Fostering Alphabet Knowledge Development: A Comparison of Two Instructional Approaches

ERIC Educational Resources Information Center

Piasta, Shayne B.; Purpura, David J.; Wagner, Richard K.

2010-01-01

Preschool-aged children (n = 58) were randomly assigned to receive small group instruction in letter names and/or sounds or numbers (treated control). Alphabet instruction followed one of two approaches currently utilized in early childhood classrooms: combined letter name and sound instruction or letter sound only instruction. Thirty-four 15…

Committee on renewable resources for industrial materials (Corrim)

Treesearch

Robert W. Meyer; Carol B. Ovens

1976-01-01

In recent years major emphasis has been placed on nonrenewable resources in relation to potential national problems that may arise from possible changes in materials supply or utilization. Renewable resources, however, have received disproportionately small attention in spite of their current importance as industrial raw materials and their potential for the future. In...

A novel stress and coping workplace program reduces illness and healthcare utilization.

PubMed

Rahe, Richard H; Taylor, C Barr; Tolles, Robbyn L; Newhall, Lynn M; Veach, Tracy L; Bryson, Susan

2002-01-01

The purpose of this study was to determine if a novel workplace stress management program, delivered either face-to-face or by self-help, would reduce illness and health services utilization among participants. Five hundred one volunteers were randomly allocated to one of three groups: full intervention, which received assessment and personalized self-study feedback and was offered six face-to-face, small-group sessions; partial intervention, a self-help group that received assessment and personalized feedback by mail; and a wait-list control group. All participants completed questionnaires for stress, anxiety, and coping at the start of the study and 6 and 12 months later. Health reports were completed at 0, 3, 6, 9, and 12 months. A subsample of subjects who subscribed to a single health maintenance organization provided objectively recorded doctor visit data across the study year. All three groups reported significant improvement in their stress, anxiety, and coping across the year. Full intervention participants showed a more rapid reduction in negative responses to stress than did participants from the other groups. Full-intervention subjects also reported fewer days of illness than subjects in the other groups. Objectively measured physician visits showed a large (34%) reduction in healthcare utilization for full intervention subjects in the HMO subsample. These results indicated that a work-site program that focuses on stress, anxiety, and coping measurement along with small-group educational intervention can significantly reduce illness and healthcare utilization.

Evolutionary Design of a Robotic Material Defect Detection System

NASA Technical Reports Server (NTRS)

Ballard, Gary; Howsman, Tom; Craft, Mike; ONeil, Daniel; Steincamp, Jim; Howell, Joe T. (Technical Monitor)

2002-01-01

During the post-flight inspection of SSME engines, several inaccessible regions must be disassembled to inspect for defects such as cracks, scratches, gouges, etc. An improvement to the inspection process would be the design and development of very small robots capable of penetrating these inaccessible regions and detecting the defects. The goal of this research was to utilize an evolutionary design approach for the robotic detection of these types of defects. A simulation and visualization tool was developed prior to receiving the hardware as a development test bed. A small, commercial off-the-shelf (COTS) robot was selected from several candidates as the proof of concept robot. The basic approach to detect the defects was to utilize Cadmium Sulfide (CdS) sensors to detect changes in contrast of an illuminated surface. A neural network, optimally designed utilizing a genetic algorithm, was employed to detect the presence of the defects (cracks). By utilization of the COTS robot and US sensors, the research successfully demonstrated that an evolutionarily designed neural network can detect the presence of surface defects.

Geographic accessibility and utilization of orthodontic services among Medicaid children and adolescents

PubMed Central

McKernan, Susan C.; Kuthy, Raymond A.; Momany, Elizabeth T.; McQuistan, Michelle R.; Hanley, Paul F.; Jones, Michael P.; Damiano, Peter C.

2014-01-01

Objectives To describe rates of Medicaid-funded services provided by orthodontists in Iowa to children and adolescents, identify factors associated with utilization, and describe geographic barriers to care. Methods We analyzed enrollment and claims data from the Iowa Medicaid program for a 3-year period, January 2008 through December 2010. Descriptive, bivariate, and multivariable logistic regression analyses were performed with utilization of orthodontic services as the main outcome variable. Service areas were identified by small area analysis in order to examine regional variability in utilization. Results The overall rate of orthodontic utilization was 3.1 percent. Medicaid enrollees living in small towns and rural areas were more likely to utilize orthodontic services than those living in urban areas. Children who had an oral evaluation by a primary care provider in the year prior to the study period were more likely to receive orthodontic services. Service areas with lower population density and greater mean travel distance to participating orthodontists had higher utilization rates than smaller, more densely populated areas. Conclusions Rural residency and increased travel distances do not appear to act as barriers to orthodontic care for this population. The wide variability of utilization rates seen across service areas may be related to workforce supply in the form of orthodontists who accept Medicaid-insured patients. Referrals to orthodontists from primary care dentists may improve access to specialty care for Medicaid enrollees. PMID:23289856

United States Department of Energy solar receiver technology development

NASA Astrophysics Data System (ADS)

Klimas, P. C.; Diver, R. B.; Chavez, J. M.

The United States Department of Energy (DOE), through Sandia National Laboratories, has been conducting a Solar Thermal Receiver Technology Development Program, which maintains a balance between analytical modeling, bench and small scale testing, and experimentation conducted at scales representative of commercially-sized equipment. Central receiver activities emphasize molten salt-based systems on large scales and volumetric devices in the modeling and small scale testing. These receivers are expected to be utilized in solar power plants rated between 100 and 200 MW. Distributed receiver research focuses on liquid metal refluxing devices. These are intended to mate parabolic dish concentrators with Stirling cycle engines in the 5 to 25 kW(sub e) power range. The effort in the area of volumetric receivers is less intensive and highly cooperative in nature. A ceramic foam absorber of Sandia design was successfully tested on the 200 kW(sub t) test bed at Plataforma Solar during 1989. Material integrity during the approximately 90-test series was excellent. Significant progress has been made with parabolic dish concentrator-mounted receivers using liquid metals (sodium or a potassium/sodium mixture) as heat transport media. Sandia has successfully solar-tested a pool boiling reflux receiver sized to power a 25 kW Stirling engine. Boiling stability and transient operation were both excellent. This document describes these activities in detail and will outline plans for future development.

Surveillance and Radiation Therapy for Stage I Seminoma—Have We Learned From the Evidence?

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

Glaser, Scott M.; Vargo, John A.; Balasubramani, Goundappa K.

2016-01-01

Purpose: To analyze, in the setting of stage I seminoma, the factors affecting adjuvant treatment decisions and resulting survival outcomes, using a national dataset. Methods and Materials: We identified 33,094 stage I seminoma patients after orchiectomy from 1998 to 2012 from the National Cancer Data Base. Factors affecting treatment selection (active surveillance [AS] vs adjuvant treatment [AT]) were identified using a parsimonious multivariate logistic regression model. Propensity scores for treatment decision were generated and incorporated into a multivariate Cox regression analysis of overall survival. This process was then repeated within the AT cohort for factors predictive for chemotherapy [CT] versus radiationmore » therapy [RT]. Results: Only 33% of patients received AS, and 65% received AT (89% RT and 11% CT). From 1998 to 2012 the proportion receiving AS increased from 23% to 60%, whereas RT utilization decreased from 73% to 21%, and CT utilization increased from 2% to 17%. Utilization of low-dose RT increased from 1.5% in 1999 to 34% in 2012. There was a small absolute overall survival advantage to AT over AS at 10 years (95.0% vs 93.4%, propensity adjusted hazard ratio 0.58, P<.0005). Conclusions: There has been a significant increase in use of AS for stage I seminoma, influenced by both sociodemogrpahic and clinicopathologic factors. Between AT options, there has been significant increase in use of CT, mirrored by a decline in use of RT. Although overall survival remains high for all 3 treatment strategies, AT seems to be associated with a small absolute survival advantage over AS up to 10 years out from diagnosis.« less

The Mystery Behind the Code: Differentiated Instruction with Quick Response Codes in Secondary Physical Education

ERIC Educational Resources Information Center

Adkins, Megan; Wajciechowski, Misti R.; Scantling, Ed

2013-01-01

Quick response codes, better known as QR codes, are small barcodes scanned to receive information about a specific topic. This article explains QR code technology and the utility of QR codes in the delivery of physical education instruction. Consideration is given to how QR codes can be used to accommodate learners of varying ability levels as…

The role of skin biopsy in differentiating small-fiber neuropathy from ganglionopathy.

PubMed

Provitera, V; Gibbons, C H; Wendelschafer-Crabb, G; Donadio, V; Vitale, D F; Loavenbruck, A; Stancanelli, A; Caporaso, G; Liguori, R; Wang, N; Santoro, L; Kennedy, W R; Nolano, M

2018-06-01

We aimed to test the clinical utility of the leg:thigh intraepidermal nerve-fiber (IENF) density ratio as a parameter to discriminate between length-dependent small-fiber neuropathy (SFN) and small-fiber sensory ganglionopathy (SFSG) in subjects with signs and symptoms of small-fiber pathology. We retrospectively evaluated thigh and leg IENF density in 314 subjects with small-fiber pathology (173 with distal symmetrical length-dependent SFN and 141 with non-length-dependent SFSG). A group of 288 healthy subjects was included as a control group. The leg:thigh IENF density ratio was calculated for all subjects. We used receiver operating characteristic curve analyses to assess the ability of this parameter to discriminate between length-dependent SFN and SFSG, and the decision curve analysis to estimate its net clinical benefit. In patients with neuropathy, the mean IENF density was 14.8 ± 6.8/mm at the thigh (14.0 ± 6.9/mm in length-dependent SFN and 15.9 ± 6.7/mm in patients with SFSG) and 7.5 ± 4.5/mm at the distal leg (5.4 ± 3.2/mm in patients with length-dependent SFN and 10.1 ± 4.6/mm in patients with SFSG). The leg:thigh IENF density ratio was significantly (P < 0.01) lower in patients with length-dependent SFN (0.44 ± 0.23) compared with patients with SFSG (0.68 ± 0.28). The area under the curve of the receiver operating characteristic analysis to discriminate between patients with length-dependent SFN and SFSG was 0.79. The decision curve analysis demonstrated the clinical utility of this parameter. The leg:thigh IENF ratio represents a valuable tool in the differential diagnosis between SFSG and length-dependent SFN. © 2018 EAN.

Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States.

PubMed

Fraser, John J; Glaviano, Neal R; Hertel, Jay

2017-02-01

Study Design Retrospective observational study. Background Plantar fasciitis is responsible for 1 million ambulatory patient care visits annually in the United States. Few studies have investigated practice patterns in the treatment of patients with plantar fasciitis. Objective To assess physical therapist utilization and employment of manual therapy and supervised rehabilitation in the treatment of patients with plantar fasciitis. Methods A retrospective review of the PearlDiver patient record database was used to evaluate physical therapist utilization and use of manual therapy and supervised rehabilitation in patients with plantar fasciitis between 2007 and 2011. An International Classification of Diseases code (728.71) was used to identify plantar fasciitis, and Current Procedural Terminology codes were used to identify evaluations (97001), manual therapy (97140), and rehabilitation services (97110, 97530, 97112). Results A total of 819 963 unique patients diagnosed with plantar fasciitis accounted for 5 739 737 visits from 2007 to 2011, comprising 2.7% of all patients in the database. Only 7.1% (95% confidence interval: 7.0%, 7.1%) of patients received a physical therapist evaluation. Of the 57 800 patients evaluated by a physical therapist (59.8% female), 50 382 (87.2% ± 0.4%) received manual therapy, with significant increases in utilization per annum. A large proportion (89.5% ± 0.4%) received rehabilitation following physical therapist evaluation. Conclusion Despite plantar fasciitis being a frequently occurring musculoskeletal condition, a small proportion of patients with plantar fasciitis were seen by physical therapists. Most patients who were evaluated by a physical therapist received manual therapy and a course of supervised rehabilitation as part of their plan of care. Level of Evidence Treatment, level 2a. J Orthop Sports Phys Ther 2017;47(2):49-55. doi:10.2519/jospt.2017.6999.

Biomechanical Evaluation of Standard Versus Extended Proximal Fixation Olecranon Plates for Fixation of Olecranon Fractures.

PubMed

Boden, Allison L; Daly, Charles A; Dalwadi, Poonam P; Boden, Stephanie A; Hutton, William C; Muppavarapu, Raghuveer C; Gottschalk, Michael B

2018-01-01

Small olecranon fractures present a significant challenge for fixation, which has resulted in development of plates with proximal extension. Olecranon-specific plates with proximal extensions are widely thought to offer superior fixation of small proximal fragments but have distinct disadvantages: larger dissection, increased hardware prominence, and the increased possibility of impingement. Previous biomechanical studies of olecranon fracture fixation have compared methods of fracture fixation, but to date there have been no studies defining olecranon plate fixation strength for standard versus extended olecranon plates. The purpose of this study is to evaluate the biomechanical utility of the extended plate for treatment of olecranon fractures. Sixteen matched pairs of fresh-frozen human cadaveric elbows were used. Of the 16, 8 matched pairs received a transverse osteotomy including 25% and 8 including 50% of the articular surface on the proximal fragment. One elbow from each pair was randomly assigned to a standard-length plate, and the other elbow in the pair received the extended-length plate, for fixation of the fracture. The ulnae were cyclically loaded and subsequently loaded to failure, with ultimate load, number of cycles, and gap formation recorded. There was no statistically significant difference between the standard and extended fixation plates in simple transverse fractures at either 25% or 50% from the proximal most portion of the articular surface of the olecranon. Standard fixation plates are sufficient for the fixation of small transverse fractures, but caution should be utilized particularly with comminution and nontransverse fracture patterns.

Utility usage forecasting

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

Hosking, Jonathan R. M.; Natarajan, Ramesh

The computer creates a utility demand forecast model for weather parameters by receiving a plurality of utility parameter values, wherein each received utility parameter value corresponds to a weather parameter value. Determining that a range of weather parameter values lacks a sufficient amount of corresponding received utility parameter values. Determining one or more utility parameter values that corresponds to the range of weather parameter values. Creating a model which correlates the received and the determined utility parameter values with the corresponding weather parameters values.

System design of a 1 MW north-facing, solid particle receiver

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

Christian, J.; Ho, C.

Falling solid particle receivers (SPR) utilize small particles as a heat collecting medium within a cavity receiver structure. The components required to operate an SPR include the receiver (to heat the particles), bottom hopper (to catch the falling particles), particle lift elevator (to lift particles back to the top of the receiver), top hopper (to store particles before being dropped through the receiver), and ducting. In addition to the required components, there are additional features needed for an experimental system. These features include: a support structure to house all components, calibration panel to measure incident radiation, cooling loops, and sensorsmore » (flux gages, thermocouples, pressure gages). Each of these components had to be designed to withstand temperatures ranging from ambient to 700 °C. Thermal stresses from thermal expansion become a key factor in these types of high temperature systems. The SPR will be housing ~3000 kg of solid particles. The final system will be tested at the National Solar Thermal Test Facility in Albuquerque, NM.« less

System design of a 1 MW north-facing, solid particle receiver

DOE PAGES

Christian, J.; Ho, C.

2015-05-01

Falling solid particle receivers (SPR) utilize small particles as a heat collecting medium within a cavity receiver structure. The components required to operate an SPR include the receiver (to heat the particles), bottom hopper (to catch the falling particles), particle lift elevator (to lift particles back to the top of the receiver), top hopper (to store particles before being dropped through the receiver), and ducting. In addition to the required components, there are additional features needed for an experimental system. These features include: a support structure to house all components, calibration panel to measure incident radiation, cooling loops, and sensorsmore » (flux gages, thermocouples, pressure gages). Each of these components had to be designed to withstand temperatures ranging from ambient to 700 °C. Thermal stresses from thermal expansion become a key factor in these types of high temperature systems. The SPR will be housing ~3000 kg of solid particles. The final system will be tested at the National Solar Thermal Test Facility in Albuquerque, NM.« less

Dynamic-Receive Focusing with High-Frequency Annular Arrays

NASA Astrophysics Data System (ADS)

Ketterling, J. A.; Mamou, J.; Silverman, R. H.

High-frequency ultrasound is commonly employed for ophthalmic and small-animal imaging because of the fine-resolution images it affords. Annular arrays allow improved depth of field and lateral resolution versus commonly used single-element, focused transducers. The best image quality from an annular array is achieved by using synthetic transmit-to-receive focusing while utilizing data from all transmit-to-receive element combinations. However, annular arrays must be laterally scanned to form an image and this requires one pass for each of the array elements when implementing full synthetic transmit-to-receive focusing. A dynamic-receive focusing approach permits a single pass, although at a sacrifice of depth of field and lateral resolution. A five-element, 20-MHz annular array is examined to determine the acoustic beam properties for synthetic and dynamic-receive focusing. A spatial impulse response model is used to simulate the acoustic beam properties for each focusing case and then data acquired from a human eye-bank eye are processed to demonstrate the effect of each approach on image quality.

Smart Sensors Assess Structural Health

NASA Technical Reports Server (NTRS)

2010-01-01

NASA frequently inspects launch vehicles, fuel tanks, and other components for structural damage. To perform quick evaluation and monitoring, the Agency pursues the development of structural health monitoring systems. In 2001, Acellent Technologies Inc., of Sunnyvale, California, received Small Business Innovation Research (SBIR) funding from Marshall Space Flight Center to develop a hybrid Stanford Multi-Actuator Receiver Transduction (SMART) Layer for aerospace vehicles and structures. As a result, Acellent expanded the technology's capability and now sells it to aerospace and automotive companies; construction, energy, and utility companies; and the defense, space, transportation, and energy industries for structural condition monitoring, damage detection, crack growth monitoring, and other applications.

Mesothelioma following Wilms' tumor in childhood

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

Antman, K.H.; Ruxer, R.L. Jr.; Aisner, J.

A high percentage of children with Wilms' tumor are cured with multimodal treatment. A small percentage of these children will develop second tumors, perhaps related to a genetic predisposition to neoplasia or possibly secondary to the treatment utilized for Wilms' tumor. Malignant mesothelioma has been associated with contact with asbestos but has also been reported after radiation exposure. Two patients are reported who developed malignant mesothelioma of the pleura after treatment for Wilms' tumor in childhood. Both received orthovoltage radiation; one patient also received triethylenemelamine (TEM), an alkylating agent closely related to nitrogen mustard, for 5 years. Factors in themore » development of second tumors are discussed.« less

A solar thermal electric power plant for small communities

NASA Technical Reports Server (NTRS)

Holl, R. J.

1979-01-01

A solar power plant has been designed with a rating of 1000-kW electric and a 0.4 annual capacity factor. It was configured as a prototype for plants in the 1000 to 10,000-kWe size range for application to small communities or industrial users either grid-connected or isolated from a utility grid. A small central receiver was selected for solar energy collection after being compared with alternative distributed collectors. Further trade studies resulted in the selection of Hitec (heat transfer salt composed of 53 percent KNO3, 40 percent NaNO2, 7 percent NaNO3) as both the receiver coolant and the sensible heat thermal stroage medium and the steam Rankine cycle for power conversion. The plant is configured with road-transportable units to accommodate remote sites and minimize site assembly requirements. Results of the analyses indicate that busbar energy costs are competitive with diesel-electric plants in certain situations, e.g., off-grid, remote regions with high insolation. Sensitivity of energy costs to plant power rating and system capacity factor are given.

Method and apparatus for detecting external cracks from within a metal tube

DOEpatents

Caffey, Thurlow W. H.

2001-08-07

A method and tool using a continuous electromagnetic wave from a transverse magnetic-dipole source with a coaxial electric-dipole receiver is described for the detection of external sidewall cracks and other anomalies in boiler tubes and other enclosures. The invention utilizes the concept of radar backscatter rather than eddy-currents or ultrasound, which are sometimes used in prior art crack-detection methods. A numerical study of the distribution of the fields shows that the direct transmission from the source to the receiver is reduced from that in free space. Further, if the diameter of the receiver dipole is made sufficiently small, it should be possible to detect cracks with a scattering loss of up to -40 dB in thin-walled boiler tubes.

An Array of Optical Receivers for Deep-Space Communications

NASA Technical Reports Server (NTRS)

Vilnrotter, Chi-Wung; Srinivasan, Meera; Andrews, Kenneth

2007-01-01

An array of small optical receivers is proposed as an alternative to a single large optical receiver for high-data-rate communications in NASA s Deep Space Network (DSN). Because the telescope for a single receiver capable of satisfying DSN requirements must be greater than 10 m in diameter, the design, building, and testing of the telescope would be very difficult and expensive. The proposed array would utilize commercially available telescopes of 1-m or smaller diameter and, therefore, could be developed and verified with considerably less difficulty and expense. The essential difference between a single-aperture optical-communications receiver and an optical-array receiver is that a single-aperture receiver focuses all of the light energy it collects onto the surface of an optical detector, whereas an array receiver focuses portions of the total collected energy onto separate detectors, optically detects each fractional energy component, then combines the electrical signal from the array of detector outputs to form the observable, or "decision statistic," used to decode the transmitted data. A conceptual block diagram identifying the key components of the optical-array receiver suitable for deep-space telemetry reception is shown in the figure. The most conspicuous feature of the receiver is the large number of small- to medium-size telescopes, with individual apertures and number of telescopes selected to make up the desired total collecting area. This array of telescopes is envisioned to be fully computer- controlled via the user interface and prediction-driven to achieve rough pointing and tracking of the desired spacecraft. Fine-pointing and tracking functions then take over to keep each telescope pointed toward the source, despite imperfect pointing predictions, telescope-drive errors, and vibration caused by wind.

Randomized controlled trial of Gastrografin in adhesive small bowel obstruction.

PubMed

Burge, Jonathan; Abbas, Saleh M; Roadley, Graeme; Donald, Jennifer; Connolly, Andrew; Bissett, Ian P; Hill, Andrew G

2005-08-01

Several previous studies have shown that Gastrografin can be utilized to triage patients with adhesive small bowel obstruction (ASBO) to an operative or a non-operative course. Previous studies assessing the therapeutic effect of Gastrografin have been confounded by post-administration radiology alerting the physician to the treatment group of the patient. Therefore the aim of the present paper was to test the hypothesis that Gastrografin hastens the non-operative resolution of (ASBO). Patients, diagnosed with ASBO on clinical and radiological grounds, were randomized to receive Gastrografin or placebo in a double-blinded fashion. Patients did not undergo further radiological investigation. If the patient required subsequent radiological intervention or surgical intervention they were excluded from the study. End-points were passage of time to resolution of ASBO (flatus and bowel motion), length of hospital stay and complications. Forty-five patients with ASBO were randomized to receive either Gastrografin or placebo. Two patients were excluded due to protocol violations. Four patients in each group required surgery. Eighteen of the remaining patients received Gastrografin and 17 received placebo. Patients who received Gastrografin had complete resolution of their ASBO significantly earlier than placebo patients (12 vs 21 h, P = 0.009) and this translated into a median of a 1-day saving in time in hospital (3 vs 4 days, P = 0.03). Gastrografin accelerates resolution of ASBO by a specific therapeutic effect.

Cost-Utility of a Prognostic Test Guiding Adjuvant Chemotherapy Decisions in Early-Stage Non-Small Cell Lung Cancer.

PubMed

Stenehjem, David D; Bellows, Brandon K; Yager, Kraig M; Jones, Joshua; Kaldate, Rajesh; Siebert, Uwe; Brixner, Diana I

2016-02-01

A prognostic test was developed to guide adjuvant chemotherapy (ACT) decisions in early-stage non-small cell lung cancer (NSCLC) adenocarcinomas. The objective of this study was to compare the cost-utility of the prognostic test to the current standard of care (SoC) in patients with early-stage NSCLC. Lifetime costs (2014 U.S. dollars) and effectiveness (quality-adjusted life-years [QALYs]) of ACT treatment decisions were examined using a Markov microsimulation model from a U.S. third-party payer perspective. Cancer stage distribution and probability of receiving ACT with the SoC were based on data from an academic cancer center. The probability of receiving ACT with the prognostic test was estimated from a physician survey. Risk classification was based on the 5-year predicted NSCLC-related mortality. Treatment benefit with ACT was based on the prognostic score. Discounting at a 3% annual rate was applied to costs and QALYs. Deterministic one-way and probabilistic sensitivity analyses examined parameter uncertainty. Lifetime costs and effectiveness were $137,403 and 5.45 QALYs with the prognostic test and $127,359 and 5.17 QALYs with the SoC. The resulting incremental cost-effectiveness ratio for the prognostic test versus the SoC was $35,867/QALY gained. One-way sensitivity analyses indicated the model was most sensitive to the utility of patients without recurrence after ACT and the ACT treatment benefit. Probabilistic sensitivity analysis indicated the prognostic test was cost-effective in 65.5% of simulations at a willingness to pay of $50,000/QALY. The study suggests using a prognostic test to guide ACT decisions in early-stage NSCLC is potentially cost-effective compared with using the SoC based on globally accepted willingness-to-pay thresholds. Providing prognostic information to decision makers may help some patients with high-risk early stage non-small cell lung cancer receive appropriate adjuvant chemotherapy while avoiding the associated toxicities and costs in patients with low-risk disease. This study used an economic model to assess the effectiveness and costs associated with using a prognostic test to guide adjuvant chemotherapy decisions compared with the current standard of care in patients with non-small cell lung cancer. When compared with current standard care, the prognostic test was potentially cost effective at commonly accepted thresholds in the U.S. This study can be used to help inform decision makers who are considering using prognostic tests. ©AlphaMed Press.

Integrated Arrays on Silicon at Terahertz Frequencies

NASA Technical Reports Server (NTRS)

Chattopadhayay, Goutam; Lee, Choonsup; Jung, Cecil; Lin, Robert; Peralta, Alessandro; Mehdi, Imran; Llombert, Nuria; Thomas, Bertrand

2011-01-01

In this paper we explore various receiver font-end and antenna architecture for use in integrated arrays at terahertz frequencies. Development of wafer-level integrated terahertz receiver front-end by using advanced semiconductor fabrication technologies and use of novel integrated antennas with silicon micromachining are reported. We report novel stacking of micromachined silicon wafers which allows for the 3-dimensional integration of various terahertz receiver components in extremely small packages which easily leads to the development of 2- dimensioanl multi-pixel receiver front-ends in the terahertz frequency range. We also report an integrated micro-lens antenna that goes with the silicon micro-machined front-end. The micro-lens antenna is fed by a waveguide that excites a silicon lens antenna through a leaky-wave or electromagnetic band gap (EBG) resonant cavity. We utilized advanced semiconductor nanofabrication techniques to design, fabricate, and demonstrate a super-compact, low-mass submillimeter-wave heterodyne frontend. When the micro-lens antenna is integrated with the receiver front-end we will be able to assemble integrated heterodyne array receivers for various applications such as multi-pixel high resolution spectrometer and imaging radar at terahertz frequencies.

Stakeholder benefit from depression disease management: differences by rurality?

PubMed

Xu, Stanley; Rost, Kathryn; Dong, Fran; Dickinson, L Miriam

2011-01-01

Despite increasing consensus about the value of depression disease management programs, the field has not identified which stakeholders should absorb the relatively small additional costs associated with these programs. This paper investigates whether two proposed stakeholders (health plans and employer purchasers) economically benefit from depression care management (reduced outpatient utilization and work costs, respectively) in two delivery systems (rural and urban). This study examined the main and differential effects of depression care management on outpatient utilization and work costs over 24 months in a preplanned secondary analysis of 479 depressed patients from rural and urban primary care practices in a randomized controlled trial. Over 24 months, the intervention did not significantly reduce outpatient utilization costs in the entire cohort (-$191, 95% confidence interval (CI)=-$2,083 to $1,647), but it did decrease work costs (-$1,970, 95% CI=-$3,934 to -$92). While not statistically significant, rural-urban differences in work costs were in the same direction, while rural-urban differences in utilization costs differed in direction. These findings provide preliminary evidence that employers who elect to cover depression care management costs should receive comparable economic benefits in the rural and urban employees they insure. Given the limited sample size, further research may be needed to determine whether health plans who elect to cover depression care management costs will receive comparable economic benefits in the rural and urban enrollees they insure.

Thermal Storage Applications Workshop. Volume 1: Plenary Session Analysis

NASA Technical Reports Server (NTRS)

1979-01-01

The importance of the development of inexpensive and efficient thermal and thermochemical energy storage technology to the solar power program is discussed in a summary of workship discussions held to exchange information and plan for future systems. Topics covered include storage in central power applications such as the 10 MW-e demonstration pilot receiver to be constructed in Barstow, California; storage for small dispersed systems, and problems associated with the development of storage systems for solar power plants interfacing with utility systems.

Design for On-Sun Evaluation of Evaporator Receivers

NASA Technical Reports Server (NTRS)

Jaworske, Donald A.; Colozza, Anthony; Sechkar, Edward A.

2011-01-01

A heat pipe designed for operation as a solar power receiver should be optimized to accept the solar energy flux and transfer this heat into a reactor. Optical properties of the surface, thermal conductance of the receiver wall, contact resistance of the heat pipe wick, and other heat pipe wick properties ultimately define the maximum amount of power that can be extracted from the concentrated sunlight impinging on the evaporator surface. Modeling of solar power receivers utilizing optical and physical properties provides guidance to their design. On-sun testing is another important means of gathering information on performance. A test rig is being designed and built to conduct on-sun testing. The test rig is incorporating a composite strip mirror concentrator developed as part of a Small Business Innovative Research effort and delivered to NASA Glenn Research Center. In the strip concentrator numerous, lightweight composite parabolic strips of simple curvature were combined to form an array 1.5 m x 1.5 m in size. The line focus of each strip is superimposed in a central area simulating a point of focus. A test stand is currently being developed to hold the parabolic strip concentrator, track the sun, and turn the beam downward towards the ground. The hardware is intended to be sufficiently versatile to accommodate on-sun testing of several receiver concepts, including those incorporating heat pipe evaporators. Characterization devices are also being developed to evaluate the effectiveness of the solar concentrator, including a receiver designed to conduct calorimetry. This paper describes the design and the characterization devices of the on-sun test rig, and the prospect of coupling the concentrated sunlight to a heat pipe solar power receiver developed as part of another Small Business Innovative Research effort.

Health, Social, and Economic Outcomes Experienced by Families as a Result of Receiving Assistance from a Community-Based Diaper Bank.

PubMed

Massengale, Kelley E C; Erausquin, Jennifer Toller; Old, Michelle

2017-10-01

Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers. Results Families experience regularly a range of challenges meeting basic needs. These difficulties include high unmet needs for transportation, food, and nonfood essentials such as personal hygiene items. Families experiencing the greatest difficulty in paying utility or medical bills were significantly more likely to have a high level of diaper need compared to families facing these challenges less often (AORs ranging from 3.40 to 9.39). As a result of receiving diapers, families reported positive health, social, and economic outcomes. Families reported positive changes in parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to divert household finances toward other basic needs, including utilities and medical care. Conclusions for Practice The monetary value of the supplemental provision of diapers is a small investment in affected families' economic, social, and health outcomes. The positive effects continue far longer than the diapers provided. We demonstrate the social value of such an operation, and recommend the expansion of federal, state, and local safety net programs to help low-income families secure a steady supply of diapers.

Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction.

PubMed

Zielinski, Martin D; Haddad, Nadeem N; Cullinane, Daniel C; Inaba, Kenji; Yeh, Dante D; Wydo, Salina; Turay, David; Pakula, Andrea; Duane, Therese M; Watras, Jill; Widom, Kenneth A; Cull, John; Rodriguez, Carlos J; Toschlog, Eric A; Sams, Valerie G; Hazelton, Joshua P; Graybill, John Christopher; Skinner, Ruby; Yune, Ji-Ming

2017-07-01

Existing trials studying the use of Gastrografin for management of adhesive small bowel obstruction (SBO) are limited by methodological flaws and small sample sizes. We compared institutional protocols with and without Gastrografin (GG), hypothesizing that a SBO management protocol utilizing GG is associated with lesser rates of exploration, shorter length of stay, and fewer complications. A multi-institutional, prospective, observational study was performed on patients appropriate for GG with adhesive SBO. Exclusion criteria were internal/external hernia, signs of strangulation, history of abdominal/pelvic malignancy, or exploration within the past 6 weeks. Patients receiving GG were compared to patients receiving standard care without GG. Overall, 316 patients were included (58 ± 18 years; 53% male). There were 173 (55%) patients in the GG group (of whom 118 [75%] successfully passed) and 143 patients in the non-GG group. There were no differences in duration of obstipation (1.6 vs. 1.9 days, p = 0.77) or small bowel feces sign (32.9% vs. 25.0%, p = 0.14). Fewer patients in the GG protocol cohort had mesenteric edema on CT (16.3% vs. 29.9%; p = 0.009). There was a lower rate of bowel resection (6.9% vs. 21.0%, p < 0.001) and exploration rate in the GG group (20.8% vs. 44.1%, p < 0.0001). GG patients had a shorter duration of hospital stay (4 IQR 2-7 vs. 5 days IQR 2-12; p = 0.036) and a similar rate of complications (12.5% vs. 17.9%; p = 0.20). Multivariable analysis revealed that GG was independently associated with successful nonoperative management. Patients receiving Gastrografin for adhesive SBO had lower rates of exploration and shorter hospital length of stay compared to patients who did not receive GG. Adequately powered and well-designed randomized trials are required to confirm these findings and establish causality. Therapeutic, level III.

48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prescribed from time to time in furtherance of overall small and small disadvantaged business utilization... business utilization specialists. 1519.201-72 Section 1519.201-72 Federal Acquisition Regulations System... disadvantaged business utilization specialists. (a) Small Business Specialists (SBS) shall be appointed in...

Reliability and cost/worth evaluation of generating systems utilizing wind and solar energy

NASA Astrophysics Data System (ADS)

Bagen

The utilization of renewable energy resources such as wind and solar energy for electric power supply has received considerable attention in recent years due to adverse environmental impacts and fuel cost escalation associated with conventional generation. At the present time, wind and/or solar energy sources are utilized to generate electric power in many applications. Wind and solar energy will become important sources for power generation in the future because of their environmental, social and economic benefits, together with public support and government incentives. The wind and sunlight are, however, unstable and variable energy sources, and behave far differently than conventional sources. Energy storage systems are, therefore, often required to smooth the fluctuating nature of the energy conversion system especially in small isolated applications. The research work presented in this thesis is focused on the development and application of reliability and economic benefits assessment associated with incorporating wind energy, solar energy and energy storage in power generating systems. A probabilistic approach using sequential Monte Carlo simulation was employed in this research and a number of analyses were conducted with regards to the adequacy and economic assessment of generation systems containing wind energy, solar energy and energy storage. The evaluation models and techniques incorporate risk index distributions and different operating strategies associated with diesel generation in small isolated systems. Deterministic and probabilistic techniques are combined in this thesis using a system well-being approach to provide useful adequacy indices for small isolated systems that include renewable energy and energy storage. The concepts presented and examples illustrated in this thesis will help power system planners and utility managers to assess the reliability and economic benefits of utilizing wind energy conversion systems, solar energy conversion systems and energy storage in electric power systems and provide useful input to the managerial decision process.

Investigating the benefits of molecular profiling of advanced non-small cell lung cancer tumors to guide treatments.

PubMed

Alifrangis, Costi; Carter, Philip; Cereser, Biancastella; Chandrasinghe, Pramodh; Belluz, Lisa Del Bel; Lim, Eric; Moderau, Nina; Poyia, Fotini; Tabassum, Neha; Zhang, Hua; Krell, Jonathan; Stebbing, Justin

2018-02-27

In this study we utilized data on patient responses to guided treatments, and we evaluated their benefit for a non-small cell lung cancer cohort. The recommended therapies used were predicted using tumor molecular profiles that involved a range of biomarkers but primarily used immunohistochemistry markers. A dataset describing 91 lung non-small cell lung cancer patients was retrospectively split into two. The first group's drugs were consistent with a treatment plan whereby all drugs received agreed with their tumor's molecular profile. The second group each received one or more drug that was expected to lack benefit. We found that there was no significant difference in overall survival or mortality between the two groups. Patients whose treatments were predicted to be of benefit survived for an average of 402 days, compared to 382 days for those that did not ( P = 0.7934). In the matched treatment group, 48% of patients were deceased by the time monitoring had finished compared to 53% in the unmatched group ( P = 0.6094). The immunohistochemistry biomarker for the ERCC1 receptor was found to be a marker that could be used to predict future survival; ERCC1 loss was found to be predictive of poor survival.

Super Resolution Imaging of the Bottomside Ionosphere with the LWA

NASA Astrophysics Data System (ADS)

Obenberger, K.; Parris, R. T.; Taylor, G. B.; Dowell, J.; Malins, J. B.; Pedersen, T.

2017-12-01

Standard ionospheric sounding instruments typically only utilize a handful HF antennas to receive their transmitted signal, and therefore are limited in their ability to image reflections from the bottomside ionosphere. This limitation is primarily due to the low signal to noise ratio of only a few receiving elements. However, recent advancements in digital processing have ushered in a new era of many-element radio telescopes, capable of sub degree all-sky imaging in the HF band. The Long Wavelength Array station at Sevilleta National Wildlife Refuge, New Mexico (LWA-SV), which was specifically designed with improved HF performance for imaging bottomside propagation, began observations this year. I will discuss the new capabilities and imaging techniques of LWA-SV, and show some preliminary measurements of small scale ionospheric structure.

