the two liver transplant centers in Iran. Group discussions were conducted among groups of ordinary people who had not dealt previously with the subject. Data was analyzed by Thematic Analysis method. Results Most of the participants in this study believe that in equal medical conditions, some individual and societal criteria could be used to prioritize patients for receiving donated livers. The criteria include psychological acceptance, ability to pay post-operative care costs, being breadwinner of the family, family support, being socially valued, ability to be instructed, lack of mental disorders, young age of the recipient, being on waiting list for a long time, lack of patient’s role in causing the illness, first time transplant recipient, critical medical condition, high success rate of transplantation, lack of concurrent medical illnesses, not being an inmate at the time of receiving transplant, and bearing Iranian nationality. Conclusions Taking public opinion into consideration may smooth the process of organ allocation to needful patients with equal medical conditions. It seems that considering these viewpoints in drafting organ allocation guidelines

  6. 48 CFR 352.216-70 - Additional cost principles.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... indirect costs on the same basis as the allocation of indirect costs to sponsored research and development. (3) The cost of IR & D, including its proportionate share of indirect costs, is unallowable. (End of... are allowable as indirect costs. (3) B & P costs of past accounting periods are unallowable in...

  7. 48 CFR 3452.216-70 - Additional cost principles.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... costs of the current accounting period are allowable as indirect costs; bid and proposal costs of past... indirect costs on the same basis as the allocations of indirect costs of sponsored research and development. The costs of independent research and development, including its proportionate share of indirect...

  8. 48 CFR 3452.216-70 - Additional cost principles.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... costs of the current accounting period are allowable as indirect costs; bid and proposal costs of past... indirect costs on the same basis as the allocations of indirect costs of sponsored research and development. The costs of independent research and development, including its proportionate share of indirect...

  9. 48 CFR 3452.216-70 - Additional cost principles.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... costs of the current accounting period are allowable as indirect costs; bid and proposal costs of past... indirect costs on the same basis as the allocations of indirect costs of sponsored research and development. The costs of independent research and development, including its proportionate share of indirect...

  10. Endotracheal Tube Management and Obstructed Airway.

    PubMed

    Sancheti, Manu; Force, Seth

    2015-08-01

    Thoracic surgery encompasses a wide array of surgical techniques, most of which require lung isolation for surgical exposure in the pleural cavity; this, in turn, demands an extensive knowledge of respiratory mechanics and modalities of airway control. Likewise, effective treatment of an acute central airway obstruction calls for a systematic approach using clear communication between teams and a comprehensive knowledge of available therapeutic modalities by the surgeon. PMID:26210924

  11. Medical management considerations for upper airway disease.

    PubMed

    Spaulding, G L

    1992-06-01

    The conducting airways, also commonly referred to as the upper airways, provide for the passage of air to and from the atmosphere and lungs. Anatomical components include the nasal passages, pharynx, larynx, trachea, and mainstem bronchi. Clinical problems involving the conducting airways can be manifested by relatively mild clinical signs of stertorous breathing, by life-threatening dyspnea, or by chronic bouts of inspiratory stridor and cough. Concurrent disease of the lower respiratory system (ie, chronic bronchitis) as well as other organ systems (ie, cardiovascular, nervous, endocrine) may significantly contribute to the etiology and pathophysiology of upper airway disease. Diagnosis of the diseases of the conducting airways is primarily based on history and physical examination. The dynamic nature of some conditions, related to the phases of respiration, can make diagnosis more difficult. In addition to direct visualization, radiographic and endoscopic evaluation are often useful. Many upper airway problems, especially congenital conditions, lend themselves to surgical palliation that should be performed as early in life as possible. Medical management is often directed at treating underlying diseases and the relief of clinical signs. Historically, the use of variety of drugs have been advocated and frequently include decongestants, cough suppressants, bronchodilators, glucocorticoids, and antibiotics. However, their use may be detrimental and contraindicated. In addition, therapy for some conditions (ie, laryngeal paralysis and intrathoracic tracheal collapse) may be better directed at increasing airway muscle tone in order to stabilized airway patency. Therapeutic agents that may be useful include aspirin and digitalis. The overall objective to medical management must be to balance potential therapeutic benefit against untoward effects in order to minimize clinical signs and to improve the animal's quality of life. PMID:1643322

