Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.

PubMed

Finkelstein, Eric A; Tham, Kwang-Wei; Haaland, Benjamin A; Sahasranaman, Aarti

2017-07-01

The prevalence of overweight and obesity has more than doubled in the past three decades, leading to rising rates of non-communicable diseases. This study tests whether adding a payment/rewards (term reward) program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance. We conducted a parallel-group randomized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals randomized to either control or reward arm in a 1:2 ratio. Control and reward arm participants received a four month weight loss program at the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital. Those in the reward arm paid a fee of S$165.00 (1US$ = 1.35S$) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals. Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value. The primary outcome was weight loss at months 4, 8, and 12. 161 participants were randomized to control (n = 54) or reward (n = 107) arms. Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded (3.4 kg vs 1.4 kg, p < 0.01), month 8 when rewards concluded (3.3 kg vs 1.8 kg, p < 0.05), and at month 12 (2.3 kg vs 0.8 kg, p < 0.05). These results reveal that a payment/rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence-based weight loss program. Future efforts should attempt to replicate this approach and identify how to cost effectively expand these programs to maximize their reach. This study is registered at www.clinicaltrials.gov (Identifier: NCT01533454). Copyright © 2017 Elsevier Ltd. All rights reserved.

A pilot study comparing two weight loss maintenance interventions among low-income, mid-life women.

PubMed

Samuel-Hodge, Carmen D; Johnston, Larry F; Gizlice, Ziya; Garcia, Beverly A; Lindsley, Sara C; Gold, Alison D; Braxton, Danielle F; Keyserling, Thomas C

2013-07-15

Despite high obesity prevalence rates, few low-income midlife women participate in weight loss maintenance trials. This pilot study aims to assess the effectiveness of two weight loss maintenance interventions in this under-represented population. Low-income midlife women who completed a 16-week weight loss intervention and lost  ≥ 8 lbs (3.6 kg) were eligible to enroll in one of two 12-month maintenance programs. The programs were similar in content and had the same number of total contacts, but were different in the contact modality (Phone + Face-to-Face vs. Face-to-Face Only). Two criteria were used to assess successful weight loss maintenance at 12 months: (1) retaining a loss of  ≥ 5% of body weight from the start of the weight loss phase and (2) a change in body weight of  < 3%, from the start to the end of the maintenance program. Outcome measures of changes in physiologic and psychosocial factors, and evaluations of process measures and program acceptability (measured at 12 months) are also reported. For categorical variables, likelihood ratio or Fisher's Exact (for small samples) tests were used to evaluate statistically significant relationships; for continuous variables, t-tests or their equivalents were used to assess differences between means and also to identify correlates of weight loss maintenance. Overall, during the 12-month maintenance period, 41% (24/58) of participants maintained a loss of  ≥ 5% of initial weight and 43% (25/58) had a <3% change in weight. None of the comparisons between the two maintenance programs were statistically significant. However, improvements in blood pressure and dietary behaviors remained significant at the end of the 12-month maintenance period for participants in both programs. Participant attendance and acceptability were high for both programs. The effectiveness of two pilot 12-month maintenance interventions provides support for further research in weight loss maintenance among high-risk, low-income women. ClinicalTrials.gov Identifier: NCT00288301.

TCF7L2 polymorphism, weight loss and proinsulin:insulin ratio in the diabetes prevention program.

PubMed

McCaffery, Jeanne M; Jablonski, Kathleen A; Franks, Paul W; Dagogo-Jack, Sam; Wing, Rena R; Knowler, William C; Delahanty, Linda; Dabelea, Dana; Hamman, Richard; Shuldiner, Alan R; Florez, Jose C

2011-01-01

TCF7L2 variants have been associated with type 2 diabetes, body mass index (BMI), and deficits in proinsulin processing and insulin secretion. Here we sought to test whether these effects were apparent in high-risk individuals and modify treatment responses. We examined the potential role of the TCF7L2 rs7903146 variant in predicting resistance to weight loss or a lack of improvement of proinsulin processing during 2.5-years of follow-up participants (N = 2,994) from the Diabetes Prevention Program (DPP), a randomized controlled trial designed to prevent or delay diabetes in high-risk adults. We observed no difference in the degree of weight loss by rs7903146 genotypes. However, the T allele (conferring higher risk of diabetes) at rs7903146 was associated with higher fasting proinsulin at baseline (P<0.001), higher baseline proinsulin:insulin ratio (p<0.0001) and increased proinsulin:insulin ratio over a median of 2.5 years of follow-up (P = 0.003). Effects were comparable across treatment arms. The combination of a lack of impact of the TCF7L2 genotypes on the ability to lose weight, but the presence of a consistent effect on the proinsulin:insulin ratio over the course of DPP, suggests that high-risk genotype carriers at this locus can successfully lose weight to counter diabetes risk despite persistent deficits in insulin production.

Adherence to an overweight and obesity treatment: how to motivate a patient?

PubMed Central

Rizo, Mercedes; Cortés-Castell, Ernesto

2014-01-01

Objective. To explore anthropometric changes in normal-weight, overweight and obese subjects who did not dropout or fail a weight loss program over the 16 treatment weeks to improve patient motivation and treatment adherence. Methods. A clinical intervention study was conducted among 271 (including 100 dropouts and/or failures) obese and overweight patients who consulted a nutrition clinic in Barranquilla (Colombia) for the purpose of nutritional assessment. They were subject to a personalized weekly follow-up consultation over the course of 16 weeks in which initial and the final Body Mass Index (BMI, kg/m2), photographs, food consumption patterns, percentage weight loss, waist and hip circumference were registered and grouped according to BMI, measuring treatment response. Data’s nonparametric statistical comparison was made. Results. In 62 patients from the BMI < 25 group, there is weight loss of 2.6% (3.1 SD), 5.5% (3.3 SD) in waist circumference and 3.0% (2.5 SD) in hip circumference. In 67 patients from the 25 ≥ BMI < 30 group, there is weight loss of 3.8% (4.1 SD), 5.7% (4.5 SD) in waist circumference loss and 3.7% (3.0 SD) in hip circumference loss. In 42 patients from the BMI > 30 group, there is weight loss of 4.8% (3.7 SD), 7.0% (3.6 SD) in waist circumference loss and 3.9% (2.4 SD) in hip circumference loss. Monitoring is done every 4 weeks by the Friedman test, with significant differences between the three groups (p < 0.001). Patients do not drop out of treatment because they start to see physical results in waist decrease. When comparing final values of initial waist/hip circumference ratios and waist/height ratios, a clear decrease in the three BMI groups was observed (p < 0.001). Conclusion. After three weeks of continuous treatment patients improved in all overweight and obesity parameter indicators; there were not statistically significant differences in hip circumference (HC) and waist loss (WC) (%) among the three BMI groups (normal-weight, overweight, and obesity). In contrast, there were statistically significant differences in weight loss (%) and waist-to-hip ratios. Based on anthropometric outcomes and patient perception of their body image it can be concluded that the waist circumference loss is the parameter that retains obese patients in the weight loss program. PMID:25101227

Job Loss and Unmet Health Care Needs in the Economic Recession: Different Associations by Family Income

PubMed Central

Birkenmaier, Julie; Kim, Youngmi

2014-01-01

Objectives. We examined heterogeneous associations between job loss and unmet health care needs by family income level in the recent economic recession. Methods. We conducted logistic regression analyses with the sample from the 2008 Survey of Income and Program Participation (n = 12 658). Dependent variables were 2 dichotomous measures of unmet health care needs in medical and dental services. The primary independent variables were a dummy indicator of job loss during a 2-year period and the family income-to-needs ratio. We used an interaction term between job loss and the family income-to-needs ratio to test the proposed research question. Results. Job loss was significantly associated with the increased risk of unmet health care needs. The proportion with unmet needs was highest for the lowest-income unemployed, but the association between job loss and health hardship was stronger for the middle- and higher-income unemployed. Conclusions. The unemployed experience health hardship differently by income level. A comprehensive coordination of applications for unemployment and health insurance should be considered to protect the unemployed from health hardship. PMID:25211745

Job loss and unmet health care needs in the economic recession: different associations by family income.

PubMed

Huang, Jin; Birkenmaier, Julie; Kim, Youngmi

2014-11-01

We examined heterogeneous associations between job loss and unmet health care needs by family income level in the recent economic recession. We conducted logistic regression analyses with the sample from the 2008 Survey of Income and Program Participation (n = 12,658). Dependent variables were 2 dichotomous measures of unmet health care needs in medical and dental services. The primary independent variables were a dummy indicator of job loss during a 2-year period and the family income-to-needs ratio. We used an interaction term between job loss and the family income-to-needs ratio to test the proposed research question. Job loss was significantly associated with the increased risk of unmet health care needs. The proportion with unmet needs was highest for the lowest-income unemployed, but the association between job loss and health hardship was stronger for the middle- and higher-income unemployed. The unemployed experience health hardship differently by income level. A comprehensive coordination of applications for unemployment and health insurance should be considered to protect the unemployed from health hardship.

Predicting complete loss to follow-up after a health-education program: number of absences and face-to-face contact with a researcher.

PubMed

Park, M J; Yamazaki, Yoshihiko; Yonekura, Yuki; Yukawa, Keiko; Ishikawa, Hirono; Kiuchi, Takahiro; Green, Joseph

2011-10-27

Research on health-education programs requires longitudinal data. Loss to follow-up can lead to imprecision and bias, and complete loss to follow-up is particularly damaging. If that loss is predictable, then efforts to prevent it can be focused on those program participants who are at the highest risk. We identified predictors of complete loss to follow-up in a longitudinal cohort study. Data were collected over 1 year in a study of adults with chronic illnesses who were in a program to learn self-management skills. Following baseline measurements, the program had one group-discussion session each week for six weeks. Follow-up questionnaires were sent 3, 6, and 12 months after the baseline measurement. A person was classified as completely lost to follow-up if none of those three follow-up questionnaires had been returned by two months after the last one was sent.We tested two hypotheses: that complete loss to follow-up was directly associated with the number of absences from the program sessions, and that it was less common among people who had had face-to-face contact with one of the researchers. We also tested predictors of data loss identified previously and examined associations with specific diagnoses.Using the unpaired t-test, the U test, Fisher's exact test, and logistic regression, we identified good predictors of complete loss to follow-up. The prevalence of complete loss to follow-up was 12.2% (50/409). Complete loss to follow-up was directly related to the number of absences (odds ratio; 95% confidence interval: 1.78; 1.49-2.12), and it was inversely related to age (0.97; 0.95-0.99). Complete loss to follow-up was less common among people who had met one of the researchers (0.51; 0.28-0.95) and among those with connective tissue disease (0.29; 0.09-0.98). For the multivariate logistic model the area under the ROC curve was 0.77. Complete loss to follow-up after this health-education program can be predicted to some extent from data that are easy to collect (age, number of absences, and diagnosis). Also, face-to-face contact with a researcher deserves further study as a way of increasing participation in follow-up, and health-education programs should include it.

A pilot study comparing two weight loss maintenance interventions among low-income, mid-life women

PubMed Central

2013-01-01

Background Despite high obesity prevalence rates, few low-income midlife women participate in weight loss maintenance trials. This pilot study aims to assess the effectiveness of two weight loss maintenance interventions in this under-represented population. Methods Low-income midlife women who completed a 16-week weight loss intervention and lost ≥ 8 lbs (3.6 kg) were eligible to enroll in one of two 12-month maintenance programs. The programs were similar in content and had the same number of total contacts, but were different in the contact modality (Phone + Face-to-Face vs. Face-to-Face Only). Two criteria were used to assess successful weight loss maintenance at 12 months: (1) retaining a loss of ≥ 5% of body weight from the start of the weight loss phase and (2) a change in body weight of < 3%, from the start to the end of the maintenance program. Outcome measures of changes in physiologic and psychosocial factors, and evaluations of process measures and program acceptability (measured at 12 months) are also reported. For categorical variables, likelihood ratio or Fisher’s Exact (for small samples) tests were used to evaluate statistically significant relationships; for continuous variables, t-tests or their equivalents were used to assess differences between means and also to identify correlates of weight loss maintenance. Results Overall, during the 12-month maintenance period, 41% (24/58) of participants maintained a loss of ≥ 5% of initial weight and 43% (25/58) had a <3% change in weight. None of the comparisons between the two maintenance programs were statistically significant. However, improvements in blood pressure and dietary behaviors remained significant at the end of the 12-month maintenance period for participants in both programs. Participant attendance and acceptability were high for both programs. Conclusions The effectiveness of two pilot 12-month maintenance interventions provides support for further research in weight loss maintenance among high-risk, low-income women. Trial registration ClinicalTrials.gov Identifier: NCT00288301 PMID:23855318

Financial performance of health plans in Medicaid managed care.

PubMed

McCue, Mike

2012-01-01

This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly traded, and provider-sponsored. National Association of Insurance Commissioners (NAIC) financial data, coupled with selected state financial data, were analyzed for 170 Medicaid health plans for 2009. A mean test compared the mean values for medical loss, administrative cost, and operating margin ratios across these plan traits. Medicaid dominant plans are plans with 75 percent of their total enrollment in the Medicaid line of business. Plans that are Medicaid dominant and publicly traded incurred a lower medical loss ratio and higher administrative cost ratio than multi-product and non-publicly traded plans. Medicaid dominant plans also earned a higher operating profit margin. Plans offering commercial and Medicare products are operating at a loss for their Medicaid line of business. Health plans that do not specialize in Medicaid are losing money. Higher medical cost rather than administrative cost is the underlying reason for this financial loss. Since Medicaid enrollees do not account for their primary book of business, these plans may not have invested in the medical management programs to reduce inappropriate emergency room use and avoid costly hospitalization.

[Cost-benefit analysis of a school-based smoking prevention program].

PubMed

Hormigo Amaro, Jordi; García-Altés, Anna; López, M José; Bartoll, Xavier; Nebot, Manel; Ariza, Carles

2009-01-01

To analyze the efficiency of a school-based smoking prevention program in Barcelona (PASE.bcn program). A cost-benefit analysis was performed. As costs we included those corresponding to the design and implementation of the program. As benefits we considered healthcare costs and the productivity losses avoided. This study was conducted from a societal perspective, and the estimations of costs and benefits related to 2005. Assuming an effectiveness of 1%, the PASE.bcn program would achieve a total benefit of 1,558,311.46euro. The healthcare benefits per prevented smoker were 1997.57euro, and the indirect benefits per prevented smoker were 21,260.80euro. Given the total cost of the school-based program (68,526.03euro), the cost-benefit ratio was 22.74. From a societal perspective, the benefits of school-based tobacco prevention programs, in terms of healthcare costs and productivity losses avoided, are far greater than the costs. These results support universal application of this type of intervention.

Teammates and social influence affect weight loss outcomes in a team-based weight loss competition.

PubMed

Leahey, Tricia M; Kumar, Rajiv; Weinberg, Brad M; Wing, Rena R

2012-07-01

Team-based internet interventions are increasing in popularity as a way of promoting weight loss in large numbers of individuals. Given that social networks influence health behavior change, this study investigated the effects of teammates and social influence on individual weight loss during a team-based weight loss competition. Shape Up Rhode Island (SURI) 2009 was a 12-week online program open to adult residents of Rhode Island. Participants joined with a team and competed with other teams on weight loss and/or physical activity. Overweight/obese (OW/OB) individuals (N = 3,330; 76% female; age = 46.1 ± 10.8; BMI = 31.2 ± 5.3 kg/m(2)), representing 987 teams, completed the weight loss program. Multilevel modeling was used to examine whether weight loss clustered among teammates and whether percentage of teammates in the weight loss division and reported teammate influence on weight loss were associated with individual weight outcomes. OW/OB completers reported losing 4.2 ± 3.4% of initial body weight. Weight loss was similar among teammates (intraclass correlation coefficient (ICC) = 0.10, P < 0.001). Moreover, having a greater percentage of teammates in the weight loss division and reporting higher social influence for weight loss were associated with greater percent weight loss (P's ≤ 0.002). Similarly, achieving a clinically significant (5%) weight loss tended to cluster within teams (ICC = 0.09; P < 0.001) and having more teammates in the weight loss division and higher social influence for weight loss were associated with increased likelihood of achieving a 5% weight loss (odds ratio (OR) = 1.06; OR = 1.20, respectively). These results suggest that teammates affect weight loss outcomes during a team-based intervention. Harnessing and maximizing teammate influence for weight loss may enhance weight outcomes in large-scale team-based programs.

76 FR 4703 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... regarding medical loss ratio standards and the insurance premium rate review process, and issues premium... Oriented Plan program. Collects, compiles and maintains comparative pricing data for an Internet portal... benefit from the new health insurance system. Collects, compiles and maintains comparative pricing data...

Optimal Control Strategy Design Based on Dynamic Programming for a Dual-Motor Coupling-Propulsion System

PubMed Central

Zhang, Shuo; Zhang, Chengning; Han, Guangwei; Wang, Qinghui

2014-01-01

A dual-motor coupling-propulsion electric bus (DMCPEB) is modeled, and its optimal control strategy is studied in this paper. The necessary dynamic features of energy loss for subsystems is modeled. Dynamic programming (DP) technique is applied to find the optimal control strategy including upshift threshold, downshift threshold, and power split ratio between the main motor and auxiliary motor. Improved control rules are extracted from the DP-based control solution, forming near-optimal control strategies. Simulation results demonstrate that a significant improvement in reducing energy loss due to the dual-motor coupling-propulsion system (DMCPS) running is realized without increasing the frequency of the mode switch. PMID:25540814

Optimal control strategy design based on dynamic programming for a dual-motor coupling-propulsion system.

PubMed

Zhang, Shuo; Zhang, Chengning; Han, Guangwei; Wang, Qinghui

2014-01-01

A dual-motor coupling-propulsion electric bus (DMCPEB) is modeled, and its optimal control strategy is studied in this paper. The necessary dynamic features of energy loss for subsystems is modeled. Dynamic programming (DP) technique is applied to find the optimal control strategy including upshift threshold, downshift threshold, and power split ratio between the main motor and auxiliary motor. Improved control rules are extracted from the DP-based control solution, forming near-optimal control strategies. Simulation results demonstrate that a significant improvement in reducing energy loss due to the dual-motor coupling-propulsion system (DMCPS) running is realized without increasing the frequency of the mode switch.

Accounting for Uncertainty and Time Lags in Equivalency Calculations for Offsetting in Aquatic Resources Management Programs

NASA Astrophysics Data System (ADS)

Bradford, Michael J.

2017-10-01

Biodiversity offset programs attempt to minimize unavoidable environmental impacts of anthropogenic activities by requiring offsetting measures in sufficient quantity to counterbalance losses due to the activity. Multipliers, or offsetting ratios, have been used to increase the amount of offsets to account for uncertainty but those ratios have generally been derived from theoretical or ad-hoc considerations. I analyzed uncertainty in the offsetting process in the context of offsetting for impacts to freshwater fisheries productivity. For aquatic habitats I demonstrate that an empirical risk-based approach for evaluating prediction uncertainty is feasible, and if data are available appropriate adjustments to offset requirements can be estimated. For two data-rich examples I estimate multipliers in the range of 1.5:1 - 2.5:1 are sufficient to account for the uncertainty in the prediction of gains and losses. For aquatic habitats adjustments for time delays in the delivery of offset benefits can also be calculated and are likely smaller than those for prediction uncertainty. However, the success of a biodiversity offsetting program will also depend on the management of the other components of risk not addressed by these adjustments.

Accounting for Uncertainty and Time Lags in Equivalency Calculations for Offsetting in Aquatic Resources Management Programs.

PubMed

Bradford, Michael J

2017-10-01

Biodiversity offset programs attempt to minimize unavoidable environmental impacts of anthropogenic activities by requiring offsetting measures in sufficient quantity to counterbalance losses due to the activity. Multipliers, or offsetting ratios, have been used to increase the amount of offsets to account for uncertainty but those ratios have generally been derived from theoretical or ad-hoc considerations. I analyzed uncertainty in the offsetting process in the context of offsetting for impacts to freshwater fisheries productivity. For aquatic habitats I demonstrate that an empirical risk-based approach for evaluating prediction uncertainty is feasible, and if data are available appropriate adjustments to offset requirements can be estimated. For two data-rich examples I estimate multipliers in the range of 1.5:1 - 2.5:1 are sufficient to account for the uncertainty in the prediction of gains and losses. For aquatic habitats adjustments for time delays in the delivery of offset benefits can also be calculated and are likely smaller than those for prediction uncertainty. However, the success of a biodiversity offsetting program will also depend on the management of the other components of risk not addressed by these adjustments.

SST Technology Follow-On Program-Phase 2, Noise Suppressor/Nozzle Development. Volume 2. Noise Technology

DTIC Science & Technology

1975-03-01

Loss Relationships 199 109 37-Tube, 4.5 Area Ratio Nozzle, Premergcd Jet Turbulence Noise 200 110 37-Tube Nozzle Premerged Jet Noise Peak...were obtained with the tunnel oil and at 165 knots. The tunnel air flows through a large , rectangular bell-mouth inlet, a (low straightening grid... ratio conditions on a fourteen-track annlog tape recorder for subsecjuent analysis after test com- pletion. Basic analysis of the recorded acoustic

A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial.

PubMed

Mensinger, Janell L; Calogero, Rachel M; Stranges, Saverio; Tylka, Tracy L

2016-10-01

Weight loss is the primary recommendation for health improvement in individuals with high body mass index (BMI) despite limited evidence of long-term success. Alternatives to weight-loss approaches (such as Health At Every Size - a weight-neutral approach) have been met with their own concerns and require further empirical testing. This study compared the effectiveness of a weight-neutral versus a weight-loss program for health promotion. Eighty women, aged 30-45 years, with high body mass index (BMI ≥ 30 kg/m(2)) were randomized to 6 months of facilitator-guided weekly group meetings using structured manuals that emphasized either a weight-loss or weight-neutral approach to health. Health measurements occurred at baseline, post-intervention, and 24-months post-randomization. Measurements included blood pressure, lipid panels, blood glucose, BMI, weight, waist circumference, hip circumference, distress, self-esteem, quality of life, dietary risk, fruit and vegetable intake, intuitive eating, and physical activity. Intention-to-treat analyses were performed using linear mixed-effects models to examine group-by-time interaction effects and between and within-group differences. Group-by-time interactions were found for LDL cholesterol, intuitive eating, BMI, weight, and dietary risk. At post-intervention, the weight-neutral program had larger reductions in LDL cholesterol and greater improvements in intuitive eating; the weight-loss program had larger reductions in BMI, weight, and larger (albeit temporary) decreases in dietary risk. Significant positive changes were observed overall between baseline and 24-month follow-up for waist-to-hip ratio, total cholesterol, physical activity, fruit and vegetable intake, self-esteem, and quality of life. These findings highlight that numerous health benefits, even in the absence of weight loss, are achievable and sustainable in the long term using a weight-neutral approach. The trial positions weight-neutral programs as a viable health promotion alternative to weight-loss programs for women of high weight. Copyright © 2016 Elsevier Ltd. All rights reserved.

78 FR 31283 - Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... organizations, insurance industry trade groups, provider associations, pharmacist and pharmacy associations, beneficiary advocacy groups, private citizens, and others. Overall, commenters supported our decision to model... enrollees, for 3 consecutive years, it will be forced to stop enrolling new individuals in such Part D...

Patient Protection and Affordable Care Act; HHS notice of benefit and payment parameters for 2016. Final rule.

PubMed

2015-02-27

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also finalizes additional standards for the individual market annual open enrollment period for the 2016 benefit year, essential health benefits, qualified health plans, network adequacy, quality improvement strategies, the Small Business Health Options Program, guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio program, and other related topics.

A Pilot Feasibility Study of Whole-systems Ayurvedic Medicine and Yoga Therapy for Weight Loss.

PubMed

Rioux, Jennifer; Thomson, Cynthia; Howerter, Amy

2014-01-01

To develop and test the feasibility of a whole-systems lifestyle intervention for obesity treatment based on the practices of Ayurvedic medicine/ Yoga therapy. A pre-post weight loss intervention pilot study using conventional and Ayurvedic diagnosis inclusion criteria, tailored treatment within a standardized treatment algorithm, and standardized data collection instruments for collecting Ayurvedic outcomes. A convenience sample of overweight/obese adult community members from Tucson, Arizona interested in a "holistic weight loss program" and meeting predetermined inclusion/exclusion criteria. A comprehensive diet, activity, and lifestyle modification program based on principles of Ayurvedic medicine/yoga therapy with significant self-monitoring of lifestyle behaviors. The 3-month program was designed to change eating and activity patterns and to improve self-efficacy, quality of life, well-being, vitality, and self-awareness around food choices, stress management, and barriers to weight loss. Changes in body weight, body mass index; body fat percentage, fat/lean mass, waist/hip circumference and ratio, and blood pressure. Diet and exercise self-efficacy scales; perceived stress scale; visual analog scales (VAS) of energy, appetite, stress, quality of life, well-being, and program satisfaction at all time points. Twenty-two adults attended an in-person Ayurvedic screening; 17 initiated the intervention, and 12 completed the 3-month intervention. Twelve completed follow-up at 6 months and 11 completed follow-up at 9 months. Mean weight loss at 3 months was 3.54 kg (SD 4.76); 6 months: 4.63 kg, (SD 6.23) and 9 months: 5.9 kg (SD 8.52). Self-report of program satisfaction was more than 90% at all time points. An Ayurveda-/yoga-based lifestyle modification program is an acceptable and feasible approach to weight management. Data collection, including self-monitoring and conventional and Ayurvedic outcomes, did not unduly burden participants, with attrition similar to that of other weight loss studies.

The economic consequences of malnutrition in Cambodia, more than 400 million US dollar lost annually.

PubMed

Bagriansky, Jack; Champa, Ngy; Pak, Kimchoeun; Whitney, Sophie; Laillou, Arnaud

2014-01-01

Cambodia is among the 28 worst countries globally with the highest rates of childhood malnutrition. The aim of the assessment was to apply published evidence associating malnutrition and a variety of functional consequences to project economic implications of this high rate of childhood malnutrition. Such information is vital to advocate for appropriate programs and action plan to reduce malnutrition (from severe stunting to micronutrient deficiencies). This exercise used a "consequence model" to apply these "coefficients of loss" established in the global scientific literature to Cambodia health, demographic and economic data to develop a national estimation of the economic losses link to malnutrition. The impact of the indicators of malnutrition analysed represent a burden to the national economy of Cambodia estimated at more than $400 million annually -2.5% of GDP. Micronutrient deficiencies suggest deficits in the quality of the diet - representing a national burden of more than $200 million annually while breastfeeding behaviours account for 6% of the burden. 57% of the losses emerge from indicators measured in children, while 43% of losses are from indicators independent of childhood measurements - indicators of maternal behaviour along with maternal and adult nutrition. Given the low cost of interventions and the high baseline losses, investment in nutrition programs in Cambodia is likely to offer high returns and attractive benefit cost ratios. Since nearly half the losses are determined prior to the birth of the child, this has implications for targeting and timing of programs.

New Method for Estimating Landslide Losses for Major Winter Storms in California.

NASA Astrophysics Data System (ADS)

Wills, C. J.; Perez, F. G.; Branum, D.

2014-12-01

We have developed a prototype system for estimating the economic costs of landslides due to winter storms in California. This system uses some of the basic concepts and estimates of the value of structures from the HAZUS program developed for FEMA. Using the only relatively complete landslide loss data set that we could obtain, data gathered by the City of Los Angeles in 1978, we have developed relations between landslide susceptibility and loss ratio for private property (represented as the value of wood frame structures from HAZUS). The landslide loss ratios estimated from the Los Angeles data are calibrated using more generalized data from the 1982 storms in the San Francisco Bay area to develop relationships that can be used to estimate loss for any value of 2-day or 30-day rainfall averaged over a county. The current estimates for major storms are long projections from very small data sets, subject to very large uncertainties, so provide a very rough estimate of the landslide damage to structures and infrastructure on hill slopes. More importantly, the system can be extended and improved with additional data and used to project landslide losses in future major winter storms. The key features of this system—the landslide susceptibility map, the relationship between susceptibility and loss ratio, and the calibration of estimates against losses in past storms—can all be improved with additional data. Most importantly, this study highlights the importance of comprehensive studies of landslide damage. Detailed surveys of landslide damage following future storms that include locations and amounts of damage for all landslides within an area are critical for building a well-calibrated system to project future landslide losses. Without an investment in post-storm landslide damage surveys, it will not be possible to improve estimates of the magnitude or distribution of landslide damage, which can range up to billions of dollars.

Calculation methods for steadily loaded, off-set pivot, tilting pad thrust bearings. (Guide to use of computer program A9235.)

NASA Astrophysics Data System (ADS)

1992-12-01

ESDU 92035 provides details of a FORTRAN program that implements the calculation method of ESDU 83004. It allows performance analysis of an existing design, or the design of a bearing dimensions, subject to any space constraint, are recommended. The predicted performance includes the lubricant film thickness under load, its temperature and flow rate, the power loss, and the bearing temperature. Recommendations are also made on surface finish. Warning messages are output in the following cases, for each of which possible remedial actions are suggested: drain or pad temperature too high, churning losses too great, film thickness too small, pad number too high, ratio or inner to outer pad radius too large, flow rate too great, lubricant or pad temperature outside usable range. A lubricant database is provided that may be extended or edited. The program applies to Newtonian lubricants in laminar flow. Worked examples illustrate the use of the program.

RTOD- RADIAL TURBINE OFF-DESIGN PERFORMANCE ANALYSIS

NASA Technical Reports Server (NTRS)

Glassman, A. J.

1994-01-01

The RTOD program was developed to accurately predict radial turbine off-design performance. The radial turbine has been used extensively in automotive turbochargers and aircraft auxiliary power units. It is now being given serious consideration for primary powerplant applications. In applications where the turbine will operate over a wide range of power settings, accurate off-design performance prediction is essential for a successful design. RTOD predictions have already illustrated a potential improvement in off-design performance offered by rotor back-sweep for high-work-factor radial turbines. RTOD can be used to analyze other potential performance enhancing design features. RTOD predicts the performance of a radial turbine (with or without rotor blade sweep) as a function of pressure ratio, speed, and stator setting. The program models the flow with the following: 1) stator viscous and trailing edge losses; 2) a vaneless space loss between the stator and the rotor; and 3) rotor incidence, viscous, trailing-edge, clearance, and disk friction losses. The stator and rotor viscous losses each represent the combined effects of profile, endwall, and secondary flow losses. The stator inlet and exit and the rotor inlet flows are modeled by a mean-line analysis, but a sector analysis is used at the rotor exit. The leakage flow through the clearance gap in a pivoting stator is also considered. User input includes gas properties, turbine geometry, and the stator and rotor viscous losses at a reference performance point. RTOD output includes predicted turbine performance over a specified operating range and any user selected flow parameters. The RTOD program is written in FORTRAN IV for batch execution and has been implemented on an IBM 370 series computer with a central memory requirement of approximately 100K of 8 bit bytes. The RTOD program was developed in 1983.

The 20 kW battery study program

NASA Technical Reports Server (NTRS)

1971-01-01

Six battery configurations were selected for detailed study and these are described. A computer program was modified for use in estimation of the weights, costs, and reliabilities of each of the configurations, as a function of several important independent variables, such as system voltage, battery voltage ratio (battery voltage/bus voltage), and the number of parallel units into which each of the components of the power subsystem was divided. The computer program was used to develop the relationship between the independent variables alone and in combination, and the dependent variables: weight, cost, and availability. Parametric data, including power loss curves, are given.

76 FR 72912 - TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the data necessary to update the FY 2012 rates.

78 FR 65618 - TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios, and the data necessary to update the FY 2014 rates.

77 FR 71180 - TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-29

...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the data necessary to update the FY 2013 rates.

A 12-week commercial web-based weight-loss program for overweight and obese adults: randomized controlled trial comparing basic versus enhanced features.

PubMed

Collins, Clare E; Morgan, Philip J; Jones, Penelope; Fletcher, Kate; Martin, Julia; Aguiar, Elroy J; Lucas, Ashlee; Neve, Melinda J; Callister, Robin

2012-04-25

The development and use of Web-based programs for weight loss is increasing rapidly, yet they have rarely been evaluated using randomized controlled trials (RCTs). Interestingly, most people who attempt weight loss use commercially available programs, yet it is very uncommon for commercial programs to be evaluated independently or rigorously. To compare the efficacy of a standard commercial Web-based weight-loss program (basic) versus an enhanced version of this Web program that provided additional personalized e-feedback and contact from the provider (enhanced) versus a wait-list control group (control) on weight outcomes in overweight and obese adults. This purely Web-based trial using a closed online user group was an assessor-blinded RCT with participants randomly allocated to the basic or enhanced 12-week Web-based program, based on social cognitive theory, or the control, with body mass index (BMI) as the primary outcome. We enrolled 309 adults (129/309, 41.8% male, BMI mean 32.3, SD 4 kg/m(2)) with 84.1% (260/309) retention at 12 weeks. Intention-to-treat analysis showed that both intervention groups reduced their BMI compared with the controls (basic: -0.72, SD 1.1 kg/m(2), enhanced: -1.0, SD 1.4, control: 0.15, SD 0.82; P < .001) and lost significant weight (basic: -2.1, SD 3.3 kg, enhanced: -3.0, SD 4.1, control: 0.4, SD 2.3; P < .001) with changes in waist circumference (basic: -2.0, SD 3.5 cm, enhanced: -3.2, SD 4.7, control: 0.5, SD 3.0; P < .001) and waist-to-height ratio (basic: -0.01, SD 0.02, enhanced: -0.02, SD 0.03, control: 0.0, SD 0.02; P < .001), but no differences were observed between the basic and enhanced groups. The addition of personalized e-feedback and contact provided limited additional benefits compared with the basic program. A commercial Web-based weight-loss program can be efficacious across a range of weight-related outcomes and lifestyle behaviors and achieve clinically important weight loss. Although the provision of additional personalized feedback did not facilitate greater weight loss after 12 weeks, the impact of superior participant retention on longer-term outcomes requires further study. Further research is required to determine the optimal mix of program features that lead to the biggest treatment impact over time. Australian New Zealand Clinical Trials Registry (ANZCTR): 12610000197033.

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2018; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program. Final rule.

PubMed

2016-12-22

This final rule sets forth payment parameters and provisions related to the risk adjustment program; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform. It also provides additional guidance relating to standardized options; qualified health plans; consumer assistance tools; network adequacy; the Small Business Health Options Programs; stand-alone dental plans; fair health insurance premiums; guaranteed availability and guaranteed renewability; the medical loss ratio program; eligibility and enrollment; appeals; consumer-operated and oriented plans; special enrollment periods; and other related topics.

Interleukin-20 circulating levels in obese women: effect of weight loss.

PubMed

Maiorino, M I; Schisano, B; Di Palo, C; Vietri, M T; Cioffi, M; Giugliano, G; Giugliano, D; Esposito, K

2010-03-01

Obesity is associated with an increased risk of developing atherosclerosis. Interleukin-20 (IL-20) is a pleiotropic cytokine thought to be involved in the onset and progression of atherosclerosis. The aim of this study was to determine whether circulating levels of IL-20 are elevated in obese women and whether they could be affected by a substantial decrease in body weight. Fifty obese and 50 age-matched, normal weight, premenopausal women participated in the study. Obese women entered into a medically supervised weight loss program aimed at reducing body weight to 90% of baseline. We measured anthropometric, glucose and lipid parameters, and IL-20, C-Reactive Protein (CRP) and interleukin-10 (IL-10) circulating levels. Circulating IL-20 and CRP levels were significantly higher in obese than control women (P=0.01), while IL-10 levels were significantly lower; IL-20 levels were positively associated with body weight (r=0.35; P=0.02) and visceral fat (waist-hip ratio; r=0.32; P=0.025). Caloric restriction-induced weight loss (>10% of original weight) over 6 months reduced IL-20 levels from 152 (112/184) to 134 (125/153)pg/ml (median and 25%/75%; P=0.03), and it was positively associated with changes in body mass index and waist-hip ratio. In premenopausal obese women, IL-20 levels are higher than matched normal weight control women, are associated with body weight and waist-hip ratio, and are reduced by weight loss. (c) 2009 Elsevier B.V. All rights reserved.

The Effects of Non-Compulsory Freshman Seminar and Core Curriculum Completion Ratios on Post-Secondary Persistence and Baccalaureate Degree Attainment

ERIC Educational Resources Information Center

Clouse, Wendi A.

2012-01-01

This study contributes to the body of research that is attempting to uncover what student characteristics and university programs and policies are predictive of student persistence and graduation. Loss of student enrollments through attrition prior to graduation and low graduation rates have significant negative consequences for universities and…

75 FR 79348 - TRICARE; Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

...This notice describes the changes made to the TRICARE DRG- based payment system in order to conform to changes made to the Medicare Prospective Payment System (PPS). It also provides the updated fixed loss cost outlier threshold, cost-to-charge ratios and the data necessary to update the Fiscal Year 2011 rates.

No net loss of fish habitat: a review and analysis of habitat compensation in Canada.

PubMed

Harper, D J; Quigley, J T

2005-09-01

The achievement of No Net Loss (NNL) through habitat compensation has rarely been assessed in Canada. Files relating to 124 Fisheries Act Section 35(2) authorizations issued by Fisheries and Oceans Canada for the harmful alteration, disruption, and destruction of fish habitat (HADD) were collected and reviewed. Data extracted from these files were pooled and analyzed to provide an indication of the types of HADDs that have been authorized in Canada, what habitats have been affected, and what habitat management approaches have been used when compensating for HADDs and monitoring and ensuring the success of the compensation. Determinations regarding the effectiveness of habitat compensation in achieving NNL were made. Impacts to 419,562 m2 of fish habitat from the 124 authorized HADDs were offset by 1,020,388 m2 of compensatory habitat. Eighty percent of the authorizations had compensation ratios (compensation area:HADD area) of 2:1 or less, and 25% of the authorizations had a compensation ratio that was less than 1:1. In-channel and riparian habitat were the most frequently impacted habitats. Urban development and roads and highways resulted in the greatest areal loss of habitat. The compensation option that was most often selected was the creation of in-kind habitat. The mean duration of post-construction monitoring programs was 3.7 years. Determinations of NNL could only be made for 17 authorizations as a result of poor proponent compliance with monitoring requirements and the qualitative assessment procedures used by the monitoring programs. Adequate resources, proper training, and standardized approaches to data management and monitoring programs are required to ensure that the conservation goal of NNL can be achieved in Canada.

Simulating the impacts of fire: A computer program

NASA Astrophysics Data System (ADS)

Ffolliott, Peter F.; Guertin, D. Phillip; Rasmussen, William D.

1988-11-01

Recurrent fire has played a dominant role in the ecology of southwestern ponderosa pine forests. To assess the benefits or losses of fire in these forests, a computer simulation model, called BURN, considers vegetation (mortality, regeneration, and production of herbaceous vegetation), wildlife (populations and habitats), and hydrology (streamflow and water quality). In the formulation of the model, graphical representations (time-trend response curves) of increases or losses (compared to an unburned control) after the occurrence of fire are converted to fixedterm annual ratios, and then annuities for the simulation components. Annuity values higher than 1.0 indicate benefits, while annuity values lower than 1.0 indicate losses. Studies in southwestern ponderosa pine forests utilized in the development of BURN are described briefly.

Hearing loss associated with US military combat deployment

PubMed Central

Wells, Timothy S.; Seelig, Amber D.; Ryan, Margaret A. K.; Jones, Jason M.; Hooper, Tomoko I.; Jacobson, Isabel G.; Boyko, Edward J.

2015-01-01

The objective of this study was to define the risk of hearing loss among US military members in relation to their deployment experiences. Data were drawn from the Millennium Cohort Study. Self-reported data and objective military service data were used to assess exposures and outcomes. Among all 48,540 participants, 7.5% self-reported new-onset hearing loss. Self-reported hearing loss showed moderate to substantial agreement (k = 0.57-0.69) with objective audiometric measures. New-onset hearing loss was associated with combat deployment (adjusted odds ratio [AOR] = 1.63, 95% confidence interval [CI] = 1.49-1.77), as well as male sex and older age. Among deployers, new-onset hearing loss was also associated with proximity to improvised explosive devices (AOR = 2.10, 95% CI = 1.62-2.73) and with experiencing a combat-related head injury (AOR = 6.88, 95% CI = 3.77-12.54). These findings have implications for health care and disability planning, as well as for prevention programs. PMID:25599756

Changes in Regional Adiposity and Cardio-Metabolic Function Following a Weight Loss Program with Sibutramine in Obese Men with Obstructive Sleep Apnea

PubMed Central

Phillips, Craig L.; Yee, Brendon J.; Trenell, Mike I.; Magnussen, John S.; Wang, David; Banerjee, Dev; Berend, Norbert; Grunstein, Ronald R.

2009-01-01

Background: Although obstructive sleep apnea (OSA) is strongly linked with obesity, both conditions have been associated with increased cardiovascular risk including glucose intolerance, dyslipidemia, and hypertension independent of one another. Weight loss is known to improve both cardiovascular risk and OSA severity. The aim of this study was to evaluate cardiovascular and metabolic changes, including compartment-specific fat loss in obese OSA subjects undergoing a weight loss program. Design: Observational study. Participants: 93 men with moderate-severe OSA. Interventions: 6-month open-label weight loss trial combining sibutramine (a serotonin and noradrenaline reuptake inhibitor) with a 600-kcal deficit diet and exercise. Measurements and Results: At baseline and following 6 months of weight loss, OSA was assessed together with CT-quantified intra-abdominal and liver fat and markers of metabolic and cardiovascular function. At 6 months, weight loss and improvements in OSA were accompanied by improved insulin resistance (HOMA), increased HDL cholesterol, and reduced total cholesterol/HDL ratio. There were also reductions in measures of visceral and subcutaneous abdominal fat and liver fat. Reductions in liver fat and sleep time spent below 90% oxyhemoglobin saturation partly explained the improvement in HOMA (R2 = 0.18). In contrast, arterial stiffness (aortic augmentation index), heart rate, blood pressure, and total cholesterol did not change. Conclusions: Weight loss with sibutramine was associated with improvements in metabolic and body composition risk factors but not blood pressure or arterial stiffness. Improved insulin resistance was partly associated with reductions in liver fat and hypoxemia associated with sleep apnea. Citation: Phillips CL; Yee BJ; Trenell MI; Magnussen JS; Wang D; Banerjee D; Berend N; Grunstein RR. Changes in regional adiposity and cardio-metabolic function following a weight loss program with sibutramine in obese men with obstructive sleep apnea. J Clin Sleep Med 2009;5(5):416-421. PMID:19961024

75 FR 82277 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

...-AA06 Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient... Register (FR Doc 2010-29596 (75 FR 74864)) entitled ``Health Insurance Issuers Implementing Medical Loss... request for comments entitled ``Health Insurance Issuers Implementing Medical Loss Ratio (MLR...

Application of a stream-aquifer model to Monument Creek for development of a method to estimate transit losses for reusable water, El Paso County, Colorado

USGS Publications Warehouse

Kuhn, Gerhard; Arnold, L. Rick

2006-01-01

The U.S. Geological Survey, in cooperation with Colorado Springs Utilities, the Colorado Water Conservation Board, and the El Paso County Water Authority, began a study in 2004 to (1) apply a stream-aquifer model to Monument Creek, (2) use the results of the modeling to develop a transit-loss accounting program for Monument Creek, (3) revise the existing transit-loss accounting program for Fountain Creek to incorporate new water-management strategies and allow for incorporation of future changes in water-management strategies, and (4) integrate the two accounting programs into a single program with a Web-based user interface. The purpose of this report is to present the results of applying a stream-aquifer model to the Monument Creek study reach.Transit losses were estimated for reusable-water flows in Monument Creek that ranged from 1 to 200 cubic feet per second (ft3/s) and for native streamflows that ranged from 0 to 1,000 ft3/s. Transit losses were estimated for bank-storage, channel-storage, and evaporative losses. The same stream-aquifer model used in the previously completed (1988) Fountain Creek study was used in the Monument Creek study.Sixteen model nodes were established for the Monument Creek study reach, defining 15 subreaches. Channel length, aquifer length, and aquifer width for the subreaches were estimated from available topographic and geologic maps. Thickness of alluvial deposits and saturated thickness were estimated using lithologic and water-level data from about 100 wells and test holes in or near the Monument Creek study reach. Estimated average transmissivities for the subreaches ranged from 2,000 to 12,000 feet squared per day, and a uniform value of 0.20 was used for storage coefficient.Qualitative comparison of recorded and simulated streamflow at the downstream node for the calibration and verification simulations indicated that the two streamflows compared reasonably well. No adjustments were made to the model parameters. Differences between recorded and simulated streamflow volumes for all calibration and verification simulations ranged from about –8.8 to 7.5 percent; the total error for all simulations was about –0.7 percent.The model was used to estimate bank-storage losses for 10 to 15 native streamflows for each reusable-water flow of 1, 3, 5, 7, 10, 15, 20, 30, 40, 50, 100, and 200 ft3/s. Then the 10 to 15 bank-storage loss values were used in least-squares linear regression to estimate a relation between bank-storage loss and native streamflow for each of the 12 reusable-water flow rates. The 12 regression relations then were used to develop “look-up” tables of bank-storage loss for reusable-water flows ranging from 1 to 200 ft3/s (in 1-ft3/s increments). Additional model simulations indicated that (1) when the ratio of downstream native streamflow to upstream native streamflow was less than 1, bank-storage loss generally increased and (2) when the ratio of downstream native streamflow to upstream native streamflow was larger than 1, bank-storage loss generally decreased. These results were used to develop a bank-storage loss adjustment factor based on the ratio of native streamflow at the downstream node to native streamflow at the upstream node. The model also was used to estimate a recovery period, which is the length of time needed for the bank-storage loss to return to the stream. The recovery period was 1 day for six subreaches; 2 days for four subreaches; between 3 and 12 days for four subreaches; and 28 days for one subreach.Channel-storage losses are about 10 percent of the reusable-water flow for most of the subreaches, except for two subreaches, where the channel-storage losses are about 20 percent, and one subreach, where the losses are about 30 percent, owing to the greater channel lengths. Evaporative losses were estimated by the use of monthly pan-evaporation data and the incremental increase in stream width resulting from any reusable-water flows. Monthly pan-evaporation data were converted to a daily rate. The daily rate, when multiplied by the stream-width increase (in feet) that results from reusable-water flow and by the subreach length (in miles) gives the daily evaporative loss in cubic feet per second.

Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand

PubMed Central

Poonual, Watcharapol; Navacharoen, Niramon; Kangsanarak, Jaran; Namwongprom, Sirianong

2016-01-01

Objective To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program. Materials and methods A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study. Results Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500–2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1–2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1–4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6–4.2), sepsis (RR 1.8, 95% CI 1.0–3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9–8.6). Conclusion This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people’s quality of life. PMID:26766912

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017. Final rule.

PubMed

2016-03-08

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics.

Water leakage management by district metered areas at water distribution networks.

PubMed

Özdemir, Özgür

2018-03-01

The aim of this study is to design a district metered area (DMA) at water distribution network (WDN) for determination and reduction of water losses in the city of Malatya, Turkey. In the application area, a pilot DMA zone was built by analyzing the existing WDN, topographic map, length of pipes, number of customers, service connections, and valves. In the DMA, International Water Association standard water balance was calculated considering inflow rates and billing records. The ratio of water losses in DMAs was determined as 82%. Moreover, 3124 water meters of 2805 customers were examined while 50% of water meters were detected as faulty. This study revealed that DMA application is useful for the determination of water loss rate in WDNs and identify a cost-effective leakage reduction program.

Analytical correlation of centrifugal compressor design geometry for maximum efficiency with specific speed

NASA Technical Reports Server (NTRS)

Galvas, M. R.

1972-01-01

Centrifugal compressor performance was examined analytically to determine optimum geometry for various applications as characterized by specific speed. Seven specific losses were calculated for various combinations of inlet tip-exit diameter ratio, inlet hub-tip diameter ratio, blade exit backsweep, and inlet-tip absolute tangential velocity for solid body prewhirl. The losses considered were inlet guide vane loss, blade loading loss, skin friction loss, recirculation loss, disk friction loss, vaneless diffuser loss, and vaned diffuser loss. Maximum total efficiencies ranged from 0.497 to 0.868 for a specific speed range of 0.257 to 1.346. Curves of rotor exit absolute flow angle, inlet tip-exit diameter ratio, inlet hub-tip diameter ratio, head coefficient and blade exit backsweep are presented over a range of specific speeds for various inducer tip speeds to permit rapid selection of optimum compressor size and shape for a variety of applications.

Mediators of weight loss and weight loss maintenance in middle-aged women.

PubMed

Teixeira, Pedro J; Silva, Marlene N; Coutinho, Sílvia R; Palmeira, António L; Mata, Jutta; Vieira, Paulo N; Carraça, Eliana V; Santos, Teresa C; Sardinha, Luís B

2010-04-01

Long-term behavioral self-regulation is the hallmark of successful weight control. We tested mediators of weight loss and weight loss maintenance in middle-aged women who participated in a randomized controlled 12-month weight management intervention. Overweight and obese women (N = 225, BMI = 31.3 +/- 4.1 kg/m(2)) were randomly assigned to a control or a 1-year group intervention designed to promote autonomous self-regulation of body weight. Key exercise, eating behavior, and body image variables were assessed before and after the program, and tested as mediators of weight loss (12 months, 86% retention) and weight loss maintenance (24 months, 81% retention). Multiple mediation was employed and an intention-to-treat analysis conducted. Treatment effects were observed for all putative mediators (Effect size: 0.32-0.79, P < 0.01 vs. controls). Weight change was -7.3 +/- 5.9% (12-month) and -5.5 +/- 5.0% (24-month) in the intervention group and -1.7 +/- 5.0% and -2.2 +/- 7.5% in controls. Change in most psychosocial variables was associated with 12-month weight change, but only flexible cognitive restraint (P < 0.01), disinhibition (P < 0.05), exercise self-efficacy (P < 0.001), exercise intrinsic motivation (P < 0.01), and body dissatisfaction (P < 0.05) predicted 24-month weight change. Lower emotional eating, increased flexible cognitive restraint, and fewer exercise barriers mediated 12-month weight loss (R(2) = 0.31, P < 0.001; effect ratio: 0.37), but only flexible restraint and exercise self-efficacy mediated 24-month weight loss (R(2) = 0.17, P < 0.001; effect ratio: 0.89). This is the first study to evaluate self-regulation mediators of weight loss and 2-year weight loss maintenance, in a large sample of overweight women. Results show that lowering emotional eating and adopting a flexible dietary restraint pattern are critical for sustained weight loss. For long-term success, interventions must also be effective in promoting exercise intrinsic motivation and self-efficacy.

A Study of Computer-Aided Geometric Optical Design.

DTIC Science & Technology

1982-10-01

short programs on tape. A computer account number and Cyber computer manuals were obtained. A familiarity with the use and maintenance of computer files...in the interpretation of the information. Ray fans, spot diagrams, wavefront variance, Strehl ratio, vignetting .- diagrams Pnd optical transfer...other surface begins to cut off these rays (20:113). This is characterized by a loss of intensity at the outside of the image. A known manual

Estimating TCP Packet Loss Ratio from Sampled ACK Packets

NASA Astrophysics Data System (ADS)

Yamasaki, Yasuhiro; Shimonishi, Hideyuki; Murase, Tutomu

The advent of various quality-sensitive applications has greatly changed the requirements for IP network management and made the monitoring of individual traffic flows more important. Since the processing costs of per-flow quality monitoring are high, especially in high-speed backbone links, packet sampling techniques have been attracting considerable attention. Existing sampling techniques, such as those used in Sampled NetFlow and sFlow, however, focus on the monitoring of traffic volume, and there has been little discussion of the monitoring of such quality indexes as packet loss ratio. In this paper we propose a method for estimating, from sampled packets, packet loss ratios in individual TCP sessions. It detects packet loss events by monitoring duplicate ACK events raised by each TCP receiver. Because sampling reveals only a portion of the actual packet loss, the actual packet loss ratio is estimated statistically. Simulation results show that the proposed method can estimate the TCP packet loss ratio accurately from a 10% sampling of packets.

Research on Annular Frictional Pressure Loss of Hydraulic-Fracturing in Buckling Coiled Tubing

NASA Astrophysics Data System (ADS)

Liu, Bin; Cai, Meng; Li, Junliang; Xu, Yongquan; Wang, Peng

2018-01-01

Compared with conventional hydraulic fracturing, coiled tubing (CT) annular delivery sand fracturing technology is a new method to enhance the recovery ratio of low permeability reservoir. Friction pressure loss through CT has been a concern in fracturing. The small diameter of CT limits the cross-sectional area open to flow, therefore, to meet large discharge capacity, annular delivery sand technology has been gradually developed in oilfield. Friction pressure is useful for determining the required pump horsepower and fracturing construction design programs. Coiled tubing can buckle when the axial compressive load acting on the tubing is greater than critical buckling load, then the geometry shape of annular will change. Annular friction pressure loss elevates dramatically with increasing of discharge capacity, especially eccentricity and CT buckling. Despite the frequency occurrence of CT buckling in oilfield operations, traditionally annular flow frictional pressure loss considered concentric and eccentric annuli, not discussing the effects of for discharge capacity and sand ratio varying degree of CT buckling. The measured data shows that the factors mentioned above cannot be ignored in the prediction of annular pressure loss. It is necessary to carry out analysis of annulus flow pressure drop loss in coiled tubing annular with the methods of theoretical analysis and numerical simulation. Coiled tubing buckling has great influence on pressure loss of fracturing fluid. Therefore, the correlations have been developed for turbulent flow of Newtonian fluids and Two-phase flow (sand-liquid), and that improve the friction pressure loss estimation in coiled tubing operations involving a considerable level of buckling. Quartz sand evidently increases pressure loss in buckling annular, rising as high as 40%-60% more than fresh water. Meanwhile, annulus flow wetted perimeter increases with decreasing helical buckling pitch of coiled tubing, therefore, the annulus flow frictional pressure loss rapidly increases with decreasing helical buckling pitch. The research achievement provides theoretical guidance for coiled tubing annular delivery sand fracturing operation and design.

Investigation of performance deterioration of the CF6/JT9D, high-bypass ratio turbofan engines

NASA Technical Reports Server (NTRS)

Ziemianski, J. A.; Mehalic, C. M.

1980-01-01

The aircraft energy efficiency program within NASA is developing technology required to improve the fuel efficiency of commercial subsonic transport aricraft. One segment of this program includes engine diagnostics which is directed toward determining the sources and causes of performance deterioration in the Pratt and Whitney Aircraft JT9D and General Electric CF6 high-bypass ratio turbofan engines and developing technology for minimizing the performance losses. Results of engine performance deterioration investigations based on historical data, special engine tests, and specific tests to define the influence of flight loads and component clearances on performance are presented. The results of analysis of several damage mechanisms that contribute to performance deterioration such as blade tip rubs, airfoil surface roughness and erosion, and thermal distortion are also included. The significance of these damage mechanisms on component and overall engine performance is discussed.

Dynamic response of induced pressures, suckdown, and temperatures for two tandem jet STOVL configurations

NASA Technical Reports Server (NTRS)

Wardwell, Douglas A.; Corsiglia, Victor R.; Kuhn, Richard E.

1992-01-01

NASA Ames Research Center has been conducting a program to improve the methods for predicting the jet-induced lift loss (suckdown) and hot gas ingestion on jet Short Takeoff and Vertical Landing (STOVL) aircraft during hover near the ground. As part of that program, small-scale hover tests were conducted to expand the current data base and to improve upon the current empirical methods for predicting jet-induced lift loss and hot gas ingestion (HGI) effects. This report is one of three data reports covering data obtained from hover tests conducted at Lockheed Aeronautical Systems, Rye Canyon Facility. It will include dynamic (time dependent) test data for both lift loss and HGI parameters (height, nozzle temperature, nozzle pressure ratio, and inlet location). The flat plate models tested were tandem jet configurations with three planform variations and variable position side-by-side sucking inlets mounted above the planform. Temperature time lags from 8-15 seconds were observed before the model temperatures stabilize. This was larger than the expected 1.5-second lag calculated from literature. Several possible explanations for the flow temperatures to stabilize may include some, or all, of the following: thermocouple lag, radiation to the model surface, and heat loss to the ground board. Further investigations are required to understand the reasons for this temperature lag.

Cost-benefit study of school nursing services.

PubMed

Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

2014-07-01

In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in the Massachusetts ESHS schools were a cost-beneficial investment of public money, warranting careful consideration by policy makers and decision makers when resource allocation decisions are made about school nursing positions.

Increasing the effectiveness of the Diabetes Prevention Program through if-then plans: study protocol for the randomized controlled trial of the McGill CHIP Healthy Weight Program.

PubMed

Knäuper, Bärbel; Ivanova, Elena; Xu, Zhen; Chamandy, Melodie; Lowensteyn, Ilka; Joseph, Lawrence; Luszczynska, Aleksandra; Grover, Steven

2014-05-18

The Diabetes Prevention Program (DPP) is highly effective in promoting weight loss in overweight and obese individuals. However, one-on-one DPP sessions are costly. As a cost-saving alternative, a group version of the DPP, called Group Lifestyle Balance program (GLB), has been developed but has been shown to be less effective. The aim of this two-arm parallel randomized controlled trial is to increase the effectiveness of the GLB by integrating habit formation techniques, namely if-then plans and their mental practice, into the program. A total of 154 participants will be randomized to a standard or enriched GLB program. For the enriched GLB program, if-then plans and their mental practice will be integrated into the standard GLB program. Participants will be overweight or obese men and women (BMI of 28 to 45 kg/m2, waist circumference ≥ 88 for women, ≥ 102 for men, 18 to 75 years of age) who do less than 200 minutes of self-reported moderate or vigorous exercise per week. Measures will be completed at baseline, 3 months, post-intervention (12 months), and 12 months post-intervention (24 months). The primary outcome measure is weight loss at 3, 12, and 24 months. Secondary outcomes include percent reaching weight loss goal, physical activity at 3, 12, and 24 months, and weight-related risk factors (waist circumference, hemoglobin A1c, systolic/diastolic blood pressure, total cholesterol/HDL ratio). Standardized training of the life-style coaches, use of standardized manuals, and audio taping and reviewing of the sessions will ensure intervention fidelity. The study will provide evidence-based data on the effectiveness of an enhanced GLB intervention in promoting weight loss and in reducing weight-related risk factors for chronic health problems. Ethical clearance has been received from the Research Ethics and Compliance Board of the Faculty of Medicine Research and Graduate Studies Office at McGill University (Montreal, Canada). ClinicalTrials.gov Identifier: NCT02008435. Registered 6 December 2013.

Compressive sensing based wireless sensor for structural health monitoring

NASA Astrophysics Data System (ADS)

Bao, Yuequan; Zou, Zilong; Li, Hui

2014-03-01

Data loss is a common problem for monitoring systems based on wireless sensors. Reliable communication protocols, which enhance communication reliability by repetitively transmitting unreceived packets, is one approach to tackle the problem of data loss. An alternative approach allows data loss to some extent and seeks to recover the lost data from an algorithmic point of view. Compressive sensing (CS) provides such a data loss recovery technique. This technique can be embedded into smart wireless sensors and effectively increases wireless communication reliability without retransmitting the data. The basic idea of CS-based approach is that, instead of transmitting the raw signal acquired by the sensor, a transformed signal that is generated by projecting the raw signal onto a random matrix, is transmitted. Some data loss may occur during the transmission of this transformed signal. However, according to the theory of CS, the raw signal can be effectively reconstructed from the received incomplete transformed signal given that the raw signal is compressible in some basis and the data loss ratio is low. This CS-based technique is implemented into the Imote2 smart sensor platform using the foundation of Illinois Structural Health Monitoring Project (ISHMP) Service Tool-suite. To overcome the constraints of limited onboard resources of wireless sensor nodes, a method called random demodulator (RD) is employed to provide memory and power efficient construction of the random sampling matrix. Adaptation of RD sampling matrix is made to accommodate data loss in wireless transmission and meet the objectives of the data recovery. The embedded program is tested in a series of sensing and communication experiments. Examples and parametric study are presented to demonstrate the applicability of the embedded program as well as to show the efficacy of CS-based data loss recovery for real wireless SHM systems.

A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program.

PubMed

Benson, Brian W; Meeuwisse, Willem H; Rizos, John; Kang, Jian; Burke, Charles J

2011-05-17

In 1997, the National Hockey League (NHL) and NHL Players' Association (NHLPA) launched a concussion program to improve the understanding of this injury. We explored initial postconcussion signs, symptoms, physical examination findings and time loss (i.e., time between the injury and medical clearance by the physician to return to competitive play), experienced by male professional ice-hockey players, and assessed the utility of initial postconcussion clinical manifestations in predicting time loss among hockey players. We conducted a prospective case series of concussions over seven NHL regular seasons (1997-2004) using an inclusive cohort of players. The primary outcome was concussion and the secondary outcome was time loss. NHL team physicians documented post-concussion clinical manifestations and recorded the date when a player was medically cleared to return to play. Team physicians reported 559 concussions during regular season games. The estimated incidence was 1.8 concussions per 1000 player-hours. The most common postconcussion symptom was headache (71%). On average, time loss (in days) increased 2.25 times (95% confidence interval [CI] 1.41-3.62) for every subsequent (i.e., recurrent) concussion sustained during the study period. Controlling for age and position, significant predictors of time loss were postconcussion headache (p < 0.001), low energy or fatigue (p = 0.01), amnesia (p = 0.02) and abnormal neurologic examination (p = 0.01). Using a previously suggested time loss cut-point of 10 days, headache (odds ratio [OR] 2.17, 95% CI 1.33-3.54) and low energy or fatigue (OR 1.72, 95% CI 1.04-2.85) were significant predictors of time loss of more than 10 days. Postconcussion headache, low energy or fatigue, amnesia and abnormal neurologic examination were significant predictors of time loss among professional hockey players.

Effect of flame stabilizer design on performance and exhaust pollutants of a two-row 72-module swirl-can combustor

NASA Technical Reports Server (NTRS)

Biaglow, J. A.; Trout, A. M.

1976-01-01

A test program was conducted to evaluate the effects of four flame stabilizer designs on the performance and gaseous pollutant levels of an experimental full-annular swirl-can combustor. Combustor operating parameters, including inlet-air temperature, reference velocity, and fuel-air ratio, were set to simulate conditions in a 30:1 pressure ratio engine. Combustor inlet total pressure was held constant at 6 atm due to the facility limit. Combustor performance and gaseous pollutant levels were strongly affected by the geometry and resulting total pressure loss of the four flame stabilizer designs investigated. The addition of shrouds to two designs produced an 18 to 22% decrease in the combustion chamber pressure loss and thus resulted in doubling the exit temperature pattern factor and up to 42% higher levels of oxides of nitrogen. A previously developed oxides of nitrogen correlating parameter agreed with each model within an emission index of plus or minus 1 but was not capable of correlating all models together.

Loss of genetic diversity in Culex quinquefasciatus targeted by a lymphatic filariasis vector control program in Recife, Brazil.

PubMed

Cartaxo, Marina F S; Ayres, Constância F J; Weetman, David

2011-09-01

Recife is one of the largest cities in north-eastern Brazil and is endemic for lymphatic filariasis transmitted by Culex quinquefasciatus. Since 2003 a control program has targeted mosquito larvae by elimination of breeding sites and bimonthly application of Bacillus sphaericus. To assess the impact of this program on the local vector population we monitored the genetic diversity and differentiation of Cx. quinquefasciatus using microsatellites and a B. sphaericus-resistance associated mutation (cqm1(REC)) over a 3-year period. We detected a significant but gradual decline in allelic diversity, which, coupled with subtle temporal genetic structure, suggests a major impact of the control program on the vector population. Selection on cqm1(REC) does not appear to be involved with loss of neutral diversity from the population, with no temporal trend in resistant allele frequency and no correlation with microsatellite differentiation. The evidence for short-term genetic drift we detected suggests a low ratio of effective population size: census population size for Cx. quinquefasciatus, perhaps coupled with strong geographically-restricted population structure. Spatial definition of populations will be an important step for success of an expanded vector control program. Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus.

PubMed

Goday, A; Bellido, D; Sajoux, I; Crujeiras, A B; Burguera, B; García-Luna, P P; Oleaga, A; Moreno, B; Casanueva, F F

2016-09-19

Brackground:The safety and tolerability of very low-calorie-ketogenic (VLCK) diets are a current concern in the treatment of obese type 2 diabetes mellitus (T2DM) patients. Evaluating the short-term safety and tolerability of a VLCK diet (<50 g of carbohydrate daily) in an interventional weight loss program including lifestyle and behavioral modification support (Diaprokal Method) in subjects with T2DM. Eighty-nine men and women, aged between 30 and 65 years, with T2DM and body mass index between 30 and 35 kg m(-)(2) participated in this prospective, open-label, multi-centric randomized clinical trial with a duration of 4 months. Forty-five subjects were randomly assigned to the interventional weight loss (VLCK diet), and 44 to the standard low-calorie diet. No significant differences in the laboratory safety parameters were found between the two study groups. Changes in the urine albumin-to-creatinine ratio in VLCK diet were not significant and were comparable to control group. Creatinine and blood urea nitrogen did not change significantly relative to baseline nor between groups. Weight loss and reduction in waist circumference in the VLCK diet group were significantly larger than in control subjects (both P<0.001). The decline in HbA1c and glycemic control was larger in the VLCK diet group (P<0.05). No serious adverse events were reported and mild AE in the VLCK diet group declined at last follow-up. The interventional weight loss program based on a VLCK diet is most effective in reducing body weight and improvement of glycemic control than a standard hypocaloric diet with safety and good tolerance for T2DM patients.

Serum osteopontin concentration is decreased by exercise-induced fat loss but is not correlated with body fat percentage in obese humans.

PubMed

You, Jeong Soon; Ji, Hye-In; Chang, Kyung Ja; Yoo, Myung Chul; Yang, Hyung-In; Jeong, In-Kyung; Kim, Kyoung Soo

2013-08-01

To evaluate the extent to which fat mass contributes to serum osteopontin (OPN) concentration, we investigated whether serum OPN levels are decreased by exercise-induced fat mass loss and whether they are associated with body fat percentage in obese humans. Twenty‑three female college students were recruited to participate in an 8‑week body weight control program. Body composition [body weight, soft lean mass, body fat mass, body fat percentage, waist-hip ratio and body mass index (BMI)] were assessed prior to and following the program. Serum lipid profiles and serum adiponectin, leptin and osteopontin levels were measured from serum collected prior to and following the program. To understand the effect of fat mass loss on the serum levels of adipokine, which is mainly produced in adipose tissue, the leptin and adiponectin levels were also measured prior to and following the program. Serum leptin levels (mean ± standard error of the mean) decreased significantly following the program (from 9.82±0.98 to 7.23±0.67 ng/ml) and were closely correlated with body fat percentage. In addition, serum adiponectin levels were negatively correlated with body fat percentage, while serum adiponectin levels were not significantly altered. By contrast, serum OPN levels decreased significantly following the program (from 16.03±2.34 to 10.65±1.22 ng/ml). However, serum OPN levels were not correlated with body fat percentage, suggesting that serum OPN levels are controlled by several other factors in humans. In conclusion, a high expression of OPN in adipose tissues may not be correlated with serum OPN levels in obese humans. Thus, tissues or physiological factors other than fat mass may have a greater contribution to the serum OPN levels.