Passive Tracking System and Method

NASA Technical Reports Server (NTRS)

Arndt, G. Dickey (Inventor); Ngo, Phong H. (Inventor); Chen, Henry A. (Inventor); Phan, Chau T. (Inventor); Bourgeois, Brian A. (Inventor); Dusl, Jon (Inventor); Hill, Brent W. (Inventor)

2003-01-01

Systems and methods are disclosed for passively determining the location of a moveable transmitter utilizing a pair of phase shifts at a receiver for extracting a direction vector from a receiver to the transmitter. In a preferred embodiment, a phase difference between the transmitter and receiver is extracted utilizing a noncoherent demodulator in the receiver. The receiver includes an antenna array with three antenna elements, which preferably are patch antenna elements spaced apart by one-half wavelength. Three receiver channels are preferably utilized for simultaneously processing the received signal from each of the three antenna elements. Multipath transmission paths for each of the three receiver channels are indexed so that comparisons of the same multipath component are made for each of the three receiver channels. The phase difference for each received signal is determined by comparing only the magnitudes of received and stored modulation signals to determine a winning modulation symbol.

Passive Tracking System and Method

NASA Technical Reports Server (NTRS)

Arndt, G. Dickey (Inventor); Ngo, Phong H. (Inventor); Chen, Henry A. (Inventor); Phan, Chau T. (Inventor); Bourgeois, Brian A. (Inventor); Dusl, John (Inventor); Hill, Brent W. (Inventor)

2005-01-01

System and methods are disclosed for passively determining the location of a moveable transmitter utilizing a pair of phase shifts at a receiver for extracting a direction vector from a receiver to the transmitter. In a preferred embodiment, a phase difference between the transmitter and receiver is extracted utilizing a noncoherent demodulator in the receiver. The receiver includes antenna array with three antenna elements, which preferably are patch antenna elements placed apart by one-half wavelength. Three receiver channels are preferably utilized for simultaneously processing the received signal from each of the three antenna elements. Multipath transmission paths for each of the three receiver channels are indexed so that comparisons of the same multipath component are made for each of the three receiver channels. The phase difference for each received signal is determined by comparing only the magnitudes of received and stored modulation signals to determine a winning modulation symbol.

Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations.

PubMed

Gibson, Britton A; Ghosh, Debarchana; Morano, Jamie P; Altice, Frederick L

2014-07-01

We mapped mobile medical clinic (MMC) clients for spatial distribution of their self-reported locations and travel behaviors to better understand health-seeking and utilization patterns of medically vulnerable populations in Connecticut. Contrary to distance decay literature, we found that a small but significant proportion of clients was traveling substantial distances to receive repeat care at the MMC. Of 8404 total clients, 90.2% lived within 5 miles of a MMC site, yet mean utilization was highest (5.3 visits per client) among those living 11-20 miles of MMCs, primarily for those with substance use disorders. Of clients making >20 visits, 15.0% traveled >10 miles, suggesting that a significant minority of clients traveled to MMC sites because of their need-specific healthcare services, which are not only free but available at an acceptable and accommodating environment. The findings of this study contribute to the important research on healthcare utilization among vulnerable population by focusing on broader dimensions of accessibility in a setting where both mobile and fixed healthcare services coexist. Copyright © 2014 Elsevier Ltd. All rights reserved.

25 CFR 1000.69 - How can a Tribe/Consortium obtain comments or selection documents received or utilized after OSG...

Code of Federal Regulations, 2010 CFR

2010-04-01

...-DETERMINATION AND EDUCATION ACT Other Financial Assistance for Planning and Negotiation Grants for Non-BIA... documents received or utilized after OSG has made a decision on a planning grant application? 1000.69... selection documents received or utilized after OSG has made a decision on a planning grant application? A...

Patients With Brain Tumors: Who Receives Postacute Occupational Therapy Services?

PubMed

Chan, Vincy; Xiong, Chen; Colantonio, Angela

2015-01-01

Data on the utilization of occupational therapy among patients with brain tumors have been limited to those with malignant tumors and small samples of patients outside North America in specialized palliative care settings. We built on this research by examining the characteristics of patients with brain tumors who received postacute occupational therapy services in Ontario, Canada, using health care administrative data. Between fiscal years 2004-2005 and 2008-2009, 3,199 patients with brain tumors received occupational therapy services in the home care setting after hospital discharge; 12.4% had benign brain tumors, 78.2% had malignant brain tumors, and 9.4% had unspecified brain tumors. However, patients with benign brain tumors were older (mean age=63.3 yr), and a higher percentage were female (65.2%). More than 90% of patients received in-home occupational therapy services. Additional research is needed to examine the significance of these differences and to identify factors that influence access to occupational therapy services in the home care setting. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Preliminary results from the Arecibo Heating Experiment (HEX): HF to GNSS

NASA Astrophysics Data System (ADS)

Jackson-Booth, N.; Penney, R.; Bernhardt, P. A.; Martin, P. L.; Buckland, R.; Morton-Orr, T.; Nossa, E.; Buckland, R.

2017-12-01

The ionosphere is subject to many solar and terrestrial influences that can generate disturbances, causing degradation to modern communication and navigational systems. Whilst the disturbances are normally caused by natural phenomena such as hurricanes, earthquakes and solar storms; they can also be generated by artificially modifying the ionosphere. Artificial Ionospheric Modification (AIM) attempts to alter a small region of the ionosphere in order to perturb the RF propagation environment. This can be achieved through injecting the ionosphere with aerosols, chemicals or radio signals. The effects of any such modification can be detected through the deployment of sensors, including ground based high-frequency (HF) sounders and dual-band Global Navigation Satellite System (GNSS) receivers. HF sounders allow measurements of the bottom-side of the ionosphere. GNSS receivers offer a convenient means of obtaining information about the ionosphere, including ionospheric disturbances through changes in the derived total electron content information. The Heating EXperiment (HEX), which took place in March and May 2017, was designed to further our understanding of the phenomena caused by artificially heating a small region of the ionosphere, using the Arecibo facility in Puerto Rico. This was achieved by utilizing a HF measurement experiment spread between Texas and Trinidad and the deployment of a small scale travelling ionospheric disturbance (TID) network near the heater. The TID network comprised three GNSS receivers along baselines of approximately 4 km, located 20 km north of the heater. This paper presents preliminary results from the HEX campaign, including evidence of heating-induced disturbances enhancing propagation between Virginia and Trinidad. The implications of generated irregularities on GNSS will also be discussed.

Highly sensitive lidar with a thumb-sized sensor-head built using an optical fiber preamplifier

NASA Astrophysics Data System (ADS)

Inoue, Daisuke; Ichikawa, Tadashi; Matsubara, Hiroyuki; Mao, Xueon; Maeda, Mitsutoshi; Nagashima, Chie; Kagami, Manabu

2011-06-01

We developed a LIDAR system with a sensor head as small as 22 cc, in spite of the inclusion of a scanning mechanism. This LIDAR system not only has a small body, but is also highly sensitive. Our LIDAR system is based on time-of-flight measurements, and it incorporates an optical fiber. The main feature of our system is the utilization of optical amplifiers for both the transmitter and the receiver, and the optical amplifiers enabled us to exceed the detection limit of thermal noise. In conventional LIDAR systems the detection limit is determined by thermal noise, because the avalanche photo-diodes (APD) and trans-impedance amplifiers (TIA) that they use detect the received signals directly. In the case of our LIDAR system, received signal is amplified by an optical fiber amplifier in front of the photo diode and the TIA. Therefore, our LIDAR system can boost the signal level before the weak incoming signal is depleted by thermal noise. There are conditions under which the noise figure for the combination of an optical fiber amplifier and a photo diode is superior to the noise figure for an avalanche photo diode. We optimized the gain of the optical fiber amplifier and TIA in our LIDAR system such that it is capable of detecting a single photon. As a result, the detection limit of our LIDAR system is determined by shot noise. This small and highly sensitive measurement technology shows great potential for use in LIDAR with an optical preamplifier.

Design requirements, challenges, and solutions for high-temperature falling particle receivers

NASA Astrophysics Data System (ADS)

Christian, Joshua; Ho, Clifford

2016-05-01

Falling particle receivers (FPR) utilize small particles as a heat collecting medium within a cavity receiver structure. Previous analysis for FPR systems include computational fluid dynamics (CFD), analytical evaluations, and experiments to determine the feasibility and achievability of this CSP technology. Sandia National Laboratories has fabricated and tested a 1 MWth FPR that consists of a cavity receiver, top hopper, bottom hopper, support structure, particle elevator, flux target, and instrumentation. Design requirements and inherent challenges were addressed to enable continuous operation of flowing particles under high-flux conditions and particle temperatures over 700 °C. Challenges include being able to withstand extremely high temperatures (up to 1200°C on the walls of the cavity), maintaining particle flow and conveyance, measuring temperatures and mass flow rates, filtering out debris, protecting components from direct flux spillage, and measuring irradiance in the cavity. Each of the major components of the system is separated into design requirements, associated challenges and corresponding solutions. The intent is to provide industry and researchers with lessons learned to avoid pitfalls and technical problems encountered during the development of Sandia's prototype particle receiver system at the National Solar Thermal Test Facility (NSTTF).

Nonresearch Industry Payments to Radiologists: Characteristics and Associations With Regional Medical Imaging Utilization.

PubMed

Kokabi, Nima; Junn, Jacqueline C; Xing, Minzhi; Hemingway, Jennifer; Hughes, Danny R; Duszak, Richard

2017-03-01

To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization. Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level. Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08). In 2014, only a small minority of United States radiologists received nonresearch payments from industry. At the state level, medical imaging utilization does not seem to be influenced by such financial relationships. Copyright © 2016. Published by Elsevier Inc.

Semi-automatic system for ultrasonic measurement of texture

DOEpatents

Thompson, R. Bruce; Wormley, Samuel J.

1991-09-17

A means and method for ultrasonic measurement of texture non-destructively and efficiently. Texture characteristics are derived by transmitting ultrasound energy into the material, measuring the time it takes to be received by ultrasound receiving means, and calculating velocity of the ultrasound energy from the timed measurements. Textured characteristics can then be derived from the velocity calculations. One or more sets of ultrasound transmitters and receivers are utilized to derive velocity measurements in different angular orientations through the material and in different ultrasound modes. An ultrasound transmitter is utilized to direct ultrasound energy to the material and one or more ultrasound receivers are utilized to receive the same. The receivers are at a predetermined fixed distance from the transmitter. A control means is utilized to control transmission of the ultrasound, and a processing means derives timing, calculation of velocity and derivation of texture characteristics.

Semi-automatic system for ultrasonic measurement of texture

DOEpatents

Thompson, R.B.; Wormley, S.J.

1991-09-17

A means and method are disclosed for ultrasonic measurement of texture nondestructively and efficiently. Texture characteristics are derived by transmitting ultrasound energy into the material, measuring the time it takes to be received by ultrasound receiving means, and calculating velocity of the ultrasound energy from the timed measurements. Textured characteristics can then be derived from the velocity calculations. One or more sets of ultrasound transmitters and receivers are utilized to derive velocity measurements in different angular orientations through the material and in different ultrasound modes. An ultrasound transmitter is utilized to direct ultrasound energy to the material and one or more ultrasound receivers are utilized to receive the same. The receivers are at a predetermined fixed distance from the transmitter. A control means is utilized to control transmission of the ultrasound, and a processing means derives timing, calculation of velocity and derivation of texture characteristics. 5 figures.

Director of Small and Disadvantaged Business Utilization

DTIC Science & Technology

1989-03-17

Small and Disadvantaged Business Utilization References: (a) Title 15, United States Code (b) Title 10, United States Code (c) DoD 5025.1-M, "Department...position of Director of Small and Disadvantaged Business Utilization (Director, SADBU) under the direction, authority, and control of the Under...Defense Agencies, and the DoD Field Activities. C. RESPONSIBILITIES The Director of Small and Disadvantaged Business Utilization shall serve as the

Combuster. [low nitrogen oxide formation

NASA Technical Reports Server (NTRS)

Mckay, R. A. (Inventor)

1978-01-01

A combuster is provided for utilizing a combustible mixture containing fuel and air, to heat a load fluid such as water or air, in a manner that minimizes the formation of nitrogen oxide. The combustible mixture passes through a small diameter tube where the mixture is heated to its combustion temperature, while the load fluid flows past the outside of the tube to receive heat. The tube is of a diameter small enough that the combustible mixture cannot form a flame, and yet is not subject to wall quench, so that combustion occurs, but at a temperature less than under free flame conditions. Most of the heat required for heating the combustible mixture to its combustion temperature, is obtained from heat flow through the walls of the pipe to the mixture.

Parabolic dish systems at work - Applying the concepts

NASA Technical Reports Server (NTRS)

Marriott, A. T.

1981-01-01

An overview is given of parabolic dish solar concentrator application experiments being conducted by the U.S. Department of Energy. The 'engineering experiments' comprise the testing of (1) a small-community powerplant system, in conjunction with a grid-connected utility; (2) stand-alone applications at remote sites such as military installations, radar stations and villages; and (3) dish modules that can deliver heat for direct use in industrial processes. Applicability projections are based on a dish and receiver that use a Brayton engine with an engine/generator efficiency of 25% and a production level of up to 25,000 units per year. Analyses indicate that parabolic-dish power systems can potentially replace small, oil-fired power plants in all regions of the U.S. between 1985 and 1991.

Radiation heat transfer simulation in a window for a small particle solar receiver using the Monte Carlo method

NASA Astrophysics Data System (ADS)

Whitmore, Alexander Jason

Concentrating solar power systems are currently the predominant solar power technology for generating electricity at the utility scale. The central receiver system, which is a concentrating solar power system, uses a field of mirrors to concentrate solar radiation onto a receiver where a working fluid is heated to drive a turbine. Current central receiver systems operate on a Rankine cycle, which has a large demand for cooling water. This demand for water presents a challenge for the current central receiver systems as the ideal locations for solar power plants have arid climates. An alternative to the current receiver technology is the small particle receiver. The small particle receiver has the potential to produce working fluid temperatures suitable for use in a Brayton cycle which can be more efficient when pressurized to 0.5 MPa. Using a fused quartz window allows solar energy into the receiver while maintaining a pressurized small particle receiver. In this thesis, a detailed numerical investigation for a spectral, three dimensional, cylindrical glass window for a small particle receiver was performed. The window is 1.7 meters in diameter and 0.0254 meters thick. There are three Monte Carlo Ray Trace codes used within this research. The first MCRT code, MIRVAL, was developed by Sandia National Laboratory and modified by a fellow San Diego State University colleague Murat Mecit. This code produces the solar rays on the exterior surface of the window. The second MCRT code was developed by Steve Ruther and Pablo Del Campo. This code models the small particle receiver, which creates the infrared spectral direction flux on the interior surface of the window used in this work. The third MCRT, developed for this work, is used to model radiation heat transfer within the window itself and is coupled to an energy equation solver to produce a temperature distribution. The MCRT program provides a source term to the energy equation. This in turn, produces a new temperature field for the MCRT program; together the equations are solved iteratively. These iterations repeat until convergence is reached for a steady state temperature field. The energy equation was solved using a finite volume method. The window's thermal conductivity is modeled as a function of temperature. This thermal model is used to investigate the effects of different materials, receiver geometries, interior convection coefficients and exterior convection coefficients. To prevent devitrification and the ultimate failure of the window, the window needs to stay below the devitrification temperature of the material. In addition, the temperature gradients within the window need to be kept to a minimum to prevent thermal stresses. A San Diego State University colleague E-Fann Saung uses these temperature maps to insure that the mounting of the window does not produce thermal stresses which can cause cracking in the brittle fused quartz. The simulations in this thesis show that window temperatures are below the devitrification temperature of the window when there are cooling jets on both surfaces of the window. Natural convection on the exterior window surface was explored and it does not provide adequate cooling; therefore forced convection is required. Due to the low thermal conductivity of the window, the edge mounting thermal boundary condition has little effect on the maximum temperature of the window. The simulations also showed that the solar input flux absorbed less than 1% of the incoming radiation while the window absorbed closer to 20% of the infrared radiation emitted by the receiver. The main source of absorbed power in the window is located directly on the interior surface of the window where the infrared radiation is absorbed. The geometry of the receiver has a large impact on the amount of emitted power which reached the interior surface of the window, and using a conical shaped receiver dramatically reduced the receiver's infrared flux on the window. The importance of internal emission is explored within this research. Internal emission produces a more even emission field throughout the receiver than applying radiation surface emission only. Due to a majority of the infrared receiver re-radiation being absorbed right at the interior surface, the surface emission only approximation method produces lower maximum temperatures.

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2012 CFR

2012-04-01

... small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Adjustment § 39.145 Can a school receive both a small school adjustment and a small high school adjustment? A school that meets the criteria in § 39.140 can receive both a small school adjustment and a small high...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2014 CFR

2014-04-01

... small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Adjustment § 39.145 Can a school receive both a small school adjustment and a small high school adjustment? A school that meets the criteria in § 39.140 can receive both a small school adjustment and a small high...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2013 CFR

2013-04-01

... small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... Adjustment § 39.145 Can a school receive both a small school adjustment and a small high school adjustment? A school that meets the criteria in § 39.140 can receive both a small school adjustment and a small high...

Pretreatment With Caffeine Citrate to Increase Seizure Duration During Electroconvulsive Therapy: A Case Series.

PubMed

Pinkhasov, Aaron; Biglow, Michael; Chandra, Subhash; Pica, Tiffany

2016-04-01

Due to the shortage of parenteral caffeine and sodium benzoate, patients were pretreated with caffeine citrate to increase therapeutic seizure duration during electroconvulsive therapy (ECT). To date, no data are available on the use of caffeine citrate during ECT. This retrospective case series was done to demonstrate utilization of caffeine citrate as a substitute for caffeine and sodium benzoate in optimizing ECT. Medical records were reviewed to identify patients who received ECT and caffeine citrate. Physician notes were reviewed to determine the parameters of the ECT procedure, the seizure length, and the dose of caffeine citrate. Each chart was thoroughly studied to find the relationship between seizure duration and dose of caffeine citrate. Of the 12 ECT treatments utilizing caffeine citrate, 9 achieved at least 1 session lasting >30 seconds with an average seizure duration of 35 seconds. Increase in seizure duration ranged from -41% to 276% with an average increase of 48%. Only 3 treatment sessions utilizing caffeine citrate showed no increase in seizure duration. Doses ranged from 120 to 600 mg of both oral and parenteral caffeine citrate. Although increase in seizure duration was achieved for the majority of the ECT sessions, no dose-response correlation could be made. No significant adverse reactions were noted with the use of caffeine citrate during ECT. It was determined that, much like caffeine and sodium benzoate, caffeine citrate does increase the seizure duration. However, this response did vary due to many reasons including small sample size, concomitant medications, duration of illness, and number of ECTs they received in the past and how long ago they received the last ECT. Further research is required to elucidate the effect of these variables on seizure duration. © The Author(s) 2014.

Embedded parallel processing based ground control systems for small satellite telemetry

NASA Technical Reports Server (NTRS)

Forman, Michael L.; Hazra, Tushar K.; Troendly, Gregory M.; Nickum, William G.

1994-01-01

The use of networked terminals which utilize embedded processing techniques results in totally integrated, flexible, high speed, reliable, and scalable systems suitable for telemetry and data processing applications such as mission operations centers (MOC). Synergies of these terminals, coupled with the capability of terminal to receive incoming data, allow the viewing of any defined display by any terminal from the start of data acquisition. There is no single point of failure (other than with network input) such as exists with configurations where all input data goes through a single front end processor and then to a serial string of workstations. Missions dedicated to NASA's ozone measurements program utilize the methodologies which are discussed, and result in a multimission configuration of low cost, scalable hardware and software which can be run by one flight operations team with low risk.

Cumulative Weighing of Time in Intertemporal Tradeoffs

PubMed Central

2016-01-01

We examine preferences for sequences of delayed monetary gains. In the experimental literature, two prominent models have been advanced as psychological descriptions of preferences for sequences. In one model, the instantaneous utilities of the outcomes in a sequence are discounted as a function of their delays, and assembled into a discounted utility of the sequence. In the other model, the accumulated utility of the outcomes in a sequence is considered along with utility or disutility from improvement in outcome utilities and utility or disutility from the spreading of outcome utilities. Drawing on three threads of evidence concerning preferences for sequences of monetary gains, we propose that the accumulated utility of the outcomes in a sequence is traded off against the duration of utility accumulation. In our first experiment, aggregate choice behavior provides qualitative support for the tradeoff model. In three subsequent experiments, one of which incentivized, disaggregate choice behavior provides quantitative support for the tradeoff model in Bayesian model contests. One thread of evidence motivating the tradeoff model is that, when, in the choice between two single dated outcomes, it is conveyed that receiving less sooner means receiving nothing later, preference for receiving more later increases, but when it is conveyed that receiving more later means receiving nothing sooner, preference is left unchanged. Our results show that this asymmetric hidden-zero effect is indeed driven by those supporting the tradeoff model. The tradeoff model also accommodates all remaining evidence on preferences for sequences of monetary gains. PMID:27560853

Dynamic changes in quality of life after three first-line therapies for EGFR mutation-positive advanced non-small-cell lung cancer.

PubMed

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

2018-01-01

Three different tyrosine kinase inhibitors have been approved as first-line therapies for epidermal growth factor receptor (EGFR) mutation-positive advanced non-small-cell lung cancer with similar overall survival. This study determined dynamic changes in quality of life (QoL) for patients using these therapies after controlling for potential confounders. From 2011 to 2016, we prospectively assessed the utility values and QoL scores of patients using the EuroQol five-dimension and World Health Organization Quality-of-Life - Brief questionnaires. QoL functions after initiation of treatment were estimated using a kernel-smoothing method. Dynamic changes in major determinants were repeatedly assessed for constructing mixed models. A total of 344 patients were enrolled, with 934 repeated assessments. After controlling for performance status, disease progression, EGFR mutation subtype and other confounders, the mixed models showed significantly lower QoL scores for afatinib versus gefitinib in the physical, psychological and social domains, and 10 facets. The differences seemed to appear 10 months after initiation of treatment. In contrast, there was no significant difference between erlotinib and gefitinib in the scores of all domains and facets. QoL in patients receiving afatinib seemed to be lower than in those receiving gefitinib. Since the sample sizes in this study were relatively small, more studies are warranted to corroborate these results.

Habitat selection by green turtles in a spatially heterogeneous benthic landscape in Dry Tortugas National Park, Florida

USGS Publications Warehouse

Fujisaki, Ikuko; Hart, Kristen M.; Sartain-Iverson, Autumn R.

2016-01-01

We examined habitat selection by green turtles Chelonia mydas at Dry Tortugas National Park, Florida, USA. We tracked 15 turtles (6 females and 9 males) using platform transmitter terminals (PTTs); 13 of these turtles were equipped with additional acoustic transmitters. Location data by PTTs comprised periods of 40 to 226 d in varying months from 2009 to 2012. Core areas were concentrated in shallow water (mean bathymetry depth of 7.7 m) with a comparably dense coverage of seagrass; however, the utilization distribution overlap index indicated a low degree of habitat sharing. The probability of detecting a turtle on an acoustic receiver was inversely associated with the distance from the receiver to turtle capture sites and was lower in shallower water. The estimated daily detection probability of a single turtle at a given acoustic station throughout the acoustic array was small (<0.1 in any year), and that of multiple turtle detections was even smaller. However, the conditional probability of multiple turtle detections, given at least one turtle detection at a receiver, was much higher despite the small number of tagged turtles in each year (n = 1 to 5). Also, multiple detections of different turtles at a receiver frequently occurred within a few minutes (40%, or 164 of 415, occurred within 1 min). Our numerical estimates of core area overlap, co-occupancy probabilities, and habitat characterization for green turtles could be used to guide conservation of the area to sustain the population of this species.

Application of GPS tracking techniques to orbit determination for TDRS

NASA Technical Reports Server (NTRS)

Haines, B. J.; Lichten, S. M.; Malla, R. P.; Wu, S. C.

1993-01-01

In this paper, we evaluate two fundamentally different approaches to TDRS orbit determination utilizing Global Positioning System (GPS) technology and GPS-related techniques. In the first, a GPS flight receiver is deployed on the TDRSS spacecraft. The TDRS ephemerides are determined using direct ranging to the GPS spacecraft, and no ground network is required. In the second approach, the TDRSS spacecraft broadcast a suitable beacon signal, permitting the simultaneous tracking of GPS and TDRSS satellites from a small ground network. Both strategies can be designed to meet future operational requirements for TDRS-2 orbit determination.

Relations between Brain Structure and Attentional Function in Spina Bifida: Utilization of Robust Statistical Approaches

PubMed Central

Kulesz, Paulina A.; Tian, Siva; Juranek, Jenifer; Fletcher, Jack M.; Francis, David J.

2015-01-01

Objective Weak structure-function relations for brain and behavior may stem from problems in estimating these relations in small clinical samples with frequently occurring outliers. In the current project, we focused on the utility of using alternative statistics to estimate these relations. Method Fifty-four children with spina bifida meningomyelocele performed attention tasks and received MRI of the brain. Using a bootstrap sampling process, the Pearson product moment correlation was compared with four robust correlations: the percentage bend correlation, the Winsorized correlation, the skipped correlation using the Donoho-Gasko median, and the skipped correlation using the minimum volume ellipsoid estimator Results All methods yielded similar estimates of the relations between measures of brain volume and attention performance. The similarity of estimates across correlation methods suggested that the weak structure-function relations previously found in many studies are not readily attributable to the presence of outlying observations and other factors that violate the assumptions behind the Pearson correlation. Conclusions Given the difficulty of assembling large samples for brain-behavior studies, estimating correlations using multiple, robust methods may enhance the statistical conclusion validity of studies yielding small, but often clinically significant, correlations. PMID:25495830

Relations between volumetric measures of brain structure and attentional function in spina bifida: utilization of robust statistical approaches.

PubMed

Kulesz, Paulina A; Tian, Siva; Juranek, Jenifer; Fletcher, Jack M; Francis, David J

2015-03-01

Weak structure-function relations for brain and behavior may stem from problems in estimating these relations in small clinical samples with frequently occurring outliers. In the current project, we focused on the utility of using alternative statistics to estimate these relations. Fifty-four children with spina bifida meningomyelocele performed attention tasks and received MRI of the brain. Using a bootstrap sampling process, the Pearson product-moment correlation was compared with 4 robust correlations: the percentage bend correlation, the Winsorized correlation, the skipped correlation using the Donoho-Gasko median, and the skipped correlation using the minimum volume ellipsoid estimator. All methods yielded similar estimates of the relations between measures of brain volume and attention performance. The similarity of estimates across correlation methods suggested that the weak structure-function relations previously found in many studies are not readily attributable to the presence of outlying observations and other factors that violate the assumptions behind the Pearson correlation. Given the difficulty of assembling large samples for brain-behavior studies, estimating correlations using multiple, robust methods may enhance the statistical conclusion validity of studies yielding small, but often clinically significant, correlations. PsycINFO Database Record (c) 2015 APA, all rights reserved.

A multifrequency MUSIC algorithm for locating small inhomogeneities in inverse scattering

NASA Astrophysics Data System (ADS)

Griesmaier, Roland; Schmiedecke, Christian

2017-03-01

We consider an inverse scattering problem for time-harmonic acoustic or electromagnetic waves with sparse multifrequency far field data-sets. The goal is to localize several small penetrable objects embedded inside an otherwise homogeneous background medium from observations of far fields of scattered waves corresponding to incident plane waves with one fixed incident direction but several different frequencies. We assume that the far field is measured at a few observation directions only. Taking advantage of the smallness of the scatterers with respect to wavelength we utilize an asymptotic representation formula for the far field to design and analyze a MUSIC-type reconstruction method for this setup. We establish lower bounds on the number of frequencies and receiver directions that are required to recover the number and the positions of an ensemble of scatterers from the given measurements. Furthermore we briefly sketch a possible application of the reconstruction method to the practically relevant case of multifrequency backscattering data. Numerical examples are presented to document the potentials and limitations of this approach.

Gene expression of enzymes involved in utilization of xylooligosaccharides by Lactobacillus strains

PubMed Central

Maria, Ananieva; Margarita, Tzenova; IIlia, Iliev; Iskra, Ivanova

2014-01-01

Prebiotics are defined as food components that confer health benefits on the host through modulation of the microbiota. Xylooligosaccharides (XOS) are non-digestible oligosaccharides that have recently received increasing attention as potential prebiotic candidates. XOS are sugar oligomers composed of 1,4-linked xylopyranosyl backbone and are obtained by either chemical or, more commonly, enzymatic hydrolysis of xylan polysaccharides, extracted from the plant cell wall. The bifidogenic effect of XOS was demonstrated by both in vitro studies and small-scale in vivo human studies. Some intestinal bacterial strains are able to grow on XOS, yet numerous studies have demonstrated that the ability to utilize these oligosaccharides varies considerably among these bacteria. The aim of this study is to investigate the ability of several strains Lactobacillus to use XOS. Fifteen Lactobacillus strains, allifiated to L. plantarum, L. brevis and L. sakei, were studied. Screening procedure was performed for the ability of the strains to utilize XOS as an alternative carbon source. Only some of them utilize XOS. The growth kinetics show the presence of two lag phases, indicating that these bacteria utilize probably some monosaccharides present in the used XOS. XOS were fermented with high specificity by Bifidobacteria strains, but Lactobacilli did not metabolize XOS efficiently. PMID:26019582

RPMIS: The Roswell Park Management Information System

PubMed Central

Priore, R.L.; Lane, W.W.; Edgerton, F.T.; Naeher, C.H.; Reese, P.A.

1978-01-01

This paper presents a generalized approach to data entry and editing utilizing formatted video computer terminals. The purpose of the system developed is to facilitate the creation of many small data bases, with a minimum of implementation time, while maintaining extensive editing capability and preserving ease of use by data entry personnel. RPMIS has demonstrated its utility in shortening the time between research activities and clinical application of results. The system allows entry and retrieval of overlapping subsets of the patient's record in an order and format most appropriate to the individual application. It is used for production of synoptic presentations of information from the labs, the ward and the clinic. RPMIS was designed for the clinical trials setting and has been well received and implemented for numerous such studies. Additional uses have included several registries, screening clinics, retrospective studies, and epidemiologic investigations. The system has found fortuitous use in maintaining curriculum vitae, publications lists and continuing medical education credits.

Briefcase Communicator

NASA Technical Reports Server (NTRS)

1979-01-01

In the photo at bottom right, a U.S. Park Police officer is demonstrating a battery-powered communications system, sufficiently compact to be packed in a briefcase-size container, which can send and receive signals over great distances by means of satellite relay. Key to the system's efficacy is the high-powered transmitting and receiving equipment aboard such NASA satellites as the Applications Technology Satellite6 (ATS-6) and the joint U.S.-Canadian Communications Technology Satellite (CTS); this enables the briefcase communicator to pick up satellite-relayed signals by means of the small hook-on antenna shown instead of the more elaborate-ground equipment customarily needed. Developed by NASA's Goddard Space Flight Center, the communicator is intended for use in emergency situations. It has utility, for example, in disasters, such as floods and hurricanes, where power failure disrupts conventional communications; for on-the-spot transmissions from major accident sites; or in remote areas where no other means of communication exists

48 CFR 752.219-8 - Utilization of small business concerns and small disadvantaged business concerns.

Code of Federal Regulations, 2010 CFR

2010-10-01

... business concerns and small disadvantaged business concerns. 752.219-8 Section 752.219-8 Federal... AND CONTRACT CLAUSES Texts of Provisions and Clauses 752.219-8 Utilization of small business concerns and small disadvantaged business concerns. The Foreign Assistance Act calls for USAID to give small...

48 CFR 752.219-8 - Utilization of small business concerns and small disadvantaged business concerns.

Code of Federal Regulations, 2011 CFR

2011-10-01

... business concerns and small disadvantaged business concerns. 752.219-8 Section 752.219-8 Federal... AND CONTRACT CLAUSES Texts of Provisions and Clauses 752.219-8 Utilization of small business concerns and small disadvantaged business concerns. The Foreign Assistance Act calls for USAID to give small...

48 CFR 52.219-8 - Utilization of small business concerns.

Code of Federal Regulations, 2010 CFR

2010-10-01

... business concerns. 52.219-8 Section 52.219-8 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.219-8 Utilization of small business concerns. As prescribed in 19.708(a), insert the following clause: Utilization of Small Business Concerns (MAY 2004) (a) It is the policy of the United States that...

41 CFR 105-53.130-4 - Office of Small and Disadvantaged Business Utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Disadvantaged Business Utilization. 105-53.130-4 Section 105-53.130-4 Public Contracts and Property Management... ORGANIZATION AND FUNCTIONS Central Offices § 105-53.130-4 Office of Small and Disadvantaged Business Utilization. (a) Creation and authority. Public Law 95-507, October 14, 1978, an amendment to the Small...

Radio Tracking Fish with Small Unmanned Aircraft Systems (sUAS).

NASA Astrophysics Data System (ADS)

Dahlgren, R. P.; Anderson, K. R.; Hanson, L.; Pinsker, E. A.; Jonsson, J.; Chapman, D. C.; Witten, D. M.; O'Connor, K. A.

2017-12-01

Tracking radio tagged fish by boat or on foot in riverine systems is difficult and time consuming, particularly in large braided island complexes, shallow wetlands, and rocky reaches. Invasive Asian carp are commonly found in these hard to reach areas, but their near-surface feeding behavior makes radio tracking possible. To identify new methods of fish tracking that could same time and money, this study tested the feasibility of tracking Asian carp with Small Unmanned Aerial Systems (sUAS) in areas generally inaccessible to traditional tracking equipment. The U.S. Geological Survey worked with NanoElectromagnetics LLC and WWR Development to create and integrate a lightweight custom radio receiver, directional antenna, and accompanying software into a sUAS platform. The receiver includes independent GPS, software defined radio, and compass. The NASA Ames Research Center (ARC) completed payload integration, electromagnetic-interference and airworthiness testing, and provided a DJI Matrice 600 sUAS for this study. Additionally, ARC provided subject matter experts, airworthiness and flight readiness evaluation, and flight test facilities during preparation; and a pilot, range safety officer, and aircraft engineer during field deployment. Results demonstrate that this custom sUAS and sensor combination can detect radio tags at 100m above ground level and at horizontal ranges of 100m and 300m, with operators in either onshore or offshore locations. With this combination of sUAS and radio receiver, fish can be tracked in areas previously inaccessible and during flooding, providing new insights into riverine fish movement and habitat utilization.

Concurrent communication among multi-transceiver stations over shared media. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Birk, Yitzhak

1987-01-01

In order to increase a local-area network's throughput beyond a single bus data rate without using dedicated switching nodes, multiple buses and multitransceiver stations are required. The design space of single-hop interconnections is explored among such stations. Interconnections are presented whose throughput can grow quadratically with the number of transmitters and receivers per station. These are referred to as selective broadcast interconnections (SBIs). The performance of various SBIs are studied. A spread-spectrum channel can accommodate several current successful transmission, and a single-transceiver node can thus utilize only a small fraction of the channel capacity. In order to allocate the appropriate fraction of capacity to a busy node, it is proposed to equip it with several transmitters and receivers, thereby turning it into a supernode. Several architectures and operation policies for supernodes are suggested and compared. It is shown that a supernode can significantly outperform a collection of independent conventional nodes with the same total numbers of transmitters and receivers. Packet-radio networks with half-duplex nodes, as well as networks with full-duplex nodes, are considered.

Multi-service small-cell cloud wired/wireless access network based on tunable optical frequency comb

NASA Astrophysics Data System (ADS)

Xiang, Yu; Zhou, Kun; Yang, Liu; Pan, Lei; Liao, Zhen-wan; Zhang, Qiang

2015-11-01

In this paper, we demonstrate a novel multi-service wired/wireless integrated access architecture of cloud radio access network (C-RAN) based on radio-over-fiber passive optical network (RoF-PON) system, which utilizes scalable multiple- frequency millimeter-wave (MF-MMW) generation based on tunable optical frequency comb (TOFC). In the baseband unit (BBU) pool, the generated optical comb lines are modulated into wired, RoF and WiFi/WiMAX signals, respectively. The multi-frequency RoF signals are generated by beating the optical comb line pairs in the small cell. The WiFi/WiMAX signals are demodulated after passing through the band pass filter (BPF) and band stop filter (BSF), respectively, whereas the wired signal can be received directly. The feasibility and scalability of the proposed multi-service wired/wireless integrated C-RAN are confirmed by the simulations.

Utility photovoltaic group: Status report

NASA Astrophysics Data System (ADS)

Serfass, Jeffrey A.; Hester, Stephen L.; Wills, Bethany N.

1996-01-01

The Utility PhotoVoltaic Group (UPVG) was formed in October of 1992 with a mission to accelerate the use of cost-effective small-scale and emerging grid-connected applications of photovoltaics for the benefit of electric utilities and their customers. The UPVG is now implementing a program to install up to 50 megawatts of photovoltaics in small-scale and grid-connected applications. This program, called TEAM-UP, is a partnership of the U.S. electric utility industry and the U.S. Department of Energy to help develop utility PV markets. TEAM-UP is a utility-directed program to significantly increase utility PV experience by promoting installations of utility PV systems. Two primary program areas are proposed for TEAM-UP: (1) Small-Scale Applications (SSA)—an initiative to aggregate utility purchases of small-scale, grid-independent applications; and (2) Grid-Connected Applications (GCA)—an initiative to identify and competitively award cost-sharing contracts for grid-connected PV systems with high market growth potential, or collective purchase programs involving multiple buyers. This paper describes these programs and outlines the schedule, the procurement status, and the results of the TEAM-UP process.