  12. Tracheal and airway collapse in dogs.

    PubMed

    Maggiore, Ann Della

    2014-01-01

    Tracheal and airway collapse (bronchomalacia) are common causes of chronic cough in middle-aged to older dogs where weakening of cartilage within the respiratory system leads to narrowing of airways, coughing, wheezing, and other secondary effects. Successful treatment involves correct identification of the problem, recognition of concurrent problems, and appropriate medical therapy. Surgical and noninvasive treatment options are becoming readily available, and it is important to understand indications for such procedures. PMID:24268337

  13. Basolateral chloride current in human airway epithelia.

    PubMed

    Itani, Omar A; Lamb, Fred S; Melvin, James E; Welsh, Michael J

    2007-10-01

    Electrolyte transport by airway epithelia regulates the quantity and composition of liquid covering the airways. Previous data indicate that airway epithelia can absorb NaCl. At the apical membrane, cystic fibrosis transmembrane conductance regulator (CFTR) provides a pathway for Cl(-) absorption. However, the pathways for basolateral Cl(-) exit are not well understood. Earlier studies, predominantly in cell lines, have reported that the basolateral membrane contains a Cl(-) conductance. However, the properties have varied substantially in different epithelia. To better understand the basolateral Cl(-) conductance in airway epithelia, we studied primary cultures of well-differentiated human airway epithelia. The basolateral membrane contained a Cl(-) current that was inhibited by 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS). The current-voltage relationship was nearly linear, and the halide selectivity was Cl(-) > Br(-) > I(-). Several signaling pathways increased the current, including elevation of cellular levels of cAMP, activation of protein kinase C (PKC), and reduction of pH. In contrast, increasing cell Ca(2+) and inducing cell swelling had no effect. The basolateral Cl(-) current was present in both cystic fibrosis (CF) and non-CF airway epithelia. Likewise, airway epithelia from wild-type mice and mice with disrupted genes for ClC-2 or ClC-3 all showed similar Cl(-) currents. These data suggest that the basolateral membrane of airway epithelia possesses a Cl(-) conductance that is not due to CFTR, ClC-2, or ClC-3. Its regulation by cAMP and PKC signaling pathways suggests that coordinated regulation of Cl(-) conductance in both apical and basolateral membranes may be important in controlling transepithelial Cl(-) movement. PMID:17660331

  14. Allocating Variability and Reserve Requirements (Presentation)

    SciTech Connect

    Kirby, B.; King, J.; Milligan, M.

    2011-10-01

    This presentation describes how you could conceivably allocate variability and reserve requirements, including how to allocate aggregation benefits. Conclusions of this presentation are: (1) Aggregation provides benefits because individual requirements are not 100% correlated; (2) Method needed to allocate reduced requirement among participants; (3) Differences between allocation results are subtle - (a) Not immediately obvious which method is 'better'; (b) Many are numerically 'correct', they sum to the physical requirement; (c) Many are not 'fair', Results depend on sub-aggregation and/or the order individuals are included; and (4) Vector allocation method is simple and fair.