Reduction in obesity and coronary risk factors after high caloric exercise training in overweight coronary patients.

PubMed

Savage, Patrick D; Brochu, Martin; Poehlman, Eric T; Ades, Philip A

2003-08-01

The majority of patients with coronary heart disease (CHD) are overweight. However, little weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. Fifteen overweight patients (average body mass index of 31.0 kg/m2) with CHD completed a 4-month exercise training program in a CR program. The exercise program consisted primarily of walking long duration (60-90 minutes per session) 5 to 7 days per week at a relatively low intensity of 50% to 60% of peak VO2. Measures of body composition by dual-energy x-ray absorptiometry, body fat distribution by computed tomography, plasma lipid-lipoprotein, glucose and insulin concentrations, and peak VO2 were obtained before and after the exercise intervention. Patients maintained an isocaloric diet throughout the study. Patients had reductions in total body weight (-4.6 kg), fat mass (-3.6 kg), percent body fat (-2.9%), and waist circumference (-5.6 cm) (all P <.001) while maintaining fat-free mass. Subcutaneous adipose tissue was reduced by 12% (P <.001) and visceral adipose tissue was lowered by 14% (P <.001). There were favorable changes in the lipid-metabolic profile with reductions in triglyceride levels (-23.7%), total cholesterol/HDL-C ratio (-14.3%), and fasting insulin levels (-22.3%) (all P <.05). Peak VO2 increased by 21.2% (P <.001). The present pilot study results suggest that a high caloric training exercise training program in the CR setting may be effective in promoting weight loss and improving coronary risk factors in overweight coronary patients. Although additional research with randomized control patients is needed, this alternative to traditional CR may be considered to maximize weight loss as part of a secondary prevention program.

45 CFR 158.210 - Minimum medical loss ratio.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a) Large...

45 CFR 158.210 - Minimum medical loss ratio.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a) Large...

45 CFR 158.210 - Minimum medical loss ratio.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a) Large...

Medicare and Medicaid; payment for the cost of malpractice insurance--HCFA. Interim final rule with comment period.

PubMed

1986-04-01

In this final rule we are adopting an apportionment methodology for determining reasonable cost reimbursement for hospital malpractice insurance costs. The new apportionment policy for hospitals will divide total malpractice insurance premium cost into two components. The "administrative component," which accounts for 8.5 percent of total premium cost, will be included in the General and Administrative cost center and will be apportioned on the basis of the individual hospital's Medicare utilization rate. The "risk component," which comprises 91.5 percent of total cost, will be apportioned on the basis of a formula that takes into account the individual hospital's utilization as well as the national Medicare patient utilization rate and the national Medicare malpractice loss ratio (as adjusted to account for associated claims handling costs). Effectively, the "scaling factor formula" will relate the national utilization rate to the adjusted national loss ratio. As a hospital's own utilization rate exceeds or falls below the national utilization rate, the risk component will be reimbursed on the basis of a "scaling factor" that is more or less than the national Medicare malpractice loss ratio. Different apportionment policies are being adopted for Medicare skilled nursing facilities and for providers of services under the Medicaid and Maternal and Child Health programs. This final rule replaces our current apportionment policy for reimbursement of malpractice insurance costs and is applicable, subject to the rules of reopening and administrative finality, to cost reporting periods beginning on or after July 1, 1979.

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia

PubMed Central

Nguyen, Kim-Huong; Smith, Anthony C.; Armfield, Nigel R.; Bensink, Mark; Scuffham, Paul A.

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013–14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia’s health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited. PMID:26406592

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia.

PubMed

Nguyen, Kim-Huong; Smith, Anthony C; Armfield, Nigel R; Bensink, Mark; Scuffham, Paul A

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013-14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia's health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited.

Economic evaluation of a weight control program with e-mail and telephone counseling among overweight employees: a randomized controlled trial

PubMed Central

2012-01-01

Background Distance lifestyle counseling for weight control is a promising public health intervention in the work setting. Information about the cost-effectiveness of such interventions is lacking, but necessary to make informed implementation decisions. The purpose of this study was to perform an economic evaluation of a six-month program with lifestyle counseling aimed at weight reduction in an overweight working population with a two-year time horizon from a societal perspective. Methods A randomized controlled trial comparing a program with two modes of intervention delivery against self-help. 1386 Employees from seven companies participated (67% male, mean age 43 (SD 8.6) years, mean BMI 29.6 (SD 3.5) kg/m2). All groups received self-directed lifestyle brochures. The two intervention groups additionally received a workbook-based program with phone counseling (phone; n=462) or a web-based program with e-mail counseling (internet; n=464). Body weight was measured at baseline and 24 months after baseline. Quality of life (EuroQol-5D) was assessed at baseline, 6, 12, 18 and 24 months after baseline. Resource use was measured with six-monthly diaries and valued with Dutch standard costs. Missing data were multiply imputed. Uncertainty around differences in costs and incremental cost-effectiveness ratios was estimated by applying non-parametric bootstrapping techniques and graphically plotting the results in cost-effectiveness planes and cost-effectiveness acceptability curves. Results At two years the incremental cost-effectiveness ratio was €1009/kg weight loss in the phone group and €16/kg weight loss in the internet group. The cost-utility analysis resulted in €245,243/quality adjusted life year (QALY) and €1337/QALY, respectively. The results from a complete-case analysis were slightly more favorable. However, there was considerable uncertainty around all outcomes. Conclusions Neither intervention mode was proven to be cost-effective compared to self-help. Trial registration ISRCTN04265725 PMID:22967224

[Total brain T2-hyperintense lesion-volume and the axonal damage in the normal-appearing white matter of brainstem in early lapsing-remitting multiple sclerosis].

PubMed

Pascual-Lozano, A M; Martínez-Bisbal, M C; Boscá-Blasco, I; Valero-Merino, C; Coret-Ferrer, F; Martí-Bonmatí, L; Martínez-Granados, B; Celda, B; Casanova-Estruch, B

To evaluate the relationship between the total brain T2-hyperintense lesion volume (TBT2LV) and the axonal damage in the normal-appearing white matter of brainstem measured by 1H-MRS in a group of early relapsing-remitting multiple sclerosis patients. 40 relapsing-remitting multiple sclerosis patients and ten sex- and age-matched healthy subjects were prospectively studied for two years. T2-weighted MR and 1H-MRS imaging were acquired at time of recruitment and at year two. The TBT2LV was calculated with a semiautomatic program; N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) resonances areas were integrated with jMRUI program and the ratios were calculated for four volume elements that represented the brainstem. At basal study we obtained an axonal loss (as a decrement of NAA/ Cho ratio) in the group of patients compared with controls (p = 0.017); this axonal loss increased at the second year of the follow-up for patients (NAA/Cho decrease, p = 0.004, and NAA/Cr decrease, p = 0.002) meanwhile control subjects had no significant metabolic changes. Higher lesion load was correlated with a poor clinical outcome, being the correlation between the basal TBT2LV and the Expanded Disability Status Scale at second year (r = 0.299; p = 0.05). Besides, axonal loss was not homogeneous for all multiple sclerosis patients, being stronger in the subgroup of patients with high basal TBT2LV (p = 0.043; ANOVA). Our data suggest that axonal damage is early in multiple sclerosis and higher in patients high basal TBT2LV, suggesting a possible relationship between these two phenomena.

Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women

PubMed Central

Kerksick, Chad; Thomas, Ashli; Campbell, Bill; Taylor, Lem; Wilborn, Colin; Marcello, Brandon; Roberts, Mike; Pfau, Emily; Grimstvedt, Megan; Opusunju, Jasmine; Magrans-Courtney, Teresa; Rasmussen, Christopher; Wilson, Ron; Kreider, Richard B

2009-01-01

Objective To determine the safety and efficacy of altering the ratio of carbohydrate and protein in low-energy diets in conjunction with a popular exercise program in obese women. Design Matched, prospective clinical intervention study to assess efficacy of varying ratios of carbohydrate and protein intake in conjunction with a regular exercise program. Participants One-hundred sixty one sedentary, obese, pre-menopausal women (38.5 ± 8.5 yrs, 164.2 ± 6.7 cm, 94.2 ± 18.8 kg, 34.9 ± 6.4 kg·m-2, 43.8 ± 4.2%) participated in this study. Participants were weight stable and not participating in additional weight loss programs. Methods Participants were assigned to either a no exercise + no diet control (CON), a no diet + exercise group (ND), or one of four diet + exercise groups (presented as kcals; % carbohydrate: protein: fat): 1) a high energy, high carbohydrate, low protein diet (HED) [2,600; 55:15:30%], 2) a very low carbohydrate, high protein diet (VLCHP) [1,200 kcals; 63:7:30%], 3) a low carbohydrate, moderate protein diet (LCMP) [1,200 kcals; 50:20:30%] and 4) a high carbohydrate, low protein diet (HCLP) [1,200 kcals; 55:15:30%]. Participants in exercise groups (all but CON) performed a pneumatic resistance-based, circuit training program under supervision three times per week. Measurements Anthropometric, body composition, resting energy expenditure (REE), fasting blood samples and muscular fitness assessments were examined at baseline and weeks 2, 10 and 14. Results All groups except CON experienced significant reductions (P < 0.05 – 0.001) in waist circumference over 14 weeks. VLCHP, LCHP and LPHC participants experienced similar but significant (P < 0.05 – 0.001) reductions in body mass when compared to other groups. Delta responses indicated that fat loss after 14 weeks was significantly greatest in VLCHP (95% CI: -5.2, -3.2 kg), LCMP (-4.0, -1.9 kg) and HCLP (-3.8, -2.1 kg) when compared to other groups. Subsequent reductions in % body fat were significantly greater in VLCHP, LCMP and HCLP participants. Initial dieting decreased (P < 0.05) relative REE similarly in all groups. All exercise groups significantly (P < 0.05) improved in muscular fitness, but these improvements were not different among groups. Favorable but non-significant mean changes occurred in lipid panels, glucose and HOMA-IR. Leptin levels decreased (P < 0.05) in all groups, except for CON, after two weeks of dieting and remained lower throughout the 14 week program. Exercise participation resulted in significant improvements in quality of life and body image. Conclusion Exercise alone (ND) appears to have minimal impact on measured outcomes with positive outcomes apparent when exercise is combined with a hypoenergetic diet. Greater improvements in waist circumference and body composition occurred when carbohydrate is replaced in the diet with protein. Weight loss in all diet groups (VLCHP, LCMP and HCLP) was primarily fat and stimulated improvements in markers of cardiovascular disease risk, body composition, energy expenditure and psychosocial parameters. PMID:19442301

Preconception B-vitamin and homocysteine status, conception, and early pregnancy loss.

PubMed

Ronnenberg, Alayne G; Venners, Scott A; Xu, Xiping; Chen, Changzhong; Wang, Lihua; Guang, Wenwei; Huang, Aiqun; Wang, Xiaobin

2007-08-01

Maternal vitamin status contributes to clinical spontaneous abortion, but the role of B-vitamin and homocysteine status in subclinical early pregnancy loss is unknown. Three-hundred sixty-four textile workers from Anqing, China, who conceived at least once during prospective observation (1996-1998), provided daily urine specimens for up to 1 year, and urinary human chorionic gonadotropin was assayed to detect conception and early pregnancy loss. Homocysteine, folate, and vitamins B6 and B12 were measured in preconception plasma. Relative to women in the lowest quartile of vitamin B6, those in the third and fourth quartiles had higher adjusted proportional hazard ratios of conception (hazard ratio (HR)=2.2, 95% confidence interval (CI): 1.3, 3.4; HR=1.6, 95% CI: 1.1, 2.3, respectively), and the adjusted odds ratio for early pregnancy loss in conceptive cycles was lower in the fourth quartile (odds ratio=0.5, 95% CI: 0.3, 1.0). Women with sufficient vitamin B6 had a higher adjusted hazard ratio of conception (HR=1.4, 95% CI: 1.1, 1.9) and a lower adjusted odds ratio of early pregnancy loss in conceptive cycles (odds ratio=0.7, 95% CI: 0.4, 1.1) than did women with vitamin B6 deficiency. Poor vitamin B6 status appears to decrease the probability of conception and to contribute to the risk of early pregnancy loss in this population.

Exprimental Results of the First Two Stages of an Advanced Transonic Core Compressor Under Isolated and Multi-Stage Conditions.

NASA Technical Reports Server (NTRS)

Prahst, Patricia S.; Kulkarni, Sameer; Sohn, Ki H.

2015-01-01

NASA's Environmentally Responsible Aviation (ERA) Program calls for investigation of the technology barriers associated with improved fuel efficiency for large gas turbine engines. Under ERA, the highly loaded core compressor technology program attempts to realize the fuel burn reduction goal by increasing overall pressure ratio of the compressor to increase thermal efficiency of the engine. Study engines with overall pressure ratio of 60 to 70 are now being investigated. This means that the high pressure compressor would have to almost double in pressure ratio while keeping a high level of efficiency. NASA and GE teamed to address this challenge by testing the first two stages of an advanced GE compressor designed to meet the requirements of a very high pressure ratio core compressor. Previous test experience of a compressor which included these front two stages indicated a performance deficit relative to design intent. Therefore, the current rig was designed to run in 1-stage and 2-stage configurations in two separate tests to assess whether the bow shock of the second rotor interacting with the upstream stage contributed to the unpredicted performance deficit, or if the culprit was due to interaction of rotor 1 and stator 1. Thus, the goal was to fully understand the stage 1 performance under isolated and multi-stage conditions, and additionally to provide a detailed aerodynamic data set for CFD validation. Full use was made of steady and unsteady measurement methods to understand fluid dynamics loss source mechanisms due to rotor shock interaction and endwall losses. This paper will present the description of the compressor test article and its measured performance and operability, for both the single stage and two stage configurations. We focus the paper on measurements at 97% corrected speed with design intent vane setting angles.

Compression Ratio Ion Mobility Programming (CRIMP) Accumulation and Compression of Billions of Ions for Ion Mobility-Mass Spectrometry Using Traveling Waves in Structures for Lossless Ion Manipulations (SLIM)

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

Deng, Liulin; Garimella, Sandilya V. B.; Hamid, Ahmed M.

We report on the implementation of a traveling wave (TW) based compression ratio ion mobility programming (CRIMP) approach within Structures for Lossless Ion Manipulations (SLIM) that enables both greatly enlarged trapped ion charge capacities and also their subsequent efficient compression for use in ion mobility (IM) separations. Ion accumulation is conducted in a long serpentine path TW SLIM region after which CRIMP allows the large ion populations to be ‘squeezed’. The compression process occurs at an interface between two SLIM regions, one operating conventionally and the second having an intermittently pausing or ‘stuttering’ TW, allowing the contents of multiple binsmore » of ions from the first region to be merged into a single bin in the second region. In this initial work stationary voltages in the second region were used to block ions from exiting the first (trapping) region, and the resumption of TWs in the second region allows ions to exit, and the population to also be compressed if CRIMP is applied. In our initial evaluation we show that the number of charges trapped for a 40 s accumulation period was ~5×109, more than two orders of magnitude greater than the previously reported charge capacity using an ion funnel trap. We also show that over 1×109 ions can be accumulated with high efficiency in the present device, and that the extent of subsequent compression is only limited by the space charge capacity of the trapping region. Lower compression ratios allow increased IM peak heights without significant loss of signal, while excessively large compression ratios can lead to ion losses and other artifacts. Importantly, we show that extended ion accumulation in conjunction with CRIMP and multiple passes provides the basis for a highly desirable combination of ultra-high sensitivity and ultra-high resolution IM separations using SLIM.« less

Effect of structural parameters on burning behavior of polyester fabrics having flame retardancy property

NASA Astrophysics Data System (ADS)

Çeven, E. K.; Günaydın, G. K.

2017-10-01

The aim of this study is filling the gap in the literature about investigating the effect of yarn and fabric structural parameters on burning behavior of polyester fabrics. According to the experimental design three different fabric types, three different weft densities and two different weave types were selected and a total of eighteen different polyester drapery fabrics were produced. All statistical procedures were conducted using the SPSS Statistical software package. The results of the Analysis of Variance (ANOVA) tests indicated that; there were statistically significant (5% significance level) differences between the mass loss ratios (%) in weft and mass loss ratios (%) in warp direction of different fabrics calculated after the flammability test. The Student-Newman-Keuls (SNK) results for mass loss ratios (%) both in weft and warp directions revealed that the mass loss ratios (%) of fabrics containing Trevira CS type polyester were lower than the mass loss ratios of polyester fabrics subjected to washing treatment and flame retardancy treatment.

Liquid rocket performance computer model with distributed energy release

NASA Technical Reports Server (NTRS)

Combs, L. P.

1972-01-01

Development of a computer program for analyzing the effects of bipropellant spray combustion processes on liquid rocket performance is described and discussed. The distributed energy release (DER) computer program was designed to become part of the JANNAF liquid rocket performance evaluation methodology and to account for performance losses associated with the propellant combustion processes, e.g., incomplete spray gasification, imperfect mixing between sprays and their reacting vapors, residual mixture ratio striations in the flow, and two-phase flow effects. The DER computer program begins by initializing the combustion field at the injection end of a conventional liquid rocket engine, based on injector and chamber design detail, and on propellant and combustion gas properties. It analyzes bipropellant combustion, proceeding stepwise down the chamber from those initial conditions through the nozzle throat.

Rebound weight gain as associated with high plasma norepinephrine levels that are mediated through polymorphisms in the beta2-adrenoceptor.

PubMed

Masuo, Kazuko; Katsuya, Tomohiro; Kawaguchi, Hideki; Fu, Yuxiao; Rakugi, Hiromi; Ogihara, Toshio; Tuck, Michael L

2005-11-01

A successful weight loss program is essential treatment for obesity-related diseases, but it is well known that the majority of individuals do not succeed in weight loss maintenance. The present study evaluates hormonal mechanisms and the relationship of beta2-adrenoceptor polymorphisms involved in individuals who regain weight after initially successful weight loss. Overweight Japanese men (n = 154) were enrolled in a 24-month weight loss program. Body mass index (BMI), total body fat mass, plasma norepinephrine (NE) and leptin levels, and beta2-adrenoceptor polymorphisms (Arg16Gly, Gln27Glu) were measured every 6 months for the 24-month period. Maintenance of weight loss was defined as significant weight loss (>or=10% reduction) from entry weight at 6 months and maintenance of the weight loss for an additional 18 months. Rebound weight gain was defined as significant weight loss at 6 months but subsequent regain of body weight during the next 18 months. The results showed that 37 subjects maintained weight loss during 24 months, whereas 36 subjects had rebound weight gain. The BMI at entry and calorie intake and physical activity at each period were similar between the two groups. Subjects who maintained weight loss had at entry a significantly lower fat mass and plasma NE levels compared to those with rebound weight gain. Body fat mass, NE, and leptin levels at entry predicted the degree of change in body weight during the 24-month study period. Subjects with rebound weight gain had a significantly higher frequency of the Gly16 allele for the beta2-adrenoceptor polymorphism compared to subjects who had a 24-month maintenance of weight loss. Subjects carrying the Gly16 allele also had significantly higher plasma NE, leptin, and body fat mass levels and a greater waist-to-hip ratio both at entry and throughout the study. A high initial degree of body fat mass and high plasma NE levels as determined by the Gly16 allele for the beta2-adrenoceptor polymorphisms predict those individuals who will have rebound weight gain after their initial successful weight loss.

[A cost-effectiveness analysis on universal infant rotavirus vaccination strategy in China].

PubMed

Sun, S L; Gao, Y Q; Yin, J; Zhuang, G H

2016-02-01

To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy, in China. Through constructing decision tree-Markov model, we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as: group with no vaccination, Rotavirus vaccination group and Rotateq vaccination group, respectively. We determined the optimal program, based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP). Compared with non-vaccination group, the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss, respectively. RESULTS from sensitivity analysis indicated that both results were robust. Compared with Rotavirus vaccination program, the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss. Data from the sensitivity analysis indicated that the result was not robust. From the perspective of health economics, both two-dose Rotarix vaccine and three-dose' s Rotateq vaccine programs were highly cost-effective, when compared to the non-vaccination program. It was appropriate to integrate rotavirus vaccine into the routine immunization program. Considering the large amount of extra cost that had to spend on Rotateq vaccination program, results from the sensitivity analysis showed that it was not robust. Rotateq vaccine required one more dose than the Rotarix vaccine, to be effective. However, it appeared more difficult to practice, suggesting that it was better to choose the Rotarix vaccine, at current stage.

Sex differences in the composition of weight gain and loss in overweight and obese adults.

PubMed

Millward, D Joe; Truby, Helen; Fox, Kenneth R; Livingstone, M Barbara E; Macdonald, Ian A; Tothill, Peter

2014-03-14

Sex differences in the ratio of fat mass (FM):fat-free mass (FFM) during weight change should differentially affect the extent of weight change during energy imbalance in men and women. In the present study, we determined FM and FFM contents by dual-energy X-ray absorptiometry and calculated the P-ratios (protein energy/total energy) of excess weight and weight loss during a randomised controlled trial of four commercial weight loss regimens. Overweight and obese women (n 210) and men (n 77) were studied at baseline and at 2 and 6 months during weight loss on four dietary regimens: Dr Atkins' New Diet Revolution; The Slim-Fast Plan; Weight-Watchers programme; Rosemary Conley's Diet and Fitness Plan. At baseline, the percentage of FFM (%FFM) and P-ratios of excess weight were 40 % and 0·071 for men and 27 % and 0·039 for women. At 2 months, men had lost twice as much weight as women and three times more FFM than women, indicating higher FFM content and P-ratios of weight loss for men, 0·052, than for women, 0·029, with no dietary effects. Between 2 and 6 months, the rate at which weight was lost decreased and the %FFM of weight loss decreased to similar low levels in men (7 %) and women (5 %): i.e. P-ratios of 0·009 and 0·006, respectively, with no dietary effects. Thus, for men compared with women, there were greater FFM content and P-ratios of weight change, which could partly, but not completely, explain their greater weight loss at 2 months. However, protein-conserving adaptations occur with increasing weight loss and over time, more extensively in men, eventually eliminating any sex difference in the composition of weight loss.

Signal-to-Noise Ratio Requirements for Half-Wave and Full-Wave Nonlinear Detectors with Arbitrary Power Laws, Sampling Rates, Input Spectra, and Filter Characteristics

DTIC Science & Technology

1986-06-10

system consisting of a sampler, a nonlinear rectifier, and a low-pass filter is evaluated generally , for arbitrary half-wave or full-wave v-th law...spectra, the possibility of using deliberate undersampling with no loss of performance is illustrated. The use of a half-wave rectifier generally ... some cases, significantly so. Programs for all procedures employed are presented so that investigation of additional cases or combinations of

A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program

PubMed Central

Benson, Brian W.; Meeuwisse, Willem H.; Rizos, John; Kang, Jian; Burke, Charles J.

2011-01-01

Background In 1997, the National Hockey League (NHL) and NHL Players’ Association (NHLPA) launched a concussion program to improve the understanding of this injury. We explored initial postconcussion signs, symptoms, physical examination findings and time loss (i.e., time between the injury and medical clearance by the physician to return to competitive play), experienced by male professional ice-hockey players, and assessed the utility of initial postconcussion clinical manifestations in predicting time loss among hockey players. Methods We conducted a prospective case series of concussions over seven NHL regular seasons (1997–2004) using an inclusive cohort of players. The primary outcome was concussion and the secondary outcome was time loss. NHL team physicians documented post-concussion clinical manifestations and recorded the date when a player was medically cleared to return to play. Results Team physicians reported 559 concussions during regular season games. The estimated incidence was 1.8 concussions per 1000 player-hours. The most common postconcussion symptom was headache (71%). On average, time loss (in days) increased 2.25 times (95% confidence interval [CI] 1.41–3.62) for every subsequent (i.e., recurrent) concussion sustained during the study period. Controlling for age and position, significant predictors of time loss were postconcussion headache (p < 0.001), low energy or fatigue (p = 0.01), amnesia (p = 0.02) and abnormal neurologic examination (p = 0.01). Using a previously suggested time loss cut-point of 10 days, headache (odds ratio [OR] 2.17, 95% CI 1.33–3.54) and low energy or fatigue (OR 1.72, 95% CI 1.04–2.85) were significant predictors of time loss of more than 10 days. Interpretation Postconcussion headache, low energy or fatigue, amnesia and abnormal neurologic examination were significant predictors of time loss among professional hockey players. PMID:21502355

48 CFR 232.503-6 - Suspension or reduction of payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... also 242.7503. (g) Loss contracts. Use the following loss ratio adjustment procedures for making... subsection, the contracting officer must prepare a supplementary analysis of the contractor's request for progress payments and calculate the loss ratio adjustment using the procedures in FAR 32.503-6(g). (ii) The...

Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus

PubMed Central

Goday, A; Bellido, D; Sajoux, I; Crujeiras, A B; Burguera, B; García-Luna, P P; Oleaga, A; Moreno, B; Casanueva, F F

2016-01-01

Brackground: The safety and tolerability of very low-calorie-ketogenic (VLCK) diets are a current concern in the treatment of obese type 2 diabetes mellitus (T2DM) patients. Objective: Evaluating the short-term safety and tolerability of a VLCK diet (<50 g of carbohydrate daily) in an interventional weight loss program including lifestyle and behavioral modification support (Diaprokal Method) in subjects with T2DM. Methods: Eighty-nine men and women, aged between 30 and 65 years, with T2DM and body mass index between 30 and 35 kg m−2 participated in this prospective, open-label, multi-centric randomized clinical trial with a duration of 4 months. Forty-five subjects were randomly assigned to the interventional weight loss (VLCK diet), and 44 to the standard low-calorie diet. Results: No significant differences in the laboratory safety parameters were found between the two study groups. Changes in the urine albumin-to-creatinine ratio in VLCK diet were not significant and were comparable to control group. Creatinine and blood urea nitrogen did not change significantly relative to baseline nor between groups. Weight loss and reduction in waist circumference in the VLCK diet group were significantly larger than in control subjects (both P<0.001). The decline in HbA1c and glycemic control was larger in the VLCK diet group (P<0.05). No serious adverse events were reported and mild AE in the VLCK diet group declined at last follow-up. Conclusions: The interventional weight loss program based on a VLCK diet is most effective in reducing body weight and improvement of glycemic control than a standard hypocaloric diet with safety and good tolerance for T2DM patients. PMID:27643725

Stages of change of behavior in women on a multi-professional program for treatment of obesity 1

PubMed Central

Bevilaqua, Cheila Aparecida; Pelloso, Sandra Marisa; Marcon, Sonia Silva

2016-01-01

ABSTRACT Objective: to ascertain the effectiveness of an intervention program in relation to anthropometric measurements and stage of readiness for behavioral change in women with excess weight. Methods: the intervention group (IG) was made up of 13 women, and the control group (CG), by 20. The intervention lasted 16 weeks, and included the practice of guided physical activity three times a week, and health education once a week. The application of the questionnaire on stage of readiness for behavioral change, and the anthropometric evaluations, were undertaken at two points - before and after the period of intervention. The statistical analysis involved tests of comparison and association. Results: in general, at the first point, the participants in the two groups were predisposed to make changes in what they ate and in their physical activity. However, significant difference was only observed in relation to weight, body mass index (BMI), waist circumference and waist-hip ratio and readiness for change among the members of the intervention group. Conclusion: the intervention programmed was effective in weight loss, reduction of waist circumference and waist-hip ratio, and in changing behaviors related to the practicing of physical exercise and eating habits. PMID:27737377

SUBSONIC WIND TUNNEL PERFORMANCE ANALYSIS SOFTWARE

NASA Technical Reports Server (NTRS)

Eckert, W. T.

1994-01-01

This program was developed as an aid in the design and analysis of subsonic wind tunnels. It brings together and refines previously scattered and over-simplified techniques used for the design and loss prediction of the components of subsonic wind tunnels. It implements a system of equations for determining the total pressure losses and provides general guidelines for the design of diffusers, contractions, corners and the inlets and exits of non-return tunnels. The algorithms used in the program are applicable to compressible flow through most closed- or open-throated, single-, double- or non-return wind tunnels or ducts. A comparison between calculated performance and that actually achieved by several existing facilities produced generally good agreement. Any system through which air is flowing which involves turns, fans, contractions etc. (e.g., an HVAC system) may benefit from analysis using this software. This program is an update of ARC-11138 which includes PC compatibility and an improved user interface. The method of loss analysis used by the program is a synthesis of theoretical and empirical techniques. Generally, the algorithms used are those which have been substantiated by experimental test. The basic flow-state parameters used by the program are determined from input information about the reference control section and the test section. These parameters were derived from standard relationships for compressible flow. The local flow conditions, including Mach number, Reynolds number and friction coefficient are determined for each end of each component or section. The loss in total pressure caused by each section is calculated in a form non-dimensionalized by local dynamic pressure. The individual losses are based on the nature of the section, local flow conditions and input geometry and parameter information. The loss forms for typical wind tunnel sections considered by the program include: constant area ducts, open throat ducts, contractions, constant area corners, diffusing corners, diffusers, exits, flow straighteners, fans, and fixed, known losses. Input to this program consists of data describing each section; the section type, the section end shapes, the section diameters, and parameters which vary from section to section. Output from the program consists of a tabulation of the performance-related parameters for each section of the wind tunnel circuit and the overall performance values that include the total circuit length, the total pressure losses and energy ratios for the circuit, and the total operating power required. If requested, the output also includes an echo of the input data, a summary of the circuit characteristics and plotted results on the cumulative pressure losses and the wall pressure differentials. The Subsonic Wind Tunnel Performance Analysis Software is written in FORTRAN 77 (71%) and BASIC (29%) for IBM PC series computers and compatibles running MS-DOS 2.1 or higher. The machine requirements include either an 80286 or 80386 processor, a math co-processor and 640K of main memory. The PERFORM analysis software is written for the RM/FORTRAN v2.4 compiler. This portion of the code is portable to other platforms which support a standard FORTRAN 77 compiler. Source code and executables for the PC are included with the distribution. They are compressed using the PKWARE archiving tool; the utility to unarchive the files, PKUNZIP.EXE, is included. With the PERFINTER program interface the user is allowed to enter the wind tunnel characteristics via the menu driven program, but this is only available for the PC. The standard distribution medium for this package is a 5.25 inch 360K MS-DOS format diskette. This software package was developed in 1990. DEC, VAX and VMS are trademarks of Digital Equipment Corporation. RM/FORTRAN is trademark of Ryan McFarland Corporation. PERFORM is a trademark of Prime Computer Inc. MS-DOS is a registered trademark of Microsoft Corporation.

76 FR 35445 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... Information Collection: Medical Loss Ratio Quarterly Reporting; Use: Under Section 2718 of the Affordable Care... ratio, referred to as the medical loss ratio (MLR). An interim final rule (IFR) implementing the MLR was... information collections, please reference the document identifier or OMB control number. To be assured...

Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.

PubMed

Pellegrini, Christine A; Ledford, Gwendolyn; Hoffman, Sara A; Chang, Rowland W; Cameron, Kenzie A

2017-08-01

Most knee replacement patients are overweight/obese, yet are commonly excluded from evidence-based weight loss programs due to mobility limitations and barriers faced around the time of surgery. The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss attempts as well as strategies used to facilitate behavior changes. Patients who were either scheduled to have knee replacement or had one recently completed within the last 3 months were recruited to participate. Patients completed a brief weight loss program preference questionnaire assessing preferred components of a weight loss program (i.e. self-monitoring, educational topics, program duration). Qualitative interviews were completed to identify motives for and strategies used during past weight loss attempts. All interviews were transcribed, de-identified, and analyzed using constant comparative analysis. Twenty patients (11 pre-operative and 9 post-operative) between 47 and 79 years completed the study (55% male, 90% White, and 85% with a BMI ≥25 kg/m 2 ). Patients reported a preference for a weight loss program that starts before surgery, is at least 6 months in duration, and focuses both on diet and exercise. The majority of patients preferred to have a telephone-based program and wanted to track diet and physical activity on a smartphone application. The most common motive for weight loss mentioned by patients related to physical appearance (including how clothing fit), followed by wanting to lose weight to improve knee symptoms or to prevent or delay knee replacement. Strategies that patients identified as helpful during weight loss attempts included joining a formal weight loss program, watching portion sizes, and self-monitoring their dietary intake, physical activity, or weight. This study provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients. These results will help guide the development and adaptation of future patient-centered weight loss programs as well as help clinicians recommend targeted weight programs based on the specific preferences of the knee replacement population.

Commercial programs' online weight loss claims as compared to results from randomized controlled trials

PubMed Central

Vakil, Rachit M.; Chaudhry, Zoobia W.; Doshi, Ruchi S.; Clark, Jeanne M.; Gudzune, Kimberly A.

2017-01-01

Objective To characterize weight-loss claims and disclaimers present on websites for commercial weight-loss programs and compare them to results from published randomized controlled trials (RCT). Methods We performed a content analysis of all homepages and testimonials available on the websites of 24 randomly selected programs. Two team members independently reviewed each page and abstracted information from text and images to capture relevant content including demographics, weight loss, and disclaimers. We performed a systematic review to evaluate the efficacy of these programs by searching MEDLINE and Cochrane Database of Systematic Reviews, and abstracted mean weight change from each included RCT. Results Overall, the amount of weight loss portrayed in the testimonials was extreme across all programs examined (range median weight loss 10.7 to 49.5 kg). Only 10 out of the 24 programs had eligible RCTs. Median weight losses reported in testimonials exceeded that achieved by trial participants. Most programs with RCTs (78%) provided disclaimers stating that the testimonial's results were non-typical and/or giving a range of typical weight loss. Conclusion Weight loss claims within testimonials were higher than results from RCTs. Future studies should examine whether commercial programs' advertising practices influence patients' expectations or satisfaction with modest weight loss results. PMID:28865085

Mediators of weight loss in a family-based intervention presented over the internet.

PubMed

White, Marney A; Martin, Pamela D; Newton, Robert L; Walden, Heather M; York-Crowe, Emily E; Gordon, Stewart T; Ryan, Donna H; Williamson, Donald A

2004-07-01

To assess the process variables involved in a weight loss program for African-American adolescent girls. Several process variables have been identified as affecting success in in vivo weight loss programs for adults and children, including program adherence, self-efficacy, and social support. The current study sought to broaden the understanding of these process variables as they pertain to an intervention program that is presented using the Internet. It was hypothesized that variables such as program adherence, dietary self-efficacy, psychological factors, and family environment factors would mediate the effect of the experimental condition on weight loss. Participants were 57 adolescent African-American girls who joined the program with one obese parent; family pairs were randomized to either a behavioral or control condition in an Internet-based weight loss program. Outcome data (weight loss) are reported for the first 6 months of the intervention. Results partially supported the hypotheses. For weight loss among adolescents, parent variables pertaining to life and family satisfaction were the strongest mediating variables. For parental weight loss, changes in dietary practices over the course of 6 months were the strongest mediators. The identification of factors that enhance or impede weight loss for adolescents is an important step in improving weight loss programs for this group. The current findings suggest that family/parental variables exert a strong influence on weight loss efforts for adolescents and should be considered in developing future programs. Copyright 2004 NAASO

Association of Loss of Independence With Readmission and Death After Discharge in Older Patients After Surgical Procedures.

PubMed

Berian, Julia R; Mohanty, Sanjay; Ko, Clifford Y; Rosenthal, Ronnie A; Robinson, Thomas N

2016-09-21

Older adults are at increased risk for adverse events after surgical procedures. Loss of independence (LOI), defined as a decline in function or mobility, increased care needs at home, or discharge to a nonhome destination, is an important patient-centered outcome measure. To evaluate LOI among older adult patients after surgical procedures and examine the association of LOI with readmission and death after discharge in this population. This retrospective cohort study examined 9972 patients 65 years and older with known baseline function, mobility, and living situation undergoing inpatient operations from January 2014 to December 2014 at 26 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program Geriatric Surgery Pilot Project. A total of 4895 patients were excluded because they were totally dependent, classified as class 5 by the American Society of Anesthesiologists, undergoing orthopedic or spinal procedures, or died prior to discharge. Loss of independence at time of discharge. Readmission and death after discharge. Of the 5077 patients included in this study, 2736 (53.9%) were female and 3876 (76.3%) were white, with a mean (SD) age of 75 (7) years. For this cohort, LOI increased with age; LOI occurred in 1386 of 2780 patients (49.9%) aged 65 to 74 years, 1162 of 1726 (67.3%) aged 75 to 84 years, and 479 of 571 (83.9%) 85 years and older (P < .001). Readmission occurred in 517 patients (10.2%). In a risk-adjusted model, LOI was strongly associated with readmission (odds ratio, 1.7; 95% CI, 1.4-2.2) and postoperative complication (odds ratio, 6.7; 95% CI, 4.9-9.0). Death after discharge occurred in 69 patients (1.4%). After risk adjustment, LOI was the strongest factor associated with death after discharge (odds ratio, 6.7; 95% CI, 2.4-19.3). Postoperative complication was not significantly associated with death after discharge. Loss of independence, a patient-centered outcome, was associated with postoperative readmissions and death after discharge. Loss of independence can feasibly be collected across multiple hospitals in a national registry. Clinical initiatives to minimize LOI will be important for improving surgical care for older adults.

Preliminary Results of an Altitude-Wind-Tunnel Investigation of a TG-100A Gas Turbine-Propeller Engine. V; Combustion-Chamber Characteristics

NASA Technical Reports Server (NTRS)

Gensenheyner, Robert M.; Berdysz, Joseph J.

1947-01-01

An investigation to determine the performance and operational characteristics of the TG-1OOA gas turbine-propeller engine was conducted in the Cleveland altitude wind tunnel. As part of this investigation, the combustion-chamber performance was determined at pressure altitudes from 5000 to 35,000 feet, compressor-inlet rm-pressure ratios of 1.00 and 1.09, and engine speeds from 8000 to 13,000 rpm. Combustion-chamber performance is presented as a function of corrected engine speed and.correcte& horsepower. For the range of corrected engine speeds investigated, over-all total-pressure-loss ratio, cycle efficiency, ana the frac%ional loss in cycle efficiency resulting from pressure losses in the combustion chambers were unaffected by a change in altitude or compressor-inlet ram-pressure ratio. The scatter of combustion- efficiency data tended to obscure any effect of altitude or ram-pressure ratio. For the range of corrected horse-powers investigated, the total-pressure-loss ratio an& the fractional loss in cycle efficiency resulting from pressure losses in the combustion chambers decreased with an increase in corrected horsepower at a constant corrected engine speed. The combustion efficiency remained constant for the range of corrected horse-powers investigated at all corrected engine speeds.

Return to work in sick-listed cancer survivors with job loss: design of a randomised controlled trial.

PubMed

van Egmond, Martine P; Duijts, Saskia F A; Vermeulen, Sylvia J; van der Beek, Allard J; Anema, Johannes R

2015-02-18

Despite long-term or permanent health problems, cancer survivors are often motivated to return to work. For cancer survivors who have lost their job, return to work can be more challenging compared to employed survivors, as they generally find themselves in a more vulnerable social and financial position. Cancer survivors with job loss may therefore be in need of tailored return to work support. However, there is a lack of return to work intervention programs specifically targeting these cancer survivors. The number of cancer survivors with job loss in developed countries is rising due to, amongst others, increases in the incidence and survivor rate of cancer, the retirement age and the proportion of flexible employment contracts. Hence, we consider it important to develop a tailored return to work intervention program for cancer survivors with job loss, and to evaluate its effectiveness compared to usual care. This study employs a two-armed randomised controlled trial with a follow-up period of 12 months. The study population (n = 164) will be recruited from a national sample of cancer survivors (18-60 years), who have been sick-listed for 12-36 months. Participants will be randomised by using computerized blocked randomisation (blocks of four). All participants will receive usual care as provided by the Dutch Social Security Agency. Additionally, participants in the intervention group will receive a tailored return to work intervention program, which includes vocational rehabilitation and supportive psychosocial components, as well as (therapeutic) placement at work. The primary outcome measure is duration until sustainable return to work; the secondary outcome measure is rate of return to work. Other parameters include, amongst others, fatigue, coping strategy and quality of life. We will perform Cox regression analyses to estimate hazard ratios for time to sustainable return to work. The hypothesis of this study is that a tailored approach for cancer survivors with job loss is more effective, regarding return to work, compared to usual care. The results of this study will provide insight into the ways in which return to work can be facilitated for cancer survivors with job loss. Netherlands Trial Register: NTR3562 .

Hearing loss may be a non-motor feature of Parkinson's disease in older people in Taiwan.

PubMed

Lai, S-W; Liao, K-F; Lin, C-L; Lin, C-C; Sung, F-C

2014-05-01

The aim of this study was to explore whether hearing loss is associated with the risk of Parkinson's disease in the elderly in Taiwan. Using claims data of the Taiwan National Health Insurance Program, 4976 patients (aged 65 years or older) with newly diagnosed hearing loss from 2000 to 2010 were identified and 19 904 subjects without hearing loss were randomly selected as comparisons, frequency matched by sex, age and index year of diagnosing hearing loss. The incidence of Parkinson's disease by the end of 2010 and the associated risk factors were investigated. The incidence of Parkinson's disease in the hearing loss group was 1.77-fold higher than that in the non-hearing-loss group (3.11 vs. 1.76 per 1000 person-years). After controlling for confounding factors, the adjusted hazard ratio (HR) of Parkinson's disease was 1.53 (95% CI 1.17, 1.99) for the hearing loss group compared with the non-hearing-loss group. Male sex (HR = 1.33, 95% CI 1.02, 1.74), age (for each year, HR = 1.06, 95% CI 1.04, 1.09), hypertension (HR = 1.70, 95% CI 1.26, 2.30) and cerebrovascular disease (HR = 1.78, 95% CI 1.37, 2.32) were also significantly associated with the risk of Parkinson's disease. Hearing loss correlates with an increased risk of Parkinson's disease in the elderly. Further studies are needed to confirm whether hearing loss could be a non-motor feature of Parkinson's disease. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program

PubMed Central

Pan, Qing; Jablonski, Kathleen A.; Aroda, Vanita R.; Watson, Karol E.; Bray, George A.; Kahn, Steven E.; Florez, Jose C.; Perreault, Leigh; Franks, Paul W.

2014-01-01

OBJECTIVE This study examined specific measures of weight loss in relation to incident diabetes and improvement in cardiometabolic risk factors. RESEARCH DESIGN AND METHODS This prospective, observational study analyzed nine weight measures, characterizing baseline weight, short- versus long-term weight loss, short- versus long-term weight regain, and weight cycling, within the Diabetes Prevention Program (DPP) lifestyle intervention arm (n = 1,000) for predictors of incident diabetes and improvement in cardiometabolic risk factors over 2 years. RESULTS Although weight loss in the first 6 months was protective of diabetes (hazard ratio [HR] 0.94 per kg, 95% CI 0.90, 0.98; P < 0.01) and cardiometabolic risk factors (P < 0.01), weight loss from 0 to 2 years was the strongest predictor of reduced diabetes incidence (HR 0.90 per kg, 95% CI 0.87, 0.93; P < 0.01) and cardiometabolic risk factor improvement (e.g., fasting glucose: β = −0.57 mg/dL per kg, 95% CI −0.66, −0.48; P < 0.01). Weight cycling (defined as number of 5-lb [2.25-kg] weight cycles) ranged 0–6 times per participant and was positively associated with incident diabetes (HR 1.33, 95% CI 1.12, 1.58; P < 0.01), fasting glucose (β = 0.91 mg/dL per cycle; P = 0.02), HOMA-IR (β = 0.25 units per cycle; P = 0.04), and systolic blood pressure (β = 0.94 mmHg per cycle; P = 0.01). After adjustment for baseline weight, the effect of weight cycling remained statistically significant for diabetes risk (HR 1.22, 95% CI 1.02, 1.47; P = 0.03) but not for cardiometabolic traits. CONCLUSIONS Two-year weight loss was the strongest predictor of reduced diabetes risk and improvements in cardiometabolic traits. PMID:25024396

Cost-effectiveness of implementing computed tomography screening for lung cancer in Taiwan.

PubMed

Yang, Szu-Chun; Lai, Wu-Wei; Lin, Chien-Chung; Su, Wu-Chou; Ku, Li-Jung; Hwang, Jing-Shiang; Wang, Jung-Der

2017-06-01

A screening program for lung cancer requires more empirical evidence. Based on the experience of the National Lung Screening Trial (NLST), we developed a method to adjust lead-time bias and quality-of-life changes for estimating the cost-effectiveness of implementing computed tomography (CT) screening in Taiwan. The target population was high-risk (≥30 pack-years) smokers between 55 and 75 years of age. From a nation-wide, 13-year follow-up cohort, we estimated quality-adjusted life expectancy (QALE), loss-of-QALE, and lifetime healthcare expenditures per case of lung cancer stratified by pathology and stage. Cumulative stage distributions for CT-screening and no-screening were assumed equal to those for CT-screening and radiography-screening in the NLST to estimate the savings of loss-of-QALE and additional costs of lifetime healthcare expenditures after CT screening. Costs attributable to screen-negative subjects, false-positive cases and radiation-induced lung cancer were included to obtain the incremental cost-effectiveness ratio from the public payer's perspective. The incremental costs were US$22,755 per person. After dividing this by savings of loss-of-QALE (1.16 quality-adjusted life year (QALY)), the incremental cost-effectiveness ratio was US$19,683 per QALY. This ratio would fall to US$10,947 per QALY if the stage distribution for CT-screening was the same as that of screen-detected cancers in the NELSON trial. Low-dose CT screening for lung cancer among high-risk smokers would be cost-effective in Taiwan. As only about 5% of our women are smokers, future research is necessary to identify the high-risk groups among non-smokers and increase the coverage. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

PubMed

Fraser, Melissa A; Grooms, Dustin R; Guskiewicz, Kevin M; Kerr, Zachary Y

2017-07-01

  Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries.   To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009-2010 through 2014-2015 academic years.   Descriptive epidemiology study.   Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009-2010 through 2014-2015 academic years.   Collegiate student-athletes participating in 11 sports.   Ball-contact-injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years.   During the 2009-2010 through 2014-2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were non-time loss (ie, participation-restriction time <24 hours), and 6.6% were severe (ie, participation-restriction time ≥21 days). The most common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10).   Ball-contact-injury rates were the highest in women's softball, women's field hockey, and men's baseball. Although more than half were non-time-loss injuries, severe injuries such as concussions and fractures were reported.

Characterization of the Gut Microbial Community of Obese Patients Following a Weight-Loss Intervention Using Whole Metagenome Shotgun Sequencing.

PubMed

Louis, Sandrine; Tappu, Rewati-Mukund; Damms-Machado, Antje; Huson, Daniel H; Bischoff, Stephan C

2016-01-01

Cross-sectional studies suggested that obesity is promoted by the gut microbiota. However, longitudinal data on taxonomic and functional changes in the gut microbiota of obese patients are scarce. The aim of this work is to study microbiota changes in the course of weight loss therapy and the following year in obese individuals with or without co-morbidities, and to asses a possible predictive value of the gut microbiota with regard to weight loss maintenance. Sixteen adult patients, who followed a 52-week weight-loss program comprising low calorie diet, exercise and behavioral therapy, were selected according to their weight-loss course. Over two years, anthropometric and metabolic parameters were assessed and microbiota from stool samples was functionally and taxonomically analyzed using DNA shotgun sequencing. Overall the microbiota responded to the dietetic and lifestyle intervention but tended to return to the initial situation both at the taxonomical and functional level at the end of the intervention after one year, except for an increase in Akkermansia abundance which remained stable over two years (12.7x103 counts, 95%CI: 322-25100 at month 0; 141x103 counts, 95%CI: 49-233x103 at month 24; p = 0.005). The Firmicutes/Bacteroidetes ratio was higher in obese subjects with metabolic syndrome (0.64, 95%CI: 0.34-0.95) than in the "healthy obese" (0.27, 95%CI: 0.08-0.45, p = 0.04). Participants, who succeeded in losing their weight consistently over the two years, had at baseline a microbiota enriched in Alistipes, Pseudoflavonifractor and enzymes of the oxidative phosphorylation pathway compared to patients who were less successful in weight reduction. Successful weight reduction in the obese is accompanied with increased Akkermansia numbers in feces. Metabolic co-morbidities are associated with a higher Firmicutes/Bacteroidetes ratio. Most interestingly, microbiota differences might allow discrimination between successful and unsuccessful weight loss prior to intervention.

Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009-2010 Through 2013-2014.

PubMed

Kerr, Zachary Y; Hayden, Ross; Barr, Megan; Klossner, David A; Dompier, Thomas P

2015-08-01

Recent injury-surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non-time-loss injuries (ie, injuries resulting in restriction of participation <1 day). To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009-2010 through 2013-2014 academic years. Descriptive epidemiology study. Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data. Collegiate student-athletes participating in women's gymnastics during the 2009-2010 through 2013-2014 academic years. Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009-2010 through 2013-2014 academic years were analyzed. Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82). We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as "sting mats," padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury.

Weight loss practices among newly enrolling clients in a commercial weightloss program in Ghana.

PubMed

Ayisi-Addo, Sandra; Ayisi-Addo, Stephen; Ohemeng, Agartha

2016-03-01

In Ghana, obesity is showing a rising trend and there are weight loss initiatives being practised by individuals. However, the levels of commitment to such programs and the reasons for discontinuing have not been assessed. The objectives of this study were to investigate the weight loss practices of participants and reasons for quitting chosen weight loss programs. This was a cross-sectional study involving 50 subjects conveniently selected from people who were enrolling into a commercial weight loss program. A questionnaire was used to collect data on past weight loss practices and reasons for abandoning chosen programs. Data analysis was conducted using simple frequency and descriptive tests of the Excel software. More than half of the subjects (66%) had undertaken a weight loss practice before enrolment in study. Of these, 88.5% abandoned the strategy before the achievement of their desired weight goal. The three common programs that were practised were internet based diets (67.9%), commercial weight loss shakes (42.9%) and exercises (28.6%). Reasons given for abandoning programs included lack of sustainability (50%), lack of determination on the part of the client (15%), boredom with program (10%), not achieving desired results (10%), safety concerns (10%), and getting pregnant (5%). The findings suggest that future weight loss programs can be effective and have reduced attrition rates if they are designed to achieve sustainable dietary and other lifestyle changes, as well as boost motivation for weight loss.

Valuing the benefits of weight loss programs: an application of the discrete choice experiment.

PubMed

Roux, Larissa; Ubach, Christina; Donaldson, Cam; Ryan, Mandy

2004-08-01

Obesity is a leading health threat. Determination of optimal therapies for long-term weight loss remains a challenge. Evidence suggests that successful weight loss depends on the compliance of weight loss program participants with their weight loss efforts. Despite this, little is known regarding the attributes influencing such compliance. The purpose of this study was to assess, using a discrete choice experiment (DCE), the relative importance of weight loss program attributes to its participants and to express these preferences in terms of their willingness to pay for them. A DCE survey explored the following weight loss program attributes in a sample of 165 overweight adults enrolled in community weight loss programs: cost, travel time required to attend, extent of physician involvement (e.g., none, monthly, every 2 weeks), components (e.g., diet, exercise, behavior change) emphasized, and focus (e.g., group, individual). The rate at which participants were willing to trade among attributes and the willingness to pay for different configurations of combined attributes were estimated using regression modeling. All attributes investigated appeared to be statistically significant. The most important unit change was "program components emphasized" (e.g., moving from diet only to diet and exercise). The majority of participants were willing to pay for weight loss programs that reflected their preferences. The DCE tool was useful in quantifying and understanding individual preferences in obesity management and provided information that could help to maximize the efficiency of existing weight loss programs or the design of new programs.

Greater weight loss among men participating in a commercial weight loss program: a pooled analysis of 2 randomized controlled trials.

PubMed

Barraj, Leila M; Murphy, Mary M; Heshka, Stanley; Katz, David L

2014-02-01

Being overweight and obese are significant health concerns for men and women, yet despite comparable needs for effective weight loss and maintenance strategies, little is known about the success of commercial weight loss programs in men. This study tests the hypothesis that men participating in a commercial weight loss program (Weight Watchers) had significantly greater weight loss than men receiving limited support from health professionals for weight loss (controls). A pooled analysis of weight loss and related physiologic parameter data from 2 randomized clinical trials was conducted. After 12 months, analysis of covariance tests showed that men in the commercial program group (n = 85) lost significantly more weight (P < .01) than men in the control group (n = 84); similar significant differences were observed for body mass index and waist circumference. These results suggest that participation in a commercial weight loss program may be a more effective means to lose weight and maintain weight loss. Published by Elsevier Inc.

42 CFR 403.256 - Loss ratio supporting data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... service. (vi) Interest. (vii) Expected distribution, by age and sex, of persons who will purchase the... insuring organization must submit the following to CMS— (1) A description of all changes in the loss ratio...

42 CFR 403.256 - Loss ratio supporting data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... service. (vi) Interest. (vii) Expected distribution, by age and sex, of persons who will purchase the... insuring organization must submit the following to CMS— (1) A description of all changes in the loss ratio...

Advanced Subsonic Technology (AST) Separate-Flow High-Bypass Ratio Nozzle Noise Reduction Program Test Report

NASA Technical Reports Server (NTRS)

Low, John K. C.; Schweiger, Paul S.; Premo, John W.; Barber, Thomas J.; Saiyed, Naseem (Technical Monitor)

2000-01-01

NASA s model-scale nozzle noise tests show that it is possible to achieve a 3 EPNdB jet noise reduction with inwardfacing chevrons and flipper-tabs installed on the primary nozzle and fan nozzle chevrons. These chevrons and tabs are simple devices and are easy to be incorporated into existing short duct separate-flow nonmixed nozzle exhaust systems. However, these devices are expected to cause some small amount of thrust loss relative to the axisymmetric baseline nozzle system. Thus, it is important to have these devices further tested in a calibrated nozzle performance test facility to quantify the thrust performances of these devices. The choice of chevrons or tabs for jet noise suppression would most likely be based on the results of thrust loss performance tests to be conducted by Aero System Engineering (ASE) Inc. It is anticipated that the most promising concepts identified from this program will be validated in full scale engine tests at both Pratt & Whitney and Allied-Signal, under funding from NASA s Engine Validation of Noise Reduction Concepts (EVNRC) programs. This will bring the technology readiness level to the point where the jet noise suppression concepts could be incorporated with high confidence into either new or existing turbofan engines having short-duct, separate-flow nacelles.

Is a Mass Prevention and Control Program for Pandemic (H1N1) 2009 Good Value for Money? Evidence from the Chinese Experience.

PubMed

Wang, Biyan; Xie, Jinliang; Fang, Pengqian

2012-01-01

In order to provide guidance on the efficient allocation of health resources when handling public health emergencies in the future, the study evaluated the H1N1 influenza prevention and control program in Hubei Province of China using cost-benefit analysis. The costs measured the resources consumed and other expenses incurred in the prevention and control of H1N1. The assumed benefits include resource consumption and economic losses which could be avoided by the measures for the prevention and control of H1N1. The benefit was evaluated by counterfactual thinking, which estimates the resource consumption and economic losses could be happened without any measures for the prevention and control, which have been avoided after measures were taken to prevent and control H1N1 in Hubei Province, these constitutes the benefit of this project. The total costs of this program were 38.81 million U.S. dollars, while the total benefit was assessed as 203.71 million U.S. dollars. The net benefit was 164.9 million U.S. dollars with a cost-effectiveness ratio of 1:5.25. The joint prevention and control strategy introduced by Hubei for H1N1 influenza is cost-effective.

Impact of medical loss regulation on the financial performance of health insurers.

PubMed

McCue, Michael; Hall, Mark; Liu, Xinliang

2013-09-01

The Affordable Care Act's regulation of medical loss ratios requires health insurers to use at least 80-85 percent of the premiums they collect for direct medical expenses (care delivery) or for efforts to improve the quality of care. To gauge this rule's effect on insurers' financial performance, we measured changes between 2010 and 2011 in key financial ratios reflecting insurers' operating profits, administrative costs, and medical claims. We found that the largest changes occurred in the individual market, where for-profit insurers reduced their median administrative cost ratio and operating margin by more than two percentage points each, resulting in a seven-percentage-point increase in their median medical loss ratio. Financial ratios changed much less for insurers in the small- and large-group markets.

Founder effects, inbreeding, and loss of genetic diversity in four avian reintroduction programs.

PubMed

Jamieson, Ian G

2011-02-01

The number of individuals translocated and released as part of a reintroduction is often small, as is the final established population, because the reintroduction site is typically small. Small founder and small resulting populations can result in population bottlenecks, which are associated with increased rates of inbreeding and loss of genetic diversity, both of which can affect the long-term viability of reintroduced populations. I used information derived from pedigrees of four monogamous bird species reintroduced onto two different islands (220 and 259 ha) in New Zealand to compare the pattern of inbreeding and loss of genetic diversity among the reintroduced populations. Although reintroduced populations founded with few individuals had higher levels of inbreeding, as predicted, other factors, including biased sex ratio and skewed breeding success, contributed to high levels of inbreeding and loss of genetic diversity. Of the 10-58 individuals released, 4-25 genetic founders contributed at least one living descendent and yielded approximately 3-11 founder-genome equivalents (number of genetic founders assuming an equal contribution of offspring and no random loss of alleles across generations) after seven breeding seasons. This range is much lower than the 20 founder-genome equivalents recommended for captive-bred populations. Although the level of inbreeding in one reintroduced population initially reached three times that of a closely related species, the long-term estimated rate of inbreeding of this one population was approximately one-third that of the other species due to differences in carrying capacities of the respective reintroduction sites. The increasing number of reintroductions to suitable areas that are smaller than those I examined here suggests that it might be useful to develop long-term strategies and guidelines for reintroduction programs, which would minimize inbreeding and maintain genetic diversity. ©2010 Society for Conservation Biology.

Surveillance of hearing loss among older construction and trade workers at Department of Energy nuclear sites.

PubMed

Dement, John; Ringen, Knut; Welch, Laura; Bingham, Eula; Quinn, Patricia

2005-11-01

Medical screening programs at three Departments of Energy (DOE) nuclear weapons facilities (Hanford Nuclear Reservation, Oak Ridge, and the Savannah River Site) have included audiometric testing since approximately 1996. This report summarizes hearing evaluations through March 31, 2003. Occupational examinations included a medical history, limited physical examination, and tests for medical effects from specific hazards, including audiometric testing. Hearing thresholds by frequency for DOE workers were compared to age-standardized thresholds among an external comparison population of industrial workers with noise exposures <80 dBA. Multivariate analyses were used to explore the risk of hearing impairment by duration of construction trade work and self-reported noise exposure, while controlling for potential confounders such as age, race, sex, smoking, elevated serum cholesterol, hypertension, solvent exposures, and recreational noise exposures. Hearing thresholds among DOE workers were much higher than observed in a comparison population of industrial workers with low noise exposures. Overall, 59.7% of workers examined were found to have material hearing impairment by NIOSH criteria. Age, duration of construction work, smoking, and self-reported noise exposure increased the risk of hearing loss. The risk of material hearing impairment was significantly elevated for construction trade workers compared to the external comparison population (odds-ratio = 1.6, 95% CI = 1.3-2.1) and increased with the duration of trade work. These medical screening programs confirm worker concerns about risks for hearing loss and the need for hearing conservation programs for construction workers, with emphasis on the prevention of noise exposures.

Ineffectiveness of commercial weight-loss programs for achieving modest but meaningful weight loss: Systematic review and meta-analysis.

PubMed

McEvedy, Samantha M; Sullivan-Mort, Gillian; McLean, Siân A; Pascoe, Michaela C; Paxton, Susan J

2017-10-01

This study collates existing evidence regarding weight loss among overweight but otherwise healthy adults who use commercial weight-loss programs. Systematic search of 3 databases identified 11 randomized controlled trials and 14 observational studies of commercial meal-replacement, calorie-counting, or pre-packaged meal programs which met inclusion criteria. In meta-analysis using intention-to-treat data, 57 percent of individuals who commenced a commercial weight program lost less than 5 percent of their initial body weight. One in two (49%) studies reported attrition ≥30 percent. A second meta-analysis found that 37 percent of program completers lost less than 5 percent of initial body weight. We conclude that commercial weight-loss programs frequently fail to produce modest but clinically meaningful weight loss with high rates of attrition suggesting that many consumers find dietary changes required by these programs unsustainable.

Optomechanically-induced transparency in parity-time-symmetric microresonators

PubMed Central

Jing, H.; Özdemir, Şahin K.; Geng, Z.; Zhang, Jing; Lü, Xin-You; Peng, Bo; Yang, Lan; Nori, Franco

2015-01-01

Optomechanically-induced transparency (OMIT) and the associated slowing of light provide the basis for storing photons in nanoscale devices. Here we study OMIT in parity-time (PT)-symmetric microresonators with a tunable gain-to-loss ratio. This system features a sideband-reversed, non-amplifying transparency , i.e., an inverted-OMIT. When the gain-to-loss ratio is varied, the system exhibits a transition from a PT-symmetric phase to a broken-PT-symmetric phase. This PT-phase transition results in the reversal of the pump and gain dependence of the transmission rates. Moreover, we show that by tuning the pump power at a fixed gain-to-loss ratio, or the gain-to-loss ratio at a fixed pump power, one can switch from slow to fast light and vice versa. These findings provide new tools for controlling light propagation using nanofabricated phononic devices. PMID:26169253

Preliminary Results of an Altitude-Wind-Tunnel Investigation of an Axial-Flow Gas Turbine-Propeller Engine. 5; Combustion-Chamber Characterisitcs

NASA Technical Reports Server (NTRS)

Geisenheyner, Robert M.; Berdysz, Joseph J.

1948-01-01

An investigation to determine the performance and operational characteristics of an axial-flow gas turbine-propeller engine was conducted in the Cleveland altitude wind tunnel. As part of this investigation, the combustion-chamber performance was determined at pressure altitudes from 5000 to 35,000 feet, compressor-inlet ram-pressure ratios of 1.00 and 1.09, and engine speeds from 8000 to 13,000 rpm. Combustion-chamber performance is presented as a function of corrected engine speed and corrected horsepower. For the range of corrected engine speeds investigated, overall total-pressure-loss ratio, cycle efficiency, and the fractional loss in cycle efficiency resulting from pressure losses in the combustion chambers were unaffected by a change in altitude or compressor-inlet ram-pressure ratio. For the range of corrected horsepowers investigated, the total-pressure-loss ratio and the fractional loss in cycle efficiency resulting from pressure losses in the combustion chambers decreased with an increase in corrected horsepower at a constant corrected engine speed. The combustion efficiency remained constant for the range of corrected horsepowers investigated at all corrected engine speeds.

Tuberculosis-Related Deaths within a Well-Functioning DOTS Control Program

PubMed Central

García-García, Maria de Lourdes; Ponce-de-León, Alfredo; García-Sancho, Maria Cecilia; Ferreyra-Reyes, Leticia; Palacios-Martínez, Manuel; Fuentes, Javier; Kato-Maeda, Midori; Bobadilla, Miriam; Small, Peter; Sifuentes-Osornio, José

2002-01-01

To describe the molecular epidemiology of tuberculosis (TB)-related deaths in a well-managed program in a low-HIV area, we analyzed data from a cohort of 454 pulmonary TB patients recruited between March 1995 and October 2000 in southern Mexico. Patients who were sputum acid-fast bacillus smear positive underwent clinical and mycobacteriologic evaluation (isolation, identification, drug-susceptibility testing, and IS6110-based genotyping and spoligotyping) and received treatment from the local directly observed treatment strategy (DOTS) program. After an average of 2.3 years of follow-up, death was higher for clustered cases (28.6 vs. 7%, p=0.01). Cox analysis revealed that TB-related mortality hazard ratios included treatment default (8.9), multidrug resistance (5.7), recently transmitted TB (4.1), weight loss (3.9), and having less than 6 years of formal education (2). In this community, TB is associated with high mortality rates. PMID:12453365

7 CFR 1493.130 - Recovery of losses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.130 Recovery of losses. (a) Notification. Upon payment of loss to the exporter or the exporter's assignee, CCC...

7 CFR 1493.130 - Recovery of losses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.130 Recovery of losses. (a) Notification. Upon payment of loss to the exporter or the exporter's assignee, CCC...

7 CFR 1493.130 - Recovery of losses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.130 Recovery of losses. (a) Notification. Upon payment of loss to the exporter or the exporter's assignee, CCC...

Space tug geosynchronous mission simulation

NASA Technical Reports Server (NTRS)

Lang, T. J.

1973-01-01

Near-optimal three dimensional trajectories from a low earth park orbit inclined at 28.5 deg to a synchronous-equatorial mission orbit were developed for both the storable (thrust = 28,912 N (6,500 lbs), I sub sp = 339 sec) and cryogenic (thrust = 44,480 N (10,000 lbs), I sub sp = 470 sec) space tug using the iterative cost function minimization technique contained within the modularized vehicle simulation (MVS) program. The finite burn times, due to low thrust-to-weight ratios, and the associated gravity losses are accounted for in the trajectory simulation and optimization. The use of an ascent phasing orbit to achieve burnout in synchronous orbit at any longitude is investigated. The ascent phasing orbit is found to offer the additional advantage of significantly reducing the overall delta velocity by splitting the low altitude burn into two parts and thereby reducing gravity losses.

Terrestrial C sequestration at elevated CO2 and temperature: the role of dissolved organic N loss

USGS Publications Warehouse

Rastetter, Edward B.; Perakis, Steven S.; Shaver, Gaius R.; Agren, Goran I.

2005-01-01

We used a simple model of carbon–nitrogen (C–N) interactions in terrestrial ecosystems to examine the responses to elevated CO2 and to elevated CO2 plus warming in ecosystems that had the same total nitrogen loss but that differed in the ratio of dissolved organic nitrogen (DON) to dissolved inorganic nitrogen (DIN) loss. We postulate that DIN losses can be curtailed by higher N demand in response to elevated CO2, but that DON losses cannot. We also examined simulations in which DON losses were held constant, were proportional to the amount of soil organic matter, were proportional to the soil C:N ratio, or were proportional to the rate of decomposition. We found that the mode of N loss made little difference to the short‐term (<60 years) rate of carbon sequestration by the ecosystem, but high DON losses resulted in much lower carbon sequestration in the long term than did low DON losses. In the short term, C sequestration was fueled by an internal redistribution of N from soils to vegetation and by increases in the C:N ratio of soils and vegetation. This sequestration was about three times larger with elevated CO2 and warming than with elevated CO2 alone. After year 60, C sequestration was fueled by a net accumulation of N in the ecosystem, and the rate of sequestration was about the same with elevated CO2 and warming as with elevated CO2alone. With high DON losses, the ecosystem either sequestered C slowly after year 60 (when DON losses were constant or proportional to soil organic matter) or lost C (when DON losses were proportional to the soil C:N ratio or to decomposition). We conclude that changes in long‐term C sequestration depend not only on the magnitude of N losses, but also on the form of those losses.