High-temperature superconductivity for avionic electronic warfare and radar systems

NASA Astrophysics Data System (ADS)

Ryan, Paul A.

1994-01-01

The electronic warfare (EW) and radar communities expect to be major beneficiaries of the performance advantages high-temperature superconductivity (HTS) has to offer over conventional technology. Near term upgrades to system hardware can be envisioned using extremely small, high Q, microwave filters and resonators; compact, wideband, low loss, microwave delay and transmission lines; as well as, wideband, low loss, monolithic microwave integrated circuit phase shifters. The most dramatic impact will be in the far term, using HTS to develop new, real time threat identification and response strategy receiver/processing systems designed to utilize the unique high frequency properties of microwave and ultimately digital HTS.

Quantifying the utilization of medical devices necessary to detect postmarket safety differences: A case study of implantable cardioverter defibrillators.

PubMed

Bates, Jonathan; Parzynski, Craig S; Dhruva, Sanket S; Coppi, Andreas; Kuntz, Richard; Li, Shu-Xia; Marinac-Dabic, Danica; Masoudi, Frederick A; Shaw, Richard E; Warner, Frederick; Krumholz, Harlan M; Ross, Joseph S

2018-06-12

To estimate medical device utilization needed to detect safety differences among implantable cardioverter defibrillators (ICDs) generator models and compare these estimates to utilization in practice. We conducted repeated sample size estimates to calculate the medical device utilization needed, systematically varying device-specific safety event rate ratios and significance levels while maintaining 80% power, testing 3 average adverse event rates (3.9, 6.1, and 12.6 events per 100 person-years) estimated from the American College of Cardiology's 2006 to 2010 National Cardiovascular Data Registry of ICDs. We then compared with actual medical device utilization. At significance level 0.05 and 80% power, 34% or fewer ICD models accrued sufficient utilization in practice to detect safety differences for rate ratios <1.15 and an average event rate of 12.6 events per 100 person-years. For average event rates of 3.9 and 12.6 events per 100 person-years, 30% and 50% of ICD models, respectively, accrued sufficient utilization for a rate ratio of 1.25, whereas 52% and 67% for a rate ratio of 1.50. Because actual ICD utilization was not uniformly distributed across ICD models, the proportion of individuals receiving any ICD that accrued sufficient utilization in practice was 0% to 21%, 32% to 70%, and 67% to 84% for rate ratios of 1.05, 1.15, and 1.25, respectively, for the range of 3 average adverse event rates. Small safety differences among ICD generator models are unlikely to be detected through routine surveillance given current ICD utilization in practice, but large safety differences can be detected for most patients at anticipated average adverse event rates. Copyright © 2018 John Wiley & Sons, Ltd.

48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

Code of Federal Regulations, 2010 CFR

2010-10-01

... small businesses with respect to the financial assistance available under existing laws and regulations... business utilization specialists. 1519.201-72 Section 1519.201-72 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Policies 1519.201-72 Small and...

13 CFR 107.860 - Financing fees and expense reimbursements a Licensee may receive from a Small Business.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Financing fees and expense... § 107.860 Financing fees and expense reimbursements a Licensee may receive from a Small Business. You may collect Financing fees and receive expense reimbursements from a Small Business only as permitted...

NASA Office of Small and Disadvantaged Business Utilization

NASA Technical Reports Server (NTRS)

2001-01-01

The Office of Small and Disadvantaged Business Utilization (OSDBU) within NASA promotes the utilization of small, disadvantaged, and women-owned small businesses in compliance with Federal laws, regulations, and policies. We assist such firms in obtaining contracts and subcontracts with NASA and its prime contractors. The OSDBU also facilitates the participation of small businesses in NASA's technology transfer and commercialization activities. Our driving philosophy is to consider small businesses as our products. Our customers are the NASA Enterprises, Field Centers, Functional Staff Offices, major prime contractors, and other large institutions. We hone the skills of our products to make them marketable to our customers in the performance of NASA missions.

Assessing the Local Need for Family and Child Care Services: A Small Area Utilization Analysis.

ERIC Educational Resources Information Center

Percy, Andrew; Carr-Hill, Roy; Dixon, Paul; Jamison, James Q.

2000-01-01

Describes study of administrative data from Northern Ireland on the costs of family and child care services, using small area utilization modeling, to derive a new set of needs indicators that could be used within the family and child care capitation funding formula. Argues that small area utilization modeling produces a fairer and more equitable…

Interactions between energy efficiency and emission trading under the 1990 Clean Air Act Amendments

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

Hillsman, E.L.; Alvic, D.R.

1994-08-01

The 1990 Clean Air Act Amendments affect electric utilities in numerous ways. The feature that probably has received the greatest attention is the provision to let utilities trade emissions of sulfur dioxide (SO{sub 2}), while at the same time requiring them to reduce S0{sub 2} emissions in 2000 by an aggregate 43%. The emission trading system was welcomed by many as a way of reducing the cost of reducing emissions, by providing greater flexibility than past approaches. This report examines some of the potential interactions between trading emissions and increasing end-use energy efficiency. The analysis focuses on emission trading inmore » the second phase of the trading program, which begins in 2000. The aggregate effects, calculated by an emission compliance and trading model, turn out to be rather small. Aggressive improvement of end-use efficiency by all utilities might reduce allowance prices by $22/ton (1990 dollars), which is small compared to the reduction that has occurred in the estimates of future allowance prices and when compared to the roughly $400/ton price we estimate as a base case. However, the changes in the allowance market that result are large enough to affect some compliance decisions. If utilities in only a few states improve end-use efficiency aggressively, their actions may not have a large effect on the price of an allowance, but they could alter the demand for allowances and thereby the compliance decisions of utilities in other states. The analysis shows how improving electricity end-use efficiency in some states can cause smaller emission reductions in other states, relative to what would have happened without the improvements. Such a result, while not surprising given the theory behind the emission trading system, is upsetting to people who view emissions, environmental protection, and energy efficiency in moral rather than strictly economic terms.« less

A high speed compact microwave interferometer for density fluctuation measurements in Sino-UNIted Spherical Tokamak

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

Zhong, H., E-mail: zhongh14@126.com; Tan, Y.; Liu, Y. Q.

2016-11-15

A single-channel 3 mm interferometer has been developed for plasma density diagnostics in the Sino-UNIted Spherical Tokamak (SUNIST). The extremely compact microwave interferometer utilizes one corrugated feed horn antenna for both emitting and receiving the microwave. The beam path lies on the equatorial plane so the system would not suffer from beam path deflection problems due to the symmetry of the cross section. A focusing lens group and an oblique vacuum window are carefully designed to boost the signal to noise ratio, which allows this system to show good performance even with the small-diameter central column itself as a reflector,more » without a concave mirror. The whole system discards the reference leg for maximum compactness, which is particularly suitable for the small-sized tokamak. An auto-correcting algorithm is developed to calculate the phase evolution, and the result displays good phase stability of the whole system. The intermediate frequency is adjustable and can reach its full potential of 2 MHz for best temporal resolution. Multiple measurements during ohmic discharges proved the interferometer’s capability to track typical density fluctuations in SUNIST, which enables this system to be utilized in the study of MHD activities.« less

Potential use of low-copy nuclear genes in DNA barcoding: a comparison with plastid genes in two Hawaiian plant radiations

PubMed Central

2013-01-01

Background DNA barcoding of land plants has relied traditionally on a small number of markers from the plastid genome. In contrast, low-copy nuclear genes have received little attention as DNA barcodes because of the absence of universal primers for PCR amplification. Results From pooled-species 454 transcriptome data we identified two variable intron-less nuclear loci for each of two species-rich genera of the Hawaiian flora: Clermontia (Campanulaceae) and Cyrtandra (Gesneriaceae) and compared their utility as DNA barcodes with that of plastid genes. We found that nuclear genes showed an overall greater variability, but also displayed a high level of heterozygosity, intraspecific variation, and retention of ancient alleles. Thus, nuclear genes displayed fewer species-diagnostic haplotypes compared to plastid genes and no interspecies gaps. Conclusions The apparently greater coalescence times of nuclear genes are likely to limit their utility as barcodes, as only a small proportion of their alleles were fixed and unique to individual species. In both groups, species-diagnostic markers from either genome were scarce on the youngest island; a minimum age of ca. two million years may be needed for a species flock to be barcoded. For young plant groups, nuclear genes may not be a superior alternative to slowly evolving plastid genes. PMID:23394592

UAV-borne lidar with MEMS mirror-based scanning capability

NASA Astrophysics Data System (ADS)

Kasturi, Abhishek; Milanovic, Veljko; Atwood, Bryan H.; Yang, James

2016-05-01

Firstly, we demonstrated a wirelessly controlled MEMS scan module with imaging and laser tracking capability which can be mounted and flown on a small UAV quadcopter. The MEMS scan module was reduced down to a small volume of <90mm x 60mm x 40mm, weighing less than 40g and consuming less than 750mW of power using a ~5mW laser. This MEMS scan module was controlled by a smartphone via Bluetooth while flying on a drone, and could project vector content, text, and perform laser based tracking. Also, a "point-and-range" LiDAR module was developed for UAV applications based on low SWaP (Size, Weight and Power) gimbal-less MEMS mirror beam-steering technology and off-the-shelf OEM LRF modules. For demonstration purposes of an integrated laser range finder module, we used a simple off-the-shelf OEM laser range finder (LRF) with a 100m range, +/-1.5mm accuracy, and 4Hz ranging capability. The LRFs receiver optics were modified to accept 20° of angle, matching the transmitter's FoR. A relatively large (5.0mm) diameter MEMS mirror with +/-10° optical scanning angle was utilized in the demonstration to maintain the small beam divergence of the module. The complete LiDAR prototype can fit into a small volume of <70mm x 60mm x 60mm, and weigh <50g when powered by the UAV's battery. The MEMS mirror based LiDAR system allows for ondemand ranging of points or areas within the FoR without altering the UAV's position. Increasing the LRF ranging frequency and stabilizing the pointing of the laser beam by utilizing the onboard inertial sensors and the camera are additional goals of the next design.

Ultrawideband asynchronous tracking system and method

NASA Technical Reports Server (NTRS)

Arndt, G. Dickey (Inventor); Ngo, Phong H. (Inventor); Phan, Chau T. (Inventor); Gross, Julia A. (Inventor); Ni, Jianjun (Inventor); Dusl, John (Inventor)

2012-01-01

A passive tracking system is provided with a plurality of ultrawideband (UWB) receivers that is asynchronous with respect to a UWB transmitter. A geometry of the tracking system may utilize a plurality of clusters with each cluster comprising a plurality of antennas. Time Difference of Arrival (TDOA) may be determined for the antennas in each cluster and utilized to determine Angle of Arrival (AOA) based on a far field assumption regarding the geometry. Parallel software communication sockets may be established with each of the plurality of UWB receivers. Transfer of waveform data may be processed by alternately receiving packets of waveform data from each UWB receiver. Cross Correlation Peak Detection (CCPD) is utilized to estimate TDOA information to reduce errors in a noisy, multipath environment.

We cannot staff for 'what ifs': the social organization of rural nurses' safeguarding work.

PubMed

MacKinnon, Karen

2012-09-01

Rural nurses play an important role in the provision of maternity care for Canadian women. This care is an important part of how rural nurses safeguard the patients who receive care in small rural hospitals. This study utilized institutional ethnography as an approach for describing rural nursing work and for exploring how nurses' work experiences are socially organized. Rural nurses advocated for safe healthcare environments by ensuring that skilled nurses were available for every shift, day and night, at their local hospital. Rural nurses noted that this work was particularly difficult for the provision of maternity care. This article explores two threads or cues to institutional organization that were identified in our interviews and observations; namely staffing and safety standards, and the need for flexibility in staffing in small rural hospitals. Rural nurses' concerns about ensuring that skilled nurses are available in small rural hospitals do not enter into current management discourses that focus on efficiency and cost savings or find a home within current discourses of patient safety 'competencies'. © 2011 Blackwell Publishing Ltd.

Analyzing the feasibility of utilizing small diameter hardwood timber for solid wood products and residues

Treesearch

Brian Perkins; Bob Smith; Philip Araman

2008-01-01

The eastern hardwood forest contains small diameter timber that is often of lower quality and lower value than larger sawtimber. This small diameter hardwood timber has traditionally been utilized for pulpwood, but it can also be used for lumber and residue production. In order to increase the utilization of this resource by sawmills, a number of analyses need to be...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can a school receive both a small school adjustment and a small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Can a school receive both a small school adjustment and a small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School...

14 CFR 1204.402 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Business Policy § 1204.402 Responsibilities. (a) Office of Small and Disadvantaged Business Utilization (OSDBU). The Associate Administrator for Small and Disadvantaged Business Utilization, NASA Headquarters... Installation considers that the volume of procurement at the Installation does not warrant a full-time Small...

14 CFR 1204.402 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Business Policy § 1204.402 Responsibilities. (a) Office of Small and Disadvantaged Business Utilization (OSDBU). The Associate Administrator for Small and Disadvantaged Business Utilization, NASA Headquarters... Installation considers that the volume of procurement at the Installation does not warrant a full-time Small...

A Comparison of the Small and Disadvantaged Business Utilization Specialists (SADBUS’) Role at Navy Regional Contracting Center (NRCC) philadelphia, Pennsylvania and Navy Regional Contracting Center (NRCC) San Diego, California Detachment Long Beach

DTIC Science & Technology

1991-12-31

NAVAL POSTGRADUATE SCHOOL Monterey, California ITan THESIS A comparison of the Small and Disadvantaged Business Utilization Specialists (SADBUS...8217A -Approved for public release: distribution is unlimited A Comparison of the small and Disadvantaged Business Utilization-Specialists (SADBUSI) Role...I D TIC ufst Spcati1 ABSTRACT This thesis analyzes the role of the Small and Disadvantaged Business Utii4zati6n Specialist (SADBUS) at the Navy

Comparison of health utility weights among elderly patients receiving breast-conserving surgery plus hormonal therapy with or without radiotherapy

PubMed Central

Ali, Askal Ayalew; Xiao, Hong; Tawk, Rima; Campbell, Ellen; Semykina, Anastasia; Montero, Alberto J.; Diaby, Vakaramoko

2017-01-01

Background The selection of the most appropriate treatment combinations requires the balancing of benefits and harms of these treatment options as well as the patients’ preferences for the resulting outcomes. Objective This research aimed at estimating and comparing the utility weights between elderly women with early stage hormone receptor positive (HR+) breast cancer receiving a combination of radiotherapy and hormonal therapy after breast conserving surgery (BCS) and those receiving a combination of BCS and hormonal therapy. Methods The Surveillance, Epidemiology, and End Results (SEER) linked with Medicare Health Outcomes Survey (MHOS) was used as the data source. Health utility weights were derived from the VR-12 health-related quality of life instrument using a mapping algorithm. Descriptive statistics of the sample were provided. Two sample t-tests were performed to determine potential differences in mean health utility weights between the two groups after propensity score matching. Results The average age at diagnosis was 72 vs. 76 years for the treated and the untreated groups, respectively. The results showed an inverse relationship between the receipt of radiotherapy and age. Patients who received radiotherapy had, on average, a higher health utility weight (0.70; SD = 0.123) compared with those who did not receive radiotherapy (0.676; SD = 0.130). Only treated patients who had more than two comorbid conditions had significantly higher health utility weights compared with patients who were not treated. Conclusions The mean health utility weights estimated for the radiotherapy and no radiotherapy groups can be used to inform a comparative cost-effectiveness analysis of the treatment options. However, the results of this study may not be generalizable to those who are outside a managed care plan because MHOS data is collected on managed care beneficiaries. PMID:27819160

Population-based pharmacoeconomic model for adopting capecitabine/docetaxel combination treatment for anthracycline-pretreated metastatic breast cancer.

PubMed

Verma, Shailendra; Ilersich, A Lane

2003-01-01

To model the cost-effectiveness of adopting capecitabine/docetaxel combination therapy in place of single-agent taxane therapy for women in the province of Ontario, Canada, receiving treatment for anthracycline-pretreated metastatic breast cancer. Clinical effectiveness and economic data were combined in a population model, from the perspective of a universal health care system. Estimates of clinical effectiveness and medical resource utilization were derived prospectively during a phase III randomized controlled trial comparing single-agent docetaxel with capecitabine/docetaxel combination therapy. Population data were obtained from the Cancer Care Ontario Registry and provincial prescription claims data. During 1999-2000, 542 patients were eligible for taxane monotherapy. As capecitabine/docetaxel treatment confers a median 3-month survival benefit compared with docetaxel monotherapy, the projected survival gain in these patients was 136 life-years. The results of the cost-effectiveness analysis demonstrate that the survival benefit provided by the addition of capecitabine to single-agent docetaxel is afforded at a small incremental cost of Canadian $3,691 per life-year gained. Hospitalization costs for treatment of adverse events were less for patients receiving capecitabine/docetaxel combination therapy than for those receiving docetaxel monotherapy. The results were robust for adjustments in treatment costs and adverse effects costs. Due to its 3-month survival gain and small incremental treatment cost, capecitabine/docetaxel is judged to be a highly cost-effective treatment in anthracycline-pretreated advanced breast cancer. From the perspective of the Ontario health care system, the addition of capecitabine to docetaxel in this patient population is a clinically appropriate and economically acceptable treatment strategy.

Patterns of harm reduction service utilization and HIV incidence among people who inject drugs in Ukraine: A two-part latent profile analysis.

PubMed

Ompad, Danielle C; Wang, Jiayu; Dumchev, Konstantin; Barska, Julia; Samko, Maria; Zeziulin, Oleksandr; Saliuk, Tetiana; Varetska, Olga; DeHovitz, Jack

2017-05-01

Program utilization patterns are described within a large network of harm reduction service providers in Ukraine. The relationship between utilization patterns and HIV incidence is determined among people who inject drugs (PWID) controlling for oblast-level HIV incidence and treatment/syringe coverage. Data were extracted from the network's monitoring and evaluation database (January 2011-September 2014, n=327,758 clients). Latent profile analysis was used to determine harm reduction utilization patterns using the number of HIV tests received annually and the number of condoms, syringes, and services (i.e., information and counseling sessions) received monthly over a year. Cox proportional hazards regression determined the relations between HIV seroconversion and utilization class membership. In the final 4-class model, class 1 (34.0% of clients) received 0.1 HIV tests, 1.3 syringes, 0.6 condom and minimal counseling and information sessions per month; class 2 (33.6%) received 8.6 syringes, 3.2 condoms, and 0.5 HIV tests and counseling and information sessions; class 3 (19.1%) received 1 HIV test, 11.9 syringes, 4.3 condoms, and 0.7 information and counseling sessions; class 4 (13.3%) received 1 HIV test, 26.1 syringes, 10.3 condoms, and 1.8 information and 1.9 counseling sessions. Class 4 clients had significantly decreased risk for HIV seroconversion as compared to those in class 1 after controlling for oblast-level characteristics. Injection drug use continues to be a major mode of HIV transmission in Ukraine, making evaluation of harm reduction efforts in reducing HIV incidence among PWID critical. These analyses suggest that receiving more syringes and condoms decreased risk of HIV. Scaling up HIV testing and harm reduction services is warranted. Copyright © 2016. Published by Elsevier B.V.

Design considerations for a LORAN-C timing receiver in a hostile signal to noise environment

NASA Technical Reports Server (NTRS)

Porter, J. W.; Bowell, J. R.; Price, G. E.

1981-01-01

The environment in which a LORAN-C Timing Receiver may function effectively depends to a large extent on the techniques utilized to insure that interfering signals within the pass band of the unit are neutralized. The baseline performance manually operated timing receivers is discussed and the basic design considerations and necessary parameters for an automatic unit utilizing today's technology are established. Actual performance data is presented comparing the results obtained from a present generation timing receiver against a new generation microprocessor controlled automatic acquisition receiver. The achievements possible in a wide range of signal to noise situations are demonstrated.

48 CFR 619.803-70 - Responsibilities of the Office of Small and Disadvantaged Business Utilization (A/SDBU).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Responsibilities of the Office of Small and Disadvantaged Business Utilization (A/SDBU). 619.803-70 Section 619.803-70 Federal Acquisition Regulations System DEPARTMENT OF STATE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Contracting with the Small Business Administration...

Maintaining Small Business Support in Times of Increased Army National Guard Utilization An Impending Crisis

DTIC Science & Technology

2006-02-13

business clientele, additional costs to hire a manager or replacement workers, complete loss of family income, and in extreme situations, bankruptcy, are...USAWC STRATEGY RESEARCH PROJECT MAINTAINING SMALL BUSINESS SUPPORT IN TIMES OF INCREASED ARMY NATIONAL GUARD UTILIZATION: AN IMPENDING CRISIS by...00-00-2005 to 00-00-2006 4. TITLE AND SUBTITLE Maintaining Small Business Support in Times of Increased Army National Guard Utilization An

Receivers

NASA Technical Reports Server (NTRS)

Donnelly, H.

1983-01-01

Before discussing Deep Space Network receivers, a brief description of the functions of receivers and how they interface with other elements of the Network is presented. Different types of receivers are used in the Network for various purposes. The principal receiver type is used for telemetry and tracking. This receiver provides the capability, with other elements of the Network, to track the space probe utilizing Doppler and range measurements, and to receive telemetry, including both scientific data from the onboard experiments and engineering data pertaining to the health of the probe. Another type of receiver is used for radio science applications. This receiver measures phase perturbations on the carrier signal to obtain information on the composition of solar and planetary atmospheres and interplanetary space. A third type of receiver utilizes very long baseline interferometry (VLBI) techniques for both radio science and spacecraft navigation data. Only the telemetry receiver is described in detail in this document. The integration of the Receiver-Exciter subsystem with other portions of the Deep Space Network is described.

Utilization of ERTS-1 data to monitor and classify eutrophication of inland lakes

NASA Technical Reports Server (NTRS)

Chase, P. E. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Bands 6 and 7 have fine structure as obtained by proper selection of digital levels in processing the CCT's. This is contrary to the imagery density received. This means that the small lakes can be classified in IR for different types of water masses. At least four distinct water masses have been determined for test lakes. They are shoreline, shallow water, and two deep waters. One deep water is patchy and presents difficulty in training set selection. The excellent weather and a completely successful field test form a significant happening. It required 12 orbits over the test area before perfect weather occurred.

Limited Influence of Urban Stormwater Runoff on Salt Marsh Platform and Marsh Creek Oxygen Dynamics in Coastal Georgia.

PubMed

Savidge, William B; Brink, Jonathan; Blanton, Jackson O

2016-12-01

Oxygen concentrations and oxygen utilization rates were monitored continuously for 23 months on marsh platforms and in small tidal creeks at two sites in coastal Georgia, USA, that receive urban stormwater runoff via an extensive network of drainage canals. These data were compared to nearby control sites that receive no significant surface runoff. Overall, rainfall and runoff per se were not associated with differences in the oxygen dynamics among the different locations. Because of the large tidal range and long tidal excursions in coastal Georgia, localized inputs of stormwater runoff are rapidly mixed with large volumes of ambient water. Oxygen concentrations in tidal creeks and on flooded marsh platforms were driven primarily by balances of respiration and photosynthesis in the surrounding regional network of marshes and open estuarine waters. Local respiration, while measurable, was of relatively minor importance in determining oxygen concentrations in tidal floodwaters. Water residence time on the marshes could explain differences in oxygen concentration between the runoff-influenced and control sites.

Limited Influence of Urban Stormwater Runoff on Salt Marsh Platform and Marsh Creek Oxygen Dynamics in Coastal Georgia

NASA Astrophysics Data System (ADS)

Savidge, William B.; Brink, Jonathan; Blanton, Jackson O.

2016-12-01

Oxygen concentrations and oxygen utilization rates were monitored continuously for 23 months on marsh platforms and in small tidal creeks at two sites in coastal Georgia, USA, that receive urban stormwater runoff via an extensive network of drainage canals. These data were compared to nearby control sites that receive no significant surface runoff. Overall, rainfall and runoff per se were not associated with differences in the oxygen dynamics among the different locations. Because of the large tidal range and long tidal excursions in coastal Georgia, localized inputs of stormwater runoff are rapidly mixed with large volumes of ambient water. Oxygen concentrations in tidal creeks and on flooded marsh platforms were driven primarily by balances of respiration and photosynthesis in the surrounding regional network of marshes and open estuarine waters. Local respiration, while measurable, was of relatively minor importance in determining oxygen concentrations in tidal floodwaters. Water residence time on the marshes could explain differences in oxygen concentration between the runoff-influenced and control sites.

High magnetic field measurement utilizing Faraday rotation in SF11 glass in simplified diagnostics.

PubMed

Dey, Premananda; Shukla, Rohit; Venkateswarlu, D

2017-04-01

With the commercialization of powerful solid-state lasers as pointer lasers, it is becoming simpler nowadays for the launch and free-space reception of polarized light for polarimetric applications. Additionally, because of the high power of such laser diodes, the alignment of the received light on the small sensor area of a photo-diode with a high bandwidth response is also greatly simplified. A plastic sheet polarizer taken from spectacles of 3D television (commercially available) is simply implemented as an analyzer before the photo-receiver. SF11 glass is used as a magneto-optic modulating medium for the measurement of the magnetic field. A magnetic field of magnitude more than 8 Tesla, generated by a solenoid has been measured using this simple assembly. The measured Verdet constant of 12.46 rad/T-m is obtained at the wavelength of 672 nm for the SF11 glass. The complete measurement system is a cost-effective solution.

Application of convolve-multiply-convolve SAW processor for satellite communications

NASA Technical Reports Server (NTRS)

Lie, Y. S.; Ching, M.

1991-01-01

There is a need for a satellite communications receiver than can perform simultaneous multi-channel processing of single channel per carrier (SCPC) signals originating from various small (mobile or fixed) earth stations. The number of ground users can be as many as 1000. Conventional techniques of simultaneously processing these signals is by employing as many RF-bandpass filters as the number of channels. Consequently, such an approach would result in a bulky receiver, which becomes impractical for satellite applications. A unique approach utilizing a realtime surface acoustic wave (SAW) chirp transform processor is presented. The application of a Convolve-Multiply-Convolve (CMC) chirp transform processor is described. The CMC processor transforms each input channel into a unique timeslot, while preserving its modulation content (in this case QPSK). Subsequently, each channel is individually demodulated without the need of input channel filters. Circuit complexity is significantly reduced, because the output frequency of the CMC processor is common for all input channel frequencies. The results of theoretical analysis and experimental results are in good agreement.

Channel correlation of free space optical communication systems with receiver diversity in non-Kolmogorov atmospheric turbulence

NASA Astrophysics Data System (ADS)

Ma, Jing; Fu, Yulong; Tan, Liying; Yu, Siyuan; Xie, Xiaolong

2018-05-01

Spatial diversity as an effective technique to mitigate the turbulence fading has been widely utilized in free space optical (FSO) communication systems. The received signals, however, will suffer from channel correlation due to insufficient spacing between component antennas. In this paper, the new expressions of the channel correlation coefficient and specifically its components (the large- and small-scale channel correlation coefficients) for a plane wave with aperture effects are derived for horizontal link in moderate-to-strong turbulence, using a non-Kolmogorov spectrum that has a generalized power law in the range of 3-4 instead of the fixed classical Kolmogorov power law of 11/3. And then the influence of power law variations on the channel correlation coefficient and its components are analysed. The numerical results indicated that various value of the power law lead to varying effects on the channel correlation coefficient and its components. This work will help with the further investigation on the fading correlation in spatial diversity systems.

Small Business Awards Program

DTIC Science & Technology

1987-01-12

Department of Defense - ’ ’> INSTRUCTION SAD-A269 980 o493 04199’ J3anuary 12, 1987 NUMBIPR 13 !•.SD (A) SUBJECT: Small Business Awards Program...References: (a) DoD Directive 4205.1, "DoD Small Business and Small Disadvantaged Business Utilization Programs," June 21, 1984 (b) DoD Federal Acquisition...the Department of Defense who have made significant contribution to the Small and Disadvantaged Business Utilization Program. 2. Prescribes

Academic interventions for students in introductory biology while concurrently enrolled in developmental courses: An action research study

NASA Astrophysics Data System (ADS)

Barnes, William D.

Each fall semester, approximately half of the students enrolled in the introductory biology course of a small rural college are concurrently enrolled in at least one developmental education math or English course. The resulting grades of D, F and Withdraw for this cohort will be as high as 50% for those enrolled in one developmental course and 65% for those enrolled in two. The purpose of this study was to provide academic interventions such as use of online supplemental learning materials and resources, as well as to emphasize the Campus Tutoring and Learning Center (CTLC) as a resource, for students in the introductory biology course in order to analyze the impact on the learning outcomes of the developmental students. The approach used was an action research model utilizing a pretest-posttest experimental design with the treatment group receiving weekly reminders regarding the availability and value of utilizing the CTLC and the control group receiving only an initial invitation to visit the CTLC. The results found a statistically significant effect ( p < .05) on student use of the CTLC in the treatment group as compared to the control. This suggests that faculty emphasis of campus learning resources can have a positive impact on student behavior. The effect of online supplemental learning materials and resources, including use of the CTLC, on student learning outcomes was found to be statistically insignificant ( p > .05).

Estimated cost savings of increased use of intravenous tissue plasminogen activator for acute ischemic stroke in Canada.

PubMed

Yip, Todd R; Demaerschalk, Bart M

2007-06-01

Intravenous tissue plasminogen activator (tPA) is an economically worthwhile but underused treatment option for acute ischemic stroke. We sought to identify the extent of tPA use in Canadian medical centers and the potential savings associated with increased use nationally and by province. We determined the nationwide annual incidence of ischemic stroke from the Canadian Institute of Health Information. The proportion of all ischemic stroke patients who received tPA was derived from published data. Economic analyses that report the expected annual cost savings of tPA were consulted. The analysis was conducted from the perspective of a universal health care system during 1 year. We estimated cost-savings with incrementally (eg, 2%, 4%, 6%, 8%, 10%, 15%, and 20%) increased use of tPA for acute ischemic stroke nationally and provincially. The current average national tPA utilization is 1.4%. For every increase of 2 percentage points in utilization, $757,204 (Canadian) could possibly be saved annually (95% CI maximum loss of $3,823,992 to a maximum savings of $2,201,252). With a 20% rate, >$7.5 million (Canadian) could be saved nationwide the first year. We estimate that even small increases in the proportion of all Canadian ischemic stroke patients receiving tPA could result in substantial realized savings for Canada's health care system.

75 FR 27556 - Agency Information Collection Activities: Final Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... utilization and management prospective insurance liability relative to risk premiums received. DATES: Comments... utilization and management prospective insurance liability relative to risk premiums received. Affected Public... 92-30). SUMMARY: The Export-Import Bank of the United States (Ex-Im Bank), as a part of its...

Impact of Implementing Antibiotic Stewardship Programs in 15 Small Hospitals: A Cluster-Randomized Intervention.

PubMed

Stenehjem, Edward; Hersh, Adam L; Buckel, Whitney R; Jones, Peter; Sheng, Xiaoming; Evans, R Scott; Burke, John P; Lopansri, Bert K; Srivastava, Rajendu; Greene, Tom; Pavia, Andrew T

2018-02-23

Studies on the implementation of antibiotic stewardship programs (ASPs) in small hospitals are limited. Accreditation organizations now require all hospitals to have ASPs. The objective of this cluster-randomized intervention was to assess the effectiveness of implementing ASPs in Intermountain Healthcare's 15 small hospitals. Each hospital was randomized to 1 of 3 ASPs of escalating intensity. Program 1 hospitals were provided basic antibiotic stewardship education and tools, access to an infectious disease hotline, and antibiotic utilization data. Program 2 hospitals received those interventions plus advanced education, audit and feedback for select antibiotics, and locally controlled antibiotic restrictions. Program 3 hospitals received program 2 interventions plus audit and feedback on the majority of antibiotics, and an infectious diseases-trained clinician approved restricted antibiotics and reviewed microbiology results. Changes in total and broad-spectrum antibiotic use within programs (intervention versus baseline) and the difference between programs in the magnitude of change in antibiotic use (eg, program 3 vs 1) were evaluated with mixed models. Program 3 hospitals showed reductions in total (rate ratio, 0.89; confidence interval, .80-.99) and broad-spectrum (0.76; .63-.91) antibiotic use when the intervention period was compared with the baseline period. Program 1 and 2 hospitals did not experience a reduction in antibiotic use. Comparison of the magnitude of effects between programs showed a similar trend favoring program 3, but this was not statistically significant. Only the most intensive ASP intervention was associated with reduction in total and broad-spectrum antibiotic use when compared with baseline. NCT03245879.

Performance Analysis of Transmit Diversity Systems with Multiple Antenna Replacement

NASA Astrophysics Data System (ADS)

Park, Ki-Hong; Yang, Hong-Chuan; Ko, Young-Chai

Transmit diversity systems based on orthogonal space-time block coding (OSTBC) usually suffer from rate loss and power spreading. Proper antenna selection scheme can help to more effectively utilize the transmit antennas and transmission power in such systems. In this paper, we propose a new antenna selection scheme for such systems based on the idea of antenna switching. In particular, targeting at reducing the number of pilot channels and RF chains, the transmitter now replaces the antennas with the lowest received SNR with unused ones if the output SNR of space time decoder at the receiver is below a certain threshold. With this new scheme, not only the number of pilot channels and RF chains to be implemented is decreased, the average amount of feedback information is also reduced. To analyze the performance of this scheme, we derive the exact integral closed form for the probability density function (PDF) of the received SNR. We show through numerical examples that the proposed scheme offers better performance than traditional OSTBC systems using all available transmitting antennas, with a small amount of feedback information. We also examine the effect of different antenna configuration and feedback delay.

Progress with treating the microbial dysbiosis associated with irritable bowel syndrome.

PubMed

Pearson, James S; Whorwell, Peter J

2017-01-01

Microbial dysbiosis is receiving increasing attention as possibly being important in the pathophysiology of irritable bowel syndrome. This review will summarize the most recent literature addressing attempts to explore and target the microbiome in patients with irritable bowel syndrome. Manipulation of the intestinal microbiota in irritable bowel syndrome is receiving increasing attention. Traditionally, dietary manipulation has been utilized. There is now evidence that a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet has not only been able to improve symptoms, but may have an effect on the gut microbiota. Probiotics are a safe and attractive option for the manipulation of the microbiota. There have been a number of well-designed trials examining the efficacy of certain strains of bacteria, and even yeasts are receiving attention. The role of antibiotics remains controversial and it seems likely that their use should currently be limited to those individuals with small intestinal bacterial overgrowth. Interest in the role of faecal microbiota transplantation for the treatment of a number of gastrointestinal conditions has intensified and irritable bowel syndrome is no exception. The manipulation of the microbial dysbiosis is gaining momentum. Further research, however, is required in order to identify the most appropriate treatment option for each individual patient.

Small-diameter utilization issues and opportunities

Treesearch

John Rusty Dramm

1999-01-01

This presentation provides a thought-provoking look at options for utilizing small- diameter wood to help reduce the widespread risk of catastrophic wildfire throughout the West while providing economic recovery of timber-depressed communities and sustaining viable forest products industry. Potentially viable utilization and marketing options are explored and current...

38 CFR 74.22 - What are the procedures for cancellation?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Small and Disadvantaged Business Utilization and Center for Veterans Enterprise (00VE), U.S. Department... AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Oversight Guidelines § 74.22 What are the... appeal with the Executive Director, Office of Small and Disadvantaged Business Utilization and Center for...

DOD Small and Disadvantaged Business Subcontracting Reporting System

DTIC Science & Technology

1987-07-06

referred to as "other Defense Agencies"). b. Applies to the Small and Disadvantaged Business Utilization (SADBU) offices:; of the DloD Components. C...Forward one copy of implementing documents to the Office of the Secretary of Defense (Small and Disadvantaged Business Utilization Office) within 120 days

Female fecundity variation affects reproducibility of experiments on host plant preference and acceptance in a phytophagous insect

PubMed Central

Schäpers, Alexander; Petrén, Hampus; Wheat, Christopher W.; Wiklund, Christer

2017-01-01

Reproducibility is a scientific cornerstone. Many recent studies, however, describe a reproducibility crisis and call for assessments of reproducibility across scientific domains. Here, we explore the reproducibility of a classic ecological experiment—that of assessing female host plant preference and acceptance in phytophagous insects, a group in which host specialization is a key driver of diversification. We exposed multiple cohorts of Pieris napi butterflies from the same population to traditional host acceptance and preference tests on three Brassicaceae host species. Whereas the host plant rank order was highly reproducible, the propensity to oviposit on low-ranked hosts varied significantly even among cohorts exposed to similar conditions. Much variation could be attributed to among-cohort variation in female fecundity, a trait strongly correlated both to female size and to the size of the nuptial gift a female receives during mating. Small males provide small spermatophores, and in our experiment small females that mated with small males had a disproportionally low propensity to oviposit on low-ranked hosts. Hence, our results provide empirical support to the theoretical prediction that female host utilization is strongly affected by non-genetic, environmental variation, and that such variation can affect the reproducibility of ecological experiments even under seemingly identical conditions. PMID:28202813

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... initiatives to assist, promote, and utilize small business (SB), small disadvantaged business (SDB), women... initiatives to assist, promote and utilize SB, SDB, WOSB, HUBZone, VOSB, and SDVOSB. Complied with FAR 52.219...