  15. Trichobezoar Causing Airway Compromise during Esophagogastroduodenoscopy.

    PubMed

    Kao, Erica Y; Scalzitti, Nicholas J; Dion, Gregory R; Bowe, Sarah N

    2015-01-01

    Objectives. (1) Report the case of a 5-year-old female with trichotillomania and trichophagia that suffered airway compromise during esophagogastroduodenoscopy for removal of a trichobezoar. (2) Provide management recommendations for an unusual foreign body causing extubation and partial airway obstruction. Methods. Case report of a rare situation of airway compromise caused by a trichobezoar. Results. A 5-year-old patient underwent endoscopic retrieval of a gastric trichobezoar (hairball) by the gastroenterology service under general endotracheal anesthesia in a sedation unit. During removal, the hairball, due to its large size, dislodged the endotracheal tube, effectively extubating the patient. The bezoar became lodged at the cricopharyngeus muscle. Attempts to remove the bezoar or reintubation were unsuccessful. The child was able to be mask ventilated while the otolaryngology service was called. Direct laryngoscopy revealed a hairball partially obstructing the view of the glottis from its position in the postcricoid area. The hairball, still entrapped in the snare from the esophagoscope, was grasped with Magill forceps and slowly extracted. The patient was then reintubated and the airway and esophagus were reevaluated. Conclusions. Trichobezoar is an uncommon cause of airway foreign body. Careful attention to airway management during these and similar foreign body extractions can prevent inadvertent extubations. PMID:26457086

  16. Acid-sensing by airway afferent nerves

    PubMed Central

    Lee, Lu-Yuan; Gu, Qihai; Xu, Fadi; Hong, Ju-Lun

    2013-01-01

    Inhalation of acid aerosol or aspiration of acid solution evokes a stimulatory effect on airway C-fiber and Aδ afferents, which in turn causes airway irritation and triggers an array of defense reflex responses (e.g., cough, reflex bronchoconstriction, etc.). Tissue acidosis can also occur locally in the respiratory tract as a result of ischemia or inflammation, such as in the airways of asthmatic patients during exacerbation. The action of proton on the airway sensory neurons is generated by activation of two different current species: a transient (rapidly activating and inactivating) current mediated through the acid-sensing ion channels, and a slowly activating and sustained current mediated through the transient receptor potential vanilloid type 1 (TRPV1) receptor. In view of the recent findings that the expression and/or sensitivity of TRPV1 are up-regulated in the airway sensory nerves during chronic inflammatory reaction, the proton-evoked irritant effects on these nerves may play an important part in the manifestation of various symptoms associated with airway inflammatory diseases. PMID:23524016

  17. Interleukin-20 promotes airway remodeling in asthma.

    PubMed

    Gong, Wenbin; Wang, Xin; Zhang, Yuguo; Hao, Junqing; Xing, Chunyan; Chu, Qi; Wang, Guicheng; Zhao, Jiping; Wang, Junfei; Dong, Qian; Liu, Tian; Zhang, Yuanyuan; Dong, Liang

    2014-12-01

    Previous studies have demonstrated that interleukin-20 (IL-20) is a pro-inflammatory cytokine, and it has been implicated in psoriasis, lupus nephritis, rheumatoid arthritis, atherosclerosis, and ulcerative colitis. Little is known about the effects of IL-20 in airway remodeling in asthma. The aim of our study was to demonstrate the function of IL-20 in airway remodeling in asthma. To identify the expression of IL-20 and its receptor, IL-20R1/IL-20R2, in the airway epithelium in bronchial tissues, bronchial biopsy specimens were collected from patients and mice with asthma and healthy subjects and stained with specific antibodies. To characterize the effects of IL-20 in asthmatic airway remodeling, we silenced and stimulated IL-20 in cell lines isolated from mice by shRNA and recombinant protein approaches, respectively, and detected the expression of α-SMA and FN-1 by Western blot analysis. First, overexpression of IL-20 and its receptor, IL-20R1/IL-20R2, was detected in the airway epithelium collected from patients and mice with asthma. Second, IL-20 increased the expression of fibronectin-1 and α-SMA, and silencing of IL-20 in mouse lung epithelial (MLE)-12 cells decreased the expression of fibronectin-1 and α-SMA. IL-20 may be a critical cytokine in airway remodeling in asthma. This study indicates that targeting IL-20 and/or its receptors may be a new therapeutic strategy for asthma. PMID:25028099