Ratio of Sodium to Potassium in the Mercurian Exosphere

NASA Technical Reports Server (NTRS)

Potter, A. E.; Anderson, C. M.; Killen, R. M.; Morgan, T. H.

2001-01-01

Sodium (Na) and Potassium (K) atoms can be seen in the exosphere of Mercury and the Moon because they are extremely efficient at scattering sunlight. These species must be derived from surface materials, so that we might expect the ratio of sodium to potassium to reflect the ratio of these elements in the surface crust. This expectation is approximately born out for the Moon, where the ratio of sodium to potassium in the lunar exosphere averages to be about 6, not too far from the ratio in lunar rocks of 2 to 7. However, the ratio in the Mercury exosphere was found to be in the range 80 to 190, and at least once, as high as 400. The sodium and potassium atoms seen in the Mercury exosphere represent a balance between production from the surface and loss to space. Only if the production efficiencies and loss rates for Na and K were equal, would the ratio of Na to K in the exosphere reflect the ratio in the surface rocks. Since a value of 100 or more for the ratio of sodium to potassium in the surface rocks seems very unlikely, the high values of the observed ratios suggests that either production efficiencies or loss processes for the two elements are not equivalent. It does not seem likely that source processes should be different on the Moon and Mercury by an order of magnitude. This suggests that loss processes rather than source processes are the cause of the difference between the two. The major loss processes for sodium and potassium on Mercury are radiation pressure and trapping of photoions by the solar wind. Radiation pressure can reach 50-70% of surface gravity, and can sweep sodium and potassium atoms off the planet, provided they are sufficiently hot. Photoionization followed by trapping of the ions in the solar wind is the other major loss process. Photoions are accelerated to keV energies in the magnetosphere, and may either intercept the magnetopause, and be lost from the planet, or impact the planetary surface. Ions that impact the surface are neutralized, and are then available for resupply to the exosphere. The loss efficiency depends on characteristics of the magnetosphere that determine the fraction of the ions that are recycled by neutralization on the surface. Over the preceding decade, we have collected sodium and potassium data for Mercury at irregular intervals. We analyzed these data to extract values for the Na/K ratio at a variety of conditions on Mercury. Additional information is contained in the original extended abstract.

7 CFR 760.816 - Value loss crops.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Value loss crops. 760.816 Section 760.816 Agriculture... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS 2005-2007 Crop Disaster Program § 760.816 Value loss crops. (a) Notwithstanding any other provisions of this part, this section applies to value loss crops and tropical crops...

Weight loss and retention in a commercial weight-loss program and the effect of corporate partnership.

PubMed

Martin, C K; Talamini, L; Johnson, A; Hymel, A M; Khavjou, O

2010-04-01

No studies report whether improvements to commercial weight-loss programs affect retention and weight loss. Similarly, no studies report whether enrolling in a program through work (with a corporate partner) affects retention and weight loss. To determine whether: (1) adding evidence-based improvements to a commercial weight-loss program increased retention and weight loss, (2) enrolling in a program through work increased retention and weight loss and (3) whether increased weight loss was because of longer retention. Data were collected on 60 164 adults who enrolled in Jenny Craig's Platinum Program over 1 year in 2001-2002. The program was subsequently renamed the Rewards Program and improved by increasing treatment personalization and including motivational interviewing. Data were then collected on 81 505 participants of the Rewards Program who enrolled during 2005 (2418 of these participants enrolled through their employer, but paid out-of-pocket). Retention (participants were considered active until >or=42 consecutive days were missed) and weight loss (percent of original body weight) from baseline to the last visit (data were evaluated through week 52) were determined. Alpha was set at 0.001. Mean (95% confidence interval (CI)) retention (weeks) was significantly higher among Rewards (19.5 (19.4-19.6)) compared with Platinum (16.3 (16.2-16.4)) participants, and Rewards Corporate (25.9 (25.0-26.8)) compared with Noncorporate (21.9 (21.7-22.1)) participants. Modified intent-to-treat analyses indicated that mean (95% CI) percent weight loss was significantly larger among Rewards (6.36 (6.32-6.40)) compared with Platinum (5.45 (5.41-5.49)) participants, and Rewards Corporate (7.16 (6.92-7.40)) compared with Noncorporate (6.20 (6.16-6.24)) participants, with and without adjustment for baseline participant characteristics. In all cases, greater weight loss was secondary to longer retention. The study was not a randomized controlled trial, rather, a translational effectiveness study. Improvements to a commercial program and enrolling through a corporate partner are associated with greater weight loss that is because of improved retention.

First versus repeat treatment with a lifestyle intervention program: attendance and weight loss outcomes.

PubMed

Venditti, E M; Bray, G A; Carrion-Petersen, M L; Delahanty, L M; Edelstein, S L; Hamman, R F; Hoskin, M A; Knowler, W C; Ma, Y

2008-10-01

Following unblinding of the Diabetes Prevention Program (DPP) results, a 16-session lifestyle intervention program was offered to all study participants, including those who had initially been randomized to lifestyle treatment. This study compares the effects of the lifestyle program between participants who had previous exposure and those who had not. A 16-session behavioral intervention was conducted in groups at each of the 27 DPP sites during a transitional (bridge) period from the DPP trial to the DPP Outcomes Study (DPPOS). Session participation for this 6-month behavioral weight loss program was confirmed by originally randomized treatment groups. Independently assessed weight measurements were available within a 7-month period before and after the program for 2808 ethnically diverse participants. Participants from the lifestyle group in the DPP were the least likely to attend a repeat offering of a 16-session behavioral weight loss program conducted in groups. Weight loss during the transitional lifestyle program was strongly related to the duration of attendance in the three groups that were participating in the program for the first time (metformin, placebo and troglitazone), but not related to amount of earlier weight loss. Individuals who were naive to the behavioral program lost a greater amount of weight and this was strongly related to their degree of participation. A second exposure to a behavioral weight loss program resulted in unsatisfactory low attendance rates and weight loss.

Directed reflectivity, long life AMTEC condenser (DRC). Final report of Phase II SBIR program[Alkali Metal ThermoElectric Converter

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

Hunt, Thomas K.

The Alkali Metal Thermal to Electric Converter (AMTEC) is a static energy conversion device that operates at high thermal to electric conversion efficiencies that are essentially independent of size, have reached 19% and are expected to reach 25% to 30% in 1997. AMTEC systems have been chosen by NASA and DOE for spacecraft applications and have considerable promise for a wide variety of terrestrial applications. Reduction of parasitic heat losses in AMTEC systems related to radiative heat transfer from the hot side to the condenser can make a substantial contribution to system efficiency. Through design, analysis and the fabrication andmore » testing of cells and systems, the proposed program to develop a Directed Reflectivity Condenser (DRC) has investigated the feasibility of an improved AMTEC condenser component. Phase 1 work showed the potential for adding from 4% to 7% to overall system efficiency for identical operating conditions using the concept. A detailed thermal analysis of several DRC capped cell designs was carried out and some of the conditions under which a DRC, used as the condenser at an end cap of a cylindrical converter, can reduce thermal radiation related losses were determined. A model experimental converter was built and tested to compare DRC and planar condenser surfaces. The results of both analysis and experiment indicate that for moderate aspect ratios of a cylindrical, end condensed converter, the DRC can reduce overall thermal losses by up to 4%. The initial effort in Phase 2 extended the analysis to a novel 150 watt radial AMTEC cell design. This analysis indicated that for the effective aspect ratio of this new converter design, the system performance at the 100+ watt level was not significantly improved by use of a DRC type condenser surface. Further analyses however showed that for cylindrical, end-condensed converters, optimized for use with internal radiation shields, the use of DRC surfaces on the side walls of the converter could be more effective than on the condenser end surface itself. The experimental work in Phase 2 was intended to incorporate a DRC into this cell design and use its measured performance to refine the state-of-the-art AMTEC analytical models. Because the analysis had indicated that the new radial converter design, which may be useful for systems at the {approx} 100 watt level was not much assisted by the DRC properties, this program was redirected toward the simpler cylindrical converter design with the corner cube surfaces on the side walls. The Phase II program was proposed and planned with a funding level substantially below the maximum potentially available for Phase II programs at that time. At the time, there were two other funded government sponsored programs at AMPS for which positive results of the analyses described in this report were expected to lead to incorporation of the DRC concept into converters scheduled to be built for these programs. The programs of interest were the Air Force program titled ''Radiation Tolerant, Eclipse Compatible, Solar AMTEC System'' (F29601-99-C-0132) and the DOE/NASA Advanced Radioisotope Power System (ARPS) program. Shortly after its start, the Air Force program was canceled due to elimination of AF SBIR funds at AFRL and the ARPS program was reduced to a level that could not support introduction of novel concept testing. As a result of these two circumstances, the direct testing of the DRC concept in a full up converter was not completed in the Phase II period.« less

75 FR 41397 - Asparagus Revenue Market Loss Assistance Payment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... Revenue Market Loss Assistance Payment Program AGENCY: Commodity Credit Corporation and Farm Service... to implement the new Asparagus Revenue Market Loss Assistance Payment (ALAP) Program authorized by the Food, Conservation, and Energy Act of 2008 (the 2008 Farm Bill). The purpose of the program is to...

Weight Loss Strategies Utilized in a Men's Weight Loss Intervention

ERIC Educational Resources Information Center

Crane, Melissa M.; Lutes, Lesley D.; Sherwood, Nancy E.; Ward, Dianne S.; Tate, Deborah F.

2018-01-01

Men are underrepresented in weight loss programs and little is currently known about the weight loss strategies men prefer. This study describes the weight loss strategies used by men during a men-only weight loss program. At baseline, 3 months, and 6 months, participants reported how frequently they used 45 weight loss strategies including…

Rewetting effects on soil CO2 flux and nutrients leaching in alpine Kobresia pasture on the Tibetan Plateau

NASA Astrophysics Data System (ADS)

Liu, Shibin; Schleuss, Per; Kuzyakov, Yakov

2015-04-01

Kobresia pygmaea pastures of the Tibetan Plateau are one of the most important ecosystems around the world due to its large grazing area and very high soil organic carbon storage. Since the last decades grasslands of the TP are highly affected by grassland degradation because of various sedimentary programs and strongly increase grazing pressure. Climate changes (e.g. increased precipitation and temperature) may accelerate this degradation processes by enhancing soil organic matter mineralization and nutrients leaching. We exposed repeated rewetting cycles to test the effects of increased precipitation frequency on CO2 fluxes and leaching on varying K. pygmaea root mats (including: intact root mats (KL); recently died root mats (KD); crust covered root mats (LI)). Two phases were conducted (a) to identify the response of nighttime CO2 flux to changing soil moisture and (b) to investigate the impacts of rewetting cycles on day-, night-, and full day CO2 fluxes together with leaching of carbon (C) and nitrogen (N). Nighttime CO2 fluxes correlated positively with soil moisture, indicating that increasing precipitation will accelerate SOC losses due to increasing mineralization rates. KD showed highest C losses as CO2 efflux and also the highest leaching compared to KL and LI. It indicates that dying of Kobresia root mats (as induced by overgrazing and continuously removal of photosynthetically active shoot biomass) will rapidly decrease SOC storage. The lowest C losses (from soil respiration and DOC leaching) were obtained in the crust covered root mats (LI), because most C losses have already occurred during the early period. Highest N losses (especially NO3-) were obtained in the highly degraded pasture (LI). Due to long-term SOM decomposition of crust covered root mats (LI) in situ, inorganic nitrogen (NO3-) was accumulated in and was leached out during the first rewetting cycles. In contrast, no losses of NH4+ and NO3- occurred for intact Kobresia root mats (KL), because the plants took up mineral nitrogen. These results were consistent to very low C/N ratios of leachates in crust-covered root mats. The low C/N ratio in LI was mainly connected by nitrogen accumulation before leaching, whereas the slightly lower C/N ratio in KD was mainly affected by carbon losses (DOC) due to increased SOM decomposition. This study indicates that in combination overgrazing and precipitation change might strongly reduce SOC storage. Furthermore, the high nutrient losses after initial degradation of these N and P limited grasslands might have dramatic consequences for this ecosystem. Therefore, saving and restoration of natural vegetation cover by decreasing grazing intensities is the only strategy to maintain soil fertility and protect Kobresia ecosystems against degradation.

Prolonged winter undernutrition and the interpretation of urinary allantoin:creatinine ratios in white-tailed deer

USGS Publications Warehouse

DelGiudice, Glenn D.; Kerr, Ken D.; Mech, L. David; Seal, Ulysses S.

2000-01-01

The urinary allantoin:creatinine (A:C) ratio (expressed in micromoles of allantoin to micromoles of creatinine) has shown potential as an index of recent winter energy intake in preliminary controlled studies of elk (Cervus elaphus) involving mild condition deterioration (up to 11% loss of body mass). To ensure reliable nutritional assessments of free-ranging cervids by measuring A:C ratios of urine in snow, it is essential to extend this work. We assessed the effect of moderate and severe winter nutritional restriction on urinary A:C ratios of captive white-tailed deer (Odocoileus virginianus) that lost up to 32% body mass and related these ratios to metabolizable energy intake (MEI), body-mass loss, and other reported nutritional indicators. Deer in the control group were fed a low-protein, low-energy diet ad libitum, whereas deer in the treatment group were fed restricted amounts of the same diet. MEI was below the winter maintenance requirement for all deer, but was lower (P = 0.029) in treatment deer than in control deer. Percent body-mass loss differed between the two groups as the study progressed, and represented the full range of physiological tolerance (0-32% loss). Mean A:C ratios of control deer, which lost up to 17.4% body mass, showed a slight increasing (P = 0.086) trend, whereas initially similar A:C ratios of severely restricted deer increased (P = 0.0002) markedly by the eighth week (0.52 vs. 0.09 µmol:µmol). The urinary A:C ratio was not related (P = 0.839) to recent (2 days prior to urine sampling) MEI, but there was a marginally significant relation (r2 = 0.42, P = 0.110) between the A:C ratio and cumulative percent mass loss. The urinary A:C ratio was directly related to urinary urea nitrogen:creatinine (r2 = 0.59, P < 0.0001) and 3-methylhistidine:creatinine (r2 = 0.43, P < 0.0001) ratios. This study confirms that elevated and increasing A:C ratios may be due either to increasing energy intake or to accelerated tissue catabolism and increased endogenous contributions to urinary allantoin excretion.

Obese Employee Participation Patterns in a Wellness Program.

PubMed

Fink, Jennifer T; Smith, David R; Singh, Maharaj; Ihrke, Doug M; Cisler, Ron A

2016-04-01

The purpose of this research was to retrospectively examine whether demographic differences exist between those who participated in an employee wellness program and those who did not, and to identify the selection of employees' choice in weight management activities. A nonequivalent, 2-group retrospective design was used. This study involved employees at a large, not-for-profit integrated health system. Of the total organization employee pool (29,194), 19,771 (68%) employees volunteered to be weighed (mean body mass index [BMI]=28.9) as part of an employee wellness program. Weight management activities available included: (1) Self-directed 5% total body weight loss; (2) Healthy Solutions at home; (3) Weight Watchers group meetings; (4) Weight Watchers online; and (5) Employee Assistance Program (EAP)-directed healthy weight coaching. Measures were participation rate and available weight management activity participation rate among obese employees across demographic variables, including sex, age, race, job type, and job location. The analysis included chi-square tests for all categorical variables; odds ratios were calculated to examine factors predictive of participation. Of the total 19,771 employees weighed, 6375 (32%) employees were obese (defined as BMI ≥30); of those, 3094 (49%) participated in available weight management activities. Participation was higher among females, whites, those ages >50 years, and non-nursing staff. In conclusion, participation rate varied significantly based on demographic variables. Self-directed 5% weight loss was the most popular weight management activity selected. (Population Health Management 2016;19:132-135).

Health risk factor modification predicts incidence of diabetes in an employee population: results of an 8-year longitudinal cohort study.

PubMed

Rolando, Lori; Byrne, Daniel W; McGown, Paula W; Goetzel, Ron Z; Elasy, Tom A; Yarbrough, Mary I

2013-04-01

To understand risk factor modification effect on Type 2 diabetes incidence in a workforce population. Annual health risk assessment data (N = 3125) in years 1 through 4 were used to predict diabetes development in years 5 through 8. Employees who reduced their body mass index from 30 or more to less than 30 decreased their chances of developing diabetes (odds ratio = 0.22, 95% confidence interval: 0.05 to 0.93), while those who became obese increased their diabetes risk (odds ratio = 8.85, 95% confidence interval: 2.53 to 31.0). Weight reduction observed over a long period can result in clinically important reductions in diabetes incidence. Workplace health promotion programs may prevent diabetes among workers by encouraging weight loss and adoption of healthy lifestyle habits.

Fiscal loss and program fidelity: impact of the economic downturn on HIV/STI prevention program fidelity.

PubMed

Catania, Joseph A; Dolcini, M Margaret; Gandelman, Alice A; Narayanan, Vasudha; McKay, Virginia R

2014-03-01

The economic downturn of 2007 created significant fiscal losses for public and private agencies conducting behavioral prevention. Such macro-economic changes may influence program implementation and sustainability. We examined how public and private agencies conducting RESPECT, a brief HIV/STI (sexually transmitted infection) counseling and testing intervention, adapted to fiscal loss and how these adaptations impacted program fidelity. We collected qualitative and quantitative data in a national sample of 15 agencies experiencing fiscal loss. Using qualitative analyses, we examined how program fidelity varied with different types of adaptations. Agencies reported three levels of adaptation: agency-level, program-level, and direct fiscal remedies. Private agencies tended to use direct fiscal remedies, which were associated with higher fidelity. Some agency-level adaptations contributed to reductions in procedural fit, leading to negative staff morale and decreased confidence in program effectiveness, which in turn, contributed to poor fidelity. Findings describe a "work stress pathway" that links program fiscal losses to poor staff morale and low program fidelity.

Incidence loss for a core turbine rotor blade in a two-dimensional cascade

NASA Technical Reports Server (NTRS)

Stabe, R. G.; Kline, J. F.

1974-01-01

The effect of incidence angle on the aerodynamic performance of an uncooled core turbine rotor blade was investigated experimentally in a two-dimensional cascade. The cascade test covered a range of incidence angles from minus 15 deg to 15 deg in 5-degree increments and a range of pressure ratios corresponding to ideal exit critical velocity ratios of 0.6 to 0.95. The principal measurements were blade-surface static pressures and cross-channel surveys of exit total pressure, static pressure, and flow angle. The results of the investigation include blade-surface velocity distribution and overall performance in terms of weight flow and loss for the range of incidence angles and exit velocity ratios investigated. The measured losses are also compared with two common methods of predicting incidence loss.

Study protocol: evaluation of 'JenMe', a commercially-delivered weight management program for adolescents: a randomised controlled trial.

PubMed

Dordevic, Aimee L; Bonham, Maxine P; Ware, Robert S; Brennan, Leah; Truby, Helen

2015-06-19

Early lifestyle intervention with overweight and obese adolescents could help to avoid serious health events in early adulthood, ultimately alleviating some of the strain on the public health system due to obesity-related morbidity. Commercial weight loss programs have wide reach into the community setting, and have demonstrated success in long term weight management in adults, beyond that of current public health care. Commercial weight-management programs have not been evaluated as a method of delivery for overweight and obese adolescents. This study aims to evaluate the efficacy of a new adolescent weight management program in a commercial environment. One hundred and forty adolescents, 13 to 17 years old, will be randomised to either a weight management program intervention or a wait-listed group for 12 weeks. The commercial program will consist of a combined dietary and lifestyle approach targeting improved health behaviours for weight-loss or weight-stability. Participants will be overweight or obese (above the 85(th) percentile for BMI) and without existing co-morbidities. Outcome measures will be assessed at baseline and after 12 weeks. Primary outcome measures will be changes in BMI Z-score and waist-height ratio. Secondary outcome measures will include changes in behaviour, physical activity and psychosocial wellbeing. Intervention participants will be followed up at 6 months following completion of the initial program. Ethics approval has been granted from the Monash University Human Research Ethics Committee (CF11/3687-2011001940). This independent evaluation of a weight management program for adolescents, delivered in a commercial setting, will provide initial evidence for the effectiveness of such programs; which may offer adolescents an avenue of weight-management with ongoing support prior to the development of obesity related co-morbidities. The protocol for this study is registered with the International Clinical Trials Registry ISRCTN13602313.

75 FR 19185 - Direct and Counter-Cyclical Program and Average Crop Revenue Election Program, Disaster...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

... Program, Disaster Assistance Programs, Marketing Assistance Loans and Loan Deficiency Payments Program... Disaster Program (LFP), the Supplemental Revenue Assistance Payments Program (SURE) and the Marketing... losses, unless the loss has already been reported for the Noninsured Crop Disaster Assistance Program...

Pediatric heart transplantation at adult-specialty centers in the US: a multicenter registry analysis.

PubMed

Duong, Son Q; Yabes, Johnathan G; Teuteberg, Jeffery J; Shellmer, Diana A; Feingold, Brian

2018-05-14

Recent OPTN bylaw revisions mandate US transplant programs have an "approved pediatric component" in order to perform heart transplantation (HT) in patients <18 years old. The impact of this change on adolescents, a group known to be at high-risk for graft loss and nonadherence, is unknown. We studied all US pediatric (age <18 years) HT from 2000-2015 to compare graft survival between centers organized primarily for adult versus pediatric care. Centers were designated as pediatric- or adult-specialty care according to the ratio of pediatric:adult HT performed and minimum age of HT (pediatric-specialty defined as ratio>0.7; adult-specialty ratio<0.05 and minimum age >8 years). In propensity score-matched cohorts we observed no difference in graft loss by center type (median survival: adult 12.4 vs. pediatric 9.2 years, p=0.174). Compared to the matched pediatric cohort, adult-specialty center recipients lived closer to their transplant center (31 vs. 45 miles, p=0.012), and trended toward fewer out-of-state transplants (15 vs. 25%, p=0.082). Our data suggest that select adolescents can achieve similar mid-term graft survival at centers organized primary for adult HT care. Regardless of post-HT setting, the development of care models that demonstrably improve adherence, may be of greatest benefit to improving survival of this high-risk population. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Motivation for Participating in a Weight Loss Program and Financial Incentives: An Analysis from a Randomized Trial

PubMed Central

Crane, Melissa M.; Tate, Deborah F.; Finkelstein, Eric A.; Linnan, Laura A.

2012-01-01

This analysis investigated if changes in autonomous or controlled motivation for participation in a weight loss program differed between individuals offered a financial incentive for weight loss compared to individuals not offered an incentive. Additionally, the same relationships were tested among those who lost weight and either received or did not receive an incentive. This analysis used data from a year-long randomized worksite weight loss program that randomly assigned employees in each worksite to either a low-intensity weight loss program or the same program plus small financial incentives for weight loss ($5.00 per percentage of initial weight lost). There were no differences in changes between groups on motivation during the study, however, increases in autonomous motivation were consistently associated with greater weight losses. This suggests that the small incentives used in this program did not lead to increases in controlled motivation nor did they undermine autonomous motivation. Future studies are needed to evaluate the magnitude and timing of incentives to more fully understand the relationship between incentives and motivation. PMID:22577524

Quantifying the impacts of road construction on wetlands loss : preliminary analysis

DOT National Transportation Integrated Search

1997-06-10

Over the past decades, the role of federal programs in the generation of wetlands losses has received much attention. One of the federal programs most responsible for wetlands losses and degradation is believed to be the Federal Aid Highway Program. ...

Effect of transfer, lifting, and repositioning (TLR) injury prevention program on musculoskeletal injury among direct care workers.

PubMed

Black, Timothy R; Shah, Syed M; Busch, Angela J; Metcalfe, Judy; Lim, Hyun J

2011-04-01

Musculoskeletal injuries among health care workers is very high, particularly so in direct care workers involved in patient handling. Efforts to reduce injuries have shown mixed results, and strong evidence for intervention effectiveness is lacking. The purpose of our study was to evaluate the effectiveness of a Transfer, Lifting and Repositioning (TLR) program to reduce musculoskeletal injuries (MSI) among direct health care workers. This study was a pre- and post-intervention design, utilizing a nonrandomized control group. Data were collected from the intervention group (3 hospitals; 411 injury cases) and the control group (3 hospitals; 355 injury cases) for periods 1 year pre- and post-intervention. Poisson regression analyses were performed. Of a total 766 TLR injury cases, the majority of injured workers were nurses, mainly with back, neck, and shoulder body parts injured. Analysis of all injuries and time-loss rates (number of injuries/100 full-time employees), rate ratios, and rate differences showed significant differences between the intervention and control groups. All-injuries rates for the intervention group dropped from 14.7 pre-intervention to 8.1 post-intervention. The control group dropped from 9.3 to 8.4. Time-loss injury rates decreased from 5.3 to 2.5 in the intervention group and increased in the control group (5.9 to 6.5). Controlling for group and hospital size, the relative rate of all-injuries and time-loss injuries for the pre- to post-period decreased by 30% (RR = 0.693; 95% CI = 0.60-0.80) and 18.6% (RR = 0.814; 95% CI = 0.677-0.955), respectively. The study provides evidence for the effectiveness of a multifactor TLR program for direct care health workers, especially in small hospitals.

Long-term Isothermal Aging Effects on Weight Loss, Compression Properties, and Dimensions of T650-35 Fabric-reinforced PMR-15 Composites-data

NASA Technical Reports Server (NTRS)

Bowles, Kenneth J.; Tsuji, Luis; Kamvouris, John; Roberts, Gary D.

2003-01-01

A cooperative program was conducted with the General Electric Aircraft Engines plant in Evendale, Ohio, to study the effects of long-term isothermal aging at elevated temperatures on compression and thermal durability properties of T650 35 fabric-reinforced PMR 15 composites. This degradation study was conducted over an approximate time period of 3 1/2 yr. The aging temperatures were 204, 260, 288, 316, and 343 C. Specimens of different dimensions were evaluated. Specimens with ratios of the cut edge to total surface area of 0.03 to 0.89 were fabricated and aged. The aged and unaged specimens were tested in compression as specified in Test Method for Compressive Properties of Rigid Plastics (ASTM D695M). Thickness changes, degraded surface layer growth, weight loss, and failure modes were monitored and recorded. All property changes were thickness dependent.

Experimental investigation and performance analysis of six low flow coefficient centrifugal compressor stages

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

Paroubek, J.; Cyrus, V.; Kyncl, J.

1995-10-01

Some results of a research and development program for centrifugal compressors are presented. Six-stage configurations with low flow coefficient were tested. The stages had channel width parameter b{sub 2}/D{sub 2} = 0.01 and 0.03. For each value of the width parameter, three different impellers with inlet hub to outlet diameter ratio d{sub 0}/D{sub 2} = 0.3, 0.4, and 0.5 were designed. Test rig, instrumentation, and data analysis are described. Special attention was devoted to probe calibrations and to evaluation of the leakage, bearing, and disk friction losses. Aerodynamic performance of all tested stages is presented. Slip factors of impellers obtainedmore » experimentally and theoretically are compared. Losses in both vaneless diffuser and return channel with deswirl vanes are discussed. Rotating stall was also investigated. Criteria for stall limit were tested.« less

Mass loss from red giant stars. II - Carbon stars

NASA Technical Reports Server (NTRS)

Wannier, P. G.; Sahai, R.; Andersson, B.-G.; Johnson, H. R.

1990-01-01

A millimeter-wave survey has been made of bright relatively unobscured, carbon stars, chosen on the basis of their optical properties. Out of 26 program objects, (J = 2-1)CO emission is detected from 15. Most of these had not been previously detected. There are many differences among the observed objects, but one rather interesting trend emerges: a positive correlation, at moderate IR excesses, between the IR dust emission and the expansion velocity of the dense wind. A similar, positive correlation with the mass-loss rate implies that stars with larger mass fluxes also accelerate them to larger velocities. At high-IR excesses, both correlations break down, and the momentum rate may be limited by the momentum rate of the stellar radiation. All these effects could be ascribed to differences in the gas-to-dust ratio, assuming that radiation pressure initiates and accelerates the wind.

Is a Mass Prevention and Control Program for Pandemic (H1N1) 2009 Good Value for Money? Evidence from the Chinese Experience

PubMed Central

Wang, Biyan; Xie, Jinliang; Fang, Pengqian

2012-01-01

Background In order to provide guidance on the efficient allocation of health resources when handling public health emergencies in the future, the study evaluated the H1N1 influenza prevention and control program in Hubei Province of China using cost-benefit analysis. Methods: The costs measured the resources consumed and other expenses incurred in the prevention and control of H1N1. The assumed benefits include resource consumption and economic losses which could be avoided by the measures for the prevention and control of H1N1. The benefit was evaluated by counterfactual thinking, which estimates the resource consumption and economic losses could be happened without any measures for the prevention and control, which have been avoided after measures were taken to prevent and control H1N1 in Hubei Province, these constitutes the benefit of this project. Results: The total costs of this program were 38.81 million U.S. dollars, while the total benefit was assessed as 203.71 million U.S. dollars. The net benefit was 164.9 million U.S. dollars with a cost-effectiveness ratio of 1:5.25. Conclusions: The joint prevention and control strategy introduced by Hubei for H1N1 influenza is cost-effective. PMID:23304674

Experimental Results of the First Two Stages of an Advanced Transonic Core Compressor Under Isolated and Multi-Stage Conditions

NASA Technical Reports Server (NTRS)

Prahst, Patricia S.; Kulkarni, Sameer; Sohn, Ki H.

2015-01-01

NASA's Environmentally Responsible Aviation (ERA) Program calls for investigation of the technology barriers associated with improved fuel efficiency of large gas turbine engines. Under ERA the task for a High Pressure Ratio Core Technology program calls for a higher overall pressure ratio of 60 to 70. This mean that the HPC would have to almost double in pressure ratio and keep its high level of efficiency. The challenge is how to match the corrected mass flow rate of the front two supersonic high reaction and high corrected tip speed stages with a total pressure ratio of 3.5. NASA and GE teamed to address this challenge by using the initial geometry of an advanced GE compressor design to meet the requirements of the first 2 stages of the very high pressure ratio core compressor. The rig was configured to run as a 2 stage machine, with Strut and IGV, Rotor 1 and Stator 1 run as independent tests which were then followed by adding the second stage. The goal is to fully understand the stage performances under isolated and multi-stage conditions and fully understand any differences and provide a detailed aerodynamic data set for CFD validation. Full use was made of steady and unsteady measurement methods to isolate fluid dynamics loss source mechanisms due to interaction and endwalls. The paper will present the description of the compressor test article, its predicted performance and operability, and the experimental results for both the single stage and two stage configurations. We focus the detailed measurements on 97 and 100 of design speed at 3 vane setting angles.

Influence of field penetration ratios and filamentation on end-effect related hysteretic loss reductions for superconducting strips

NASA Astrophysics Data System (ADS)

Dong, K.; Sumption, M.; Collings, E. W.; Majoros, M.; Yu, H.; Hu, M.

2017-12-01

There are a few key conductor-specific factors which influence the power loss of superconductors; these include critical current, geometry, and normal metal resistivity. This paper focuses on the influence of sample geometry on the power loss of superconducting strips and the effect of filamentation and sample length as a function of the field penetration state of the superconductor. We start with the analytical equations for infinite slabs and strips and then consider the influence of end effects for both unstriated and striated conductor. The loss is then calculated and compared as a function of applied field for striated and unstriated conductors. These results are much more general than they might seem at first glance, since they will be important building blocks for analytic loss calculations for twisted geometries for coated conductors, including helical (Conductor on Round Core, CORC), and twisted (e.g., twist stack cables) geometries. We show that for relatively low field penetration, end effects and reduced field penetration both reduce loss. In addition, for filamentary samples the relevant ratio of length scales becomes the filament width to sample length, thus modifying the loss ratios.

Validity of height loss as a predictor for prevalent vertebral fractures, low bone mineral density, and vitamin D deficiency.

PubMed

Mikula, A L; Hetzel, S J; Binkley, N; Anderson, P A

2017-05-01

Many osteoporosis-related vertebral fractures are unappreciated but their detection is important as their presence increases future fracture risk. We found height loss is a useful tool in detecting patients with vertebral fractures, low bone mineral density, and vitamin D deficiency which may lead to improvements in patient care. This study aimed to determine if/how height loss can be used to identify patients with vertebral fractures, low bone mineral density, and vitamin D deficiency. A hospital database search in which four patient groups including those with a diagnosis of osteoporosis-related vertebral fracture, osteoporosis, osteopenia, or vitamin D deficiency and a control group were evaluated for chart-documented height loss over an average 3 1/2 to 4-year time period. Data was retrieved from 66,021 patients (25,792 men and 40,229 women). A height loss of 1, 2, 3, and 4 cm had a sensitivity of 42, 32, 19, and 14% in detecting vertebral fractures, respectively. Positive likelihood ratios for detecting vertebral fractures were 1.73, 2.35, and 2.89 at 2, 3, and 4 cm of height loss, respectively. Height loss had lower sensitivities and positive likelihood ratios for detecting low bone mineral density and vitamin D deficiency compared to vertebral fractures. Specificity of 1, 2, 3, and 4 cm of height loss was 70, 82, 92, and 95%, respectively. The odds ratios for a patient who loses 1 cm of height being in one of the four diagnostic groups compared to a patient who loses no height was higher for younger and male patients. This study demonstrated that prospective height loss is an effective tool to identify patients with vertebral fractures, low bone mineral density, and vitamin D deficiency although a lack of height loss does not rule out these diagnoses. If significant height loss is present, the high positive likelihood ratios support a further workup.

Research: The Effect of Wetland Mitigation Banking on the Achievement of No-Net-Loss.

PubMed

BROWN; LANT

1999-04-01

/ This study determines whether the 68 wetland mitigation banks in existence in the United States through 1 January 1996 are achieving no-net-loss of wetland acreage nationally and regionally. Although 74% of the individual banks achieve no-net-loss by acreage, overall, wetland mitigation banks are projected to result in a net loss of 21,328 acres of wetlands nationally, 52% of the acreage in banks, as already credited wetland acreages are converted to otheruses. While most wetland mitigation banks are using appropriate compensation methods and ratios, several of the largest banks use preservation or enhancement, instead of restoration or creation. Most of these preservation/enhancement banks use minimum mitigation ratios of 1:1, which is much lower than ratios given in current guidelines. Assuming that mitigation occurs in these banks as preservation at the minimum allowable ratio, ten of these banks, concentrated in the western Gulf Coast region, will account for over 99% of projected net wetland acreage loss associated with banks. We conclude that wetland mitigation banking is a conceptually sound environmental policy and planning tool, but only if applied according to recently issued guidelines that ensure no-net-loss of wetland functions and values. Wetland mitigation banking inevitably leads to geographic relocation of wetlands, and therefore changes, either positively or negatively, the functions they perform and ecosystem services they provide. KEY WORDS: Mitigation banking; Wetlands; Army Corps of Engineers; No-net-loss

Mortality through ontogeny of soft-bottom marine invertebrates with planktonic larvae

NASA Astrophysics Data System (ADS)

Pedersen, Troels Møller; Hansen, Jørgen L. S.; Josefson, Alf B.; Hansen, Benni W.

2008-09-01

The present survey covers one spawning season of marine benthic invertebrates in a large geographical area, the inner Danish waters, and includes a wide range of habitats with steep salinity and nutrient load gradients. The loss ratios of soft-bottom marine invertebrates from one development stage to the next is calculated based on average abundances of pelagic larvae, benthic post-larvae and adults of Bivalvia, Gastropoda, Polychaeta and Echinodermata, with planktonic development. This gives a rough estimate of the larval and post-larval mortality. Loss ratios between post-larvae stage and adult stage (post-larval mortality) varies from 3:1 to 7:1 (71.2-84.9%) and loss ratios between larvae and post-larvae (larval mortality) and between larvae and adult, ranging from 7:1 to 42:1 (85.2-97.6%) and from 45:1 to 210:1 (97.8-99.5%), respectively. The results show a remarkable unity in loss ratios (mortality) between the mollusc taxa (Bivalvia and Gastropoda) at the phylum/class level. This similarity in loss ratios among the mollusc taxa exhibiting the same developmental pathways suggests that the mortality is governed by the same biotic and abiotic factors. Larval mortality is estimated to range from 0.10 d - 1 to 0.32 d - 1 for Bivalvia and ranging from 0.09 d - 1 to 0.23 d - 1 for Polychaeta. The species loss ratios combined with specific knowledge of the reproduction cycles give estimated loss ratios (mortality) between the post-larvae and the adult stage of 25:1 and 14:1 for the bivalves Abra spp. and Mysella bidentata. For the polychaete Pygospio elegans the loss ratio (larval mortality) between the larvae and the post-larval stage is 154:1 and between the post-larvae and the adult stage 41:1. For Pholoe inornata the loss ratio between post-larvae and adults is 7:1. The present results confirm that the larval stage, metamorphosis and settlement are the critical phase in terms of mortality in the life cycle for Bivalvia. Assuming steady state based on actual measurements of pelagic larval densities an estimated input to the water column of pelagic bivalve larvae is ranging from 10,930 to 17,157 larvae m - 2 d - 1 and for Polychaeta between 2544 and 3994 larvae m - 2 d - 1 . These estimates seem to correspond to the reproductive capacity of the observed adult densities using life-table values from the literature. The potential settlement of post-larvae is 43 post-larvae m - 2 d - 1 for Bivalvia and 56 post-larvae m - 2 d - 1 for Polychaeta. The adult turnover time for Bivalvia is estimated to be 1.5 years and 2.1 years for Polychaeta. This exemplifies that species with short generation times may dominate in very dynamic transitional zones with a high frequency of catastrophic events like the frequent incidents of hypoxia in the inner Danish waters.

Psychological well-being, health behaviors, and weight loss among participants in a residential, Kripalu yoga-based weight loss program.

PubMed

Braun, Tosca D; Park, Crystal L; Conboy, Lisa Ann

2012-01-01

The increasing prevalence of overweight and obesity in humans is a growing public health concern in the United States. Concomitants include poor health behaviors and reduced psychological well-being. Preliminary evidence suggests yoga and treatment paradigms incorporating mindfulness, self-compassion (SC), acceptance, non-dieting, and intuitive eating may improve these ancillary correlates, which may promote long-term weight loss. We explored the impact of a 5-day residential weight loss program, which was multifaceted and based on Kripalu yoga, on health behaviors, weight loss, and psychological well-being in overweight/obese individuals. Thirty-seven overweight/obese program participants (age 32-65, BMI<25) completed validated mind-fulness, SC, lifestyle behavior, and mood questionnaires at baseline, post-program, and 3-month follow-up and reported their weight 1 year after program completion. Significant improvements in nutrition behaviors, SC, mindfulness, stress management, and spiritual growth were observed immediately post-program (n = 31, 84% retention), with medium to large effect sizes. At 3-month follow-up (n = 18, 49% retention), most changes persisted. Physical activity and mood disturbance had improved significantly post-program but failed to reach significance at 3-month follow-up. Self-report weight loss at 1 year (n = 19, 51% retention) was significant. These findings suggest a Kripalu yoga-based, residential weight loss program may foster psychological well-being, improved nutrition behaviors, and weight loss. Given the exploratory nature of this investigation, more rigorous work in this area is warranted.

Effects of weight changes in the autonomic nervous system: A systematic review and meta-analysis.

PubMed

Costa, João; Moreira, André; Moreira, Pedro; Delgado, Luís; Silva, Diana

2018-01-09

Obesity has been linked to autonomic dysfunction, which is thought to be one of the main contributors for hypertension, cardiac remodelling and death. Exercise and diet-based weight loss are the mainstay therapy for obesity, but there is a paucity of data regarding the effect of weight changes in autonomic nervous system (ANS) activity. To describe the impact of weight changes in autonomic nervous system. A systematic literature search of four biomedical databases was performed evaluating effects of weight changes, thorough diet and/or exercise-based interventions, in the following ANS outcomes: heart rate variability, namely low frequency (LF)/high frequency (HF) ratio (LF/HF ratio), normalized units of LF (LFnu) and HF (HFnu), muscle sympathetic nerve activity (MSNA), noradrenaline spillover rate (NA-SR), standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), baroreflex sensitivity and pupillometry. Quality appraisal was performed using the GRADE methodology and, where fitting, studies with comparable outcomes were pooled for meta-analysis. Twenty-seven studies - 7 controlled clinical trials and 20 observational studies - were included. Weight gain was reported in 4 studies and weight loss in all the other studies. Interventions inducing weight changes included: hypocaloric or hypercaloric diets, exercise (strength, endurance or aerobic training) and hypocaloric diet coupled with exercise programs. Most studies which resulted in weight loss reported decreases in LF/HF ratio, LFnu, MSNA burst frequency and incidence, NA-SR, and an increase of baroreflex sensitivity, HF, HFnu and RMSSD, pointing to a parasympathetic nervous system activation. Meta-analysis regarding weight loss interventions showed a significant pooled effect size (95% CI) with a decreased of MSNA burst frequency -5.09 (-8.42, -1.75), MSNA incidence -6.66 (-12.40, -0.62), however this was not significant for SDNN 14.32 (-4.31, 32.96). Weight gain was associated with an increase in LF/HF, LFnu, MSNA burst frequency and incidence. The weight loss effects were potentiated by the association of hypocaloric diet with exercise. Nevertheless, weight changes effects in these outcomes were based in low or very low quality of evidence. Diet and exercise based weight loss appears to increase parasympathetic and decrease sympathetic activity, the opposing effects being observed with weight gain. These findings are not uniformly reported in the literature, possibly due to differences in study design, methodology, characteristics of the participants and techniques used to estimate autonomic nervous activity. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

76 FR 6313 - Asparagus Revenue Market Loss Assistance Payment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... Revenue Market Loss Assistance Payment Program AGENCY: Commodity Credit Corporation and Farm Service Agency, USDA. ACTION: Final rule. SUMMARY: This rule implements the Asparagus Revenue Market Loss Assistance Payment (ALAP) Program authorized by the Food, Conservation and Energy Act of 2008 (the 2008 Farm...

42 CFR 403.256 - Loss ratio supporting data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... individual or a group policy. (2) The earliest age at which policyholders can purchase the policy. (3) The... service. (vi) Interest. (vii) Expected distribution, by age and sex, of persons who will purchase the...) The past loss ratio experience for the policy, including the experience of all riders and endorsements...

42 CFR 403.253 - Calculation of benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the gross premiums are computed to provide coverage. (iv) Reserve for future contingent benefits means... the loss ratio calculation period. (iii) Net premium means the level portion of the gross premium used... period, to— (B) The total policy reserve at the last day of the loss ratio calculation period: and (ii...

Predictors of long term weight loss maintenance in patients at high risk of type 2 diabetes participating in a lifestyle intervention program in primary health care: The DE-PLAN study.

PubMed

Gilis-Januszewska, Aleksandra; Barengo, Noël C; Lindström, Jaana; Wójtowicz, Ewa; Acosta, Tania; Tuomilehto, Jaakko; Schwarz, Peter E H; Piwońska-Solska, Beata; Szybiński, Zbigniew; Windak, Adam; Hubalewska-Dydejczyk, Alicja

2018-01-01

Lifestyle interventions in type 2 diabetes (DM2) prevention implementation studies can be effective and lasting. Long-term weight loss maintenance enhances the intervention effect through a significant decrease in diabetes incidence over time. Our objective was to identify factors predicting long-term successful weight reduction maintenance achieved during a DM2 prevention program in patients with high DM2 risk in primary health care. Study participants (n = 263), middle-aged, slightly obese with baseline increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC)>14), but no diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. The study participants had three clinical examinations during the study (baseline, one and three years). Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of weight reduction maintenance two years after the discontinuation of the intervention. Out of 105 patients who completed all three examinations (baseline age 56.6 (standard deviation (SD) = 10.7), body mass index 31.1 kg/m2 (SD = 4.9), FINDRISC 18.6 (SD = 3.1)), 73 patients (70%) showed weight loss during the intervention (mean weight loss 4.2 kg, SD = 5.1). The total weight loss achieved in the maintainers (27 of 73 study participants) two years after the intervention had finished was 6.54 kg (4.47 kg+2.0 kg). The non-maintainers, on the other hand, returned to their initial weight at the start of the intervention (+0.21 kg). In multivariable analysis baseline history of increased glucose (odds ratio (OR) = 3.7; 95% confidence interval (CI) 1.0-13.6) and reduction of total fat in diet during follow-up (OR = 4.3; 95% CI 1.5-12.2) were independent predictors of successful weight loss. Further studies exploring predictors of weight loss maintenance in diabetes prevention are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.

The Refurbishment and Upgrade of the Atmospheric Radiation Measurement Raman Lidar

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

Turner, D.D.; Goldsmith, J.E.M.

The Atmospheric Radiation Measurement Program (ARM) Climate Research Facility (ACRF) Raman lidar (CARL) is an autonomous, turn-key system that profiles water vapor, aerosols, and clouds throughout the diurnal cycle for days without attention (Goldsmith et al. 1998). CARL was first deployed to the Southern Great Plains CRF during the summer of 1996 and participated in the 1996 and 1997 water vapor intensive operational periods (IOPs). Since February 1998, the system has collected over 38,000 hrs of data (equivalent of almost 4.4 years), with an average monthly uptime of 62% during this time period. This unprecedented performance by CARL makes itmore » the premier operational Raman lidar in the world. Unfortunately, CARL began degrading in early 2002. This loss of sensitivity, which affected all observed variables, was very gradual and thus was not identified until the autumn of 2003. Analysis of the data suggested the problem was not associated with the laser or transmit portion of the system, but rather in the detection subsystem, as both the background values and the peak signals showed a marked decreases over this time period. The loss of sensitivity of a factor of 2-4, depending on the channel, resulted in higher random error in the retrieved products, such as the aerosol backscatter coefficient and water vapor mixing ratio. Figure 1 shows the random error at 2 km for aerosol backscatter coefficient (top) and water vapor mixing ratio (middle), in terms of percent of the signal for both average daytime (red) and nighttime (blue) data from 1998 to 2005. The seasonal variation of water vapor is easily seen in the random error in the water vapor mixing ratio data. The loss of sensitivity also affected the maximum range of the usable data, as illustrated by the dramatic decrease in the maximum height seen in the water vapor mixing ratio data (bottom). This degradation, which results in much larger random errors, greatly hinders the analysis of data sets such as the Aerosol IOP (March 2003) and the AIRS Water Vapor Experiment (December 2003). The degradation and its impact on the Aerosol IOP analysis are reported in Ferrare et al. 2005.« less

Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: results of an economic evaluation alongside a randomised controlled trial.

PubMed

Oostdam, Nicolette; Bosmans, Judith; Wouters, Maurice G A J; Eekhoff, Elisabeth M W; van Mechelen, Willem; van Poppel, Mireille N M

2012-07-04

The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM and the risks associated with GDM lead to increased health care costs and losses in productivity. The objective of this study is to evaluate whether the FitFor2 exercise program during pregnancy is cost-effective from a societal perspective as compared to standard care. A randomised controlled trial (RCT) and simultaneous economic evaluation of the FitFor2 program were conducted. Pregnant women at risk for GDM were randomised to an exercise program to prevent high maternal blood glucose (n = 62) or to standard care (n = 59). The exercise program consisted of two sessions of aerobic and strengthening exercises per week. Clinical outcome measures were maternal fasting blood glucose levels, insulin sensitivity and infant birth weight. Quality of life was measured using the EuroQol 5-D and quality-adjusted life-years (QALYs) were calculated. Resource utilization and sick leave data were collected by questionnaires. Data were analysed according to the intention-to-treat principle. Missing data were imputed using multiple imputations. Bootstrapping techniques estimated the uncertainty surrounding the cost differences and incremental cost-effectiveness ratios. There were no statistically significant differences in any outcome measure. During pregnancy, total health care costs and costs of productivity losses were statistically non-significant (mean difference €1308; 95%CI €-229 - €3204). The cost-effectiveness analyses showed that the exercise program was not cost-effective in comparison to the control group for blood glucose levels, insulin sensitivity, infant birth weight or QALYs. The twice-weekly exercise program for pregnant women at risk for GDM evaluated in the present study was not cost-effective compared to standard care. Based on these results, implementation of this exercise program for the prevention of GDM cannot be recommended. NTR1139.

DESIGN OF TWO-DIMENSIONAL SUPERSONIC TURBINE ROTOR BLADES WITH BOUNDARY-LAYER CORRECTION

NASA Technical Reports Server (NTRS)

Goldman, L. J.

1994-01-01

A computer program has been developed for the design of supersonic rotor blades where losses are accounted for by correcting the ideal blade geometry for boundary layer displacement thickness. The ideal blade passage is designed by the method of characteristics and is based on establishing vortex flow within the passage. Boundary-layer parameters (displacement and momentum thicknesses) are calculated for the ideal passage, and the final blade geometry is obtained by adding the displacement thicknesses to the ideal nozzle coordinates. The boundary-layer parameters are also used to calculate the aftermixing conditions downstream of the rotor blades assuming the flow mixes to a uniform state. The computer program input consists essentially of the rotor inlet and outlet Mach numbers, upper- and lower-surface Mach numbers, inlet flow angle, specific heat ratio, and total flow conditions. The program gas properties are set up for air. Additional gases require changes to be made to the program. The computer output consists of the corrected rotor blade coordinates, the principal boundary-layer parameters, and the aftermixing conditions. This program is written in FORTRAN IV for batch execution and has been implemented on an IBM 7094. This program was developed in 1971.

Clinicopathological significance of SMAD4 loss in pancreatic ductal adenocarcinomas: a systematic review and meta-analysis.

PubMed

Wang, Jin-Dao; Jin, Ketao; Chen, Xiao-Ying; Lv, Jie-Qing; Ji, Ke-Wei

2017-03-07

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer mortality. Although advances have been made in understanding the pathogenesis of PDAC, the outcome still remains poor. The aim of this study is to conduct a meta-analysis to evaluate the precise association between SMAD4 loss and clinicopathological significance in PDAC. A literature search was made in PubMed, Web of Science, Google scholar, and EMBASE for related publications. The data were extracted and assessed by two reviewers independently. Analysis of pooled data was performed, Odds Ratio or Hazard Ratio with corresponding confidence intervals was calculated and summarized. 12 relevant articles were included for full review in detail and meta-analysis. The frequency of SMAD4 protein loss was significantly increased in PDAC than in nonmalignant pancreatic tissue, Odd Ratio was 0.05 with 95% confidence interval 0.01-0.23, p<0.0001. SMAD4 loss was significantly associated with poor overall survival in patients with PDAC, Hazard Ratio was 0.61 with 95% confidence interval 0.38-0.99, p=0.05. SMAD4 loss was not correlated with the size, grades, and lymph node metastasis of PDAC. In conclusion, SMAD4 is a biomarker for the diagnosis of PDAC. SMAD4 loss is significantly related to poor prognosis in patients with PDAC.

Motivational interviewing fails to improve outcomes of a behavioral weight loss program for obese African American women: a pilot randomized trial.

PubMed

Befort, Christie A; Nollen, Nicole; Ellerbeck, Edward F; Sullivan, Debra K; Thomas, Janet L; Ahluwalia, Jasjit S

2008-10-01

Compared to other racial/ethnic groups, African American (AA) women are more likely to be obese but less likely to participate in weight loss interventions or to successfully lose weight. Sustained motivation for weight loss may be especially difficult for AA women due to socioeconomic and cultural factors. The purpose of this study was to examine whether the addition of motivational interviewing (MI) to a culturally-targeted behavioral weight loss program for AA women improved adherence to the program, diet and physical activity behaviors, and weight loss outcomes. Forty-four obese (mean BMI = 39.4, SD = 7.1) AA women were randomized to receive a 16-week behavioral weight loss program plus four MI sessions, or the same behavioral weight loss program plus four health education (HE; attention control) sessions. Results showed that participants in both MI and HE conditions lost a significant amount of weight, reduced their energy intake and percent calories from fat, and increased their fruit and vegetable consumption (ps < .05). However, adherence to the behavioral weight loss program and changes in diet, physical activity, and weight did not differ across MI and HE conditions. Future research is warranted to determine the subpopulations with which MI is most effective.

Parental perspectives on adolescent hearing loss risk and prevention.

PubMed

Sekhar, Deepa L; Clark, Sarah J; Davis, Matthew M; Singer, Dianne C; Paul, Ian M

2014-01-01

Data indicate that 1 in 6 adolescents has high-frequency hearing loss, which is typically noise related and preventable. Parental participation improves the success of adolescent behavioral interventions, yet little is known about parental perspectives regarding adolescent noise-induced hearing loss. To perform a survey to determine parental knowledge of adolescent hearing loss and willingness to promote hearing conservation to discern information that is critical to design adolescent hearing loss prevention programs. A cross-sectional, Internet-based survey of a nationally representative online sample of parents of 13- to 17-year-olds. A survey conducted with the C.S. Mott Children's Hospital National Poll on Children's Health, a recurring online survey. Parental knowledge of adolescent hearing loss and willingness to promote hearing conservation. Of 716 eligible respondents, 96.3% of parents reported that their adolescent was slightly or not at all at risk of hearing problems from excessive noise, and 69.0% had not spoken with their adolescent about noise exposure, mainly because of the perceived low risk. Nonetheless, to protect their adolescents' hearing, more than 65.0% of parents are either willing or very willing to consider limiting time listening to music, limiting access to excessively noisy situations, or insisting on the use of hearing protection (earplugs or earmuffs). Higher parental education increased the odds of promoting hearing-protective strategies. Parents were less likely to insist on hearing protection for older adolescents. Parents who understood that both volume and time of exposure affect hearing damage were more likely to have discussed hearing loss with their adolescent (odds ratio [OR], 1.98; 95% CI, 1.29-3.03). The odds of discussing hearing loss were also increased for those who were willing or very willing to limit time listening to music (OR, 1.88; 95% CI, 1.19-2.26) and to insist on hearing protection (OR, 1.92; 95% CI, 1.15-3.18) compared with parents who were very unwilling, unwilling, or neutral. Despite the rising prevalence of acquired adolescent hearing loss, few parents believe their adolescent is at risk. Those with higher education are more willing to promote hearing conservation, especially with younger adolescents. To create effective hearing conservation programs, parents need better education on this subject as well as effective and acceptable strategies to prevent adolescent noise exposure.

7 CFR 760.503 - Eligible losses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.503 Eligible losses. (a) To be considered an eligible loss under this subpart: (1) Eligible trees, bushes, or vines must have been lost or... reasonable and available measures; and (4) The trees, bushes, or vines, in the absence of a natural disaster...

7 CFR 760.503 - Eligible losses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.503 Eligible losses. (a) To be considered an eligible loss under this subpart: (1) Eligible trees, bushes, or vines must have been lost or... reasonable and available measures; and (4) The trees, bushes, or vines, in the absence of a natural disaster...

7 CFR 760.503 - Eligible losses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.503 Eligible losses. (a) To be considered an eligible loss under this subpart: (1) Eligible trees, bushes, or vines must have been lost or... reasonable and available measures; and (4) The trees, bushes, or vines, in the absence of a natural disaster...

7 CFR 760.503 - Eligible losses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.503 Eligible losses. (a) To be considered an eligible loss under this subpart: (1) Eligible trees, bushes, or vines must have been lost or... reasonable and available measures; and (4) The trees, bushes, or vines, in the absence of a natural disaster...

A pilot study of a weight management program with food provision in schizophrenia.

PubMed

Jean-Baptiste, Michel; Tek, Cenk; Liskov, Ellen; Chakunta, Umesh Rao; Nicholls, Sarah; Hassan, Akm Q; Brownell, Kelly D; Wexler, Bruce E

2007-11-01

Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity.

[The 8-year follow-up study for clinical diagnostic potentials of frequency-doubling technology perimetry for perimetrically normal eyes of open-angle glaucoma patients with unilateral visual field loss].

PubMed

Fan, X; Wu, L L; Xiao, G G; Ma, Z Z; Liu, F

2018-03-11

Objective: To analyze potentials of frequency-doubling technology perimetry (FDP) for diagnosing open-angle glaucoma (OAG) in perimetrically normal eyes of OAG patients diagnosed with standard automated perimetry (SAP) and relating factors from abnormalities on FDP to visual field loss on SAP. Methods: A prospective cohort study. Sixty-eight eyes of 68 OAG patients visiting the ophthalmic clinic of Peking University Third Hospital during November 2003 and October 2007 [32 primary open-angle glaucoma patients and 36 normal tension glaucoma patients, 32 males and 36 females, with an average age of (59±13) years] with unilateral field loss detected by SAP (Octopus101 tG2 program) were examined with the FDP N-30 threshold program (Humphrey Instruments) at baseline. Two groups, FDP positive group and FDP negative group, were divided based on the FDP results, and visual field examinations were followed by a series of SAP examinations for the perimetrically normal eyes over 8 years. During the follow-up, the difference of the converting rate of SAP tests between the two groups was analyzed. Differences between "convertors" and "non-convertors" of SAP tests in the FDP positive group, such as the cup-to-disk ratio and glaucomatous optic neuropathy rate, were also compared with the independent-sample t test or Wilcoxon two-sample test for continuous variable data and the χ(2) test or Fisher exact test for classified variable data and rates. Results: Forty-eight perimetrically normal eyes of 48 participants had complete data and a qualifying follow-up. Baseline FDP results were positive in 33 eyes and negative in 15 eyes. Of the eyes with positive FDP results, 22 eyes developed abnormal SAP results after 4.0 to 90.0 months (median 14.5 months) , whereas none of the eyes with negative FDP results developed abnormal SAP results. For perimetrically normal eyes in the FDP positive group, "converters" showed a greater cup-to-disk ratio (0.73±0.09 vs . 0.63±0.14, Wilcoxon two-sample test, P= 0.011) and more eyes with glaucomatous optic neuropathy (19/22 vs . 4/11, Fisher exact test, P= 0.006). Conclusions: In perimetrically normal eyes of OAG patients, FDP could detect visual field loss of these eyes and predict to some extent future visual field loss on SAP. Severity of glaucomatous optic neuropathy at baseline is related to converting from abnormalities on FDP to visual field loss on SAP. (Chin J Ophthalmol, 2018, 54: 177-183) .

75 FR 58468 - Terrorism Risk Insurance Program; Program Loss Reporting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Program Loss Reporting AGENCY: Departmental Offices, Terrorism Risk Insurance Program Office, Treasury. ACTION: Notice and request for... 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A)). Currently, the Terrorism Risk Insurance Program...

Effect of short-term weight loss on mental stress-induced cardiovascular and pro-inflammatory responses in women.

PubMed

Endrighi, Romano; Hamer, Mark; Hackett, Ruth A; Carvalho, Livia A; Jackson, Sarah E; Wardle, Jane; Steptoe, Andrew

2015-01-01

Epidemiologic evidence links psychosocial stress with obesity but experimental studies examining the mechanisms that mediates the effect of stress on adiposity are scarce. The aim of this study was to investigate whether changes in adiposity following minimal weight loss affect heightened stress responses in women, and examine the role of the adipokine leptin in driving inflammatory responses. Twenty-three overweight or obese, but otherwise healthy, women (M age = 30.41 ± 8.0 years; BMI = 31.9 ± 4.1 kg/m(2)) completed standardized acute mental stress before and after a 9-week calorie restriction program designed to modify adiposity levels. Cardiovascular (blood pressure and heart rate) and inflammatory cytokines (leptin and interleukin-6; IL-6) responses to mental stress were assessed several times between baseline and a 45-min post-stress recovery period. There were modest changes in adiposity measures while the adipokine leptin was markedly reduced (-27%) after the intervention. Blood pressure reactivity was attenuated (-3.38 ± 1.39 mmHg) and heart rate recovery was improved (2.07 ± 0.96 Bpm) after weight loss. Blood pressure responses were inversely associated with changes in waist to hip ratio post intervention. Decreased levels of circulating leptin following weight loss were inversely associated with the IL-6 inflammatory response to stress (r = -0.47). We offered preliminary evidence suggesting that modest changes in adiposity following a brief caloric restriction program may yield beneficial effect on cardiovascular stress responses. In addition, reductions in basal leptin activity might be important in blunting pro-inflammatory responses. Large randomized trials of the effect of adiposity on autonomic responses are thus warranted.

An intensive behavioral weight loss intervention and hot flushes in women.

PubMed

Huang, Alison J; Subak, Leslee L; Wing, Rena; West, Delia Smith; Hernandez, Alexandra L; Macer, Judy; Grady, Deborah

2010-07-12

Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear. Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors. Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89). Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control. Trial Registration clinicaltrials.gov Identifier: NCT00091988.

Differential Impact of Weight Loss on Nonalcoholic Fatty Liver Resolution in a North American Cohort with Obesity.

PubMed

Rachakonda, Vikrant; Wills, Rachel; DeLany, James P; Kershaw, Erin E; Behari, Jaideep

2017-08-01

Nonalcoholic fatty liver disease (NAFLD) is closely associated with obesity. In this study, a North American cohort with obesity enrolled in a lifestyle modification program was examined to determine the impact of weight loss on NAFLD resolution and sarcopenia. Nondiabetic individuals with World Health Organization Class II/III obesity enrolled in a 6-month weight loss intervention were included. Steatosis was measured using computed tomography (CT)-derived liver:spleen attenuation ratio. Body composition was assessed using dual X-ray absorptiometry, air-displacement plethysmography, and CT anthropometry. At baseline, participants with NAFLD had greater visceral adipose tissue (VAT) but similar skeletal muscle area compared to those without NAFLD. After intervention, weight loss was similar in the two groups, but participants with NAFLD lost more VAT than those without NAFLD (-38.81 [-55.98 to -21.63] cm 2 vs. -13.82 [-29.65 to -2.02] cm 2 ; P = 0.017). In the subset with NAFLD at baseline, participants with NAFLD resolution after intervention lost more VAT than those with persistent NAFLD (-57.23 [-88.63 to -25.84) cm 2 vs. -26.92 [-52.14 to -26.92] cm 2 , P = 0.039). In a Western cohort with obesity, NAFLD was not associated with sarcopenia. After lifestyle modification, there was a differential impact on NAFLD resolution, with twofold greater VAT loss in participants who resolved NAFLD compared with those with persistent NAFLD despite similar weight loss. © 2017 The Obesity Society.

Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009–2010 Through 2013–2014

PubMed Central

Kerr, Zachary Y.; Hayden, Ross; Barr, Megan; Klossner, David A.; Dompier, Thomas P.

2015-01-01

Context Recent injury-surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non–time-loss injuries (ie, injuries resulting in restriction of participation <1 day). Objective To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009–2010 through 2013–2014 academic years. Design Descriptive epidemiology study. Setting Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data. Patients or Other Participants Collegiate student-athletes participating in women's gymnastics during the 2009–2010 through 2013–2014 academic years. Intervention(s) Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009–2010 through 2013–2014 academic years were analyzed. Main Outcome Measure(s) Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). Results The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82). Conclusions We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as “sting mats,” padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury. PMID:26196702

A descriptive study of past experiences with weight-loss treatment.

PubMed

Burke, Lora E; Steenkiste, Ann; Music, Edvin; Styn, Mindi A

2008-04-01

Overweight and obesity affect more than 60% of the adult population in the United States. Most adults who are overweight have a history of previous weight-loss treatment. Exploring individuals' past experiences with weight-loss treatment may allow improvements to the current approach to treatment. To examine individuals' prior experiences with weight-loss treatment, their treatment preferences, and what they found to be most and least satisfying. Cross-sectional descriptive study. Individuals (N=155) who had registered for a weight-loss study wait list and met standard criteria for a weight-loss program (aged 18 to 55 years and body mass index between 25 and 42). Questionnaire packets were mailed to participants. Descriptive analyses of the participants' past history with weight-loss treatment, treatment preference, self-efficacy, therapeutic efficacy, barriers to adherence to weight-loss treatment, barriers to healthy eating, and experiences associated with following a low-fat diet. One hundred ten participants (71%) returned completed questionnaire packets. The sample (82% white, 84% female, aged 42.6+/-8.5 years, and body mass index 33.5+/-5.3) was representative of those who seek weight-loss treatment in research settings. Participants were, on average, aged 21.1+/-8.9 years when they first tried a weight-loss program; 96.3% had tried to lose weight since that first time. The two most frequently tried programs were doing it on their own (93.5%) and commercial programs (70.8%). Barriers included having trouble controlling what I eat when hungry (71.3%), difficulty motivating myself to eat appropriately (66.2%), and using food as a reward (59.3%). Preferred weight-loss regimens were doing it on their own (30.6%) and a research program (22.4%). Participants were not seeking their preferred treatment. These data can be used to improve weight-loss programs by tailoring programs to meet the needs and preferences of participants.

Thrust Augmentation with Mixer/Ejector Systems

NASA Technical Reports Server (NTRS)

Presz, Walter M., Jr.; Reynolds, Gary; Hunter, Craig

2002-01-01

Older commercial aircraft often exceed FAA (Federal Aviation Administration) sideline noise regulations. The major problem is the jet noise associated with the high exhaust velocities of the low bypass ratio engines on such aircraft. Mixer/ejector exhaust systems can provide a simple means of reducing the jet noise on these aircraft by mixing cool ambient air with the high velocity engine gases before they are exhausted to ambient. This paper presents new information on thrust performance predictions, and thrust augmentation capabilities of mixer/ejectors. Results are presented from the recent development program of the patented Alternating Lobe Mixer Ejector Concept (ALMEC) suppressor system for the Gulfstream GII, GIIB and GIII aircraft. Mixer/ejector performance procedures are presented which include classical control volume analyses, compound compressible flow theory, lobed nozzle loss correlations and state of the art computational fluid dynamic predictions. The mixer/ejector thrust predictions are compared to subscale wind tunnel test model data and actual aircraft flight test measurements. The results demonstrate that a properly designed mixer/ejector noise suppressor can increase effective engine bypass ratio and generate large thrust gains at takeoff conditions with little or no thrust loss at cruise conditions. The cruise performance obtained for such noise suppressor systems is shown to be a strong function of installation effects on the aircraft.