A New Paradigm in Earth Environmental Monitoring with the CYGNSS Small Satellite Constellation

NASA Technical Reports Server (NTRS)

Ruf, C. S.; Chew, C.; Lang, T.; Morris, M. G.; Kyle, K.; Ridley, A.; Balasubramaniam, R.

2018-01-01

A constellation of small, low-cost satellites is able to make scientifically valuable measurements of the Earth which can be used for weather forecasting, disaster monitoring, and climate studies. Eight CYGNSS satellites were launched into low Earth orbit on December 15, 2016. Each satellite carries a science radar receiver which measures GPS signals reflected from the Earth surface. The signals contain information about the surface, including wind speed over ocean and soil moisture and flooding over land. The satellites are distributed around the globe so that measurements can be made more often to capture extreme weather events. Innovative engineering approaches are used to reduce per satellite cost, increase the number in the constellation, and improve temporal sampling. These include the use of differential drag rather than propulsion to adjust the spacing between satellites and the use of existing GPS signals as the science radars’ transmitter. Initial on-orbit results demonstrate the scientific utility of the CYGNSS observations, and suggest that a new paradigm in spaceborne Earth environmental monitoring is possible.

Effects of a proposed rural dental school on regional dental workforce and access to care.

PubMed

Wanchek, Tanya N; Rephann, Terance J

2013-01-01

Southwest Virginia is a rural, low-income region with a relatively small dentist workforce and poor oral health outcomes. The opening of a dental school in the region has been proposed by policy-makers as one approach to improving the size of the dentist workforce and oral health outcomes. A policy simulation was conducted to assess how a hypothetical dental school in rural Southwest Virginia would affect the availability of dentists and utilization levels of dental services. The simulation focuses on two channels through which the dental school would most likely affect the region. First, the number of graduates who are expected to remain in the region was varied, based on the extensiveness of the education pipeline used to attract local students. Second, the number of patients treated in the dental school clinic under different dental school clinical models, including the traditional model, a patient-centered clinic model and a community-based clinic model, was varied in the simulation to obtain a range of additional dentists and utilization rates under differing dental school models. Under a set of plausible assumptions, the low yield scenario (ie private school with a traditional clinic) would result in three additional dentists residing in the region and a total of 8090 additional underserved patients receiving care. Under the high yield scenario (ie dental pipeline program with community based clinics) nine new dentists would reside in the region and as many as 18 054 underserved patients would receive care. Even with the high yield scenario and the strong assumption that these patients would not otherwise access care, the utilization rate increases to 68.9% from its current 60.1%. While the new dental school in Southwest Virginia would increase the dentist workforce and utilization rates, the high cost combined with the continued low rate of dental utilization suggests that there may be more effective alternatives to improving oral health in rural areas. Alternative policies that have shown considerable promise in expanding access to disadvantaged populations include virtual dental homes, enhanced Medicaid reimbursement programs, and school-based dental care systems.

48 CFR 719.271-2 - The USAID Office of Small and Disadvantaged Business Utilization (SDB).

Code of Federal Regulations, 2014 CFR

2014-10-01

... and Disadvantaged Business Utilization (SDB). 719.271-2 Section 719.271-2 Federal Acquisition... Policies 719.271-2 The USAID Office of Small and Disadvantaged Business Utilization (SDB). (a) SDB is... business enterprises) program. (b) SDB, headed by the Director SDB, who also serves as the Minority...

48 CFR 719.271-2 - The USAID Office of Small and Disadvantaged Business Utilization (SDB).

Code of Federal Regulations, 2010 CFR

2010-10-01

... and Disadvantaged Business Utilization (SDB). 719.271-2 Section 719.271-2 Federal Acquisition... Policies 719.271-2 The USAID Office of Small and Disadvantaged Business Utilization (SDB). (a) SDB is... business enterprises) program. (b) SDB, headed by the Director SDB, who also serves as the Minority...

48 CFR 719.271-2 - The USAID Office of Small and Disadvantaged Business Utilization (SDB).

Code of Federal Regulations, 2013 CFR

2013-10-01

... and Disadvantaged Business Utilization (SDB). 719.271-2 Section 719.271-2 Federal Acquisition... Policies 719.271-2 The USAID Office of Small and Disadvantaged Business Utilization (SDB). (a) SDB is... business enterprises) program. (b) SDB, headed by the Director SDB, who also serves as the Minority...

48 CFR 719.271-2 - The USAID Office of Small and Disadvantaged Business Utilization (SDB).

Code of Federal Regulations, 2011 CFR

2011-10-01

... and Disadvantaged Business Utilization (SDB). 719.271-2 Section 719.271-2 Federal Acquisition... Policies 719.271-2 The USAID Office of Small and Disadvantaged Business Utilization (SDB). (a) SDB is... business enterprises) program. (b) SDB, headed by the Director SDB, who also serves as the Minority...

48 CFR 719.271-2 - The USAID Office of Small and Disadvantaged Business Utilization (SDB).

Code of Federal Regulations, 2012 CFR

2012-10-01

... and Disadvantaged Business Utilization (SDB). 719.271-2 Section 719.271-2 Federal Acquisition... Policies 719.271-2 The USAID Office of Small and Disadvantaged Business Utilization (SDB). (a) SDB is... business enterprises) program. (b) SDB, headed by the Director SDB, who also serves as the Minority...

A Preliminary Engineering Design of Intravascular Dual-Frequency Transducers for Contrast-Enhanced Acoustic Angiography and Molecular Imaging

PubMed Central

Ma, Jianguo; Martin, K. Heath; Dayton, Paul A.; Jiang, Xiaoning

2014-01-01

Current intravascular ultrasound (IVUS) probes are not optimized for contrast detection because of their design for high-frequency fundamental-mode imaging. However, data from transcutaneous contrast imaging suggests the possibility of utilizing contrast ultrasound for molecular imaging or vasa vasorum assessment to further elucidate atherosclerotic plaque deposition. This paper presents the design, fabrication, and characterization of a small-aperture (0.6 × 3 mm) IVUS probe optimized for high-frequency contrast imaging. The design utilizes a dual-frequency (6.5 MHz/30 MHz) transducer arrangement for exciting microbubbles at low frequencies (near their resonance) and detecting their broadband harmonics at high frequencies, minimizing detected tissue backscatter. The prototype probe is able to generate nonlinear microbubble response with more than 1.2 MPa of rarefractional pressure (mechanical index: 0.48) at 6.5 MHz, and is also able to detect microbubble response with a broadband receiving element (center frequency: 30 MHz, −6-dB fractional bandwidth: 58.6%). Nonlinear super-harmonics from microbubbles flowing through a 200-μm-diameter micro-tube were clearly detected with a signal-to-noise ratio higher than 12 dB. Preliminary phantom imaging at the fundamental frequency (30 MHz) and dual-frequency super-harmonic imaging results suggest the promise of small aperture, dual-frequency IVUS transducers for contrast-enhanced IVUS imaging. PMID:24801226

A comparison of individualized treatment guided by VeriStrat with standard of care treatment strategies in patients receiving second-line treatment for advanced non-small cell lung cancer: A cost-utility analysis.

PubMed

Nelson, Richard E; Stenehjem, David; Akerley, Wallace

2013-12-01

Two therapies are appropriate as 2nd-line treatment of non-small cell lung cancer (NSCLC) patients: chemotherapy and epidermal growth factor receptor (EGFR) inhibitor therapy. VeriStrat, a serum proteomic test, can be used to guide treatment decisions for NSCLC patients. The test classifies patients as likely to benefit from either of these two treatment options. The objective of this research was to model the anticipated survival and cost-effectiveness of four different treatment strategies: chemotherapy for all patients (C-all), EGFR inhibitor for all (E-all), a performance status guided selection strategy (PS-guided), and a strategy guided by VeriStrat test results (V-guided). We developed a Markov model with the perspective of the U.S. health care system. Model inputs were taken from published literature for the base-case analysis. One-way and probabilistic sensitivity analyses were performed. The C-all treatment strategy showed the best overall survival outcome (10.1 months), followed by V-guided (9.6 months), PS-guided (9.2 months), and E-all (8.2 months) strategies. The incremental cost-effectiveness ratio (ICER) of a V-guided treatment strategy was $91,111 (vs. E-all) and $8462 (vs. PS-guided) per quality-adjusted life year (QALY). The ICER for C-all compared to V-guided was $105,616. This cost-utility analysis indicates that a treatment strategy guided by the VeriStrat test in patients receiving second-line therapy for NSCLC may experience an overall survival benefit at an incremental cost-effectiveness ratio that is reasonable when compared with other practices, including cancer treatments, generally covered in the U.S. health care system. However, treating all patients with chemotherapy yielded the greatest expected survival. Copyright © 2013. Published by Elsevier Ireland Ltd.

Study protocol: a cluster randomized controlled trial to assess the effectiveness of a multi-pronged behavioural intervention to improve use of personal protective equipment among migrant workers exposed to organic solvents in small and medium-sized enterprises.

PubMed

Chen, Wen; Li, Tongyang; Zou, Guanyang; Li, Xudong; Shi, Leiyu; Feng, Shanshan; Shi, Jingrong; Zhou, Fangjing; Han, Siqi; Ling, Li

2016-07-16

In China, most of migrant workers work in the small and medium-sized enterprises (SMEs) and are a vulnerable group for occupational health. Migrant workers are at increased risk of occupational health risks due to poor occupational health behaviours such as the low use of personal protective equipment (PPE). However, there is a lack of solid evidence regarding how to improve the use of PPE among migrant workers in SMEs. The current study will assess the effectiveness of a multi-pronged behavioural intervention designed to promote PPE utilization among migrant workers exposed to organic solvents in SMEs. This is a single blind, three-arm cluster randomized trial with 60 SMEs equally randomized to receive a top-down intervention (i.e. general health education and mHealth intervention provided by researchers) or a comprehensive intervention (which includes both top-down intervention and peer education) or a control condition (participants will not receive the intervention, but study measures will be obtained). Interventions will be conducted at the SMEs level for 6 months and all eligible migrant workers in these SMEs will be enrolled into the trial. The primary outcome is effective use of PPE during the last week. The secondary outcomes are occupational health knowledge and attitude and participation in occupational health check-up. Data will be collected and assessed at baseline; 3 months post baseline and the end of the intervention. This theory- and evidence based intervention will contribute to the limited evidence of behaviour change intervention in improving PPE utilization of migrant workers in SMEs, and provide timely evidence for the development of basic occupational health services in China and elsewhere with similar industrialization contexts. ChiCTR-IOR-15006929 . Registered on 16 August 2015.

Real-World EQ5D Health Utility Scores for Patients With Metastatic Lung Cancer by Molecular Alteration and Response to Therapy.

PubMed

Labbé, Catherine; Leung, Yvonne; Silva Lemes, João Gabriel; Stewart, Erin; Brown, Catherine; Cosio, Andrea Perez; Doherty, Mark; O'Kane, Grainne M; Patel, Devalben; Cheng, Nicholas; Liang, Mindy; Gill, Gursharan; Rett, Alexandra; Naik, Hiten; Eng, Lawson; Mittmann, Nicole; Leighl, Natasha B; Bradbury, Penelope A; Shepherd, Frances A; Xu, Wei; Liu, Geoffrey; Howell, Doris

2017-07-01

Economic analyses of upcoming treatments for lung cancer benefit from real-world health utility scores (HUSs) in an era of targeted therapy. A longitudinal cohort study at Princess Margaret Cancer Centre evaluated 1571 EQ5D-3L-derived HUSs in 475 outpatients with metastatic lung cancer across various disease states. Patients with epidermal growth factor receptor (EGFR) (n = 183) and anaplastic lymphoma kinase (ALK) (n = 38) driver alterations were enriched through targeted enrolment; patients with wild-type non-small-cell lung cancer (WT NSCLC) (n = 224) and small-cell lung cancer (SCLC) (n = 30) were sampled randomly. For patients stable on most appropriate treatment, the mean HUSs were 0.81 and 0.82 in patients receiving EGFR and ALK tyrosine kinase inhibitors (TKIs) respectively (with similar HUSs across agents), which were higher than patients with WT NSCLC (0.78; P = .04) and SCLC receiving chemotherapy (0.72; P = .06). In mutation-specific comparisons, disease stability on appropriate therapy resulted in significantly higher mean HUSs (P < .002-.02) than when disease was progressing (mean HUS: EGFR, 0.70; ALK, 0.69; WT NSCLC, 0.66; SCLC, 0.52). When evaluating treatment-related toxicities, significant inverse relationships were observed between HUS and the severity of fatigue and decreased appetite in the EGFR group. There was also a significant inverse relationship between the total number of clinically significant symptoms and HUS, both in patients who were EGFR-mutated and patients with WT NSCLC. In a North American setting, HUSs generated from patients with metastatic lung cancer are higher in treated, stable patients carrying driver mutations. This is partially explainable by treatment toxicity and patient symptom differences. Such differences in scores should be considered in economic analyses. Copyright © 2016 Elsevier Inc. All rights reserved.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Health Care Utilization and Spending Among Carve-In Enrollees.

PubMed

Harwood, Jessica M; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K; Tseng, Chi-Hong; Wells, Kenneth B; Friedman, Sarah; Ettner, Susan L

2017-02-01

The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA's impact on BH expenditures and utilization among "carve-in" enrollees. We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits, medication management, individual and family psychotherapy); intermediate care utilization (structured outpatient, day treatment, residential); and inpatient utilization. MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits [respective immediate increases of: $1.05 (P=0.02); $0.88 (P=0.04); 0.00045 visits (P=0.00)], and individual psychotherapy visits [immediate increase of 0.00578 visits (P=0.00) and additional increases of 0.00017 visits/mo (P=0.03)]. MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; for example, in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act's inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets.

Wireless sensors powered by microbial fuel cells.

PubMed

Shantaram, Avinash; Beyenal, Haluk; Raajan, Raaja; Veluchamy, Angathevar; Lewandowski, Zbigniew

2005-07-01

Monitoring parameters characterizing water quality, such as temperature, pH, and concentrations of heavy metals in natural waters, is often followed by transmitting the data to remote receivers using telemetry systems. Such systems are commonly powered by batteries, which can be inconvenient at times because batteries have a limited lifetime and must be recharged or replaced periodically to ensure that sufficient energy is available to power the electronics. To avoid these inconveniences, a microbial fuel cell was designed to power electrochemical sensors and small telemetry systems to transmit the data acquired by the sensors to remote receivers. The microbial fuel cell was combined with low-power, high-efficiency electronic circuitry providing a stable power source for wireless data transmission. To generate enough power for the telemetry system, energy produced by the microbial fuel cell was stored in a capacitor and used in short bursts when needed. Since commercial electronic circuits require a minimum 3.3 V input and our cell was able to deliver a maximum of 2.1 V, a DC-DC converter was used to boost the potential. The DC-DC converter powered a transmitter, which gathered the data from the sensor and transmitted it wirelessly to a remote receiver. To demonstrate the utility of the system, temporal variations in temperature were measured, and the data were wirelessly transmitted to a remote receiver.

Symbiosis of sea anemones and hermit crabs: different resource utilization patterns in the Aegean Sea

NASA Astrophysics Data System (ADS)

Vafeiadou, Anna-Maria; Antoniadou, Chryssanthi; Chintiroglou, Chariton

2012-09-01

The small-scale distribution and resource utilization patterns of hermit crabs living in symbiosis with sea anemones were investigated in the Aegean Sea. Four hermit crab species, occupying shells of nine gastropod species, were found in symbiosis with the sea anemone Calliactis parasitica. Shell resource utilization patterns varied among hermit crabs, with Dardanus species utilizing a wide variety of shells. The size structure of hermit crab populations also affected shell resource utilization, with small-sized individuals inhabiting a larger variety of shells. Sea anemone utilization patterns varied both among hermit crab species and among residence shells, with larger crabs and shells hosting an increased abundance and biomass of C. parasitica. The examined biometric relationships suggested that small-sized crabs carry, proportionally to their weight, heavier shells and increased anemone biomass than larger ones. Exceptions to the above patterns are related either to local resource availability or to other environmental factors.

Solar thermal power plants in small utilities - An economic impact analysis

NASA Technical Reports Server (NTRS)

Bluhm, S. A.; Ferber, R. R.; Mayo, L. G.

1979-01-01

A study was performed to assess the potential economic impact of small solar thermal electric power systems in statistically representative synthetic small utilities of the Southwestern United States. Power supply expansion plans were compared on the basis of present worth of future revenue requirements for 1980-2000 with and without solar thermal plants. Coal-fired and oil-fired municipal utility expansion plans with 5 percent solar penetration were 0.5 percent and 2.25 percent less expensive, respectively, than the corresponding conventional plan. At $969/kWe, which assumes the same low cost solar equipment but no improvement in site development costs, solar penetration of 5 percent in the oil-fired municipal reduced revenue requirements 0.88 percent. The paper concludes that some solar thermal plants are potentially economic in small community utilities of the Southwest.

NASA technology utilization program: The small business market

NASA Technical Reports Server (NTRS)

Vannoy, J. K.; Garcia-Otero, F.; Johnson, F. D.; Staskin, E.

1980-01-01

Technology transfer programs were studied to determine how they might be more useful to the small business community. The status, needs, and technology use patterns of small firms are reported. Small business problems and failures are considered. Innovation, capitalization, R and D, and market share problems are discussed. Pocket, captive, and new markets are summarized. Small manufacturers and technology acquisition are discussed, covering external and internal sources, and NASA technology. Small business and the technology utilization program are discussed, covering publications and industrial applications centers. Observations and recommendations include small business market development and contracting, and NASA management technology.

Highly sensitive LIDAR with a thumb-sized sensor-head built using an optical fiber preamplifier (3)

NASA Astrophysics Data System (ADS)

Inoue, Daisuke; Ichikawa, Tadashi; Matsubara, Hiroyuki; Kagami, Manabu

2013-05-01

We have developed a LIDAR system with a sensor head which, although it includes a scanning mechanism, is less than 20 cc in size. The system is not only small, but is also highly sensitive. Our LIDAR system is based on time-of-flight measurements, and incorporates an optical fiber. The main feature of our system is the utilization of optical amplifiers for both the transmitter and the receiver, and the optical amplifiers enable us to exceed the detection limit set by thermal noise. In conventional LIDAR systems the detection limit is determined by the thermal noise, because the avalanche photo-diodes (APD) and trans-impedance amplifiers (TIA) that they use detect the received signals directly. In the case of our LIDAR system, the received signal is amplified by an optical fiber amplifier before reaching the photo diode and the TIA. Therefore, our LIDAR system boosts the signal level before the weak incoming signal is depleted by thermal noise. There are conditions under which the noise figure for the combination of an optical fiber amplifier and a photo diode is superior to the noise figure for an avalanche photo diode. We optimized the gains of the optical fiber amplifier and the TIA in our LIDAR system such that it would be capable of detecting a single photon. As a result, the detection limit of our system is determined by shot noise. We have previously demonstrated scanning up to a range of 80 m with this LIDAR system with a 2 mm diameter of receiving lens. We improved the optical amplifier and the peak output power of LIDAR was over 10KW. We redesigned the sensor-head and improved coupling efficiency. As a result, we succeeded in scanning over a range of 100 m. This small and highly sensitive measurement technology shows great potential for use in LIDAR.

ERDA's central receiver solar thermal power system studies

NASA Technical Reports Server (NTRS)

Lippy, L. J.; Heaton, T. R.

1977-01-01

The utilization of solar energy for electrical power production was studied. Efforts underway on the central receiver solar thermal power system are presented. Preliminary designs are included of pilot plant utilizing large numbers of heliostats in a collector field. Safety hazards are also discussed, as well as the most beneficial location of such a plant within the United States.

Introductory Tools for Radiative Transfer Models

NASA Astrophysics Data System (ADS)

Feldman, D.; Kuai, L.; Natraj, V.; Yung, Y.

2006-12-01

Satellite data are currently so voluminous that, despite their unprecedented quality and potential for scientific application, only a small fraction is analyzed due to two factors: researchers' computational constraints and a relatively small number of researchers actively utilizing the data. Ultimately it is hoped that the terabytes of unanalyzed data being archived can receive scientific scrutiny but this will require a popularization of the methods associated with the analysis. Since a large portion of complexity is associated with the proper implementation of the radiative transfer model, it is reasonable and appropriate to make the model as accessible as possible to general audiences. Unfortunately, the algorithmic and conceptual details that are necessary for state-of-the-art analysis also tend to frustrate the accessibility for those new to remote sensing. Several efforts have been made to have web- based radiative transfer calculations, and these are useful for limited calculations, but analysis of more than a few spectra requires the utilization of home- or server-based computing resources. We present a system that is designed to allow for easier access to radiative transfer models with implementation on a home computing platform in the hopes that this system can be utilized in and expanded upon in advanced high school and introductory college settings. This learning-by-doing process is aided through the use of several powerful tools. The first is a wikipedia-style introduction to the salient features of radiative transfer that references the seminal works in the field and refers to more complicated calculations and algorithms sparingly5. The second feature is a technical forum, commonly referred to as a tiki-wiki, that addresses technical and conceptual questions through public postings, private messages, and a ranked searching routine. Together, these tools may be able to facilitate greater interest in the field of remote sensing.

An Examination of the Utilization of Electronic Government Services by Minority Small Businesses

ERIC Educational Resources Information Center

Ford, Wendy G.

2010-01-01

There are a wide variety of e-government information and services that small business owners and managers can utilize. However, in spite of all of the service incentives and initiatives to promote e-government, research studies have shown that this information is not widely accessed. Studies that explore the utilization of e-government information…

Evaluation of micro-GPS receivers for tracking small-bodied mammals

PubMed Central

Shipley, Lisa A.; Forbey, Jennifer S.; Olsoy, Peter J.

2017-01-01

GPS telemetry markedly enhances the temporal and spatial resolution of animal location data, and recent advances in micro-GPS receivers permit their deployment on small mammals. One such technological advance, snapshot technology, allows for improved battery life by reducing the time to first fix via postponing recovery of satellite ephemeris (satellite location) data and processing of locations. However, no previous work has employed snapshot technology for small, terrestrial mammals. We evaluated performance of two types of micro-GPS (< 20 g) receivers (traditional and snapshot) on a small, semi-fossorial lagomorph, the pygmy rabbit (Brachylagus idahoensis), to understand how GPS errors might influence fine-scale assessments of space use and habitat selection. During stationary tests, microtopography (i.e., burrows) and satellite geometry had the largest influence on GPS fix success rate (FSR) and location error (LE). There was no difference between FSR while animals wore the GPS collars above ground (determined via light sensors) and FSR generated during stationary, above-ground trials, suggesting that animal behavior other than burrowing did not markedly influence micro-GPS errors. In our study, traditional micro-GPS receivers demonstrated similar FSR and LE to snapshot receivers, however, snapshot receivers operated inconsistently due to battery and software failures. In contrast, the initial traditional receivers deployed on animals experienced some breakages, but a modified collar design consistently functioned as expected. If such problems were resolved, snapshot technology could reduce the tradeoff between fix interval and battery life that occurs with traditional micro-GPS receivers. Our results suggest that micro-GPS receivers are capable of addressing questions about space use and resource selection by small mammals, but that additional techniques might be needed to identify use of habitat structures (e.g., burrows, tree cavities, rock crevices) that could affect micro-GPS performance and bias study results. PMID:28301495

Statistical improvement in detection level of gravitational microlensing events from their light curves

NASA Astrophysics Data System (ADS)

Ibrahim, Ichsan; Malasan, Hakim L.; Kunjaya, Chatief; Timur Jaelani, Anton; Puannandra Putri, Gerhana; Djamal, Mitra

2018-04-01

In astronomy, the brightness of a source is typically expressed in terms of magnitude. Conventionally, the magnitude is defined by the logarithm of received flux. This relationship is known as the Pogson formula. For received flux with a small signal to noise ratio (S/N), however, the formula gives a large magnitude error. We investigate whether the use of Inverse Hyperbolic Sine function (hereafter referred to as the Asinh magnitude) in the modified formulae could allow for an alternative calculation of magnitudes for small S/N flux, and whether the new approach is better for representing the brightness of that region. We study the possibility of increasing the detection level of gravitational microlensing using 40 selected microlensing light curves from the 2013 and 2014 seasons and by using the Asinh magnitude. Photometric data of the selected events are obtained from the Optical Gravitational Lensing Experiment (OGLE). We found that utilization of the Asinh magnitude makes the events brighter compared to using the logarithmic magnitude, with an average of about 3.42 × 10‑2 magnitude and an average in the difference of error between the logarithmic and the Asinh magnitude of about 2.21 × 10‑2 magnitude. The microlensing events OB140847 and OB140885 are found to have the largest difference values among the selected events. Using a Gaussian fit to find the peak for OB140847 and OB140885, we conclude statistically that the Asinh magnitude gives better mean squared values of the regression and narrower residual histograms than the Pogson magnitude. Based on these results, we also attempt to propose a limit in magnitude value for which use of the Asinh magnitude is optimal with small S/N data.

Making It Count: Understanding the Value of Energy Efficiency Financing Programs Funded by Utility Customers

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

Kramer, Chris; Fadrhonc, Emily Martin; Goldman, Charles

Utility customer-supported financing programs are receiving increased attention as a strategy for achieving energy saving goals. Rationales for using utility customer funds to support financing initiatives

Small Spacecraft Constellation Concept for Mars Atmospheric Radio Occultations

NASA Astrophysics Data System (ADS)

Asmar, S. W.; Mannucci, A. J.; Ao, C. O.; Kobayashi, M. M.; Lazio, J.; Marinan, A.; Massone, G.; McCandless, S. E.; Preston, R. A.; Seubert, J.; Williamson, W.

2017-12-01

First demonstrated in 1965 when Mariner IV flew by Mars and determined the salient features of its atmosphere, radio occultation experiments have been carried out on numerous planetary missions with great discoveries. These experiments utilize the now classic configuration of a signal from a single planetary spacecraft to Earth receiving stations, where the science data are acquired. The Earth science community advanced the technique to utilizing a constellation of spacecraft with the radio occultation links between the spacecraft, enabled by the infrastructure of the Global Positioning System. With the advent of small and less costly spacecraft, such as planetary CubeSats and other variations, such as the anticipated innovative Mars Cube One mission, crosslinks among small spacecraft can be used to study other planets in the near future. Advantages of this type of experiment include significantly greater geographical coverage, which could reach global coverage over a few weeks with a small number of spacecraft. Repeatability of the global coverage can lead to examining temperature-pressure profiles and ionospheric electron density profiles, on daily, seasonal, annual, or other time scales of interest. The higher signal-to-noise ratio for inter-satellite links, compared to a link to Earth, decreases the design demands on the instrumentation (smaller antennas and transmitters, etc.). After an actual Mars crosslink demonstration, this concept has been in development using Mars as a possible target. Scientific objectives, delivery methods, operational scenarios and end-to-end configuration have been documented. Science objectives include determining the state and variability of the lower Martian atmosphere, which has been an identified as a high priority objective by the Mars Exploration Program Analysis Group, particularly as it relates to entry, descent, and landing and ascent for future crewed and robotic missions. This paper will present the latest research on the proposed mission concept including the possible spatial and temporal coverage, resolution of observables, mission design and expected results.

40 CFR 142.303 - Which size public water systems can receive a small system variance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Which size public water systems can receive a small system variance? 142.303 Section 142.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances for Small System General...

40 CFR 142.303 - Which size public water systems can receive a small system variance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Which size public water systems can receive a small system variance? 142.303 Section 142.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances for Small System General...

Employment services utilization and outcomes among substance abusing offenders participating in California's proposition 36 drug treatment initiative.

PubMed

Evans, Elizabeth; Hser, Yih-Ing; Huang, David

2010-10-01

California drug treatment programs may use funds to address barriers to work faced by Proposition 36 offenders, most of whom are not working at treatment entry, but employment services utilization and related behavioral outcomes have never been studied. This study examined primary data collected on 1,453 offenders by 30 programs during 2004 to explore the characteristics, employment services utilization, and outcomes of those who did and did not receive employment services while in drug treatment. One-year outcomes were mostly similar across groups, however, increases in the proportion of offenders employed, receiving income from employment and family or friends, and being paid for work were significantly greater among the received-employment-services group, and a greater proportion of this group also completed drug treatment. Employment services utilization was less likely for persons recruited from outpatient settings and more likely with greater severity of family/social problems and desire for services. Odds of employment one-year post-treatment entry were higher for those of Hispanic race/ethnicity (vs. White) and for those with treatment completion/longer retention but lower for those who were older, lived in specific counties, had greater employment problem severity at intake, and received other income-related services. Strategies for improving employment services utilization and outcomes among Proposition 36 offenders are discussed.

Your Laptop to the Rescue: Using the Child Language Data Exchange System Archive and CLAN Utilities to Improve Child Language Sample Analysis.

PubMed

Ratner, Nan Bernstein; MacWhinney, Brian

2016-05-01

In this article, we review the advantages of language sample analysis (LSA) and explain how clinicians can make the process of LSA faster, easier, more accurate, and more insightful than LSA done "by hand" by using free, available software programs such as Computerized Language Analysis (CLAN). We demonstrate the utility of CLAN analysis in studying the expressive language of a very large cohort of 24-month-old toddlers tracked in a recent longitudinal study; toddlers in particular are the most likely group to receive LSA by clinicians, but existing reference "norms" for this population are based on fairly small cohorts of children. Finally, we demonstrate how a CLAN utility such as KidEval can now extract potential normative data from the very large number of corpora now available for English and other languages at the Child Language Data Exchange System project site. Most of the LSA measures that we studied appear to show developmental profiles suggesting that they may be of specifically higher value for children at certain ages, because they do not show an even developmental trajectory from 2 to 7 years of age. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Utilization of psychiatric services integrated with primary care by persons of color with HIV in the inner city.

PubMed

Budin, John; Boslaugh, Sarah; Beckett, Emily; Winiarski, Mark G

2004-08-01

We identify the psychiatric diagnoses and utilization patterns of HIV-positive persons of color who received culturally responsive mental health services integrated into a community medical clinic. Ninety-three patients were referred and 86% (n = 80) appeared for at least one encounter. Hispanics, compared with African-Americans, and HIV patients, compared with AIDS patients, were more likely to receive psychotropic prescriptions. Patients with six or more visits were defined as high utilizers: they comprised 27.5% of the patients but used 67.3% of the services. Development of a broader range of psychiatric interventions that address diagnoses, utilization, and psychotropics will better meet these patients' needs.

The POLARBEAR Experiment: Design and Characterization

NASA Astrophysics Data System (ADS)

Kermish, Zigmund David

We present the design and characterization of the POLARBEAR experiment. POLARBEAR is a millimeter-wave polarimeter that will measure the Cosmic Microwave Background (CMB) polarization. It was designed to have both the sensitivity and angular resolution to detect the expected B-mode polarization due to gravitational lensing at small angular scales while still enabling a search for the degree scale B-mode polarization caused by inflationary gravitational waves. The instrument utilizes the Huan Tran Telescope (HTT), a 2.5-meter primary mirror telescope, coupled to a unique focal plane of 1,274 antenna-coupled transition-edge sensor (TES) detectors to achieve unprecedented sensitivity from angular scales of the experiment's 4 arcminute beam to several degrees. This dissertation focuses on the design, integration and characterization of the cryogenic receiver for the POLARBEAR instrument. The receiver cools the ˜20 cm focal plane to 0.25 Kelvin, with detector readout provided by a digital frequency-multiplexed SQUID system. The POLARBEAR receiver was been successfully deployed on the HTT for an engineering run in the Eastern Sierras of California and is currently deployed on Cerro Toco in the Atacama Dessert of Chile. We present results from lab tests done to characterize the instrument, from the engineering run and preliminary results from Chile.

The Luminous Convolution Model-The light side of dark matter

NASA Astrophysics Data System (ADS)

Cisneros, Sophia; Oblath, Noah; Formaggio, Joe; Goedecke, George; Chester, David; Ott, Richard; Ashley, Aaron; Rodriguez, Adrianna

2014-03-01

We present a heuristic model for predicting the rotation curves of spiral galaxies. The Luminous Convolution Model (LCM) utilizes Lorentz-type transformations of very small changes in the photon's frequencies from curved space-times to construct a dynamic mass model of galaxies. These frequency changes are derived using the exact solution to the exterior Kerr wave equation, as opposed to a linearized treatment. The LCM Lorentz-type transformations map between the emitter and the receiver rotating galactic frames, and then to the associated flat frames in each galaxy where the photons are emitted and received. This treatment necessarily rests upon estimates of the luminous matter in both the emitter and the receiver galaxies. The LCM is tested on a sample of 22 randomly chosen galaxies, represented in 33 different data sets. LCM fits are compared to the Navarro, Frenk & White (NFW) Dark Matter Model and to the Modified Newtonian Dynamics (MOND) model when possible. The high degree of sensitivity of the LCM to the initial assumption of a luminous mass to light ratios (M/L), of the given galaxy, is demonstrated. We demonstrate that the LCM is successful across a wide range of spiral galaxies for predicting the observed rotation curves. Through the generous support of the MIT Dr. Martin Luther King Jr. Fellowship program.

Evaluation of a "loss-framed" minimal intervention to increase mammography utilization among medically un- and under-insured women.

PubMed

Abood, Doris A; Coster, Daniel C; Mullis, Ann K; Black, David R

2002-01-01

This study was conducted because mammography is under-utilized, even though it is the most effective early detection screening device for breast cancer. A loss-framed telephonic message based on prospect theory was evaluated for the effects on mammography utilization among medically un- and under-insured women living in demographically similar rural counties in Florida. The sample consisted mostly of White women (approximately 89%) 50-64 years old. Experimental group participants received the loss-framed message telephonically and those in the comparison group received the "usual telephone procedure." Logistic regression analyses revealed that women who received the loss-framed message were six times more likely to obtain a mammogram (OR = 6.6, P < 0.0001). The impact of the loss-framed message persisted even after adjustment for initial versus re-screen mammogram effects. This in-reach, loss-framed, minimal intervention seems to have viability and may serve as an alternative or adjunct program for encouraging women to receive mammograms.

Decentralized method for utility regulation: a comment

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

Sharkey, W.W.

The author comments on the article by Loeb and Magat in this journal issue (P 399); he feels their idea is worthy of more-detailed examination on an industry-specific level. He confines his comments, however, to a more-general comparison of the Loeb-Magat (L-M) scheme, traditional rate-of-return regulation, and pure franchise bidding. The basic L-M proposal consists of two parts. First it is shown that if a utility is subsidized by an amount corresponding to total consumer surplus, then it will have the incentive to pursue cost-minimizing behavior and to set its price equal to the marginal cost of production. Mr. Sharkeymore » believes that this pure subsidy scheme would be wholly unworkable in practice. The second part of the L-M proposal consists of the subsidy scheme combined with either franchise bidding or a lump-sum tax. Mr. Sharkey feels that this proposal has considerable merit if conditions exist such that the net subsidy paid to the utility is sufficiently small; net subsidy is defined as the excess of the actual subsidy plus revenues of the firm over the total cost of production. Thus, the net subsidy is the excess profit the utility receives compared to a utility perfectly regulated by traditional means. Mr. Sharkey elaborates on some of his objections to the L-M proposal for cases in which the net subsidy is large. Then, he briefly considers the characteristics of a natural monopoly market which could potentially be regulated by a combined subsidy-franchise-tax scheme.« less

Relative position control design of receiver UAV in flying-boom aerial refueling phase.

PubMed

An, Shuai; Yuan, Suozhong

2018-02-01

This paper proposes the design of the relative position-keeping control of the receiver unmanned aerial vehicle (UAV) with the time-varying mass in the refueling phase utilizing an inner-outer loop structure. Firstly, the model of the receiver in the refueling phase is established. And then tank model is set up to analyze the influence of fuel transfer on the receiver. Subsequently, double power reaching law based sliding mode controller is designed to control receiver translational motion relative to tanker aircraft in the outer loop while active disturbance rejection control technique is applied to the inner loop to stabilize the receiver. In addition, the closed-loop stabilities of the subsystems are established, respectively. Finally, an aerial refueling model under various refueling strategies is utilized. Simulations and comparative analysis demonstrate the effectiveness and robustness of the proposed controllers. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Radiometric Calibration Techniques for Signal-of-Opportunity Reflectometers

NASA Technical Reports Server (NTRS)

Piepmeier, Jeffrey R.; Shah, Rashmi; Deshpande, Manohar; Johnson, Carey

2014-01-01

Bi-static reflection measurements utilizing global navigation satellite service (GNSS) or other signals of opportunity (SoOp) can be used to sense ocean and terrestrial surface properties. End-to-end calibration of GNSS-R has been performed using well-characterized reflection surface (e.g., water), direct path antenna, and receiver gain characterization. We propose an augmented approach using on-board receiver electronics for radiometric calibration of SoOp reflectometers utilizing direct and reflected signal receiving antennas. The method calibrates receiver and correlator gains and offsets utilizing a reference switch and common noise source. On-board electronic calibration sources, such as reference switches, noise diodes and loop-back circuits, have shown great utility in stabilizing total power and correlation microwave radiometer and scatterometer receiver electronics in L-band spaceborne instruments. Application to SoOp instruments is likely to bring several benefits. For example, application to provide short and long time scale calibration stability of the direct path channel, especially in low signal-to-noise ratio configurations, is directly analogous to the microwave radiometer problem. The direct path channel is analogous to the loopback path in a scatterometer to provide a reference of the transmitted power, although the receiver is independent from the reflected path channel. Thus, a common noise source can be used to measure the gain ratio of the two paths. Using these techniques long-term (days to weeks) calibration stability of spaceborne L-band scatterometer and radiometer has been achieved better than 0.1. Similar long-term stability would likely be needed for a spaceborne reflectometer mission to measure terrestrial properties such as soil moisture.