  18. Regulation of Airway Mucin Gene Expression

    PubMed Central

    Thai, Philip; Loukoianov, Artem; Wachi, Shinichiro; Wu, Reen

    2015-01-01

    Mucins are important components that exert a variety of functions in cell-cell interaction, epidermal growth factor receptor signaling, and airways protection. In the conducting airways of the lungs, mucins are the major contributor to the viscoelastic property of mucous secretion, which is the major barrier to trapping inhaled microbial organism, particulates, and oxidative pollutants. The homeostasis of mucin production is an important feature in conducting airways for the maintenance of mucociliary function. Aberrant mucin secretion and accumulation in airway lumen are clinical hallmarks associated with various lung diseases, such as asthma, chronic obstructive pulmonary disease, cystic fibrosis, emphysema, and lung cancer. Among 20 known mucin genes identified, 11 of them have been verified at either the mRNA and/or protein level in airways. The regulation of mucin genes is complicated, as are the mediators and signaling pathways. This review summarizes the current view on the mediators, the signaling pathways, and the transcriptional units that are involved in the regulation of airway mucin gene expression. In addition, we also point out essential features of epigenetic mechanisms for the regulation of these genes. PMID:17961085

  19. Trichobezoar Causing Airway Compromise during Esophagogastroduodenoscopy

    PubMed Central

    Kao, Erica Y.; Scalzitti, Nicholas J.; Dion, Gregory R.; Bowe, Sarah N.

    2015-01-01

    Objectives. (1) Report the case of a 5-year-old female with trichotillomania and trichophagia that suffered airway compromise during esophagogastroduodenoscopy for removal of a trichobezoar. (2) Provide management recommendations for an unusual foreign body causing extubation and partial airway obstruction. Methods. Case report of a rare situation of airway compromise caused by a trichobezoar. Results. A 5-year-old patient underwent endoscopic retrieval of a gastric trichobezoar (hairball) by the gastroenterology service under general endotracheal anesthesia in a sedation unit. During removal, the hairball, due to its large size, dislodged the endotracheal tube, effectively extubating the patient. The bezoar became lodged at the cricopharyngeus muscle. Attempts to remove the bezoar or reintubation were unsuccessful. The child was able to be mask ventilated while the otolaryngology service was called. Direct laryngoscopy revealed a hairball partially obstructing the view of the glottis from its position in the postcricoid area. The hairball, still entrapped in the snare from the esophagoscope, was grasped with Magill forceps and slowly extracted. The patient was then reintubated and the airway and esophagus were reevaluated. Conclusions. Trichobezoar is an uncommon cause of airway foreign body. Careful attention to airway management during these and similar foreign body extractions can prevent inadvertent extubations. PMID:26457086

  20. Small Airway Dysfunction and Abnormal Exercise Responses

    PubMed Central

    Petsonk, Edward L.; Stansbury, Robert C.; Beeckman-Wagner, Lu-Ann; Long, Joshua L.; Wang, Mei Lin

    2016-01-01

    Rationale Coal mine dust exposure can cause symptoms and loss of lung function from multiple mechanisms, but the roles of each disease process are not fully understood. Objectives We investigated the implications of small airway dysfunction for exercise physiology among a group of workers exposed to coal mine dust. Methods Twenty coal miners performed spirometry, first breathing air and then helium-oxygen, single-breath diffusing capacity, and computerized chest tomography, and then completed cardiopulmonary exercise testing. Measurements and Main Results Six participants meeting criteria for small airway dysfunction were compared with 14 coal miners who did not. At submaximal workload, miners with small airway dysfunction used a higher proportion of their maximum voluntary ventilation and had higher ventilatory equivalents for both O2 and CO2. Regression modeling indicated that inefficient ventilation was significantly related to small airway dysfunction but not to FEV1 or diffusing capacity. At the end of exercise, miners with small airway dysfunction had 27% lower O2 consumption. Conclusions Small airway abnormalities may be associated with important inefficiency of exercise ventilation. In dust-exposed individuals with only mild abnormalities on resting lung function tests or chest radiographs, cardiopulmonary exercise testing may be important in defining causes of exercise intolerance. PMID:27073987