Stoichiometry and climatic stress drive respiration and nutrient dynamics of beech litter decomposition

NASA Astrophysics Data System (ADS)

Keiblinger, Katharina Maria; Hämmerle, Ieda; Zechmeister-Boltenstern, Sophie

2010-05-01

Little is known about how the variance in resources in terms of carbon (C), nitrogen (N), phosphorus (P) ratios affects respiration and nutrient dynamics. To elucidate how resource quantity and stoichiometry affect the decomposition process of beech (Fagus sylvatica) litter a terrestrial microcosm experiment was conducted. Our aim was to follow changes of beech litter stoichiometry and biogeochemical processes, and to quantify element losses as affected by temperature and moisture extremes. In addition to gaseous element losses (CO2) we examined the release of nutrients prone to leaching and the importance of environmental controls. We addressed mechanisms and pathways of carbon, nitrogen and phosphorus losses. In our experiment sterilised dried leaves were inoculated with a litter-soil suspension from a beech forest in order to ensure similar starting conditions. Beech litter from different Austrian sites covering C:N ratios from 45 to 66 and C:P ratios from 652 to 1467 were incubated at 15°C for six months. The water content was adjusted to 60% at regular intervals to keep the moisture constant. To monitor transient and persistent influences of environmental stress, the microcosms were subject to extreme changes in temperature (+30°C and -20°C) and moisture (draught) after an incubation time of three months. Litter stoichiometries (C:N, C:P) turned out to be strong predictors for respiration, and nitrogen, and phosphorous losses. (i) Litter with narrow litter C:nutrient ratios decomposed faster than litter with wider litter C:nutrient ratios; and therefore showed higher respiration rates. (ii) Increased nutrient losses as leachates were observed for high quality leaf litter i.e. inorganic nitrogen losses for sites with narrow litter C:N ratios and phosphate was released more quickly in sites with narrow C:P ratios. There was a strong functional response of the microbial community to environmental extremes. Respiration increased upon temperature extremes, especially in the litter with highest C:P ratio. A persistent effect of temperature extremes on NH4 and NO3 concentrations was observed for three months after stress application. However, the effect on PO4 concentrations was only transient. Environmental conditions had a strong affect on nutrient losses but only a minor affect on microbial carbon Cmic and microbial nitrogen Nmic. The impact of environmental stress (heat or freezing) on microbes in terms of Cmic, Nmic and C:Nmic was strongest in sites with narrow litter C:N ratios. Our results indicate a similar stoichiometric demand of microbes, with temporal changes which results in differences in nutrient cycling on substrates with different C:N:P ratios.

TM-pass polarizer based on multilayer graphene polymer waveguide

NASA Astrophysics Data System (ADS)

Cai, Ke-su; Li, Yue-e.; Wei, Wen-jing; Mu, Xi-jiao; Ma, A.-ning; Wang, Zhong; Song, Dan-ming

2018-05-01

A TM-pass polarizer based on multilayer graphene polymer waveguide is proposed and theoretically analyzed. The mode properties, the extinction ratio, the insertion loss and the bandwidth are also discussed. The results show that a TM-pass polarizer, which only guides the TM mode, can be achieved by multilayer graphene polymer waveguide. With length of 150 μm, the proposed polarizer can achieve extinction ratio of 33 dB and insertion loss of 0.5 dB at optical wavelength of 1.55 μm. This device has an excellent performance, including large extinction ratio and low insertion loss within the spectral range from 1.45 μm to 1.6 μm.

Financial analysis of biogas utilization : input cattle, pig feces and coffee waste in Karo, Indonesia

NASA Astrophysics Data System (ADS)

Ginting, N.; Zuhri, F.; Hasnudi; Mirwandhono, E.; Sembiring, I.; Daulay, A. H.

2018-02-01

The community's need for renewable energy was very urgent. In addition, efforts to preserve the environment from waste caused biogas technology feasible to apply. This study aims to provide biogas technology with minimal cost and utilize agricultural waste that were coffee and livestock waste. The study was conducted from July to October 2016. The theoretical and empirical methods used in this study were included data from officials resources, field survey on 16 biogas locations, focus group discussion and interview with stake holders. Data were tabulated by Excel Program which then were analysed by SAS. Parameters were included Production Cost, Production Result, Profit Loss Analysis, Revenue Cost Ratio (R/C Ratio), Return On Investment (ROI), Net B/C, and IRR. The result of this research showed that the application of bioplastic gas with cow dung and coffee waste as bioplasticgas input cause the best results.

Loss of iron to gold capsules in rock-melting experiments

USGS Publications Warehouse

Ratajeski, K.; Sisson, T.W.

1999-01-01

Gold is used widely for capsules in high-temperature rock-melting studies because it is generally thought to absorb negligible Fe from silicate samples. However, we observed significant losses of Fe from fluid-absent melting experiments on hornblende gabbros at 800-975 ??C and 8 kbar, using standard piston-cylinder techniques. The extent of Fe loss from the sample is dependent on the relative masses of the sample and the capsule. Low sample to capsule mass ratios (~0.04) lead to the highest Fe losses (32-49% relative). Concentrations of Fe in silicate melt and used gold capsules define an apparent equilibrium constant (K') that follows a linear 1n K' vs. 1/T relation (at an estimated log f(O)(2) of QFM-1). The apparent equilibrium constant is used to make limiting upper estimates on the amount of Fe that could be lost during rock-melting experiments for a range of f(O)(2) and sample to capsule mass ratios. At high f(O)(2) (NNO + 2), loss of Fe to gold is negligible (<2% relative) for a wide range of sample to capsule mass ratios. At an f(O)(2) of NNO, Fe loss can be kept to <10% relative by using a sample to capsule mass ratio of 0.2 or greater. At low f(O)(2) (QFM-1), presaturating the Au with Fe would be necessary to ensure that Fe losses remained <10% relative. Fe loss can compromise experimental results for small samples run at low f(O)(2) conditions, be they buffered, imposed by the pressure media, or produced by intrinsically reduced (graphitic) starting materials.

Immunization against Haemophilus Influenzae Type b in Iran; Cost-utility and Cost-benefit Analyses

PubMed Central

Moradi-Lakeh, Maziar; Shakerian, Sareh; Esteghamati, Abdoulreza

2012-01-01

Background: Haemophilus Influenzae type b (Hib) is an important cause of morbidity and mortality in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to assess the cost-benefit and cost-utility of running an Hib vaccination program in Iran. Methods: Based on a previous systematic review and meta-analysis for vaccine efficacy, we estimated the averted DALYs (Disability adjusted life years) and cost-benefit of vaccination. Different acute invasive forms of Hib infection and the permanent sequels were considered for estimating the attributed DALYs. We used a societal perspective for economic evaluation and included both direct and indirect costs of alternative options about vaccination. An annual discount rate of 3% and standard age-weighting were used for estimation. To assess the robustness of the results, a sensitivity analysis was performed. Results: The incidence of Hib infection was estimated 43.0 per 100000, which can be reduced to 6.7 by vaccination. Total costs of vaccination were estimated at US$ 15,538,129. Routine vaccination of the 2008 birth cohort would prevent 4079 DALYs at a cost per averted-DALY of US$ 4535. If we consider parents’ loss of income and future productivity loss of children, it would save US$ 8,991,141, with a benefit-cost ratio of 2.14 in the base-case analysis. Sensitivity analysis showed a range of 0.78 to 3.14 for benefit-to-cost ratios. Conclusion: Considering costs per averted DALY, vaccination against Hib is a cost-effective health intervention in Iran, and allocating resources for routine vaccination against Hib seems logical. PMID:22708030

Changes in weight control behaviors and hedonic hunger during a 12-week commercial weight loss program.

PubMed

O'Neil, Patrick M; Theim, Kelly R; Boeka, Abbe; Johnson, Gail; Miller-Kovach, Karen

2012-12-01

Greater use of key self-regulatory behaviors (e.g., self-monitoring of food intake and weight) is associated with greater weight loss within behavioral weight loss treatments, although this association is less established within widely-available commercial weight loss programs. Further, high hedonic hunger (i.e., susceptibility to environmental food cues) may present a barrier to successful behavior change and weight loss, although this has not yet been examined. Adult men and women (N=111, body mass index M±SD=31.5±2.7kg/m(2)) were assessed before and after participating in a 12-week commercial weight loss program. From pre- to post-treatment, reported usage of weight control behaviors improved and hedonic hunger decreased, and these changes were inversely associated. A decrease in hedonic hunger was associated with better weight loss. An improvement in reported weight control behaviors (e.g., self-regulatory behaviors) was associated with better weight loss, and this association was even stronger among individuals with high baseline hedonic hunger. Findings highlight the importance of specific self-regulatory behaviors within weight loss treatment, including a commercial weight loss program developed for widespread community implementation. Assessment of weight control behavioral skills usage and hedonic hunger may be useful to further identify mediators of weight loss within commercial weight loss programs. Future interventions might specifically target high hedonic hunger and prospectively examine changes in hedonic hunger during other types of weight loss treatment to inform its potential impact on sustained behavior change and weight control. Copyright © 2012 Elsevier Ltd. All rights reserved.

Medical loss ratio rebate requirements for non-federal governmental plans. Interim final rule with request for comments.

PubMed

2011-12-07

This interim final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to establish rules governing the distribution of rebates by issuers in group markets for non-Federal governmental plans.

Health insurance issuers implementing medical loss ratio (MLR) requirements under the Patient Protection and Affordable Care Act. Interim final rule with request for comments.

PubMed

2010-12-01

This document contains the interim final regulation implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act).

42 CFR 422.2420 - Calculation of the medical loss ratio.

Code of Federal Regulations, 2013 CFR

2013-10-01

... contract for activities that improve health care quality, as defined in § 422.2430. (iv) The amount of the... 42 Public Health 3 2013-10-01 2013-10-01 false Calculation of the medical loss ratio. 422.2420 Section 422.2420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 422.2420 - Calculation of the medical loss ratio.

Code of Federal Regulations, 2014 CFR

2014-10-01

... contract for activities that improve health care quality, as defined in § 422.2430. (iv) The amount of the... 42 Public Health 3 2014-10-01 2014-10-01 false Calculation of the medical loss ratio. 422.2420 Section 422.2420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

76 FR 31337 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-31

... Collection: Request for Adjustment to the Medical Loss Ratio Standard for a State's Individual Market; Use... medical loss ratio (MLR) by market (individual, small group, and large group) within each State in which... Number: CMS-10361 (OMB Control No. 0938-1114); Frequency: Once; Affected Public: State, local or tribal...

Adding evidence-based behavioral weight loss strategies to a statewide wellness campaign: a randomized clinical trial.

PubMed

Leahey, Tricia M; Thomas, Graham; Fava, Joseph L; Subak, Leslee L; Schembri, Michael; Krupel, Katie; Kumar, Rajiv; Weinberg, Brad; Wing, Rena R

2014-07-01

We determined the efficacy and cost-effectiveness of adding an evidence-based Internet behavioral weight loss intervention alone or combined with optional group sessions to ShapeUp Rhode Island 2011 (SURI), a 3-month statewide wellness campaign. We randomized participants (n = 230; body mass index = 34.3 ±6.8 kg/m(2); 84% female) to the standard SURI program (S) or to 1 of 2 enhanced programs: SURI plus Internet behavioral program (SI) or SI plus optional group sessions (SIG). The primary outcome was weight loss at the end of the 3-month program. Weight losses differed among all 3 conditions (S: 1.1% ±0.9%; SI: 4.2% ±0.6%; SIG: 6.1% ±0.6%; Ps ≤ .04). Both SI and SIG increased the percentage of individuals who achieved a 5% weight loss (SI: 42%; SIG: 54%; S: 7%; Ps < .001). Cost per kilogram of weight loss was similar for S ($39) and SI ($35); both were lower than SIG ($114). Although weight losses were greatest at the end of SURI with optional group sessions, the addition of an Internet behavioral program was the most cost-effective method to enhance weight losses.

Elasto-optics in double-coated optical fibers induced by axial strain and hydrostatic pressure.

PubMed

Yang, Yu-Ching; Lee, Haw-Long; Chou, Huann-Ming

2002-04-01

Stresses, microbending loss, and refractive-index changes induced simultaneously by axial strain and hydrostatic pressure in double-coated optical fibers are analyzed. The lateral pressure and normal stresses in the optical fiber, primary coating, and secondary coating are derived. Also presented are the microbending loss and refractive-index changes in the glass fiber. The normal stresses are affected by axial strain, hydrostatic pressure, material properties, and thickness of the primary and secondary coatings. It is found that microbending loss decreases with increasing thickness, the Young's modulus, and the Poisson's ratio of the secondary coating but increases with the increasing Young's modulus and Poisson's ratio of the primary coating. Similarly, changes in refractive index in the glass fiber decrease with the increasing Young's modulus and Poisson's ratio of the secondary coating but increase with the increasing Young's modulus and Poisson's ratio of the primary coating. Therefore, to minimize microbending loss induced simultaneously by axial strain and hydrostatic pressure in the glass fiber, the polymeric coatings should be suitably selected. An optimal design procedure is also indicated.

Mood and Weight Loss in a Behavioral Treatment Program.

ERIC Educational Resources Information Center

Wing, Rena R.; And Others

1983-01-01

Evaluated the relationship between mood and weight loss for 76 patients participating in two consecutive behavioral treatment programs. Weight losses averaged 12.2 pounds (5.55 kg) during the 10-week program. Positive changes in mood were reported during this interval, and these changes appeared to be related to changes in weight. (Author/RC)

Extension Home Economists as Therapists in a Behavior Modification Weight Loss Program.

ERIC Educational Resources Information Center

Beneke, William M.; Paulsen, Barbara K.

A total of 150 overweight female subjects entered a behavior modification weight loss program with extension home economists as therapists to determine the feasibility of state extension services as a vehicle for widespread dissemination of behavioral weight loss programs. The treatment, emphasizing stimulus control and nutrition education,…

Global budgets in Maryland: early evidence on revenues, expenses, and margins in regulated and unregulated services.

PubMed

Malmmose, Margit; Mortensen, Karoline; Holm, Claus

2018-04-02

Maryland implemented one of the most aggressive payment innovations the nation has seen in several decades when it introduced global budgets in all its acute care hospitals in 2014. Prior to this, a pilot program, total patient revenue (TPR), was established for 8 rural hospitals in 2010. Using financial hospital report data from the Health Services Cost Review Commission from 2007 to 2013, we examined the hospitals' financial results including revenue, costs, and profit/loss margins to explore the impact of the adoption of the TPR pilot global budget program relative to the remaining hospitals in the state. We analyze financial results for both regulated (included in the global budget and subject to rate-setting) and unregulated services in order to capture a holistic image of the hospitals' actual revenue, cost and margin structures. Common size and difference-in-differences analyses of the data suggest that regulated profit ratios for treatment hospitals increased (from 5% in 2007 to 8% in 2013) and regulated expense-to-gross patient revenue ratios decreased (75% in 2007 and 68% in 2013) relative to the controls. Simultaneously, the profit margins for treatment hospitals' unregulated services decreased (- 12% in 2007 and - 17% in 2013), which reduced the overall margin significantly. This analysis therefore indicates cost shifting and less profit gain from the program than identified by solely focusing on the regulated margins.

Availability and Accessibility of Student-Specific Weight Loss Programs and Other Risk Prevention Health Services on College Campuses

PubMed Central

Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina

2016-01-01

Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate enrollment of 41,122 (7657) students were examined. The websites of the universities were assessed to determine the availability of weight loss programs. Services for high-risk health needs common to university campuses (ie, alcohol and other drugs, victim services, sexual health, and eating disorders) were searched. Results Of the universities searched, 3 (30%, 3/10) offered weight loss programming, however, none met the predetermined criteria. Comparatively, all schools (100%, 10/10) offered no-cost and continual enrollment programming for the other high-risk health needs. Conclusions There are limited weight loss services available to undergraduate students compared with other university services. Collaboration between existing college health service providers is suggested for the delivery of appropriate programming for overweight and obese undergraduates wanting to lose weight. PMID:27278261

Intercooler cooling-air weight flow and pressure drop for minimum drag loss

NASA Technical Reports Server (NTRS)

Reuter, J George; Valerino, Michael F

1944-01-01

An analysis has been made of the drag losses in airplane flight of cross-flow plate and tubular intercoolers to determine the cooling-air weight flow and pressure drop that give a minimum drag loss for any given cooling effectiveness and, thus, a maximum power-plant net gain due to charge-air cooling. The drag losses considered in this analysis are those due to (1) the extra drag imposed on the airplane by the weight of the intercooler, its duct, and its supports and (2) the drag sustained by the cooling air in flowing through the intercooler and its duct. The investigation covers a range of conditions of altitude, airspeed, lift-drag ratio, supercharger-pressure ratio, and supercharger adiabatic efficiency. The optimum values of cooling air pressure drop and weight flow ratio are tabulated. Curves are presented to illustrate the results of the analysis.

Weight Loss and Complementary Health Practices: What the Science Says

MedlinePlus

... lifestyles, including weight-loss and weight management programs. Mindfulness Meditation To date there are only a few studies on the effects of mindfulness as a component of weight-loss programs, but ...

Multi-objective optimization and design for free piston Stirling engines based on the dimensionless power

NASA Astrophysics Data System (ADS)

Mou, Jian; Hong, Guotong

2017-02-01

In this paper, the dimensionless power is used to optimize the free piston Stirling engines (FPSE). The dimensionless power is defined as a ratio of the heat power loss and the output work. The heat power losses include the losses of expansion space, heater, regenerator, cooler and the compression space and every kind of the heat loss calculated by empirical formula. The output work is calculated by the adiabatic model. The results show that 82.66% of the losses come from the expansion space and 54.59% heat losses of expansion space come from the shuttle loss. At different pressure the optimum bore-stroke ratio, heat source temperature, phase angle and the frequency have different values, the optimum phase angles increase with the increase of pressure, but optimum frequencies drop with the increase of pressure. However, no matter what the heat source temperature, initial pressure and frequency are, the optimum ratios of piston stroke and displacer stroke all about 0.8. The three-dimensional diagram is used to analyse Stirling engine. From the three-dimensional diagram the optimum phase angle, frequency and heat source temperature can be acquired at the same time. This study offers some guides for the design and optimization of FPSEs.

Performance of a 1.57 pressure-ratio transonic fan stage with a screen-induced 90 deg circumferential inlet flow distortion

NASA Technical Reports Server (NTRS)

Sanger, N. L.

1976-01-01

A transonic fan stage having a design pressure ratio of 1.57 was tested with a 90 degree circumferential distortion imposed on the inlet flow. The rotor diameter was approximately 50.8 cm, and the design pressure ratio was 1.60 at a tip speed of 425 m/sec. Overall performance at 70 and 100 percent of design speed showed a loss of stall pressure ratio and flow range at design speed and no significant loss in stall pressure ratio at 70 percent of design speed. Detailed flow measurements are presented to show the rotor-upstream flow interactions and the attenuation and amplification properties through the stage.

A Quasi-Experiment to Assess the Impact of a Scalable, Community-Based Weight Loss Program: Combining Reach, Effectiveness, and Cost.

PubMed

Estabrooks, Paul A; Wilson, Kathryn E; McGuire, Todd J; Harden, Samantha M; Ramalingam, NithyaPriya; Schoepke, Lia; Almeida, Fabio A; Bayer, Amy L

2017-04-01

Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants. To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics. Longitudinal pre-post quasi-experiment without control. Enrolled participants in Weigh and Win (WAW), a community-based weight loss program. A 12-month program with daily social cognitive theory-based email and/or text support, online access to health coaches, objective weight assessment through 83 community-based kiosks, and modest financial incentives to increase program reach. Number of participants, representativeness, weight loss achievement (3%, 5% of initial weight lost), and cost of implementation. A total of 40,308 adults (79% women; 73% white; BMI = 32.3 ± 7.44, age = 43.9 ± 13.1 years) enrolled in WAW. Women were more likely than men to enroll in the program and continue engagement beyond an initial weigh-in (57% vs. 53%). Based on census data, African Americans were over-represented in the sample. Among participants who engaged in the program beyond an initial weigh-in (n = 19,029), 47% and 34% of participants lost 3% and 5% of their initial body weight, respectively. The average duration for those who achieved 5% weight loss was 1.7 ± 1.3 years. African American participants were more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants (2.0 ± 1.3 vs. 1.6 ± 1.2 years). Implementation costs were $2,822,698. Cost per clinically meaningful weight loss for African Americans ($257.97/3% loss; $335.96/5% loss) was lower than that for Hispanics ($318.62; $431.10) and Caucasians ($313.65; $441.87), due to the higher success rate of that subgroup of participants. Weigh and Win is a scalable technology-supported and community-based weight loss program that reaches a large number of participants and may contribute to reducing health disparities.

Resonant tube for measurement of sound absorption in gases at low frequency/pressure ratios

NASA Technical Reports Server (NTRS)

Zuckerwar, A. J.; Griffin, W. A.

1980-01-01

The paper describes a resonant tube for measuring sound absorption in gases, with specific emphasis on the vibrational relaxation peak of N2, over a range of frequency/pressure ratios from 0.1 to 2500 Hz/atm. The experimental background losses measured in argon agree with the theoretical wall losses except at few isolated frequencies. Rigid cavity terminations, external excitation, and a differential technique of background evaluation were used to minimize spurious contributions to the background losses. Room temperature measurements of sound absorption in binary mixtures of N2-CO2 in which both components are excitable resulted in the maximum frequency/pressure ratio in Hz/atm of 0.063 + 123m for the N2 vibrational relaxation peak, where m is mole percent of added CO2; the maximum ratio for the CO2 peak was 34,500 268m where m is mole percent of added N2.

Marginal structural modeling of associations of occupational injuries with voluntary and involuntary job loss among nursing home workers

PubMed Central

Bacic, Janine; Velasquez, Esther; Hammer, Leslie B

2016-01-01

Objectives Qualitative studies have highlighted the possibility of job loss following occupational injuries for some workers, but prospective investigations are scant. We used a sample of nursing home workers from the Work, Family, and Health Network to prospectively investigate association between occupational injuries and job loss. Methods We merged data on 1331 workers assessed four times over an 18-month period with administrative data that include job loss from employers and publicly-available data on their workplaces. Workers self-reported occupational injuries in surveys. Multivariable logistic regression models estimated risk ratios for the impact of occupational injuries on overall job loss, whereas multinomial models were used to estimate odds ratio of voluntary and involuntary job loss. Use of marginal structural models allowed for adjustments of multilevel list of confounders that may be time-varying and/or on the causal pathway. Results By 12 months, 30.3% of workers experienced occupational injury, whereas 24.2% experienced job loss by 18 months. Comparing workers who reported occupational injuries to those reporting no injuries, risk ratio of overall job loss within subsequent 6 months was 1.31 (95% CI=0.93–1.86). Comparing the same groups, injured workers had higher odds of experiencing involuntary job loss (OR:2.19; 95% CI:1.27–3.77). Also, compared to uninjured workers, those injured more than once had higher odds of voluntary job loss (OR:1.95; 95% CI:1.03–3.67), while those injured once had higher odds of involuntary job loss (OR:2.19; 95% CI:1.18–4.05). Conclusions Despite regulatory protections, occupational injuries were associated with increased risk of voluntary and involuntary job loss for nursing home workers. PMID:26786757

Intentional Weight Loss and Endometrial Cancer Risk.

PubMed

Luo, Juhua; Chlebowski, Rowan T; Hendryx, Michael; Rohan, Thomas; Wactawski-Wende, Jean; Thomson, Cynthia A; Felix, Ashley S; Chen, Chu; Barrington, Wendy; Coday, Mace; Stefanick, Marcia; LeBlanc, Erin; Margolis, Karen L

2017-04-10

Purpose Although obesity is an established endometrial cancer risk factor, information about the influence of weight loss on endometrial cancer risk in postmenopausal women is limited. Therefore, we evaluated associations among weight change by intentionality with endometrial cancer in the Women's Health Initiative (WHI) observational study. Patients and Methods Postmenopausal women (N = 36,794) ages 50 to 79 years at WHI enrollment had their body weights measured and body mass indices calculated at baseline and at year 3. Weight change during that period was categorized as follows: stable (change within ± 5%), loss (change ≥ 5%), and gain (change ≥ 5%). Weight loss intentionality was assessed via self-report at year 3; change was characterized as intentional or unintentional. During the subsequent 11.4 years (mean) of follow-up, 566 incident endometrial cancer occurrences were confirmed by medical record review. Multivariable Cox proportional hazards regression models were used to evaluate relationships (hazard ratios [HRs] and 95% CIs) between weight change and endometrial cancer incidence. Results In multivariable analyses, compared with women who had stable weight (± 5%), women with weight loss had a significantly lower endometrial cancer risk (HR, 0.71; 95% CI, 0.54 to 0.95). The association was strongest among obese women with intentional weight loss (HR, 0.44; 95% CI, 0.25 to 0.78). Weight gain (≥ 10 pounds) was associated with a higher endometrial cancer risk than was stable weight, especially among women who had never used hormones. Conclusion Intentional weight loss in postmenopausal women is associated with a lower endometrial cancer risk, especially among women with obesity. These findings should motivate programs for weight loss in obese postmenopausal women.

Meal replacement with a low-calorie diet formula in weight loss maintenance after weight loss induction with diet alone.

PubMed

Vázquez, C; Montagna, C; Alcaraz, F; Balsa, J A; Zamarrón, I; Arrieta, F; Botella-Carretero, J I

2009-10-01

Weight loss in obesity can reduce morbidity and mortality and benefits persist as long as weight loss is maintained. Weight maintenance is difficult in the long term and new strategies need to be developed to achieve this goal. We aimed to evaluate the efficacy of substituting a low-calorie diet formula for a meal in a weight loss program during the maintenance phase. Randomized paralleled clinical trial including 62 adult patients with at least a 5% weight loss with diet alone for 6 months, randomized to two groups: daily replacement of one meal with a low-calorie diet formula, or dieting alone for another 6 months (weight maintenance phase). Weight maintenance or further weight loss occurred in 83.9% of patients in the intervention group, whereas only in 58.1% in the control group (P=0.025). As a whole, patients in the intervention group lost a further 3.2+/-3.7% of initial weight compared with a 1.3+/-3.6% in the control group (P=0.030). Body fat mass diminished in both groups, with no differences between them (1.6+/-3.5 vs 1.0+/-9.3 kg, respectively, P=0.239), and the same happened with free fat mass (0.9+/-3.3 vs 0.4+/-6.7 kg, respectively, P=0.471). A multivariate logistic regression analysis (R (2)=0.114, P=0.023) retained only the intervention as a predictor of the achievement of weight maintenance with an odds ratio (95% confidence interval) of 3.756 (1.138-12.391). Substitution of a low-calorie diet formula for a meal is an effective measure for weight loss maintenance compared with dieting alone.

Intentional Weight Loss and Endometrial Cancer Risk

PubMed Central

Chlebowski, Rowan T.; Hendryx, Michael; Rohan, Thomas; Wactawski-Wende, Jean; Thomson, Cynthia A.; Felix, Ashley S.; Chen, Chu; Barrington, Wendy; Coday, Mace; Stefanick, Marcia; LeBlanc, Erin; Margolis, Karen L.

2017-01-01

Purpose Although obesity is an established endometrial cancer risk factor, information about the influence of weight loss on endometrial cancer risk in postmenopausal women is limited. Therefore, we evaluated associations among weight change by intentionality with endometrial cancer in the Women’s Health Initiative (WHI) observational study. Patients and Methods Postmenopausal women (N = 36,794) ages 50 to 79 years at WHI enrollment had their body weights measured and body mass indices calculated at baseline and at year 3. Weight change during that period was categorized as follows: stable (change within ± 5%), loss (change ≥ 5%), and gain (change ≥ 5%). Weight loss intentionality was assessed via self-report at year 3; change was characterized as intentional or unintentional. During the subsequent 11.4 years (mean) of follow-up, 566 incident endometrial cancer occurrences were confirmed by medical record review. Multivariable Cox proportional hazards regression models were used to evaluate relationships (hazard ratios [HRs] and 95% CIs) between weight change and endometrial cancer incidence. Results In multivariable analyses, compared with women who had stable weight (± 5%), women with weight loss had a significantly lower endometrial cancer risk (HR, 0.71; 95% CI, 0.54 to 0.95). The association was strongest among obese women with intentional weight loss (HR, 0.44; 95% CI, 0.25 to 0.78). Weight gain (≥ 10 pounds) was associated with a higher endometrial cancer risk than was stable weight, especially among women who had never used hormones. Conclusion Intentional weight loss in postmenopausal women is associated with a lower endometrial cancer risk, especially among women with obesity. These findings should motivate programs for weight loss in obese postmenopausal women. PMID:28165909

Musculoskeletal injuries in professional modern dancers: a prospective cohort study of 15 years.

PubMed

Bronner, Shaw; McBride, Caroline; Gill, Allison

2018-08-01

We analysed work-related musculoskeletal injuries (WMSI) in two modern dance companies to determine whether injury rates decreased and patterns altered compared to previous 3-yr and 6-yr audits (0.48 and 0.25/1000-hrs exposure respectively). In this prospectively designed 15-yr cohort study, data were collected in 30-dancer Company-1 and 12-dancer Company-2. In-house physical therapists tracked WMSI and time-loss-injuries for 159 dancers (42 dancers/yr). 15-yrs were grouped into five 3-yr blocks for comparison with prior audits. Negative binomial logistic regression analyses were conducted with exposure-hrs converted to the natural log and used as the offset variable. Block and company were categorical predictors for dependent variables: WMSI, time-loss-injuries, trauma-injuries and overuse-injuries (p < 0.05). 69% of dancers reported WMSI; 45% sustained at least one time-loss-injury. Company-1, with greater annual exposure, was 1.6-times more likely to sustain time-loss-injuries (p = 0.016, CI = 1.095-2.422) and 5.6-times more likely to sustain time-loss overuse-injuries (p = 0.003, CI = 1.812-17.327). Compared to Block-1, WMSI and time-loss-injuries decreased in Blocks-2, 3, and 5 (p ≤ 0.027). The ratio of time-loss overuse to trauma-injuries was reversed, with trauma-injuries accounting for over 80% of injuries by Block 5. Time-loss-injuries averaged 0.16 injuries/1000-hrs, lower than rates in ballet and sports. Decreased injury rates and changed injury patterns demonstrate efficacious injury management and prevention programming.

Low-loss hollow-core silica fibers with adjacent nested anti-resonant tubes.

PubMed

Habib, Md Selim; Bang, Ole; Bache, Morten

2015-06-29

We report on numerical design optimization of hollow-core anti-resonant fibers with the aim of reducing transmission losses. We show that re-arranging the nested anti-resonant tubes in the cladding to be adjacent has the effect of significantly reducing leakage as well as bending losses, and for reaching high loss extinction ratios between the fundamental mode and higher order modes. We investigate two versions of the proposed design, one optimized for the mid-IR and another scaled down version for the near-IR and compare them in detail with previously proposed anti-resonant fiber designs including nested elements. Our proposed design is superior with respect to obtaining the lowest leakage losses and the bend losses are also much lower than for the previous designs. Leakage losses as low as 0.0015 dB/km and bending losses of 0.006 dB/km at 5 cm bending radius are predicted at the ytterbium lasing wavelength 1.06 µm. When optimizing the higher-order-mode extinction ratio, the low leakage loss is sacrificed to get an effective single-mode behavior of the fiber. We show that the higher-order-mode extinction ratio is more than 1500 in the range 1.0-1.1 µm around the ytterbium lasing wavelength, while in the mid-IR it can be over 100 around λ = 2.94 μm. This is higher than the previously considered structures in the literature using nested tubes.

A Program Evaluation of a Worksite Wellness Initiative for Weight Loss

ERIC Educational Resources Information Center

Martinez, Nicholas

2017-01-01

The purpose of this study was to conduct a program evaluation of ACME's worksite weight loss initiative and collect evidence relative to the efficacy of the program. An anonymous online survey was administered to participants of the weight loss initiative. The survey was designed to gather information relative to the research questions, which…

Weight change in a commercial web-based weight loss program and its association with website use: cohort study.

PubMed

Neve, Melinda; Morgan, Philip J; Collins, Clare E

2011-10-12

There is a paucity of information in the scientific literature on the effectiveness of commercial weight loss programs, including Web-based programs. The potential of Web-based weight loss programs has been acknowledged, but their ability to achieve significant weight loss has not been proven. The objectives were to evaluate the weight change achieved within a large cohort of individuals enrolled in a commercial Web-based weight loss program for 12 or 52 weeks and to describe participants' program use in relation to weight change. Participants enrolled in an Australian commercial Web-based weight loss program from August 15, 2007, through May 31, 2008. Self-reported weekly weight records were used to determine weight change after 12- and 52-week subscriptions. The primary analysis estimated weight change using generalized linear mixed models (GLMMs) for all participants who subscribed for 12 weeks and also for those who subscribed for 52 weeks. A sensitivity analysis was conducted using the last observation carried forward (LOCF) method. Website use (ie, the number of days participants logged on, made food or exercise entries to the Web-based diary, or posted to the discussion forum) was described from program enrollment to 12 and 52 weeks, and differences in website use by percentage weight change category were tested using Kruskal-Wallis test for equality of populations. Participants (n = 9599) had a mean (standard deviation [SD]) age of 35.7 (9.5) years and were predominantly female (86% or 8279/9599) and obese (61% or 5866/9599). Results from the primary GLMM analysis including all enrollees found the mean percentage weight change was -6.2% among 12-week subscribers (n = 6943) and -6.9% among 52-week subscribers (n = 2656). Sensitivity analysis using LOCF revealed an average weight change of -3.0% and -3.5% after 12 and 52 weeks respectively. The use of all website features increased significantly (P < .01) as percentage weight change improved. The weight loss achieved by 12- and 52-week subscribers of a commercial Web-based weight loss program is likely to be in the range of the primary and sensitivity analysis results. While this suggests that, on average, clinically important weight loss may be achieved, further research is required to evaluate the efficacy of this commercial Web-based weight loss program prospectively using objective measures. The potential association between greater website use and increased weight loss also requires further evaluation, as strategies to improve participants' use of Web-based program features may be required.

Dynamic Secondary Ion Mass Spectrometry | Materials Science | NREL

Science.gov Websites

different temperatures. Hydrogen loss is greater for higher temperatures; however, the rate of loss for a ions according to their mass-to-charge ratio. Ions of different mass-to-charge ratios are selected by Identifies all elements or isotopes present in a material, from hydrogen to uranium. Different primary-ion

77 FR 28788 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the Patient Protection and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 158 [CMS-9998-IFC3] Health Insurance Issuers..., entitled ``Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...) requirements for health insurance issuers under section 2718 of the Public Health Service Act, as added by the...

Weight Loss Associated With Employee Income in an Incentivized Employee Wellness Program.

PubMed

Fink, Jennifer T; Rich, Jennifer; Smith, David R; Singh, Maharaj; Sutton, Kelly; Mueller, George; Ihrke, Doug M; Skalla, Jessica L; Cisler, Ron A

2016-12-01

We examined the relationship between the type of incentivized wellness program and employee weight loss and the effects of participant income. We retrospectively examined employees who participated in one of six weight loss wellness programs, which were categorized for the present analysis: reweigh/body mass index, Coaching, and Weight Watchers/Meal Replacement. Those who participated were eligible for a $350/year insurance premium discount. Employees in the low-income category of $45K or less participated at a higher rate, however, did not lose as much weight as those participants in the higher income categories of $70K or more. We found a positive association with weight loss in two of the categories, reweigh/body mass index, and Weight Watchers/Meal Replacement programs. Wellness programs have a significant impact on employee weight loss, but this relationship may vary across the income level of participants.

A Computer Program for the Prediction of Solid Propellant Rocket Motor Performance. Volume 3

DTIC Science & Technology

1975-07-01

following losses: two-dimensional/two-phase (coupled), nozzle erosion, kinetics, boundary layer, combustion efficiency, submergence . The program...loss •Two dimensional or divergence less •Finite Rate Kinetics loss •Boundary Layer Loss •Combustion Efficiency - • Submergence Loss •Erosion...counted twice. The iforcmcr.tioned assumptions are describ- ed In Section US, The submergence efficiency, ijgno* ^* rased on an empirical

PREDICTING TURBINE STAGE PERFORMANCE

NASA Technical Reports Server (NTRS)

Boyle, R. J.

1994-01-01

This program was developed to predict turbine stage performance taking into account the effects of complex passage geometries. The method uses a quasi-3D inviscid-flow analysis iteratively coupled to calculated losses so that changes in losses result in changes in the flow distribution. In this manner the effects of both the geometry on the flow distribution and the flow distribution on losses are accounted for. The flow may be subsonic or shock-free transonic. The blade row may be fixed or rotating, and the blades may be twisted and leaned. This program has been applied to axial and radial turbines, and is helpful in the analysis of mixed flow machines. This program is a combination of the flow analysis programs MERIDL and TSONIC coupled to the boundary layer program BLAYER. The subsonic flow solution is obtained by a finite difference, stream function analysis. Transonic blade-to-blade solutions are obtained using information from the finite difference, stream function solution with a reduced flow factor. Upstream and downstream flow variables may vary from hub to shroud and provision is made to correct for loss of stagnation pressure. Boundary layer analyses are made to determine profile and end-wall friction losses. Empirical loss models are used to account for incidence, secondary flow, disc windage, and clearance losses. The total losses are then used to calculate stator, rotor, and stage efficiency. This program is written in FORTRAN IV for batch execution and has been implemented on an IBM 370/3033 under TSS with a central memory requirement of approximately 4.5 Megs of 8 bit bytes. This program was developed in 1985.

The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat: a randomized trial.

PubMed

Aude, Y Wady; Agatston, Arthur S; Lopez-Jimenez, Francisco; Lieberman, Eric H; Marie Almon; Hansen, Melinda; Rojas, Gerardo; Lamas, Gervasio A; Hennekens, Charles H

2004-10-25

In the United States, obesity is a major clinical and public health problem causing diabetes, dyslipidemia, and hypertension, as well as increasing cardiovascular and total mortality. Dietary restrictions of calories and saturated fat are beneficial. However, it remains unclear whether replacement of saturated fat with carbohydrates (as in the US National Cholesterol Education Program [NCEP] diet) or protein and monounsaturated fat (as in our isocaloric modified low-carbohydrate [MLC] diet, which is lower in total carbohydrates but higher in protein, monounsaturated fat, and complex carbohydrates) is optimal. We randomized 60 participants (29 women and 31 men) to the NCEP or the MLC diet and evaluated them every 2 weeks for 12 weeks. They were aged 28 to 71 years (mean age, 44 years in the NCEP and 46 years in the MLC group). A total of 36% of participants from the NCEP group and 35% from the MLC group had a body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than 27. The primary end point was weight loss, and secondary end points were blood lipid levels and waist-to-hip ratio. Weight loss was significantly greater in the MLC (13.6 lb) than in the NCEP group (7.5 lb), a difference of 6.1 lb (P = .02). There were no significant differences between the groups for total, low density, and high-density lipoprotein cholesterol, triglycerides, or the proportion of small, dense low-density lipoprotein particles. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was not significantly reduced between the groups (P = .27), but it significantly decreased within the MLC group (P = .009). Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. There were no significant differences between the groups in blood lipid levels, but favorable changes were observed within the MLC diet group.

Adding Evidence-Based Behavioral Weight Loss Strategies to a Statewide Wellness Campaign: A Randomized Clinical Trial

PubMed Central

Thomas, Graham; Fava, Joseph L.; Subak, Leslee L.; Schembri, Michael; Krupel, Katie; Kumar, Rajiv; Weinberg, Brad; Wing, Rena R.

2014-01-01

Objectives. We determined the efficacy and cost-effectiveness of adding an evidence-based Internet behavioral weight loss intervention alone or combined with optional group sessions to ShapeUp Rhode Island 2011 (SURI), a 3-month statewide wellness campaign. Methods. We randomized participants (n = 230; body mass index = 34.3 ±6.8 kg/m2; 84% female) to the standard SURI program (S) or to 1 of 2 enhanced programs: SURI plus Internet behavioral program (SI) or SI plus optional group sessions (SIG). The primary outcome was weight loss at the end of the 3-month program. Results. Weight losses differed among all 3 conditions (S: 1.1% ±0.9%; SI: 4.2% ±0.6%; SIG: 6.1% ±0.6%; Ps ≤ .04). Both SI and SIG increased the percentage of individuals who achieved a 5% weight loss (SI: 42%; SIG: 54%; S: 7%; Ps < .001). Cost per kilogram of weight loss was similar for S ($39) and SI ($35); both were lower than SIG ($114). Conclusions. Although weight losses were greatest at the end of SURI with optional group sessions, the addition of an Internet behavioral program was the most cost-effective method to enhance weight losses. PMID:24832424

Improving Weight Loss Outcomes of Community Interventions by Incorporating Behavioral Strategies

PubMed Central

Crane, Melissa M.; Thomas, J. Graham; Kumar, Rajiv; Weinberg, Brad

2010-01-01

Objectives. We examined whether adding behavioral weight loss strategies could improve the outcomes of a community weight loss campaign. Methods. Shape Up RI is a 12-week, online, team-based program for health improvement in Rhode Island. In study 1, we randomly assigned participants to the standard Shape Up RI program or to the program plus video lessons on weight loss. In study 2, we randomly assigned participants to the standard program or to the program plus video lessons; daily self-monitoring of weight, eating, and exercise; and computer-generated feedback. Results. Adding video lessons alone (study 1) did not result in significantly improved weight loss (2.0 ±2.8 kg vs 1.4 ±2.9 kg; P = .15). However, when the video lessons were supplemented with self-monitoring and feedback (study 2), the average weight loss more than doubled (3.5 ±3.8 kg vs 1.4 ±2.7 kg; P < .01), and the proportion of individuals achieving a weight loss of 5% or more tripled (40.5% vs 13.2%; P < .01). Participants in study 2 submitted self-monitoring records on 78% of days, and adherence was significantly related to outcome. Conclusions. Adding behavioral strategies to community campaigns may improve weight loss outcomes with minimal additional cost. PMID:20966375

Data compression using Chebyshev transform

NASA Technical Reports Server (NTRS)

Cheng, Andrew F. (Inventor); Hawkins, III, S. Edward (Inventor); Nguyen, Lillian (Inventor); Monaco, Christopher A. (Inventor); Seagrave, Gordon G. (Inventor)

2007-01-01

The present invention is a method, system, and computer program product for implementation of a capable, general purpose compression algorithm that can be engaged on the fly. This invention has particular practical application with time-series data, and more particularly, time-series data obtained form a spacecraft, or similar situations where cost, size and/or power limitations are prevalent, although it is not limited to such applications. It is also particularly applicable to the compression of serial data streams and works in one, two, or three dimensions. The original input data is approximated by Chebyshev polynomials, achieving very high compression ratios on serial data streams with minimal loss of scientific information.

The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial.

PubMed

Peters, John C; Beck, Jimikaye; Cardel, Michelle; Wyatt, Holly R; Foster, Gary D; Pan, Zhaoxing; Wojtanowski, Alexis C; Vander Veur, Stephanie S; Herring, Sharon J; Brill, Carrie; Hill, James O

2016-02-01

To evaluate the effects of water versus beverages sweetened with non-nutritive sweeteners (NNS) on body weight in subjects enrolled in a year-long behavioral weight loss treatment program. The study used a randomized equivalence design with NNS or water beverages as the main factor in a trial among 303 weight-stable people with overweight and obesity. All participants participated in a weight loss program plus assignment to consume 24 ounces (710 ml) of water or NNS beverages daily for 1 year. NNS and water treatments were non-equivalent, with NNS treatment showing greater weight loss at the end of 1 year. At 1 year subjects receiving water had maintained a 2.45 ± 5.59 kg weight loss while those receiving NNS beverages maintained a loss of 6.21 ± 7.65 kg (P < 0.001 for difference). Water and NNS beverages were not equivalent for weight loss and maintenance during a 1-year behavioral treatment program. NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program. These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program. © 2015 The Authors, Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Can weight management programs in worksites reduce the obesity epidemic?

USDA-ARS?s Scientific Manuscript database

Worksites can potentially be important locations for weight management programs that contribute to curbing the national obesity epidemic. In published studies, weight loss programs targeting overweight and obese employees have been relatively more effective for weight loss than programs for preventi...

Outcomes and Utilization of a Low Intensity Workplace Weight Loss Program

PubMed Central

Carpenter, Kelly M.; Lovejoy, Jennifer C.; Lange, Jane M.; Hapgood, Jenny E.; Zbikowski, Susan M.

2014-01-01

Obesity is related to high health care costs and lost productivity in the workplace. Employers are increasingly sponsoring weight loss and wellness programs to ameliorate these costs. We evaluated weight loss outcomes, treatment utilization, and health behavior change in a low intensity phone- and web-based, employer-sponsored weight loss program. The intervention included three proactive counseling phone calls with a registered dietician and a behavioral health coach as well as a comprehensive website. At six months, one third of those who responded to the follow-up survey had lost a clinically significant amount of weight (≥5% of body weight). Clinically significant weight loss was predicted by the use of both the counseling calls and the website. When examining specific features of the web site, the weight tracking tool was the most predictive of weight loss. Health behavior changes such as eating more fruits and vegetables, increasing physical activity, and reducing stress were all predictive of clinically significant weight loss. Although limited by the low follow-up rate, this evaluation suggests that even low intensity weight loss programs can lead to clinical weight loss for a significant number of participants. PMID:24688791

A Microdata Model of Delayed Entry Program (DEP) Behavior. Technical Report 666.

ERIC Educational Resources Information Center

Phillips, Chester E.; Schmitz, Edward J.

High personnel loss rates among recruits who have signed up for the Army's Delayed Entry Program (DEP) are becoming an increasing problem for DEP program managers. Therefore, a research project was conducted to examine DEP loss as a function of sociodemography and policy variables at the microdata level. Two DEP loss models were created. The first…

A Family and Community Focused Lifestyle Program Prevents Weight Regain in Pacific Islanders: A Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Kaholokula, Joseph Keawe'aimoku; Mau, Marjorie K.; Efird, Jimmy T.; Leake, Anne; West, Margaret; Palakiko, Donna-Marie; Yoshimura, Sheryl R.; Kekauoha, B. Puni; Rose, Charles; Gomes, Henry

2012-01-01

Preventing weight regain after the loss of excess weight is challenging for people, especially for ethnic minorities in the United States. A 6-month weight loss maintenance intervention designed for Pacific Islanders, called the PILI Lifestyle Program (PLP), was compared with a 6-month standard behavioral weight loss maintenance program (SBP) in a…

The Tracking Study: Description of a randomized controlled trial of variations on weight tracking frequency in a behavioral weight loss program

PubMed Central

Linde, Jennifer A.; Jeffery, Robert W.; Crow, Scott J.; Brelje, Kerrin L.; Pacanowski, Carly R.; Gavin, Kara L.; Smolenski, Derek J.

2014-01-01

Observational evidence from behavioral weight control trials and community studies suggests that greater frequency of weighing oneself, or tracking weight, is associated with better weight outcomes. Conversely, it has also been suggested that frequent weight tracking may have a negative impact on mental health and outcomes during weight loss, but there are minimal experimental data that address this concern in the context of an active weight loss program. To achieve the long-term goal of strengthening behavioral weight loss programs, the purpose of this randomized controlled trial (the Tracking Study) is to test variations on frequency of self-weighing during a behavioral weight loss program, and to examine psychosocial and mental health correlates of weight tracking and weight loss outcomes. Three hundred thirty-nine overweight and obese adults were recruited and randomized to one of three variations on weight tracking frequency during a 12-month weight loss program with a 12-month follow-up: daily weight tracking, weekly weight tracking, or no weight tracking. The primary outcome is weight in kilograms at 24 months. The weight loss program integrates each weight tracking instruction with standard behavioral weight loss techniques (goal setting, self-monitoring, stimulus control, dietary and physical activity enhancements, lifestyle modifications); participants in weight tracking conditions were provided with wireless Internet technology (Wi-Fi-enabled digital scales and touchscreen personal devices) to facilitate weight tracking during the study. This paper describes the study design, intervention features, recruitment, and baseline characteristics of participants enrolled in the Tracking Study. PMID:25533727

A cost-effective weight loss program at the worksite.

PubMed

Seidman, L S; Sevelius, G G; Ewald, P

1984-10-01

A major focus of Lockheed Missiles and Space Company's wellness program (Sunnyvale, Calif.) was to motivate weight loss in a cost-effective manner. The educationally based "Take It Off '83" campaign was created using the concepts of competition and self-responsibility. Seventy percent of the initial 2,499 participants completed the program, and 90% of these lost weight. Program completion rates and weight lost were higher for men than for women and higher for those who participated as team members rather than as individuals. Encouraging the formation of supportive/competitive teams proved to be a very effective means of promoting weight loss. The cost-effective motivation of weight loss in an industrial setting was accomplished successfully through this program (the cost to the company per initial participant was +5.40). Because of these results, the program will be repeated annually.

Large energy absorption in Ni-Mn-Ga/polymer composites

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

Feuchtwanger, Jorge; Richard, Marc L.; Tang, Yun J.

2005-05-15

Ferromagnetic shape memory alloys can respond to a magnetic field or applied stress by the motion of twin boundaries and hence they show large hysteresis or energy loss. Ni-Mn-Ga particles made by spark erosion have been dispersed and oriented in a polymer matrix to form pseudo 3:1 composites which are studied under applied stress. Loss ratios have been determined from the stress-strain data. The loss ratios of the composites range from 63% to 67% compared to only about 17% for the pure, unfilled polymer samples.

Results of a faith-based weight loss intervention for black women.

PubMed

Fitzgibbon, Marian L; Stolley, Melinda R; Ganschow, Pamela; Schiffer, Linda; Wells, Anita; Simon, Nolanna; Dyer, Alan

2005-10-01

Obesity is a risk factor for a variety of chronic diseases. Although weight loss may reduce these risks, weight loss programs designed for black women have yielded mixed results. Studies suggest that religion/spirituality is a prominent component of black culture. Given this, the inclusion of religion/spirituality as an active component of a weight loss program may enhance the benefits of the program. The role of religion/spirituality, however, has not been specifically tested as a mechanism that enhances the weight loss process. This paper presents the results of "Faith on the Move," a randomized pilot study of a faith-based weight loss program for black women. The goals of the study were to estimate the effects of a 12-week culturally tailored, faith-based weight loss intervention on weight loss, dietary fat consumption and physical activity. The culturally tailored, faith-based weight loss intervention was compared to a culturally tailored weight loss intervention with no active faith component. Fifty-nine overweight/obese black women were randomized to one of the two interventions. Although the results were not statistically significant, the effect size suggests that the addition of the faith component improved results. These promising preliminary results will need to be tested in an adequately powered trial.

7 CFR 1493.120 - Payment for loss.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.120 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and...

7 CFR 1493.120 - Payment for loss.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.120 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and...

7 CFR 1493.120 - Payment for loss.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.120 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and...

Analysis of No-load Iron Losses of Turbine Generators by 3D Magnetic Field Analysis

NASA Astrophysics Data System (ADS)

Nakahara, Akihito; Mogi, Hisashi; Takahashi, Kazuhiko; Ide, Kazumasa; Kaneda, Junya; Hattori, Ken'Ichi; Watanabe, Takashi; Kaido, Chikara; Minematsu, Eisuke; Hanzawa, Kazufumi

This paper focuses on no-load iron losses of turbine generators. To calculate iron losses of turbine generators a program was developed. In the program, core loss curves of materials used for stator core were reproduced precisely by using tables of loss coefficients. Accuracy of calculation by this method was confirmed by comparing calculated values with measured in a model stator core. The iron loss of a turbine generator estimated with considering three-dimensional distribution of magnetic fluxes. And additional losses included in measured iron loss was evaluated with three-dimensional magnetic field analysis.

Comparative study of volatile organic compounds in ambient air using observed mixing ratios and initial mixing ratios taking chemical loss into account - A case study in a typical urban area in Beijing.

PubMed

Gao, Jian; Zhang, Jie; Li, Hong; Li, Lei; Xu, Linghong; Zhang, Yujie; Wang, Zhanshan; Wang, Xuezhong; Zhang, Weiqi; Chen, Yizhen; Cheng, Xi; Zhang, Hao; Peng, Liang; Chai, Fahe; Wei, Yongjie

2018-07-01

Volatile organic compounds (VOCs) can react with atmospheric radicals while being transported after being emitted, resulting in substantial losses. Using only observed VOC mixing ratios to assess VOC pollution, is therefore problematic. The observed mixing ratios and initial mixing ratios taking chemical loss into consideration were performed using data for 90 VOCs in the atmosphere in a typical urban area in Beijing in winter 2013 to gain a more accurate view of VOC pollution. The VOC sources, ambient VOC mixing ratios and compositions, variability and influencing factors, contributions to near-ground-ozone and health risks posed were assessed. Source apportionment should be conducted using initial mixing ratios, but health risks should be assessed using observed mixing ratios. The daytime daily mean initial mixing ratio (72.62ppbv) was 7.72ppbv higher than the daytime daily mean observed mixing ratio (64.90ppbv). Alkenes contributed >70% of the consumed VOCs. The nighttime daily mean observed mixing ratio was 71.66ppbv, 6.76ppbv higher than the daytime mixing ratio. The observed mixing ratio for 66 VOCs was 40.31% higher in Beijing than New York. The OFPs of Ini-D (266.54ppbv) was underestimated 23.41% compared to the OFP of Obs-D (204.14ppbv), improving emission control of ethylene and propene would be an effective way of controlling O 3 . Health risk assessments performed for 28 hazardous VOCs show that benzene, chloroform, 1,2-dichloroethane, and acetaldehyde pose carcinogenic risk and acrolein poses non-carcinogenic risks. Source apportionment results indicated that vehicle exhausts, solvent usage and industrial processes were the main VOC source during the study. Copyright © 2018. Published by Elsevier B.V.

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

Kim, Hyeokjin; Chen, Hua; Maksimovic, Dragan

An experimental 30 kW boost composite converter is described in this paper. The composite converter architecture, which consists of a buck module, a boost module, and a dual active bridge module that operates as a DC transformer (DCX), leads to substantial reductions in losses at partial power points, and to significant improvements in weighted efficiency in applications that require wide variations in power and conversion ratio. A comprehensive loss model is developed, accounting for semiconductor conduction and switching losses, capacitor losses, as well as dc and ac losses in magnetic components. Based on the developed loss model, the module andmore » system designs are optimized to maximize efficiency at a 50% power point. Experimental results for the 30 kW prototype demonstrate 98.5%peak efficiency, very high efficiency over wide ranges of power and voltage conversion ratios, as well as excellent agreements between model predictions and measured efficiency curves.« less

Behavior Change Strategies for Successful Long-Term Weight Loss: Focusing on Dietary and Physical Activity Adherence, Not Weight Loss

ERIC Educational Resources Information Center

Hongu, Nobuko; Kataura, Martha P.; Block, Linda M.

2011-01-01

This article helps Extension professionals guide individuals in a successful long-term weight loss program. A program should focus on behavioral changes (improving eating habits and physical activity), not just weight loss. In order to do this, Extension professionals should implement behavior change strategies that motivate individuals to…

[State of the art in fluid and volume therapy : A user-friendly staged concept].

PubMed

Rehm, M; Hulde, N; Kammerer, T; Meidert, A S; Hofmann-Kiefer, K

2017-03-01

Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein). Fluid losses as urine or perspiratio insensibilis (0.5-1.0 ml/kg/h) should be replaced by balanced crystalloids in a ratio of 1:1. Volume therapy step 1: Blood loss up to a maximum value of 20% of the patient's blood volume should be replaced by balanced crystalloids in a ratio of 4(-5):1. Volume therapy step 2: Higher blood losses should be treated by using iso-oncotic, preferential balanced colloids in a ratio of 1:1. For this purpose hydroxyethyl starch can also be used perioperatively if there is no respective contraindication, such as sepsis, burn injuries, critically ill patients, renal impairment or renal replacement therapy, and severe coagulopathy. Volume therapy step 3: If there is an indication for red cell concentrates or coagulation factors, a differentiated application of blood and blood products should be performed.

How much is a pheromone worth?

PubMed Central

Bento, Jose Mauricio S.; Parra, Jose Roberto P.; de Miranda, Silvia H. G.; Adami, Andrea C. O.; Vilela, Evaldo F.; Leal, Walter S.

2016-01-01

Pheromone-baited traps have been widely used in integrated pest management programs, but their economic value for growers has never been reported.  We analyzed the economic benefits of long-term use of traps baited with the citrus fruit borer Gymnandrosoma aurantianum sex pheromone in Central-Southern Brazil. Our analysis show that from 2001 to 2013 citrus growers avoided accumulated pest losses of 132.7 million to 1.32 billion USD in gross revenues, considering potential crop losses in the range of 5 to 50%. The area analyzed, 56,600 to 79,100 hectares of citrus (20.4 to 29.4 million trees), corresponds to 9.7 to 13.5% of the total area planted with citrus in the state of São Paulo. The data show a benefit-to-cost ratio of US$ 2,655 to US$ 26,548 per dollar spent on research with estimated yield loss prevented in the range of 5-50%, respectively. This study demonstrates that, in addition to the priceless benefits for the environment, sex pheromones are invaluable tools for growers as their use for monitoring populations allows rational and reduced use of insecticides, a win-win situation. PMID:27583133

Effect of temperature rise and hydrostatic pressure on microbending loss and refractive index change in double-coated optical fiber

NASA Astrophysics Data System (ADS)

Seraji, Faramarz E.; Toutian, Golnoosh

This paper presents an analysis of the effect of temperature rise and hydrostatic pressure on microbending loss, refractive index change, and stress components of a double-coated optical fiber by considering coating material parameters such as Young's modulus and the Poisson ratio. It is shown that, when temperature rises, the microbending loss and refractive index changes would decrease with increase of thickness of primary coating layer and will increase after passing through a minima. Increase of thickness of secondary coating layer causes the microbending loss and refractive index changes to decrease. We have shown that the temperature rise affecting the fiber makes the microbending loss and refractive index decrease, linearly. At a particular temperature, the microbending loss takes negative values, due to tensile pressure applied on the fiber. The increase of Young's modulus and the Poisson ratio of primary coating would lower the microbending loss and refractive index change whereas in the secondary coating layer, the condition reverses.

The Stiles-Crawford Effect: spot-size ratio departure in retinitis pigmentosa

NASA Astrophysics Data System (ADS)

Sharma, Nachieketa K.; Lakshminarayanan, Vasudevan

2016-04-01

The Stiles-Crawford effect of the first kind is the retina's compensative response to loss of luminance efficiency for oblique stimulation manifested as the spot-size ratio departure from the perfect power coupling for a normal human eye. In a retinitis pigmentosa eye (RP), the normal cone photoreceptor morphology is affected due to foveal cone loss and disrupted cone mosaic spatial arrangement with reduction in directional sensitivity. We show that the flattened Stiles-Crawford function (SCF) in a RP eye is due to a different spot-size ratio departure profile, that is, for the same loss of luminance efficiency, a RP eye has a smaller departure from perfect power coupling compared to a normal eye. Again, the difference in spot-size ratio departure increases from the centre towards the periphery, having zero value for axial entry and maximum value for maximum peripheral entry indicating dispersal of photoreceptor alignment which prevents the retina to go for a bigger compensative response as it lacks both in number and appropriate cone morphology to tackle the loss of luminance efficiency for oblique stimulation. The slope of departure profile also testifies to the flattened SCF for a RP eye. Moreover, the discrepancy in spot-size ratio departure between a normal and a RP eye is shown to have a direct bearing on the Stiles-Crawford diminution of visibility.

Noise-Induced Hearing Loss – A Preventable Disease? Results of a 10-Year Longitudinal Study of Workers Exposed to Occupational Noise

PubMed Central

Frederiksen, Thomas W.; Ramlau-Hansen, Cecilia H.; Stokholm, Zara A.; Grynderup, Matias B.; Hansen, Åse M.; Kristiansen, Jesper; Vestergaard, Jesper M.; Bonde, Jens P.; Kolstad, Henrik A.

2017-01-01

Aims: To survey current, Danish industrial noise levels and the use of hearing protection devices (HPD) over a 10-year period and to characterise the association between occupational noise and hearing threshold shift in the same period. Furthermore, the risk of hearing loss among the baseline and the follow-up populations according to first year of occupational noise exposure is evaluated. Materials and Methods: In 2001–2003, we conducted a baseline survey of noise- and hearing-related disorders in 11 industries with suspected high noise levels. In 2009–2010, we were able to follow up on 271 out of the 554 baseline workers (49%). Mean noise levels per industry and self-reported HPD use are described at baseline and follow-up. The association between cumulative occupational noise exposure and hearing threshold shift over the 10-year period was assessed using linear regression, and the risk of hearing loss according to year of first occupational noise exposure was evaluated with logistic regression. Results: Over the 10-year period, mean noise levels declined from 83.9 dB(A) to 82.8 dB(A), and for workers exposed >85 dB(A), the use of HPD increased from 70.1 to 76.1%. We found a weak, statistically insignificant, inverse association between higher ambient cumulative noise exposure and poorer hearing (−0.10 dB hearing threshold shift per dB-year (95% confidence interval (CI): −0.36; 0.16)). The risk of hearing loss seemed to increase with earlier first year of noise exposure, but odds ratios were only statistically significant among baseline participants with first exposure before the 1980s (odds ratio: 1.90, 95% CI: 1.11; 3.22). Conclusions: We observed declining industrial noise levels, increased use of HPD and no significant impact on hearing thresholds from current ambient industrial noise levels, which indicated a successful implementation of Danish hearing conservation programs. PMID:29192620

Epidemiology of 3825 injuries sustained in six seasons of National Collegiate Athletic Association men's and women's soccer (2009/2010-2014/2015).

PubMed

Roos, Karen G; Wasserman, Erin B; Dalton, Sara L; Gray, Aaron; Djoko, Aristarque; Dompier, Thomas P; Kerr, Zachary Y

2017-07-01

To describe the epidemiology of National Collegiate Athletic Association (NCAA) men's and women's soccer injuries during the 2009/2010-2014/2015 academic years. This descriptive epidemiology study used NCAA Injury Surveillance Program (NCAA-ISP) data during the 2009/2010-2014/2015 academic years, from 44 men's and 64 women's soccer programmes (104 and 167 team seasons of data, respectively). Non-time-loss injuries were defined as resulting in <24 h lost from sport. Injury counts, percentages and rates were calculated. Injury rate ratios (RRs) and injury proportion ratios (IPRs) with 95% CIs compared rates and distributions by sex. There were 1554 men's soccer and 2271 women's soccer injuries with injury rates of 8.07/1000 athlete exposures (AE) and 8.44/1000AE, respectively. Injury rates for men and women did not differ in competitions (17.53 vs 17.04/1000AE; RR=1.03; 95% CI 0.94 to 1.13) or practices (5.47 vs 5.69/1000AE; RR=0.96; 95% CI 0.88 to 1.05). In total, 47.2% (n=733) of men's soccer injuries and 47.5% (n=1079) of women's were non-time loss. Most injuries occurred to the lower extremity and were diagnosed as sprains. Women had higher concussion rates (0.59 vs 0.34/1000AE; RR=1.76; 95% CI 1.32 to 2.35) than men. Non-time-loss injuries accounted for nearly half of the injuries in men's and women's soccer. Sex differences were found in competition injuries, specifically for concussion. Further study into the incidence, treatment and outcome of non-time-loss injuries may identify a more accurate burden of these injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Noise-Induced Hearing Loss - A Preventable Disease? Results of a 10-Year Longitudinal Study of Workers Exposed to Occupational Noise.

PubMed

Frederiksen, Thomas W; Ramlau-Hansen, Cecilia H; Stokholm, Zara A; Grynderup, Matias B; Hansen, Åse M; Kristiansen, Jesper; Vestergaard, Jesper M; Bonde, Jens P; Kolstad, Henrik A

2017-01-01

To survey current, Danish industrial noise levels and the use of hearing protection devices (HPD) over a 10-year period and to characterise the association between occupational noise and hearing threshold shift in the same period. Furthermore, the risk of hearing loss among the baseline and the follow-up populations according to first year of occupational noise exposure is evaluated. In 2001-2003, we conducted a baseline survey of noise- and hearing-related disorders in 11 industries with suspected high noise levels. In 2009-2010, we were able to follow up on 271 out of the 554 baseline workers (49%). Mean noise levels per industry and self-reported HPD use are described at baseline and follow-up. The association between cumulative occupational noise exposure and hearing threshold shift over the 10-year period was assessed using linear regression, and the risk of hearing loss according to year of first occupational noise exposure was evaluated with logistic regression. Over the 10-year period, mean noise levels declined from 83.9 dB(A) to 82.8 dB(A), and for workers exposed >85 dB(A), the use of HPD increased from 70.1 to 76.1%. We found a weak, statistically insignificant, inverse association between higher ambient cumulative noise exposure and poorer hearing (-0.10 dB hearing threshold shift per dB-year (95% confidence interval (CI): -0.36; 0.16)). The risk of hearing loss seemed to increase with earlier first year of noise exposure, but odds ratios were only statistically significant among baseline participants with first exposure before the 1980s (odds ratio: 1.90, 95% CI: 1.11; 3.22). We observed declining industrial noise levels, increased use of HPD and no significant impact on hearing thresholds from current ambient industrial noise levels, which indicated a successful implementation of Danish hearing conservation programs.

Using Multitemporal and Multispectral Airborne Lidar to Assess Depth of Peat Loss and Correspondence With a New Active Normalized Burn Ratio for Wildfires

NASA Astrophysics Data System (ADS)

Chasmer, L. E.; Hopkinson, C. D.; Petrone, R. M.; Sitar, M.

2017-12-01

Accuracy of depth of burn (an indicator of consumption) in peatland soils using prefire and postfire airborne light detection and ranging (lidar) data is determined within a wetland-upland forest environment near Fort McMurray, Alberta, Canada. The relationship between peat soil burn depth and an "active" normalized burn ratio (ANBR) is also examined beneath partially and fully burned forest and understory canopies using state-of-the-art active reflectance from a multispectral lidar compared with normalized burn ratio (NBR) derived from Landsat 7 ETM+. We find significant correspondence between depth of burn, lidar-derived ANBR, and difference NBR (dNBR) from Landsat. However, low-resolution optical imagery excludes peatland burn losses in transition zones, which are highly sensitive to peat loss via combustion. The findings presented here illustrate the utility of this new remote sensing technology for expanding an area of research where it has previously been challenging to spatially detect and quantify such wildfire burn losses.

Reactive power optimization strategy considering analytical impedance ratio

NASA Astrophysics Data System (ADS)

Wu, Zhongchao; Shen, Weibing; Liu, Jinming; Guo, Maoran; Zhang, Shoulin; Xu, Keqiang; Wang, Wanjun; Sui, Jinlong

2017-05-01

In this paper, considering the traditional reactive power optimization cannot realize the continuous voltage adjustment and voltage stability, a dynamic reactive power optimization strategy is proposed in order to achieve both the minimization of network loss and high voltage stability with wind power. Due to the fact that wind power generation is fluctuant and uncertain, electrical equipments such as transformers and shunt capacitors may be operated frequently in order to achieve minimization of network loss, which affect the lives of these devices. In order to solve this problem, this paper introduces the derivation process of analytical impedance ratio based on Thevenin equivalent. Thus, the multiple objective function is proposed to minimize the network loss and analytical impedance ratio. Finally, taking the improved IEEE 33-bus distribution system as example, the result shows that the movement of voltage control equipment has been reduced and network loss increment is controlled at the same time, which proves the applicable value of this strategy.