Compact reflective imaging spectrometer utilizing immersed gratings

DOEpatents

Chrisp, Michael P [Danville, CA

2006-05-09

A compact imaging spectrometer comprising an entrance slit for directing light, a first mirror that receives said light and reflects said light, an immersive diffraction grating that diffracts said light, a second mirror that focuses said light, and a detector array that receives said focused light. The compact imaging spectrometer can be utilized for remote sensing imaging spectrometers where size and weight are of primary importance.

Size-Based Separation of Particles and Cells Utilizing Viscoelastic Effects in Straight Microchannels.

PubMed

Liu, Chao; Xue, Chundong; Chen, Xiaodong; Shan, Lei; Tian, Yu; Hu, Guoqing

2015-06-16

Viscoelasticity-induced particle migration has recently received increasing attention due to its ability to obtain high-quality focusing over a wide range of flow rates. However, its application is limited to low throughput regime since the particles can defocus as flow rate increases. Using an engineered carrier medium with constant and low viscosity and strong elasticity, the sample flow rates are improved to be 1 order of magnitude higher than those in existing studies. Utilizing differential focusing of particles of different sizes, here, we present sheathless particle/cell separation in simple straight microchannels that possess excellent parallelizability for further throughput enhancement. The present method can be implemented over a wide range of particle/cell sizes and flow rates. We successfully separate small particles from larger particles, MCF-7 cells from red blood cells (RBCs), and Escherichia coli (E. coli) bacteria from RBCs in different straight microchannels. The proposed method could broaden the applications of viscoelastic microfluidic devices to particle/cell separation due to the enhanced sample throughput and simple channel design.

Socioeconomic status and the utilization of diagnostic imaging in an urban setting

PubMed Central

Demeter, Sandor; Reed, Martin; Lix, Lisa; MacWilliam, Leonard; Leslie, William D.

2005-01-01

Background In publicly funded health care systems, the utilization of health care services should be equitable, irrespective of socioeconomic status (SES). Although the association between SES and health care utilization has been examined in Canada relative to surgical, cardiac and preventive health care services, no published studies have specifically explored the association between SES and diagnostic imaging. Methods We examined over 300 000 diagnostic imaging claims made in the Winnipeg Regional Health Authority between Apr. 1, 2001, and Mar. 31, 2002. Using patient postal codes, we assigned SES on the basis of average household incomes in Canada's 1996 census. Using multiple regression, we examined the association between income quintile, patient age group (≤16, 17–64, ≥ 65 years), patient morbidity level according to the Johns Hopkins University Adjusted Clinical Group method (high, moderate, low), and imaging modality (general radiology, vascular, computed tomography, magnetic resonance, and general and obstetric ultrasound). Results Relative rates (RR) of diagnostic imaging utilization (highest v. lowest income quintile) were significantly increased in pediatric and adult patient groups at all morbidity levels receiving general radiology (highest RR 2.47, 95% confidence interval [CI] 2.07–2.93); pediatric and adult patient groups at high and low morbidity levels and elderly patient groups at low morbidity levels receiving general ultrasound (highest RR 2.26, 95% CI 1.20–4.26); pediatric and adult patient groups at all morbidity levels and elderly patients at high and moderate morbidity levels receiving magnetic resonance imaging (highest RR 2.51, 95% CI 1.78– 3.52); and adult patient groups at all morbidity levels receiving computed tomography (highest RR 1.46, 95% CI 1.35– 1.59). A lower RR of diagnostic imaging utilization in the highest income quintile was found only among patients receiving obstetric ultrasound (RR 0.80, 95% CI 0.73–0.87). No significant associations were found among elderly patients receiving general radiology or computed tomography or adult patients receiving vascular imaging. Interpretation We found a pattern of increased diagnostic imaging utilization in patient groups with a higher SES. Further research is needed to better understand the nature of this finding and how it contributes to health outcomes. PMID:16275968

Evaluation of annual efficiencies of high temperature central receiver concentrated solar power plants with thermal energy storage.

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

Ehrhart, Brian David; Gill, David Dennis

The current study has examined four cases of a central receiver concentrated solar power plant with thermal energy storage using the DELSOL and SOLERGY computer codes. The current state-of-the-art base case was compared with a theoretical high temperature case which was based on the scaling of some input parameters and the estimation of other parameters based on performance targets from the Department of Energy SunShot Initiative. This comparison was done for both current and high temperature cases in two configurations: a surround field with an external cylindrical receiver and a north field with a single cavity receiver. There is amore » fairly dramatic difference between the design point and annual average performance, especially in the solar field and receiver subsystems, and also in energy losses due to the thermal energy storage being full to capacity. Additionally, there are relatively small differences (<2%) in annual average efficiencies between the Base and High Temperature cases, despite an increase in thermal to electric conversion efficiency of over 8%. This is due the increased thermal losses at higher temperature and operational losses due to subsystem start-up and shut-down. Thermal energy storage can mitigate some of these losses by utilizing larger thermal energy storage to ensure that the electric power production system does not need to stop and re-start as often, but solar energy is inherently transient. Economic and cost considerations were not considered here, but will have a significant impact on solar thermal electric power production strategy and sizing.« less

Range-azimuth decouple beamforming for frequency diverse array with Costas-sequence modulated frequency offsets

NASA Astrophysics Data System (ADS)

Wang, Zhe; Wang, Wen-Qin; Shao, Huaizong

2016-12-01

Different from the phased-array using the same carrier frequency for each transmit element, the frequency diverse array (FDA) uses a small frequency offset across the array elements to produce range-angle-dependent transmit beampattern. FDA radar provides new application capabilities and potentials due to its range-dependent transmit array beampattern, but the FDA using linearly increasing frequency offsets will produce a range and angle coupled transmit beampattern. In order to decouple the range-azimuth beampattern for FDA radar, this paper proposes a uniform linear array (ULA) FDA using Costas-sequence modulated frequency offsets to produce random-like energy distribution in the transmit beampattern and thumbtack transmit-receive beampattern. In doing so, the range and angle of targets can be unambiguously estimated through matched filtering and subspace decomposition algorithms in the receiver signal processor. Moreover, random-like energy distributed beampattern can also be utilized for low probability of intercept (LPI) radar applications. Numerical results show that the proposed scheme outperforms the standard FDA in focusing the transmit energy, especially in the range dimension.

Improving UDP/IP Transmission Without Increasing Congestion

NASA Technical Reports Server (NTRS)

Burleigh, Scott

2006-01-01

Datagram Retransmission (DGR) is a computer program that, within certain limits, ensures the reception of each datagram transmitted under the User Datagram Protocol/Internet Protocol. [User Datagram Protocol (UDP) is considered unreliable because it does not involve a reliability-ensuring connection-initiation dialogue between sender and receiver. UDP is well suited to issuing of many small messages to many different receivers.] Unlike prior software for ensuring reception of UDP datagrams, DGR does not contribute to network congestion by retransmitting data more frequently as an ever-increasing number of messages and acknowledgements is lost. Instead, DGR does just the opposite: DGR includes an adaptive timeout-interval- computing component that provides maximum opportunity for reception of acknowledgements, minimizing retransmission. By monitoring changes in the rate at which message-transmission transactions are completed, DGR detects changes in the level of congestion and responds by imposing varying degrees of delay on the transmission of new messages. In addition, DGR maximizes throughput by not waiting for acknowledgement of a message before sending the next message. All DGR communication is asynchronous, to maximize efficient utilization of network connections. DGR manages multiple concurrent datagram transmission and acknowledgement conversations.

Promoting Experimental Problem-solving Ability in Sixth-grade Students Through Problem-oriented Teaching of Ecology: Findings of an intervention study in a complex domain

NASA Astrophysics Data System (ADS)

Roesch, Frank; Nerb, Josef; Riess, Werner

2015-03-01

Our study investigated whether problem-oriented designed ecology lessons with phases of direct instruction and of open experimentation foster the development of cross-domain and domain-specific components of experimental problem-solving ability better than conventional lessons in science. We used a paper-and-pencil test to assess students' abilities in a quasi-experimental intervention study utilizing a pretest/posttest control-group design (N = 340; average performing sixth-grade students). The treatment group received lessons on forest ecosystems consistent with the principle of education for sustainable development. This learning environment was expected to help students enhance their ecological knowledge and their theoretical and methodological experimental competencies. Two control groups received either the teachers' usual lessons on forest ecosystems or non-specific lessons on other science topics. We found that the treatment promoted specific components of experimental problem-solving ability (generating epistemic questions, planning two-factorial experiments, and identifying correct experimental controls). However, the observed effects were small, and awareness for aspects of higher ecological experimental validity was not promoted by the treatment.

Evaluating Utility in Diagnostic Decision Making.

ERIC Educational Resources Information Center

Harber, Jean R.

1981-01-01

The utility of the procedures special educators apply in making decisions about the identification of handicapped individuals has not been thoroughly studied. The paper examines the utility of diagnostic decision making from the perspective of receiver operating curve analysis. (Author)

Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy.

PubMed

Carey, Evan P; Nolan, Charlotte; Kerns, Robert D; Ho, P Michael; Frank, Joseph W

2018-05-01

Expert guidelines recommend non-pharmacologic treatments and non-opioid medications for chronic pain and recommend against initiating long-term opioid therapy (LTOT). We examined whether veterans with incident chronic pain receiving care at facilities with greater utilization of non-pharmacologic treatments and non-opioid medications are less likely to initiate LTOT. Retrospective cohort study PARTICIPANTS: Veterans receiving primary care from a Veterans Health Administration facility with incident chronic pain between 1/1/2010 and 12/31/2015 based on either of 2 criteria: (1) persistent moderate-to-severe patient-reported pain and (2) diagnoses "likely to represent" chronic pain. The independent variable was facility-level utilization of pain-related treatment modalities (non-pharmacologic, non-opioid medications, LTOT) in the prior calendar year. The dependent variable was patient-level initiation of LTOT (≥ 90 days within 365 days) in the subsequent year, adjusting for patient characteristics. Among 1,094,569 veterans with incident chronic pain from 2010 to 2015, there was wide facility-level variation in utilization of 10 pain-related treatment modalities, including initiation of LTOT (median, 16%; range, 5-32%). Veterans receiving care at facilities with greater utilization of non-pharmacologic treatments were less likely to initiate LTOT in the year following incident chronic pain. Conversely, veterans receiving care at facilities with greater non-opioid and opioid medication utilization were more likely to initiate LTOT; this association was strongest for past year facility-level LTOT initiation (adjusted rate ratio, 2.10; 95% confidence interval, 2.06-2.15, top vs. bottom quartile of facility-level LTOT initiation in prior calendar year). Facility-level utilization patterns of non-pharmacologic, non-opioid, and opioid treatments for chronic pain are associated with subsequent patient-level initiation of LTOT among veterans with incident chronic pain. Further studies should seek to understand facility-level variation in chronic pain care and to identify facility-level utilization patterns that are associated with improved patient outcomes.

Comparisons between Murine Polyomavirus and Simian Virus 40 Show Significant Differences in Small T Antigen Function ▿

PubMed Central

Andrabi, Shaida; Hwang, Justin H.; Choe, Jennifer Kean; Roberts, Thomas M.; Schaffhausen, Brian S.

2011-01-01

Although members of a virus family produce similar gene products, those products may have quite different functions. Simian virus 40 (SV40) large T antigen (LT), for example, targets p53 directly, but murine polyomavirus LT does not. SV40 small T antigen (SVST) has received considerable attention because of its ability to contribute to transformation of human cells. Here, we show that there are major differences between SVST and polyomavirus small T antigen (POLST) in their effects on differentiation, transformation, and cell survival. Both SVST and POLST induce cell cycle progression. However, POLST also inhibits differentiation of 3T3-L1 preadipocytes and C2C12 myoblasts. Additionally, POLST induces apoptosis of mouse embryo fibroblasts. SVST reduces the proapoptotic transcriptional activity of FOXO1 through phosphorylation. On the other hand, SVST complements large T antigen and Ras for the transformation of human mammary epithelial cells (HMECs), but POLST does not. Mechanistically, the differences between SVST and POLST may lie in utilization of protein phosphatase 2A (PP2A). POLST binds both Aα and Aβ scaffolding subunits of PP2A while SVST binds only Aα. Knockdown of Aβ could mimic POLST-induced apoptosis. The two small T antigens can target different proteins for dephosphorylation. POLST binds and dephosphorylates substrates, such as lipins, that SVST does not. PMID:21835797

Expecting excellence is key to receivable success in small and rural hospitals.

PubMed

Boucher, D

1990-06-01

Although small and rural hospitals may have trouble hiring experienced billing and collection personnel, they can succeed in keeping down receivable levels and receivable days by adopting two principles for the business office: expect excellence and inspect for excellence. These principles include setting goals for business office staff as well as listening to and implementing their ideas for more effective operations.

WE-AB-207B-10: On Spinal Nerve Toxicity from Single-Session SAbR in Pigs and the Translation of Small Animal NTCP Models

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

Hrycushko, B; Medin, P

Purpose: The incidence of peripheral neuropathy has risen with increased utilization of SAbR. There is no consensus regarding the dose-tolerance of the peripheral nervous system. In 2015, we commenced an investigation to test the hypotheses that single-session irradiation to the pig spinal nerves exhibit a similar dose-tolerance as that of the spinal cord and that a dose-length effect exists. This work evaluates the direct application of small animal NTCP models to both large animal spinal cord and preliminary peripheral nerve data. Methods: To date, 16 of 25 Yucatan minipigs have received single-session SAbR to a 1.5cm length and 4 ofmore » 25 have received irradiation to a 0.5cm length of left-sided C6-C8 spinal nerves. Toxicity related gait change has been observed in 13 animals (9 from the long length group and 4 from the short). This preliminary data is overlaid on several dose-response models which have been fit to rodent spinal cord tolerance experiments. Model parameters define a toxicity profile between a completely serial or parallel behaving organ. Adequacy of model application, including how length effects are handled, to published minipig spinal cord dose-response data and to preliminary peripheral nerve response data was evaluated through residual analysis. Results: No rodent-derived dose-response models were directly applicable to all pig data for the different lengths irradiated. Several models fit the long-length irradiated spinal cord data well, with the more serial-like models fitting best. Preliminary data on the short-length irradiation suggests no length effect exists, disproving our hypothesis. Conclusion: Direct application of small-animal NTCP models to pig data suggests dose-length effect predictions from small animal data may not translate clinically. However, the small animal models used have not considered dose heterogeneity and it is expected that including the low-to-mid dose levels in the penumbral region will improve this match. This work was funded by the Cancer Prevention Research Institute of Texas (CPRIT).« less

Utilization patterns of insulin therapy and healthcare services among Japanese insulin initiators during their first year: a descriptive analysis of administrative hospital data.

PubMed

Ikeda, Shunya; Crawford, Bruce; Sato, Masayo

2016-01-12

Type 2 diabetes poses an increasing healthcare burden in Japan. Although insulin treatment has diversified in recent years, the literature on the utilization of healthcare services among patients with type 2 diabetes undergoing different insulin therapy regimens is scarce. The current study aimed to characterize the real-world insulin treatment patterns and associated utilization of healthcare services among patients with type 2 diabetes who initiated insulin therapy during the study period. We examined data from a hospital-based database consisting of administrative and laboratory data from 121 acute-phase hospitals throughout Japan from April 2008 to August 2012. Patients diagnosed with type 2 diabetes and receiving continuous insulin therapy, defined by three insulin claims or more, were included in the analysis. Of the 2,145 insulin initiators, at initiation 46.5% received rapid-acting insulin alone, 36.6% received an intensive regimen, 11.4% received long-acting insulin alone, and 5.5% received pre-mixed insulin alone. Patients treated with rapid-acting insulin alone were older, experienced more comorbid conditions, had lower HbA1c, and more often had initiated their insulin treatment at inpatient admission, compared to patients treated with other types of insulin. Inpatient admission was more common and longer for patients taking rapid-acting insulin and an intensive regimen than those taking long-acting or pre-mixed insulin, and most were readmitted within 1 year. Utilization of outpatient clinics was approximately once per month, and emergency department visits were observed to be rare. This retrospective observational descriptive study found varied treatment and healthcare service utilization patterns, as well as disparities in patient characteristics across insulin regimens. Future research should assess the basis for these various utilization patterns associated with insulin to conduct robust analyses of clinical and economic outcomes.

Comparison of Square and Radial Geometries for High Intensity Laser Power Beaming Receivers

NASA Technical Reports Server (NTRS)

Raible, Daniel E.; Fast, Brian R.; Dinca, Dragos; Nayfeh, Taysir H.; Jalics, Andrew K.

2012-01-01

In an effort to further advance a realizable form of wireless power transmission (WPT), high intensity laser power beaming (HILPB) has been developed for both space and terrestrial applications. Unique optical-to-electrical receivers are employed with near infrared (IR-A) continuous-wave (CW) semiconductor lasers to experimentally investigate the HILPB system. In this paper, parasitic feedback, uneven illumination and the implications of receiver array geometries are considered and experimental hardware results for HILPB are presented. The TEM00 Gaussian energy profile of the laser beam presents a challenge to the effectiveness of the receiver to perform efficient photoelectric conversion, due to the resulting non-uniform illumination of the photovoltaic cell arrays. In this investigation, the geometry of the receiver is considered as a technique to tailor the receiver design to accommodate the Gaussian beam profile, and in doing so it is demonstrated that such a methodology is successful in generating bulk receiver output power levels reaching 25 W from 7.2 sq cm of photovoltaic cells. These results are scalable, and may be realized by implementing receiver arraying and utilizing higher power source lasers to achieve a 1.0 sq m receiver capable of generating over 30 kW of electrical power. This type of system would enable long range optical "refueling" of electric platforms, such as MUAV s, airships, robotic exploration missions and provide power to spacecraft platforms which may utilize it to drive electric means of propulsion. In addition, a smaller HILPB receiver aperture size could be utilized to establish a robust optical communications link within environments containing high levels of background radiance, to achieve high signal to noise ratios.

Status report on renewable energy in the States

NASA Astrophysics Data System (ADS)

Swezey, B.; Sinclair, K.

1992-12-01

As the concept of integrated resource planning has spread among states and utilities, a reexamination of the role of renewable energy sources in the utility resource mix is taking place. This report documents the findings of a study of state regulatory commissions undertaken to: (1) help assess the state of knowledge and awareness about renewable energy resources and technologies; (2) assess the impacts of state policies on renewable energy development; and (3) identify important information needs. The key findings from this effort are: Renewable energy development has occurred only slowly over the last decade, and a small number of states account for the bulk of development. The development that has occurred has been limited to non-utility entities. Directed state policies have been a key driver in renewable energy development. Those states not currently addressing renewables may need more data and information before they proceed with directed policies. Other important observations are: The cost of renewables is an overriding concern. Regulators distinguish between 'emerging' and 'established' renewable energy technologies. Specific data are lacking on state-level renewable energy development. Detailed renewable resource assessments have yet to be performed in many states. This report identifies renewable energy information needs of state regulators. However, a number of concerns are also identified that must be addressed before renewables will receive serious attention in many of those states with limited renewables experience. Finally, the report catalogs a wide variety of policies that have been utilized in the states to promote greater development of renewable energy.

Ecological and economic dynamics of the Shunde agricultural system under China's small city development strategy.

PubMed

Lu, Hongfang; Campbell, Daniel E

2009-06-01

The agricultural and industrial development of small cities is the primary environmental management strategy employed to make full use of extra labor in the rural areas of China. The ecological and economic consequences of this development strategy will affect over 100 million people and change the organization of the Chinese landscape. In this study, we examined the agricultural development of Shunde, a small city in Guangdong Province, over the period 1978 until 2000. Our analysis of the ecological and economic dynamics of the agricultural system revealed the dominant role of labor in the intensification of agricultural production, even though the use of fuels, fertilizers and machines also increased during this time. The Shunde agricultural system was examined from both biophysical or donor-based and human utility or receiver-based perspectives, using emergy and economic methods, respectively. After 22 years of urbanization, the Shunde agricultural system was still able to fill 96% of the local demand for agricultural products using only 6% of its total yield compared to using 14% of the total yield in 1978. Aquaculture developed quickly during the study period as grain production decreased. In 2000, the production of fish, pork, and vegetables accounted for 92% of the total emergy output of the system; however, the emergy buying power of the money received in exchange was lower than the emergy contained in the products exported. The excess emergy exported is the basis for a high quality diet delivered to city dwellers at a relatively low price. In the 1980s, the productivity of both land and labor increased; but after 1992 the productivity of labor decreased, causing the efficiency of the whole agricultural system to decrease. We recommend that processing plants be established for the main agricultural products of Shunde to decrease the emergy loss in trading and to increase employment. The effect of including monetized ecosystem services in the balance between the emergy delivered to the markets in agricultural products and the emergy buying power of the money received was to decrease the emergy gained by the Shunde agricultural system.

Development of a lightweight portable ventilator for far-forward battlefield combat casualty support

NASA Astrophysics Data System (ADS)

Cutchis, Protagoras N.; Smith, Dexter G.; Ko, Harvey W.; Wiesmann, William P.; Pranger, L. Alex

1999-07-01

Immediate medical provision substantially reduces the number of fatalities sustained during military operations. However, the shift from large-scale regional conflicts to smaller peacekeeping and humanitarian missions has reduced the military medical support infrastructure. Civilian emergency medical services have long emphasized the 'golden hour' during which a patient must receive definitive medical attention. Without on-scene medical support, injured soldiers must be transported significant distances before receiving advanced medical care, and rapid transport to a medical facility is not always a viable option. Technological solutions enable military medics to deliver advanced medical care on the battlefield. We report here on the development of a small lightweight portable respirator for the treatment of far- forward battlefield casualties. The Far Forward Life Support System (FFLSS) utilizes a combination of COTS (commercial off the shelf) components and custom designed systems to provide ventilatory support to injured combatants. It also incorporates a small IV fluid pump and IV fluids for resuscitation. A microcompressor control system monitors both system performance and patient parameters for system control. Telemetry to a pager-like device worn by the front line medic alerts of any anomalies in ventilator or patient parameters, which will add greatly to triage decisions and resource management. Novel elements of the FLSS design include oxygen generation, low-pressure air generation, available patient suction, and the absence of any high pressure air cylinders. A prototype developed for animal testing will be described in detail as well as further design requirements for the human rated prototype.

The impact of brain metastasis on quality of life, resource utilization and survival in patients with non-small-cell lung cancer.

PubMed

Peters, Solange; Bexelius, Christin; Munk, Veronica; Leighl, Natasha

2016-04-01

This systematic review aims to improve understanding of the burden of disease associated with brain metastases from non-small-cell lung cancer (NSCLC) in terms of survival, quality of life (QoL) and economic impact. PubMed/MEDLINE, Cochrane collaboration and EMBASE databases were searched for articles published in English from 2000 to 2014. Of 3288 abstracts retrieved, 3156 were eliminated without a full-text review. Of the 132 articles that received a full-text review, a final set of 93 articles was included in an initial literature analysis. In order to homogenize the patient populations evaluated, we included entries that were either entirely composed of NSCLC patients or that had >50% of NSCLC patients in the total study population. From the studies identified in this systematic review, median OS and PFS varied based on the type of treatment received, although whole-brain radiotherapy (WBRT) was associated with the shortest OS and PFS durations. Regimens incorporating targeted therapy in molecularly selected patients were associated with the longest OS and PFS durations. QoL findings varied among studies, generally WBRT resulted in stable or worsening QoL scores rather than improvements. Healthcare costs were increased following diagnosis of brain metastases regardless of treatment. The findings from this review highlight the need for more effective treatments of brain metastases from NSCLC that improve survival function, QoL and potentially decrease costs. Copyright © 2016. Published by Elsevier Ltd.

Family planning utilization and factors associated among women receiving abortion services in health facilities of central zone towns of Tigray, Northern Ethiopia: a cross sectional Study.

PubMed

Hagos, Goshu; Tura, Gurmesa; Kahsay, Gizienesh; Haile, Kebede; Grum, Teklit; Araya, Tsige

2018-06-05

Abortion remains among the leading causes of maternal death worldwide. Post-abortion contraception is significantly effective in preventing unintended pregnancy and abortion if provided before women leave the health facilty. However, the status of post-abortion family planning (PAFP) utilization and the contributing factors are not well studied in Tigray region. So, we conduct study aimed on family planning utilization and factors associated with it among women receiving abortion services. A facility based cross-sectional study design was conducted among women receiving abortion services in central zone of Tigray from December 2015to February 2016 using a total of 416 sample size. Women who came for abortion services were selected using systematic random sampling technique.. The data were collected using a pre-tested interviewer administered questionnair. Data were coded and entered in to Epi info 7 and then exported to SPSS for analysis. Descriptive statisticslike frequencies and mean were computed to display the results. Both Bivariable and multivariable logistic regression was used in the analysis. Variables statistically significant at p < 0.05 in the bivariable analysis were checked in multivariable logistic regration to identify independently associated factors. Then variables which were significantly associated with post abortion family planning utilization at p-value < 0.05 in the multivariable analysis were declared as significantly associated factors. A total of 409 abortion clients were interviewed in this study with 98.3% of response rate. Majority 290 (70.9%) of study participants utilized contracepives after abortion. Type of health facility, the decision maker on timing of having child, knowledge that pregnancy can happen soon after abortion and husband's opposition towards contraceptives were significantly associated with Post-abortion family planning ustilization. About one-third of abortion women failed to receive contraceptive before leaving the facility. Private facilities should strengthen utilization of contraceptives on post abortion care service. Health providers should provide counseling on timing of fertility-return following abortion before women left the facility once they receive abortion care. Women empowerment through enhancing community's awareness focusing on own decision making in the family planning utilization including the partner should be strengthened.

Utilization of hypofractionated whole-breast radiation therapy in patients receiving chemotherapy: a National Cancer Database analysis.

PubMed

Diwanji, Tejan P; Molitoris, Jason K; Chhabra, Arpit M; Snider, James W; Bentzen, Soren M; Tkaczuk, Katherine H; Rosenblatt, Paula Y; Kesmodel, Susan B; Bellavance, Emily C; Cohen, Randi J; Cheston, Sally B; Nichols, Elizabeth M; Feigenberg, Steven J

2017-09-01

Results from four major hypofractionated whole-breast radiotherapy (HF-WBRT) trials have demonstrated equivalence in select patients with early-stage breast cancer when compared with conventionally fractionated WBRT (CF-WBRT). Because relatively little data were available on patients receiving neoadjuvant or adjuvant chemotherapy, consensus guidelines published in 2011 did not endorse the use of HF-WBRT in this population. Our goal is to evaluate trends in utilization of HF-WBRT in patients receiving chemotherapy. We retrospectively analyzed data from 2004 to 2013 in the National Cancer DataBase on breast cancer patients treated with HF-WBRT who met the clinical criteria proposed by consensus guidelines (i.e., age >0 years, T1-2N0, and breast-conserving surgery), regardless of receipt of chemotherapy. We employed logistic regression to delineate and compare clinical and demographic factors associated with utilization of HF-WBRT and CF-WBRT. A total of 56,836 women were treated with chemotherapy and WBRT (without regional nodal irradiation) from 2004 to 2013; 9.0% (n = 5093) were treated with HF-WBRT. Utilization of HF-WBRT increased from 4.6% in 2004 to 18.2% in 2013 (odds ratio [OR] 1.21/year; P < 0.001). Among patients receiving chemotherapy, factors most dramatically associated with increased odds of receiving HF-WBRT on multivariate analysis were academic facilities (OR 2.07; P < 0.001), age >80 (OR 2.58; P < 0.001), west region (OR 1.91; P < 0.001), and distance >50 miles from cancer reporting facility (OR 1.43; P < 0.001). Factors associated with decreased odds of receiving HF-WBRT included white race, income <$48,000, lack of private insurance, T2 versus T1, and higher grade (all P < 0.02). Despite the absence of consensus guideline recommendations, the use of HF-WBRT in patients receiving chemotherapy has increased fourfold (absolute = 13.6%) over the last decade. Increased utilization of HF-WBRT should result in institutional reports verifying its safety and efficacy.

48 CFR 19.705-7 - Liquidated damages.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-7 Liquidated damages. (a) Maximum practicable utilization of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business and women-owned...

48 CFR 19.705-7 - Liquidated damages.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-7 Liquidated damages. (a) Maximum practicable utilization of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business and women-owned...

48 CFR 19.705-7 - Liquidated damages.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-7 Liquidated damages. (a) Maximum practicable utilization of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business and women-owned...

48 CFR 19.705-7 - Liquidated damages.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-7 Liquidated damages. (a) Maximum practicable utilization of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business and women-owned...

Healthcare utilization and associated barriers experienced by wheelchair users: A pilot study.

PubMed

Stillman, Michael D; Bertocci, Gina; Smalley, Craig; Williams, Steve; Frost, Karen L

2017-10-01

More than twenty-five years after passage of the ADA, little remains known about the experiences of wheelchair users when attempting to access health care and how accessibility may influence health care utilization. To describe health care utilization among wheelchair users and characterize barriers encountered when attempting to obtain access to health care. An internet-based survey of wheelchair users was conducted. Measures included demographics, condition, socioeconomic status, health care utilization and receipt of preventive services within the past year, physical barriers encountered at outpatient facilities, and satisfaction with care. Four hundred thirty-two wheelchair users responded to the survey. Nearly all respondents (97.2%) had a primary care appointment within the past year and most reported 3-5 visits to both primary and specialty care providers. Most encountered physical barriers when accessing care (73.8% primary, 68.5% specialty). Participants received most preventive interventions at rates similar to national averages with the exception of Pap tests. Most participants remained clothed for their primary care evaluation (76.1%), and were examined seated in their wheelchair (69.7%). More than half of participants (54.1%) felt they received incomplete care, and 57% believed their physician had no more than a moderate understanding of their disability-specific medical concerns. Wheelchair users face persistent barriers to care, may receive less than thorough physical evaluations, receive fewer screenings for cervical cancer, and largely believe they receive incomplete care. Copyright © 2017 Elsevier Inc. All rights reserved.

Small Bowel Dose Parameters Predicting Grade ≥3 Acute Toxicity in Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation: An Independent Validation Study Comparing Peritoneal Space Versus Small Bowel Loop Contouring Techniques

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

Banerjee, Robyn, E-mail: robynbanerjee@gmail.com; Chakraborty, Santam; Nygren, Ian

Purpose: To determine whether volumes based on contours of the peritoneal space can be used instead of individual small bowel loops to predict for grade ≥3 acute small bowel toxicity in patients with rectal cancer treated with neoadjuvant chemoradiation therapy. Methods and Materials: A standardized contouring method was developed for the peritoneal space and retrospectively applied to the radiation treatment plans of 67 patients treated with neoadjuvant chemoradiation therapy for rectal cancer. Dose-volume histogram (DVH) data were extracted and analyzed against patient toxicity. Receiver operating characteristic analysis and logistic regression were carried out for both contouring methods. Results: Grade ≥3more » small bowel toxicity occurred in 16% (11/67) of patients in the study. A highly significant dose-volume relationship between small bowel irradiation and acute small bowel toxicity was supported by the use of both small bowel loop and peritoneal space contouring techniques. Receiver operating characteristic analysis demonstrated that, for both contouring methods, the greatest sensitivity for predicting toxicity was associated with the volume receiving between 15 and 25 Gy. Conclusion: DVH analysis of peritoneal space volumes accurately predicts grade ≥3 small bowel toxicity in patients with rectal cancer receiving neoadjuvant chemoradiation therapy, suggesting that the contours of the peritoneal space provide a reasonable surrogate for the contours of individual small bowel loops. The study finds that a small bowel V15 less than 275 cc and a peritoneal space V15 less than 830 cc are associated with a less than 10% risk of grade ≥3 acute toxicity.« less

Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared With Intact Capsules for Marginal Ulceration Following Roux-en-Y Gastric Bypass.

PubMed

Schulman, Allison R; Chan, Walter W; Devery, Aiofe; Ryan, Michele B; Thompson, Christopher C

2017-04-01

Marginal ulceration, or ulceration at the gastrojejunal anastomosis, is a common complication of Roux-en-Y gastric bypass (RYGB). Acidity likely contributes to the pathophysiology, and proton pump inhibitors (PPIs) frequently are prescribed for treatment. However, patients with gastric bypass only have a small gastric pouch and rapid small-bowel transit, which limits the opportunity for capsule breakdown and PPI absorption. Soluble PPIs (open capsules [OCs]) might be absorbed more easily than intact capsules (ICs). We compared time to ulcer healing, number of endoscopic procedures, and use of health care for patients with marginal ulceration who received PPIs in OC vs IC form. We performed a retrospective study of 164 patients diagnosed with marginal ulceration who underwent RYGB at the Brigham and Women's Hospital from 2000 through 2015. Patients received high-dose PPIs and underwent repeat endoscopy every 3 months until ulcer healing was confirmed. We used time-to-event analysis with a Cox proportional hazards model to evaluate the association between mode of PPI administration and time to ulcer healing, in addition to Cox multivariate regression analysis. Total charge (procedural and maintenance) was determined by comparison of categorized charges incurred from time of ulcer diagnosis to resolution. The primary outcome was time to healing of marginal ulceration in RYGB patients receiving high-dose PPIs in OC vs IC form. A total of 162 patients were included (115 received OC and 49 received IC). All patients were followed up until ulcer healing was confirmed. The median time to ulcer healing was 91.0 days for the OC group vs 342.0 days for the IC group (P < .001). OC was the only independent predictor of time to ulcer healing (P < .001) when we controlled for known risk factors. The number of endoscopic procedures (P = .02) and overall health care utilization (P = .05) were lower in the OC than the IC group. Patients with marginal ulceration after RYGB who receive OC PPIs have shorter ulcer healing times, fewer endoscopic procedures, and use less health care resources compared with patients who receive IC PPIs. Given these results and the high prevalence of marginal ulceration in this patient population, the use of OC PPIs is a low-risk, low-cost alternative that should be considered. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

PubMed

Fekadu, Melaku; Regassa, Nigatu

2014-12-01

Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia. The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression). The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization. The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.

Comparison of Downstream Health Care Utilization, Costs, and Long-Term Opioid Use: Physical Therapist Management Versus Opioid Therapy Management After Arthroscopic Hip Surgery.

PubMed

Rhon, Daniel I; Snodgrass, Suzanne J; Cleland, Joshua A; Greenlee, Tina A; Sissel, Charles D; Cook, Chad E

2018-05-01

Physical therapy and opioid prescriptions are common after hip surgery, but are sometimes delayed or not used. The objective of this study was to compare downstream health care utilization and opioid use following hip surgery for different patterns of physical therapy and prescription opioids. The design of this study was an observational cohort. Health care utilization was abstracted from the Military Health System Data Repository for patients who were 18 to 50 years old and were undergoing arthroscopic hip surgery between 2004 and 2013. Patients were grouped into those receiving an isolated treatment (only opioids or only physical therapy) and those receiving both treatments on the basis of timing (opioid first or physical therapy first). Outcomes included overall health care visits and costs, hip-related visits and costs, additional surgeries, and opioid prescriptions. Of 1870 total patients, 82.7% (n = 1546) received physical therapy only, 71.6% (n = 1339) received prescription opioids, and 1073 (56.1%) received both physical therapy and opioids. Because 24 patients received both opioids and physical therapy on the same day, they were eventually removed the final timing-of-care analysis. Adjusted hip-related mean costs were the same in both groups receiving isolated treatments (${\\$}$11,628 vs ${\\$}$11,579), but the group receiving only physical therapy had significantly lower overall total health care mean costs (${\\$}$18,185 vs ${\\$}$23,842) and fewer patients requiring another hip surgery. For patients receiving both treatments, mean hip-related downstream costs were significantly higher in the group receiving opioids first than in the group receiving physical therapy first (${\\$}$18,806 vs ${\\$}$16,955) and resulted in greater opioid use (7.83 vs 4.14 prescriptions), greater total days' supply of opioids (90.17 vs 44.30 days), and a higher percentage of patients with chronic opioid use (69.5% vs 53.2%). Claims data were limited by the accuracy of coding, and observational data limit inferences of causality. Physical therapy first was associated with lower hip-related downstream costs and lower opioid use than opioids first; physical therapy instead of opioids was associated with less total downstream health care utilization. These results need to be validated in prospective controlled trials.

A New Paradigm in Earth Environmental Monitoring with the CYGNSS Small Satellite Constellation.

PubMed

Ruf, Christopher S; Chew, Clara; Lang, Timothy; Morris, Mary G; Nave, Kyle; Ridley, Aaron; Balasubramaniam, Rajeswari

2018-06-08

A constellation of small, low-cost satellites is able to make scientifically valuable measurements of the Earth which can be used for weather forecasting, disaster monitoring, and climate studies. Eight CYGNSS satellites were launched into low Earth orbit on December 15, 2016. Each satellite carries a science radar receiver which measures GPS signals reflected from the Earth surface. The signals contain information about the surface, including wind speed over ocean, and soil moisture and flooding over land. The satellites are distributed around their orbit plane so that measurements can be made more often to capture extreme weather events. Innovative engineering approaches are used to reduce per satellite cost, increase the number in the constellation, and improve temporal sampling. These include the use of differential drag rather than propulsion to adjust the spacing between satellites and the use of existing GPS signals as the science radars' transmitter. Initial on-orbit results demonstrate the scientific utility of the CYGNSS observations, and suggest that a new paradigm in spaceborne Earth environmental monitoring is possible.