[The comparison of clinical features and laboratory indexes between flat descending hearing loss and total hearing loss].

PubMed

Wang, R L; Zhang, D M

2017-12-20

Objective: To discuss similarities and differences in clinical features and laboratory indexes between patients with flat descending type sudden hearing loss and those with total hearing loss. Method: The clinical data of 123 patients with full frequencies hearing loss were retrospectively analyzed. The differences in clinical features and laboratory tests(platelet, coagulation series, D-dimer, blood lipids, hemorheology) between patients with flat descending hearing loss and those with total hearing loss were analyzed by gender, age and ear side, treatment time, concomitant symptom (tinnitus, dizziness), original underlying diseases (hypertension, diabetes), etc. Result: In the clinical features,among 51 flat descending cases, the ratio of male and female was 2.401:1; among 72 total hearing loss cases, the ratio of men and women ratio was 1.058:1 ( P <0.05). Among two groups of patients,the majority received treatment within 7 days, among whom 66.7% were flat descending population, and 83.3% were total hearing loss population ( P <0.05). Flat descending population with dizziness only accounted for 35.3% while this figure was up to 70.8% when it came to total hearing loss patients ( P <0.01). Two groups showed no differences in age, ear side, tinnitus, the original underlying diseases (hypertension, diabetes). In the laboratory tests, the total hearing loss population overtopped the plat descending population in PLT and PCT ( P <0.05), while falling below the plat descending population in APTT ( P <0.01). Two groups showed no differences in other indicators of platelet and coagulation series and laboratory data of D-dimer, blood lipids, hemorheology. Conclusion: Compared with flat descending sudden hearing loss, sudden total hearing loss more frequently happened to females who also were accompanied by dizziness. The treatment rate within 7 days was high and the patients with hypercoagulable state accounted for a higher proportion. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

A case study of a workplace wellness program that offers financial incentives for weight loss.

PubMed

Cawley, John; Price, Joshua A

2013-09-01

Employers are increasingly adopting workplace wellness programs designed to improve employee health and decrease employer costs associated with health insurance and job absenteeism. This paper examines the outcomes of 2635 workers across 24 worksites who were offered financial incentives for weight loss that took various forms, including fixed payments and forfeitable bonds. We document extremely high attrition and modest weight loss associated with the financial incentives in this program, which contrasts with the better outcomes associated with pilot programs. We conclude by offering suggestions, motivated by behavioral economics, for increasing the effectiveness of financial incentives for weight loss. Copyright © 2013 Elsevier B.V. All rights reserved.

Improvement of insulin resistance and reduction of cardiovascular risk among obese patients with type 2 diabetes with the duodenojejunal bypass liner.

PubMed

de Moura, Eduardo Guimarães Hourneaux; Orso, Ivan Roberto Bonotto; Martins, Bruno da Costa; Lopes, Guilherme Sauniti; de Oliveira, Suzana Lopes; Galvão-Neto, Manoel dos Passos; Mancini, Marcio Correa; Santo, Marco Aurélio; Sakai, Paulo; Ramos, Almino Cardoso; Garrido-Júnior, Arthur Belarmino; Halpern, Alfredo; Cecconello, Ivan

2011-07-01

This study aims to evaluate the effectiveness of the duodenojejunal bypass liner (DJBL) in the improvement of insulin resistance and reduction of cardiovascular risk among morbidly obese patients with type 2 diabetes mellitus, using the triglyceride/high-density lipoprotein (HDL) cholesterol ratio, percentage of weight loss, and glycemic control. We used the TG/HDL ratio with a cutoff value of 3.5 to identify patients with insulin resistance. The value of the initial ratio was compared with the ratio obtained 6 months after implantation to evaluate whether an improvement in insulin resistance occurred. We also evaluated the improvement of glycated hemoglobin levels and the weight loss resulted from the use of the device and correlated that with the improvement of the TG/HDL ratio. All patients implanted with the device presented a statistically significant reduction of the HbA1c levels, with most patients (70.3%) obtaining diabetes control with HbA1c levels lower than 7% at the end of the study. All patients also presented a significant weight reduction, with an average loss of 12.6% of their initial weight. We observed an important improvement in insulin resistance and metabolic syndrome, with a significant reduction of the TG/HDL ratio from 5.75 to 4.36 (p < 0.001) and 42.6% of the patients presenting a TG/HDL ratio lower than 3.5 at the end of the study. The DJBL, when used for a period of 6 months, is effective in the control of diabetes, weight loss, improvement of insulin resistance, and decrease of cardiovascular risk among morbidly obese patients with type 2 diabetes mellitus.

A Psychological and Nutritional Approach to Weight Loss: A Collaborative Program.

ERIC Educational Resources Information Center

Kessler, Lisa; Kalodner, Cynthia

Collaboration between a dietitian and a psychologist has been described as critical to the development and implementation of this weight control programs, and this paper describes such a program conducted through a college student health center. Nutritional components of weight loss programs should provide information which will enable…

Cohort Study of the Success of Controlled Weight Loss Programs for Obese Dogs.

PubMed

German, A J; Titcomb, J M; Holden, S L; Queau, Y; Morris, P J; Biourge, V

2015-01-01

Most weight loss studies in obese dogs assess rate and percentage of weight loss in the first 2-3 months, rather than the likelihood of successfully reaching target weight. To determine outcome of controlled weight loss programs for obese dogs, and to determine the factors associated with successful completion. 143 obese dogs undergoing a controlled weight loss program. This was a cohort study of obese dogs attending a referral weight management clinic. Dogs were studied during their period of weight loss, and cases classified according to outcome as "completed" (reached target weight), "euthanized" (was euthanized before reaching target weight), or "stopped prematurely" (program stopped early for other reasons). Factors associated with successful completion were assessed using simple and multiple logistic regression. 87/143 dogs (61%) completed their weight loss program, 11 [8%] died or were euthanized, and the remaining 45 [32%] stopped prematurely. Reasons for dogs stopping prematurely included inability to contact owner, refusal to comply with weight management advice, or development of another illness. Successful weight loss was positively associated with a faster rate (P < .001), a longer duration (P < .001), and feeding a dried weight management diet (P = .010), but negatively associated with starting body fat (P < .001), and use of dirlotapide (P = .0046). Just over half of all obese dogs on a controlled weight loss program reach their target weight. Future studies should better clarify reasons for success in individual cases, and also the role of factors such as activity and behavioral modification. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Adsorption losses from urine-based cannabinoid calibrators during routine use.

PubMed

Blanc, J A; Manneh, V A; Ernst, R; Berger, D E; de Keczer, S A; Chase, C; Centofanti, J M; DeLizza, A J

1993-08-01

The major metabolite of cannabis found in urine, 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (delta 9-THC), is the compound most often used to calibrate cannabinoid immunoassays. The hydrophobic delta 9-THC molecule is known to adsorb to solid surfaces. This loss of analyte from calibrator solutions can lead to inaccuracy in the analytical system. Because the calibrators remain stable when not used, analyte loss is most probably caused by handling techniques. In an effort to develop an effective means of overcoming adsorption losses, we quantified cannabinoid loss from calibrators during the testing process. In studying handling of these solutions, we found noticeable, significant losses attributable to both the kind of pipette used for transfer and the contact surface-to-volume ratio of calibrator solution in the analyzer cup. Losses were quantified by immunoassay and by radioactive tracer. We suggest handling techniques that can minimize adsorption of delta 9-THC to surfaces. Using the appropriate pipette and maintaining a minimum surface-to-volume ratio in the analyzer cup effectively reduces analyte loss.

Symbol signal-to-noise ratio loss in square-wave subcarrier downconversion

NASA Technical Reports Server (NTRS)

Feria, Y.; Statman, J.

1993-01-01

This article presents the simulated results of the signal-to-noise ratio (SNR) loss in the process of a square-wave subcarrier down conversion. In a previous article, the SNR degradation was evaluated at the output of the down converter based on the signal and noise power change. Unlike in the previous article, the SNR loss is defined here as the difference between the actual and theoretical symbol SNR's for the same symbol-error rate at the output of the symbol matched filter. The results show that an average SNR loss of 0.3 dB can be achieved with tenth-order infinite impulse response (IIR) filters. This loss is a 0.2-dB increase over the SNR degradation in the previous analysis where neither the signal distortion nor the symbol detector was considered.

Design, fabrication and acoustic tests of a 36 inch (0.914 meter) statorless turbotip fan

NASA Technical Reports Server (NTRS)

Smith, E. G.; Stempert, D. L.; Uhl, W. R.

1975-01-01

The LF336/E is a 36 inch (0.914 meter) diameter fan designed to operate in a rotor-alone configuration. Design features required for modification of the existing LF336/A rotor-stator fan into the LF336/E statorless fan configuration are discussed. Tests of the statorless fan identified an aerodynamic performance deficiency due to inaccurate accounting of the fan exit swirl during the aerodynamic design. This performance deficiency, related to fan exit static pressure levels, produced about a 20 percent thrust loss. A study was then conducted for further evaluation of the fan exit flow fields typical of statorless fan systems. This study showed that through proper selection of fan design variables such as pressure ratio, radius ratio, and swirl distributions, performance of a statorless fan configuration could be improved with levels of thrust approaching the conventional rotor-stator fan system. Acoustic measurements were taken for the statorless fan system at both GE and NASA, and when compared to other lift fan systems, showed noise levels comparable to the quietest lift fan configuration which included rotor-stator spacing and acoustic treatment. The statorless fan system was also used to determine effects of rotor leading edge serrations on noise generations. A cascade test program identified the serration geometry based on minimum pressure losses, wake turbulence levels and noise generations.

Ratio of Cut Surface Area to Leaf Sample Volume for Water Potential Measurements by Thermocouple Psychrometers

PubMed Central

Walker, Sue; Oosterhuis, Derrick M.; Wiebe, Herman H.

1984-01-01

Evaporative losses from the cut edge of leaf samples are of considerable importance in measurements of leaf water potential using thermocouple psychrometers. The ratio of cut surface area to leaf sample volume (area to volume ratio) has been used to give an estimate of possible effects of evaporative loss in relation to sample size. A wide range of sample sizes with different area to volume ratios has been used. Our results using Glycine max L. Merr. cv Bragg indicate that leaf samples with area to volume values less than 0.2 square millimeter per cubic millimeter give psychrometric leaf water potential measurements that compare favorably with pressure chamber measurements. PMID:16663578

Pregnancy loss history at first parity and selected adverse pregnancy outcomes.

PubMed

Ahrens, Katherine A; Rossen, Lauren M; Branum, Amy M

2016-07-01

To evaluate the association between pregnancy loss history and adverse pregnancy outcomes. Pregnancy history was captured during a computer-assisted personal interview for 21,277 women surveyed in the National Survey of Family Growth (1995-2013). History of pregnancy loss (<20 weeks) at first parity was categorized in three ways: number of losses, maximum gestational age of loss(es), and recency of last pregnancy loss. We estimated risk ratios for a composite measure of selected adverse pregnancy outcomes (preterm, stillbirth, or low birthweight) at first parity and in any future pregnancy, separately, using predicted margins from adjusted logistic regression models. At first parity, compared with having no loss, having 3+ previous pregnancy losses (adjusted risk ratio (aRR) = 1.66 [95% CI = 1.13, 2.43]), a maximum gestational age of loss(es) at ≥10 weeks (aRR = 1.28 [1.04, 1.56]) or having experienced a loss 24+ months ago (aRR = 1.36 [1.10, 1.68]) were associated with increased risks of adverse pregnancy outcomes. For future pregnancies, only having a history of 3+ previous pregnancy losses at first parity was associated with increased risks (aRR = 1.97 [1.08, 3.60]). Number, gestational age, and recency of pregnancy loss at first parity were associated with adverse pregnancy outcomes in U.S. women. Published by Elsevier Inc.

Association of hearing loss with decreased employment and income among adults in the United States.

PubMed

Jung, David; Bhattacharyya, Neil

2012-12-01

We evaluated the association of hearing loss with employment and income in adults. Patients with a coded diagnosis of hearing loss were identified from the 2006 and 2008 Medical Expenditure Panel Survey linked household and medical conditions files and compared to patients without hearing loss. Differences in employment, wage income, and Supplemental Security Income were evaluated with multivariate regression models after adjustment for several demographic and Charlson comorbidity variables. An estimated 933,921 +/- 88,474 adults were identified with hearing loss (54.7% of whom were male; mean age for all, 51.0 years). Patients with hearing loss were more likely to be unemployed or partly unemployed than those without hearing loss (adjusted odds ratio, 2.2; p < 0.001). Similarly, adults with hearing loss were less likely to have any wage income than those without hearing loss (adjusted odds ratio, 2.5; p < 0.001). The population with hearing loss earned a mean wage of $23,481 +/- $3,366, versus $31,272 +/- $517 for the population without hearing loss (difference in wages, $7,791; p < 0.001). The association between hearing loss and receiving Supplemental Security Income was not significant (p = 0.109). Adults with hearing loss are more likely to be unemployed and on average earn significantly less wage income than adults without hearing loss. Further work is needed to determine the potential impact of treatment on these differences.

Virtual Reality–Enhanced Cognitive–Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up

PubMed Central

Cesa, Gian Luca; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

2016-01-01

Abstract It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive–behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT. PMID:26430819

Diabetic retinopathy screening with pharmacy-based teleophthalmology in a semiurban setting: a cost-effectiveness analysis.

PubMed

Coronado, Andrea C; Zaric, Gregory S; Martin, Janet; Malvankar-Mehta, Monali; Si, Francie F; Hodge, William G

2016-01-01

Diabetic eye complications are the leading cause of visual loss among working-aged people. Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examination that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. The objective of this study was to estimate the cost-effectiveness of mobile teleophthalmology screening compared with in-person examination (primary care) for the diabetic population residing in semiurban areas of southwestern Ontario. A decision tree was constructed to compare in-person examination (comparator program) versus pharmacy-based teleophthalmology (intervention program). The economic model was designed to identify patients with more than minimal diabetic retinopathy, manifested by at least 1 microaneurysm at examination (modified Airlie House classification grade of ≥ 20). Cost-effectiveness was assessed as cost per case detected (true-positive result) and cost per case correctly diagnosed (including true-positive and true-negative results). The cost per case detected was $510 with in-person examination and $478 with teleophthalmology, and the cost per case correctly diagnosed was $107 and $102 respectively. The incremental cost-effectiveness ratio was $314 per additional case detected and $73 per additional case correctly diagnosed. Use of pharmacologic dilation and health care specialists' fees were the most important cost drivers. The study showed that a compound teleophthalmology program in a semiurban community would be more effective but more costly than in-person examination. The findings raise the question of whether the benefits of pharmacy-based teleophthalmology in semiurban areas, where in-person examination is still available, are equivalent to those observed in remote communities. Further study is needed to investigate the impact of this program on the prevention of severe vision loss and quality of life in a semiurban setting.

Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.

PubMed

Manzoni, Gian Mauro; Cesa, Gian Luca; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

2016-02-01

It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.

A Formative Evaluation of a Diabetes Prevention Program Using the RE-AIM Framework in a Learning Health Care System, Utah, 2013-2015.

PubMed

Brunisholz, Kimberly D; Kim, Jaewhan; Savitz, Lucy A; Hashibe, Mia; Gren, Lisa H; Hamilton, Sharon; Huynh, Kelly; Joy, Elizabeth A

2017-07-20

Evaluation of interventions can help to close the gap between research and practice but seldom takes place during implementation. Using the RE-AIM framework, we conducted a formative evaluation of the first year of the Intermountain Healthcare Diabetes Prevention Program (DPP). Adult patients who met the criteria for prediabetes (HbA1c of 5.70%-6.49% or fasting plasma glucose of 100-125 mg/dL) were attributed to a primary care provider from August 1, 2013, through July 31, 2014. Physicians invited eligible patients to participate in the program during an office visit. We evaluated 1) reach, with data on patient eligibility, participation, and representativeness; 2) effectiveness, with data on attaining a 5% weight loss; 3) adoption, with data on providers and clinics that referred patients to the program; and 4) implementation, with data on patient encounters. We did not measure maintenance. Of the 6,862 prediabetes patients who had an in-person office visit with their provider, 8.4% of eligible patients enrolled. Likelihood of participation was higher among patients who were female, aged 70 years or older, or overweight; had depression and higher weight at study enrollment; or were prescribed metformin. DPP participants were more likely than nonparticipants to achieve a 5% weight loss (odds ratio, 1.70; 95% confidence interval, 1.29-2.25; P < .001). Providers from 7 of 8 regions referred patients to the DPP; 174 providers at 53 clinics enrolled patients. The mean number of DPP counseling encounters per patient was 2.3 (range, 1-16). The RE-AIM framework was useful for estimating the formative impact (ie, reach, effectiveness, adoption, and implementation fidelity) of a DPP-based lifestyle intervention deployed in a learning health care system.

Systematic review: an evaluation of major commercial weight loss programs in the United States.

PubMed

Tsai, Adam Gilden; Wadden, Thomas A

2005-01-04

Each year millions of Americans enroll in commercial and self-help weight loss programs. Health care providers and their obese patients know little about these programs because of the absence of systematic reviews. To describe the components, costs, and efficacy of the major commercial and organized self-help weight loss programs in the United States that provide structured in-person or online counseling. Review of company Web sites, telephone discussion with company representatives, and search of the MEDLINE database. Randomized trials at least 12 weeks in duration that enrolled only adults and assessed interventions as they are usually provided to the public, or case series that met these criteria, stated the number of enrollees, and included a follow-up evaluation that lasted 1 year or longer. Data were extracted on study design, attrition, weight loss, duration of follow-up, and maintenance of weight loss. We found studies of eDiets.com, Health Management Resources, Take Off Pounds Sensibly, OPTIFAST, and Weight Watchers. Of 3 randomized, controlled trials of Weight Watchers, the largest reported a loss of 3.2% of initial weight at 2 years. One randomized trial and several case series of medically supervised very-low-calorie diet programs found that patients who completed treatment lost approximately 15% to 25% of initial weight. These programs were associated with high costs, high attrition rates, and a high probability of regaining 50% or more of lost weight in 1 to 2 years. Commercial interventions available over the Internet and organized self-help programs produced minimal weight loss. Because many studies did not control for high attrition rates, the reported results are probably a best-case scenario. With the exception of 1 trial of Weight Watchers, the evidence to support the use of the major commercial and self-help weight loss programs is suboptimal. Controlled trials are needed to assess the efficacy and cost-effectiveness of these interventions.

FACTORS RELATED TO TOOTH LOSS AMONG INDUSTRIAL WORKERS IN PHATHUM THANI, THAILAND.

PubMed

Jaaidee, Jeerateep; Chatrchaiwiwatana, Supaporn; Ratanasiri, Amornrat

2017-01-01

Tooth loss is an important oral health problem among Thai people. The objectives of this study were to evaluate the prevalence of and factors associated with tooth loss among Thai industrial workers in order to apply preventive oral health programs to this population. The study consisted of 1,500 adults working in Nava Nakorn Industrial Estate, Pathum Thani Province, Thailand in 2014. Probability proportion to size cluster sampling was used and 16 clusters were included in the study. An oral health questionnaire was developed, evaluated for content validity by experts and then given to participants to fill out. The study population consisted of 621 males (41.4%) and 879 females (58.6%) aged between 19-25 years. The overall prevalence of tooth loss was 62.2% and the major reason for tooth loss was dental caries (60%). Results from multivariable logistic regression analysis show that factors associated with tooth loss were: having a history of scaling or tooth cleaning [adjusted odds ratio (AOR)= 2.47; 95% CI: 1.21-4.65], having dental caries with exposed pulp (AOR=4.12; 95% CI: 3.26-7.67), having tooth mobility due to periodontal disease (AOR=2.41; 95% CI: 2.71-5.22), having needed tooth restoration (AOR=1.75; 95% CI: 1.23-2.65), having a history of maxillofacial or a temporo-mandibular joint accident (AOR=2.13; 95% CI: 1.87- 3.23), wearing dentures (AOR=2.58; 95% CI: 2.17-6.72), using dental care services during the previous year (AOR=2.21; 95% CI: 1.26-4.57), eating snacks and candy daily (AOR=2.14; 95% CI: 1.82-2.92), having toothache (AOR=2.64; 95% CI: 1.43- 3.92), having dental caries (AOR=2.23; 95% CI: 1.62-3.27) and having a history of orthodontic treatment (AOR=3.61; 95% CI: 1.84-5.68). The Nagelkerke R squared for the model was 0.42. Our findings suggest several clinical, socio-economic and lifestyle factors are associated with tooth loss among these Thai industrial workers. An appropriate preventive oral health program targeting this high-risk group taking these factors into consideration needs to be developed and implemented in this at risk population.

Interpreting aCGH-defined karyotypic changes in gliomas using copy number status, loss of heterozygosity and allelic ratios

PubMed Central

Cowell, John K; Lo, Ken C; Luce, Jesse; Hawthorn, Lesleyann

2009-01-01

We have used SNP mapping arrays to simultaneously record copy number changes, loss of heterozygosity and allele ratios (ploidy) in a series of 13 gliomas. This combined analysis has defined novel amplification events in this tumor type involving chr1:241544532-243005121 and chr18:54716681-54917277 which contain the AKT3 and ZNF532 genes respectively. The high resolution of this analysis has also identified homozygous deletions involving chr17:25600031-26490848 and Chr19:53883612-55061878. Throughout the karyotypes of these tumors, the combined analysis revealed counter intuitive relationships between copy number and LOH that requires reinterpretation of the significance of copy number gains and losses. It was not uncommon to observe copy number gains that were associated with loss of heterozygosity as well as copy number losses that were not. These events appeared to be related to ploidy status in the tumors as determined using allelic ratio calculations. Overall, this analysis of gliomas provides evidence for the need to perform more comprehensive interpretation of the CGH data beyond copy number analysis alone to evaluate the significance of individual events in the karyotypes. PMID:19818351

MERIDL- VELOCITIES AND STREAMLINES ON THE HUB-SHROUD MIDCHANNEL STREAM SURFACE OF AN AXIAL, RADIAL, OR MIXED FLOW TURBOMACHINE OR ANNULAR DUCT

NASA Technical Reports Server (NTRS)

Katsanis, T.

1994-01-01

This computer program was developed for calculating the subsonic or transonic flow on the hub-shroud mid-channel stream surface of a single blade row of a turbomachine. The design and analysis of blades for compressors and turbines ideally requires methods for analyzing unsteady, three-dimensional, turbulent viscous flow through a turbomachine. Since an exact solution is impossible at present, solutions on two-dimensional surfaces are calculated to obtain a quasi-three dimensional solution. When three-dimensional effects are important, significant information can be obtained from a solution on a cross-sectional surface of the passage normal to the flow. With this program, a solution to the equations of flow on the meridional surface can be carried out. This solution is chosen when the turbomachine under consideration has significant variation in flow properties in the hubshroud direction, especially when input is needed for use in blade-to-blade calculations. The program can also perform flow calculations for annular ducts without blades. This program should prove very useful in the design and analysis of any turbomachine. This program calculates a solution for two-dimensional, adiabatic shockfree flow. The flow must be essentially subsonic, but there may be local areas of supersonic flow. To obtain the solution, this program uses both the finite difference and the quasi-orthogonal (velocity gradient) methods combined in a way that takes maximum advantage of both. The finite-difference method solves a finite-difference equation along the meridional stream surface in a very efficient manner but is limited to subsonic velocities. This approach must be used in cases where the blade aspect ratios are above one, cases where the passage is curved, and cases with low hub-tip-ratio blades. The quasi-orthogonal method solves the velocity gradient equation on the meridional surface and is used if it is necessary to extend the range of solutions into the transonic regime. In general the blade row may be fixed or rotating and the blades may be twisted and leaned. The flow may be axial, radial, or mixed. The upstream and downstream flow conditions can vary from hub to shroud with provisions made for an approximate correction for loss of stagnation pressure. Also, viscous forces are neglected along solution mesh lines running from hub to tip. The capabilities of this program include handling of nonaxial flows without restriction, annular ducts without blades, and specified streamwise loss distributions. This program is written in FORTRAN IV for batch execution and has been implemented on an IBM 360 computer with a central memory requirement of approximately 700K of 8 bit bytes. This core requirement can be reduced depending on the size of the problem and the desired solution accuracy. This program was developed in 1977.

Simulation of Electron Scattering in Complex Nanostructures: Lithography, Metrology, and Characterization.

NASA Astrophysics Data System (ADS)

Johnson, Sylvester, IV

A CAE (Computer Aided Engineering) tool called SEEL (Simulation of Electron Energy Loss) is described in detail. SEEL simulates in any material the energy loss and trajectories of electrons in the complex, multilayered nanostructures typical of ULSI, at beam energies from 1 to 50 keV. Structures and materials are defined in the input file rather than in the source code of the program, for which flowcharts are included in addition to an explanation of the algorithms implemented. Satisfactory comparisons of simulated with experimental results are made of both secondary electron (SE) and backscattered electron (BSE) linescans across an array of MOS gate structures capped by rough oxide. Many other comparisons are made. The effects of varying line edge slopes on SE linescan peak shape are simulated and analyzed. A data library containing the simulated variation of the FWHM, peak height, and peak location with slope for different materials, line heights or trench depths, widths, beam energies, and nominal diameters could be used to find the edge location relative to the peak for improvement of the accuracy of linewidth measurement algorithms. An investigation indicates that the use of such a library would be complicated by the effect of surface roughness on the SE signal at the edge of a feature. SEEL can be used as the first module in a series of programs that simulate energy deposition in resist structures and correct the exposure of a circuit pattern. Pixel by pixel convolution for prediction of the proximity effect is time-consuming. Another method of proximity effect prediction based on the reciprocity of the RED is described. Such programs could be used to reduce the number of iterations in the lab required to optimize resist structures and exposure parameters. For both smooth and rough interfaces between a bottom layer of PMMA in a multilayer resist structure and a W film, the simulated exposure contrast declines from that with an oxide film beneath the structure. A comparison of Auger peak to background ratios resulting from simulation of smooth and rough surfaces indicates that roughening of an Al surface on a small scale could result in a smaller ratio.

Dynamic Modeling of the Economic Impacts of a Terrorist Attack using a Radiological Dispersion Device

DTIC Science & Technology

2009-03-01

Coverage to Loss Ratio Increasing Indiv idual Losses f rom Contamination Daining Recovery Decreasing Losses Through Community Recov ery Community...Localized Stimulus Plan Switch Noname 1 Daining Recov ery Converter Business Loss Structure 64 were never directly refunded by federal...Incentiv es Revitalization Plan Legislative Financial Backing of Localized Stimulus Plan Switch Daining Recovery Converter Tax Rev enue Loss Structure

Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection.

PubMed

Kim, T Y; Park, D W; Lee, Y J; Lee, J Y; Lee, S H; Chung, J H; Lee, S

2015-12-01

Recently 4-hour delayed-enhanced 3D-FLAIR MR imaging has been used in pathophysiologic analysis of the inner ear in many auditory diseases, including sudden sensorineural hearing loss, but comparison among different time points is not clear in patients with unilateral inner ear symptoms. We compared the signal-intensity ratios of the inner ears in patients with unilateral inner ear symptoms on 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images after IV gadolinium injection. The 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images were retrospectively analyzed. Signal-intensity ratios between the cerebellum and inner ear structures, such as the cochleae, vestibules, and vestibulocochlear nerve were assessed. Multiple comparisons were performed. Signal-intensity ratios of the affected cochleae, vestibules, and vestibulocochlear nerve were higher than those of unaffected sides in both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. At the affected side, signal-intensity ratios of the vestibulocochlear nerve were higher in patients with nonsudden sensorineural hearing loss than in those with sudden sensorineural hearing loss on both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The signal-intensity ratios of some affected inner ear structures were higher than those of the unaffected sides in a group of 30 patients with sudden sensorineural hearing loss and 20 patients with nonsudden sensorineural hearing loss on 10-minute delayed-enhanced and 4-hour delayed-enhanced images. Signal-intensity ratios of the inner ear show statistically significant increases in many diseases, especially neuritis, in 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The 4-hour delayed-enhanced images may be superior in neural inflammatory-dominant conditions, while 10-minute delayed-enhanced images may be superior in neural noninflammatory-dominant conditions. © 2015 by American Journal of Neuroradiology.

Paradox of vaccination: is vaccination really effective against avian flu epidemics?

PubMed

Iwami, Shingo; Suzuki, Takafumi; Takeuchi, Yasuhiro

2009-01-01

Although vaccination can be a useful tool for control of avian influenza epidemics, it might engender emergence of a vaccine-resistant strain. Field and experimental studies show that some avian influenza strains acquire resistance ability against vaccination. We investigated, in the context of the emergence of a vaccine-resistant strain, whether a vaccination program can prevent the spread of infectious disease. We also investigated how losses from immunization by vaccination imposed by the resistant strain affect the spread of the disease. We designed and analyzed a deterministic compartment model illustrating transmission of vaccine-sensitive and vaccine-resistant strains during a vaccination program. We investigated how the loss of protection effectiveness impacts the program. Results show that a vaccination to prevent the spread of disease can instead spread the disease when the resistant strain is less virulent than the sensitive strain. If the loss is high, the program does not prevent the spread of the resistant strain despite a large prevalence rate of the program. The epidemic's final size can be larger than that before the vaccination program. We propose how to use poor vaccines, which have a large loss, to maximize program effects and describe various program risks, which can be estimated using available epidemiological data. We presented clear and simple concepts to elucidate vaccination program guidelines to avoid negative program effects. Using our theory, monitoring the virulence of the resistant strain and investigating the loss caused by the resistant strain better development of vaccination strategies is possible.

Pin stack array for thermoacoustic energy conversion

DOEpatents

Keolian, Robert M.; Swift, Gregory W.

1995-01-01

A thermoacoustic stack for connecting two heat exchangers in a thermoacoustic energy converter provides a convex fluid-solid interface in a plane perpendicular to an axis for acoustic oscillation of fluid between the two heat exchangers. The convex surfaces increase the ratio of the fluid volume in the effective thermoacoustic volume that is displaced from the convex surface to the fluid volume that is adjacent the surface within which viscous energy losses occur. Increasing the volume ratio results in an increase in the ratio of transferred thermal energy to viscous energy losses, with a concomitant increase in operating efficiency of the thermoacoustic converter. The convex surfaces may be easily provided by a pin array having elements arranged parallel to the direction of acoustic oscillations and with effective radial dimensions much smaller than the thicknesses of the viscous energy loss and thermoacoustic energy transfer volumes.

Effect of Installation of Mixer/Ejector Nozzles on the Core Flow Exhaust of High-Bypass-Ratio Turbofan Engines

NASA Technical Reports Server (NTRS)

Harrington, Douglas E.

1998-01-01

The aerospace industry is currently investigating the effect of installing mixer/ejector nozzles on the core flow exhaust of high-bypass-ratio turbofan engines. This effort includes both full-scale engine tests at sea level conditions and subscale tests in static test facilities. Subscale model tests are to be conducted prior to full-scale testing. With this approach, model results can be analyzed and compared with analytical predications. Problem areas can then be identified and design changes made and verified in subscale prior to committing to any final design configurations for engine ground tests. One of the subscale model test programs for the integrated mixer/ejector development was a joint test conducted by the NASA Lewis Research Center and Pratt & Whitney Aircraft. This test was conducted to study various mixer/ejector nozzle configurations installed on the core flow exhaust of advanced, high-bypass-ratio turbofan engines for subsonic, commercial applications. The mixer/ejector concept involves the introduction of largescale, low-loss, streamwise vortices that entrain large amounts of secondary air and rapidly mix it with the primary stream. This results in increased ejector pumping relative to conventional ejectors and in more complete mixing within the ejector shroud. The latter improves thrust performance through the efficient energy exchange between the primary and secondary streams. This experimental program was completed in April 1997 in Lewis' CE-22 static test facility. Variables tested included the nozzle area ratio (A9/A8), which ranged from 1.6 to 3.0. This ratio was varied by increasing or decreasing the nozzle throat area, A8. Primary nozzles tested included both lobed mixers and conical primaries. These configurations were tested with and without an outer shroud, and the shroud position was varied by inserting spacers in it. In addition, data were acquired with and without secondary flow.

Measurement value analysis overall equipment effectiveness (OEE) packaging process in line 2 (Case Study of PT. MBI Tbk)

NASA Astrophysics Data System (ADS)

Rimawan, Erry; Kholil, Muhammad; Hendri

2018-03-01

PT. MBI Tbk is engaged in the manufacture of beverage industry, where the company’s production is based on the magnitude of customer demand that is marketing offices that had been scattered in various regions of Indonesia. In the packaging process steps in PT.MBI through the line 3 lines including racking, canning line, bottling line. In the canning process to existing packing on Line 2 (canning line), there are some machines that are used continuously, among other Depalletizer machine, filler machine, can seamer machine, pasteurizer machine, machine FLD, Wrap Around engine, engine Shrink Wrap. Due to the large demand from customers that is relentless, therefore the calculation of overall equipment effectiveness (OEE) as a whole on line 2 (canning line) is needed in order to make improvements continuously (Continuous Improvement) at line 2 (canning line). This study aims to determine the value of overall equipment effectiveness (OEE) and Losses of the most influential of the big six OEE Losses focused on equipment or machinery as a whole into a single unit that is on the line 2, which will then be known root cause of the losses that occur from the research over the field. From the calculation of overall equipment effectiveness (OEE), there are two ratios are still poor and under world-class standards, while the ratio of the availability of 88.85% of the world-class standards by 90% and the performance ratio of 78.51% of the standard world class by 95%, whereas for quality ratio has entered the world-class standard that is equal to 99.90%. Thus the value of OEE on Line 2 line is below world class standards. In this study there were only five losses, which can be identified, and while the losses were very influential, namely the Speed Reduced Losses, losses, these losses accounted for the largest percentage of the value of the rate of 19.12%, of the results of this study losses occurred due to poor surveillance systems (less good) that causes the employee or operator does not perform the work in accordance with a predetermined.

A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial.

PubMed

Pellegrini, Christine A; Duncan, Jennifer M; Moller, Arlen C; Buscemi, Joanna; Sularz, Alyson; DeMott, Andrew; Pictor, Alex; Pagoto, Sherry; Siddique, Juned; Spring, Bonnie

2012-11-30

Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Ninety-six obese adults (BMI 30-39.9 kg/m2) will be randomized to one of three treatment conditions: (1) standard behavioral weight loss (STND), (2) technology-supported behavioral weight loss (TECH); or (3) self-guided behavioral weight loss (SELF). All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD's and will not receive coaching calls. During months 1-6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer). STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. NCT01051713.

Determinants of Successful Weight Loss After Using a Commercial Web-Based Weight Reduction Program for Six Months: Cohort Study

PubMed Central

Postrach, Elisa; Aspalter, Rosa; Elbelt, Ulf; Koller, Michael; Longin, Rita; Schulzke, Jörg-Dieter

2013-01-01

Background The Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program currently available in German-speaking countries, incorporates these features. A previous investigation showed that the program effectively supports users in losing weight. Objective We investigated weight loss dynamics stratified by weight loss success after 6-month use of KiloCoach. Furthermore, we analyzed possible associations between intensity of program use and weight loss. The results are intended for tailoring user recommendations for weight-loss Internet platforms. Methods Datasets of KiloCoach users (January 1, 2008 to December 31, 2011) who actively used the platform for 6 months or more were assigned to this retrospective analysis. Users (N=479) were 42.2% men, mean age of 44.0 years (SD 11.7), with a mean body mass index (BMI) of 31.7 kg/m2 (SD 3.2). Based on the weight loss achieved after 6 months, 3 success groups were generated. The unsuccessful group lost <5%, the moderate success group lost 5%-9.9%, and the high success group lost ≥10% of their baseline body weight. At baseline, the unsuccessful (n=261, 54.5%), moderate success (n=133, 27.8%), and high success (n=85, 17.8%) groups were similar in age, weight, BMI, and gender distribution. Results After 6 months, the unsuccessful group lost 1.2% (SD 2.4), the moderate success group lost 7.4% (SD 1.5), and the high success group lost 14.2% (SD 3.8) of their initial weight (P<.001). Multivariate regression showed that early weight loss (weeks 3-4), the total number of dietary protocols, and the total number of weight entries were independent predictors for 6-month weight reduction (all P<.001) explaining 52% of the variance in weight reduction. Sensitivity analysis by baseline carried forward method confirmed all independent predictors of 6-month weight loss and reduced the model fit by only 11%. The high success group lost weight faster and maintained weight loss more efficiently than the other groups (P<.001). Early weight loss was associated with weight maintenance after 1 year and 2 years (both P<.001). Weight dynamics did not differ between men and women over 6 months when adjusted for baseline and usage parameters (P=.91). The percentage of male long-term users was unusually high (42.2%). Conclusions Our results suggest that early weight loss and close program adherence (ie, 5 dietary protocols per week and weekly entering of current weight), especially in the early phase of program usage, can improve weight loss outcome. PMID:24126250

Does Spirituality Predict Weight Loss In A Behavioral Weight Loss Program?

DTIC Science & Technology

2009-01-01

SPIRITUALfl 1 A ~~D WEIGHT LOSS APPROVAL SHEET Title of Thesis: "Does Spirituality Predict Weight Loss in a Behavioral Weight Loss Program 7" Name...notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does...not display a currently valid OMB control number. 1. REPORT DATE 2009 2. REPORT TYPE 3. DATES COVERED 00-00-2009 to 00-00-2009 4. TITLE AND

42 CFR 422.132 - Protection against liability and loss of benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.132 Protection against liability and loss of benefits. Enrollees of MA organizations are... 42 Public Health 3 2010-10-01 2010-10-01 false Protection against liability and loss of benefits...

44 CFR 79.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION GRANTS § 79.1 Purpose. (a... the hazard mitigation grant programs made available under the National Flood Insurance Act of 1968, as... Repetitive Loss (SRL) and Flood Mitigation Assistance (FMA) grant programs mitigate losses from floods...

44 CFR 79.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION GRANTS § 79.1 Purpose. (a... the hazard mitigation grant programs made available under the National Flood Insurance Act of 1968, as... Repetitive Loss (SRL) and Flood Mitigation Assistance (FMA) grant programs mitigate losses from floods...

44 CFR 79.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION GRANTS § 79.1 Purpose. (a... the hazard mitigation grant programs made available under the National Flood Insurance Act of 1968, as... Repetitive Loss (SRL) and Flood Mitigation Assistance (FMA) grant programs mitigate losses from floods...

44 CFR 79.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION GRANTS § 79.1 Purpose. (a... the hazard mitigation grant programs made available under the National Flood Insurance Act of 1968, as... Repetitive Loss (SRL) and Flood Mitigation Assistance (FMA) grant programs mitigate losses from floods...

State of the art in fluid and volume therapy : A user-friendly staged concept. English version.

PubMed

Rehm, M; Hulde, N; Kammerer, T; Meidert, A S; Hofmann-Kiefer, K

2017-04-10

Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space. Fluid loss via urine excretion or insensible perspiration (0.5-1.0 ml/kg/h) should be replaced with balanced, isooncotic, crystalloid infusion solutions in a ratio of 1:1. Volume therapy stage 1: intraoperative volume losses up to a blood loss corresponding to 20% of the patient's total blood volume are compensated for by balanced crystalloids in a ratio of 4-5:1. Stage 2: blood losses exceeding this level are to be treated with isooncotic colloids (preferably balanced) in a 1:1 ratio. In this regard taking into consideration the contraindications, e. g., sepsis, burns, critical illness (usually patients in the intensive care unit), impaired renal function or renal replacement therapy, intracranial hemorrhage, or severe coagulopathy, artificial colloids such as hydroxyethyl starch (HES) can be used perioperatively for volume replacement. Stage 3: if an allogeneic blood transfusion is indicated, blood and blood products are applied in a differentiated manner.

Cost-benefit analysis of foot and mouth disease control in Ethiopia.

PubMed

Jemberu, Wudu T; Mourits, Monique; Rushton, Jonathan; Hogeveen, Henk

2016-09-15

Foot and mouth disease (FMD) occurs endemically in Ethiopia. Quantitative insights on its national economic impact and on the costs and benefits of control options are, however, lacking to support decision making in its control. The objectives of this study were, therefore, to estimate the annual costs of FMD in cattle production systems of Ethiopia, and to conduct an ex ante cost-benefit analysis of potential control alternatives. The annual costs of FMD were assessed based on production losses, export losses and control costs. The total annual costs of FMD under the current status quo of no official control program were estimated at 1354 (90% CR: 864-2042) million birr. The major cost (94%) was due to production losses. The costs and benefits of three potential control strategies: 1) ring vaccination (reactive vaccination around outbreak area supported by animal movement restrictions, 2) targeted vaccination (annual preventive vaccination in high risk areas plus ring vaccination in the rest of the country), and 3) preventive mass vaccination (annual preventive vaccination of the whole national cattle population) were compared with the baseline scenario of no official control program. Experts were elicited to estimate the influence of each of the control strategies on outbreak incidence and number of cases per outbreak. Based on these estimates, the incidence of the disease was simulated stochastically for 10 years. Preventive mass vaccination was epidemiologically the most efficient control strategy by reducing the national outbreak incidence below 5% with a median time interval of 3 years, followed by targeted vaccination strategy with a corresponding median time interval of 5 years. On average, all evaluated control strategies resulted in positive net present values. The ranges in the net present values were, however, very wide, including negative values. The targeted vaccination strategy was the most economic strategy with a median benefit cost ratio of 4.29 (90%CR: 0.29-9.63). It was also the least risky strategy with 11% chance of a benefit cost ratio of less than one. The study indicates that FMD has a high economic impact in Ethiopia. Its control is predicted to be economically profitable even without a full consideration of gains from export. The targeted vaccination strategy is shown to provide the largest economic return with a relatively low risk of loss. More studies to generate data, especially on production impact of the disease and effectiveness of control measures are needed to improve the rigor of future analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

A descriptive analysis of the 2008 credit crisis on multistate healthcare systems: what impact did it have on their financial performance?

PubMed

McCue, Michael J

2010-01-01

Due to the recent credit crisis and recession of 2008, hospitals experienced substantial losses in their investment portfolios. The author analyzed key financial accounts of 15 large, multistate healthcare systems that measured their changes in value of their investments, changes in net assets, liquidity ratios, and other performance ratios. Overall, he found that the majority of these systems did incur financial losses in their investment portfolios; however, for the majority of these systems, their liquidity and cash flow margin ratios declined slightly whereas their capital expenditure and community benefits increased.

Plasma myostatin is only a weak predictor for weight maintenance in obese adults.

PubMed

Tsioga, M N; Oikonomou, D; Vittas, S; Kalscheuer, H; Roeder, E; Wintgens, K F; Nawroth, P P; Wolfrum, C; Rudofsky, G

2015-09-01

Predicting an individual's success in a non-surgical weight loss approach is a demanding need since obesity is becoming an epidemic burden. A possible predictive marker is myostatin, a member of the transforming growth factor b superfamily, which has been shown to be an important regulator of muscle homeostasis. In the present study, we analyzed myostatin as a marker to predict weight loss of patients that participated in a 2 phased weight reduction program, comprising a weight loss period of 12 weeks and a weight stabilization period of 40 weeks. Therefore, 62 obese individuals with a mean BMI of 40.6 kg/m(2) were included. Plasma myostatin was measured with ELISA at the beginning (T0), after weight loss (T1) and at the end of the program (T2). Although significant weight loss of -23.9±14.9 kg was achieved, myostatin did not change significantly during the program (T0>T1: p=0.46; T1>T2: p=0.70; T0>T2: p=0.57). Myostatin at baseline did neither negatively correlate with the achieved weight loss in the weight reduction phase (T0>T1: r=0.27, p=0.16) nor with weight loss during the whole program (T0>T2: r=0.20, p=0.29). Only a minor correlation with myostatin levels after weight loss with weight regain during maintenance period was detected. (T1>T2: r=-0.37, p=0.05). Plasma myostatin might be suitable in predicting weight regain after marked weight loss, but no association with weight loss was observed in patients undergoing a non-surgical weight loss program. Therefore, myostatin does not seem to be a predictor for success in non-surgical weight loss approaches. © Georg Thieme Verlag KG Stuttgart · New York.

The effect of aerobic training on CXL5, tumor necrosis factor α and insulin resistance index (HOMA-IR) in sedentary obese women.

PubMed

Zehsaz, Farzad; Farhangi, Negin; Mirheidari, Lamia

2014-01-01

The purpose of the present study was to investigate the effects of a 12-week training program on serum CXC ligand 5, tumor necrosis factor α (TNF-α) and insulin resistance index in obese sedentary women. To this end, twenty-four obese sedentary women were evaluated before and after a 12-week exercise program including a brief warm-up, followed by ~45 min per session of aerobic exercise at an intensity of 60-75% of age-predicted maximum heart rate (~300 kcal/day), followed by a brief cool down, five times per week. After the exercise program, body weight, waist circumference, waist to hip ratio, percentage body fat mass, fasting glucose and insulin of participants were decreased. Furthermore, serum CXCL5 levels were significantly decreased from 2693.2 ±375.8 to 2290.2 ±345.9 pg/ml (p < 0.001) after the training program, which was accompanied with significantly decreased HOMA-IR (p < 0.001) and TNF-α (p < 0.001). Exercise training induced weight loss resulted in a significant reduction in serum CXCL5 concentrations and caused an improvement in insulin resistance in obese sedentary women.

The impact of aging, hearing loss, and body weight on mouse hippocampal redox state, measured in brain slices using fluorescence imaging.

PubMed

Stebbings, Kevin A; Choi, Hyun W; Ravindra, Aditya; Llano, Daniel Adolfo

2016-06-01

The relationships between oxidative stress in the hippocampus and other aging-related changes such as hearing loss, cortical thinning, or changes in body weight are not yet known. We measured the redox ratio in a number of neural structures in brain slices taken from young and aged mice. Hearing thresholds, body weight, and cortical thickness were also measured. We found striking aging-related increases in the redox ratio that were isolated to the stratum pyramidale, while such changes were not observed in thalamus or cortex. These changes were driven primarily by changes in flavin adenine dinucleotide, not nicotinamide adenine dinucleotide hydride. Multiple regression analysis suggested that neither hearing threshold nor cortical thickness independently contributed to this change in hippocampal redox ratio. However, body weight did independently contribute to predicted changes in hippocampal redox ratio. These data suggest that aging-related changes in hippocampal redox ratio are not a general reflection of overall brain oxidative state but are highly localized, while still being related to at least one marker of late aging, weight loss at the end of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Can Chronic Disease Management Programs for Patients with Type 2 Diabetes Reduce Productivity-Related Indirect Costs of the Disease? Evidence from a Randomized Controlled Trial

PubMed Central

Bolin, Jane N.; Ohsfeldt, Robert L.; Phillips, Charles D.; Zhao, Hongwei; Ory, Marcia G.; Forjuoh, Samuel N.

2014-01-01

Abstract The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; P<0.001) and persons with greater than high school education were associated with additional productivity losses (+$758/year; P<0.001). Persons with more than 1 comorbid condition were marginally associated with lower productivity losses (-$326/year; P=0.055). No evidence was found that the chronic disease management programs examined in this trial affect indirect productivity losses. (Population Health Management 2014;17:112–120) PMID:24152055

Can chronic disease management programs for patients with type 2 diabetes reduce productivity-related indirect costs of the disease? Evidence from a randomized controlled trial.

PubMed

Adepoju, Omolola E; Bolin, Jane N; Ohsfeldt, Robert L; Phillips, Charles D; Zhao, Hongwei; Ory, Marcia G; Forjuoh, Samuel N

2014-04-01

The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; P<0.001) and persons with greater than high school education were associated with additional productivity losses (+$758/year; P<0.001). Persons with more than 1 comorbid condition were marginally associated with lower productivity losses (-$326/year; P=0.055). No evidence was found that the chronic disease management programs examined in this trial affect indirect productivity losses.

Human local and total heat losses in different temperature.

PubMed

Wang, Lijuan; Yin, Hui; Di, Yuhui; Liu, Yanfeng; Liu, Jiaping

2016-04-01

This study investigates the effects of operative temperature on the local and total heat losses, and the relationship between the heat loss and thermal sensation. 10 local parts of head, neck, chest, abdomen, upper arm, forearm, hand, thigh, leg and foot are selected. In all these parts, convection, radiation, evaporation, respiration, conduction and diffusion heat losses are analyzed when operative temperature is 23, 28, 33 and 37 °C. The local heat losses show that the radiation and convection heat losses are mainly affected by the area of local body, and the heat loss of the thigh is the most in the ten parts. The evaporation heat loss is mainly affected by the distribution of sweat gland, and the heat loss of the chest is the most. The total heat loss of the local body shows that in low temperature, the thigh, leg and chest have much heat loss, while in high temperature, the chest, abdomen, thigh and head have great heat loss, which are useful for clothing design. The heat losses of the whole body show that as the operative temperature increases, the radiation and convection heat losses decrease, the heat losses of conduction, respiration, and diffusion are almost constant, and the evaporation heat loss increases. By comparison, the heat loss ratios of the radiation, convection and sweat evaporation, are in agreement with the previous researches. At last, the formula about the heat loss ratio of convection and radiation is derived. It's useful for thermal comfort evaluation and HVAC (heating, ventilation and air conditioning) design. Copyright © 2016 Elsevier Inc. All rights reserved.

Financial Performance of Health Insurers: State-Run Versus Federal-Run Exchanges.

PubMed

Hall, Mark A; McCue, Michael J; Palazzolo, Jennifer R

2018-06-01

Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses. Insurers performed better in states with state-run exchanges than insurers in states using the federal exchange in 2014. Medical loss ratios are the underlying driver more than administrative costs in the difference in performance between states with federal versus state-run exchanges. Policy makers looking to improve the financial performance of the individual market should focus on features that differentiate the markets associated with state-run versus federal exchanges.

A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women: a 6-mo randomized controlled trial.

PubMed

Geiker, Nina Rw; Ritz, Christian; Pedersen, Sue D; Larsen, Thomas M; Hill, James O; Astrup, Arne

2016-07-01

Hormonal fluctuations during the menstrual cycle influence energy intake and expenditure as well as eating preferences and behavior. We examined the effect in healthy, overweight, premenopausal women of a diet and exercise weight-loss program that was designed to target and moderate the effects of the menstrual cycle compared with the effect of simple energy restriction. A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m(2)): 32.0 ± 5.2]. Both groups lost weight during the study. In an intention-to-treat analysis, the Menstralean group did not achieve a clinically significant weight loss compared with that of the control group (P = 0.61). In per-protocol analyses, a more-pronounced weight loss of 4.3 ± 1.4 kg (P = 0.002) was shown in adherent Menstralean subjects than in the control group. A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial was registered at clinicaltrials.gov as NCT01622114. © 2016 American Society for Nutrition.

Using Avatars to Model Weight Loss Behaviors: Participant Attitudes and Technology Development

PubMed Central

Napolitano, Melissa A.; Hayes, Sharon; Russo, Giuseppe; Muresu, Debora; Giordano, Antonio; Foster, Gary D.

2013-01-01

Background: Virtual reality and other avatar-based technologies are potential methods for demonstrating and modeling weight loss behaviors. This study examined avatar-based technology as a tool for modeling weight loss behaviors. Methods: This study consisted of two phases: (1) an online survey to obtain feedback about using avatars for modeling weight loss behaviors and (2) technology development and usability testing to create an avatar-based technology program for modeling weight loss behaviors. Results: Results of phase 1 (n = 128) revealed that interest was high, with 88.3% stating that they would participate in a program that used an avatar to help practice weight loss skills in a virtual environment. In phase 2, avatars and modules to model weight loss skills were developed. Eight women were recruited to participate in a 4-week usability test, with 100% reporting they would recommend the program and that it influenced their diet/exercise behavior. Most women (87.5%) indicated that the virtual models were helpful. After 4 weeks, average weight loss was 1.6 kg (standard deviation = 1.7). Conclusion: This investigation revealed a high level of interest in an avatar-based program, with formative work indicating promise. Given the high costs associated with in vivo exposure and practice, this study demonstrates the potential use of avatar-based technology as a tool for modeling weight loss behaviors. PMID:23911189

7 CFR 1493.310 - Payment for loss.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Facility Guarantee Program (FGP) Operations § 1493.310 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.300, CCC will determine whether or...

7 CFR 1493.120 - Payment for loss.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.120 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of...

7 CFR 1493.310 - Payment for loss.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Facility Guarantee Program (FGP) Operations § 1493.310 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.300, CCC will determine whether or...

7 CFR 1493.310 - Payment for loss.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Facility Guarantee Program (FGP) Operations § 1493.310 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.300, CCC will determine whether or...

Effectiveness of the online weight reduction program KiloCoach™ and comparison with other evaluated commercial direct intervention and online programs.

PubMed

Longin, Rita; Grasse, Marina; Aspalter, Rosa; Waldherr, Karin

2012-01-01

Preliminary results indicated effectiveness of the online weight reduction program KiloCoach. The current study presents a large collection of user data and compares KiloCoach with other evaluated commercial weight loss programs. Furthermore, potential factors influencing the effectiveness of internet weight loss programs should be identified. 4,310 data sets of KiloCoach users were available, 3,150 of them were suitable for further analysis. 946 program users were considered completers (at least 60 days of continuous protocol). For comparison with other programs, different subsamples were drawn that matched to the inclusion criteria of reference studies. On average, KiloCoach overweight and obese completers lost 4.5 % of initial body weight. KiloCoach was as effective as the commercial program Weight Watchers® after 1 year (6.4% vs. 5.3% weight loss; p = 0.11) and 2 years (5.1% vs. 3.2% weight loss; p = 0.15). KiloCoach proved to be more effective than other online programs (Viktklubb, eDiets.com) as well as an in-person behavioral program, but less effective than Vtrim®, an online behavioral program providing intensive support. In comparison to reference programs, KiloCoach proved to be effective for weight reduction. The effect of online weight reduction programs seems to depend on methods and features applied.

7 CFR 4288.137 - Succession and loss of control of advanced biofuel facilities and production.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Succession and loss of control of advanced biofuel... PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.137 Succession and loss of control of advanced biofuel facilities and production. (a) Contract succession. An entity who becomes the eligible...

7 CFR 4288.137 - Succession and loss of control of advanced biofuel facilities and production.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Succession and loss of control of advanced biofuel... PROGRAMS Advanced Biofuel Payment Program General Provisions Payment Provisions § 4288.137 Succession and loss of control of advanced biofuel facilities and production. (a) Contract succession. An entity who...

7 CFR 4288.137 - Succession and loss of control of advanced biofuel facilities and production.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Succession and loss of control of advanced biofuel... PROGRAMS Advanced Biofuel Payment Program General Provisions § 4288.137 Succession and loss of control of advanced biofuel facilities and production. (a) Contract succession. An entity who becomes the eligible...

Comparison of weight loss by weight classification in a commercial, community-based weight loss program

USDA-ARS?s Scientific Manuscript database

The objective of our study was to determine the impact of grade of obesity on weight-loss outcomes of a community-based, intensive behavioral counseling program (Weight Watchers Points-Plus). Previous studies have shown that individuals with a higher body mass index (BMI) at the beginning of treatme...

Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile

PubMed Central

Swisher, Anne K.; Abraham, Jame; Bonner, Daniel; Gilleland, Diana; Hobbs, Gerald; Kurian, Sobha; Yanosik, Mary Anne; Vona-Davis, Linda

2015-01-01

Purpose Regular exercise and healthy eating are routinely recommended for breast cancer survivors, and past studies show benefits in quality of life and decreased inflammation. However, this has not been testing specifically in triple-negative breast cancer survivors. Increasing physical activity and losing body fat are thought to positively affect inflammatory biomarkers that have been associated with breast cancer. Therefore, the primary purpose of this study was to determine if participation in an exercise and dietary counseling program can improve body fat, physical function, and quality of life in survivors of this aggressive breast cancer. Secondarily, we sought to determine if participation in the program had beneficial effects on obesity-related markers of the adipokine profile. Methods Sixty-six survivors of triple-negative breast cancer with BMI >25 were invited to participate. Twenty-eight enrolled and 23 completed the randomized, controlled trial (13 intervention, 10 control). Moderate-intensity aerobic exercise (150 min per week, for 12 weeks) and diet counseling were compared to usual care, education only. The primary outcome of interest was weight loss (body mass, BMI, % fat), and secondary outcomes included physical function (exercise capacity), quality of life (Function After Cancer Therapy—Breast (FACT-B)), cytokines (C-reactive protein (CRP), TNF-α, IL-6), and adipokine profile (leptin, adiponectin, insulin). Results Participants in the program lost more body fat (2.4 % loss vs. 0.4 % gain, p<0.05) than the control group. The intervention group also improved quality of life (FACT-B total score +14 pts) and decreased sedentary time but did not improve peak exercise capacity. The intervention had no effect on serum cytokines and adipokines after 12 weeks in the program. However, serum leptin and adiponectin and their ratio were significantly correlated with BMI in the intervention group (p<0.05). Conclusions Exercise and dietary counseling led to loss of body fat and improved quality of life in survivors of triple-negative breast cancer. BMI was associated with favorable changes in leptin and adiponectin which may reflect a change in adiposity with intervention. Exercise and healthy eating may be equally effective in this high-risk population as in other breast cancer survivors and should be encouraged as a part of a cancer survivorship program. PMID:25724409

Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile.

PubMed

Swisher, Anne K; Abraham, Jame; Bonner, Daniel; Gilleland, Diana; Hobbs, Gerald; Kurian, Sobha; Yanosik, Mary Anne; Vona-Davis, Linda

2015-10-01

Regular exercise and healthy eating are routinely recommended for breast cancer survivors, and past studies show benefits in quality of life and decreased inflammation. However, this has not been tested specifically in triple-negative breast cancer survivors. Increasing physical activity and losing body fat are thought to positively affect inflammatory biomarkers that have been associated with breast cancer. Therefore, the primary purpose of this study was to determine if participation in an exercise and dietary counseling program can improve body fat, physical function, and quality of life in survivors of this aggressive breast cancer. Secondarily, we sought to determine if participation in the program had beneficial effects on obesity-related markers of the adipokine profile. Sixty-six survivors of triple-negative breast cancer with BMI >25 were invited to participate. Twenty-eight enrolled and 23 completed the randomized, controlled trial (13 intervention, 10 control). Moderate-intensity aerobic exercise (150 min per week, for 12 weeks) and diet counseling were compared to usual care, education only. The primary outcome of interest was weight loss (body mass, BMI, % fat), and secondary outcomes included physical function (exercise capacity), quality of life (Function After Cancer Therapy-Breast (FACT-B)), cytokines (C-reactive protein (CRP), TNF-α, IL-6), and adipokine profile (leptin, adiponectin, insulin). Participants in the program lost more body fat (2.4 % loss vs. 0.4 % gain, p < 0.05) than the control group. The intervention group also improved quality of life (FACT-B total score +14 pts) and decreased sedentary time but did not improve peak exercise capacity. The intervention had no effect on serum cytokines and adipokines after 12 weeks in the program. However, serum leptin and adiponectin and their ratio were significantly correlated with BMI in the intervention group (p < 0.05). Exercise and dietary counseling led to loss of body fat and improved quality of life in survivors of triple-negative breast cancer. BMI was associated with favorable changes in leptin and adiponectin which may reflect a change in adiposity with intervention. Exercise and healthy eating may be equally effective in this high-risk population as in other breast cancer survivors and should be encouraged as a part of a cancer survivorship program.

The corrosion behavior of CVI SiC matrix in SiCf/SiC composites under molten fluoride salt environment

NASA Astrophysics Data System (ADS)

Wang, Hongda; Feng, Qian; Wang, Zhen; Zhou, Haijun; Kan, Yanmei; Hu, Jianbao; Dong, Shaoming

2017-04-01

High temperature corrosion behavior and microstructural evolution of designed chemical-vapor-infiltrated SiC matrix in SiC fiber reinforced SiC ceramic matrix composites in 46.5LiF-11.5NaF-42.0KF (mol. %) eutectic salt at 800 °C for various corrosion time was studied. Worse damage was observed as extending the exposure time, with the mass loss ratio increasing from 0.716 wt. % for 50 h to 5.914 wt. % for 500 h. The mass loss rate showed a trend of first decrease and then increase with the extended corrosion exposure. Compared with the near-stoichiometric SiC matrix layers, the O-contained boundaries between deposited matrix layers and the designed Si-rich SiC matrix layers were much less corrosion resistant and preferentially corroded. Liner relationship between the mass loss ratio and the corrosion time obtained from 50 h to 300 h indicated that the corrosion action was reaction-control process. Further corrosion would lead to matrix layer exfoliation and higher mass loss ratio.

7 CFR 760.505 - Application.

Code of Federal Regulations, 2012 CFR

2012-01-01

... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...

7 CFR 760.505 - Application.

Code of Federal Regulations, 2014 CFR

2014-01-01

... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...

7 CFR 760.505 - Application.

Code of Federal Regulations, 2011 CFR

2011-01-01

... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...

7 CFR 760.505 - Application.

Code of Federal Regulations, 2013 CFR

2013-01-01

... date when the loss of trees, bushes, or vines is apparent to the producer. (b) The producer must submit... SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Tree Assistance Program § 760.505 Application. (a) To apply for TAP, a producer that suffered eligible tree, bush, or vine losses that occurred: (1) During...

7 CFR 1493.510 - Payment for loss.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.510 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.500, CCC will determine whether or not a...

7 CFR 1493.510 - Payment for loss.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.510 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.500, CCC will determine whether or not a...

7 CFR 1493.510 - Payment for loss.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.510 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.500, CCC will determine whether or not a...

Teammates and social influence affect weight loss outcomes in a team-based weight loss competition

PubMed Central

Leahey, Tricia M.; Kumar, Rajiv; Weinberg, Brad M.; Wing, Rena R.

2013-01-01

Team-based Internet interventions are increasing in popularity as a way of promoting weight loss in large numbers of individuals. Given that social networks influence health behavior change, this study investigated the effects of teammates and social influence on individual weight loss during a team-based weight loss competition. Shape Up Rhode Island 2009 was a 12-week online program open to adult residents of Rhode Island. Participants joined with a team and competed with other teams on weight loss and/or physical activity. OW/OB individuals (N=3,330; 76%female; age=46.1±10.8; BMI=31.2±5.3kg/m2), representing 987 teams, completed the weight loss program. Multilevel modeling was used to examine whether weight loss clustered among teammates and whether percentage of teammates in the weight loss division and reported teammate influence on weight loss were associated with individual weight outcomes. OW/OB completers reported losing 4.2±3.4% of initial body weight. Weight loss was similar among teammates (ICC=.10, p<.001). Moreover, having a greater percentage of teammates in the weight loss division and reporting higher social influence for weight loss were associated with greater percent weight loss (p’s≤.002). Similarly, achieving a clinically significant (5%) weight loss tended to cluster within teams (ICC=0.09;p<.001) and having more teammates in the weight loss division and higher social influence for weight loss were associated with increased likelihood of achieving a 5% weight loss (OR=1.06; OR=1.20, respectively). These results suggest that teammates affect weight loss outcomes during a team-based intervention. Harnessing and maximizing teammate influence for weight loss may enhance weight losses in large-scale team-based weight loss programs. PMID:22310234

Guideline-concordant weight-loss programs in an urban area are uncommon and difficult to identify through the Internet

PubMed Central

Bloom, Benjamin; Mehta, Ambereen K.; Clark, Jeanne M.; Gudzune, Kimberly A.

2015-01-01

Objective To determine the reliability of Internet-based information on community-based weight-loss programs and grade their degree of concordance with 2013 American Heart Association, American College of Cardiology, and The Obesity Society weight management guidelines. Methods We conducted an online search for weight-loss programs in the Maryland-Washington, DC-Virginia corridor. We performed content analysis to abstract program components from their websites, and then randomly selected 80 programs for a telephone survey to verify this information. We determined reliability of Internet information in comparison with telephone interview responses. Results Of the 191 programs, we graded 1% as high, 8% as moderate, and 91% as low with respect to guideline concordance based on website content. Fifty-two programs participated in the telephone survey (65% response rate). Program intensity, diet, physical activity, and use of behavioral strategies were underreported on websites as compared to description of these activities during phone interview. Within our subsample, we graded 6% of programs as high based on website information, whereas we graded 19% as high after telephone interview. Conclusions Most weight-loss programs in an urban, mid-Atlantic region do not currently offer guideline-concordant practices and fail to disclose key information online, which may make clinician referrals challenging. PMID:26861769

Individual Differences in Auditory Brainstem Response Wave Characteristics

PubMed Central

Jagadeesh, Anoop; Mauermann, Manfred; Ernst, Frauke

2016-01-01

Little is known about how outer hair cell loss interacts with noise-induced and age-related auditory nerve degradation (i.e., cochlear synaptopathy) to affect auditory brainstem response (ABR) wave characteristics. Given that listeners with impaired audiograms likely suffer from mixtures of these hearing deficits and that ABR amplitudes have successfully been used to isolate synaptopathy in listeners with normal audiograms, an improved understanding of how different hearing pathologies affect the ABR source generators will improve their sensitivity in hearing diagnostics. We employed a functional model for human ABRs in which different combinations of hearing deficits were simulated and show that high-frequency cochlear gain loss steepens the slope of the ABR Wave-V latency versus intensity and amplitude versus intensity curves. We propose that grouping listeners according to a ratio of these slope metrics (i.e., the ABR growth ratio) might offer a way to factor out the outer hair cell loss deficit and maximally relate individual differences for constant ratios to other peripheral hearing deficits such as cochlear synaptopathy. We compared the model predictions to recorded click-ABRs from 30 participants with normal or high-frequency sloping audiograms and confirm the predicted relationship between the ABR latency growth curve and audiogram slope. Experimental ABR amplitude growth showed large individual differences and was compared with the Wave-I amplitude, Wave-V/I ratio, or the interwaveI–W latency in the same listeners. The model simulations along with the ABR recordings suggest that a hearing loss profile depicting the ABR growth ratio versus the Wave-I amplitude or Wave-V/I ratio might be able to differentiate outer hair cell deficits from cochlear synaptopathy in listeners with mixed pathologies. PMID:27837052

Incidence loss for fan turbine rotor blade in two-dimensional cascade

NASA Technical Reports Server (NTRS)

Kline, J. F.; Moffitt, T. P.; Stabe, R. G.

1983-01-01

The effect of incidence angle on the aerodynamic performance of a fan turbine rotor blade was investigated experimentally in a two dimensional cascade. The test covered a range of incidence angles from -15 deg to 10 deg and exit ideal critical velocity ratios from 0.75 to 0.95. The principal measurements were blade-surface static pressures and cross-channel survey of exit total pressure, static pressure, and flow angle. Flow adjacent to surfaces was examined using a visualization technique. The results of the investigation include blade-surface velocity distribution and overall kinetic energy loss coefficients for the incidence angles and exit velocity ratios tested. The measured losses are compared with those from a reference core turbine rotor blade and also with two common analytical methods of predicting incidence loss.