Autonomous Adaptive Low-Power Instrument Platform (AAL-PIP) for remote high latitude geospace data collection

NASA Astrophysics Data System (ADS)

Clauer, C. R.; Kim, H.; Deshpande, K.; Xu, Z.; Weimer, D.; Musko, S.; Crowley, G.; Fish, C.; Nealy, R.; Humphreys, T. E.; Bhatti, J. A.; Ridley, A. J.

2014-06-01

We present the development considerations and design for ground based instrumentation that is being deployed on the East Antarctic Plateau along a 40° magnetic meridian chain to investigate interhemispheric magnetically conjugate geomagnetic coupling and other space weather related phenomena. The stations are magnetically conjugate to geomagnetic stations along the west coast of Greenland. The autonomous adaptive low-power instrument platforms being deployed in the Antarctic are designed to operate unattended in remote locations for at least 5 years. They utilize solar power and AGM storage batteries for power, two-way Iridium satellite communication for data acquisition and program/operation modification, support fluxgate and induction magnetometers as well as dual-frequency gps receiver and an HF radio experiment. Size and weight considerations are considered to enable deployment by a small team using small aircraft. Considerable experience has been gained in the development and deployment of remote polar instrumentation that is reflected in the present generation of instrumentation discussed here. We conclude with the lessons learned from our experience in the design, deployment and operation of remote polar instrumentation.

An autonomous adaptive low-power instrument platform (AAL-PIP) for remote high-latitude geospace data collection

NASA Astrophysics Data System (ADS)

Clauer, C. R.; Kim, H.; Deshpande, K.; Xu, Z.; Weimer, D.; Musko, S.; Crowley, G.; Fish, C.; Nealy, R.; Humphreys, T. E.; Bhatti, J. A.; Ridley, A. J.

2014-10-01

We present the development considerations and design for ground-based instrumentation that is being deployed on the East Antarctic Plateau along a 40° magnetic meridian chain to investigate interhemispheric magnetically conjugate geomagnetic coupling and other space-weather-related phenomena. The stations are magnetically conjugate to geomagnetic stations along the west coast of Greenland. The autonomous adaptive low-power instrument platforms being deployed in the Antarctic are designed to operate unattended in remote locations for at least 5 years. They utilize solar power and AGM storage batteries for power, two-way Iridium satellite communication for data acquisition and program/operation modification, support fluxgate and induction magnetometers as well as a dual-frequency GPS receiver and a high-frequency (HF) radio experiment. Size and weight considerations are considered to enable deployment by a small team using small aircraft. Considerable experience has been gained in the development and deployment of remote polar instrumentation that is reflected in the present generation of instrumentation discussed here. We conclude with the lessons learned from our experience in the design, deployment and operation of remote polar instrumentation.

Cockpit weather information needs

NASA Technical Reports Server (NTRS)

Scanlon, Charles H.

1992-01-01

The primary objective is to develop an advanced pilot weather interface for the flight deck and to measure its utilization and effectiveness in pilot reroute decision processes, weather situation awareness, and weather monitoring. Identical graphical weather displays for the dispatcher, air traffic control (ATC), and pilot crew should also enhance the dialogue capabilities for reroute decisions. By utilizing a broadcast data link for surface observations, forecasts, radar summaries, lightning strikes, and weather alerts, onboard weather computing facilities construct graphical displays, historical weather displays, color textual displays, and other tools to assist the pilot crew. Since the weather data is continually being received and stored by the airborne system, the pilot crew has instantaneous access to the latest information. This information is color coded to distinguish degrees of category for surface observations, ceiling and visibilities, and ground radar summaries. Automatic weather monitoring and pilot crew alerting is accomplished by the airborne computing facilities. When a new weather information is received, the displays are instantaneously changed to reflect the new information. Also, when a new surface or special observation for the intended destination is received, the pilot crew is informed so that information can be studied at the pilot's discretion. The pilot crew is also immediately alerted when a severe weather notice, AIRMET or SIGMET, is received. The cockpit weather display shares a multicolor eight inch cathode ray tube and overlaid touch panel with a pilot crew data link interface. Touch sensitive buttons and areas are used for pilot selection of graphical and data link displays. Time critical ATC messages are presented in a small window that overlays other displays so that immediate pilot alerting and action can be taken. Predeparture and reroute clearances are displayed on the graphical weather system so pilot review of weather along the route can be accomplished prior to pilot acceptance of the clearance. An ongoing multiphase test series is planned for testing and modifying the graphical weather system. Preliminary data shows that the nine test subjects considered the graphical presentation to be much better than their current weather information source for situation awareness, flight safety, and reroute decision making.

Modeling and characterization of multipath in global navigation satellite system ranging signals

NASA Astrophysics Data System (ADS)

Weiss, Jan Peter

The Global Positioning System (GPS) provides position, velocity, and time information to users in anywhere near the earth in real-time and regardless of weather conditions. Since the system became operational, improvements in many areas have reduced systematic errors affecting GPS measurements such that multipath, defined as any signal taking a path other than the direct, has become a significant, if not dominant, error source for many applications. This dissertation utilizes several approaches to characterize and model multipath errors in GPS measurements. Multipath errors in GPS ranging signals are characterized for several receiver systems and environments. Experimental P(Y) code multipath data are analyzed for ground stations with multipath levels ranging from minimal to severe, a C-12 turboprop, an F-18 jet, and an aircraft carrier. Comparisons between receivers utilizing single patch antennas and multi-element arrays are also made. In general, the results show significant reductions in multipath with antenna array processing, although large errors can occur even with this kind of equipment. Analysis of airborne platform multipath shows that the errors tend to be small in magnitude because the size of the aircraft limits the geometric delay of multipath signals, and high in frequency because aircraft dynamics cause rapid variations in geometric delay. A comprehensive multipath model is developed and validated. The model integrates 3D structure models, satellite ephemerides, electromagnetic ray-tracing algorithms, and detailed antenna and receiver models to predict multipath errors. Validation is performed by comparing experimental and simulated multipath via overall error statistics, per satellite time histories, and frequency content analysis. The validation environments include two urban buildings, an F-18, an aircraft carrier, and a rural area where terrain multipath dominates. The validated models are used to identify multipath sources, characterize signal properties, evaluate additional antenna and receiver tracking configurations, and estimate the reflection coefficients of multipath-producing surfaces. Dynamic models for an F-18 landing on an aircraft carrier correlate aircraft dynamics to multipath frequency content; the model also characterizes the separate contributions of multipath due to the aircraft, ship, and ocean to the overall error statistics. Finally, reflection coefficients for multipath produced by terrain are estimated via a least-squares algorithm.

Study of dispersed small wind systems interconnected with a utility distribution system

NASA Astrophysics Data System (ADS)

Curtice, D.; Patton, J.; Bohn, J.; Sechan, N.

1980-03-01

Operating problems for various penetrations of small wind systems connected to the distribution system on a utility are defined. Protection equipment, safety hazards, feeder voltage regulation, line losses, and voltage flicker problems are studied, assuming different small wind systems connected to an existing distribution system. To identify hardware deficiencies, possible solutions provided by off-the-shelf hardware and equipment are assessed. Results of the study indicate that existing techniques are inadequate for detecting isolated operation of a small wind system. Potential safety hazards posed by small wind systems are adequately handled by present work procedures although these procedures require a disconnect device at synchronous generator and self commutated inverter small wind systems.

Challenges in universal coverage and utilization of insecticide-treated bed nets in migrant plantation workers in Myanmar

PubMed Central

2014-01-01

Background High coverage of the bed nets can reduce mortality and morbidity of mosquito-borne diseases including malaria. Although the migrant workers are at high risk of malaria, there are many hidden challenges in universal coverage and utilization of the insecticide-treated nets (ITNs) in this populations. Methods Cross sectional study was conducted in 170 migrant workers in palm oil plantation sites in Tanintharyi Region and 175 in rubber plantation sites in Mon State. A multistage stratified cluster sampling was applied to select the participants. During household visit, face-to-face interviews using structured pre-coded, pre tested questionnaires and direct observation on installation of the bed nets was conducted. Two focus group discussions in each site were done by sample stratified purposive sampling method mainly focused on effective utilization of bed nets. Results Among them, 332 (96.2%) had a bed net and 284 (82.3%) had an ITN, while 204 (59.1%) had unused extranets. Among the ITNs users, 28.9% reported problems including insecticide smell (56.9%), dizziness (20.2%), headache (12.8%) and itchiness (9.2%). More than 75% received ITNs from health authorities and NGOs free-of-charge. More than 70% wanted to buy a net but they were unaffordable for 64% of them. On observation, only five families could show no bed net, but 80% showed 1–3 ITNs. Consistent utilization in all seasons was noted in 189 (53.1%), that was higher in palm oil plantation than rubber plantation workers (p = 0.0001) due to the nature of the work at night. Perceived malaria risk was also significantly higher ITNs consistent users than non-users (p = 0.0004) and better willingness to buy an ITN by themselves (p = 0.0005). They said that effectiveness of the ITNs was reduced after 6 months and 2–3 times washing. They wished to receive more durable smooth nets with small holes in lace. Misuses of the ITNs such as use the nets for animals and fishing, were also noted. Conclusion There should be efforts to improve effective utilization of ITNs by continuous mass free distribution, durability monitoring, surveillance of insecticide resistance of the vector and behaviour change interventions in migrant plantation workers. PMID:24888548

48 CFR 52.219-8 - Utilization of small business concerns.

Code of Federal Regulations, 2013 CFR

2013-10-01

... United States Small Business Administration or the awarding agency of the United States as may be... List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration... small disadvantaged business in the Dynamic Small Business Search database maintained by the Small...

48 CFR 52.219-8 - Utilization of Small Business Concerns.

Code of Federal Regulations, 2014 CFR

2014-10-01

... United States Small Business Administration or the awarding agency of the United States as may be... List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration... small disadvantaged business in the Dynamic Small Business Search database maintained by the Small...

Submillimeter Confocal Imaging Active Module

NASA Technical Reports Server (NTRS)

Hong, John; Mehdi, Imran; Siegel, Peter; Chattopadhyay, Goutam; Cwik, Thomas; Rowell, Mark; Hacker, John

2009-01-01

The term submillimeter confocal imaging active module (SCIAM) denotes a proposed airborne coherent imaging radar system that would be suitable for use in reconnaissance, surveillance, and navigation. The development of the SCIAM would include utilization and extension of recent achievements in monolithic microwave integrated circuits capable of operating at frequencies up to and beyond a nominal radio frequency of 340 GHz. Because the SCIAM would be primarily down-looking (in contradistinction to primarily side-looking), it could be useful for imaging shorter objects located between taller ones (for example, objects on streets between buildings). The SCIAM would utilize a confocal geometry to obtain high cross-track resolution, and would be amenable to synthetic-aperture processing of its output to obtain high along-track resolution. The SCIAM (see figure) would include multiple (two in the initial version) antenna apertures, separated from each other by a cross-track baseline of suitable length (e.g., 1.6 m). These apertures would both transmit the illuminating radar pulses and receive the returns. A common reference oscillator would generate a signal at a controllable frequency of (340 GHz + (Delta)f)/N, where (Delta)f is an instantaneous swept frequency difference and N is an integer. The output of this oscillator would be fed to a frequency- multiplier-and-power-amplifier module to obtain a signal, at 340 GHz + (Delta)f, that would serve as both the carrier signal for generating the transmitted pulses and a local-oscillator (LO) signal for a receiver associated with each antenna aperture. Because duplexers in the form of circulators or transmit/receive (T/R) switches would be lossy and extremely difficult to implement, the antenna apertures would be designed according to a spatial-diplexing scheme, in which signals would be coupled in and out via separate, adjacent transmitting and receiving feed horns. This scheme would cause the transmitted and received beams to be aimed in slightly different directions, and, hence, to not overlap fully on the targets on the ground. However, a preliminary analysis has shown that the loss of overlap would be small enough that the resulting loss in signal-to-noise ratio (SNR) would be much less than the SNR loss associated with the use of a 340-GHz T/R switch.

Evidence of a broken healthcare delivery system in korea: unnecessary hospital outpatient utilization among patients with a single chronic disease without complications.

PubMed

Lee, Jin Yong; Jo, Min-Woo; Yoo, Weon-Seob; Kim, Hyun Joo; Eun, Sang Jun

2014-12-01

This study aims to estimate the volume of unnecessarily utilized hospital outpatient services in Korea and quantify the total cost resulting from the inappropriate utilization. The analysis included a sample of 27,320,505 outpatient claims from the 2009 National Inpatient Sample database. Using the Charlson Comorbidity Index (CCI), patients were considered to have received 'unnecessary hospital outpatient utilization' if they had a CCI score of 0 and were concurrently admitted to hospital for treatment of a single chronic disease - hypertension (HTN), diabetes mellitus (DM), or hyperlipidemia (HL) - without complication. Overall, 85% of patients received unnecessary hospital services. Also hospitals were taking away 18.7% of HTN patients, 18.6% of DM and 31.6% of HL from clinics. Healthcare expenditures from unnecessary hospital outpatient utilization were estimated at: HTN (94,058 thousands USD, 38.6% of total expenditure); DM (17,795 thousands USD, 40.6%) and HL (62,876 thousands USD, 49.1%). If 100% of patients who received unnecessary hospital outpatient services were redirected to clinics, the estimated savings would be 104,226 thousands USD. This research proves that approximately 85% of hospital outpatient utilizations are unnecessary and that a significant amount of money is wasted on unnecessary healthcare services; thus burdening the National Health Insurance Service (NHIS) and patients.

Incentives for increasing prenatal care use by women in order to improve maternal and neonatal outcomes.

PubMed

Till, Sara R; Everetts, David; Haas, David M

2015-12-15

Prenatal care is recommended during pregnancy as a method to improve neonatal and maternal outcomes. Improving the use of prenatal care is important, particularly for women at moderate to high risk of adverse outcomes. Incentives are sometimes utilized to encourage women to attend prenatal care visits. To determine whether incentives are an effective tool to increase utilization of timely prenatal care among women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015) and the reference lists of all retrieved studies. Randomized controlled trials (RCTs), quasi-RCTs, and cluster-RCTs that utilized direct incentives to pregnant women explicitly linked to initiation and frequency of prenatal care were included. Incentives could include cash, vouchers, coupons or products not generally offered to women as a standard of prenatal care. Comparisons were to no incentives and to incentives not linked directly to utilization of care. We also planned to compare different types of interventions, i.e. monetary versus products or services. Two review authors independently assessed studies for inclusion and methodological quality. Two review authors independently extracted data. Data were checked for accuracy. We identified 11 studies (19 reports), six of which we excluded. Five studies, involving 11,935 pregnancies were included, but only 1893 pregnancies contributed data regarding our specified outcomes. Incentives in the studies included cash, gift card, baby carrier, baby blanket or taxicab voucher and were compared with no incentives. Meta-analysis was performed for only one outcome 'Return for postpartum care' and this outcome was not pre-specified in our protocol. Other analyses were restricted to data from single studies.Trials were at a moderate risk of bias overall. Randomization and allocation were adequate and risk of selection bias was low in three studies and unclear in two studies. None of the studies were blinded to the participants. Blinding of outcome assessors was adequate in one study, but was limited or not described in the remaining four studies. Risk of attrition was deemed to be low in all studies that contributed data to the review. Two of the studies reported or analyzed data in a manner that was not consistent with the predetermined protocol and thus were deemed to be at high risk. The other three studies were low risk for reporting bias. The largest two of the five studies comprising the majority of participants took place in rural, low-income, homogenously Hispanic communities in Central America. This setting introduces a number of confounding factors that may affect generalizability of these findings to ethnically and economically diverse urban communities in developed countries.The five included studies of incentive programs did not report any of this review's primary outcomes: preterm birth, small-for-gestational age, or perinatal death.In terms of this review's secondary outcomes, pregnant women receiving incentives were no more likely to initiate prenatal care (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.78 to 1.38, one study, 104 pregnancies). Pregnant women receiving incentives were more likely to attend prenatal visits on a frequent basis (RR 1.18, 95% CI 1.01 to 1.38, one study, 606 pregnancies) and obtain adequate prenatal care defined by number of "procedures" such as testing blood sugar or blood pressure, vaccinations and counseling about breastfeeding and birth control (mean difference (MD) 5.84, 95% CI 1.88 to 9.80, one study, 892 pregnancies). In contrast, women who received incentives were more likely to deliver by cesarean section (RR 1.97, 95% CI 1.18 to 3.30, one study, 979 pregnancies) compared to those women who did not receive incentives.Women who received incentives were no more likely to return for postpartum care based on results of meta-analysis (average RR 0.75, 95% CI 0.21 to 2.64, two studies, 833 pregnancies, Tau² = 0.81, I² = 98%). However, there was substantial heterogeneity in this analysis so a subgroup analysis was performed and this identified a clear difference between subgroups based on the type of incentive being offered. In one study, women receiving non-cash incentives were more likely to return for postpartum care (RR 1.26, 95% CI 1.09 to 1.47, 240 pregnancies) than women who did not receive non-cash incentives. In another study, women receiving cash incentives were less likely to return for postpartum care (RR 0.43, 95% CI 0.30 to 0.62, 593 pregnancies) than women who did not receive cash incentives.No data were identified for the following secondary outcomes: frequency of prenatal care; pre-eclampsia; satisfaction with birth experience; maternal mortality; low birthweight (less than 2500 g); infant macrosomia (birthweight greater than 4000 g); or five-minute Apgar less than seven. The included studies did not report on this review's main outcomes: preterm birth, small-for-gestational age, or perinatal death. There is limited evidence that incentives may increase utilization and quality of prenatal care, but may also increase cesarean rate. Overall, there is insufficient evidence to fully evaluate the impact of incentives on prenatal care initiation. There are conflicting data as to the impact of incentives on return for postpartum care. Two of the five studies which accounted for the majority of women in this review were conducted in rural, low-income, overwhelmingly Hispanic communities in Central America, thus limiting the external validity of these results.There is a need for high-quality RCTs to determine whether incentive program increase prenatal care use and improve maternal and neonatal outcomes. Incentive programs, in particular cash-based programs, as suggested in this review and in several observational studies may improve the frequency and ensure adequate quality of prenatal care. No peer-reviewed data have been made publicly available for one of the largest incentive-based prenatal programs - the statewide Medicaid-based programs within the United States. These observational data represent an important starting point for future research with significant implications for policy development and allocation of healthcare resources. The disparate findings related to attending postpartum care should also be further explored as the findings were limited by the number of studies. Future large RCTs are needed to focus on the outcomes of preterm birth, small-for-gestational age and perinatal outcomes.

Multichannel homodyne receiver

DOEpatents

Landt, Jeremy A.

1982-01-01

A homodyne radar transmitter/receiver device which produces a single combined output which contains modulated backscatter information for all phase conditions of both modulated and unmodulated backscatter signals. The device utilizes taps along coaxial transmission lines, strip transmission line, and waveguides which are spaced by 1/8 wavelength or 1/6 wavelength, etc. This greatly reduces costs by eliminating separate transmission and reception antennas and an expensive arrangement of power splitters and mixers utilized in the prior art.

Multichannel homodyne receiver

DOEpatents

Landt, J.A.

1981-01-19

A homodyne radar transmitter/receiver device which produces a single combined output which contains modulated backscatter information for all phase conditions of both modulated and unmodulated backscatter signals is described. The device utilizes taps along coaxial transmission lines, strip transmission line, and waveguides which are spaced by 1/8 wavelength or 1/6 wavelength, etc. This greatly reduces costs by eliminating separate transmission and reception antennas and an expensive arrangement of power splitters and mixers utilized in the prior art.

Method and apparatus for detecting and/or imaging clusters of small scattering centers in the body

DOEpatents

Perez-Mendez, V.; Sommer, F.G.

1982-07-13

An ultrasonic method and apparatus are provided for detecting and imaging clusters of small scattering centers in the breast wherein periodic pulses are applied to an ultrasound emitting transducer and projected into the body, thereafter being received by at least one receiving transducer positioned to receive scattering from the scattering center clusters. The signals are processed to provide an image showing cluster extent and location. 6 figs.

Method and apparatus for detecting and/or imaging clusters of small scattering centers in the body

DOEpatents

Perez-Mendez, Victor; Sommer, Frank G.

1982-01-01

An ultrasonic method and apparatus are provided for detecting and imaging clusters of small scattering centers in the breast wherein periodic pulses are applied to an ultrasound emitting transducer and projected into the body, thereafter being received by at least one receiving transducer positioned to receive scattering from the scattering center clusters. The signals are processed to provide an image showing cluster extent and location.

The Evolution and Utility of the Small-Carrion Prosthesis, Its Impact, and Progression to the Modern-Day Malleable Penile Prosthesis.

PubMed

Martinez, Daniel R; Terlecki, Ryan; Brant, William O

2015-11-01

Erectile dysfunction has plagued humanity for millennia. For years, treatment had been in the hands of mental health professionals. It was not until the 1970s that urologists created a modality that was marketable, reproducible, and consistently successful at treating impotence, the Small-Carrion Penile Prosthesis. We present the evolution of the malleable/semi-rigid penile prosthesis, concentrating our efforts reviewing and critiquing the pivotal article published by Drs. Michael P. Small, Hernan M. Carrion, and Julian A. Gordon. We then discuss its continued advancement, current-day utilization, and the future of the malleable prosthesis. From the early 1900s, surgeons have been toying with the idea of creating a penile implant. These initial attempts utilized rib cartilage, and eventually synthetic materials, including acrylic, silicone, and polyethylene. In 1975, Drs. Carrion and Small presented their initial experience of 31 patients utilizing their silicone implant. In their manuscript titled, "The Small-Carrion Penile Prosthesis: New Implant for the Management of Impotence," they discuss their technique, perioperative management of complications, and results. The malleable penile prosthesis continued to evolve throughout the years to the current day Genesis and Spectra. Although the current market is dominated by the inflatable penile prosthesis, there are specific situations where the malleable is ideally utilized. The pivotal article by Drs. Carrion and Small helped pave the way for the "New Era" of penile prosthetics and still remains one of the most impactful contributions to the management of erectile dysfunction. © 2015 International Society for Sexual Medicine.

Faraday rotation measurement method and apparatus

NASA Technical Reports Server (NTRS)

Brockman, M. H. (Inventor)

1981-01-01

A method and device for measuring Faraday rotation of a received RF signal is described. A simultaneous orthogonal polarization receiver compensates for a 3 db loss due to splitting of a received signal into left circular and right circular polarization channels. The compensation is achieved by RF and modulation arraying utilizing a specific receiver array which also detects and measures Faraday rotation in the presence or absence of spin stabilization effects on a linear polarization vector. Either up-link or down-link measurement of Faraday rotation is possible. Specifically, the Faraday measurement apparatus utilized in conjunction with the specific receiver array provides a means for comparing the phase of a reference signal in the receiver array to the phase of a tracking loop signal related to the incoming signal, and comparing the phase of the reference signal to the phase of the tracking signal shifted in phase by 90 degrees. The averaged and unaveraged signals, are compared, the phase changes between the two signals being related to Faraday rotation.

Heterodyne interferometer with angstrom-level periodic nonlinearity

DOEpatents

Schmitz, Tony L.; Beckwith, John F.

2005-01-25

Displacement measuring interferometer systems and methods are disclosed. One or more acousto-optic modulators for receiving a laser light beam from a laser light source can be utilized to split the laser light beam into two or more laser light beams, while spatially separating frequencies thereof. One or more reflective mechanisms can be utilized to reflect one or more of the laser light beams back to the acousto-optic modulator. Interference of two or more of the laser light beams generally at the acousto-optic modulator can provide an interfered laser light beam thereof. A detector for receiving the interfered laser light beam can be utilized to provide interferometer measurement data.

Usual Course of Treatment and Predictors of Treatment Utilization for Patients With Posttraumatic Stress Disorder.

PubMed

Nobles, Carrie J; Valentine, Sarah E; Zepeda, E David; Ahles, Emily M; Shtasel, Derri L; Marques, Luana

2017-05-01

Posttraumatic stress disorder (PTSD) is a debilitating psychiatric illness that frequently remains undiagnosed and untreated. While extensive research has been conducted among veterans, little research has evaluated course of treatment for PTSD in a general hospital setting. We utilized data from the Partners HealthCare Research Patient Data Registry to evaluate mental health treatment utilization, including psychotherapy and pharmacotherapy, by patients with recently diagnosed primary PTSD following DSM-IV criteria between January 1, 2002, and June 30, 2011. We additionally evaluated predictors of treatment utilization 6 months postdiagnosis. Among 2,475 patients with recently diagnosed primary PTSD, approximately half (55.7%) had any therapy visit and 10% had at least 12 therapy visits in the 6 months following diagnosis. Approximately half (47.0%) received a psychiatric prescription, with 29.3% receiving a selective serotonin reuptake inhibitor (SSRI), 11.8% receiving an atypical antipsychotic, and 24.4% receiving a benzodiazepine. Latinos were 25% (95% CL = 1.09, 1.43) more likely to have an SSRI prescription, 35% (95% CL = 1.05, 1.75) more likely to have an atypical antipsychotic prescription, and 28% (95% CL = 1.19, 1.38) more likely to receive any psychotherapy. Women were 49% (95% CL = 0.42, 0.63) less likely to have an atypical antipsychotic prescription. Patients with Medicare were 23% (95% CL = 0.67, 0.88) less likely to have any psychotherapy, and patients with Medicaid were 35% (95% CL = 0.46, 0.92) less likely to have 12 or more therapy visits. Many patients with a primary diagnosis of PTSD do not receive psychotherapy, and psychiatric prescriptions, including atypical antipsychotics and benzodiazepines, are common. Future research is needed to determine the quality of care received and explore subpopulation-specific barriers limiting access to care. © Copyright 2017 Physicians Postgraduate Press, Inc.

Exploring the Impact of Language Services on Utilization and Clinical Outcomes for Diabetics

PubMed Central

Hacker, Karen; Choi, Yoon Susan; Trebino, Lisa; Hicks, LeRoi; Friedman, Elisa; Blanchfield, Bonnie; Gazelle, G. Scott

2012-01-01

Background Significant health disparities exist between limited English proficient and English-proficient patients. Little is known about the impact of language services on chronic disease outcomes such as for diabetes. Methods/Principal Findings To determine whether the amount and type of language services received during primary care visits had an impact on diabetes-related outcomes (hospitalization, emergency room utilization, glycemic control) in limited English proficient patients, a retrospective cohort design was utilized. Hospital and medical record data was examined for 1425 limited English proficient patients in the Cambridge Health Alliance diabetes registry. We categorized patients receiving usual care into 7 groups based on the amount and combination of language services (language concordant providers, formal interpretation and nothing) received at primary care visits during a 9 month period. Bivariate analyses and multiple logistic regression were used to determine relationships between language service categories and outcomes in the subsequent 6 months. Thirty-one percent of patients (445) had no documentation of interpreter use or seeing a language concordant provider in any visits. Patients who received 100% of their primary care visits with language concordant providers were least likely to have diabetes-related emergency department visits compared to other groups (p<0001) in the following 6 months. Patients with higher numbers of co-morbidities were more likely to receive formal interpretation. Conclusions/Significance Language concordant providers may help reduce health care utilization for limited English proficient patients with diabetes. However, given the lack of such providers in sufficient numbers to meet patients' communication needs, strategies are needed to both increase their numbers and ensure that the highest risk patients receive the most appropriate language services. In addition, systems serving diverse populations must clarify why some limited English proficient patients do not receive language services at some or all of their visits and whether this has an impact on quality of care. PMID:22675571

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Healthcare Utilization and Spending Among Carve-In Enrollees

PubMed Central

Harwood, Jessica M.; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K.; Tseng, Chi-Hong; Wells, Kenneth B.; Friedman, Sarah; Ettner, Susan L.

2016-01-01

Objective The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA’s impact on BH expenditures and utilization among “carve-in” enrollees. Method We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008–2009), during (2010), and after (2011–2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual and family psychotherapy); intermediate care utilization (structured outpatient; day treatment; residential); and inpatient utilization. Results MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits (respective immediate increases of: $1.05 [p=0.02]; $0.88 [p=0.04]; 0.00045 visits [p=0.00]), and individual psychotherapy visits (immediate increase of 0.00578 visits [p=0.00] and additional increases of 0.00017 visits/month [p=0.03]). Conclusions MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; e.g., in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act’s inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets. PMID:27632769

Healthy Water

MedlinePlus

... Medical Professionals Aquatics, Water Utilities, & Other Water-related Sectors Publications, Data, & Statistics Get Email Updates To receive ... Medical Professionals Aquatics, Water Utilities, & Other Water-related Sectors Publications, Data, & Statistics Magnitude & Burden of Waterborne Disease ...

48 CFR 52.219-8 - Utilization of small business concerns.

Code of Federal Regulations, 2011 CFR

2011-10-01

... United States Small Business Administration or the awarding agency of the United States as may be... List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration... small disadvantaged business in the CCR Dynamic Small Business Search database maintained by the Small...

48 CFR 52.219-8 - Utilization of small business concerns.

Code of Federal Regulations, 2012 CFR

2012-10-01

... United States Small Business Administration or the awarding agency of the United States as may be... List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration... small disadvantaged business in the CCR Dynamic Small Business Search database maintained by the Small...

Effectiveness of a Multimodal Therapy for Patients with Chronic Low Back Pain Regarding Pre-Admission Healthcare Utilization

PubMed Central

Borys, Constanze; Lutz, Johannes; Strauss, Bernhard; Altmann, Uwe

2015-01-01

Objective The aim of the study was to examine the effectiveness of an intensive inpatient three-week multimodal therapy. We focused especially on the impact on the multimodal therapy outcome of the pre-admission number of treatment types patients had received and of medical specialist groups patients had consulted. Methods 155 patients with chronic low back pain and indication for multimodal therapy were evaluated with respect to pain intensity, depression, anxiety, well-being, and pre-admission health care utilization. In our controlled clinical trial we compared N = 66 patients on the waiting list with N = 89 patients who received immediate treatment. The waiting list patients likewise attended multimodal therapy after the waiting period. Longitudinal post-treatment data for both were collected at three- and twelve-month follow-ups. The impact of pre-admission health care utilization on multimodal therapy outcome (post) was analysed by structural equation model. Results Compared to the control group, multimodal therapy patients’ pain intensity and psychological variables were significantly reduced. Longitudinal effects with respect to pre-measures were significant at three-month follow-up for pain intensity (ES = -0.48), well-being (ES = 0.78), anxiety (ES = -0.33), and depression (ES = -0.30). Effect sizes at twelve-month follow-up were small for anxiety (ES = -0.22), and moderate for general well-being (ES = 0.61). Structural equation model revealed that a higher number of pre-admission treatment types was associated with poorer post-treatment outcomes in pain intensity, well-being, and depression. Conclusion Multimodal therapy proved to be effective with regard to improvements in pain intensity, depression, anxiety, and well-being. The association between treatment effect and number of pre-admission pain treatment types suggests that patients would benefit more from attending multimodal therapy in an earlier stage of health care. PMID:26599232

On the Application of Inverse-Mode SiGe HBTs in RF Receivers for the Mitigation of Single-Event Transients

NASA Astrophysics Data System (ADS)

Song, Ickhyun; Cho, Moon-Kyu; Oakley, Michael A.; Ildefonso, Adrian; Ju, Inchan; Buchner, Stephen P.; McMorrow, Dale; Paki, Pauline; Cressler, John. D.

2017-05-01

Best practice in mitigation strategies for single-event transients (SETs) in radio-frequency (RF) receiver modules is investigated using a variety of integrated receivers utilizing inverse-mode silicon-germanium (SiGe) heterojunction bipolar transistors (HBTs). The receivers were designed and implemented in a 130-nm SiGe BiCMOS technology platform. In general, RF switches, low-noise amplifiers (LNAs), and downconversion mixers utilizing inverse-mode SiGe HBTs exhibit less susceptibility to SETs than conventional RF designs, in terms of transient peaks and duration, at the cost of RF performance. Under normal RF operation, the SET-hardened switch is mainly effective in peak reduction, while the LNA and the mixer exhibit reductions in transient peaks as well as transient duration.

The changing pattern of prenatal care utilization in the United States, 1981-1995, using different prenatal care indices.

PubMed

Kogan, M D; Martin, J A; Alexander, G R; Kotelchuck, M; Ventura, S J; Frigoletto, F D

1998-05-27

Two measures traditionally used to examine adequacy of prenatal care indicate that prenatal care utilization remained unchanged through the 1980s and only began to rise slightly in the 1990s. In recent years, new measures have been developed that include a category for women who receive more than the recommended amount of care (intensive utilization). To compare the older and newer indices in the monitoring of prenatal care trends in the United States from 1981 to 1995, for the overall population and for selected subpopulations. Second, to examine factors associated with receiving intensive utilization. Cross-sectional and trend analysis of national birth records. The United States. All live births between 1981 and 1995 (N=54 million). Trends in prenatal care utilization, according to 4 indices (the older indices: the Institute of Medicine Index and the trimester that care began, and the newer indices: the R-GINDEX and the Adequacy of Prenatal Care Utilization Index). Multiple logistic regression was used to assess the risk of intensive prenatal care use in 1981 and 1995. The newer indices showed a steadily increasing trend toward more prenatal care use throughout the study period (R-GINDEX, intensive or adequate use, 32.7% in 1981 to 47.1 % in 1995; the Adequacy of Prenatal Care Utilization Index, intensive use, 18.4% in 1981 to 28.8% in 1995), especially for intensive utilization. Women having a multiple birth were much more likely to have had intensive utilization in 1995 compared with 1981 (R-GINDEX, 22.8% vs 8.5%). Teenagers were more likely to begin care later than adults, but similar proportions of teens and adults had intensive utilization. Intensive use among low-risk women also increased steadily each year. Factors associated with a greater likelihood of receiving intensive use in 1981 and 1995 were having a multiple birth, primiparity, being married, and maternal age of 35 years or older. The proportion of women who began care early and received at least the recommended number of visits increased between 1981 and 1995. This change was undetected by more traditional prenatal care indices. These increases have cost and practice implications and suggest a paradox since previous studies have shown that rates of preterm delivery and low birth weight did not improve during this time.

13 CFR 124.703 - Who is eligible to receive 7(j) assistance?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Who is eligible to receive 7(j) assistance? 124.703 Section 124.703 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION 8(a) BUSINESS DEVELOPMENT/SMALL DISADVANTAGED BUSINESS STATUS DETERMINATIONS 8(a) Business Development...

40 CFR 21.12 - State issued statements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 21.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL SMALL BUSINESS § 21.12 State... where he has or is receiving from the small business concern applicant 10 percent of gross personal... year if the recipient is over 60 years of age and is receiving such portion pursuant to retirement...

Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care.

PubMed

Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

2017-01-01

Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study

PubMed Central

Quandt, Sara A; Sandberg, Joanne C; Miller Jr, David P; Latulipe, Celine; Leng, Xiaoyan; Talton, Jenifer W; Melius, Kathryn P; Smith, Alden; Bertoni, Alain G

2017-01-01

Background Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization. Objective The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities. The secondary objective was to delineate how patient portal utilization is associated with perceived usefulness and usability. Methods Patients from one urban and two rural clinics serving low income patients were recruited and completed interviewer-administered questionnaires on patient portal utilization. Results A total of 200 ethnically diverse patients completed questionnaires, of which 41 (20.5%) patients reported utilizing portals. Education, social support, and frequent Internet utilization improve the odds of patient portal utilization; receiving health care at a rural clinic decreases the odds of portal utilization. Conclusions Leverage points to address disparities in patient portal utilization include providing training for older adults in patient portal utilization, involving spouses or other care partners in this training, and making information technology access available at public places in rural and urban communities. PMID:29138129

Development of termination and utilization concepts for flat conductor cables. Volume 2: Utilization of small gage wire round conductor cables

NASA Technical Reports Server (NTRS)

1972-01-01

The practical use of small-gage round wire for electrical wiring in manned air and space vehicle environments is discussed. The investigation consisted on a study of wire construction and candidate wire harness concepts, fabrication of small-gage wire harnesses, and verification of promising configurations by laboratory evaluation. The wire constructions selected for harness fabrication are described. Results of the laboratory evaluation are included.

Comparative costs of inpatient care for HIV-infected and uninfected children and adults in Soweto, South Africa.

PubMed

Thomas, Leena S; Manning, Arthur; Holmes, Charles B; Naidoo, Shan; van der Linde, Frans; Gray, Glenda E; Martinson, Neil A

2007-12-01

HIV/AIDS creates a massive burden of care for health systems. A better understanding of the impact of HIV infection on health care utilization and costs may enable better use of limited resources. We compared public sector inpatient costs of HIV-infected versus uninfected adults and children at a large hospital in Soweto, South Africa. Daily hotel costs estimated from hospital financial data and total patient visits were combined with utilization, abstracted from patients' charts, and costed using government price lists to estimate total inpatient costs. A total of 1185 eligible records were included over a 6-week period in 2005. Eight hundred twelve were from HIV-infected patients, and of these, 77 were on antiretroviral (ARV) therapy. The mean length of stay (LOS) and mean drug and intravenous fluid utilization of HIV-infected adults not on ARVs was greater than those of uninfected adults, resulting in a $200 higher total average admission cost. Patients on ARVs had longer LOS and incurred a total average admission cost of $750 more than HIV-infected adults not on ARVs. Inpatient costs were greater for this selected group of HIV-infected adults, and even higher for the small proportion of individuals receiving ARVs. Budget allocations should incorporate case mix by HIV and ARV status as a key determinant of hospital expenditure.