Use of plume mapping data to estimate chlorinated solvent mass loss

USGS Publications Warehouse

Barbaro, J.R.; Neupane, P.P.

2006-01-01

Results from a plume mapping study from November 2000 through February 2001 in the sand-and-gravel surficial aquifer at Dover Air Force Base, Delaware, were used to assess the occurrence and extent of chlorinated solvent mass loss by calculating mass fluxes across two transverse cross sections and by observing changes in concentration ratios and mole fractions along a longitudinal cross section through the core of the plume. The plume mapping investigation was conducted to determine the spatial distribution of chlorinated solvents migrating from former waste disposal sites. Vertical contaminant concentration profiles were obtained with a direct-push drill rig and multilevel piezometers. These samples were supplemented with additional ground water samples collected with a minipiezometer from the bed of a perennial stream downgradient of the source areas. Results from the field program show that the plume, consisting mainly of tetrachloroethylene (PCE), trichloroethene (TCE), and cis-1,2-dichloroethene (cis-1,2-DCE), was approximately 670 m in length and 120 m in width, extended across much of the 9- to 18-m thickness of the surficial aquifer, and discharged to the stream in some areas. The analyses of the plume mapping data show that losses of the parent compounds, PCE and TCE, were negligible downgradient of the source. In contrast, losses of cis-1,2-DCE, a daughter compound, were observed in this plume. These losses very likely resulted from biodegradation, but the specific reaction mechanism could not be identified. This study demonstrates that plume mapping data can be used to estimate the occurrence and extent of chlorinated solvent mass loss from biodegradation and assess the effectiveness of natural attenuation as a remedial measure.

The gender gap in mobility: a global cross-sectional study.

PubMed

Mechakra-Tahiri, Samia Djemâa; Freeman, Ellen E; Haddad, Slim; Samson, Elodie; Zunzunegui, Maria Victoria

2012-08-02

Several studies have demonstrated that women have greater mobility disability than men. The goals of this research were: 1) to assess the gender gap in mobility difficulty in 70 countries; 2) to determine whether the gender gap is explained by sociodemographic and health factors; 3) to determine whether the gender gap differs across 6 regions of the world with different degrees of gender equality according to United Nations data. Population-based data were used from the World Health Survey (WHS) conducted in 70 countries throughout the world. 276,647 adults aged 18 years and over were recruited from 6 world regions. Mobility was measured by asking the level of difficulty people had moving around in the last 30 days and then creating a dichotomous measure (no difficulty, difficulty). The human development index and the gender-related development index for each country were obtained from the United Nations Development Program website. Poisson regression with Taylor series linearized variance estimation was used. Women were more likely than men to report mobility difficulty (38% versus 27%, P < 0.0001). The age-adjusted prevalence rate ratio for female gender was 1.35 (95% CI 1.31-1.38). The addition of education, marital status, and urban versus rural setting reduced the prevalence rate ratio to 1.30 (95% CI 1.26-1.33). The addition of the presence of back pain, arthritis, angina, depressive symptoms, and cognitive difficulties further reduced the prevalence rate ratio to 1.12 (95% CI 1.09-1.15). There was statistical interaction on the multiplicative scale between female gender and region (P < 0.01). The Eastern Mediterranean region, which had the greatest loss of human development due to gender inequality, showed the largest gender gap in mobility difficulty, while the Western Pacific region, with the smallest loss of human development due to gender inequality, had the smallest gender gap in mobility difficulty. These are the first world-wide data to examine the gender gap in mobility. Differences in chronic diseases are the main reasons for this gender gap. The gender gap seems to be greater in regions with the largest loss of human development due to gender inequality.

Fat-free mass loss generated with weight loss in overweight and obese adults: What may we expect?

PubMed

Dixon, J B; Lambert, E A; Grima, M; Rice, T; Lambert, G W; Straznicky, N E

2015-01-01

There is concern that intentional weight loss may generate excessive loss of fat-free mass (FFM). Idealists target minimal loss of FFM, while others consider that FFM loss of up to 25% of weight loss is acceptable. In a cross-sectional study of 275 weight-stable, overweight or obese adults, we used whole-body dual-energy X-ray absorptiometry to measure FFM. A range of models was used to estimate the expected ΔFFM/Δweight ratio required to attain the body composition of a weight-stable individual at a lower body mass index (BMI). Higher BMI was associated linearly with higher FFM in men and women. Proportional ΔFFM/Δweight was influenced by sex, BMI and age. Direct scatter plot analysis, quadratic curve fit modelling and linear FFM-BMI modelling provided similar estimates for each model of ΔFFM/Δweight ratio, with 40% for men and 33% for women. These results show that the 25% rule is inappropriate and our estimates are higher than those generally reported after intentional weight loss indicating favourable preservation of FFM. © 2014 John Wiley & Sons Ltd.

A Pilot Randomized Controlled Trial of a Commercial Diet and Exercise Weight Loss Program in Minority Breast Cancer Survivors

PubMed Central

Greenlee, Heather A.; Crew, Katherine D.; Mata, Jennie M.; McKinley, Paula S.; Rundle, Andrew G.; Zhang, Wenfei; Liao, Yuyan; Tsai, Wei Y.; Hershman, Dawn L.

2015-01-01

Objective Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival. As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage, and have higher rates of obesity, effective weight loss strategies are needed. We piloted a randomized, waitlist-controlled, crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic, African American and Afro-Caribbean breast cancer survivors. Design and Methods Women with stage 0– IIIa breast cancer ≥6 months posttreatment, sedentary, and BMI ≥25 kg/m2 were randomized to the immediate arm (IA): 6 months of the Curves program followed by 6 months of observation; or the waitlist control arm (WCA): 6 months of observation followed by 6 months of the Curves program. The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet. Results A total of 42 women enrolled (79% Hispanic, 21% black), mean age 51 (range 32–69) and mean BMI 33.2(±5.9) kg/m2; 91% were retained at month 12. At month 6, women in the IA lost an average 3.3% (±3.5%) of body weight (range: 1.7% gain to 10.6% loss), as compared with 1.8% (±2.9%) weight loss in the WCA (P = 0.04). At month 12, on average women in the IA regained some but not all of the weight lost during the first 6 months (P = 0.02). Conclusions Minority breast cancer survivors were recruited and retained in a weight loss study. Six months of the Curves program resulted in moderate weight loss, but weight loss was not maintained postintervention. Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors. PMID:23505170

A pilot randomized controlled trial of a commercial diet and exercise weight loss program in minority breast cancer survivors.

PubMed

Greenlee, Heather A; Crew, Katherine D; Mata, Jennie M; McKinley, Paula S; Rundle, Andrew G; Zhang, Wenfei; Liao, Yuyan; Tsai, Wei Y; Hershman, Dawn L

2013-01-01

Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival. As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage, and have higher rates of obesity, effective weight loss strategies are needed. We piloted a randomized, waitlist-controlled, crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic, African American and Afro-Caribbean breast cancer survivors. Women with stage 0-IIIa breast cancer ≥ 6 months posttreatment, sedentary, and BMI ≥ 25 kg/m(2) were randomized to the immediate arm (IA): 6 months of the Curves program followed by 6 months of observation; or the waitlist control arm (WCA): 6 months of observation followed by 6 months of the Curves program. The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet. A total of 42 women enrolled (79% Hispanic, 21% black), mean age 51 (range 32-69) and mean BMI 33.2(± 5.9) kg/m(2); 91% were retained at month 12. At month 6, women in the IA lost an average 3.3% (± 3.5%) of body weight (range: 1.7% gain to 10.6% loss), as compared with 1.8% (± 2.9%) weight loss in the WCA (P = 0.04). At month 12, on average women in the IA regained some but not all of the weight lost during the first 6 months (P = 0.02). Minority breast cancer survivors were recruited and retained in a weight loss study. Six months of the Curves program resulted in moderate weight loss, but weight loss was not maintained postintervention. Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors. Copyright © 2013 The Obesity Society.

Effect of Storage Temperature on Quality of Frozen Horse-mackerel

NASA Astrophysics Data System (ADS)

Kozima, Tsuneo; Ohtaka, Tateo

Quality change of frozen horse-mackerel were studied under storage temperature at -18, -23, -30 and -40°C for 12 months. Quality were measured with K value (Freshness index of muscle, degradation ratio of ATP), amount of drip (free and expressible drip), water-holdiog capacity, weight ratio of cooking loss, organoleptic test, and histological feature of muscle. K value, a mount of free drip, w eight ratio of cooking loss, histological feature of muscle, and organoleptic test in color, form and flavor were not detected any changes during frozen storage for 12 months at various temperature. However expressible drip, water-holding capacity and score of taste in organoleptic test showed some changes after 8 or 12 months at -18 and/or -23°C, it was not serious change to-loss quality as food. Frozen horse-mackerel can store under below ~ 18°C for 12 months.

Polarized Nuclei in a Simple Mirror Fusion Reactor

NASA Technical Reports Server (NTRS)

Noever, David A.

1995-01-01

The possibility of enhancing the ratio of output to input power Q in a simple mirror machine by polarizing Deuterium-Tritium (D- T) nuclei is evaluated. Taking the Livermore mirror reference design mirror ratio of 6.54, the expected sin(sup 2) upsilon angular distribution of fusion decay products reduces immediate losses of alpha particles to the loss cone by 7.6% and alpha-ion scattering losses by approx. 50%. Based on these findings, alpha- particle confinement times for a polarized plasma should therefore be 1.11 times greater than for isotropic nuclei. Coupling this enhanced alpha-particle heating with the expected greater than 50% D- T reaction cross section, a corresponding power ratio for polarized nuclei, Q(sub polarized), is found to be 1.63 times greater than the classical unpolarized value Q(sub classical). The effects of this increase in Q are assessed for the simple mirror.

Optimization of gear ratio and power distribution for a multimotor powertrain of an electric vehicle

NASA Astrophysics Data System (ADS)

Urbina Coronado, Pedro Daniel; Orta Castañón, Pedro; Ahuett-Garza, Horacio

2018-02-01

The architecture and design of the propulsion system of electric vehicles are highly important for the reduction of energy losses. This work presents a powertrain composed of four electric motors in which each motor is connected with a different gear ratio to the differential of the rear axle. A strategy to reduce energy losses is proposed, in which two phases are applied. Phase 1 uses a divide-and-conquer approach to increase the overall output efficiency by obtaining the optimal torque distribution for the electric motors. Phase 2 applies a genetic algorithm to find the optimal value of the gear ratios, in which each individual of each generation applies Phase 1. The results show an optimized efficiency map for the output torque and speed of the powertrain. The increase in efficiency and the reduction of energy losses are validated by the use of numerical experiments in various driving cycles.

Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching

PubMed Central

Michaelides, Andreas; Raby, Christine; Wood, Meghan; Farr, Kit

2016-01-01

Objective To evaluate the weight loss efficacy of a novel mobile platform delivering the Diabetes Prevention Program. Research Design and Methods 43 overweight or obese adult participants with a diagnosis of prediabetes signed-up to receive a 24-week virtual Diabetes Prevention Program with human coaching, through a mobile platform. Weight loss and engagement were the main outcomes, evaluated by repeated measures analysis of variance, backward regression, and mediation regression. Results Weight loss at 16 and 24 weeks was significant, with 56% of starters and 64% of completers losing over 5% body weight. Mean weight loss at 24 weeks was 6.58% in starters and 7.5% in completers. Participants were highly engaged, with 84% of the sample completing 9 lessons or more. In-app actions related to self-monitoring significantly predicted weight loss. Conclusions Our findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management. PMID:27651911

Smartphone applications to support weight loss: current perspectives

PubMed Central

Pellegrini, Christine A; Pfammatter, Angela F; Conroy, David E; Spring, Bonnie

2015-01-01

Lower cost alternatives are needed for the traditional in-person behavioral weight loss programs to overcome challenges of lowering the worldwide prevalence of overweight and obesity. Smartphones have become ubiquitous and provide a unique platform to aid in the delivery of a behavioral weight loss program. The technological capabilities of a smartphone may address certain limitations of a traditional weight loss program, while also reducing the cost and burden on participants, interventionists, and health care providers. Awareness of the advantages smartphones offer for weight loss has led to the rapid development and proliferation of weight loss applications (apps). The built-in features and the mechanisms by which they work vary across apps. Although there are an extraordinary number of a weight loss apps available, most lack the same magnitude of evidence-based behavior change strategies typically used in traditional programs. As features develop and new capabilities are identified, we propose a conceptual model as a framework to guide the inclusion of features that can facilitate behavior change and lead to reductions in weight. Whereas the conventional wisdom about behavior change asserts that more is better (with respect to the number of behavior change techniques involved), this model suggests that less may be more because extra techniques may add burden and adversely impact engagement. Current evidence is promising and continues to emerge on the potential of smartphone use within weight loss programs; yet research is unable to keep up with the rapidly improving smartphone technology. Future studies are needed to refine the conceptual model’s utility in the use of technology for weight loss, determine the effectiveness of intervention components utilizing smartphone technology, and identify novel and faster ways to evaluate the ever-changing technology. PMID:26236766

Loss to Follow-Up: Issues and Recommendations

ERIC Educational Resources Information Center

Hoffman, Jeff; Munoz, Karen F.; Bradham, Tamala S.; Nelson, Lauri

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Related to how EHDI programs address loss to follow-up, 47 coordinators responded with 277 items, and themes were identified in each…

77 FR 19682 - Proposed Information Collection; Wolf Livestock Demonstration Project Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

...-FF09E30000] Proposed Information Collection; Wolf Livestock Demonstration Project Grant Program AGENCY: Fish... Interior and the Secretary of Agriculture to develop a Wolf Livestock Demonstration Project Grant Program... of livestock loss due to predation by wolves; and Compensate livestock producers for livestock losses...

Design and Methods of a Synchronous Online Motivational Interviewing Intervention for Weight Management

PubMed Central

DiLillo, Vicki; Ingle, Krista; Harvey, Jean Ruth; West, Delia Smith

2016-01-01

Background While Internet-based weight management programs can facilitate access to and engagement in evidence-based lifestyle weight loss programs, the results have generally not been as effective as in-person programs. Furthermore, motivational interviewing (MI) has shown promise as a technique for enhancing weight loss outcomes within face-to-face programs. Objective This paper describes the design, intervention development, and analysis of a therapist-delivered online MI intervention for weight loss in the context of an online weight loss program. Methods The MI intervention is delivered within the context of a randomized controlled trial examining the efficacy of an 18-month, group-based, online behavioral weight control program plus individually administered, synchronous online MI sessions relative to the group-based program alone. Six individual 30-minute MI sessions are conducted in private chat rooms over 18 months by doctoral-level psychologists. Sessions use a semistructured interview format for content and session flow and incorporate core MI components (eg, collaborative agenda setting, open-ended questions, reflective listening and summary statements, objective data, and a focus on evoking and amplifying change talk). Results The project was funded in 2010 and enrollment was completed in 2012. Data analysis is currently under way and the first results are expected in 2016. Conclusions This is the first trial to test the efficacy of a synchronous online, one-on-one MI intervention designed to augment an online group behavioral weight loss program. If the addition of MI sessions proves to be successful, this intervention could be disseminated to enhance other distance-based weight loss interventions. Trial Registration Clinicaltrials.gov NCT01232699; https://clinicaltrials.gov/ct2/show/NCT01232699 PMID:27095604

One-year effectiveness of two hypocaloric diets with different protein/carbohydrate ratios in weight loss and insulin resistance.

PubMed

Calleja Fernández, A; Vidal Casariego, A; Cano Rodríguez, I; Ballesteros Pomar, Ma D

2012-01-01

The maintenance of weight loss may be influenced by the distribution of macronutrients in the diet and insulin sensitivity. The objective of the study was to evaluate the longterm effect of two hypocaloric diets with different protein/carbohydrate ratios in overweight and obese individuals either with insulin resistance (IR) or without insulin resistance (IS). Prospective, randomized, clinical intervention study. Forty patients were classified as IR/IS after a 75 g oral glucose tolerance test and then randomized to a diet with either 40% carbohydrate/30% protein/30% fat (diet A) or 55% carbohydrate/15% protein/30% fat (diet B). After one year of follow-up there was no difference in weight loss between diets A and B in each group, but the IS group maintained weight loss better than the IR group [-5.7 (3.9) vs. -0.6 (4.1); P = 0.04]. No differences were found in either Homeostasis Model Assessment (HOMA) or other metabolic glucose parameters except lower insulin at 120 minutes with diet A [21.40 (8.30) vs. 71.40 (17.11); P = 0.02]. The hypocaloric diets with different protein/carbohydrate ratios produced similar changes in weight. Insulin resistance may play a negative role in maintaining weight loss.

Societal-level Risk Factors Associated with Pediatric Hearing Loss: A Systematic Review

PubMed Central

Vasconcellos, Adam P.; Colello, Stephanie; Kyle, Meghann E.; Shin, Jennifer J.

2015-01-01

Objective To determine if the current body of evidence describes specific threshold values of concern for modifiable societal-level risk factors for pediatric hearing loss, with the overarching goal of providing actionable guidance for the prevention and screening of audiological deficits in children. Data Sources Three related systematic reviews were performed. Computerized PubMed, Embase, and Cochrane Library searches were performed from inception through October 2013 and were supplemented with manual searches. Review Methods Inclusion/exclusion criteria were designed to determine specific threshold values of societal-level risk factors on hearing loss in the pediatric population. Searches and data extraction were performed by independent reviewers. Results There were 20 criterion-meeting studies with 29,128 participants. Infants less than 2 standard deviations below standardized weight, length, or body mass index were at increased risk. Specific nutritional deficiencies related to iodine and thiamine may also increase risk, although data are limited and threshold values of concern have not been quantified. Blood lead levels above 10 μg/dL were significantly associated with pediatric sensorineural loss, and mixed findings were noted for other heavy metals. Hearing loss was also more prevalent among children of socioeconomically disadvantaged families, as measured by a poverty income ratio less than 0.3 to 1, higher deprivation category status, and head of household employment as a manual laborer. Conclusions Increasing our understanding of specific thresholds of risk associated with causative factors forms the foundation for preventive and targeted screening programs as well as future research endeavors. PMID:24671458

Societal-level Risk Factors Associated with Pediatric Hearing Loss: A Systematic Review.

PubMed

Vasconcellos, Adam P; Colello, Stephanie; Kyle, Meghann E; Shin, Jennifer J

2014-07-01

To determine if the current body of evidence describes specific threshold values of concern for modifiable societal-level risk factors for pediatric hearing loss, with the overarching goal of providing actionable guidance for the prevention and screening of audiological deficits in children. Three related systematic reviews were performed. Computerized PubMed, Embase, and Cochrane Library searches were performed from inception through October 2013 and were supplemented with manual searches. Inclusion/exclusion criteria were designed to determine specific threshold values of societal-level risk factors on hearing loss in the pediatric population. Searches and data extraction were performed by independent reviewers. There were 20 criterion-meeting studies with 29,128 participants. Infants less than 2 standard deviations below standardized weight, length, or body mass index were at increased risk. Specific nutritional deficiencies related to iodine and thiamine may also increase risk, although data are limited and threshold values of concern have not been quantified. Blood lead levels above 10 µg/dL were significantly associated with pediatric sensorineural loss, and mixed findings were noted for other heavy metals. Hearing loss was also more prevalent among children of socioeconomically disadvantaged families, as measured by a poverty income ratio less than 0.3 to 1, higher deprivation category status, and head of household employment as a manual laborer. Increasing our understanding of specific thresholds of risk associated with causative factors forms the foundation for preventive and targeted screening programs as well as future research endeavors. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Lifestyle change and mobility in obese adults with type 2 diabetes.

PubMed

Rejeski, W Jack; Ip, Edward H; Bertoni, Alain G; Bray, George A; Evans, Gina; Gregg, Edward W; Zhang, Qiang

2012-03-29

Adults with type 2 diabetes mellitus often have limitations in mobility that increase with age. An intensive lifestyle intervention that produces weight loss and improves fitness could slow the loss of mobility in such patients. We randomly assigned 5145 overweight or obese adults between the ages of 45 and 74 years with type 2 diabetes to either an intensive lifestyle intervention or a diabetes support-and-education program; 5016 participants contributed data. We used hidden Markov models to characterize disability states and mixed-effects ordinal logistic regression to estimate the probability of functional decline. The primary outcome was self-reported limitation in mobility, with annual assessments for 4 years. At year 4, among 2514 adults in the lifestyle-intervention group, 517 (20.6%) had severe disability and 969 (38.5%) had good mobility; the numbers among 2502 participants in the support group were 656 (26.2%) and 798 (31.9%), respectively. The lifestyle-intervention group had a relative reduction of 48% in the risk of loss of mobility, as compared with the support group (odds ratio, 0.52; 95% confidence interval, 0.44 to 0.63; P<0.001). Both weight loss and improved fitness (as assessed on treadmill testing) were significant mediators of this effect (P<0.001 for both variables). Adverse events that were related to the lifestyle intervention included a slightly higher frequency of musculoskeletal symptoms at year 1. Weight loss and improved fitness slowed the decline in mobility in overweight adults with type 2 diabetes. (Funded by the Department of Health and Human Services and others; ClinicalTrials.gov number, NCT00017953.).

Loss of pace capture after radiofrequency application predicts the formation of uniform transmural lesions.

PubMed

Kosmidou, Ioanna; Houde-Walter, Haley; Foley, Lori; Michaud, Gregory

2013-04-01

Lesion transmurality is critical to procedural success in radiofrequency catheter ablation. We sought to determine whether loss of pace capture (PC) with high-output unipolar and/or bipolar pacing predicts the formation of uniform transmural lesions. Ten juvenile swine were anaesthetized and prepped under sterile conditions. Seventy-seven isolated radiofrequency applications (RFAs) using a 3.5 mm tip-irrigated catheter were available for analysis. Pace capture was assessed before and after RFA at 10 mA/2 ms and catheter stability verified with a three-dimensional mapping system. Pace capture was defined as 1 : 1 or intermittent local capture per paced beat. Myocardial contact and catheter orientation were assessed using intracardiac echo. Endocardial and epicardial lesion areas were measured after sacrifice using 2,3,5-triphenyltetrazolium chloride staining. A uniform transmural lesion was defined as an epicardial-to-endocardial surface ratio (epi/endo) ≥ 76%. Seventy-four per cent of lesions were transmural and 55.8% of lesions had an epi/endo ratio ≥ 76%. In all, 79.2% of lesions associated with loss of bipolar PC were uniform whereas 20.8% of lesions with loss of bipolar PC were non-uniform (P = 0.006). Loss of bipolar PC was associated with higher mean epicardial/endocardial ratio compared with lesions with persistent PC (P = 0.019). Echocardiographic evidence of optimal catheter contact during RFA improved the predictive accuracy of uniform lesion formation when loss of bipolar PC was noted after RFA. Loss of bipolar PC after RFA is associated with the formation of uniform lesions in atrial tissue. Optimal catheter contact further improves the predictive accuracy associated with loss of PC.

Beneficial Effects of a Dietary Weight Loss Intervention on Human Gut Microbiome Diversity and Metabolism Are Not Sustained during Weight Maintenance.

PubMed

Heinsen, Femke-Anouska; Fangmann, Daniela; Müller, Nike; Schulte, Dominik M; Rühlemann, Malte C; Türk, Kathrin; Settgast, Ute; Lieb, Wolfgang; Baines, John F; Schreiber, Stefan; Franke, Andre; Laudes, Matthias

2016-01-01

In the present study, we examined the effect of a very low-calorie diet(VLCD)-based obesity program on human gut microbiome diversity and metabolism during weight loss and weight maintenance. Obese subjects underwent 3 months of VLCD followed by 3 months of weight maintenance. A lean and an obese control group were included. The microbiome was characterized by performing high-throughput dual-indexed 16S rDNA amplicon sequencing. At baseline, a significant difference in the Firmicutes/Bacteroidetes ratio between the lean and obese individuals was observed (p = 0.047). The VLCD resulted in significant alterations in gut microbiome diversity from baseline to 3 months (p = 0.0053). Acinetobacter represented an indicator species for the observed effect (indicator value = 0.998, p = 0.006). Metabolic analyses revealed alterations of the bacterial riboflavin pathway from baseline to 3 months (pnom = 0.0078). These changes in diversity and bacterial metabolism induced by VLCD diminished during the weight maintenance phase, despite sustained reductions in body weight and sustained improvements of insulin sensitivity. The present data show that a VLCD is able to beneficially alter both gut microbiome diversity and metabolism in obese humans, but that these changes are not sustained during weight maintenance. This finding might suggest that the microbiome should be targeted during obesity programs. © 2016 The Author(s) Published by S. Karger GmbH, Freiburg.

Grid-Optimization Program for Photovoltaic Cells

NASA Technical Reports Server (NTRS)

Daniel, R. E.; Lee, T. S.

1986-01-01

CELLOPT program developed to assist in designing grid pattern of current-conducting material on photovoltaic cell. Analyzes parasitic resistance losses and shadow loss associated with metallized grid pattern on both round and rectangular solar cells. Though performs sensitivity studies, used primarily to optimize grid design in terms of bus bar and grid lines by minimizing power loss. CELLOPT written in APL.

Effects of Plant Functional Group Loss on Soil Microbial Community and Litter Decomposition in a Steppe Vegetation.

PubMed

Xiao, Chunwang; Zhou, Yong; Su, Jiaqi; Yang, Fan

2017-01-01

Globally, many terrestrial ecosystems are experiencing a rapid loss of biodiversity. Continued improvements in our understanding of interrelationships between plant diversity and soil microbes are critical to address the concern over the consequences of the decline in biodiversity on ecosystem functioning and services. By removing forbs, or grasses, or, to an extreme scenario, both forbs and grasses in a steppe vegetation in Inner Mongolia, we studied how plant functional group (PFG) loss affects soil microbial community composition using phospholipid fatty acid analysis (PLFA) and litter decomposition using a litter-bag method. PFG loss significantly decreased above- and below-ground plant biomass, soil microbial biomass carbon (SMBC) and nitrogen (SMBN), but had no effect on the ratio of SMBC to SMBN. Although the ratio of fungal to bacterial PLFAs remained unaffected, PFG loss significantly reduced the amount of bacterial, fungal, and total PLFAs. PFG loss decreased litter monthly mass loss and decay constant, and such decrease was significant when both forbs and grasses were removed. Our results provide robust evidence that PFG loss in grassland ecosystem can lead to a rapid response of soil microbial activity which may affect litter decomposition and soil nutrient cycling, suggesting that the assessment of plant-microbe interactions in soils is an integral component of ecosystem response to biodiversity loss.

An evaluation of a weight-loss program incorporating E-learning for obese junior high school students.

PubMed

Hung, Sheng-Hui; Hwang, Shiow-Li; Su, Mei-Ju; Lue, Shih-Ho; Hsu, Chien-Yeh; Chen, Hsiao-Lien; Chen, Heng-Shuen

2008-10-01

Obesity in adolescents is continuing to rise at an alarming rate and is becoming an important public health problem in Taiwan. Therefore, the aims of this study were (1) to evaluate the effectiveness of a Weight-loss E-learning Program (WEP) on obese Chinese adolescents and (2) to gauge this group's satisfaction with the WEP. The design was quasi-experimental, using purposive samples from two junior high schools in Taipei, Taiwan. Obese adolescents between 12 and 14 years of age with body mass indexes (BMI) over 25 kg/m2 were recruited. A 14-week WEP was developed to expedite weight loss for the selected adolescents. Data such as BMI, waist-to-hip ratio, waist circumference, hip circumference, mid-arm circumference, triceps skinfold, blood pressure, and physical fitness were collected through standardized instruments and methods before and after the WEP. The satisfaction of the subjects and four psychosocial variables were evaluated and taken into account by authoritative scales and questionnaires. In total, 37 adolescents participated in this study. After the WEP, we found significant decreases in BMI (p < 0.05), waist circumference (p < 0.05), and triceps skinfold (p < 0.001) in the sample population. Improvements were found in three of four tests of physical fitness (p < 0.001, p < 0.05, and p < 0.01, respectively). All psychosocial variables showed significant favorable changes (p < 0.01 for self-esteem scores, p < 0.001 for the other three variables) and satisfaction levels for the WEP ranged from 56.6% to 83.8% in four different criteria. The WEP was effective in helping obese Chinese adolescents lose weight. However, there is still room for improvement.

Evaluation of the carotid artery stenosis based on minimization of mechanical energy loss of the blood flow.

PubMed

Sia, Sheau Fung; Zhao, Xihai; Li, Rui; Zhang, Yu; Chong, Winston; He, Le; Chen, Yu

2016-11-01

Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss. Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss. We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

An 8-week web-based weight loss challenge with celebrity endorsement and enhanced social support: observational study.

PubMed

Hutchesson, Melinda J; Collins, Clare E; Morgan, Philip J; Callister, Robin

2013-07-04

Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC's Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (-500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Using GLMM, including weight data for all participants, there was significantly greater (P=.03) 8-week weight loss in SC (-5.1 kg [-5.5 to -4.6 kg] or -6.0%) compared to BLC participants (-4.5 kg [-4.8, -4.2] or -5.0%). Dropout rates were low and consistent across groups (BLC: 17 (1.8%) vs SC: 2 (0.5%), P=.08) and 48.7% (456/936) of BLC and 51.2% (184/379) of SC participants accessed the website at 8 weeks, with no difference between programs (P=.48). SC participants accessed the discussion forums, menu plans, exercise plans, and educational materials significantly more than BLC participants (P<.05). Using a short-term challenge with persuasive features, including online social support with endorsement by a celebrity personal trainer, as well as a greater energy balance deficit, within a commercial Web-based weight loss program may facilitate greater initial weight loss and engagement with some program components. The results support the need for a more rigorous and prospective evaluation of Web-based weight loss programs that incorporate additional strategies to enhance initial weight loss and engagement, such as a short-term challenge.

An 8-Week Web-Based Weight Loss Challenge With Celebrity Endorsement and Enhanced Social Support: Observational Study

PubMed Central

Collins, Clare E; Morgan, Philip J; Callister, Robin

2013-01-01

Background Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. Objective To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. Methods De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC’s Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (–500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Results Using GLMM, including weight data for all participants, there was significantly greater (P=.03) 8-week weight loss in SC (–5.1 kg [–5.5 to –4.6 kg] or –6.0%) compared to BLC participants (–4.5 kg [–4.8, –4.2] or –5.0%). Dropout rates were low and consistent across groups (BLC: 17 (1.8%) vs SC: 2 (0.5%), P=.08) and 48.7% (456/936) of BLC and 51.2% (184/379) of SC participants accessed the website at 8 weeks, with no difference between programs (P=.48). SC participants accessed the discussion forums, menu plans, exercise plans, and educational materials significantly more than BLC participants (P<.05). Conclusions Using a short-term challenge with persuasive features, including online social support with endorsement by a celebrity personal trainer, as well as a greater energy balance deficit, within a commercial Web-based weight loss program may facilitate greater initial weight loss and engagement with some program components. The results support the need for a more rigorous and prospective evaluation of Web-based weight loss programs that incorporate additional strategies to enhance initial weight loss and engagement, such as a short-term challenge. PMID:23827796

Innovation in weight loss programs: a 3-dimensional virtual-world approach.

PubMed

Johnston, Jeanne D; Massey, Anne P; Devaneaux, Celeste A

2012-09-20

The rising trend in obesity calls for innovative weight loss programs. While behavioral-based face-to-face programs have proven to be the most effective, they are expensive and often inaccessible. Internet or Web-based weight loss programs have expanded reach but may lack qualities critical to weight loss and maintenance such as human interaction, social support, and engagement. In contrast to Web technologies, virtual reality technologies offer unique affordances as a behavioral intervention by directly supporting engagement and active learning. To explore the effectiveness of a virtual-world weight loss program relative to weight loss and behavior change. We collected data from overweight people (N = 54) participating in a face-to-face or a virtual-world weight loss program. Weight, body mass index (BMI), percentage weight change, and health behaviors (ie, weight loss self-efficacy, physical activity self-efficacy, self-reported physical activity, and fruit and vegetable consumption) were assessed before and after the 12-week program. Repeated measures analysis was used to detect differences between groups and across time. A total of 54 participants with a BMI of 32 (SD 6.05) kg/m(2)enrolled in the study, with a 13% dropout rate for each group (virtual world group: 5/38; face-to-face group: 3/24). Both groups lost a significant amount of weight (virtual world: 3.9 kg, P < .001; face-to-face: 2.8 kg, P = .002); however, no significant differences between groups were detected (P = .29). Compared with baseline, the virtual-world group lost an average of 4.2%, with 33% (11/33) of the participants losing a clinically significant (≥5%) amount of baseline weight. The face-to-face group lost an average of 3.0% of their baseline weight, with 29% (6/21) losing a clinically significant amount. We detected a significant group × time interaction for moderate (P = .006) and vigorous physical activity (P = .008), physical activity self-efficacy (P = .04), fruit and vegetable consumption (P = .007), and weight loss self-efficacy (P < .001). Post hoc paired t tests indicated significant improvements across all of the variables for the virtual-world group. Overall, these results offer positive early evidence that a virtual-world-based weight loss program can be as effective as a face-to-face one relative to biometric changes. In addition, our results suggest that a virtual world may be a more effective platform to influence meaningful behavioral changes and improve self-efficacy.

Innovation in Weight Loss Programs: A 3-Dimensional Virtual-World Approach

PubMed Central

Massey, Anne P; DeVaneaux, Celeste A

2012-01-01

Background The rising trend in obesity calls for innovative weight loss programs. While behavioral-based face-to-face programs have proven to be the most effective, they are expensive and often inaccessible. Internet or Web-based weight loss programs have expanded reach but may lack qualities critical to weight loss and maintenance such as human interaction, social support, and engagement. In contrast to Web technologies, virtual reality technologies offer unique affordances as a behavioral intervention by directly supporting engagement and active learning. Objective To explore the effectiveness of a virtual-world weight loss program relative to weight loss and behavior change. Methods We collected data from overweight people (N = 54) participating in a face-to-face or a virtual-world weight loss program. Weight, body mass index (BMI), percentage weight change, and health behaviors (ie, weight loss self-efficacy, physical activity self-efficacy, self-reported physical activity, and fruit and vegetable consumption) were assessed before and after the 12-week program. Repeated measures analysis was used to detect differences between groups and across time. Results A total of 54 participants with a BMI of 32 (SD 6.05) kg/m2 enrolled in the study, with a 13% dropout rate for each group (virtual world group: 5/38; face-to-face group: 3/24). Both groups lost a significant amount of weight (virtual world: 3.9 kg, P < .001; face-to-face: 2.8 kg, P = .002); however, no significant differences between groups were detected (P = .29). Compared with baseline, the virtual-world group lost an average of 4.2%, with 33% (11/33) of the participants losing a clinically significant (≥5%) amount of baseline weight. The face-to-face group lost an average of 3.0% of their baseline weight, with 29% (6/21) losing a clinically significant amount. We detected a significant group × time interaction for moderate (P = .006) and vigorous physical activity (P = .008), physical activity self-efficacy (P = .04), fruit and vegetable consumption (P = .007), and weight loss self-efficacy (P < .001). Post hoc paired t tests indicated significant improvements across all of the variables for the virtual-world group. Conclusions Overall, these results offer positive early evidence that a virtual-world-based weight loss program can be as effective as a face-to-face one relative to biometric changes. In addition, our results suggest that a virtual world may be a more effective platform to influence meaningful behavioral changes and improve self-efficacy. PMID:22995535

Defense Contracting: Key Data Not Routinely Used in Progress Payment Reviews

DTIC Science & Technology

1992-01-14

the amount of pay- By .ments based on the fair value of undelivered work. Contractors may Distibtion ] submit requests for progress payments monthly and...exceed the Federal Acquisition Regulation limitations. These checks are based on contractor data and include the fair value and the loss ratio tests. The... fair value test is intended to ensure that progress payments for work in process do not exceed the value of that work. The loss ratio test is intended

High extinction ratio and low transmission loss thin-film terahertz polarizer with a tunable bilayer metal wire-grid structure.

PubMed

Huang, Zhe; Parrott, Edward P J; Park, Hongkyu; Chan, Hau Ping; Pickwell-MacPherson, Emma

2014-02-15

A thin-film terahertz polarizer is proposed and realized via a tunable bilayer metal wire-grid structure to achieve high extinction ratios and good transmission. The polarizer is fabricated on top of a thin silica layer by standard micro-fabrication techniques to eliminate the multireflection effects. The tunable alignment of the bilayer aluminum-wire grid structure enables tailoring of the extinction ratio and transmission characteristics. Using terahertz time-domain spectroscopy (THz-TDS), a fabricated polarizer is characterized, with extinction ratios greater than 50 dB and transmission losses below 1 dB reported in the 0.2-1.1 THz frequency range. These characteristics can be improved by further tuning the polarizer parameters such as the pitch, metal film thickness, and lateral displacement.

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

PubMed

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

2015-08-01

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

Modulation of adipocytokines response and weight loss secondary to a hypocaloric diet in obese patients by -55CT polymorphism of UCP3 gene.

PubMed

de Luis, D A; Aller, R; Izaola, O; Sagrado, M G; Conde, R

2008-03-01

Decreased expression or function of UCP3 (uncoupling protein 3) could reduce energy expenditure and increase the storage of energy as fat. Some studies have pointed to a role of UCP3 in the regulation of whole body energy homeostasis, diet induced obesity, and regulation of lipids as metabolic substrates. The C/C genotype of a polymorphism in the UCP3 promoter (-55C-->T) is associated with an increased expression of UCP3 mRNA in muscle. The aim of our study was to investigate the influence of -55CT polymorphism of UCP3 gene on adipocytokines response and weight loss secondary to a hypocaloric diet in obese patients. A population of 107 obese (body mass index >30) nondiabetic outpatients was analyzed in a prospective way. Before and after three months of a hypocaloric diet, an indirect calorimetry, tetrapolar electrical bioimpedance, blood pressure, a serial assessment of nutritional intake with 3-day written food records, and biochemical analysis were performed. The lifestyle modification program consisted of a hypocaloric diet (1520 kcal, 52% of carbohydrates, 25% of lipids and 23% of proteins). The exercise program consisted of aerobic exercise for at least 3 times per week (60 minutes each). The mean age was 49.5+/-34.5 years and the mean BMI 34.5+/-4.8, with 27 males (25.3%) and 80 females (74.7%). Ninety patients (25 males/65 females) (83.6%) had the genotype 55CC (wild group) and 17 patients (2 male/15 females) (16.4%) 55CT (mutant group). The percentage of responders (weight loss) was similar in both groups (wild group: 84.7% vs. mutant group: 81.8%). BMI, weight, fat mass, systolic blood pressure, LDL cholesterol, waist circumference, and waist-to-hip ratio decreased in the wild group and RMR and VO (2) were increased. In the mutant group, BMI and weight decreased. Leptin and IL-6 levels have a significant decrease in the wild group (9.6%: p<0.05) and (30.5%: p<0.05), respectively. Patients with -55CC genotype have a significant decrease in leptin, interleukin 6, BMI, weight, fat mass, systolic blood pressure, LDL cholesterol, waist circumference, waist-to-hip ratio weight, fat mass, and systolic blood pressure.

48 CFR 1819.7211 - Loss of eligibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS NASA Mentor-Protégé Program 1819.7211 Loss of eligibility. (a) If the mentor is suspended or debarred while performing under an approved mentor-protégé agreement, the mentor— (1) May not be reimbursed or take credit for any costs of providing developmental...

PACERS: Platoon Aid for Collective Employment of Robotic Systems

DTIC Science & Technology

2007-08-01

how to program response...were instances when critical pieces of information were omitted. These included how to program the “loss of link” response, where the landing site...there a discussion on how to program response to loss of UDL links? Ask RS Team What was your mission? How did your mission relate to

31 CFR 50.92 - Determination of pro rata share.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INSURANCE PROGRAM Cap on Annual Liability § 50.92 Determination of pro rata share. (a) Pro rata loss... providing property and casualty insurance under the Program if there were no cap on annual liability under... estimates that aggregate insured losses may exceed the cap on annual liability for a Program Year, then...

Multi-component access to a community-based weight loss program: 12 week results

USDA-ARS?s Scientific Manuscript database

The current study examined weight loss between a comprehensive lifestyle modification program (Weight Watchers PointsPlus program) that included three ways to access and a self-help (SH) condition. A total of 293 participants were randomized to either a Weight Watchers condition (WW) (n=148) or a SH...

Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study.

PubMed

McGill, Bronwyn; O'Hara, Blythe J; Grunseit, Anne C; Bauman, Adrian; Osborne, Dale; Lawler, Luke; Phongsavan, Philayrath

2018-02-13

Health insurers worldwide implement financial incentive schemes to encourage health-related behaviours, including to facilitate weight loss. The maintenance of weight loss is a public health challenge, and as non-communicable diseases become more prevalent with increasing age, mid-older adults could benefit from programs which motivate weight loss maintenance. However, little is understood about their perceptions of using financial incentives to maintain weight loss. We used mixed methods to explore the attitudes and views of participants who had completed an Australian weight loss and lifestyle modification program offered to overweight and obese health insurance members with weight-related chronic diseases, about the acceptability and usefulness of different types of financial incentives to support weight loss maintenance. An online survey was completed by 130 respondents (mean age = 64 years); and a further 28 participants (mean age = 65 years) attended six focus groups. Both independent samples of participants supported a formalised maintenance program. Online survey respondents reported that non-cash (85.2%) and cash (77%) incentives would be potentially motivating; but only 40.5% reported that deposit contracts would motivate weight loss maintenance. Results of in-depth discussions found overall low support for any type of financial incentive, but particularly deposit contracts and lotteries. Some participants expressed that improved health was of more value than a monetary incentive and that they felt personally responsible for their own health, which was at odds with the idea of financial incentives. Others suggested ongoing program and peer support as potentially useful for weight loss maintenance. If financial incentives are considered for mid-older Australian adults in the health insurance setting, program planners will need to balance the discordance between participant beliefs about the individual responsibility for health and their desire for external supports to motivate and sustain weight loss maintenance.

Promoting weight control at the worksite: a pilot program of self-motivation using payroll-based incentives.

PubMed

Jeffery, R W; Forster, J L; Snell, M K

1985-03-01

Thirty-six individuals participated in a worksite weight-loss program in which the central component was a self-motivation program of biweekly payroll deductions refunded contingent on meeting self-selected weight-loss goals. Half were assigned to early treatment and the remainder to a delayed treatment control group. Nine additional individuals also enrolled at the time of delayed treatment and were included in descriptive analyses of factors associated with weight loss. Results showed low program attrition over 6 months (6%) and mean weight losses (12.3 lb) that are competitive with those obtained in clinical settings. Although not different at baseline, participants in the delayed treatment group lost more than twice as much weight as those in the early treatment condition. This difference was interpreted as either a strong seasonal effect or a critical mass effect related to the proportion of employees at the worksite participating in the program. We conclude that self-motivation programs for health behavior change using the payroll system as an organization framework offer a promising new methodology for promoting healthful behaviors in work settings.

Choosing a Safe and Successful Weight-Loss Program

MedlinePlus

... For Reporters Meetings & Workshops Follow Us Home Health Information Weight Management Choosing a Safe and Successful Weight-loss Program ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

7 CFR 1416.6 - Limitations on payments and other benefits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Emergency Conservation Program; (4) The Hurricane Indemnity Program, subpart C of part 760 of this title. (i) An applicant's actual loss or actual costs incurred because of losses due to an eligible hurricane...

7 CFR 1416.6 - Limitations on payments and other benefits.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Emergency Conservation Program; (4) The Hurricane Indemnity Program, subpart C of part 760 of this title. (i) An applicant's actual loss or actual costs incurred because of losses due to an eligible hurricane...

7 CFR 1416.6 - Limitations on payments and other benefits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Emergency Conservation Program; (4) The Hurricane Indemnity Program, subpart C of part 760 of this title. (i) An applicant's actual loss or actual costs incurred because of losses due to an eligible hurricane...

7 CFR 1416.6 - Limitations on payments and other benefits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Emergency Conservation Program; (4) The Hurricane Indemnity Program, subpart C of part 760 of this title. (i) An applicant's actual loss or actual costs incurred because of losses due to an eligible hurricane...

7 CFR 1416.6 - Limitations on payments and other benefits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Emergency Conservation Program; (4) The Hurricane Indemnity Program, subpart C of part 760 of this title. (i) An applicant's actual loss or actual costs incurred because of losses due to an eligible hurricane...

Natural hazards research and response; international decade for reducing loss from natural disasters

USGS Publications Warehouse

Hays, W.W.

1992-01-01

IDNDR offers an unprecedented opportunity to apply new knowledge and technology to minimize losses in regions at high risks. The program is very challenging because full implementation requires a multidisciplinary effort on a global scale, an undertaking never before attempted. In concert with the other signatory nations, the Untied States is carrying out a balanced and comprehensive program of research and applications as a contribution to the IDNDR. The U.S program is designed to reduce both loss of life and property damage from natural disasters.  

Weight loss in the healthy elderly might be a non-cognitive sign of preclinical Alzheimer's disease.

PubMed

Jimenez, Amanda; Pegueroles, Jordi; Carmona-Iragui, María; Vilaplana, Eduard; Montal, Victor; Alcolea, Daniel; Videla, Laura; Illán-Gala, Ignacio; Pané, Adriana; Casajoana, Anna; Belbin, Olivia; Clarimón, Jordi; Moizé, Violeta; Vidal, Josep; Lleó, Alberto; Fortea, Juan; Blesa, Rafael

2017-12-01

Weight loss has been proposed as a sign of pre-clinical Alzheimer Disease (AD). To test this hypothesis, we have evaluated the association between longitudinal changes in weight trajectories, cognitive performance, AD biomarker profiles and brain structure in 363 healthy controls from the Alzheimer´s Disease Neuroimaging Initiative (mean follow-up 50.5±30.5 months). Subjects were classified according to body weight trajectory into a weight loss group (WLG; relative weight loss ≥ 5%) and a non-weight loss group (non-WLG; relative weight loss < 5%). Linear mixed effects models were used to estimate the effect of body weight changes on ADAS-Cognitive score across time. Baseline CSF tau/AΔ 42 ratio and AV45 PET uptake were compared between WLG and non-WLG by analysis of covariance. Atrophy maps were compared between groups at baseline and longitudinally at a 2-year follow-up using Freesurfer. WLG showed increased baseline levels of cerebrospinal fluid tau/AΔ 42 ratio, increased PET amyloid uptake and diminished cortical thickness at baseline. WLG also showed faster cognitive decline and faster longitudinal atrophy. Our data support weight loss as a non-cognitive manifestation of pre-clinical AD.

Weight loss in the healthy elderly might be a non-cognitive sign of preclinical Alzheimer's disease

PubMed Central

Carmona-Iragui, María; Vilaplana, Eduard; Montal, Victor; Alcolea, Daniel; Videla, Laura; Illán-Gala, Ignacio; Pané, Adriana; Casajoana, Anna; Belbin, Olivia; Clarimón, Jordi; Moizé, Violeta; Vidal, Josep; Lleó, Alberto; Fortea, Juan; Blesa, Rafael

2017-01-01

Weight loss has been proposed as a sign of pre-clinical Alzheimer Disease (AD). To test this hypothesis, we have evaluated the association between longitudinal changes in weight trajectories, cognitive performance, AD biomarker profiles and brain structure in 363 healthy controls from the Alzheimer´s Disease Neuroimaging Initiative (mean follow-up 50.5±30.5 months). Subjects were classified according to body weight trajectory into a weight loss group (WLG; relative weight loss ≥ 5%) and a non-weight loss group (non-WLG; relative weight loss < 5%). Linear mixed effects models were used to estimate the effect of body weight changes on ADAS-Cognitive score across time. Baseline CSF tau/AΔ42 ratio and AV45 PET uptake were compared between WLG and non-WLG by analysis of covariance. Atrophy maps were compared between groups at baseline and longitudinally at a 2-year follow-up using Freesurfer. WLG showed increased baseline levels of cerebrospinal fluid tau/AΔ42 ratio, increased PET amyloid uptake and diminished cortical thickness at baseline. WLG also showed faster cognitive decline and faster longitudinal atrophy. Our data support weight loss as a non-cognitive manifestation of pre-clinical AD. PMID:29285207

Comparing Weight Loss-Maintenance Outcomes of a Worksite-Based Lifestyle Program Delivered via DVD and Face-to-Face: A Randomized Trial.

PubMed

Ing, Claire Townsend; Miyamoto, Robin E S; Fang, Rui; Antonio, Mapuana; Paloma, Diane; Braun, Kathryn L; Kaholokula, Joseph Keawe'aimoku

2018-03-01

Native Hawaiians and other Pacific Islanders have high rates of overweight and obesity compared with other ethnic groups in Hawai'i. Effective weight loss and weight loss-maintenance programs are needed to address obesity and obesity-related health inequities for this group. Compare the effectiveness of a 9-month, worksite-based, weight loss-maintenance intervention delivered via DVD versus face-to-face in continued weight reduction and weight loss maintenance beyond the initial weight loss phase. We tested DVD versus face-to-face delivery of the PILI@Work Program's 9-month, weight loss-maintenance phase in Native Hawaiian-serving organizations. After completing the 3-month weight loss phase, participants ( n = 217) were randomized to receive the weight loss-maintenance phase delivered via trained peer facilitators or DVDs. Participant assessments at randomization and postintervention included weight, height, blood pressure, physical functioning, exercise frequency, and fat intake. Eighty-three face-to-face participants were retained at 12 months (74.1%) compared with 73 DVD participants (69.5%). There was no significant difference between groups in weight loss or weight loss maintenance. The number of lessons attended in Phase 1 of the intervention (β = 0.358, p = .022) and baseline systolic blood pressure (β = -0.038, p = .048) predicted percent weight loss at 12 months. Weight loss maintenance was similar across groups. This suggests that low-cost delivery methods for worksite-based interventions targeting at-risk populations can help address obesity and obesity-related disparities. Additionally, attendance during the weight loss phase and lower baseline systolic blood pressure predicted greater percent weight loss during the weight loss-maintenance phase, suggesting that early engagement and initial physical functioning improve long-term weight loss outcomes.

PTEN loss and chromosome 8 alterations in Gleason grade 3 prostate cancer cores predicts the presence of un-sampled grade 4 tumor: implications for active surveillance.

PubMed

Trock, Bruce J; Fedor, Helen; Gurel, Bora; Jenkins, Robert B; Knudsen, B S; Fine, Samson W; Said, Jonathan W; Carter, H Ballentine; Lotan, Tamara L; De Marzo, Angelo M

2016-07-01

Men who enter active surveillance because their biopsy exhibits only Gleason grade 3 (G3) frequently have higher grade tumor missed by biopsy. Thus, biomarkers are needed that, when measured on G3 tissue, can predict the presence of higher grade tumor in the whole prostate. We evaluated whether PTEN loss, chromosome 8q gain (MYC) and/or 8p loss (LPL) measured only on G3 cores is associated with un-sampled G4 tumor. A tissue microarray was constructed of prostatectomy tissue from patients whose prostates exhibited only Gleason score 3+3, only 3+4 or only 4+3 tumor (n=50 per group). Cores sampled only from areas of G3 were evaluated for PTEN loss by immunohistochemistry, and PTEN deletion, LPL/8p loss and MYC/8q gain by fluorescence in situ hybridization. Biomarker results were compared between Gleason score 6 vs 7 tumors using conditional logistic regression. PTEN protein loss, odds ratio=4.99, P=0.033; MYC/8q gain, odds ratio=5.36, P=0.010; and LPL/8p loss, odds ratio=3.96, P=0.003 were significantly more common in G3 cores derived from Gleason 7 vs Gleason 6 tumors. PTEN gene deletion was not statistically significant. Associations were stronger comparing Gleason 4+3 vs 6 than for Gleason 3+4 vs 6. MYC/8q gain, LPL/8p loss and PTEN protein loss measured in G3 tissue microarray cores strongly differentiate whether the core comes from a Gleason 6 or Gleason 7 tumor. If validated to predict upgrading from G3 biopsy to prostatectomy these biomarkers could reduce the likelihood of enrolling high-risk men and facilitate safe patient selection for active surveillance.

The importance of Titan's current mass loss processes to understanding the evolution of Titan's atmosphere

NASA Astrophysics Data System (ADS)

Mandt, Kathleen; Waite, J. Hunter, Jr.; Bell, Jared; Mousis, Olivier

2010-04-01

Current isotopic ratios in planetary atmospheres have played an important role in determining how that atmosphere has evolved over geologic time scales (e.g. Donahue et al. 1997, Lunine et al. 1999). The current 12C/13C ratio in methane is a particularly useful indicator of Titan's atmospheric evolutionary history (Mandt et al. 2009). Primordial 12C/13C ratios throughout the solar system are limited to 89.01+4.45-2.67. (Alexander et al. 2007, Martins et al. 2008), while the methane 12C/13C ratio measured by GCMS and CIRS are 82.3+/-1.0 and 76.6+/-2.7 respectively (Niemann et al. 2005, Nixon et al. 2008). This is well below the primordial range, suggesting fractionation of the isotopes by atmospheric processes. A number of atmospheric mass loss processes can fractionate the isotopes over geologic time scales. Photochemistry and escape are of particular importance (Donahue et al 1997, Mandt et al. 2009). Measurements of the 12C/13C ratios in C2 hydrocarbons show evidence of fractionation due to photochemistry (Nixon et al. 2008) that is most likely due to a kinetic isotope effect (KIE). A KIE is a mildly efficient fractionating process in which reactions involving 12C occur 1.04 times faster than reactions involving 13C. A moderate time scale, on the order of 50 to 400 million years, is required to change the 12C/13C ratio of the atmospheric methane inventory. The exact length of this time scale depends directly on the methane photochemical loss rate. Titan's photochemistry is extremely complex, and although the total photochemical loss rate is photon-limited (Lorenz et al. 1997), the literature provides a range of loss rates between 4.9 x 10^9 cm-2s-1 (Wilson and Atreya 2004) and 3.4 x 10^10 cm-2s-1 (Lebonnois et al. 2003). This range can alter the time scale for fractionation in the carbon isotopes by as much as a factor of 8. INMS measurements of the methane 12C/13C ratio in the upper atmosphere show that atmospheric escape is a more efficient fractionating process than photochemistry (Mandt et al. 2009). The literature provides a range of possible values for the methane escape rates that depend on the input parameters to upper atmospheric models (Bell et al. 2010). The escape rate of methane could be as little as 2.75 x 10^7 cm-2s-1 (de la Haye et al. 2007) or as great as 3.0 x 10^9 cm-2s-1 (Yelle et al. 2008). This range of loss rates can alter the time scale for fractionation by as much as a factor of 5. Although the photochemical fractionation is less efficient than the escape rate, variance in its value has a greater impact on the time required to fractionate the isotopes because the magnitude of the photochemical loss is much greater than that of the escape rate. Thus, a better quantification of both mass loss rates is key to understanding the evolutionary history of Titan's atmosphere.

The effect of noise-induced hearing loss on the intelligibility of speech in noise

NASA Astrophysics Data System (ADS)

Smoorenburg, G. F.; Delaat, J. A. P. M.; Plomp, R.

1981-06-01

Speech reception thresholds, both in quiet and in noise, and tone audiograms were measured for 14 normal ears (7 subjects) and 44 ears (22 subjects) with noise-induced hearing loss. Maximum hearing loss in the 4-6 kHz region equalled 40 to 90 dB (losses exceeded by 90% and 10%, respectively). Hearing loss for speech in quiet measured with respect to the median speech reception threshold for normal ears ranged from 1.8 dB to 13.4 dB. For speech in noise the numbers are 1.2 dB to 7.0 dB which means that the subjects with noise-induced hearing loss need a 1.2 to 7.0 dB higher signal-to-noise ratio than normal to understand sentences equally well. A hearing loss for speech of 1 dB corresponds to a decrease in sentence intelligibility of 15 to 20%. The relation between hearing handicap conceived as a reduced ability to understand speech and tone audiogram is discussed. The higher signal-to-noise ratio needed by people with noise-induced hearing loss to understand speech in noisy environments is shown to be due partly to the decreased bandwidth of their hearing caused by the noise dip.

Skylight energy performance and design optimization

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

Arasteh, D.; Johnson, R.; Selkowitz, S.

1984-02-01

Proper skylight utilization can significantly lower energy requirements and peak electrical loads for space conditioning and lighting in commercial buildings. In this study we systematically explore the energy effects of skylight systems in a prototypical office building and examine the savings from daylighting. The DOE-2.1B energy analysis computer program with its newly incorporated daylighting algorithms was used to generate more than 2000 parametric simulations for seven US climates. The parameters varied include skylight-to-roof ratio, shading coefficient, visible transmittance, skylight well light loss, electric lighting power density, roof heat transfer coefficient, and type of electric lighting control. For specific climates wemore » identify roof/skylight characteristics that minimize total energy or peak electrical load requirements.« less

Neural tracking of attended versus ignored speech is differentially affected by hearing loss.

PubMed

Petersen, Eline Borch; Wöstmann, Malte; Obleser, Jonas; Lunner, Thomas

2017-01-01

Hearing loss manifests as a reduced ability to understand speech, particularly in multitalker situations. In these situations, younger normal-hearing listeners' brains are known to track attended speech through phase-locking of neural activity to the slow-varying envelope of the speech. This study investigates how hearing loss, compensated by hearing aids, affects the neural tracking of the speech-onset envelope in elderly participants with varying degree of hearing loss (n = 27, 62-86 yr; hearing thresholds 11-73 dB hearing level). In an active listening task, a to-be-attended audiobook (signal) was presented either in quiet or against a competing to-be-ignored audiobook (noise) presented at three individualized signal-to-noise ratios (SNRs). The neural tracking of the to-be-attended and to-be-ignored speech was quantified through the cross-correlation of the electroencephalogram (EEG) and the temporal envelope of speech. We primarily investigated the effects of hearing loss and SNR on the neural envelope tracking. First, we found that elderly hearing-impaired listeners' neural responses reliably track the envelope of to-be-attended speech more than to-be-ignored speech. Second, hearing loss relates to the neural tracking of to-be-ignored speech, resulting in a weaker differential neural tracking of to-be-attended vs. to-be-ignored speech in listeners with worse hearing. Third, neural tracking of to-be-attended speech increased with decreasing background noise. Critically, the beneficial effect of reduced noise on neural speech tracking decreased with stronger hearing loss. In sum, our results show that a common sensorineural processing deficit, i.e., hearing loss, interacts with central attention mechanisms and reduces the differential tracking of attended and ignored speech. The present study investigates the effect of hearing loss in older listeners on the neural tracking of competing speech. Interestingly, we observed that whereas internal degradation (hearing loss) relates to the neural tracking of ignored speech, external sound degradation (ratio between attended and ignored speech; signal-to-noise ratio) relates to tracking of attended speech. This provides the first evidence for hearing loss affecting the ability to neurally track speech. Copyright © 2017 the American Physiological Society.

Evaluation of a Weight Loss Treatment Program for Individuals with Mild Mental Retardation

ERIC Educational Resources Information Center

Sailer, Angela B.; Miltenberger, Raymond G.; Johnson, Brigitte; Zetocha, Kim; Egemo, Kristin; Hegstad, Holly

2006-01-01

Obesity is a major problem for people in the United States. Individuals with mental retardation also are prone to obesity. The most successful programs for treating obesity typically are treatment packages consisting of multiple behavioral components. Research in the area of weight loss and mental retardation has not evaluated programs for…

Early loss to follow-up and mortality of HIV-infected patients diagnosed after the era of antiretroviral treatment scale up: a call for re-invigorating the response in Iran.

PubMed

Badie, Banafsheh Moradmand; Nabaei, Ghaemeh; Rasoolinejad, Mehrnaz; Mirzazadeh, Ali; McFarland, Willi

2013-12-01

In Iran, the HIV/AIDS epidemic is growing during an era of scaling up the national surveillance system and antiretroviral therapy programs. We examined the early loss to follow-up and mortality rates in a retrospective cohort of 1495 HIV-infected patients by survival proportional hazard Cox model. We also conducted a data abstraction sub-study in a systematic random sample of 147 patients to assess the association between mortality and predictor factors. Overall, 17.3% patients were not seen after their first visit and 17.4% more were lost by 6 months. The overall mortality rate was 7.0 (95% CI 6.1-8.1) per 100 person-years. Moreover, crude mortality rate was higher in men (8.6) than in women (1.7), with an age-adjusted hazard ratio for men compared to women of 4.55 (95% CI 2.31-8.93). Lastly, history of tuberculosis and not being on antiretroviral therapy were significantly associated with higher mortality in the patient sub-sample.

A three-component cognitive behavioural lifestyle program for preconceptional weight-loss in women with polycystic ovary syndrome (PCOS): a protocol for a randomized controlled trial.

PubMed

Jiskoot, G; Benneheij, S H; Beerthuizen, A; de Niet, J E; de Klerk, C; Timman, R; Busschbach, J J; Laven, J S E

2017-03-06

Obesity in women with polycystic ovary syndrome (PCOS) negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Incorporating a healthy diet, increasing physical activity and changing dysfunctional thought patterns in women with PCOS are key points in losing weight. The biggest challenge in weight management programs is to achieve a reasonable and sustainable weight loss. The aim of this study is to explore whether Cognitive Behavioural Therapy (CBT) by a mental health professional, working in a multidisciplinary team with a dietician and a physical therapist (a three-component intervention), is more effective for weight loss in the long term, within 12 months. We will also explore whether mobile phone applications are effective in supporting behavioural change and sustainable weight loss. The present study is a longitudinal randomized controlled trial (RCT) to study the effectiveness of a three-component 1-year cognitive-behavioural lifestyle intervention in overweight/obese women with PCOS. A total of 210 participants are randomly assigned to three groups: 1) CBT provided by the multidisciplinary team or; 2) CBT provided by the multidisciplinary team and Short Message Service (SMS) or; 3) usual care: encourage weight loss through publicly available services (control group). The primary aim of the 12-month intervention is to explore whether a three-component 1-year cognitive-behavioural lifestyle intervention is effective to decrease weight, when compared to usual care. Secondary outcomes include: the effect of the intervention on the PCOS phenotype, waist circumference, waist to hip ratio, ovulation rates, total testosterone, SHBG, free androgen index (FAI), AMH, hirsutism, acne, fasting glucose, blood pressure and all psychological parameters. Additionally, we assessed time to pregnancy, ongoing pregnancies, clinical pregnancies, miscarriages and birth weight. All outcome variables are measured at the start of the study, and again at 3 months, 6 months, nine months and 12 months. We expect that CBT provided by a multidisciplinary team, especially combined with SMS, is effective in developing a healthy lifestyle and achieving a long-term weight loss in women with PCOS. Losing 5- 10% body weight improves various PCOS characteristics. Consequently, we expect to show that CBT provided by a multidisciplinary team improves reproductive and metabolic outcomes, as well as quality of life, while at the same time being cost-effective. Registered at the Netherlands National Trial Register with number NTR2450 on August 2nd, 2010.

Integration of a physical training program in a weight loss plan for overweight pet dogs.

PubMed

Vitger, Anne D; Stallknecht, Bente M; Nielsen, Dorte H; Bjornvad, Charlotte R

2016-01-15

To investigate whether a controlled physical training plan for overweight dogs during a weight loss program would improve cardiorespiratory fitness and better preserve lean body mass, compared with results for dogs undergoing a weight loss program based on caloric restriction alone. Prospective, nonrandomized clinical study. 19 client-owned overweight or obese dogs. All dogs were fed the same calorie-restricted diet rationed to achieve a weight loss rate of 1% to 2%/wk for 12 weeks. The fitness-and-diet (FD) group participated in a training program that included underwater and land-based treadmill exercise 3 times/wk. The diet-only (DO) group had no change in exercise routines. Daily activity before and during the intervention was recorded by accelerometry. Before and after intervention, heart rate during exercise was recorded to assess cardiovascular fitness, and body composition was analyzed by dual-energy x-ray absorptiometry. Differences between groups were evaluated with t tests and multiple regression analysis. Mean weight loss was 13.9% and 12.9% for the FD and DO groups, respectively (n = 8 dogs/group that completed the study). Mean accelerometer counts during intervention were 13% higher than baseline counts for the FD group. Heart rate during exercise declined after intervention in both groups. Lean body mass was preserved in the FD group and lost in the DO group during intervention. The controlled exercise plan used with a dietary weight loss program prevented loss of lean body mass in dogs. This finding supports inclusion of controlled physical training for obesity management in dogs.

Evaluation of a Voluntary Worksite Weight Loss Program on Metabolic Syndrome.

PubMed

Earnest, Conrad P; Church, Timothy S

2015-11-01

Health care costs increase with the presence of metabolic syndrome and present a significant burden to companies throughout the world. Identifying effective behavioral programs within the workplace can reduce health care costs. We examined the effect of a voluntary worksite program on weight loss and metabolic syndrome. Participants (N = 3880, from 93 companies) volunteered within their workplaces to participate in a 10-week weight loss program (Naturally Slim) focused on self-monitoring, eating behaviors, understanding hunger signals, reducing refined carbohydrate and sugar intake, and increasing protein intake to 25%-30%. Primary outcomes included weight loss and metabolic syndrome prevalence. Secondary analyses examined the individual components of metabolic syndrome and a categorical analysis within each World Health Organization body mass index category. Overall, women and men lost 9.4 (-4.8%) and 13.2 pounds (-5.8%), respectively. Each metabolic risk factor for both genders had a significant improvement but men exhibited the largest relative improvement for each risk factor. At baseline, 43% of women and 52% of men presented with metabolic syndrome, which was reduced to 30% in women and 26% in men (P < 0.001 for each) at the conclusion of the program. Secondary analysis demonstrated that individuals with greater baseline levels of metabolic dysfunction had larger metabolic improvements, similar benefits to risk factors across baseline body mass index categories, and the greater the weight loss, the greater the metabolic benefit. Our results demonstrate that a worksite program targeting core behavioral skills associated with weight loss is an effective strategy to reduce weight and improve the components of metabolic syndrome amongst at-risk employees.

Costo-iliac distance: a physical sign of understated importance.

PubMed

Barry, P J; O'Mahony, D

2012-03-01

Osteoporosis is a common condition, especially affecting the older female population. The ability to predict loss of lumbar height using simple anatomical measurements would be a useful tool. Forty subjects were recruited. Mean age was 72 years. Arm span (AS) and the costo-iliac distance (CID) were measured. The CID/AS ratio was calculated. The L(1)-L(4) vertebral height of each patient was obtained from dual-energy X-ray absorptiometry (DEXA). There was a statistically significant correlation between the lumbar height and CID/AS ratio (R (2) = 0.79, p < 0.001). The CID/AS ratio may be a useful bedside test in identifying loss of lumbar vertebral height.

Dietary Intake Can Predict and Protect Against Changes in Bone Metabolism during Spaceflight and Recovery (Pro K)

NASA Technical Reports Server (NTRS)

Smith, Scott M.; Zwart, S. R.; Shackelford, L.; Heer, M.