Access, utilization, and interest in mHealth applications among veterans receiving outpatient care for PTSD.

PubMed

Erbes, Christopher R; Stinson, Rebecca; Kuhn, Eric; Polusny, Melissa; Urban, Jessica; Hoffman, Julia; Ruzek, Josef I; Stepnowsky, Carl; Thorp, Steven R

2014-11-01

Mobile health (mHealth) refers to the use of mobile technology (e.g., smartphones) and software (i.e., applications) to facilitate or enhance health care. Several mHealth programs act as either stand-alone aids for Veterans with post-traumatic stress disorder (PTSD) or adjuncts to conventional psychotherapy approaches. Veterans enrolled in a Veterans Affairs outpatient treatment program for PTSD (N = 188) completed anonymous questionnaires that assessed Veterans' access to mHealth-capable devices and their utilization of and interest in mHealth programs for PTSD. The majority of respondents (n = 142, 76%) reported having access to a cell phone or tablet capable of running applications, but only a small group (n = 18) reported use of existing mHealth programs for PTSD. Age significantly predicted ownership of mHealth devices, but not utilization or interest in mHealth applications among device owners. Around 56% to 76% of respondents with access indicated that they were interested in trying mHealth programs for such issues as anger management, sleep hygiene, and management of anxiety symptoms. Findings from this sample suggest that Veterans have adequate access to, and interest in, using mHealth applications to warrant continued development and evaluation of mobile applications for the treatment of PTSD and other mental health conditions. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Channel Modeling of Miniaturized Battery-Powered Capacitive Human Body Communication Systems.

PubMed

Park, Jiwoong; Garudadri, Harinath; Mercier, Patrick P

2017-02-01

The purpose of this contribution is to estimate the path loss of capacitive human body communication (HBC) systems under practical conditions. Most prior work utilizes large grounded instruments to perform path loss measurements, resulting in overly optimistic path loss estimates for wearable HBC devices. In this paper, small battery-powered transmitter and receiver devices are implemented to measure path loss under realistic assumptions. A hybrid electrostatic finite element method simulation model is presented that validates measurements and enables rapid and accurate characterization of future capacitive HBC systems. Measurements from form-factor-accurate prototypes reveal path loss results between 31.7 and 42.2 dB from 20 to 150 MHz. Simulation results matched measurements within 2.5 dB. Comeasurements using large grounded benchtop vector network analyzer (VNA) and large battery-powered spectrum analyzer (SA) underestimate path loss by up to 33.6 and 8.2 dB, respectively. Measurements utilizing a VNA with baluns, or large battery-powered SAs with baluns still underestimate path loss by up to 24.3 and 6.7 dB, respectively. Measurements of path loss in capacitive HBC systems strongly depend on instrumentation configurations. It is thus imperative to simulate or measure path loss in capacitive HBC systems utilizing realistic geometries and grounding configurations. HBC has a great potential for many emerging wearable devices and applications; accurate path loss estimation will improve system-level design leading to viable products.

Earned Income Credit Utilization by Welfare Recipients: A Case Study of Minnesota's Earned Income Credit Program

ERIC Educational Resources Information Center

Hirasuna, Donald P.; Stinson, Thomas F.

2007-01-01

This paper examines utilization of a state earned income credit by AFDC and TANF recipients. Although utilization percentages are increasing, we find that among TANF recipients in 1999, 45.7 percent of all households and 34.8 percent of eligible households did not receive the state earned income credit. Moreover, we find that utilization may…

Ethnic differences in the diagnosis of schizophrenia and mood disorders during admission to an academic safety-net psychiatric hospital.

PubMed

Hamilton, Jane E; Heads, Angela M; Meyer, Thomas D; Desai, Pratikkumar V; Okusaga, Olaoluwa O; Cho, Raymond Y

2018-05-30

U.S. Hispanics, now the single largest minority group in the country, face unique mental health disparities. The current study utilizes Andersen's Behavioral Model of Health Service Use to examine ethnic disparities in receiving a schizophrenia or mood disorder diagnosis at psychiatric hospital admission. Our retrospective cohort study examined electronic health record data at an academic safety-net psychiatric hospital for adult patients (n = 5571) admitted between 2010 and 2013. Logistic regression with block-wise entry of predisposing, enabling and need variables was used to examine ethnic disparities in receiving a schizophrenia diagnosis at admission. The block of need factors was the strongest predictor of receiving a schizophrenia diagnosis compared to predisposing and enabling factors. Compared to non-Hispanic whites, Hispanics and African Americans had a greater likelihood of receiving a schizophrenia diagnosis at admission. Additionally, patients diagnosed with schizophrenia had elevated positive and negative symptoms and were more likely to be male, single/unmarried, homeless, high inpatient service utilizers, involuntarily hospitalized, and to exhibit functional impairment at psychiatric hospital admission. To address elevated positive and negative symptoms of schizophrenia, functional impairment, social withdrawal, and high inpatient service utilization, promising psychosocial interventions should be adapted for racial and ethnic minority populations and utilized as an adjuvant to antipsychotic medication. Copyright © 2018. Published by Elsevier B.V.

PC Utilities: Small Programs with a Big Impact

ERIC Educational Resources Information Center

Baule, Steven

2004-01-01

The three utility commercial programs available on the Internet are like software packages purchased through a vendor or the Internet, shareware programs are developed by individuals and distributed via the Internet for a small fee to obtain the complete version of the product, and freeware programs are distributed via the Internet free of cost.…

Preparation of isotopic molybdenum foils utilizing small quantities of material

NASA Astrophysics Data System (ADS)

Lipski, A. R.; Lee, L. L.; Liang, J. F.; Mahon, J. C.

1993-09-01

A simple method utilizing a small amount of isotopic material for production of molybdenum foils is discussed. An e-gun is used in the procedure. The Mo powder undergoes reduction-sintering and melting-solidifying steps leading to the creation of a metallic droplet suitable for further cold rolling or vacuum deposition.

Biomass utilization for bioenergy in the Western United States

Treesearch

D.L. Nicholls; R. Monserud; D. Dykstra

2008-01-01

Wildfires, hazardous fuel buildups, small-diameter timber, wildland-urban interface zones, biomass. These are some of the terms becoming familiar to communities throughout the Western United States after the record-breaking fire seasons of the past decade. Although small-diameter stems are generally expensive to remove and often have limited utilization options, the...

The Utility of IRT in Small-Sample Testing Applications.

ERIC Educational Resources Information Center

Sireci, Stephen G.

The utility of modified item response theory (IRT) models in small sample testing applications was studied. The modified IRT models were modifications of the one- and two-parameter logistic models. One-, two-, and three-parameter models were also studied. Test data were from 4 years of a national certification examination for persons desiring…

Performance Feedback Utility in a Small Organization: Effects on Organizational Outcomes and Managerial Decision Processes.

ERIC Educational Resources Information Center

Florin-Thuma, Beth C.; Boudreau, John W.

1987-01-01

Investigated the frequent but previously untested assertion that utility analysis can improve communication and decision making about human resource management programs by examining a performance feedback intervention in a small fast-food store. Results suggest substantial payoffs from performance feedback, though the store's owner-managers had…

Impact of a district-wide health center strengthening intervention on healthcare utilization in rural Rwanda: Use of interrupted time series analysis.

PubMed

Iyer, Hari S; Hirschhorn, Lisa R; Nisingizwe, Marie Paul; Kamanzi, Emmanuel; Drobac, Peter C; Rwabukwisi, Felix C; Law, Michael R; Muhire, Andrew; Rusanganwa, Vincent; Basinga, Paulin

2017-01-01

Evaluations of health systems strengthening (HSS) interventions using observational data are rarely used for causal inference due to limited data availability. Routinely collected national data allow use of quasi-experimental designs such as interrupted time series (ITS). Rwanda has invested in a robust electronic health management information system (HMIS) that captures monthly healthcare utilization data. We used ITS to evaluate impact of an HSS intervention to improve primary health care facility readiness on health service utilization in two rural districts of Rwanda. We used controlled ITS analysis to compare changes in healthcare utilization at health centers (HC) that received the intervention (n = 13) to propensity score matched non-intervention health centers in Rwanda (n = 86) from January 2008 to December 2012. HC support included infrastructure renovation, salary support, medical equipment, referral network strengthening, and clinical training. Baseline quarterly mean outpatient visit rates and population density were used to model propensity scores. The intervention began in May 2010 and was implemented over a twelve-month period. We used monthly healthcare utilization data from the national Rwandan HMIS to study changes in the (1) number of facility deliveries per 10,000 women, (2) number of referrals for high risk pregnancy per 100,000 women, and (3) the number of outpatient visits performed per 1,000 catchment population. PHIT HC experienced significantly higher monthly delivery rates post-HSS during the April-June season than comparison (3.19/10,000, 95% CI: [0.27, 6.10]). In 2010, this represented a 13% relative increase, and in 2011, this represented a 23% relative increase. The post-HSS change in monthly rate of high-risk pregnancies referred increased slightly in intervention compared to control HC (0.03/10,000, 95% CI: [-0.007, 0.06]). There was a small immediate post-HSS increase in outpatient visit rates in intervention compared to control HC (6.64/1,000, 95% CI: [-13.52, 26.81]). We failed to find strong evidence of post-HSS increases in outpatient visit rates or referral rates at health centers, which could be explained by small sample size and high baseline nation-wide health service coverage. However, our findings demonstrate that high quality routinely collected health facility data combined with ITS can be used for rigorous policy evaluation in resource-limited settings.

Impact of a district-wide health center strengthening intervention on healthcare utilization in rural Rwanda: Use of interrupted time series analysis

PubMed Central

Iyer, Hari S.; Hirschhorn, Lisa R.; Nisingizwe, Marie Paul; Kamanzi, Emmanuel; Drobac, Peter C.; Rwabukwisi, Felix C.; Law, Michael R.; Muhire, Andrew; Rusanganwa, Vincent; Basinga, Paulin

2017-01-01

Background Evaluations of health systems strengthening (HSS) interventions using observational data are rarely used for causal inference due to limited data availability. Routinely collected national data allow use of quasi-experimental designs such as interrupted time series (ITS). Rwanda has invested in a robust electronic health management information system (HMIS) that captures monthly healthcare utilization data. We used ITS to evaluate impact of an HSS intervention to improve primary health care facility readiness on health service utilization in two rural districts of Rwanda. Methods We used controlled ITS analysis to compare changes in healthcare utilization at health centers (HC) that received the intervention (n = 13) to propensity score matched non-intervention health centers in Rwanda (n = 86) from January 2008 to December 2012. HC support included infrastructure renovation, salary support, medical equipment, referral network strengthening, and clinical training. Baseline quarterly mean outpatient visit rates and population density were used to model propensity scores. The intervention began in May 2010 and was implemented over a twelve-month period. We used monthly healthcare utilization data from the national Rwandan HMIS to study changes in the (1) number of facility deliveries per 10,000 women, (2) number of referrals for high risk pregnancy per 100,000 women, and (3) the number of outpatient visits performed per 1,000 catchment population. Results PHIT HC experienced significantly higher monthly delivery rates post-HSS during the April-June season than comparison (3.19/10,000, 95% CI: [0.27, 6.10]). In 2010, this represented a 13% relative increase, and in 2011, this represented a 23% relative increase. The post-HSS change in monthly rate of high-risk pregnancies referred increased slightly in intervention compared to control HC (0.03/10,000, 95% CI: [-0.007, 0.06]). There was a small immediate post-HSS increase in outpatient visit rates in intervention compared to control HC (6.64/1,000, 95% CI: [-13.52, 26.81]). Conclusion We failed to find strong evidence of post-HSS increases in outpatient visit rates or referral rates at health centers, which could be explained by small sample size and high baseline nation-wide health service coverage. However, our findings demonstrate that high quality routinely collected health facility data combined with ITS can be used for rigorous policy evaluation in resource-limited settings. PMID:28763505

Improvement of highly sensitive lidar with a thumb-sized sensor-head built using an optical fiber preamplifier

NASA Astrophysics Data System (ADS)

Inoue, Daisuke; Ichikawa, Tadashi; Matsubara, Hiroyuki; Mao, Xueon; Maeda, Mitsutoshi; Nagashima, Chie; Kagami, Manabu

2012-06-01

We have developed a LIDAR system with a sensor head which, although it includes a scanning mechanism, is less than 20 cc in size. The system is not only small, but is also highly sensitive. Our LIDAR system is based on time-of-flight measurements, and incorporates an optical fiber. The main feature of our system is the utilization of optical amplifiers for both the transmitter and the receiver, and the optical amplifiers enable us to exceed the detection limit set by thermal noise. In conventional LIDAR systems the detection limit is determined by the thermal noise, because the avalanche photo-diodes (APD) and trans-impedance amplifiers (TIA) that they use detect the received signals directly. In the case of our LIDAR system, the received signal is amplified by an optical fiber amplifier before reaching the photo diode and the TIA. Therefore, our LIDAR system boosts the signal level before the weak incoming signal is depleted by thermal noise. There are conditions under which the noise figure for the combination of an optical fiber amplifier and a photo diode is superior to the noise figure for an avalanche photo diode. We optimized the gains of the optical fiber amplifier and the TIA in our LIDAR system such that it would be capable of detecting a single photon. As a result, the detection limit of our system is determined by shot noise. We have previously demonstrated optical pre-amplified LIDAR with a perfect co-axial optical system[1]. For this we used a variable optical attenuator to remove internal reflection from the transmission and receiving lenses. However, the optical attenuator had an insertion loss of 6dB which reduced the sensitivity of the LIDAR. We re-designed the optical system such that it was semi-co-axial and removed the variable optical attenuator. As a result, we succeeded in scanning up to a range of 80 m. This small and highly sensitive measurement technology shows great potential for use in LIDAR.

A comparison of confidence/credible interval methods for the area under the ROC curve for continuous diagnostic tests with small sample size.

PubMed

Feng, Dai; Cortese, Giuliana; Baumgartner, Richard

2017-12-01

The receiver operating characteristic (ROC) curve is frequently used as a measure of accuracy of continuous markers in diagnostic tests. The area under the ROC curve (AUC) is arguably the most widely used summary index for the ROC curve. Although the small sample size scenario is common in medical tests, a comprehensive study of small sample size properties of various methods for the construction of the confidence/credible interval (CI) for the AUC has been by and large missing in the literature. In this paper, we describe and compare 29 non-parametric and parametric methods for the construction of the CI for the AUC when the number of available observations is small. The methods considered include not only those that have been widely adopted, but also those that have been less frequently mentioned or, to our knowledge, never applied to the AUC context. To compare different methods, we carried out a simulation study with data generated from binormal models with equal and unequal variances and from exponential models with various parameters and with equal and unequal small sample sizes. We found that the larger the true AUC value and the smaller the sample size, the larger the discrepancy among the results of different approaches. When the model is correctly specified, the parametric approaches tend to outperform the non-parametric ones. Moreover, in the non-parametric domain, we found that a method based on the Mann-Whitney statistic is in general superior to the others. We further elucidate potential issues and provide possible solutions to along with general guidance on the CI construction for the AUC when the sample size is small. Finally, we illustrate the utility of different methods through real life examples.

A Randomized, Head-to-Head Study of Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder.

PubMed

McLay, Robert N; Baird, Alicia; Webb-Murphy, Jennifer; Deal, William; Tran, Lily; Anson, Heather; Klam, Warren; Johnston, Scott

2017-04-01

Virtual reality exposure therapy (VRET) is one of the few interventions supported by randomized controlled trials for the treatment of combat-related posttraumatic stress disorder (PTSD) in active duty service members. A comparative effectiveness study was conducted to determine if virtual reality technology itself improved outcomes, or if similar results could be achieved with a control exposure therapy (CET) condition. Service members with combat-related PTSD were randomly selected to receive nine weeks of VRET or CET. Assessors, but not therapists, were blinded. PTSD symptom improvement was assessed one week and 3 months after the conclusion of treatment using the clinician-administered PTSD scale (CAPS). A small crossover component was included. Results demonstrated that PTSD symptoms improved with both treatments, but there were no statistically significant differences between groups. Dropout rates were higher in VRET. Of those who received VRET, 13/42 (31%) showed >30% improvement on the CAPS, versus 16/43 (37%) who received CET. Three months after treatment, >30% improvement was seen in 10/33 (30%) of VRET participants and 12/33 (36%) in CET. Participants who crossed over (n = 11) showed no statistically significant improvements in a second round of treatment, regardless of condition. This study supported the utility of exposure therapy for PTSD, but did not support additional benefit by the inclusion of virtual reality.

Improving Service Utilization for Parents with Substance Abuse Problems: Experimenting with Recovery Coaches in Child Welfare.

PubMed

Choi, Sam

2015-01-01

Substance abusers often face substantial systematic and personal barriers to receiving required substance abuse treatment services as well as other services; hence, various linkage mechanisms have been proposed for drug abuse treatment programs to overcome such barriers. Although there is a growing interest in the use of case management with a substance abuse background, its effectiveness in child welfare has yet to be explored. In this study the author attempts to investigate the effectiveness of case management in service utilization by systematically evaluating the five-year Alcohol and Other Drug Abuse (AODA) waiver demonstration project with Recovery Coaches in Illinois. A classic experimental design with a control group was used. Random assignment occurs at the agency level. Parents in the experimental group (N = 1562) received recovery coaches in addition to traditional child welfare services while parents in the control group (N = 598) only received traditional child welfare services. Bivariate and multivariate analyses (Ordinary Last Square regressions) were used. Compared to parents in the control group, parents in the experimental group were more likely to utilize substance abuse treatment. The results suggest that gender, education level, employment status, and the number of service needs were significantly associated with service utilization. Controlling other factors, recovery coaches improved overall service utilization. Because the outcome of child welfare often depends on the improvement of risks or resolution, it is important for parents to utilize the needed services. Future studies need to address what aspects of recovery coaches facilitate the services utilization.

7 CFR 2.88 - Director, Office of Small and Disadvantaged Business Utilization.

Code of Federal Regulations, 2010 CFR

2010-01-01

... deposits, and grants and loan activities affecting small and minority businesses including women-owned business, and the small business, small minority business, and small women-owned business subcontracting... disadvantaged, and women-owned businesses with the Small Business Administration and others in public and...

Improved noise-adding radiometer for microwave receivers

NASA Technical Reports Server (NTRS)

Batelaan, P. D.; Stelzried, C. T.; Goldstein, R. M.

1973-01-01

Use of input switch and noise reference standard is avoided by using noise-adding technique. Excess noise from solid state noise-diode is coupled into receiver through directional coupler and square-wave modulated at low rate. High sensitivity receivers for radioastronomy applications are utilized with greater confidence in stability of radiometer.

Developer handbook for Section 210 of PURPA for Vermont

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

Vanacore, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Vermont the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for New Hampshire

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

Wersan, D.; O'Connell, J.

The essential element of the Public Utility Regulatory Policies Act of 1979 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in New Hampshire the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Massachusetts

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

Vanacore, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Massachusetts the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Oregon

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

Vanacore, J.; Forbes, K.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Oregon the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for New York

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

Not Available

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in New York the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Georgia

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

Not Available

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Georgia the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for the Tennessee Valley Authority

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

Wersan, D.; Dabuliewicz, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in the Tennessee Valley Region the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Virginia

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

Not Available

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Virginia the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Montana

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

Baker, C.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Montana the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for North Carolina

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

Whitelaw, J.; Getz, T.B.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in North Carolina the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Maine

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

O'Connell, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Maine the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Arkansas

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

Not Available

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Arkansas the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Colorado

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

Not Available

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Colorado the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Pennsylvania

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

Not Available

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Pennsylvania the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Connecticut

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

O'Connell, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Connecticut the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obatining the information needed to stimulate further research and development.« less

Developer handbook for Section 210 of PURPA for Rhode Island

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

Meyer, D.; Vanacore, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Rhode Island the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... business (SDB), women-owned small business (WOSB), HUBZone small business, veteran-owned small business... negotiated. Had significant success with initiatives to assist, promote and utilize SB, SDB, WOSB, HUBZone...

Regulation of Response Regulator Autophosphorylation through Interdomain Contacts*♦

PubMed Central

Barbieri, Christopher M.; Mack, Timothy R.; Robinson, Victoria L.; Miller, Matthew T.; Stock, Ann M.

2010-01-01

DNA-binding response regulators (RRs) of the OmpR/PhoB subfamily alternate between inactive and active conformational states, with the latter having enhanced DNA-binding affinity. Phosphorylation of an aspartate residue in the receiver domain, usually via phosphotransfer from a cognate histidine kinase, stabilizes the active conformation. Many of the available structures of inactive OmpR/PhoB family proteins exhibit extensive interfaces between the N-terminal receiver and C-terminal DNA-binding domains. These interfaces invariably involve the α4-β5-α5 face of the receiver domain, the locus of the largest differences between inactive and active conformations and the surface that mediates dimerization of receiver domains in the active state. Structures of receiver domain dimers of DrrB, DrrD, and MtrA have been determined, and phosphorylation kinetics were analyzed. Analysis of phosphotransfer from small molecule phosphodonors has revealed large differences in autophosphorylation rates among OmpR/PhoB RRs. RRs with substantial domain interfaces exhibit slow rates of phosphorylation. Rates are greatly increased in isolated receiver domain constructs. Such differences are not observed between autophosphorylation rates of full-length and isolated receiver domains of a RR that lacks interdomain interfaces, and they are not observed in histidine kinase-mediated phosphotransfer. These findings suggest that domain interfaces restrict receiver domain conformational dynamics, stabilizing an inactive conformation that is catalytically incompetent for phosphotransfer from small molecule phosphodonors. Inhibition of phosphotransfer by domain interfaces provides an explanation for the observation that some RRs cannot be phosphorylated by small molecule phosphodonors in vitro and provides a potential mechanism for insulating some RRs from small molecule-mediated phosphorylation in vivo. PMID:20702407

Developing hydropower in Washington state. Volume 2: An electricity marketing manual

NASA Astrophysics Data System (ADS)

James, J. W.; McCoy, G. A.

1982-03-01

An electricity marketing manual for the potential small and micro-hydroelectric project developer within the state of Washington is presented. Public utility regulatory policies (PURPA) requires electric utilities to interconnect with and pay a rate based on their full avoided costs for the purchase of electrical output from qualifying small power production facilities. The determination of avoided costs, as business organizational considerations, utility interface concerns, interconnection requirements, metering options, and liability and wheeling are discussed. The utility responses are summarized, legislation which is of importance to hydropower developers and the powers and functions of the authorities responsible for enforcing the mandate of PURPA are described.

Reliability and cost evaluation of small isolated power systems containing photovoltaic and wind energy

NASA Astrophysics Data System (ADS)

Karki, Rajesh

Renewable energy application in electric power systems is growing rapidly worldwide due to enhanced public concerns for adverse environmental impacts and escalation in energy costs associated with the use of conventional energy sources. Photovoltaics and wind energy sources are being increasingly recognized as cost effective generation sources. A comprehensive evaluation of reliability and cost is required to analyze the actual benefits of utilizing these energy sources. The reliability aspects of utilizing renewable energy sources have largely been ignored in the past due the relatively insignificant contribution of these sources in major power systems, and consequently due to the lack of appropriate techniques. Renewable energy sources have the potential to play a significant role in the electrical energy requirements of small isolated power systems which are primarily supplied by costly diesel fuel. A relatively high renewable energy penetration can significantly reduce the system fuel costs but can also have considerable impact on the system reliability. Small isolated systems routinely plan their generating facilities using deterministic adequacy methods that cannot incorporate the highly erratic behavior of renewable energy sources. The utilization of a single probabilistic risk index has not been generally accepted in small isolated system evaluation despite its utilization in most large power utilities. Deterministic and probabilistic techniques are combined in this thesis using a system well-being approach to provide useful adequacy indices for small isolated systems that include renewable energy. This thesis presents an evaluation model for small isolated systems containing renewable energy sources by integrating simulation models that generate appropriate atmospheric data, evaluate chronological renewable power outputs and combine total available energy and load to provide useful system indices. A software tool SIPSREL+ has been developed which generates risk, well-being and energy based indices to provide realistic cost/reliability measures of utilizing renewable energy. The concepts presented and the examples illustrated in this thesis will help system planners to decide on appropriate installation sites, the types and mix of different energy generating sources, the optimum operating policies, and the optimum generation expansion plans required to meet increasing load demands in small isolated power systems containing photovoltaic and wind energy sources.

Light collection optics for measuring flux and spectrum from light-emitting devices

DOEpatents

McCord, Mark A.; DiRegolo, Joseph A.; Gluszczak, Michael R.

2016-05-24

Systems and methods for accurately measuring the luminous flux and color (spectra) from light-emitting devices are disclosed. An integrating sphere may be utilized to directly receive a first portion of light emitted by a light-emitting device through an opening defined on the integrating sphere. A light collector may be utilized to collect a second portion of light emitted by the light-emitting device and direct the second portion of light into the integrating sphere through the opening defined on the integrating sphere. A spectrometer may be utilized to measure at least one property of the first portion and the second portion of light received by the integrating sphere.

Simplified calculation of solar flux distribution on the side wall of cylindrical cavity solar receivers

NASA Technical Reports Server (NTRS)

Bhandari, P.; Wu, Y. C.; Roschke, E. J.

1989-01-01

A simple solar flux calculation algorithm for a cylindrical cavity type solar receiver has been developed and implemented on an IBM PC-AT. Using cone optics, the contour error method is utilized to handle the slope error of a paraboloidal concentrator. The flux distribution on the side wall is calculated by integration of the energy incident from cones emanating from all the differential elements on the concentrator. The calculations are done for any set of dimensions and properties of the receiver and the concentrator, and account for any spillover on the aperture plate. The results of this algorithm compared excellently with those predicted by more complicated programs. Because of the utilization of axial symmetry and overall simplification, it is extremely fast. It can be esily extended to other axisymmetric receiver geometries.

Can psychiatric liaison reduce neuroleptic use and reduce health service utilization for dementia patients residing in care facilities.

PubMed

Ballard, Clive; Powell, Ian; James, Ian; Reichelt, Katharina; Myint, Pat; Potkins, Dawn; Bannister, Carol; Lana, Marisa; Howard, Robert; O'Brien, John; Swann, Alan; Robinson, Damian; Shrimanker, Jay; Barber, Robert

2002-02-01

The quality of care and overuse of neuroleptic medication in care environments are major issues in the care of elderly people with dementia. The quality of care (Dementia Care Mapping), the severity of Behavioural and Psychological Symptoms (BPSD--Neuropsychiatric Inventory), expressive language skills (Sheffield Acquired Language Disorder scale), service utilization and use of neuroleptic drugs was compared over 9 months between six care facilities receiving a psychiatric liaison service and three facilities receiving the usual clinical support, using a single blind design. There was a significant reduction in neuroleptic usage in the facilities receiving the liaison service (McNemar test p<0.0001), but not amongst those receiving standard clinical support (McNemar test p=0.07). There were also significantly less GP contacts (t=3.9 p=0.0001) for residents in the facilities receiving the liaison service, and a three fold reduction in psychiatric in-patient bed usage (Bed days per person 0.6 vs. 1.5). Residents in care facilities receiving the liaison service experienced significantly less deterioration in expressive language skills (t=2.2 p=0.03), but there were no significant differences in BPSD or wellbeing. A resource efficient psychiatric liaison service can reduce neuroleptic drug use and reduce some aspects of health service utilization; but a more extensive intervention is probably required to improve the overall quality of care. Copyright 2002 John Wiley & Sons, Ltd.

What should a fellow-in-training expect at national cardiovascular conferences? The interventional cardiology fellows' perspective.

PubMed

Kiramijyan, Sarkis; Didier, Romain; Koifman, Edward; Negi, Smita I

It has become challenging for cardiovascular fellows-in-training (FIT) to determine which national cardiovascular conference (NCC) to attend given the broad range of meetings and the breadth of information offered. The aim of this study was to report our own experiences of the utility and individual strengths of the NCCs and to further understand the interventional cardiology (IC) FITs' viewpoint regarding the benefits of the individual NCCs. A survey was formulated with questions and scenarios regarding topics deemed to be of highest importance for an IC-FIT. The survey emphasized experiences regarding the utility and benefits of the NCCs, time management, optimization of acquired education, and specific interests in clinical and research topics. The completely anonymous survey was sent via an email format to a total of 234, majority of IC (fourth and fifth years) and a minority of general (third year), FITs. A completed survey response was received from 131 of the fellows (56%). The results demonstrated that the IC-FITs endorsed that the small, focused sub-specialty interventional meetings vs. the large society general meetings were more beneficial in regard to the didactic education offered. In addition, the IC-FITs indicated that pre-planning for the meetings is the most beneficial approach in optimizing one's education and that the caliber of expert faculty, case-based and live-case presentations are among the most important aspects of the meetings. Interventional cardiology FITs prefer the small sub-specialty interventional meetings over the large society general NCCs in regard to the benefits of didactic learning. Copyright © 2016 Elsevier Inc. All rights reserved.

A double-blind randomized discontinuation phase II study of sorafenib (BAY 43-9006) in previously treated non-small cell lung cancer patients: Eastern Cooperative Oncology Group study E2501

PubMed Central

Wakelee, Heather A.; Lee, Ju-Whei; Hanna, Nasser H.; Traynor, Anne M.; Carbone, David P.; Schiller, Joan H.

2012-01-01

Introduction Sorafenib is a raf kinase and angiogenesis inhibitor with activity in multiple cancers. This phase II study in heavily pretreated non-small cell lung cancer (NSCLC) patients (≥ two prior therapies) utilized a randomized discontinuation design. Methods Patients received 400 mg of sorafenib orally twice daily for two cycles (two months) (Step 1). Responding patients on Step 1 continued on sorafenib; progressing patients went off study, and patients with stable disease were randomized to placebo or sorafenib (Step 2), with crossover from placebo allowed upon progression. The primary endpoint of this study was the proportion of patients having stable or responding disease two months after randomization. Results : There were 299 patients evaluated for Step 1 with 81 eligible patients randomized on Step 2 who received sorafenib (n=50) or placebo (n=31). The two-month disease control rates following randomization were 54% and 23% for patients initially receiving sorafenib and placebo respectively, p=0.005. The hazard ratio for progression on Step 2 was 0.51 (95% CI 0.30, 0.87, p=0.014) favoring sorafenib. A trend in favor of overall survival with sorafenib was also observed (13.7 versus 9.0 months from time of randomization), HR 0.67 (95% CI 0.40-1.11), p=0.117. A dispensing error occurred which resulted in unblinding of some patients, but not before completion of the 8 week initial step 2 therapy. Toxicities were manageable and as expected. Conclusions : The results of this randomized discontinuation trial suggest that sorafenib has single agent activity in a heavily pretreated, enriched patient population with advanced NSCLC. These results support further investigation with sorafenib as a single agent in larger, randomized studies in NSCLC. PMID:22982658

Ultra-wideband receiver

DOEpatents

McEwan, Thomas E.

1994-01-01

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

Ultra-wideband receiver

DOEpatents

McEwan, Thomas E.

1996-01-01

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, .+-.UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals.

Flight dynamics of a pterosaur-inspired aircraft utilizing a variable-placement vertical tail.

PubMed

Roberts, Brian; Lind, Rick; Chatterjee, Sankar

2011-06-01

Mission performance for small aircraft is often dependent on the turn radius. Various biologically inspired concepts have demonstrated that performance can be improved by morphing the wings in a manner similar to birds and bats; however, the morphing of the vertical tail has received less attention since neither birds nor bats have an appreciable vertical tail. This paper investigates a design that incorporates the morphing of the vertical tail based on the cranial crest of a pterosaur. The aerodynamics demonstrate a reduction in the turn radius of 14% when placing the tail over the nose in comparison to a traditional aft-placed vertical tail. The flight dynamics associated with this configuration has unique characteristics such as a Dutch-roll mode with excessive roll motion and a skid divergence that replaces the roll convergence.

A blind squirrel finds a nut: tales from at an entrepreneurial adventure

NASA Astrophysics Data System (ADS)

Doughty, Chris

2010-03-01

When I received my PhD back in the dark days of 386 computers, fax machines, and a miserable economy it was commonly said that ``a degree in Physics is a great foundation for wide variety of non-academic career paths,'' but it was never entirely clear what those paths were. I still can't say what those paths are but can describe at least one: starting, building and ultimately exiting a small entrepreneurial business. This talk will describe at least one entrepreneurial path, where a physics background has value, where it is a liability, and what other skills the physicist needs to acquire to succeed in business. I will give a personal view of what it looks like inside a startup, lessons learned, mistakes made, and copious advice of dubious utility and value.

Langley Mobile Ozone Lidar: Ozone and Aerosol Atmospheric Profiling for Air Quality Research

NASA Technical Reports Server (NTRS)

De Young, Russell; Carrion, William; Ganoe, Rene; Pliutau, Denis; Gronoff, Guillaume; Berkoff, Timothy; Kuang, Shi

2017-01-01

The Langley mobile ozone lidar (LMOL) is a mobile ground-based ozone lidar system that consists of a pulsed UV laser producing two UV wavelengths of 286 and 291 nm with energy of approximately 0.2 mJ/pulse 0.2 mJ/pulse and repetition rate of 1 kHz. The 527 nm pump laser is also transmitted for aerosol measurements. The receiver consists of a 40 cm parabolic telescope, which is used for both backscattered analog and photon counting. The lidar is very compact and highly mobile. This demonstrates the utility of very small lidar systems eventually leading to space-based ozone lidars. The lidar has been validated by numerous ozonesonde launches and has provided ozone curtain profiles from ground to approximately 4 km in support of air quality field missions.

Full-wave receiver architecture for the homodyne motion sensor

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

Haugen, Peter C.; Dallum, Gregory E.; Welsh, Patrick A.

A homodyne motion sensor or detector based on ultra-wideband radar utilizes the entire received waveform through implementation of a voltage boosting receiver. The receiver includes a receiver input and a receiver output. A first diode is connected to the receiver output. A first charge storage capacitor is connected from between the first diode and the receiver output to ground. A second charge storage capacitor is connected between the receiver input and the first diode. A second diode is connected from between the second charge storage capacitor and the first diode to ground. The dual diode receiver performs voltage boosting ofmore » a RF signal received at the receiver input, thereby enhancing receiver sensitivity.« less

Full-wave receiver architecture for the homodyne motion sensor

DOEpatents

Haugen, Peter C; Dallum, Gregory E; Welsh, Patrick A; Romero, Carlos E

2013-11-19

A homodyne motion sensor or detector based on ultra-wideband radar utilizes the entire received waveform through implementation of a voltage boosting receiver. The receiver includes a receiver input and a receiver output. A first diode is connected to the receiver output. A first charge storage capacitor is connected from between the first diode and the receiver output to ground. A second charge storage capacitor is connected between the receiver input and the first diode. A second diode is connected from between the second charge storage capacitor and the first diode to ground. The dual diode receiver performs voltage boosting of a RF signal received at the receiver input, thereby enhancing receiver sensitivity.

The perceived and actual diagnostic utility of veterinary cytological samples.

PubMed

Skeldon, N; Dewhurst, E

2009-04-01

To establish the proportion of cytology samples sent to a commercial veterinary laboratory that yields diagnostically useful information in the context of current use and perceptions of cytology. Nine hundred and forty-five cytology submissions were retrospectively collected and categorised according to diagnostic utility. A survey into the use and perceptions of cytology was distributed at the British Small Animal Veterinary Association Congress 2008. A specific diagnosis was reached in 23.1 per cent of samples and a cytological diagnosis in 35.3 per cent. 22.4 per cent of samples yielded some useful information, but 19.2 per cent were unacceptable. Seventy-four participants in the survey took an average of 3.9 cytological samples per week, of which they examined 27.0 per cent in-house only, 21.6 per cent in-house before sending to an external laboratory and 51.4 per cent were sent externally without prior examination. "To obtain a definitive diagnosis" was the principal reason cited for performing cytology. Results suggest that cytology is underused and may be applied in an inappropriate context in the UK. It is hoped that illustrating the diagnostic outcome of samples received by a commercial laboratory will encourage increased, appropriate use of cytology.

Initial flight test of a Loran-C receiver/data collection system

NASA Technical Reports Server (NTRS)

Fischer, J. P.; Nickum, J. D.

1978-01-01

Development of a low cost Loran C receiver for general aviation use is discussed. The preparation and procedure of a flight test conducted with a receiver design which utilizes a phase locked loop oscillator to track the Loran C signals is described. It is indicated that such a receiver is a viable alternative for future work in developing a low cost Loran-C navigator.

Compact Refractive Imaging Spectrometer Designs Utilizing Immersed Gratings

DOEpatents

Lerner, Scott A.; Bennett, Charles L.; Bixler, Jay V.; Kuzmenko, Paul J.; Lewis, Isabella T.

2005-07-26

A compact imaging spectrometer comprising an entrance slit for directing light, a first means for receiving the light and focusing the light, an immersed diffraction grating that receives the light from the first means and defracts the light, a second means for receiving the light from the immersed diffraction grating and focusing the light, and an image plane that receives the light from the second means

Bevacizumab-induced chronic interstitial pneumonia during maintenance therapy in non-small cell lung cancer.