2009-01-01

Bone loss is not only a well-documented effect of spaceflight on astronauts, but also a condition that affects millions of men and women on Earth each year. Many countermeasures aimed at preventing bone loss during spaceflight have been proposed, and many have been evaluated to some degree. To date, those showing potential have focused on either exercise or pharmacological interventions, but none have targeted dietary intake alone as a factor to predict or minimize bone loss during spaceflight. The "Dietary Intake Can Predict and Protect against Changes in Bone Metabolism during Spaceflight and Recovery" investigation ("Pro K") is one of the first inflight evaluations of a dietary countermeasure to lessen bone loss of astronauts. This protocol will test the hypothesis that the ratio of acid precursors to base precursors (specifically animal protein to potassium) in the diet can predict directional changes in bone mineral during spaceflight and recovery. The ratio of animal protein to potassium in the diet will be controlled for multiple short (4-day) periods before and during flight. Based on multiple sets of bed rest data, we hypothesize that a higher ratio of the intake of animal protein to the intake of potassium will yield higher concentrations of markers of bone resorption and urinary calcium excretion during flight and during recovery from bone mineral loss after long-duration spaceflight.

Industrial hearing conservation.

PubMed

Glorig, A

1979-08-01

Hearing conservation programs, when appropriate in industry, are now a necessity. Even though one may not wish to adopt an altruistic attitude toward the conservation of hearing, one must, like it or not, initiate a hearing conservation program because of both federal and state regulations. Since industrial noise exposure produced more hearing loss in more people than all other causes of hearing loss combined, it is incumbent on all industries with noise makers to do something about protecting human hearing. The tragedy is that nearly all industrial hearing loss can be prevented with proper hearing conservation measures. The cost of hearing conservation is far less than the cost of hearing loss in terms of human suffering and dollars in the compensation courts. Proper education of both managment and labor can result in successful hearing conservation programs. The method of choice is reduction of the noise at the source, but in many cases this is infeasible both technically and economically and therefore protection at the ear must be used. Experience has shown that with proper supervision ear protection programs can prevent the majority of instances of hearing loss in the majority of individuals exposed.

Personal digital assistants are comparable to traditional diaries for dietary self-monitoring during a weight loss program.

PubMed

Yon, Bethany A; Johnson, Rachel K; Harvey-Berino, Jean; Gold, Beth Casey; Howard, Alan B

2007-04-01

Dietary self-monitoring is considered the core of behavioral weight control programs. As software for personal digital assistants (PDA) has become more available, this study investigated whether the use of a PDA would improve dietary self-monitoring frequency and subsequent weight loss over the use of traditional paper diaries. One-hundred-seventy-six adults (BMI 25-39.9) participated in a 6-month behavioral weight control program. Treatment subjects (n = 61) were provided with a PalmZire 21 with Calorie King's Diet Diary software installed. Their self-monitoring habits and weight loss were compared with the results from a previous program (n = 115) which followed the same protocol using paper diaries for self-monitoring. No significant differences in weight loss or dietary self-monitoring were found. More frequent self-monitoring correlated with weight loss in both groups (p<.001). People seeking to lose weight should be encouraged to self-monitor and be matched with a mode of self-monitoring that is fitting to their lifestyle and skills.

Factors associated with interest in novel interfaces for upper limb prosthesis control

PubMed Central

Engdahl, Susannah M.; Chestek, Cynthia A.; Kelly, Brian; Davis, Alicia

2017-01-01

Background Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual’s decision to try one. Methods We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface. Results While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ≤ 0.001, odds ratio ≥ 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ≤ 0.959) and had acquired limb loss (p ≤ 0.012, odds ratio ≥ 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958). Conclusions Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant’s opinions on the interfaces, so additional exploration is warranted. PMID:28767716

Factors associated with interest in novel interfaces for upper limb prosthesis control.

PubMed

Engdahl, Susannah M; Chestek, Cynthia A; Kelly, Brian; Davis, Alicia; Gates, Deanna H

2017-01-01

Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one. We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface. While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ≤ 0.001, odds ratio ≥ 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ≤ 0.959) and had acquired limb loss (p ≤ 0.012, odds ratio ≥ 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958). Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant's opinions on the interfaces, so additional exploration is warranted.

Novel point estimation from a semiparametric ratio estimator (SPRE): long-term health outcomes from short-term linear data, with application to weight loss in obesity.

PubMed

Weissman-Miller, Deborah

2013-11-02

Point estimation is particularly important in predicting weight loss in individuals or small groups. In this analysis, a new health response function is based on a model of human response over time to estimate long-term health outcomes from a change point in short-term linear regression. This important estimation capability is addressed for small groups and single-subject designs in pilot studies for clinical trials, medical and therapeutic clinical practice. These estimations are based on a change point given by parameters derived from short-term participant data in ordinary least squares (OLS) regression. The development of the change point in initial OLS data and the point estimations are given in a new semiparametric ratio estimator (SPRE) model. The new response function is taken as a ratio of two-parameter Weibull distributions times a prior outcome value that steps estimated outcomes forward in time, where the shape and scale parameters are estimated at the change point. The Weibull distributions used in this ratio are derived from a Kelvin model in mechanics taken here to represent human beings. A distinct feature of the SPRE model in this article is that initial treatment response for a small group or a single subject is reflected in long-term response to treatment. This model is applied to weight loss in obesity in a secondary analysis of data from a classic weight loss study, which has been selected due to the dramatic increase in obesity in the United States over the past 20 years. A very small relative error of estimated to test data is shown for obesity treatment with the weight loss medication phentermine or placebo for the test dataset. An application of SPRE in clinical medicine or occupational therapy is to estimate long-term weight loss for a single subject or a small group near the beginning of treatment.

Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women

PubMed Central

Sénéchal, M; Arguin, H; Bouchard, DR; Carpentier, AC; Ardilouze, JL; Dionne, IJ; Brochu, M

2011-01-01

Objective To examine the association between weight gain since menopause and weight regain after a weight loss program. Methods Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. Results All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Conclusion Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women. PMID:21966216

Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women.

PubMed

Sénéchal, M; Arguin, H; Bouchard, D R; Carpentier, A C; Ardilouze, J L; Dionne, I J; Brochu, M

2011-01-01

To examine the association between weight gain since menopause and weight regain after a weight loss program. Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.

Low bioavailable testosterone levels predict future height loss in postmenopausal women.

PubMed

Jassal, S K; Barrett-Connor, E; Edelstein, S L

1995-04-01

The objective of this study was to examine the relation of endogenous sex hormones to subsequent height loss in postmenopausal women, in whom height loss is usually a surrogate for osteoporotic vertebral fractures. This was a prospective, community-based study. The site chosen was Rancho Bernardo, an upper middle class community in Southern California. A total of 170 postmenopausal women participated, aged 55-80 years. None of them were taking exogenous estrogen between 1972 and 1974. Plasma was obtained for sex hormone and sex hormone-binding globulin (SHBG) assays. Estradiol/SHBG and testosterone/SHBG ratios were used to estimate biologically available hormone levels; bioavailable (non-SHBG-bound) testosterone was measured directly in 60 women. Height loss was based on height measurements taken 16 years apart. Height loss was strongly correlated with age (p = 0.001). These women lost an average 0.22 cm/year in height. Neither estrone nor estradiol levels were significantly and independently related to height loss. Both estimated bioavailable testosterone (testosterone/SHBG ratio) and measured bioavailable testosterone levels predicted future height loss (p = 0.02 and 0.08, respectively) independent of age, obesity, cigarette smoking, alcohol intake, and use of thiazides and estrogen. We conclude that bioavailable testosterone is an independent predictor of height loss in elderly postmenopausal women. The reduced height loss is compatible with a direct effect of testosterone on bone mineral density or bone remodeling.

Surface area-volume ratios in insects.

PubMed

Kühsel, Sara; Brückner, Adrian; Schmelzle, Sebastian; Heethoff, Michael; Blüthgen, Nico

2017-10-01

Body mass, volume and surface area are important for many aspects of the physiology and performance of species. Whereas body mass scaling received a lot of attention in the literature, surface areas of animals have not been measured explicitly in this context. We quantified surface area-volume (SA/V) ratios for the first time using 3D surface models based on a structured light scanning method for 126 species of pollinating insects from 4 orders (Diptera, Hymenoptera, Lepidoptera, and Coleoptera). Water loss of 67 species was measured gravimetrically at very dry conditions for 2 h at 15 and 30 °C to demonstrate the applicability of the new 3D surface measurements and relevance for predicting the performance of insects. Quantified SA/V ratios significantly explained the variation in water loss across species, both directly or after accounting for isometric scaling (residuals of the SA/V ∼ mass 2/3 relationship). Small insects with a proportionally larger surface area had the highest water loss rates. Surface scans of insects to quantify allometric SA/V ratios thus provide a promising method to predict physiological responses, improving the potential of body mass isometry alone that assume geometric similarity. © 2016 Institute of Zoology, Chinese Academy of Sciences.

Resonance shifting: A simple, all-optical method for circumventing the reabsorption problem in luminescent concentrators

NASA Astrophysics Data System (ADS)

Giebink, Noel; Wiederrecht, Gary; Wasielewski, Michael

2011-03-01

Luminescent concentrators (LSCs) were developed over three decades ago as a simple route to obtain high concentration ratio for photovoltaic cells without tracking the sun. In principle, high concentration ratios 100 are possible for commonly used chromophores. In practice, however, there is typically an overlap between the chromophore absorption and emission spectra that, although small, ultimately leads to unacceptable reabsorption losses, limiting the concentration ratio to ~ 10 and hence the utility of LSCs to date. We introduce a simple, all-optical means of avoiding reabsorption loss by ``resonance shifting'' from a bilayer cavity that consists of an absorber/emitter waveguide lying upon a low refractive index layer supported by a transparent substrate. Emission is evanescently coupled into the substrate at sharply defined angles and hence, by varying the cavity thickness over the device area, the original absorption resonance can be avoided at each bounce, allowing for extremely low propagation loss to the substrate edges and hence an increase in the optical concentration ratio. We validate this concept for absorber/emitter layers composed of both a typical luminescent polymer and inorganic semiconductor nanocrystals, demonstrating near-lossless propagation in each case.

Multiple-scale prediction of forest loss risk across Borneo

Treesearch

Samuel A. Cushman; Ewan A. Macdonald; Erin L. Landguth; Yadvinder Malhi; David W. Macdonald

2017-01-01

Context: The forests of Borneo have among the highest biodiversity and also the highest forest loss rates on the planet. Objectives: Our objectives were to: (1) compare multiple modelling approaches, (2) evaluate the utility of landscape composition and configuration as predictors, (3) assess the influence of the ratio of forest loss and persistence points in the...

Terahertz and infrared Smith-Purcell radiation from Babinet metasurfaces: Loss and efficiency

NASA Astrophysics Data System (ADS)

Liu, Liu; Chang, Huiting; Zhang, Chi; Song, Yanan; Hu, Xinhua

2017-10-01

When a charged particle moves close and parallel to the surface of a Babinet metasurface composed of metallic C -aperture resonators, strong electromagnetic radiation arises at resonant frequency. Here we systematically study the Smith-Purcell effects in Babinet metasurfaces with different periods. By tuning the period, the resonant (or working) frequency of the metasurface can vary from GHz to THz and infrared ranges. It is found that for working frequencies lower than 10 GHz, the ratio of absorption loss to input power is about 3.7%. Although the loss ratio increases with increasing working frequency, it remains as low as 11% (29%) at a working frequency of 10 THz (224 THz). Due to the existence of loss, a nonlinear relationship is also found between resonant frequency and the reciprocal of period. Our results suggest that Babinet metasurfaces could be a good candidate for fabricating efficient, compact THz and infrared free-electron light sources.

Mathematical modeling of a four-stroke resonant engine for micro and mesoscale applications

NASA Astrophysics Data System (ADS)

Preetham, B. S.; Anderson, M.; Richards, C.

2014-12-01

In order to mitigate frictional and leakage losses in small scale engines, a compliant engine design is proposed in which the piston in cylinder arrangement is replaced by a flexible cavity. A physics-based nonlinear lumped-parameter model is derived to predict the performance of a prototype engine. The model showed that the engine performance depends on input parameters, such as heat input, heat loss, and load on the engine. A sample simulation for a reference engine with octane fuel/air ratio of 0.043 resulted in an indicated thermal efficiency of 41.2%. For a fixed fuel/air ratio, higher output power is obtained for smaller loads and vice-versa. The heat loss from the engine and the work done on the engine during the intake stroke are found to decrease the indicated thermal efficiency. The ratio of friction work to indicated work in the prototype engine is about 8%, which is smaller in comparison to the traditional reciprocating engines.

Modeling for CO poisoning of a fuel cell anode

NASA Technical Reports Server (NTRS)

Dhar, H. P.; Kush, A. K.; Patel, D. N.; Christner, L. G.

1986-01-01

Poisoning losses in a half-cell in the 110-190 C temperature range have been measured in 100 wt pct H3PO4 for various mixtures of H2, CO, and CO2 gases in order to investigate the polarization loss due to poisoning by CO of a porous fuel cell Pt anode. At a fixed current density, the poisoning loss was found to vary linearly with ln of the CO/H2 concentration ratio, although deviations from linearity were noted at lower temperatures and higher current densities for high CO/H2 concentration ratios. The surface coverages of CO were also found to vary linearly with ln of the CO/H2 concentration ratio. A general adsorption relationship is derived. Standard free energies for CO adsorption were found to vary from -14.5 to -12.1 kcal/mol in the 130-190 C temperature range. The standard entropy for CO adsorption was found to be -39 cal/mol per deg K.

Nitrogen losses and chemical parameters during co-composting of solid wastes and liquid pig manure.

PubMed

Vázquez, M A; de la Varga, D; Plana, R; Soto, M

2017-07-04

The aim of this research was to study nitrogen losses during the treatment of the liquid fraction (LF) of pig manure by co-composting and to establish the best conditions for compost production with higher nitrogen and low heavy metal contents. Windrows were constituted with the solid fraction (SF) of pig manure, different organic waste (SF of pig manure, sawdust and grape bagasse) as co-substrate and Populus spp. wood chips as bulking material and watered intensely with the LF. Results show that nitrogen losses ranged from 30% to 66% of initial nitrogen and were mainly governed by substrate to bulking mass ratio and liquid fraction to substrate (LF/S) ratio, and only secondarily by operational parameters. Nitrogen losses decreased from 55-65% at low LF/S ratios (1.7-1.9 m 3 /t total solids (TS)) to 30-39% at high LF/S ratios (4.4-4.7 m 3 /t TS). Therefore, integrating the LF in the composting process at high LF/S ratios favoured nitrogen recovery and conservation. Nitrogen in the fine fraction (ranging from 27% to 48% of initial nitrogen) was governed by operational parameters, namely pH and temperature. Final compost showed low content in most heavy metals, but Zn was higher than the limits for compost use in agriculture. Zn content in the obtained compost varied from 1863 to 3269 mg/kg dm, depending on several factors. The options for obtaining better quality composts from the LF of pig manure are selecting co-substrates with low heavy metal content and using them instead of the SF of pig manure.

An outcomes analysis of patients undergoing body contouring surgery after massive weight loss.

PubMed

Shermak, Michele A; Chang, David; Magnuson, Thomas H; Schweitzer, Michael A

2006-09-15

Although published reports about technical management of massive weight loss patients are beginning to appear, risk factors for complications following body contouring operations are not known. A retrospective analysis of massive weight loss patients who had body contouring operations between March of 1998 and October of 2004 was performed. Demographic and surgical factors were analyzed. Outcome measures included seroma, wound dehiscence, thromboembolic complications, blood transfusion after surgery, and extended lengths of stay (>2 days). A total of 139 patients were analyzed; 82.7 percent of them were female; mean age was 41 years. On multiple logistic regression, male gender was associated with significant risks for wound dehiscence (odds ratio, 6.4; p = 0.01). There were also trends toward increased risk for wound dehiscence with hypothyroidism (odds ratio, 4.3; p = 0.06) and Ehlers-Danlos syndrome (odds ratio, 18.7; p = 0.05). In terms of risk of blood transfusion, asthma and having three or more procedures were the two variables that emerged with significant association (odds ratio, 16.8 and 13.7, respectively; both p < 0.01). Increased length of stay to greater than 2 days was also significantly associated with having three or more procedures (odds ratio, 4.72; p < 0.01). Male gender, hypothyroidism, and Ehlers-Danlos syndrome may be risk factors for wound dehiscence following body contour operations for massive weight loss. Asthma may be a marker of poor general health status, and asthmatic patients are at increased risk for requiring blood transfusions. Having three or more procedures is associated with an increased risk of blood transfusion and increased length of stay.

Reported health, lifestyle and clinical manifestations associated with HIV status in people from rural and urban communities in the Free State Province, South Africa.

PubMed

Pienaar, Michélle; van Rooyen, Francois C; Walsh, Corinna M

2017-01-01

HIV infection impacts heavily on the infected individual's overall health status. To determine significant health, lifestyle (smoking and alcohol use) and independent clinical manifestations associated with HIV status in rural and urban communities. Adults aged between 25 and 64 years completed a questionnaire in a structured interview with each participant. Blood specimens were analysed in an accredited laboratory using standard techniques and controls. Anthropometric measurements were determined using standardised methods. Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. More than half of HIV-infected rural participants used alcohol and more than 40% smoked. Median body mass index (BMI) of HIV-infected participants was lower than that of uninfected participants. Significantly more HIV-infected participants reported experiencing cough (rural), skin rash (urban), diarrhoea (rural and urban), vomiting (rural), loss of appetite (urban) and involuntary weight loss (rural). Significantly more HIV-uninfected participants reported diabetes mellitus (urban) and high blood pressure (rural and urban). In rural areas, HIV infection was positively associated with losing weight involuntarily (odds ratio 1.86), ever being diagnosed with tuberculosis (TB) (odds ratio 2.50) and being on TB treatment (odds ratio 3.29). In the urban sample, HIV infection was positively associated with having diarrhoea (odds ratio 2.04) and ever being diagnosed with TB (odds ratio 2.49). Involuntary weight loss and diarrhoea were most likely to predict the presence of HIV. In addition, present or past diagnosis of TB increased the odds of being HIV-infected. Information related to diarrhoea, weight loss and TB is easy to obtain from patients and should prompt healthcare workers to screen for HIV.

Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: implications for program evaluation.

PubMed

Lawn, Stephen D; Myer, Landon; Harling, Guy; Orrell, Catherine; Bekker, Linda-Gail; Wood, Robin

2006-09-15

The scale-up of antiretroviral treatment (ART) services in resource-limited settings requires a programmatic model to deliver care to large numbers of people. Understanding the determinants of key outcome measures--including death and nondeath losses--would assist in program evaluation and development. Between September 2002 and August 2005, all in-program (pretreatment and on-treatment) deaths and nondeath losses were prospectively ascertained among treatment-naive adults (n=1235) who were enrolled in a community-based ART program in South Africa. At study censorship, 927 patients had initiated ART after a median of 34 days after enrollment in the program. One hundred twenty-one (9.8%) patients died. Mortality rates were 33.3 (95% CI, 25.5-43.0), 19.1 (95% CI, 14.4-25.2), and 2.9 (95% CI, 1.8-4.8) deaths/100 person-years in the pretreatment interval, during the first 4 months of ART (early deaths), and after 4 months of ART (late deaths), respectively. Pretreatment and early treatment deaths together accounted for 87% of deaths, and were independently associated with advanced immunodeficiency at enrollment. Late deaths were comparatively few and were only associated with the response to ART at 4 months. Nondeath program losses (loss to follow-up, 2.3%; transfer-out, 1.9%; relocation, 0.7%) were not associated with immune status and were evenly distributed during the study period. Loss to follow-up and late mortality rates were low, reflecting good cohort retention and treatment response. However, the extremely high pretreatment and early mortality rates indicate that patients are enrolling in ART programs with far too advanced immunodeficiency. Causes of late access to the ART program, such as delays in health care access, health system delays, or inappropriate treatment criteria, need to be addressed.

7 CFR 1430.502 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS Dairy Market Loss Assistance Program § 1430... administering the Dairy Market Loss Assistance Program established by this subpart. Application means the Dairy... dairy operation, during which milk was produced and marketed. Commodity Credit Corporation means the...

7 CFR 1430.502 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS Dairy Market Loss Assistance Program § 1430... administering the Dairy Market Loss Assistance Program established by this subpart. Application means the Dairy... dairy operation, during which milk was produced and marketed. Commodity Credit Corporation means the...

7 CFR 1430.502 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS Dairy Market Loss Assistance Program § 1430... administering the Dairy Market Loss Assistance Program established by this subpart. Application means the Dairy... dairy operation, during which milk was produced and marketed. Commodity Credit Corporation means the...

7 CFR 1430.502 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS Dairy Market Loss Assistance Program § 1430... administering the Dairy Market Loss Assistance Program established by this subpart. Application means the Dairy... dairy operation, during which milk was produced and marketed. Commodity Credit Corporation means the...

Confident living program for senior adults experiencing vision and hearing loss.

PubMed

Berry, Paige; Kelley-Bock, Mia; Rei, Christine

2008-01-01

Many people experience both vision and hearing losses as they age. The Confident Living Program was developed by Helen Keller National Center to address the unique psychosocial and educational needs of older adults living with dual-sensory impairments.

Cost-Effectiveness of Multidisciplinary Management Program and Exercise Training Program in Heart Failure.

PubMed

Dang, Weixiong; Yi, Anji; Jhamnani, Sunny; Wang, Shi-Yi

2017-10-15

Heart failure causes significant health and financial burdens for patients and society. Multidisciplinary management program (MMP) and exercise training program (ETP) have been reported as cost-effective in improving health outcomes, yet no study has compared the 2 programs. We constructed a Markov model to simulate life year (LY) gained and total costs in usual care (UC), MMP, and ETP. The probability of transitions between states and healthcare costs were extracted from previous literature. We calculated the incremental cost-effectiveness ratio (ICER) over a 10-year horizon. Model robustness was assessed through 1-way and probabilistic sensitivity analyses. The expected LY for patients treated with UC, MMP, and ETP was 7.6, 8.2, and 8.4 years, respectively. From a societal perspective, the expected cost of MMP was $20,695, slightly higher than the cost of UC ($20,092). The cost of ETP was much higher ($48,378) because of its high implementation expense and the wage loss it incurred. The ICER of MMP versus UC was $976 per LY gained, and the ICER of ETP versus MMP was $165,702 per LY gained. The results indicated that, under current cost-effectiveness threshold, MMP is cost-effective compared with UC, and ETP is not cost-effective compared with MMP. However, ETP is cost-effective compared with MMP from a healthcare payer's perspective. Copyright © 2017 Elsevier Inc. All rights reserved.

Optimized optical devices for edge-coupling-enabled silicon photonics platform

NASA Astrophysics Data System (ADS)

Png, Ching Eng; Ang, Thomas Y. L.; Ong, Jun Rong; Lim, Soon Thor; Sahin, Ezgi; Chen, G. F. R.; Tan, D. T. H.; Guo, Tina X.; Wang, Hong

2018-02-01

We present a library of high-performance passive and active silicon photonic devices at the C-band that is specifically designed and optimized for edge-coupling-enabled silicon photonics platform. These devices meet the broadband (100 nm), low-loss (< 2dB per device), high speed (>= 25 Gb/s), and polarization diversity requirements (TE and TM polarization extinction ratio <= 25 dB) for optical communication applications. Ultra-low loss edge couplers, broadband directional couplers, high-extinction ratio polarization beam splitters (PBSs), and high-speed modulators are some of the devices within our library. In particular, we have designed and fabricated inverse taper fiber-to-waveguide edge couplers of tip widths ranging from 120 nm to 200 nm, and we obtained a low coupling loss of 1.80+/-0.28 dB for 160 nm tip width. To achieve polarization diversity operation for inverse tapers, we have experimentally realized different designs of polarization beam splitters (PBS). Our optimized PBS has a measured extinction ratio of <= 25 dB for both the quasiTE modes, and quasi-TM modes. Additionally, a broadband (100 nm) directional coupler with a 50/50 power splitting ratio was experimentally realized on a small footprint of 20×3 μm2 . Last but not least, high-speed silicon modulators with a range of carrier doping concentrations and offset of the PN junction can be used to optimise the modulation efficiency, and insertion losses for operation at 25 GHz.

Is there a kink in consumers' threshold value for cost-effectiveness in health care?

PubMed

O'Brien, Bernie J; Gertsen, Kirsten; Willan, Andrew R; Faulkner, Lisa A

2002-03-01

A reproducible observation is that consumers' willingness-to-accept (WTA) monetary compensation to forgo a program is greater than their stated willingness-to-pay (WTP) for the same benefit. Several explanations exist, including the psychological principle that the utility of losses weighs heavier than gains. We sought to quantify the WTP-WTA disparity from published literature and explore implications for cost-effectiveness analysis accept-reject thresholds in the south-west quadrant of the cost-effectiveness plane (less effect, less cost). We reviewed published studies (health and non-health) to estimate the ratio of WTA to WTP for the same program benefit for each study and to determine if WTA is consistently greater than WTP in the literature. WTA/WTP ratios were greater than unity for every study we reviewed. The ratios ranged from 3.2 to 89.4 for environmental studies (n=7), 1.9 to 6.4 for health care studies (n=2), 1.1 to 3.6 for safety studies (n=4) and 1.3 to 2.6 for experimental studies (n=7). Given that WTA is greater than WTP based on individual preferences, should not societal preferences used to determine cost-effectiveness thresholds reflect this disparity? Current convention in cost-effectiveness analysis is that any given accept-rejection criterion (e.g. $50 k/QALY gained) is symmetric - a straight line through the origin of the cost-effectiveness plane. The WTA-WTP evidence suggests a downward 'kink' through the origin for the south-west quadrant, such that the 'selling price' of a QALY is greater than the 'buying price'. The possibility of 'kinky cost-effectiveness' decision rules and the size of the kink merits further exploration. Copyright 2002 John Wiley & Sons, Ltd.

Effect of ultrasound and centrifugal force on carambola (Averrhoa carambola L.) slices during osmotic dehydration.

PubMed

Barman, Nirmali; Badwaik, Laxmikant S

2017-01-01

Osmotic dehydration (OD) of carambola slices were carried out using glucose, sucrose, fructose and glycerol as osmotic agents with 70°Bx solute concentration, 50°C of temperature and for time of 180min. Glycerol and sucrose were selected on the basis of their higher water loss, weight reduction and lowers solid gain. Further the optimization of OD of carambola slices (5mm thick) were carried out under different process conditions of temperature (40-60°C), concentration of sucrose and glycerol (50-70°Bx), time (180min) and fruit to solution ratio (1:10) against various responses viz. water loss, solid gain, texture, rehydration ratio and sensory score according to a composite design. The optimized value for temperature, concentration of sucrose and glycerol has been found to be 50°C, 66°Bx and 66°Bx respectively. Under optimized conditions the effect of ultrasound for 10, 20, 30min and centrifugal force (2800rpm) for 15, 30, 45 and 60min on OD of carambola slices were checked. The controlled samples showed 68.14% water loss and 13.05% solid gain in carambola slices. While, the sample having 30min ultrasonic treatment showed 73.76% water loss and 9.79% solid gain; and the sample treated with centrifugal force for 60min showed 75.65% water loss and 6.76% solid gain. The results showed that with increasing in treatment time the water loss, rehydration ratio were increased and solid gain, texture were decreased. Copyright © 2016 Elsevier B.V. All rights reserved.

Using Natural Stable Calcium Isotopes to Rapidly Assess Changes in Bone Mineral Balance Using a Bed Rest Model to Induce Bone Loss

NASA Technical Reports Server (NTRS)

Morgan, J. L. L.; Skulan, J. L.; Gordon, G. E.; Smith, Scott M.; Romaniello, S. J.; Anbar, A. D.

2012-01-01

Metabolic bone diseases like osteoporosis result from the disruption of normal bone mineral balance (BMB) resulting in bone loss. During spaceflight astronauts lose substantial bone. Bed rest provides an analog to simulate some of the effects of spaceflight; including bone and calcium loss and provides the opportunity to evaluate new methods to monitor BMB in healthy individuals undergoing environmentally induced-bone loss. Previous research showed that natural variations in the Ca isotope ratio occur because bone formation depletes soft tissue of light Ca isotopes while bone resorption releases that isotopically light Ca back into soft tissue (Skulan et al, 2007). Using a bed rest model, we demonstrate that the Ca isotope ratio of urine shifts in a direction consistent with bone loss after just 7 days of bed rest, long before detectable changes in bone mineral density (BMD) occur. The Ca isotope variations tracks changes observed in urinary N-teleopeptide, a bone resorption biomarker. Bone specific alkaline phosphatase, a bone formation biomarker, is unchanged. The established relationship between Ca isotopes and BMB can be used to quantitatively translate the changes in the Ca isotope ratio to changes in BMD using a simple mathematical model. This model predicts that subjects lost 0.25 0.07% ( SD) of their bone mass from day 7 to day 30 of bed rest. Given the rapid signal observed using Ca isotope measurements and the potential to quantitatively assess bone loss; this technique is well suited to study the short-term dynamics of bone metabolism.

Efficacy of cognitive behavioral internet-based therapy in parents after the loss of a child during pregnancy: pilot data from a randomized controlled trial.

PubMed

Kersting, Anette; Kroker, Kristin; Schlicht, Sarah; Baust, Katja; Wagner, Birgit

2011-12-01

The loss of a child during pregnancy can be a traumatic event associated with long-lasting grief and psychological distress. This study examined the efficacy of an internet-based cognitive behavioral therapy program for mothers after pregnancy loss. In a randomized controlled trial with a waiting list control group, 83 participants who had lost a child during pregnancy were randomly allocated either to 5 weeks of internet therapy or to a 5-week waiting condition. Within a manualized cognitive behavioral treatment program, participants wrote ten essays on loss-specific topics. Posttraumatic stress, grief, and general psychopathology, especially depression, were assessed pretreatment, posttreatment, and at 3-month follow-up. Intention-to-treat analyses and completer analyses were performed. Relative to controls, participants in the treatment group showed significant improvements in posttraumatic stress, grief, depression, and overall mental health, but not in anxiety or somatization. Medium to large effect sizes were observed, and the improvement was maintained at 3-month follow-up. This internet-based cognitive behavioral therapy program represents an effective treatment approach with stable effects for women after pregnancy loss. Implementation of the program can thus help to improve the health care provision for mothers in this traumatic loss situation.

Effects of Health Insurance Interruption on Loss of Hypertension Control in Women With and Women Without HIV.

PubMed

Edmonds, Andrew; Ludema, Christina; Eron, Joseph J; Cole, Stephen R; Adedimeji, Adebola A; Cohen, Mardge H; Cooper, Hannah L; Fischl, Margaret; Johnson, Mallory O; Krause, Denise D; Merenstein, Dan; Milam, Joel; Wilson, Tracey E; Adimora, Adaora A

2017-12-01

Among low-income women with and without HIV, it is a priority to reduce age-related comorbidities, including hypertension and its sequelae. Because consistent health insurance access has been identified as an important factor in controlling many chronic diseases, we estimated the effects of coverage interruption on loss of hypertension control in a cohort of women in the United States. We analyzed prospective, longitudinal data from the Women's Interagency HIV Study. HIV-infected and HIV-uninfected women were included between 2005 and 2014 when they reported health insurance at consecutive biannual visits and had controlled hypertension, and were followed for any insurance break and loss of hypertension control. We estimated hazard ratios (HRs) by Cox proportional hazards regression with inverse-probability-of-treatment-and censoring weights (marginal structural models), and plotted the cumulative incidence of hypertension control loss. Among 890 HIV-infected women, the weighted HR for hypertension control loss comparing health insurance interruption to uninterrupted coverage was 1.37 (95% confidence interval [CI], 0.99-1.91). Inclusion of AIDS Drug Assistance Program (ADAP) participation with health insurance modestly increased the HR (1.47; 95% CI, 1.04-2.07). Analysis of 272 HIV-uninfected women yielded a similar HR (1.39; 95% CI, 0.88-2.21). Additionally, there were indications of uninterrupted coverage having a protective effect on hypertension when compared with the natural course in HIV-infected (HR, 0.82; 95% CI, 0.61-1.11) and HIV-uninfected (HR, 0.78; 95% CI, 0.52-1.19) women. This study provides evidence that health insurance continuity promotes hypertension control in key populations. Interventions that ensure coverage stability and ADAP access should be a policy priority.

Effect of Weight Loss with or without Exercise on Inflammatory Markers and Adipokines in Postmenopausal Women: The SHAPE-2 Trial, A Randomized Controlled Trial.

PubMed

van Gemert, Willemijn A; May, Anne M; Schuit, Albertine J; Oosterhof, Blanche Y M; Peeters, Petra H; Monninkhof, Evelyn M

2016-05-01

We investigated the effect of equivalent weight loss, by a hypocaloric diet or mainly exercise, on inflammatory markers and adipokines in overweight postmenopausal women. Women were randomized to a diet (n = 97), mainly exercise (n = 98), or control group (n = 48). Goal of both interventions was to lose 5 to 6 kg bodyweight by a hypocaloric diet or an exercise program (4 hours/week) combined with a small caloric intake restriction. Outcomes after 16 weeks included serum high-sensitive C-reactive protein (hsCRP), IL6, adiponectin, and leptin. Both intervention groups achieved the target weight loss. Controls remained weight stable. Compared with control, hsCRP decreased with mainly exercise [treatment effect ratio (TER) = 0.64] and borderline statistically significant with diet (TER = 0.77). There was a suggestively larger effect of exercise, directly compared with diet (TER = 0.83). Leptin decreased with both interventions: mainly exercise (TER = 0.55) and diet (TER = 0.59), versus control. Effects attenuated and lost significance after adjusting for change in body fat percentage, and to a lesser extent when adjusting for fitness. No effects were seen on IL6 and adiponectin. A 16-week randomized intervention inducing comparable weight loss by a hypocaloric diet or mainly exercise, resulted in favorable effects on serum hsCRP and leptin. We found a possible more beneficial effect on hsCRP with mainly exercise versus diet. These effects of exercise were established by changes in body fat percentage and physical fitness. A modest amount of weight loss in postmenopausal women reduces hsCRP and leptin levels which might be associated with a lower breast cancer risk. Cancer Epidemiol Biomarkers Prev; 25(5); 799-806. ©2016 AACR. ©2016 American Association for Cancer Research.

Effect of organic matter supplementation on nitrogen transformations in soils. I. Chemical and bacteriological changes.

PubMed

Abd-el-Malek, Y; Monib, M; Hosny, I; Girgis, S A

1979-01-01

The effect of supplementation with different organic materials on nitrogen transformations and on certain bacterial groups in soil was studied. Addition of wide C/N ratio organic matter, sawdust and maize stalks prevented NO3-N from being lost through leaching out or dentrification and favoured the development of Azotobacter and N2-fixing clostridia that in turn resulted in marked gains in nitrogen through N2-fixation. Nitrifying bacteria were adversely affected. Application of such materials together with high amounts of NH4NO3 lessened nitrogen losses in drainage water but increased losses through denitrification. Nitrogen-rich organic matter resulted in higher losses in nitrates from soils in comparison to those of wide C/N ratio organic materials.

Cost Effectiveness Ratio: Evaluation Tool for Comparing the Effectiveness of Similar Extension Programs

ERIC Educational Resources Information Center

Jayaratne, K. S. U.

2015-01-01

Extension educators have been challenged to be cost effective in their educational programming. The cost effectiveness ratio is a versatile evaluation indicator for Extension educators to compare the cost of achieving a unit of outcomes or educating a client in similar educational programs. This article describes the cost effectiveness ratio and…

Sex differences in the relation of weight loss self-efficacy, binge eating, and depressive symptoms to weight loss success in a residential obesity treatment program.

PubMed

Presnell, Katherine; Pells, Jennifer; Stout, Anna; Musante, Gerard

2008-04-01

The aim of the current study was to examine whether weight loss self-efficacy, binge eating, and depressive symptoms predicted weight loss during treatment, and whether gender moderates these associations with prospective data from 297 participants (223 women and 74 men) enrolled in a residential obesity treatment program. Men reported higher initial levels of self-efficacy than women, whereas women reported greater pre-treatment levels of binge eating and depressive symptoms. Higher pre-treatment levels of weight control self-efficacy, binge eating, and depressive symptoms predicted greater weight loss in men, but not in women. Results suggest that certain psychological and behavioral factors should be considered when implementing weight loss interventions, and indicate a need to consider gender differences in predictors of weight loss treatment. Future research should seek to identify predictors of weight loss among women.

A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach.

PubMed

West, D S; Gorin, A A; Subak, L L; Foster, G; Bragg, C; Hecht, J; Schembri, M; Wing, R R

2011-02-01

Maintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. Therefore, a novel weight loss maintenance program that specifically targets motivational factors was evaluated. Overweight women (N=338; 19% African American) with urinary incontinence were randomized to lifestyle obesity treatment or control and followed for 18 months. All participants in lifestyle (N=226) received the same initial 6-month group behavioral obesity treatment and were then randomized to (1) a novel motivation-focused maintenance program (N=113) or (2) a standard skill-based maintenance approach (N=113). Weight assessed at baseline, 6 and 18 months. Both treatment groups (motivation-focused and skill-based) achieved comparable 18-month weight losses (-5.48% for motivation-focused vs -5.55% in skill-based, P=0.98), and both groups lost significantly more than controls (-1.51%; P=0.0012 in motivation-focused and P=0.0021 in skill-based). A motivation-focused maintenance program offers an alternative, effective approach to weight maintenance expanding available evidence-based interventions beyond traditional skill-based programs.

An Empirical Isochrone of Very Massive Stars in R136a

NASA Astrophysics Data System (ADS)

de Koter, Alex; Heap, Sara R.; Hubeny, Ivan

1998-12-01

We report on a detailed spectroscopic study of 12 very massive and luminous stars (M >~ 35M⊙) in the core of the compact cluster R136a, near the center of the 30 Doradus complex. The three brightest stars of the cluster, R136a1, R136a2, and R136a3, have been investigated earlier by de Koter, Heap, & Hubeny. Low-resolution spectra (<200 km s-1) of the program stars were obtained with the GHRS and FOS spectrographs on the Hubble Space Telescope. These instruments covered the spectral range from 1200 to 1750 Å and from 3200 to 6700 Å, respectively. Fundamental stellar parameters were obtained by fitting the observations by model spectra calculated with the unified ISA-WIND code of de Koter et al. supplemented by synthetic data calculated using the program TLUSTY. We find that the stars are almost exclusively of spectral type O3. They occupy only a relatively narrow range in effective temperatures between 40 and 46 kK. The reason for these similar Teff's is that the isochrone of these very massive stars, which we determined to be at ~2 Myr, runs almost vertically in the H-R diagram. We present a quantitative method of determining the effective temperature of O3-type stars based on the strength of the O V λ1371 line. Present-day evolutionary calculations by Meynet et al. imply that the program stars have initial masses in the range of Mi ~ 37-76 M⊙. The observed mass-loss rates are up to 3 (2) times higher than is assumed in these evolution tracks when adopting a metallicity Z = 0.004 (0.008) for the LMC. The high observed mass-loss rates imply that already at an age of ~2 Myr the most luminous of our program stars will have lost a significant fraction of their respective initial masses. For the least luminous stars investigated in this paper, the observed mass loss agrees with the prediction by the theory of radiation-driven winds (Kudritzki et al.). However, for increasing luminosity the observed mass loss becomes larger, reaching up to 3-4 times what is expected from the theory. Such an increasing discrepancy fits in with the results of de Koter et al., where an observed overpredicted mass-loss ratio of up to 8 was reported for the brightest members of the R136a cluster, for which Mi ~ 100 M⊙ was found. The failure of the theory is also present when one compares observed over predicted wind momentum as a function of wind performance number. This strongly indicates that the shortcoming of the present state of the theory is connected to the neglect of effects of multiple photon momentum transfer. Based on observations with the NASA/ESA Hubble Space Telescope obtained at the Space Telescope Science Institute, which is operated by AURA, Inc., under NASA contract NAS 5-26555.

Serum aminotransferase changes with significant weight loss: sex and age effects.

PubMed

Suzuki, Ayako; Binks, Martin; Sha, Ronald; Wachholtz, Amy; Eisenson, Howard; Diehl, Anna Mae

2010-02-01

In obese subjects, the liver may be differentially affected by significant weight loss depending on as yet unknown factors. We explored clinical factors associated with serum alanine aminotransferase (ALT) changes during significant weight loss in a residential weight loss program. Clinical data from 362 adults who received a comprehensive weight loss intervention (ie, diets, physical fitness, and behavioral modification) in the program were analyzed. Serum ALT was used as a surrogate marker of liver injury. The ALT changes during the program were calculated to create study outcome categories (improvement, no change, or deterioration of ALT during significant weight loss). Variables of demography, lifestyle, and comorbidities at baseline, and total/rate of weight change during the program were explored for associations with the ALT change categories using multiple logistic regression models. Variation by sex was apparent among predictors of ALT deterioration; men with rapid weight loss and women with higher initial body mass index were more likely to experience ALT deterioration, whereas men with prior alcohol consumption were less likely to experience ALT deterioration even after adjusting for baseline ALT (Ps < .03). Variation by age was apparent among predictors of ALT improvement; younger patients with current smoking and older patients with rapid weight loss, diabetes or impaired fasting glucose, or sleep apnea or who followed a reduced-carbohydrate diet were less likely to experience ALT improvement (Ps < .05). A number of clinical factors influence ALT changes during weight loss in sex- and age-specific manners. The patterns that we detected may have pathophysiologic significance beyond the practical implications of our findings in clinical practice related to underlying changes in fat metabolism. Copyright 2010 Elsevier Inc. All rights reserved.

Power loss for high-voltage solar-cell arrays

NASA Technical Reports Server (NTRS)

Parker, L. W.

1979-01-01

Electric field particle collection and power loss are calculated in program written in FORTRAN IV for use on UNIVAC 1100/40 computer. Program incorporates positive and negative and negative charge flows and balance between positive and negative flows is performed by iteration.

Measuring mining safety with injury statistics: lost workdays as indicators of risk.

PubMed

Coleman, Patrick J; Kerkering, John C

2007-01-01

Mining in the United States remains one of the most hazardous industries, despite significant reductions in fatal injury rates over the last century. Coal mine fatality rates, for example, have dropped almost a thousand-fold since their peak in 1908. While incidence rates are very important indicators, lost worktime measures offer an alternative metric for evaluating job safety and health performance. The first objective of this study examined the distributions and summary statistics of all injuries reported to the Mine Safety and Health Administration from 1983 through 2004. Over the period studied (1983-2004), there were 31,515,368 lost workdays associated with mining injuries, for an equivalent of 5,700 person-years lost annually. The second objective addressed the problem of comparing safety program performance in mines for situations where denominator data were lacking. By examining the consequences of injuries, comparisons can be made between disparate operations without the need for denominators. Total risk in the form of lost workday sums can help to distinguish between lower- and higher-risk operations or time periods. Our method was to use a beta distribution to model the losses and to compare underground coal mining to underground metal/nonmetal mining from 2000 to 2004. Our results showed the probability of an injury having 10 or more lost workdays was 0.52 for coal mine cases versus 0.35 for metal/nonmetal mine cases. In addition, a comparison of injuries involving continuous mining machines over 2001-2002 versus 2003-2004 showed that the ratio of average losses in the later period to those in the earlier period was approximately 1.08, suggesting increasing risks for such operations. This denominator-free safety measure will help the mining industry more effectively identify higher-risk operations and more realistically evaluate their safety improvement programs. Attention to a variety of metrics concerning the performance of a job safety and health program will enhance industry's ability to manage these programs and reduce risk.

Treatment response to the RENEW weight loss intervention in schizophrenia: Impact of intervention setting

PubMed Central

Brown, Catana; Goetz, Jeannine; Hamera, Edna; Gajewski, Byron

2014-01-01

Background Individuals with serious mental illness have high rates of obesity and a need for specialized weight loss intervention programs. This study examines the efficacy of the RENEW weight loss intervention and examines the impact of the intervention setting on outcomes. Method 136 individuals with serious mental illness from 4 different settings were randomly assigned to receive the RENEW weight loss intervention or a control condition of treatment as usual. The RENEW intervention is a one year program that includes an intensive, maintenance and intermittent supports phase. Results The intervention group experienced a modest weight loss of 4.8 lbs at 3 months, 4.1 lbs at 6 months and a slight weight gain of 1.5 lbs at 12 months. The control group gained a total of 6.2 lbs at 12 months. However when settings were examined separately the responder sites had a weight loss of 9.4 lbs at 3 months, 10.9 lbs at 6 months and 7 lbs at 12 months. Discussion These results suggest that the settings in which individuals receive services may act as a support or hindrance toward response to weight loss interventions. The concept of the obesogenic environment deserves further examination as a factor in the success of weight loss programs. PMID:25261884

Treatment response to the RENEW weight loss intervention in schizophrenia: impact of intervention setting.

PubMed

Brown, Catana; Goetz, Jeannine; Hamera, Edna; Gajewski, Byron

2014-11-01

Individuals with serious mental illness have high rates of obesity and a need for specialized weight loss intervention programs. This study examines the efficacy of the RENEW weight loss intervention and examines the impact of the intervention setting on outcomes. 136 individuals with serious mental illness from 4 different settings were randomly assigned to receive the RENEW weight loss intervention or a control condition of treatment as usual. The RENEW intervention is a one year program that includes an intensive, maintenance and intermittent supports phase. The intervention group experienced a modest weight loss of 4.8 lbs at 3 months, 4.1 lbs at 6 months and a slight weight gain of 1.5 lbs at 12 months. The control group gained a total of 6.2 lbs at 12 months. However when settings were examined separately the responder sites had a weight loss of 9.4 lbs at 3 months, 10.9 lbs at 6 months and 7 lbs at 12 months. These results suggest that the settings in which individuals receive services may act as a support or hindrance toward response to weight loss interventions. The concept of the obesogenic environment deserves further examination as a factor in the success of weight loss programs. Copyright © 2014 Elsevier B.V. All rights reserved.

Effectiveness of a Low-Calorie Weight Loss Program in Moderately and Severely Obese Patients

PubMed Central

Winkler, Julia K.; Schultz, Jobst-Hendrik; Woehning, Annika; Piel, David; Gartner, Lena; Hildebrand, Mirjam; Roeder, Eva; Nawroth, Peter P.; Wolfrum, Christian; Rudofsky, Gottfried

2013-01-01

Aims To compare effectiveness of a 1-year weight loss program in moderately and severely obese patients. Methods The study sample included 311 obese patients participating in a weight loss program, which comprised a 12-week weight reduction phase (low-calorie formula diet) and a 40-week weight maintenance phase. Body weight and glucose and lipid values were determined at the beginning of the program as well as after the weight reduction and the weight maintenance phase. Participants were analyzed according to their BMI class at baseline (30-34.9 kg/m2; 35-39.9 kg/m2; 40-44.9 kg/m2; 45-49.9 kg/m2; ≥50 kg/m2). Furthermore, moderately obese patients (BMI ℋ 40 kg/m2) were compared to severely obese participants (BMI ≥ 40 kg/m2). Results Out of 311 participants, 217 individuals completed the program. Their mean baseline BMI was 41.8 ± 0.5 kg/m2. Average weight loss was 17.9 ± 0.6%, resulting in a BMI of 34.3 ± 0.4 kg/m2 after 1 year (p ℋ 0.001). Overall weight loss was not significantly different in moderately and severely obese participants. Yet, severely obese participants achieved greater weight loss during the weight maintenance phase than moderately obese participants (−3.1 ± 0.7% vs. −1.2 ± 0.6%; p = 0.04). Improvements in lipid profiles and glucose metabolism were found throughout all BMI classes. Conclusion 1-year weight loss intervention improves body weight as well as lipid and glucose metabolism not only in moderately, but also in severely obese individuals. PMID:24135973

The effects of exercise training in a weight loss lifestyle intervention on asthma control, quality of life and psychosocial symptoms in adult obese asthmatics: protocol of a randomized controlled trial.

PubMed

Freitas, Patricia D; Ferreira, Palmira G; da Silva, Analuci; Trecco, Sonia; Stelmach, Rafael; Cukier, Alberto; Carvalho-Pinto, Regina; Salge, João Marcos; Fernandes, Frederico L A; Mancini, Marcio C; Martins, Milton A; Carvalho, Celso R F

2015-10-21

Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown. This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m(2)) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups. This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms. NCT02188940.

A clinical score to predict dose reductions of antidiabetes medications with intentional weight loss: A retrospective cohort study.

PubMed

Shantha, Ghanshyam Palamaner Subash; Kumar, Anita Ashok; Ravi, Vimal; Khanna, Rohit C; Kahan, Scott; Cheskin, Lawrence J

2016-06-01

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: "WIG") to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss. Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed. Mean period of follow-up was 12.5 ± 3.5 months. To derive the "WIG" scoring algorithm, one point each was assigned to "W" (loss of 5% of initial body weight within the first 3 months of attempting weight loss), "I" (triglyceride [TGL]/highdensity lipoprotein ratio >3 [marker of insulin resistance] at baseline), and "G" (glycosylated hemoglobin [A1c%] >8.5 at baseline). WIG score showed moderate accuracy in discriminating anti-DM dose reductions at baseline, and after 3 months of weight loss efforts (likelihood ratios [LR] + >1, LR- <1, and area under the curve >0.7), and demonstrated good reproducibility. WIG score shows promise as a tool to predict success with dose reductions of antidiabetes medications. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

Short- and long-term effects of the modified swedish version of the Active Communication Education (ACE) program for adults with hearing loss.

PubMed

Oberg, Marie; Bohn, Therese; Larsson, Ulrika

2014-10-01

In Sweden, there is a lack of evidence-based rehabilitation programs for hearing loss. The Active Communication Education program (ACE) has successfully been used in Australia and was translated and evaluated in a Swedish pilot study. The pilot study included 23 participants (age 87 yr). No statistically significant effects were found, but the qualitative assessments indicated that this population found the program to be beneficial. The participants requested more focus on the psychosocial consequences of hearing loss, and the modules in the original ACE program were modified. The aim of this study was to explore the effects of a modified Swedish version of the ACE program in a population aged 39-82 yr old. Design was a between-group and within-group intervention study. The participants were recruited from the hearing health clinic in Linköping during 2010 and 2012. A total of 73 participants agreed to undergo the ACE, and 67 (92%) completed three or more sessions. The ACE program consists of five weekly 2 hr group sessions with 6 to 10 participants per group. The outcomes were measured before initiation of the program, 3 wk after program completion, and 6 mo after program completion and included communication strategy use, activity and participation, health-related quality of life, and anxiety and depression. In addition, outcomes were measured after program completion using the International Outcome Inventory-Alternative Interventions, a modified version of the Client Oriented Scale of Improvement, and qualitative feedback was obtained about the response to the program and actions taken as a result of participation. The treatment effects were examined using repeated-measures analyses of variance. Statistically significant effects were found for communication strategy use, activity and participation, and psychosocial well-being. Statistically significant effects were found for gender and degree of hearing loss, indicating that women and those with mild hearing loss significantly improved communication strategies. It is suggested that the program be implemented as part of regular audiological rehabilitation and offered in an early stage of rehabilitation. American Academy of Audiology.

The Deuterium to Hydrogen Ratio in the Water that Formed the Yellowknife Bay Mudstones in Gale Crater

NASA Technical Reports Server (NTRS)

Mahaffy, Paul R.; Brunner, Anna E.; Webster, Chris R.; Atreya, Sushil K.; Mcadam, Amy Catherine; Stern, Jennifer Claire; Leshin, Laurie Ann; Navarro-Gonzales, Rafael; Jones, J.; Kashyap, Srishti

2014-01-01

A suite of isotope ratios of light elements in the present martian atmosphere (13C/12C, 15N/14N, 18O/16O, 38Ar/36Ar, and D/H) are all substantially enriched in the heavy element suggesting atmospheric loss to space over the past billions of years with preferential loss of the lighter isotope from each pair. In situ measurements from MSL's Sample Analysis at Mars (SAM) instrument [e.g. 1,2,3] have considerably refined previous measurements from the Viking mass spectrometers [e.g. 4], from remote spectroscopic observations [e.g. 5,6], and from martian meteorite studies [e.g. 7,8]. The persistence of habitable environments such as the ancient Yellowknife Bay lake recently revealed by measurements from the Curiosity rover [9] depends on the surface temperatures and the duration of an atmosphere thicker than that at present. Current and planned measurements from orbit with the Mars Express and MAVEN missions respectively intend to study the processes of atmospheric escape including solar wind interaction, sputtering, thermal escape, and dissociative recombination, and determine or refine the current rate of atmospheric loss caused by these and other mechanisms. The goal of these programs is to understand the physical processes sufficiently well so that robust extrapolations over the past billions of years can be made D/H is measured by both the Tunable Laser Spectrometer (TLS) and the Quadrupole Mass Spectrometer (QMS) of the SAM suite. to predict the atmospheric and surface conditions on early Mars. However, the study of the history of martian atmospheric evolution will be greatly facilitated if we are able to also directly measure the isotopic composition of volatiles captured in rocks that are representative of the ancient atmosphere. To date, D/H is one of the most promising candidates for this study since water is the most abundant volatile thermally released from the Yellowknife Bay phylosilicates discovered by the SAM and CheMin experiments of MSL and its

Introduction to boundary-layer theory. [viscous friction loss calculation for turbine blade design

NASA Technical Reports Server (NTRS)

Mcnally, W. D.

1973-01-01

The pressure ratio across a turbine provides a certain amount of ideal energy that is available to the turbine for producing work. The portion of the ideal energy that is not converted to work is considered to be a loss. One of the more important and difficult aspects of turbine design is the prediction of the losses. The primary cause of losses is the boundary layer that develops on the blade and end wall surfaces. Boundary-layer theory is used to calculate the parameters needed to estimate viscous (friction) losses.

Alternative Shapes and Shaping Techniques for Enhanced Transformer Ratios in Beam Driven Techniques

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

Lemery, F.; Piot, P.

The transformer ration of collinear beam-driven techniques can be significantly improved by shaping the current profile of the drive bunch. To date, several current shapes have been proposed to increase the transformer ratio and produce quasi-uniform energy loss within the drive bunch. Some of these tailoring techniques are possible as a results of recent beam-dynamics advances, e.g., transverse-to-longitudinal emittance exchanger. In ths paper, we propose an alternative class of longitudinal shapes that enable high transformer ratio and uniform energy loss across the drive bunch. We also suggest a simple method based on photocathode-laser shaping and passive shaping in wakefield structuremore » to realize shape close to the theoretically optimized current profiles.« less

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

PubMed

Ticse, Caroline

2015-10-01

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

Overview of heat transfer and fluid flow problem areas encountered in Stirling engine modeling

NASA Technical Reports Server (NTRS)

Tew, Roy C., Jr.

1988-01-01

NASA Lewis Research Center has been managing Stirling engine development programs for over a decade. In addition to contractual programs, this work has included in-house engine testing and development of engine computer models. Attempts to validate Stirling engine computer models with test data have demonstrated that engine thermodynamic losses need better characterization. Various Stirling engine thermodynamic losses and efforts that are underway to characterize these losses are discussed.

Efficacy of the Type 2 Diabetes Prevention Using LifeStyle Education Program RCT.

PubMed

Aguiar, Elroy J; Morgan, Philip J; Collins, Clare E; Plotnikoff, Ronald C; Young, Myles D; Callister, Robin

2016-03-01

Self-administered lifestyle interventions have been suggested as an alternative to face-to-face delivery modes, although their efficacy remains uncertain. The aim of this study was to evaluate the efficacy of the Type 2 diabetes mellitus Prevention Using LifeStyle Education (PULSE) Program, a self-administered and gender-tailored lifestyle intervention for men at high risk for developing Type 2 diabetes mellitus. A 6-month, assessor-blinded, parallel-group RCT was conducted at the University of Newcastle, Australia in 2012-2013. Men (aged 18-65 years, BMI 25-40 kg/m(2), high risk for developing Type 2 diabetes mellitus) were stratified by age (<50 and >50 years) and BMI category (25.0-29.9, 30.0-35.9, and 35.0-40 kg/m(2)) and individually randomized (1:1 ratio) to the intervention (n=53) or waitlist control groups (n=48). The intervention group received the PULSE Program, which contained print and video resources on weight loss (Self-Help, Exercise and Diet using Internet Technology [SHED-IT] Weight Loss Program), diet modification, and exercise for Type 2 diabetes mellitus prevention. The waitlist control group received no information until 6 months. Data were collected from September 2012 to September 2013 and analyzed in 2014-2015. Linear mixed models (intention-to-treat) were used to determine group X time interactions (differences between groups in changes over time) at 6 months for the primary outcome (weight), glycated hemoglobin, and several secondary outcomes (significance level, p<0.05). Differences between groups in mean changes from baseline to 6 months (group × time interaction) favored the intervention over control group for weight loss (-5.50 kg, 95% CI=-7.40 kg, -3.61 kg, p<0.001, Cohen's d=1.15), glycated hemoglobin (-0.2%, 95% CI=-0.3%, -0.1%, p=0.002, d=0.64), and BMI, waist circumference, body fat percentage, aerobic fitness, and lower body muscular fitness (all p<0.05). No group × time effects were observed for fasting plasma glucose, upper body muscular fitness, physical activity, or energy intake. The PULSE Program improved several Type 2 diabetes mellitus risk factors in men, including weight and glycated hemoglobin. These findings provide evidence for a self-administered and gender-tailored lifestyle intervention, which has potential for dissemination in community settings. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Psychological Changes following Weight Loss in Overweight and Obese Adults: A Prospective Cohort Study

PubMed Central

Jackson, Sarah E.; Steptoe, Andrew; Beeken, Rebecca J.; Kivimaki, Mika; Wardle, Jane

2014-01-01

Background Participation in weight loss programs is often associated with improved wellbeing alongside reduced cardio-metabolic risk. In contrast, population-based analyses have found no evidence of psychological benefits of weight loss, but this may be due to inclusion of healthy-weight individuals. We therefore examined cardio-metabolic and psychological changes following weight loss in a cohort of overweight/obese adults. Methods Data were from 1,979 overweight and obese adults (BMI ≥25 kg/m2; age ≥50 y), free of long-standing illness or clinical depression at baseline, from the English Longitudinal Study of Ageing. Participants were grouped according to four-year weight change into those losing ≥5% weight, those gaining ≥5%, and those whose weight was stable within 5%. Logistic regression examined changes in depressed mood (eight-item Center for Epidemiologic Studies Depression score ≥4), low wellbeing (Satisfaction With Life Scale score <20), hypertension (systolic blood pressure ≥140 mmHg or anti-hypertensives), and high triglycerides (≥1.7 mmol/l), controlling for demographic variables, weight loss intention, and baseline characteristics. Results The proportion of participants with depressed mood increased more in the weight loss than weight stable or weight gain groups (+289%, +86%, +62% respectively; odds ratio [OR] for weight loss vs. weight stable = 1.78 [95% CI 1.29–2.47]). The proportion with low wellbeing also increased more in the weight loss group (+31%, +22%, −4%), but the difference was not statistically significant (OR = 1.16 [0.81–1.66]). Hypertension and high triglyceride prevalence decreased in weight losers and increased in weight gainers (−28%, 4%, +18%; OR = 0.61 [0.45–0.83]; −47%, −13%, +5%; OR = 0.41 [0.28–0.60]). All effects persisted in analyses adjusting for illness and life stress during the weight loss period. Conclusions Weight loss over four years in initially healthy overweight/obese older adults was associated with reduction in cardio-metabolic risk but no psychological benefit, even when changes in health and life stresses were accounted for. These results highlight the need to investigate the emotional consequences of weight loss. PMID:25098417

COSP for Windows: Strategies for Rapid Analyses of Cyclic Oxidation Behavior

NASA Technical Reports Server (NTRS)

Smialek, James L.; Auping, Judith V.

2002-01-01

COSP is a publicly available computer program that models the cyclic oxidation weight gain and spallation process. Inputs to the model include the selection of an oxidation growth law and a spalling geometry, plus oxide phase, growth rate, spall constant, and cycle duration parameters. Output includes weight change, the amounts of retained and spalled oxide, the total oxygen and metal consumed, and the terminal rates of weight loss and metal consumption. The present version is Windows based and can accordingly be operated conveniently while other applications remain open for importing experimental weight change data, storing model output data, or plotting model curves. Point-and-click operating features include multiple drop-down menus for input parameters, data importing, and quick, on-screen plots showing one selection of the six output parameters for up to 10 models. A run summary text lists various characteristic parameters that are helpful in describing cyclic behavior, such as the maximum weight change, the number of cycles to reach the maximum weight gain or zero weight change, the ratio of these, and the final rate of weight loss. The program includes save and print options as well as a help file. Families of model curves readily show the sensitivity to various input parameters. The cyclic behaviors of nickel aluminide (NiAl) and a complex superalloy are shown to be properly fitted by model curves. However, caution is always advised regarding the uniqueness claimed for any specific set of input parameters,

Experimental and analytical study of close-coupled ventral nozzles for ASTOVL aircraft

NASA Technical Reports Server (NTRS)

Mcardle, Jack G.; Smith, C. Frederic

1990-01-01

Flow in a generic ventral nozzle system was studied experimentally and analytically with a block version of the PARC3D computational fluid dynamics program (a full Navier-Stokes equation solver) in order to evaluate the program's ability to predict system performance and internal flow patterns. For the experimental work a one-third-size model tailpipe with a single large rectangular ventral nozzle mounted normal to the tailpipe axis was tested with unheated air at steady-state pressure ratios up to 4.0. The end of the tailpipe was closed to simulate a blocked exhaust nozzle. Measurements showed about 5 1/2 percent flow-turning loss, reasonable nozzle performance coefficients, and a significant aftward axial component of thrust due to flow turning loss, reasonable nozzle performance coefficients, and a significant aftward axial component of thrust due to flow turning more than 90 deg. Flow behavior into and through the ventral duct is discussed and illustrated with paint streak flow visualization photographs. For the analytical work the same ventral system configuration was modeled with two computational grids to evaluate the effect of grid density. Both grids gave good results. The finer-grid solution produced more detailed flow patterns and predicted performance parameters, such as thrust and discharge coefficient, within 1 percent of the measured values. PARC3D flow visualization images are shown for comparison with the paint streak photographs. Modeling and computational issues encountered in the analytical work are discussed.

76 FR 75458 - Servicemembers' Group Life Insurance Traumatic Injury Protection Program-Genitourinary Losses

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-02

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 9 RIN 2900-AO20 Servicemembers' Group Life Insurance... that amends the regulations governing the Servicemembers' Group Life Insurance Traumatic Injury...-AO20--Servicemembers' Group Life Insurance Traumatic Injury Protection Program--Genitourinary Losses...

Selecting a Weight-Loss Program

MedlinePlus

... 3700, April 2008. Healthy Weight Tip Choose weight-loss programs that encourage healthy behaviors that help you lose weight gradually and maintain your weight over time. Looking for easy-to-use information for eating healthy on the go? The Maintaining a Healthy Weight On the Go pocket guide ...

Aerobic exercise increases peripheral and hepatic insulin sensitivity in sedentary adolescents

USDA-ARS?s Scientific Manuscript database

Data are limited on the effects of controlled aerobic exercise programs (without weight loss) on insulin sensitivity and glucose metabolism in children and adolescents. To determine whether a controlled aerobic exercise program (without weight loss) improves peripheral and hepatic insulin sensitivi...

7 CFR 1493.310 - Payment for loss.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Facility Guarantee Program (FGP) Operations § 1493.310 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.300, CCC will...

7 CFR 1493.510 - Payment for loss.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.510 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.500, CCC will...

7 CFR 1493.510 - Payment for loss.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.510 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.500, CCC will...

7 CFR 1493.310 - Payment for loss.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Facility Guarantee Program (FGP) Operations § 1493.310 Payment for loss. (a) Determination of CCC's liability. Upon receipt in good order of the information and documents required under § 1493.300, CCC will...

Quantifying glenoid bone loss in anterior shoulder instability: reliability and accuracy of 2-dimensional and 3-dimensional computed tomography measurement techniques.

PubMed

Bois, Aaron J; Fening, Stephen D; Polster, Josh; Jones, Morgan H; Miniaci, Anthony

2012-11-01

Glenoid support is critical for stability of the glenohumeral joint. An accepted noninvasive method of quantifying glenoid bone loss does not exist. To perform independent evaluations of the reliability and accuracy of standard 2-dimensional (2-D) and 3-dimensional (3-D) computed tomography (CT) measurements of glenoid bone deficiency. Descriptive laboratory study. Two sawbone models were used; one served as a model for 2 anterior glenoid defects and the other for 2 anteroinferior defects. For each scapular model, predefect and defect data were collected for a total of 6 data sets. Each sample underwent 3-D laser scanning followed by CT scanning. Six physicians measured linear indicators of bone loss (defect length and width-to-length ratio) on both 2-D and 3-D CT and quantified bone loss using the glenoid index method on 2-D CT and using the glenoid index, ratio, and Pico methods on 3-D CT. The intraclass correlation coefficient (ICC) was used to assess agreement, and percentage error was used to compare radiographic and true measurements. With use of 2-D CT, the glenoid index and defect length measurements had the least percentage error (-4.13% and 7.68%, respectively); agreement was very good (ICC, .81) for defect length only. With use of 3-D CT, defect length (0.29%) and the Pico(1) method (4.93%) had the least percentage error. Agreement was very good for all linear indicators of bone loss (range, .85-.90) and for the ratio linear and Pico surface area methods used to quantify bone loss (range, .84-.98). Overall, 3-D CT results demonstrated better agreement and accuracy compared to 2-D CT. None of the methods assessed in this study using 2-D CT was found to be valid, and therefore, 2-D CT is not recommended for these methods. However, the length of glenoid defects can be reliably and accurately measured on 3-D CT. The Pico and ratio techniques are most reliable; however, the Pico(1) method accurately quantifies glenoid bone loss in both the anterior and anteroinferior locations. Future work is required to implement valid imaging techniques of glenoid bone loss into clinical practice. This is one of the only studies to date that has investigated both the reliability and accuracy of multiple indicators and quantification methods that evaluate glenoid bone loss in anterior glenohumeral instability. These data are critical to ensure valid methods are used for preoperative assessment and to determine when a glenoid bone augmentation procedure is indicated.

Relations of hedonic hunger and behavioral change to weight loss among adults in a behavioral weight loss program utilizing meal-replacement products.

PubMed

Theim, Kelly R; Brown, Joshua D; Juarascio, Adrienne S; Malcolm, Robert R; O'Neil, Patrick M

2013-11-01

Greater self-regulatory behavior usage is associated with greater weight loss within behavioral weight loss treatments. Hedonic hunger (i.e., susceptibility to environmental food cues) may impede successful behavior change and weight loss. Adult men and women (N = 111, body mass index M ± SD = 35.89 ± 6.97 kg/m(2)) were assessed before and after a 15-week lifestyle change weight loss program with a partial meal-replacement diet. From pre- to post-treatment, reported weight control behavior usage improved and hedonic hunger decreased, and these changes were inversely related. Individuals with higher hedonic hunger scores at baseline showed the greatest weight loss. Similarly, participants with lower baseline use of weight control behaviors lost more weight, and increased weight control behavior usage was associated with greater weight loss-particularly among individuals with low baseline hedonic hunger. Further study is warranted regarding the significance of hedonic hunger in weight loss treatments.

Options for Auditory Training for Adults with Hearing Loss.

PubMed

Olson, Anne D

2015-11-01

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

PubMed

Aithal, Sreedevi; Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie

2012-10-01

Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known. This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology. Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted. Chart review of 234 infants referred for one or both ears from a newborn hearing screening program in north Queensland was conducted. A total of 211 infants attended the diagnostic appointment. Review appointments to monitor hearing status were completed for 46 infants with middle ear pathology or conductive hearing loss. Diagnosis of hearing impairment was made using an age-appropriate battery of audiological tests. Results were analyzed for both initial and review appointments. Mean age at initial diagnostic assessment was 47.5 days (SD = 31.3). Of the 69 infants with middle ear pathology during initial diagnostic assessment, 18 had middle ear pathology with normal hearing, 47 had conductive hearing loss, and 4 had mixed hearing loss. Prevalence of conductive hearing loss in the newborns was 2.97 per 1,000 while prevalence of middle ear pathology (with or without conductive hearing loss) was 4.36 per 1,000. Indigenous Australians or Aboriginal and Torres Strait Islander (ATSI) infants had a significantly higher prevalence of conductive hearing loss and middle ear pathology than non-ATSI infants (35.19 and 44.45% vs 17.83 and 28.66%, respectively). ATSI infants also showed poor resolution of conductive hearing loss over time with 66.67% of ATSI infants reviewed showing persistent conductive hearing loss compared to 17.86% of non-ATSI infants. Medical management of 17 infants with persistent conductive hearing loss included monitoring, antibiotic treatment, examination under anesthesia, and grommet insertion. Conductive hearing loss was found to be a common diagnosis among infants referred through screening. ATSI infants had significantly higher rates of middle ear pathology and conductive hearing loss at birth and showed poor resolution of middle ear pathology over time compared to non-ATSI infants. Future research using a direct measure of middle ear function as an adjunct to the automated auditory brainstem response screening tool to distinguish conductive from sensorineural hearing loss may facilitate prioritization of infants for assessment, thus reducing parental anxiety and streamlining the management strategies for the respective types of hearing loss. American Academy of Audiology.

The efficacy of using self-monitoring diaries in a weight loss program for chronically ill obese adults in a rural area.

PubMed

Wang, Chi-Jane; Fetzer, Susan J; Yang, Yi-Ching; Wang, Wen-Ling

2012-09-01

Self-monitoring is part of many weight-loss programs and is widely accepted as effective. However, there is a lack of research related to the efficacy of various self-monitoring instruments in meeting the needs of individuals with limited mobility or access to healthcare providers, especially those with limited education living in rural settings. This study examined the efficacy of using self-monitoring diaries in a weight loss program targeting chronically ill and obese rural-dwelling adults. A community-based intervention program using a pretest and posttest design examined the effect of using self-monitoring diaries on weight loss. Fifty participants were enrolled from the chronic disease clinic of a district health center with limited medical resources in a remote village in southwestern Taiwan. All participants were diagnosed with diabetes and/or hypertension, had body mass indices between 27 and 32 kg/m, and had a minimum educational level of junior high school. Mean participant age was 43.7 years. Participants were randomly assigned to the intervention or control group. All attended a mandatory 12-week weight loss program. The intervention group received instructions on how to record diet and exercise details in a structured, graphics-based diary provided by the researchers. Body weight and percentage of body fat were measured before and after the program, and data were analyzed by chi-square and ANCOVA. The intervention group significantly lost more weight than the control group (5.7 kg vs. 2.1 kg; p < .05). The participants of 88% in the intervention group lost 5% or more of their baseline weight greater than the 23% in the control group. Both groups achieved the mean of body fat reductions by comparing pretest and posttest. Self-monitoring diaries can have a significant impact on weight loss in individuals living in rural communities. Healthcare providers and health promotion agencies can use the suggested checklist method to improve weight loss promotion programs in isolated rural communities with limited medical resources.

Size effects on miniature Stirling cycle cryocoolers

NASA Astrophysics Data System (ADS)

Yang, Xiaoqin; Chung, J. N.

2005-08-01

Size effects on the performance of Stirling cycle cryocoolers were investigated by examining each individual loss associated with the regenerator and combining these effects. For the fixed cycle parameters and given regenerator length scale, it was found that only for a specific range of the hydrodynamic diameter the system can produce net refrigeration and there is an optimum hydraulic diameter at which the maximum net refrigeration is achieved. When the hydraulic diameter is less than the optimum value, the regenerator performance is controlled by the pressure drop loss; when the hydraulic diameter is greater than the optimum value, the system performance is controlled by the thermal losses. It was also found that there exists an optimum ratio between the hydraulic diameter and the length of the regenerator that offers the maximum net refrigeration. As the regenerator length is decreased, the optimum hydraulic diameter-to-length ratio increases; and the system performance is increased that is controlled by the pressure drop loss and heat conduction loss. Choosing appropriate regenerator characteristic sizes in small-scale systems are more critical than in large-scale ones.

A structured diet and exercise program promotes favorable changes in weight loss, body composition, and weight maintenance.

PubMed

Kreider, Richard B; Serra, Monica; Beavers, Kristen M; Moreillon, Jen; Kresta, Julie Y; Byrd, Mike; Oliver, Jonathan M; Gutierrez, Jean; Hudson, Geoffrey; Deike, Erika; Shelmadine, Brian; Leeke, Patricia; Rasmussen, Chris; Greenwood, Mike; Cooke, Matthew B; Kerksick, Chad; Campbell, Jessica K; Beiseigel, Jeannemarie; Jonnalagadda, Satya S

2011-06-01

A number of diet and exercise programs purport to help promote and maintain weight loss. However, few studies have compared the efficacy of different methods. To determine whether adherence to a meal-replacement-based diet program (MRP) with encouragement to increase physical activity is as effective as following a more structured meal-plan-based diet and supervised exercise program (SDE) in sedentary obese women. Randomized comparative effectiveness trial. From July 2007 to October 2008, 90 obese and apparently healthy women completed a 10-week university-based weight loss trial while 77 women from this cohort also completed a 24-week weight maintenance phase. Participants were matched and randomized to participate in an MRP or SDE program. Weight loss, health, and fitness-related data were assessed at 0 and 10 weeks on all subjects as well as at 14, 22, and 34 weeks on participants who completed the weight maintenance phase. Data were analyzed by multivariate analysis of variance for repeated measures. During the 10-week weight loss phase, moderate and vigorous physical activity levels were significantly higher in the SDE group with no differences observed between groups in daily energy intake. The SDE group lost more weight (-3.1 ± 3.7 vs -1.6 ± 2.5 kg; P = 0.03); fat mass (-2.3 ± 3.5 vs -0.9 ± 1.6 kg; P = 0.02); centimeters from the hips (-4.6 ± 7 vs -0.2 ± 6 cm; P = 0.002) and waist (-2.9 ± 6 vs -0.6 ± 5 cm; P = 0.05); and, experienced a greater increase in peak aerobic capacity than participants in the MRP group. During the 24-week maintenance phase, participants in the SDE group maintained greater moderate and vigorous physical activity levels, weight loss, fat loss, and saw greater improvement in maximal aerobic capacity and strength. In sedentary and obese women, an SDE-based program appears to be more efficacious in promoting and maintaining weight loss and improvements in markers of health and fitness compared to an MRP type program with encouragement to increase physical activity. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Hearing loss in space

NASA Technical Reports Server (NTRS)

Buckey, J. C. Jr; Musiek, F. E.; Kline-Schoder, R.; Clark, J. C.; Hart, S.; Havelka, J.

2001-01-01

BACKGROUND: Temporary and, in some cases, permanent hearing loss has been documented after long-duration spaceflights. METHODS: We examined all existing published data on hearing loss after space missions to characterize the losses. RESULTS: Data from Russian missions suggest that the hearing loss, when it occurs, affects mainly mid to high frequencies and that using hearing protection often might prevent the loss. Several significant questions remain about hearing loss in space. While the hearing loss has been presumed to be noise-induced, no clear link has been established between noise exposure and hearing loss during spaceflight. In one documented case of temporary hearing loss from the Shuttle-Mir program, the pattern of loss was atypical for a noise-induced loss. Continuous noise levels that have been measured on the Mir and previous space stations, while above engineering standards, are not at levels usually associated with hearing loss in ground-based studies (which have usually been limited to 8-10 h exposure periods). Attempts to measure hearing in space using threshold-based audiograms have been unsuccessful in both the American and Russian programs due to noise interference with the measurements. CONCLUSIONS: The existing data highlight the need for reliable monitoring of both hearing and noise in long-duration spaceflight.

Arthritogenic alphaviral infection perturbs osteoblast function and triggers pathologic bone loss

PubMed Central

Chen, Weiqiang; Foo, Suan-Sin; Rulli, Nestor E.; Taylor, Adam; Sheng, Kuo-Ching; Herrero, Lara J.; Herring, Belinda L.; Lidbury, Brett A.; Li, Rachel W.; Walsh, Nicole C.; Sims, Natalie A.; Smith, Paul N.; Mahalingam, Suresh

2014-01-01

Arthritogenic alphaviruses including Ross River virus (RRV), Sindbis virus, and chikungunya virus cause worldwide outbreaks of musculoskeletal disease. The ability of alphaviruses to induce bone pathologies remains poorly defined. Here we show that primary human osteoblasts (hOBs) can be productively infected by RRV. RRV-infected hOBs produced high levels of inflammatory cytokine including IL-6. The RANKL/OPG ratio was disrupted in the synovial fluid of RRV patients, and this was accompanied by an increase in serum Tartrate-resistant acid phosphatase 5b (TRAP5b) levels. Infection of bone cells with RRV was validated using an established RRV murine model. In wild-type mice, infectious virus was detected in the femur, tibia, patella, and foot, together with reduced bone volume in the tibial epiphysis and vertebrae detected by microcomputed tomographic (µCT) analysis. The RANKL/OPG ratio was also disrupted in mice infected with RRV; both this effect and the bone loss were blocked by treatment with an IL-6 neutralizing antibody. Collectively, these findings provide previously unidentified evidence that alphavirus infection induces bone loss and that OBs are capable of producing proinflammatory mediators during alphavirus-induced arthralgia. The perturbed RANKL/OPG ratio in RRV-infected OBs may therefore contribute to bone loss in alphavirus infection. PMID:24733914

Urinary 3-methylhistidine and progressive winter undernutrition in white-tailed deer

USGS Publications Warehouse

DelGiudice, G.D.; Kerr, K.D.; Mech, L.D.; Riggs, M.R.; Seal, U.S.

1998-01-01

Physiological indicators of muscle catabolism would aid assessment of winter nutritional restriction of ungulates, and urinary 3-methylhistidine has exhibited potential in this regard in several species. We examined the effect of chronic moderate and severe nutritional restriction during winter on urinary 3-methylhistidine:creatinine ratios in seven adult white-tailed deer (Odocoileus virginianus) and the relationship of these ratios to urinary urea nitrogen:creatinine ratios. Mean base line estimates of urinary 3-methylhistidine:creatinine ratio for the control and severely restricted deer (0.043 and 0.086 ??mol:mg, respectively) were similar (P = 0.280) and remained unchanged in the control deer throughout the study. In contrast, mean 3-methylhistidine:creatinine ratios increased dramatically as nutritional restriction and cumulative mass loss progressed; the quadratic component of the data for the chronically restricted deer was significant (P < 0.001). Likewise, there was a strong curvilinear relationship (R2 = 0.82) between cumulative mass loss (up to 29%) of the pooled deer and urinary 3-methylhistidine:creatinine ratios. Further, urinary urea nitrogen:creatinine ratios were strongly related to 3-methylhistidine:creatinine ratios (r2 = 0.89). Our study indicates that further investigation of 3-methylhistidine as an indicator of physical condition and muscle protein breakdown is warranted.

Explaining the excess morbidity of emergency general surgery: packed red blood cell and fresh frozen plasma transfusion practices are associated with major complications in nonmassively transfused patients.

PubMed

Havens, Joaquim M; Do, Woo S; Kaafarani, Haytham; Mesar, Tomaz; Reznor, Gally; Cooper, Zara; Askari, Reza; Kelly, Edward; Columbus, Alexandra B; Gates, Jonathan D; Haider, Adil H; Salim, Ali

2016-04-01

Intraoperative blood product transfusions carry risk but are often necessary in emergency general surgery (EGS). We queried the American College of Surgery-National Surgical Quality Improvement Program database for EGS patients (2008 to 2012) at 2 tertiary academic hospitals. Outcomes included rates of high packed red blood cell (pRBC) use (estimated blood loss:pRBC < 350:1) and high fresh frozen plasma (FFP) use (FFP:pRBC >1:1.5). Patients were then stratified by exposure to high blood product use. Stepwise logistic regression was performed. Of 992 patients, 33% underwent EGS. Estimated blood loss was similar between EGS and non-EGS (282 vs 250 cc, P = .288). EGS patients were more often exposed to high pRBC use (adjusted odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.11 to 3.66) and high-FFP use (OR = 2.75, 95% CI: = 1.10 to 6.84). High blood product use was independently associated with major nonbleeding complications (high pRBC: OR = 1.73, 95% CI = 1.04 to 2.91; high FFP: OR = 2.15, 95% CI = 1.15 to 4.02). Despite similar blood loss, EGS patients received higher rates of intraoperative blood product transfusion, which was independently associated with major complication. Copyright © 2016 Elsevier Inc. All rights reserved.

Transport pathways of nitrogen and phosphorus in tile-drained cranberry farms

NASA Astrophysics Data System (ADS)

Kennedy, C. D.; Alversion, N.; Jeranyama, P.; DeMoranville, C.; Sandler, H.; Caruso, F.

2013-12-01

Rapid, controlled drainage of cranberry farms is critical to optimizing production in Massachusetts, where approximately 1/3 of the industry's crop is produced. Relatively new to cranberry farming, tile drainage has been billed as a low-cost drainage management option for reducing crop disease and weed infestations. Despite its well documented agronomic benefits, tile drainage may exacerbate nutrient loss and promote eutrophication in nearby ponds receiving cranberry drainage waters. In this study, a monitoring program was established on a Massachusetts cranberry bed to quantify (1) mass loss of nitrogen and phosphorous via tile drainage to a perimeter ditch surrounding the cranberry bed, (2) the attenuation of N and P in the ditch prior to discharge from the cranberry bed, and (3) and the component contributions of preferential vs. matrix transport of N and P in tile drainage. A combination of compound weirs, acoustic-velocity meters, propeller-driven flow meters, and rain gauges were installed to quantify drainage management characteristics of the cranberry bed. Automatic samplers were also installed to collect water samples at each monitoring site (i.e., four tile drains, an irrigation pond, and a flume used to control ditch height) for analysis of N and P concentrations and hydrogen and oxygen stable isotope ratios to estimate nutrient loss and transport pathways. These data will be used to develop a mechanistic synthesis of nutrient cycling in tile-drained cranberry beds.

Bulk tank milk prevalence and production losses, spatial analysis, and predictive risk mapping of Ostertagia ostertagi infections in Mexican cattle herds.

PubMed

Villa-Mancera, Abel; Pastelín-Rojas, César; Olivares-Pérez, Jaime; Córdova-Izquierdo, Alejandro; Reynoso-Palomar, Alejandro

2018-05-01

This study investigated the prevalence, production losses, spatial clustering, and predictive risk mapping in different climate zones in five states of Mexico. The bulk tank milk samples obtained between January and April 2015 were analyzed for antibodies against Ostertagia ostertagi using the Svanovir ELISA. A total of 1204 farm owners or managers answered the questionnaire. The overall herd prevalence and mean optical density ratio (ODR) of parasite were 61.96% and 0.55, respectively. Overall, the production loss was approximately 0.542 kg of milk per parasited cow per day (mean ODR = 0.92, 142 farms, 11.79%). The spatial disease cluster analysis using SatScan software indicated that two high-risk clusters were observed. In the multivariable analysis, three models were tested for potential association with the ELISA results supported by climatic, environmental, and management factors. The final logistic regression model based on both climatic/environmental and management variables included the factors rainfall, elevation, land surface temperature (LST) day, and parasite control program that were significantly associated with an increased risk of infection. Geostatistical kriging was applied to generate a risk map for the presence of parasite in dairy cattle herds in Mexico. The results indicate that climatic and meteorological factors had a higher potential impact on the spatial distribution of O. ostertagi than the management factors.

Measurement of transmission loss characteristics using acoustic intensity techniques at the KU-FRL Acoustic Test Facility

NASA Technical Reports Server (NTRS)

Roskam, J.

1983-01-01

The transmission loss characteristics of panels using the acoustic intensity technique is presented. The theoretical formulation, installation of hardware, modifications to the test facility, and development of computer programs and test procedures are described. A listing of all the programs is also provided. The initial test results indicate that the acoustic intensity technique is easily adapted to measure transmission loss characteristics of panels. Use of this method will give average transmission loss values. The fixtures developed to position the microphones along the grid points are very useful in plotting the intensity maps of vibrating panels.

Description and User Manual for a Web-Based Interface to a Transit-Loss Accounting Program for Monument and Fountain Creeks, El Paso and Pueblo Counties, Colorado

USGS Publications Warehouse

Kuhn, Gerhard; Krammes, Gary S.; Beal, Vivian J.

2007-01-01

The U.S. Geological Survey, in cooperation with Colorado Springs Utilities, the Colorado Water Conservation Board, and the El Paso County Water Authority, began a study in 2004 with the following objectives: (1) Apply a stream-aquifer model to Monument Creek, (2) use the results of the modeling to develop a transit-loss accounting program for Monument Creek, (3) revise an existing accounting program for Fountain Creek to easily incorporate ongoing and future changes in management of return flows of reusable water, and (4) integrate the two accounting programs into a single program and develop a Web-based interface to the integrated program that incorporates simple and reliable data entry that is automated to the fullest extent possible. This report describes the results of completing objectives (2), (3), and (4) of that study. The accounting program for Monument Creek was developed first by (1) using the existing accounting program for Fountain Creek as a prototype, (2) incorporating the transit-loss results from a stream-aquifer modeling analysis of Monument Creek, and (3) developing new output reports. The capabilities of the existing accounting program for Fountain Creek then were incorporated into the program for Monument Creek and the output reports were expanded to include Fountain Creek. A Web-based interface to the new transit-loss accounting program then was developed that provided automated data entry. An integrated system of 34 nodes and 33 subreaches was integrated by combining the independent node and subreach systems used in the previously completed stream-aquifer modeling studies for the Monument and Fountain Creek reaches. Important operational criteria that were implemented in the new transit-loss accounting program for Monument and Fountain Creeks included the following: (1) Retain all the reusable water-management capabilities incorporated into the existing accounting program for Fountain Creek; (2) enable daily accounting and transit-loss computations for a variable number of reusable return flows discharged into Monument Creek at selected locations; (3) enable diversion of all or a part of a reusable return flow at any selected node for purposes of storage in off-stream reservoirs or other similar types of reusable water management; (4) and provide flexibility in the accounting program to change the number of return-flow entities, the locations at which the return flows discharge into Monument or Fountain Creeks, or the locations to which the return flows are delivered. The primary component of the Web-based interface is a data-entry form that displays data stored in the accounting program input file; the data-entry form allows for entry and modification of new data, which then is rewritten to the input file. When the data-entry form is displayed, up-to-date discharge data for each station are automatically computed and entered on the data-entry form. Data for native return flows, reusable return flows, reusable return flow diversions, and native diversions also are entered automatically or manually, if needed. In computing the estimated quantities of reusable return flow and the associated transit losses, the accounting program uses two sets of computations. The first set of computations is made between any two adjacent streamflow-gaging stations (termed 'stream-segment loop'); the primary purpose of the stream-segment loop is to estimate the loss or gain in native discharge between the two adjacent streamflow-gaging stations. The second set of computations is made between any two adjacent nodes (termed 'subreach loop'); the actual transit-loss computations are made in the subreach loop, using the result from the stream-segment loop. The stream-segment loop is completed for a stream segment, and then the subreach loop is completed for each subreach within the segment. When the subreach loop is completed for all subreaches within a stream segment, the stream-segment loop is initiated for the ne

Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Education’s 30-hour duty period requirement

PubMed Central

2012-01-01

Background In 2003 the Accreditation Council for Graduate Medical Education mandated work hour restrictions. Violations can results in a residency program being cited or placed on probation. Recurrent violations could results in loss of accreditation. We wanted to determine specific intern and workload factors associated with violation of a specific mandate, the 30-hour duty period requirement. Methods Retrospective review of interns’ performance against the 30-hour duty period requirement during inpatient ward rotations at a pediatric residency program between June 24, 2008 and June 23, 2009. The analytical plan included both univariate and multivariable logistic regression analyses. Results Twenty of the 26 (77%) interns had 80 self-reported episodes of continuous work hours greater than 30 hours. In multivariable analysis, noncompliance was inversely associated with the number of prior inpatient rotations (odds ratio: 0.49, 95% confidence interval (0.38, 0.64) per rotation) but directly associated with the total number of patients (odds ratio: 1.30 (1.10, 1.53) per additional patient). The number of admissions on-call, number of admissions after midnight and number of discharges post-call were not significantly associated with noncompliance. The level of noncompliance also varied significantly between interns after accounting for intern experience and workload factors. Subject to limitations in statistical power, we were unable to identify specific intern characteristics, such as demographic variables or examination scores, which account for the variation in noncompliance between interns. Conclusions Both intern and workload factors were associated with pediatric intern noncompliance with the 30-hour duty period requirement during inpatient ward rotations. Residency programs must develop information systems to understand the individual and experience factors associated with noncompliance and implement appropriate interventions to ensure compliance with the duty hour regulations. PMID:22621439

Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Education's 30-hour duty period requirement.

PubMed

Maloney, Christopher G; Antommaria, Armand H Matheny; Bale, James F; Ying, Jian; Greene, Tom; Srivastava, Rajendu

2012-07-13

In 2003 the Accreditation Council for Graduate Medical Education mandated work hour restrictions. Violations can results in a residency program being cited or placed on probation. Recurrent violations could results in loss of accreditation. We wanted to determine specific intern and workload factors associated with violation of a specific mandate, the 30-hour duty period requirement. Retrospective review of interns' performance against the 30-hour duty period requirement during inpatient ward rotations at a pediatric residency program between June 24, 2008 and June 23, 2009. The analytical plan included both univariate and multivariable logistic regression analyses. Twenty of the 26 (77%) interns had 80 self-reported episodes of continuous work hours greater than 30 hours. In multivariable analysis, noncompliance was inversely associated with the number of prior inpatient rotations (odds ratio: 0.49, 95% confidence interval (0.38, 0.64) per rotation) but directly associated with the total number of patients (odds ratio: 1.30 (1.10, 1.53) per additional patient). The number of admissions on-call, number of admissions after midnight and number of discharges post-call were not significantly associated with noncompliance. The level of noncompliance also varied significantly between interns after accounting for intern experience and workload factors. Subject to limitations in statistical power, we were unable to identify specific intern characteristics, such as demographic variables or examination scores, which account for the variation in noncompliance between interns. Both intern and workload factors were associated with pediatric intern noncompliance with the 30-hour duty period requirement during inpatient ward rotations. Residency programs must develop information systems to understand the individual and experience factors associated with noncompliance and implement appropriate interventions to ensure compliance with the duty hour regulations.

Consensus statement: appropriate consumer education and communication programs for weight- loss agents in Asia.

PubMed

Chan, Siew Pheng; Chui, William C; Lo, Kwok Wing; Huang, Kuo-Chin; Leyesa, Normita D; Lin, Wen-Yuan; Mirasol, Roberto C; Robles, Yolanda R; Tey, Beng Hea; Paraidathathu, Thomas

2012-07-01

The increasing prevalence of overweight and obesity worldwide demands increased efforts in the prevention and management of obesity. This article aims to present consensus statements promoting appropriate consumer education and communication programs for weight-loss agents in Asia. Panel members from various disciplines developed consensus statements based on an expert meeting on the benefits of consumer education and communication programs for over-the-counter weight-loss agents. Key opinion leaders discussed relevant data that served as the basis of the recommendations. Obesity is a growing epidemic in Asia, turning the region into a potential market for weight-loss products and services. Current trends in direct-to-consumer advertising demonstrate the pervasiveness of false representations lacking adequate substantiation. Relevant issues and recommendations were established. Public education on weight management is a shared responsibility; there is a need to raise public awareness of obesity and its health-related consequences. Advertising guidelines should ensure responsible direct-to-consumer advertising of weight-loss agents.

Success of women in a worksite weight loss program: Does being part of a group help?

PubMed

Rigsby, Andrea; Gropper, Daniel M; Gropper, Sareen S

2009-04-01

This study reports the results of a worksite weight loss program which allowed female hospital and nursing home employees to enroll in a worksite weight loss program as individuals or as part of a group. After 8 weeks, employees (irrespective of group versus individual participation) lost an average of 6.2 lb and 1.5% body fat. The initial weight, body fat, and body mass index reductions were all significantly greater, in absolute and percentage terms, among group participants than individual participants. Weight reduction averaged 7.6+1.1 lb for group participants and 4.2+6.4 lb for individual participants; body fat reduction was 1.7+1.3% for group participants and 0.9+1.3% for individual participants. Exercising more frequently was significantly associated with weight loss in those participating as a group, while following a written diet plan was significantly associated with weight loss in those participating as individuals.

Results of an Academic, Health Care Worksite Weight Loss Contest for Southeastern Americans: Scale Back Alabama 2011-2013.

PubMed

Breaux-Shropshire, Tonya L; Whitt, Lauren; Oster, Robert A; Lewis, Dwight; Shropshire, Toneyell S; Calhoun, David A

2015-04-01

Few studies have assessed the effectiveness of competitive incentivized worksite weight loss programs. Scale Back Alabama (SBA) is a free, state-supported program designed to promote weight loss among overweight and obese citizens. The purpose of this manuscript is to describe the design and preliminary findings of SBA as a worksite intervention among employees at a collegiate institution and university hospital. In teams of 4 employees, SBA participants volunteered to engage in a 10-week competitive weight loss contest; both teams and individuals who lost significant weight were eligible for randomly drawn cash incentives. Trained staff objectively measured participants' weight before and at the conclusion of the contest. Preliminary analyses suggest that SBA as a worksite program can promote weight loss among employees, but future analyses are warranted to understand the context of these findings and determine if current results are confounded by unmeasured factors. © 2015 The Author(s).

International Review of Standards and Labeling Programs for Distribution Transformers

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

Letschert, Virginie; Scholand, Michael; Carreño, Ana María

Transmission and distribution (T&D) losses in electricity networks represent 8.5% of final energy consumption in the world. In Latin America, T&D losses range between 6% and 20% of final energy consumption, and represent 7% in Chile. Because approximately one-third of T&D losses take place in distribution transformers alone, there is significant potential to save energy and reduce costs and carbon emissions through policy intervention to increase distribution transformer efficiency. A large number of economies around the world have recognized the significant impact of addressing distribution losses and have implemented policies to support market transformation towards more efficient distribution transformers. Asmore » a result, there is considerable international experience to be shared and leveraged to inform countries interested in reducing distribution losses through policy intervention. The report builds upon past international studies of standards and labeling (S&L) programs for distribution transformers to present the current energy efficiency programs for distribution transformers around the world.« less

Brief report: Weight dissatisfaction, weight status, and weight loss in Mexican-American children

USDA-ARS?s Scientific Manuscript database

The study objectives were to assess the association between weight dissatisfaction, weight status, and weight loss in Mexican-American children participating in a weight management program. Participants included 265 Mexican American children recruited for a school-based weight management program. Al...

Prevotella-to-Bacteroides ratio predicts body weight and fat loss success on 24-week diets varying in macronutrient composition and dietary fiber: results from a post-hoc analysis.

PubMed

Hjorth, Mads F; Blædel, Trine; Bendtsen, Line Q; Lorenzen, Janne K; Holm, Jacob B; Kiilerich, Pia; Roager, Henrik M; Kristiansen, Karsten; Larsen, Lesli H; Astrup, Arne

2018-05-17

Individuals with high pre-treatment bacterial Prevotella-to-Bacteroides (P/B) ratio have been reported to lose more body weight on diets high in fiber than subjects with a low P/B ratio. Therefore, the aim of the present study was to examine potential differences in dietary weight loss responses between participants with low and high P/B. Eighty overweight participants were randomized (52 completed) to a 500 kcal/d energy deficit diet with a macronutrient composition of 30 energy percentage (E%) fat, 52 E% carbohydrate and 18 E% protein either high (≈1500 mg calcium/day) or low ( ≤ 600 mg calcium/day) in dairy products for 24 weeks. Body weight, body fat, and dietary intake (by 7-day dietary records) were determined. Individuals were dichotomized according to their pre-treatment P/B ratio derived from 16S rRNA gene sequencing of collected fecal samples to test the potential modification of dietary effects using linear mixed models. Independent of the randomized diets, individuals with high P/B lost 3.8 kg (95%CI, 1.8,5.8; P < 0.001) more body weight and 3.8 kg (95% CI, 1.1, 6.5; P = 0.005) more body fat compared to individuals with low P/B. After adjustment for multiple covariates, individuals with high P/B ratio lost 8.3 kg (95% CI, 5.8;10.9, P < 0.001) more body weight when consuming above compared to below 30 g fiber/10MJ whereas this weight loss was 3.2 kg (95% CI, 0.8;5.5, P = 0.008) among individuals with low P/B ratio [Mean difference: 5.1 kg (95% CI, 1.7;8.6, P = 0.003)]. Partial correlation coefficients between fiber intake and weight change was 0.90 (P < 0.001) among individuals with high P/B ratio and 0.25 (P = 0.29) among individuals with low P/B ratio. Individuals with high P/B lost more body weight and body fat compared to individuals with low P/B, confirming that individuals with a high P/B are more susceptible to weight loss on a diet rich in fiber.

Increase in cognitive eating restraint predicts weight loss and change in other anthropometric measurements in overweight/obese premenopausal women.

PubMed

Urbanek, J Kalina; Metzgar, Catherine J; Hsiao, Pao Ying; Piehowski, Kathryn E; Nickols-Richardson, Sharon M

2015-04-01

In modern societies characterized by food abundance, dietary restraint may serve as a factor in the successful control of weight or facilitation of weight loss. This secondary analysis of data examined whether changes in cognitive eating restraint (CER) and disinhibition predicted weight loss in a sample of 60 overweight/obese premenopausal women [mean ± SD, age = 35.9 ± 5.8 y; weight = 84.4 ± 13.1 kg; body mass index (BMI) = 31.0 ± 4.3 kg/m(2)]. Changes in weight, BMI, waist circumference, hip circumference, waist-to-hip ratio and body fat percentage (BF%) were examined in relation to changes in CER, disinhibition and hunger as measured by the Eating Inventory questionnaire at baseline and week 18 of an 18-week dietary intervention. Multivariate linear regression analysis was used to identify predictors of weight loss and changes in other anthropometric variables from baseline to study completion. Increase in CER was found to be the most robust predictor of reduction in weight (P < 0.0001), BMI (P < 0.0001), waist circumference (P < 0.001), hip circumference (P < 0.0001) and BF% (P < 0.0001). Effect of increase in CER on change in BMI, hip circumference and BF% was moderated by increase in disinhibition (all P < 0.05). Results suggest that strategies that target CER and disinhibition should be emphasized in programs proposed to treat and prevent obesity. Copyright © 2014 Elsevier Ltd. All rights reserved.

A work-site weight control program using financial incentives collected through payroll deduction.

PubMed

Forster, J L; Jeffery, R W; Sullivan, S; Snell, M K

1985-11-01

In a work-site weight control program using a self-motivational program of financial incentives implemented through payroll deduction, 131 university employees chose weight loss goals (0 to 60 lb) and incentives (+5 to +30) to be deducted from each paycheck for six months. Return of incentive money was contingent on progress toward weight goals. Participants were assigned randomly to one of four protocols, involving group educational sessions v self-instruction only and required v optional attendance at weigh-ins and sessions. Overall, dropout rates (21.4%) and mean weight loss (12.2 lb) were encouraging, especially compared with those of other work-site programs. Weight loss was positively associated with attendance at weigh-ins and educational sessions. However, requiring attendance did not increase program effectiveness and seemed also to discourage enrollment among men. The weight control program was equally effective when offered with professionally led educational sessions or when accompanied by self-instructional materials only.

Sickness absence trends after loss control management

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

Tabaluyan, T.; Kuswadji, S.

1996-12-31

To assess the influence of loss control management programs applied in an oil and gas company to sickness absence trends. After the implementation of loss control management programs in 1990, sickness absence records in 1991, 1992 and 1993 were studied. International Safety Rating System (ISRS) management elements were audited each year. Absence parameter used were sickness frequency, mean sickness days examined by employee group age, length of service, work schedule and work location. Although frequency of sickness absences remain unchanged, there was a marked decrease of mean days per absence for certain worker groups. The effects were true among agemore » group 40-49 years, service group 15-19 years, service group 20-24 years and office workers. Shorter sickness absences among certain group of employees was noted following implementation of loss control management programs.« less

Getting a Job is Only Half the Battle: Maternal Job Loss and Child Classroom Behavior in Low-Income Families

PubMed Central

Hill, Heather D.; Morris, Pamela A.; Castells, Nina; Walker, Jessica Thornton

2011-01-01

This study uses data from an experimental employment program and instrumental variables (IV) estimation to examine the effects of maternal job loss on child classroom behavior. Random assignment to the treatment at one of three program sites is an exogenous predictor of employment patterns. Cross-site variation in treatment-control differences is used to identify the effects of employment levels and transitions. Under certain assumptions, this method controls for unobserved correlates of job loss and child well-being, as well as measurement error and simultaneity. IV estimates suggest that maternal job loss sharply increases problem behavior but has neutral effects on positive social behavior. Current employment programs concentrate primarily on job entry, but these findings point to the importance of promoting job stability for workers and their children. PMID:22162901

Benefits of adding small financial incentives or optional group meetings to a web-based statewide obesity initiative.

PubMed

Leahey, Tricia M; Subak, Leslee L; Fava, Joseph; Schembri, Michael; Thomas, Graham; Xu, Xiaomeng; Krupel, Katie; Kent, Kimberly; Boguszewski, Katherine; Kumar, Rajiv; Weinberg, Brad; Wing, Rena

2015-01-01

To examine whether adding either small, variable financial incentives or optional group sessions improves weight losses in a community-based, Internet behavioral program. Participants (N = 268) from Shape Up Rhode Island 2012, a 3-month Web-based community wellness initiative, were randomized to: Shape Up+Internet behavioral program (SI), Shape Up+Internet program+incentives (SII), or Shape Up+Internet program+group sessions (SIG). At the end of the 3-month program, SII achieved significantly greater weight losses than SI (SII: 6.4% [5.1-7.7]; SI: 4.2% [3.0-5.6]; P = 0.03); weight losses in SIG were not significantly different from the other two conditions (SIG: 5.8% [4.5-7.1], P's ≥ 0.10). However, at the 12-month no-treatment follow-up visit, both SII and SIG had greater weight losses than SI (SII: 3.1% [1.8-4.4]; SIG: 4.5% [3.2-5.8]; SI: 1.2% [-0.1-2.6]; P's ≤ 0.05). SII was the most cost-effective approach at both 3 (SII: $34/kg; SI: $34/kg; SIG: $87/kg) and 12 months (SII: $64/kg; SI: $140/kg; SIG: $113/kg). Modest financial incentives enhance weight losses during a community campaign, and both incentives and optional group meetings improved overall weight loss outcomes during the follow-up period. However, the use of the financial incentives is the most cost-effective approach. © 2014 The Obesity Society.

The zinc-loss effect and mobility enhancement of DUV-patterned sol-gel IGZO thin-film transistors

NASA Astrophysics Data System (ADS)

Wang, Kuan-Hsun; Zan, Hsiao-Wen; Soppera, Olivier

2018-03-01

We investigate the composition of the DUV-patterned sol-gel indium gallium zinc oxide (IGZO) thin-film transistors (TFTs) and observe a significant zinc loss effect during developing when the DUV exposure is insufficient. The zinc loss, however, is beneficial for increasing the mobility. Reducing zinc to indium composition ratio from 0.5 to 0.02 can effectively increase mobility from 0.27 to 7.30 cm2 V-1 s-1 when the gallium to indium ratio is fixed as 0.25 and the post annealing process is fixed as 300 °C for 2 h. On the other hand, an IGO TFT fails to deliver a uniform film and a reproducible TFT performance, revealing the critical role of zinc in forming homogeneous IGZO TFTs.

The effects of time of disease occurrence, milk yield, and body condition on fertility of dairy cows.

PubMed

Loeffler, S H; de Vries, M J; Schukken, Y H

1999-12-01

The associations between occurrence of diseases, milk yield, and body condition score on conception risk after first artificial insemination (AI) were analyzed in an observational study on a convenience sample of 43 farms participating in a herd health program. Data were taken from 9369 lactations, from 4382 cows inseminated between 20 and 180 d in milk from 1990 to 1996. Two logistic regression models, one containing data from all lactations and a subset containing data from 1762 lactations with body condition scoring, were used to determine pregnancy risk at first AI. The effects of herd deviation in test-day milk yield, body condition score loss, and milk fat to protein ratio changes in early lactation were significant predictors of pregnancy risk, independent of disease; days in milk; farm; and seasonal factors. Three different methods of disease parameterization (incidence rates, binomial classes dependent on the interval in days since last occurrence with respect to AI, and a linear variable weighted for this interval) produced similar results. Metritis, cystic ovarian disease, lameness, and mastitis gave odds ratios for pregnancy risk ranging from 0.35 to 1.15, largely dependent on the interval in days from final disease occurrence to first AI. Displaced abomasum, milk fever, and retained fetal membranes resulted in odds ratios for pregnancy risk of 0.25, 0.85, and 0.55, respectively. These diseases showed little relationship between fertility and the number of days since last occurrence. Results of this study confirm the negative effects of milk yield, body score condition loss, and disease on dairy cow fertility. The effects of some diseases on first service conception were strongly dependent on the interval since last disease occurrence. This was especially valid for clinical mastitis, which has an extremely weak effect on conception if occurring prior to AI and is associated with > 50% reduction in pregnancy risk if occurring in the 3 wk directly after AI.

Long-term usage of modern signal processing by listeners with severe or profound hearing loss: a retrospective survey.

PubMed

Keidser, Gitte; Hartley, David; Carter, Lyndal

2008-12-01

To investigate the long-term benefit of multichannel wide dynamic range compression (WDRC) alone and in combination with directional microphones and noise reduction/speech enhancement for listeners with severe or profound hearing loss. At the conclusion of a research project, 39 participants with severe or profound hearing loss were fitted with WDRC in one program and WDRC with directional microphones and speech enhancement enabled in a 2nd program. More than 2 years after the 1st participants exited the project, a retrospective survey was conducted to determine the participants' use of, and satisfaction with, the 2 programs. From the 30 returned questionnaires, it seems that WDRC is used with a high degree of satisfaction in general everyday listening situations. The reported benefit from the addition of a directional microphone and speech enhancement for listening in noisy environments was lower and varied among the users. This variable was significantly correlated with how much the program was used. The less frequent and more varied use of the program with directional microphones and speech enhancement activated in combination suggests that these features may be best offered in a 2nd listening program for listeners with severe or profound hearing loss.

The comparison of two methods to manufacture fused biconical tapered optical fiber coupler

NASA Astrophysics Data System (ADS)

Wang, Yue; Liu, Hairong

2009-08-01

Optical fiber coupler is a directional coupler which is crucial component for optical fiber communication systems. The fused biconical taper is the most important method in facture of optical fiber coupler, with many advantages of low excess loss, precise coupling ratio, good consistency and stability. In this paper we have introduced a new method to manufacture optical fiber coupler. And more over the new manufacture process has been compared with the traditional manufacture method. In the traditional crafts, two optical fibers are parallel placed, and then use the method of tie a knot of the two optical fibers. In the new process, a new program of fiber placement is introduced. Two optical fibers are parallel placed in the middle of the fixture, and then in order to make the bare part of the optical fiber close as much as possible, the new plan using high temperature resistant material bind the both end of the fiber which are not removing the cladding. After many contrast tests, we can see that adopt the improved method of fiber placement, during the process of fiber pulling, the variation of optical power in the directional arm and the coupler arm are more smooth and steady. But the excess loss (EL) generated in the process of pulling is a bit higher than the traditional method of tie a knot. The tests show that the new method of optical fiber placement is feasible in the actual projects for the manufacture of coupler with low coupling ratio, but for the control of the EL still need further studying.

A pilot Internet-based behavioral weight loss intervention with or without commercially available portion-controlled foods.

PubMed

Webber, Kelly H; Rose, Stephanie A

2013-09-01

To evaluate the short-term impact of portion-controlled food provision in combination with an Internet behavioral weight loss program on weight, blood cholesterol, and blood glucose levels. Fifty participants, mean age 46 ± 10.7 years and mean body mass index 35.1 ± 3.8 kg/m2 , were randomized to one of two study groups, an Internet behavioral weight loss program (Internet-alone; n = 25) or an Internet behavioral weight loss program plus a commercially available portion-controlled diet (Internet + PCD; n = 25) for 12 weeks. An intent-to-treat analysis found that the mean weight change in the Internet + PCD group was -5.7 ± 5.6 kg and in the Internet-alone group (n = 25) was -4.1 ± 4.0 kg (P = 0.26). Participants in the Internet + PCD group achieved significantly greater improvements in blood glucose (-2.6 ± 5.7 vs. 1.4 ± 11.0 mg/dl; P = 0.05) and LDL cholesterol (-8.2 ± 18.0 vs. -0.6 ± 21.0 mg/dl; P = 0.04), compared with Internet-alone group. These data suggest that there may be short-term clinical benefit in using a PCD in conjunction with a behavioral Internet-based weight loss program to enhance weight loss and improve health indicators. Copyright © 2013 The Obesity Society.

Does apical root resection in endodontic microsurgery jeopardize the prosthodontic prognosis?

PubMed Central

Cho, Sin-Yeon

2013-01-01

Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication. PMID:23741707

Weight loss and dropout during a commercial weight-loss program including a very-low-calorie diet, a low-calorie diet, or restricted normal food: observational cohort study.

PubMed

Hemmingsson, Erik; Johansson, Kari; Eriksson, Jonas; Sundström, Johan; Neovius, Martin; Marcus, Claude

2012-11-01

The effectiveness of commercial weight-loss programs consisting of very-low-calorie diets (VLCDs) and low-calorie diets (LCDs) is unclear. The aim of the study was to quantify weight loss and dropout during a commercial weight-loss program in Sweden (Itrim; cost: $1300/€1000; all participants paid their own fee). This observational cohort study linked commercial weight-loss data with National Health Care Registers. Weight loss was induced with a 500-kcal liquid-formula VLCD [n = 3773; BMI (in kg/m(2)): 34 ± 5 (mean ± SD); 80% women; 45 ± 12 y of age (mean ± SD)], a 1200-1500-kcal formula and food-combination LCD (n = 4588; BMI: 30 ± 4; 86% women; 50 ± 11 y of age), and a 1500-1800-kcal/d restricted normal-food diet (n = 676; BMI: 29 ± 5; 81% women; 51 ± 12 y of age). Maintenance strategies included exercise and a calorie-restricted diet. Weight loss was analyzed by using an intention-to-treat analysis (baseline substitution). After 1 y, mean (±SD) weight changes were -11.4 ± 9.1 kg with the VLCD (18% dropout), -6.8 ± 6.4 kg with the LCD (23% dropout), and -5.1 ± 5.9 kg with the restricted normal-food diet (26% dropout). In an adjusted analysis, the VLCD group lost 2.8 kg (95% CI: 2.5, 3.2) and 3.8 kg (95% CI: 3.2, 4.5) more than did the LCD and restricted normal-food groups, respectively. A high baseline BMI and rapid initial weight loss were both independently associated with greater 1-y weight loss (P < 0.001). Younger age and low initial weight loss predicted an increased dropout rate (P < 0.001). Treatment of depression (OR: 1.4; 95% CI: 1.1, 1.9) and psychosis (OR: 2.6; 95% CI: 1.1, 6.3) were associated with an increased dropout rate in the VLCD group. A commercial weight-loss program, particularly one using a VLCD, was effective at reducing body weight in self-selected, self-paying adults.

Testing of the box transformer 10/04.4 kV in the network of the electricity supply company

NASA Astrophysics Data System (ADS)

Cichowski, R.; Nickling, G.

1983-08-01

Applications of a 10/0.4 kV box transformer are studied. Single phase and triple phase prototypes were tested in a distribution network. Test results show that heat loss, hence ground desiccation danger is eliminated by using lean concrete as bedding material (ratio of weight sand: cement: water = 19:1:2). Redistribution of no-load losses and winding losses reduces the total loss from 460 to 324 W, and improves the connection technique.

Phase II prospective randomized trial of weight loss prior to radical prostatectomy.

PubMed

Henning, Susanne M; Galet, Colette; Gollapudi, Kiran; Byrd, Joshua B; Liang, Pei; Li, Zhaoping; Grogan, Tristan; Elashoff, David; Magyar, Clara E; Said, Jonathan; Cohen, Pinchas; Aronson, William J

2017-12-04

Obesity is associated with poorly differentiated and advanced prostate cancer and increased mortality. In preclinical models, caloric restriction delays prostate cancer progression and prolongs survival. We sought to determine if weight loss (WL) in men with prostate cancer prior to radical prostatectomy affects tumor apoptosis and proliferation, and if WL effects other metabolic biomarkers. In this Phase II prospective trial, overweight and obese men scheduled for radical prostatectomy were randomized to a 5-8 week WL program consisting of standard structured energy-restricted meal plans (1200-1500 Kcal/day) and physical activity or to a control group. The primary endpoint was apoptotic index in the radical prostatectomy malignant epithelium. Secondary endpoints were proliferation (Ki67) in the radical prostatectomy tissue, body weight, body mass index (BMI), waist to hip ratio, body composition, and serum PSA, insulin, triglyceride, cholesterol, testosterone, estradiol, leptin, adiponectin, interleukin 6, interleukin 8, insulin-like growth factor 1, and IGF binding protein 1. In total 23 patients were randomized to the WL intervention and 21 patients to the control group. Subjects in the intervention group had significantly more weight loss (WL:-3.7 ± 0.5 kg; Control:-1.6 ± 0.5 kg; p = 0.007) than the control group and total fat mass was significantly reduced (WL:-2.1 ± 0.4; Control: 0.1 ± 0.3; p = 0.015). There was no significant difference in apoptotic or proliferation index between the groups. Among the other biomarkers, triglyceride, and insulin levels were significantly decreased in the WL compared with the control group. In summary, this short-term WL program prior to radical prostatectomy resulted in significantly more WL in the intervention vs. the control group and was accompanied by significant reductions in body fat mass, circulating triglycerides, and insulin. However, no significant changes were observed in malignant epithelium apoptosis or proliferation. Future studies should consider a longer term or more intensive weight loss intervention.

Accessible weight loss: Adapting a lifestyle intervention for adults with impaired mobility.

PubMed

Betts, Andrea C; Froehlich-Grobe, Katherine

2017-01-01

Despite disparities in obesity between those with and without disability, there is limited evidence to guide weight loss intervention in people with impaired mobility (IM), particularly those with severe impairments. Examine the usability, feasibility, and effectiveness of adapting an existing evidence-based weight loss program for people with IM. In this single-group pre-test post-test pilot study, 10 overweight or obese individuals with permanent IM (e.g. spinal cord injury, spina bifida, osteoarthritis) participated in a 20-week modification of the DPP Group Lifestyle Balance™ (DPP GLB) program, a group-based adaptation of the Diabetes Prevention Program (DPP). Fifteen conference calls encouraged reducing calorie and fat intake and increasing exercise through self-monitoring and problem solving. We defined feasibility as retention and engagement, usability as participants' program satisfaction ratings, and effectiveness as physiological and psychosocial change measured on three occasions over 20 weeks. Analytic methods included basic descriptive statistics (feasibility and usability) and repeated measures ANOVA (effectiveness). The program retained 70% of participants. These individuals attended an average of 79.3% of conference calls and self-monitored more than half of the weeks. Participants rated the program highly, with mean overall scores of 6.3 ± 0.3 and 6.2 ± 0.6 out of 7 on helpfulness and satisfaction scales, respectively. Program completers experienced a significant mean weight loss of 8.86 ± 8.37 kg (p = 0.024), or 7.4% of their start weight, and significantly reduced their BMI. An adapted version of the DPP GLB is a feasible, usable, and potentially effective intervention for promoting weight loss among persons with IM. Copyright © 2016 Elsevier Inc. All rights reserved.

Weight Loss Program in a Student Health Service.

ERIC Educational Resources Information Center

Hidalgo, Susan McConville

1980-01-01

The overweight college student is faced not only with the normal anxieties of adolescence but also with the special stress of surviving in a new environment. The nurse practitioner can guide students to bear responsibility for good health and provide a sound nutritional framework for a weight loss program. (CJ)

A design program for the estimation and abatement of soil losses from highway slopes.

DOT National Transportation Integrated Search

1974-01-01

A manual was prepared for use in estimating soil losses and designing adequate abatement structures along the ditch lines of roadways. These tasks were to be accomplished by a computer program intended to be used on the IBM Model 370 computer. The ma...

The diet game. Weighing the options.

PubMed Central

Lemaire, D.

1993-01-01

As a major source of nutrition information for the public, physicians have a responsibility to assist their patients to make safe choices about weight loss programs. While most diet programs result in weight loss, the "quick fix" potentially is harmful. This article describes weight control options and their strengths and weaknesses. PMID:8471909

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... insurer's aggregate amount of insured losses for acts of terrorism in that Program Year. Amounts recovered... terrorism, or similar events. Compensation provided by Federal programs for insured losses excludes benefit...

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... insurer's aggregate amount of insured losses for acts of terrorism in that Program Year. Amounts recovered... terrorism, or similar events. Compensation provided by Federal programs for insured losses excludes benefit...

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... insurer's aggregate amount of insured losses for acts of terrorism in that Program Year. Amounts recovered... terrorism, or similar events. Compensation provided by Federal programs for insured losses excludes benefit...

Factors Associated with Attrition in Weight Loss Programs

ERIC Educational Resources Information Center

Grave, Riccardo Dalle; Suppini, Alessandro; Calugi, Simona; Marchesini, Giulio

2006-01-01

Attrition in weight loss programs is a complex process, influenced by patients' pretreatment characteristics and treatment variables, but available data are contradictory. Only a few variables have been confirmed by more than one study as relevant risk factors, but recently new data of clinical utility emerged from "real world" large observational…

7 CFR 1493.500 - Notice of default and claims for loss.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.500 Notice of default and claims for loss... obligation, the exporter or the exporter's assignee must submit a notice of default to CCC as soon as...

7 CFR 1493.500 - Notice of default and claims for loss.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.500 Notice of default and claims for loss... obligation, the exporter or the exporter's assignee must submit a notice of default to CCC as soon as...

Effects of a multimedia project on users' knowledge about normal forgetting and serious memory loss.

PubMed

Mahoney, Diane Feeney; Tarlow, Barbara J; Jones, Richard N; Sandaire, Johnny

2002-01-01

The aim of the project was to develop and evaluate the effectiveness of a CD-ROM-based multimedia program as a tool to increase user's knowledge about the differences between "normal" forgetfulness and more serious memory loss associated with Alzheimer's disease. The research was a controlled randomized study conducted with 113 adults who were recruited from the community and who expressed a concern about memory loss in a family member. The intervention group (n=56) viewed a module entitled "Forgetfulness: What's Normal and What's Not" on a laptop computer in their homes; the control group (n=57) did not. Both groups completed a 25-item knowledge-about-memory-loss test (primary outcome) and a sociodemographic and technology usage questionnaire; the intervention group also completed a CD-ROM user's evaluation. The mean (SD) number of correct responses to the knowledge test was 14.2 (4.5) for controls and 19.7 (3.1) for intervention participants. This highly significant difference (p<0.001) corresponds to a very large effect size. The program was most effective for participants with a lower level of self-reported prior knowledge about memory loss and Alzheimer's disease (p=0.02). Viewers were very satisfied with the program and felt that it was easy to use and understand. They particularly valued having personal access to a confidential source that permitted them to become informed about memory loss without public disclosure. This multimedia CD-ROM technology program provides an efficient and effective means of teaching older adults about memory loss and ways to distinguish benign from serious memory loss. It uniquely balances public community outreach education and personal privacy.

Analysis of pressure losses in the diffuser of a control valve

NASA Astrophysics Data System (ADS)

Turecký, Petr; Mrózek, Lukáš; Tajč, Ladislav; Kolovratník, Michal

The pressure loss in the diffuser of a control valve is evaluated by using CFD computations. Pressure ratios and lifts of a cone for the recommended flow characteristics of an experimental turbine are considered. The pressure loss in a valve is compared with the pressure loss in a nozzle, i.e. the embodiment of the valve without a cone. Computations are carried out for the same mass flow. Velocity profiles are evaluated in both versions of computations. Comparison of computed pressure losses, with the loss evaluated by using relations for diffusers with the ideal velocity conditions in the input cross-section, is carried out.

Utilization patterns and user characteristics of an ad libitum Internet weight loss program.

PubMed

Binks, Martin; van Mierlo, Trevor

2010-03-29

The Internet holds promise for the delivery of evidence-based weight loss treatment to underserved populations. However, most studies do not reflect the more naturalistic and common ad libitum, or freely at will, use of the Internet. Randomized clinical trials, for example, typically include at least some direct contact with participants and often have restrictive selection criteria. There is a paucity of research examining utilization patterns of online weight loss programs, particularly in the rapidly expanding direct-to-consumer arena. To examine self-reported characteristics (age, body mass index [BMI], gender), behaviors, and Internet site utilization patterns of a sample of users of a direct-to-consumer ad libitum Internet weight loss program. This study is based on analysis of archival data from the initial 15 weeks of an ongoing, free, evidence-based, direct-to-consumer Internet weight loss program, the Healthy Weight Center, which included standard information about nutrition, fitness, and behavioral strategies; monitoring tools; and moderated support group message boards. Participants encountered the program through self-directed Internet searches and anonymously registered to utilize the site. Self-reported user characteristics and electronically tracked utilization data were extracted from existing program data, compiled, and examined. Pearson correlations were computed to examine the association of program utilization with age and BMI. One-way analysis of variance (ANOVA) was used for gender comparisons. We examined data from the first 204 adult users of the program who were classified as either overweight (BMI 25 to < 30 kg/m(2)) or obese (BMI > or = 30 kg/m(2)). The mean age of participants was 42.0 years (SD 11.7), 81.9% (167/204) were women, and mean BMI was 32.01 kg/m(2) (SD 6.26). The percent of participants who used program tools was as follows: 13.7%, meal planner; 10.8%, nutrition lookup: 17.6%, activity log; 14.2%, journal; and 22.1%, weight tracker. Participants also used the following educational resources: nutrition, 13.2%; fitness, 6.4%; and behavioral, 7.4%. Of the personal self-assessments available through the program, 57.8% of participants assessed personal barriers, and 50.5% assessed relationship with food. Only 7.8% used the support group message boards. No significant associations between site utilization and age, gender, or BMI were found. Reasons for wanting to lose weight were: health, 87%; appearance, 74%; mobility, 44%; doctor recommendation, 23%; and spouse/friend suggested, 12%. The age participants reported first becoming overweight was young adulthood, 31%; late adulthood, 28%; childhood, 22%; adolescence, 17%; and as a toddler, 3%. Self-perceived factors contributing to weight gain were lack of exercise for 70% of participants, emotions for 62%, overeating for 61%, and slow metabolism for 33%. Internet weight loss programs reach many people who cannot access traditional treatment. However, users appear not to be optimally utilizing key aspects of the weight loss intervention, such as education, monitoring, and support. This study provides insight into the patterns of ad libitum use of an online weight loss program across multiple treatment-related domains in a naturalistic Internet environment.

Efficacy of the FIFA 11+ Injury Prevention Program in the Collegiate Male Soccer Player

PubMed Central

Silvers-Granelli, Holly; Mandelbaum, Bert; Adeniji, Ola; Insler, Stephanie; Bizzini, Mario; Pohlig, Ryan; Junge, Astrid; Snyder-Mackler, Lynn; Dvorak, Jiri

2016-01-01

Background The Fédération Internationale de Football Association (FIFA) 11+ program has been shown to be an effective injury prevention program in the female soccer cohort, but there is a paucity of research to demonstrate its efficacy in the male population. Hypothesis To examine the efficacy of the FIFA 11+ program in men's collegiate United States National Collegiate Athletic Association (NCAA) Division I and Division II soccer. Study Design Randomized controlled trial; Level of evidence, 1. Methods Before the commencement of the fall 2012 season, every NCAA Division I and Division II men's collegiate soccer team (N = 396) was solicited to participate in this research study. Human ethics review board approval was obtained through Quorum Review IRB. Sixty-five teams were randomized: 34 to the control group (CG; 850 players) and 31 to the intervention group (IG; 675 players). Four teams in the IG did not complete the study, reducing the number for analysis to 61. The FIFA 11+ injury prevention program served as the intervention and was utilized weekly. Athlete-exposures (AEs), compliance, and injury data were recorded using a secure Internet-based system. Results In the CG, 665 injuries (mean ± SD, 19.56 ± 11.01) were reported for 34 teams, which corresponded to an incidence rate (IR) of 15.04 injuries per 1000 AEs. In the IG, 285 injuries (mean ± SD, 10.56 ± 3.64) were reported for 27 teams, which corresponded to an IR of 8.09 injuries per 1000 AEs. Total days missed because of injury were significantly higher for the CG (mean ± SD, 13.20 ± 26.6 days) than for the IG (mean ± SD, 10.08 ± 14.68 days) (P = .007). There was no difference for time loss due to injury based on field type (P = .341). Conclusion The FIFA 11+ significantly reduced injury rates by 46.1% and decreased time loss to injury by 28.6% in the competitive male collegiate soccer player (rate ratio, 0.54 [95% CI, 0.49-0.59]; P < .0001) (number needed to treat = 2.64). PMID:26378030

Retention in Differentiated Care: Multiple Measures Analysis for a Decentralized HIV Care and Treatment Program in North Central Nigeria

PubMed Central

Agaba, Patricia A; Genberg, Becky L; Sagay, Atiene S; Agbaji, Oche O; Meloni, Seema T; Dadem, Nancin Y; Kolawole, Grace O; Okonkwo, Prosper; Kanki, Phyllis J; Ware, Norma C

2018-01-01

Objective Differentiated care refers collectively to flexible service models designed to meet the differing needs of HIV-infected persons in resource-scarce settings. Decentralization is one such service model. Retention is a key indicator for monitoring the success of HIV treatment and care programs. We used multiple measures to compare retention in a cohort of patients receiving HIV care at “hub” (central) and “spoke” (decentralized) sites in a large public HIV treatment program in north central Nigeria. Methods This retrospective cohort study utilized longitudinal program data representing central and decentralized levels of care in the Plateau State Decentralization Initiative, north central Nigeria. We examined retention with patient- level (retention at fixed times, loss-to-follow-up [LTFU]) and visit-level (gaps-in-care, visit constancy) measures. Regression models with generalized estimating equations (GEE) were used to estimate the effect of decentralization on visit-level measures. Patient-level measures were examined using survival methods with Cox regression models, controlling for baseline variables. Results Of 15,650 patients, 43% were enrolled at the hub. Median time in care was 3.1 years. Hub patients were less likely to be LTFU (adjusted hazard ratio (AHR)=0.91, 95% CI: 0.85-0.97), compared to spoke patients. Visit constancy was lower at the hub (−4.5%, 95% CI: −3.5, −5.5), where gaps in care were also more likely to occur (adjusted odds ratio=1.95, 95% CI: 1.83-2.08). Conclusion Decentralized sites demonstrated better retention outcomes using visit-level measures, while the hub achieved better retention outcomes using patient-level measures. Retention estimates produced by incorporating multiple measures showed substantial variation, confirming the influence of measurement strategies on the results of retention research. Future studies of retention in HIV care in sub-Saharan Africa will be well-served by including multiple measures. PMID:29682399

Retention in Differentiated Care: Multiple Measures Analysis for a Decentralized HIV Care and Treatment Program in North Central Nigeria.

PubMed

Agaba, Patricia A; Genberg, Becky L; Sagay, Atiene S; Agbaji, Oche O; Meloni, Seema T; Dadem, Nancin Y; Kolawole, Grace O; Okonkwo, Prosper; Kanki, Phyllis J; Ware, Norma C

2018-01-01

Differentiated care refers collectively to flexible service models designed to meet the differing needs of HIV-infected persons in resource-scarce settings. Decentralization is one such service model. Retention is a key indicator for monitoring the success of HIV treatment and care programs. We used multiple measures to compare retention in a cohort of patients receiving HIV care at "hub" (central) and "spoke" (decentralized) sites in a large public HIV treatment program in north central Nigeria. This retrospective cohort study utilized longitudinal program data representing central and decentralized levels of care in the Plateau State Decentralization Initiative, north central Nigeria. We examined retention with patient- level (retention at fixed times, loss-to-follow-up [LTFU]) and visit-level (gaps-in-care, visit constancy) measures. Regression models with generalized estimating equations (GEE) were used to estimate the effect of decentralization on visit-level measures. Patient-level measures were examined using survival methods with Cox regression models, controlling for baseline variables. Of 15,650 patients, 43% were enrolled at the hub. Median time in care was 3.1 years. Hub patients were less likely to be LTFU (adjusted hazard ratio (AHR)=0.91, 95% CI: 0.85-0.97), compared to spoke patients. Visit constancy was lower at the hub (-4.5%, 95% CI: -3.5, -5.5), where gaps in care were also more likely to occur (adjusted odds ratio=1.95, 95% CI: 1.83-2.08). Decentralized sites demonstrated better retention outcomes using visit-level measures, while the hub achieved better retention outcomes using patient-level measures. Retention estimates produced by incorporating multiple measures showed substantial variation, confirming the influence of measurement strategies on the results of retention research. Future studies of retention in HIV care in sub-Saharan Africa will be well-served by including multiple measures.

Validation of a simple distributed sediment delivery approach in selected sub-basins of the River Inn catchment area

NASA Astrophysics Data System (ADS)

Reid, Lucas; Kittlaus, Steffen; Scherer, Ulrike

2015-04-01

For large areas without highly detailed data the empirical Universal Soil Loss Equation (USLE) is widely used to quantify soil loss. The problem though is usually the quantification of actual sediment influx into the rivers. As the USLE provides long-term mean soil loss rates, it is often combined with spatially lumped models to estimate the sediment delivery ratio (SDR). But it gets difficult with spatially lumped approaches in large catchment areas where the geographical properties have a wide variance. In this study we developed a simple but spatially distributed approach to quantify the sediment delivery ratio by considering the characteristics of the flow paths in the catchments. The sediment delivery ratio was determined using an empirical approach considering the slope, morphology and land use properties along the flow path as an estimation of travel time of the eroded particles. The model was tested against suspended solids measurements in selected sub-basins of the River Inn catchment area in Germany and Austria, ranging from the high alpine south to the Molasse basin in the northern part.

Evaluation of EEG based determination of unconsciousness vs. loss of posture in broilers.

PubMed

Benson, E R; Alphin, R L; Rankin, M K; Caputo, M P; Kinney, C A; Johnson, A L

2012-10-01

Evaluation of the loss of consciousness in poultry is an essential component in evaluating bird welfare under a variety of situations and applications. Many current approaches to evaluating loss of consciousness are qualitative and require observation of the bird. This study outlines a quantitative method for determining the point at which a bird loses consciousness. In this study, commercial broilers were individually anesthetized and the brain activity recorded as the bird became unconscious. A wireless EEG transmitter was surgically implanted and the bird anesthetized after a 24-48 h recovery. Each bird was monitored during treatment with isoflurane anesthesia and EEG data was evaluated using a frequency based approach. The alpha/delta (A/D) ratio and loss of posture (LOP) were used to determine the point at which the birds went unconscious. There was no statistically significant difference between time to unconsciousness as measured by A/D ratio or LOP. Copyright © 2011 Elsevier Ltd. All rights reserved.

Empirical mass-loss rates for 25 O and early B stars, derived from Copernicus observations

NASA Technical Reports Server (NTRS)

Gathier, R.; Lamers, H. J. G. L. M.; Snow, T. P.

1981-01-01

Ultraviolet line profiles are fitted with theoretical line profiles in the cases of 25 stars covering a spectral type range from O4 to B1, including all luminosity classes. Ion column densities are compared for the determination of wind ionization, and it is found that the O VI/N V ratio is dependent on the mean density of the wind and not on effective temperature value, while the Si IV/N V ratio is temperature-dependent. The column densities are used to derive a mass-loss rate parameter that is empirically correlated against the mass-loss rate by means of standard stars with well-determined rates from IR or radio data. The empirical mass-loss rates obtained are compared with those derived by others and found to vary by as much as a factor of 10, which is shown to be due to uncertainties or errors in the ionization fractions of models used for wind ionization balance prediction.

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

PubMed

Befort, C A; Stewart, E E; Smith, B K; Gibson, C A; Sullivan, D K; Donnelly, J E

2008-03-01

To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

Nevada's Class-Size Reduction Program. Nevada Revised Statutes 388.700-388.730: "Program To Reduce the Pupil-Teacher Ratio." Background Paper 97-7.

ERIC Educational Resources Information Center

Sturm, H. Pepper

In 1989, the Nevada Legislature enacted the Class-Size Reduction (CSR) Act. The measure was designed to reduce the pupil-teacher ratio in the public schools, particularly in the earliest grades. The program was scheduled to proceed in several phases. The first step reduced the student-teacher ratio in selected kindergartens and first grade classes…

A Meta-Analysis of Class Sizes and Ratios in Early Childhood Education Programs: Are Thresholds of Quality Associated with Greater Impacts on Cognitive, Achievement, and Socioemotional Outcomes?

ERIC Educational Resources Information Center

Bowne, Jocelyn Bonnes; Magnuson, Katherine A.; Schindler, Holly S.; Duncan, Greg J.; Yoshikawa, Hirokazu

2017-01-01

This study uses data from a comprehensive database of U.S. early childhood education program evaluations published between 1960 and 2007 to evaluate the relationship between class size, child-teacher ratio, and program effect sizes for cognitive, achievement, and socioemotional outcomes. Both class size and child-teacher ratio showed nonlinear…