PubMed

Sekimoto, Yasuhito; Kato, Motoyasu; Shukuya, Takehiko; Koyama, Ryo; Nagaoka, Tetsutaro; Takahashi, Kazuhisa

2016-04-01

Bevacizumab is a monoclonal antibody targeting the vascular endothelial growth factor receptor and a key drug for advanced non-small cell lung cancer. There are few reports describing bevacizumab-induced chronic interstitial pneumonia. A 62-year-old man with advanced non-small cell lung cancer was admitted to our hospital with dyspnea. He previously received four courses of carboplatin plus paclitaxel with bevacizumab combination therapy and thereafter received four courses of maintenance bevacizumab monotherapy. A chest-computed tomography scan on admission revealed diffuse ground glass opacity. He had not received any other drugs and did not have pneumonia. Thus, he was diagnosed with bevacizumab-induced chronic interstitial pneumonia and was treated with a high dose of corticosteroids. After steroid treatment, his dyspnea and radiological findings improved. This case report is the first description of bevacizumab-induced chronic interstitial pneumonia during maintenance therapy in a patient with non-small cell lung cancer.

Implementation of infants risk detection sensing system using IoT

NASA Astrophysics Data System (ADS)

Yang, Youseok; Lee, Taeo; Lee, Yechan; Choi, Jaehyeon; Park, Eunju; Lim, Hankyu

2017-06-01

Infants are vulnerable to surrounding environment and they receive large influence from even a small change. As their body composition is not complete yet, infants receive huge impact from small pressure. Small change can cause disease or even death of infants. This paper designed and implemented a risk-detection system for infants. In addition to the fundamental function of safety management system, the risk-detection system implemented in this paper in corporate child-caring function by using a variety of sensors.

Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students.

PubMed

Chamberlain, Neal R; Stuart, Melissa K; Singh, Vineet K; Sargentini, Neil J

2012-01-01

Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) METHODS: Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians.

Theoretical assessment of the maximum obtainable power in wireless power transfer constrained by human body exposure limits in a typical room scenario.

PubMed

Chen, Xi Lin; De Santis, Valerio; Umenei, Aghuinyue Esai

2014-07-07

In this study, the maximum received power obtainable through wireless power transfer (WPT) by a small receiver (Rx) coil from a relatively large transmitter (Tx) coil is numerically estimated in the frequency range from 100 kHz to 10 MHz based on human body exposure limits. Analytical calculations were first conducted to determine the worst-case coupling between a homogeneous cylindrical phantom with a radius of 0.65 m and a Tx coil positioned 0.1 m away with the radius ranging from 0.25 to 2.5 m. Subsequently, three high-resolution anatomical models were employed to compute the peak induced field intensities with respect to various Tx coil locations and dimensions. Based on the computational results, scaling factors which correlate the cylindrical phantom and anatomical model results were derived. Next, the optimal operating frequency, at which the highest transmitter source power can be utilized without exceeding the exposure limits, is found to be around 2 MHz. Finally, a formulation is proposed to estimate the maximum obtainable power of WPT in a typical room scenario while adhering to the human body exposure compliance mandates.

Theoretical assessment of the maximum obtainable power in wireless power transfer constrained by human body exposure limits in a typical room scenario

NASA Astrophysics Data System (ADS)

Chen, Xi Lin; De Santis, Valerio; Esai Umenei, Aghuinyue

2014-07-01

In this study, the maximum received power obtainable through wireless power transfer (WPT) by a small receiver (Rx) coil from a relatively large transmitter (Tx) coil is numerically estimated in the frequency range from 100 kHz to 10 MHz based on human body exposure limits. Analytical calculations were first conducted to determine the worst-case coupling between a homogeneous cylindrical phantom with a radius of 0.65 m and a Tx coil positioned 0.1 m away with the radius ranging from 0.25 to 2.5 m. Subsequently, three high-resolution anatomical models were employed to compute the peak induced field intensities with respect to various Tx coil locations and dimensions. Based on the computational results, scaling factors which correlate the cylindrical phantom and anatomical model results were derived. Next, the optimal operating frequency, at which the highest transmitter source power can be utilized without exceeding the exposure limits, is found to be around 2 MHz. Finally, a formulation is proposed to estimate the maximum obtainable power of WPT in a typical room scenario while adhering to the human body exposure compliance mandates.

77 FR 65380 - Notice of Proposed Administrative Settlement Pursuant to the Comprehensive Environmental Response...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-26

... Gulf State Utilities--North Ryan Street Superfund Site, Lake Charles, Calcasieu Parish, Louisiana. The... will receive written comments relating to this notice and will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the...

Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database.

PubMed

Lin, Heui-Fen; Wu, Ying-Tai; Tsauo, Jau-Yih

2012-08-16

Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients' functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients remain unmet.

Are Posttraumatic Stress Symptoms Related to Mental Health Service Use? A Prospective Study of Danish Soldiers Deployed to Afghanistan.

PubMed

Madsen, Trine; Andersen, Søren Bo; Karstoft, Karen-Inge

2016-10-01

Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan. Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers responded to a comprehensive questionnaire including a measure of PTSD symptoms (the PTSD Checklist-Civilian version). These self-reported data were combined with individual-level records of receiving psychotherapy from the Military Psychological Division at the Danish Defense and psychiatric treatment from the Danish registers. The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription for psychiatric medicine. Approximately one-third received psychotherapy at the Military Psychological Division. In those reporting high PTSD symptomatology, 83% utilized 1 or more types of mental health service. At predeployment and homecoming, high PTSD symptomatology was significantly (P < .01) associated with attending psychotherapy, but not with psychiatric treatment or redemption of psychiatric medicine. With time, more soldiers report high PTSD symptoms. Among Danish soldiers with high symptomatology, the utilization of mental health services was high. Most frequently, soldiers with high PTSD symptomatology received psychotherapy at the Military Psychological Division and less frequently received psychiatric treatment. © Copyright 2016 Physicians Postgraduate Press, Inc.

Modeling of coupling mechanism of wireless power transfer system and vibration phenomenon of receiver-coil in three-coil system

NASA Astrophysics Data System (ADS)

Liu, Suqi; Tan, Jianping; Wen, Xue

2017-11-01

Wireless power transfer (WPT) via coupled magnetic resonances has become a focus recently, but the mechanisms responsible for such work are uncertain. We found that WPT system is a self-organization system by utilizing self-organization theory to judge. Firstly, the circuit model was established and transfer characteristic of a system was researched by utilizing circuit theories. Thus, with the introduction of entropy variable S, the energy equation of state can be established from the energy of the transmitter side and the energy of the receiver side. According to the energy equation of state, this paper obtains two equations when the reactance of the transmitter side and the receiver side equate to zero respectively. The vibration phenomenon of the receiver-coil in a three-coil WPT system was predicted and explained. Our findings illuminate the unusual self-organization in the WPT system and explain the vibration phenomenon of the receiver-coil in a three-coil WPT system.

Frequency-Locked Detector Threshold Setting Criteria Based on Mean-Time-To-Lose-Lock (MTLL) for GPS Receivers

PubMed Central

Zhao, Na; Qin, Honglei; Sun, Kewen; Ji, Yuanfa

2017-01-01

Frequency-locked detector (FLD) has been widely utilized in tracking loops of Global Positioning System (GPS) receivers to indicate their locking status. The relation between FLD and lock status has been seldom discussed. The traditional PLL experience is not suitable for FLL. In this paper, the threshold setting criteria for frequency-locked detector in the GPS receiver has been proposed by analyzing statistical characteristic of FLD output. The approximate probability distribution of frequency-locked detector is theoretically derived by using a statistical approach, which reveals the relationship between probabilities of frequency-locked detector and the carrier-to-noise ratio (C/N0) of the received GPS signal. The relationship among mean-time-to-lose-lock (MTLL), detection threshold and lock probability related to C/N0 can be further discovered by utilizing this probability. Therefore, a theoretical basis for threshold setting criteria in frequency locked loops for GPS receivers is provided based on mean-time-to-lose-lock analysis. PMID:29207546

Multi-Band Received Signal Strength Fingerprinting Based Indoor Location System

NASA Astrophysics Data System (ADS)

Sertthin, Chinnapat; Fujii, Takeo; Ohtsuki, Tomoaki; Nakagawa, Masao

This paper proposes a new multi-band received signal strength (MRSS) fingerprinting based indoor location system, which employs the frequency diversity on the conventional single-band received signal strength (RSS) fingerprinting based indoor location system. In the proposed system, the impacts of frequency diversity on the enhancements of positioning accuracy are analyzed. Effectiveness of the proposed system is proved by experimental approach, which was conducted in non line-of-sight (NLOS) environment under the area of 103m2 at Yagami Campus, Keio University. WLAN access points, which simultaneously transmit dual-band signal of 2.4 and 5.2GHz, are utilized as transmitters. Likewise, a dual-band WLAN receiver is utilized as a receiver. Signal distances calculated by both Manhattan and Euclidean were classified by K-Nearest Neighbor (KNN) classifier to illustrate the performance of the proposed system. The results confirmed that Frequency diversity attributions of multi-band signal provide accuracy improvement over 50% of the conventional single-band.

Frequency-Locked Detector Threshold Setting Criteria Based on Mean-Time-To-Lose-Lock (MTLL) for GPS Receivers.

PubMed

Jin, Tian; Yuan, Heliang; Zhao, Na; Qin, Honglei; Sun, Kewen; Ji, Yuanfa

2017-12-04

Frequency-locked detector (FLD) has been widely utilized in tracking loops of Global Positioning System (GPS) receivers to indicate their locking status. The relation between FLD and lock status has been seldom discussed. The traditional PLL experience is not suitable for FLL. In this paper, the threshold setting criteria for frequency-locked detector in the GPS receiver has been proposed by analyzing statistical characteristic of FLD output. The approximate probability distribution of frequency-locked detector is theoretically derived by using a statistical approach, which reveals the relationship between probabilities of frequency-locked detector and the carrier-to-noise ratio ( C / N ₀) of the received GPS signal. The relationship among mean-time-to-lose-lock (MTLL), detection threshold and lock probability related to C / N ₀ can be further discovered by utilizing this probability. Therefore, a theoretical basis for threshold setting criteria in frequency locked loops for GPS receivers is provided based on mean-time-to-lose-lock analysis.

Studying Cosmic Evolution with 21 cm Intensity Mapping

NASA Astrophysics Data System (ADS)

Anderson, Christopher

This thesis describes early work in the developing field of 21-cm intensity mapping. The 21-cm line is a radio transition due to the hyperfine splitting of the ground state of neutral hydrogen (HI). Intensity mapping utilizes the aggregate redshifted 21-cm emission to map the three-dimensional distribution of HI on large scales. In principle, the 21-cm line can be utilized to map most of the volume of the observable Universe. But the signal is small, and dedicated instruments will be required to reach a high signal-to-noise ratio. Large spectrally smooth astrophysical foregrounds, which dwarf the 21-cm signal, present a significant challenge to the data analysis. I derive the fundamental physics of the 21-cm line and the size of the expected cosmological signal. I also provide an overview of the desired characteristics of a dedicated 21-cm instrument, and I list some instruments that are coming on-line in the next few years. I then describe the data analysis techniques and results for 21-cm intensity maps that were made with two existing radio telescopes, the Green Bank telescope (GBT) and the Parkes telescope. Both observations have detected the 21-cm HI signal by cross-correlating the 21-cm intensity maps with overlapping optical galaxy surveys. The GBT maps have been used to constrain the neutral hydrogen density at a mean redshift (z) of 0.8. The Parkes maps, at a mean redshift of 0.08, probe smaller scales. The Parkes 21-cm intensity maps reveal a lack of small-scale clustering when they are cross-correlated with 2dF optical galaxy maps. This lack of small-scale clustering is partially due to a scale-dependent and galaxy-color-dependent HI-galaxy cross- correlation coefficient. Lastly, I provide an overview of planned future analyses with the Parkes maps, with a proposed multi-beam receiver for the Green Bank telescope, and with simulations of systematic effects on foregrounds.

Small-for-gestational age and large-for-gestational age thresholds to predict infants at risk of adverse delivery and neonatal outcomes: are current charts adequate? An observational study from the Born in Bradford cohort

PubMed Central

Norris, T; Johnson, W; Farrar, D; Tuffnell, D; Wright, J; Cameron, N

2015-01-01

Objectives Construct an ethnic-specific chart and compare the prediction of adverse outcomes using this chart with the clinically recommended UK-WHO and customised birth weight charts using cut-offs for small-for-gestational age (SGA: birth weight <10th centile) and large-for-gestational age (LGA: birth weight >90th centile). Design Prospective cohort study. Setting Born in Bradford (BiB) study, UK. Participants 3980 White British and 4448 Pakistani infants with complete data for gestational age, birth weight, ethnicity, maternal height, weight and parity. Main outcome measures Prevalence of SGA and LGA, using the three charts and indicators of diagnostic utility (sensitivity, specificity and area under the receiver operating characteristic (AUROC)) of these chart-specific cut-offs to predict delivery and neonatal outcomes and a composite outcome. Results In White British and Pakistani infants, the prevalence of SGA and LGA differed depending on the chart used. Increased risk of SGA was observed when using the UK-WHO and customised charts as opposed to the ethnic-specific chart, while the opposite was apparent when classifying LGA infants. However, the predictive utility of all three charts to identify adverse clinical outcomes was poor, with only the prediction of shoulder dystocia achieving an AUROC>0.62 on all three charts. Conclusions Despite being recommended in national clinical guidelines, the UK-WHO and customised birth weight charts perform poorly at identifying infants at risk of adverse neonatal outcomes. Being small or large may increase the risk of an adverse outcome; however, size alone is not sensitive or specific enough with current detection to be useful. However, a significant amount of missing data for some of the outcomes may have limited the power needed to determine true associations. PMID:25783424

77 FR 39125 - Defense Acquisition Regulations System; Defense Federal Acquisition Regulation Supplement; Only...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... resolicitation period has been added to address the application to small business set-asides. The final rule... transactional process time in all cases where only a single offer is received in response to a competitive... requirement, if only one offer is received, has also been added for small business set-asides. c. Requirements...

Comparison of Healthcare Utilization Among Patients Treated With Alcoholism Medications

PubMed Central

Mark, Tami L.; Montejano, Leslie B.; Kranzler, Henry R.; Chalk, Mady; Gastfriend, David R.

2014-01-01

Objectives To determine in a large claims database the healthcare utilization and costs associated with treatment of alcohol dependence with medications vs no medication and across 4 US Food and Drug Administration (FDA)–approved medications. Study Design Claims database analysis. Methods Eligible adults with alcohol dependence claims (n = 27,135) were identified in a commercial database (MarketScan; Thomson Reuters Inc, Chicago, Illinois). Following propensity score–based matching and inverse probability weighting on demographic, clinical, and healthcare utilization variables, patients who had used an FDA-approved medication for alcohol dependence (n = 2977) were compared with patients who had not (n = 2977). Patients treated with oral naltrexone hydrochloride (n = 2064), oral disulfiram (n = 2076), oral acamprosate calcium (n = 5068), or extended-release injectable naltrexone (naltrexone XR) (n = 295) were also compared for 6-month utilization rates of alcoholism medication, inpatient detoxification days, alcoholism-related inpatient days, and outpatient services, as well as inpatient charges. Results Patients who received alcoholism medications had fewer inpatient detoxification days (706 vs 1163 days per 1000 patients, P <.001), alcoholism-related inpatient days (650 vs 1086 days, P <.001), and alcoholism-related emergency department visits (127 vs 171, P = .005). Among 4 medications, the use of naltrexone XR was associated with fewer inpatient detoxification days (224 days per 1000 patients) than the use of oral naltrexone (552 days, P = .001), disulfiram (403 days, P = .049), or acamprosate (525 days, P <.001). The group receiving naltrexone XR also had fewer alcoholism-related inpatient days than the groups receiving disulfiram or acamprosate. More patients in the naltrexone XR group had an outpatient substance abuse visit compared with patients in the oral alcoholism medication groups. Conclusion Patients who received an alcoholism medication had lower healthcare utilization than patients who did not. Naltrexone XR showed an advantage over oral medications in healthcare utilization and costs. PMID:21348558

Pulmonary rehabilitation in COPD – available resources and utilization in Swedish primary and secondary care

PubMed Central

Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

2017-01-01

Introduction Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Materials and methods Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. Results In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Conclusion Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD. PMID:28652722

Efficient preparation of graphene liquid cell utilizing direct transfer with large-area well-stitched graphene

NASA Astrophysics Data System (ADS)

Sasaki, Yuki; Kitaura, Ryo; Yuk, Jong Min; Zettl, Alex; Shinohara, Hisanori

2016-04-01

By utilizing graphene-sandwiched structures recently developed in this laboratory, we are able to visualize small droplets of liquids in nanometer scale. We have found that small water droplets as small as several tens of nanometers sandwiched by two single-layer graphene are frequently observed by TEM. Due to the electron beam irradiation during the TEM observation, these sandwiched droplets are frequently moving from one place to another and are subjected to create small bubbles inside. The synthesis of a large area single-domain graphene of high-quality is essential to prepare the graphene sandwiched cell which safely encapsulates the droplets in nanometer size.

Designing PURPA (Public Utilities Regulatory Policies Act) power purchase auctions: Theory and practice. [Buys from cogenerators and small power generators

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

Not Available

The Public Utilities Regulatory Act (PURPA) requires there to be procedures for electric utilities to buy electric power from qualifying cogenerators and small power producers (QFs) at rates up to ''avoided cost''. This has led to price-posting procedures at prices calculated as the utility's marginal cost. Unexpectedly large sales at these prices and slow adjustment to falling energy cost are partially responsible for payments to QFs in excess of the utility's true avoided cost. Using competitive bidding instead of posted prices has been proposed as a way to avoid this outcome. This report reviews bidding theory and explores four issuesmore » that arise in designing auction systems for the purchase of power from QFs under PURPA.« less

Variation in the Use of Therapy following Distal Radius Fractures in the United States

PubMed Central

Waljee, Jennifer F.; Zhong, Lin; Shauver, Melissa

2014-01-01

Background: Distal radius fractures (DRFs) are one of the most common injuries among the elderly, resulting in significant expense and disability. The specific aims of this study are (1) to examine rates of therapy following DRFs and (2) to identify those factors that influence utilization of therapy and time span between DRF treatment and therapy among a national cohort of elderly patients. Methods: We examined national use of physical and occupational therapy among all Medicare beneficiaries who suffered DRFs between January 1, 2007, and October 1, 2007, and assessed the effect of treatment, patient-related, and surgeon-related factors on utilization of therapy. Results: Overall, 20.6% of patients received either physical or occupational therapy following DRF. Use of therapy varied by DRF treatment, and patients who underwent open reduction and internal fixation were more likely to receive therapy compared with patients who received closed reduction. Patients who received open reduction and internal fixation were also referred to therapy earlier compared with patients who received external fixation, percutaneous pinning, and closed reduction. Surgeon specialization is associated with greater use of postoperative therapy. Patient predictors of therapy use include younger age, female sex, higher socioeconomic status, and fewer comorbidity conditions. Conclusion: Use of therapy following DRF varies significantly by both patient- and surgeon-related factors. Identifying patients who benefit from postinjury therapy can allow for better resource utilization following these common injuries. PMID:25289323

Thermo-mechanical and optical optimization of the molten salt receiver for a given heliostat field

NASA Astrophysics Data System (ADS)

Augsburger, Germain; Das, Apurba K.; Boschek, Erik; Clark, Michael M.

2016-05-01

The tower type molten salt solar thermal power plant has proven to be advantageous over other utility scale solar power plant configurations due to its scalability and provision of storage, thereby improving the dispatchability. The configuration consists of a molten salt central receiver (MSCR) located atop an optimally located tower within a heliostat field with thousands of mirrors. The MSCR receives the concentrated energy from the heliostat field which heats a molten salt heat transfer fluid for thermal storage and utilization in producing steam as and when required for power generation. The MSCR heat transfer surface consists of banks of tangent tubes arranged in panels. The combined cost of the heliostat field and the receiver is 40%-50% of the total plant cost, which calls for optimization to maximize their utilization. Several previous studies have looked into the optimum solar power plant size based on various site conditions. However, the combined optimization of the receiver and the heliostat field has not been reported before. This study looks into the optimum configuration of the receiver for a given heliostat field. An in-house tool has been developed to select and rank a few receiver surface configurations (typically <50) from a list of hundreds of thousands of possible options. The operating limits which the heliostat field needs to obey are defined for the ranked surface configurations based on several different design considerations (e.g. mechanical integrity, corrosion limits). The thermal output of the receiver configurations for a given heliostat field is maximized. A combined rank indicating the optimum configurations in descending order of preference is presented based on the performance and various other practical considerations (e.g. total surface area, cost of material, ability of aiming strategies to distribute the flux). The methodology thus provided can be used as a guideline to arrive at an optimum receiver configuration for a given heliostat field.

48 CFR 970.2671-1 - Policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Energy policy recognizes that full utilization of the talents and capabilities of a diverse work... and enhance partnerships with small, small disadvantaged, women-owned small businesses, and... disadvantaged, women-owned small business, and educational activity; and to develop innovative strategies to...

Renewable power sparks financial interest

NASA Astrophysics Data System (ADS)

Norman, C.

1981-06-01

A legal and economic assessment is given of section 210 of the Public Utility Regulatory Practices Act (PURPA) of 1978, which guarantees a market for small electrical power producers by requiring utilities to buy from them at premium rates and, in addition, exempts them from regulatory restrictions imposed on utilities. To qualify, small power producers are limited to a capacity of 80 MW at any one site, and they must use such renewable energy sources as wind, hydroelectric, biomass, solar, and waste products. There is no size limit for industrial cogeneration facilities, but those that burn oil or natural gas must meet efficiency standards to qualify. Section 210 has, however, been seriously challenged in the courts by utility companies viewing it as a Federal infringement of the right of States to regulate their utilities; a court ruling favorable to the utilities has already been given in Mississippi, and similar rulings are being sought in New York.

77 FR 9303 - National Emission Standards for Hazardous Air Pollutants From Coal- and Oil-Fired Electric...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... Utility Steam Generating Units and Standards of Performance for Fossil-Fuel-Fired Electric Utility... Performance for Fossil-Fuel-Fired Electric Utility, Industrial-Commercial-Institutional, and Small Industrial... electric utility steam generating units (EGUs) and standards of performance for fossil-fuel-fired electric...

Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment.

PubMed

DeViva, Jason C; Sheerin, Christina M; Southwick, Steven M; Roy, Alicia M; Pietrzak, Robert H; Harpaz-Rotem, Ilan

2016-05-01

Veterans of Operations Iraqi Freedom/Enduring Freedom/New Dawn (OEF/OIF/OND) tend not to engage in mental health care. Identifying modifiable factors related to mental health service utilization could facilitate development of interventions to increase utilization. The current study examined the relationship between mental health care utilization and measures of PTSD symptoms, resilience, stigma, beliefs about mental health care, perceived barriers to mental health care, posttraumatic growth and meaning, social support, and personality factors in a sample of 100 OEF/OIF/OND veterans with PTSD symptoms referred to VA mental health care. Participants who received psychotherapy and pharmacotherapy (PP) scored higher on measures of PTSD symptoms, stigma, and adaptive beliefs about mental health treatment, and lower on measures of resilience, postdeployment social support, emotional stability, and conscientiousness, than participants who received no treatment (NT). Participants who received psychotherapy only (PT) scored higher on a measure of PTSD symptoms than NT participants. PT participants scored higher on an emotional stability measure and lower on measures of PTSD symptoms and stigma than PP participants. Multinomial logistic regression including all variables significantly related to treatment utilization indicated that PTSD symptoms and adaptive beliefs about psychotherapy and pharmacotherapy were higher in the PT and PP groups than in the NT group, and concerns about discrimination were higher in the PP group than the NT group. Interventions targeting beliefs about mental health care could increase mental health treatment utilization among OEF/OIF/OND veterans. Concerns about stigma may affect the utilization process differently at different decision points. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Impact of chiropractic services at an on-site health center.

PubMed

Kindermann, Sylvia L; Hou, Qingjiang; Miller, Ross M

2014-09-01

To compare the influence of employer-sponsored, on-site chiropractic care against community-obtained care on health care utilization. This was a retrospective claims analysis of members of a single employee health plan receiving chiropractic care on-site or off-site from 2010 to 2012. Utilization differences were evaluated by having 1 health care event or more, including radiology or clinical visits. There were 876 on-site and 759 off-site participants. The off-site group received more radiology services overall (55.5% vs 38.2%; P < 0.001) including magnetic resonance imaging, ultrasound, and radiograph (all P < 0.0001); had higher outpatient (P < 0.0001) and emergency department (P = 0.022) utilization; and demonstrated greater use of chiropractic care and physical therapy (both P < 0.0001). Compared with off-site care, on-site chiropractic services are associated with lower health care utilization. These results support the value of chiropractic services offered at on-site health centers.

A feasibility study on solar utility total energy system /SUTES/

NASA Astrophysics Data System (ADS)

Bilgen, E.

1980-11-01

A fully dedicated central receiver solar utility (CRSU) designed to meet domestic energy requirements for space heating and hot water has been synthesized and assessed at the conceptual level. The solar utility total energy system (SUTES) integrates (1) a central receiver solar utility (CRSU), (2) an electrical power generating system (EPGS), (3) a hydrogen production plant (HPP), (4) a water chilling system for cooling, heat pump system (HPS), (5) necessary thermal energy storage systems (TES), (6) a district heating and cooling system (DH&CS). All subsystems are close-coupled. Using consistent costing bases, it has been found that the SUTES concept provides energy costs which are lower than those provided by a CRSU. Representative costs are $3.14/GJ versus $8.56/GJ for 10 percent recovery factor and $12.55/GJ versus $13.47/GJ for 17.5 percent recovery factor.

48 CFR 919.705-6 - Postaward responsibilities of the contracting officer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF ENERGY SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Subcontracting With Small Business, Small Disadvantaged Business, and Women-Owned Small Business Concerns 919.705-6 Postaward responsibilities of the... Small and Disadvantaged Business Utilization. [49 FR 11997, Mar. 28, 1984, as amended at 59 FR 9106, Feb...

77 FR 38181 - VA Veteran-Owned Small Business Verification Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business... small businesses (VOSBs), including service-disabled veteran-owned small businesses (SDVOSBs) in order...- AO49--VA Veteran-Owned Small Business Verification Guidelines.'' All comments received will be...

Current and Near-Term Future Measurements of the Orbital Debris Environment at NASA

NASA Technical Reports Server (NTRS)

Stansbery, Gene; Liou, J.-C.; Mulrooney, M.; Horstman, M

2010-01-01

The NASA Orbital Debris Program Office places great emphasis on obtaining and understanding direct measurements of the orbital debris environment. The Orbital Debris Program Office's environmental models are all based on these measurements. Because OD measurements must cover a very wide range of sizes and altitudes, one technique realistically cannot be used for all measurements. In general, radar measurements have been used for lower altitudes and optical measurements for higher altitude orbits. For very small debris, in situ measurements such as returned spacecraft surfaces are utilized. In addition to receiving information from large debris (> 5-10 cm diameter) from the U.S. Space Surveillance Network, NASA conducts statistical measurements of the debris population for smaller sizes. NASA collects data from the Haystack and Goldstone radars for debris in low Earth orbit as small as 2- 4 mm diameter and from the Michigan Orbital DEbris Survey Telescope for debris near geosynchronous orbit altitude for sizes as small as 30-60 cm diameter. NASA is also currently examining the radiator panel of the Hubble Space Telescope Wide Field Planetary Camera 2 which was exposed to space for 16 years and was recently returned to Earth during the STS- 125 Space Shuttle mission. This paper will give an overview of these on-going measurement programs at NASA as well as discuss progress and plans for new instruments and techniques in the near future.

48 CFR 19.708 - Contract clauses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.708 Contract clauses. (a) Insert the clause at 52.219-8, Utilization of Small Business Concerns, in solicitations and contracts... clause at 52.219-9, Small Business Subcontracting Plan, in solicitations and contracts that offer...

48 CFR 19.708 - Contract clauses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.708 Contract clauses. (a) Insert the clause at 52.219-8, Utilization of Small Business Concerns, in solicitations and contracts... clause at 52.219-9, Small Business Subcontracting Plan, in solicitations and contracts that offer...

48 CFR 19.708 - Contract clauses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.708 Contract clauses. (a) Insert the clause at 52.219-8, Utilization of Small Business Concerns, in solicitations and contracts... clause at 52.219-9, Small Business Subcontracting Plan, in solicitations and contracts that offer...

48 CFR 19.708 - Contract clauses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.708 Contract clauses. (a) Insert the clause at 52.219-8, Utilization of Small Business Concerns, in solicitations and contracts... clause at 52.219-9, Small Business Subcontracting Plan, in solicitations and contracts that offer...

Low cost omega navigation receiver

NASA Technical Reports Server (NTRS)

Lilley, R. W.

1974-01-01

The development of a low cost Omega navigation receiver is discussed. Emphasis is placed on the completion and testing of a modular, multipurpose Omega receiver which utilizes a digital memory-aided, phase-locked loop to provide phase measurement data to a variety of applications interfaces. The functional units contained in the prototype device are described. The receiver is capable of receiving and storing phase measurements for up to eight Omega signals and computes two switch-selectable lines of position, displaying this navigation data in chart-recorded form.

Racial Disparities in Orthodontic Service Utilization for Medicaid-Enrolled Children: An Evaluation of the Washington Medicaid Program

PubMed Central

Merritt, Jantraveus M.; Greenlee, Geoffrey; Bollen, Anne Marie; Scott, JoAnna M.; Chi, Donald L.

2016-01-01

Introduction We assess the relationship between race and orthodontic service utilization for Medicaid-enrolled children. Methods This cross-sectional study focused on 570,364 Washington Medicaid-enrolled children ages 6-19 years. The main predictor variable was self-reported race (White versus non-White). The outcome variable was orthodontic service utilization, defined as children who were pre-authorized for orthodontic treatment by Medicaid in 2012 and subsequently received orthodontic records and initiated treatment. Logistic regression models were used to test the hypothesis that non-Whites would be less likely to utilize orthodontic care than Whites. Results A total of 8,223 children were approved by Medicaid for orthodontic treatment and 7,313 received records and initiated treatment. Non-Whites were significantly more likely to utilize orthodontic care than Whites (Odds Ratio [OR]=1.18; 95% confidence interval [CI]=1.02, 1.36; p=.031). Hispanic non-White children were more likely to utilize orthodontic care than non-Hispanic White children (OR=1.42; 95% CI=1.18, 1.70; p<.001). Conclusion In 2012, non-White children in Washington Medicaid were significantly more likely to utilize orthodontic care than White children. The Washington Medicaid program demonstrates a potential model for addressing racial disparities in orthodontic service utilization. Future research should identify mechanisms underlying these findings and continue to monitor orthodontic service utilization for minority children in Medicaid. PMID:27021456

Heat-Energy Analysis for Solar Receivers

NASA Technical Reports Server (NTRS)

Lansing, F. L.

1982-01-01

Heat-energy analysis program (HEAP) solves general heat-transfer problems, with some specific features that are "custom made" for analyzing solar receivers. Can be utilized not only to predict receiver performance under varying solar flux, ambient temperature and local heat-transfer rates but also to detect locations of hotspots and metallurgical difficulties and to predict performance sensitivity of neighboring component parameters.

Communications/Electronics Receiver Performance Degradation Handbook (Second Edition)

DTIC Science & Technology

1975-08-01

receiver to another in the Rf and IF filter characteristics modify the transfer of inter- forence power through the receiver to the IF output, and so the...modulation system the transmitted and received messages arce in general different bemaus* of small inte, forence or noise perturbations. The probability of

The development of an in-house dispensary in a college health center.

PubMed

Nicoteri, Jo Ann L

2016-04-01

A small college health center discovered that students perceived obtaining prescribed medication was a barrier to adherence to short-term antibiotic therapy. To address this specific barrier, an in-house dispensary was developed and modified over the past several years to meet the needs of students. Partnering with a local pharmacy has made the process of obtaining prescriptions easier for the students. Data were extracted from the electronic health records at Student Health Services for the academic year 2014-2015. A total of 910 prescriptions were filled in-house during that time, compared to 102 prescriptions written for purchase elsewhere. Students are utilizing the in-house dispensary more often than taking a prescription to a pharmacy and generally regard the service as convenient. Despite challenges in changing drug prices and other factors that influence medication adherence, dispensing a small number of drugs in the clinic has been feasible and well received. Nurse practitioners must be aware of specific perceived barriers for their practice population and develop interventions to overcome them. The evaluation of such interventions is imperative for modifications and sustainability. ©2016 American Association of Nurse Practitioners.

Development of out-of-hours primary care by general practitioners (GPs) in The Netherlands: from small-call rotations to large-scale GP cooperatives.

PubMed

van Uden, Caro J T; Giesen, Paul H J; Metsemakers, Job F M; Grol, Richard P T M

2006-09-01

Over the last 10 years, care outside office hours by primary care physicians in The Netherlands has experienced a radical change. While Dutch general practitioners (GPs) formerly performed these services in small-call rotations, care is nowadays delivered by large-scale GP cooperatives. We searched the literature for relevant studies on the effect of the out-of-hours care reorganization in The Netherlands. We identified research that included before- and afterintervention studies, descriptive studies, and surveys. These studies focused on the consequences of reorganizing several aspects of out-of-hours care, such as patient and GP satisfaction, patient characteristics, utilization of care, and costs. Various studies showed that the reorganization has successfully addressed many of the critical issues that Dutch GPs were confronted with delivering these services. GPs' job satisfaction has increased, and patients seem to be satisfied with current out-of-hours care. Several aspects of out-of-hours care are discussed, such as telephone triage, self referrals, and future expectations, which should receive extra attention by researchers and health policy makers in the near future.

Shell feature: a new radiomics descriptor for predicting distant failure after radiotherapy in non-small cell lung cancer and cervix cancer

NASA Astrophysics Data System (ADS)

Hao, Hongxia; Zhou, Zhiguo; Li, Shulong; Maquilan, Genevieve; Folkert, Michael R.; Iyengar, Puneeth; Westover, Kenneth D.; Albuquerque, Kevin; Liu, Fang; Choy, Hak; Timmerman, Robert; Yang, Lin; Wang, Jing

2018-05-01

Distant failure is the main cause of human cancer-related mortalities. To develop a model for predicting distant failure in non-small cell lung cancer (NSCLC) and cervix cancer (CC) patients, a shell feature, consisting of outer voxels around the tumor boundary, was constructed using pre-treatment positron emission tomography (PET) images from 48 NSCLC patients received stereotactic body radiation therapy and 52 CC patients underwent external beam radiation therapy and concurrent chemotherapy followed with high-dose-rate intracavitary brachytherapy. The hypothesis behind this feature is that non-invasive and invasive tumors may have different morphologic patterns in the tumor periphery, in turn reflecting the differences in radiological presentations in the PET images. The utility of the shell was evaluated by the support vector machine classifier in comparison with intensity, geometry, gray level co-occurrence matrix-based texture, neighborhood gray tone difference matrix-based texture, and a combination of these four features. The results were assessed in terms of accuracy, sensitivity, specificity, and AUC. Collectively, the shell feature showed better predictive performance than all the other features for distant failure prediction in both NSCLC and CC cohorts.

The effects of portfolio purchasing on a specialized subject collection.

PubMed

Murphy, Sarah Anne

2007-01-01

To examine the impact of portfolio purchasing on a small, highly specialized medical collection at The Ohio State University. In this citation analysis, cited references for articles published by faculty in the College of Veterinary Medicine between 2000 and 2004 were collected and analyzed to determine whether The Ohio State University Libraries provided print or electronic access to the publications cited or the publishers of the cited journals, and whether the university purchased a subscription to each journal or received the subscription through a consortium-sponsored portfolio purchasing agreement. Of the 419 journals veterinary faculty cited more than 10 times, only 13 (3.1%) were in Zone 1, and 63 (15.0%) were in Zone 2 of the Bradford distribution, a citation analysis model which demonstrates that a small number of journals account for the bulk of literature utilized in any established field. Of these, only 23 (5.5%) were procured through an OhioLINK or other consortium portfolio purchasing agreement. The costs of acquiring a publisher's portfolio, even through a consortium, should be balanced with the costs of purchasing content required to provide a balanced collection for all user populations.

The effects of portfolio purchasing on a specialized subject collection

PubMed Central

Murphy, Sarah Anne

2007-01-01

Objective: To examine the impact of portfolio purchasing on a small, highly specialized medical collection at The Ohio State University. Methodology: In this citation analysis, cited references for articles published by faculty in the College of Veterinary Medicine between 2000 and 2004 were collected and analyzed to determine whether The Ohio State University Libraries provided print or electronic access to the publications cited or the publishers of the cited journals, and whether the university purchased a subscription to each journal or received the subscription through a consortium-sponsored portfolio purchasing agreement. Results: Of the 419 journals veterinary faculty cited more than 10 times, only 13 (3.1%) were in Zone 1, and 63 (15.0%) were in Zone 2 of the Bradford distribution, a citation analysis model which demonstrates that a small number of journals account for the bulk of literature utilized in any established field. Of these, only 23 (5.5%) were procured through an OhioLINK or other consortium portfolio purchasing agreement. Discussion/Conclusion: The costs of acquiring a publisher's portfolio, even through a consortium, should be balanced with the costs of purchasing content required to provide a balanced collection for all user populations. PMID:17252061

Small-Scale, Local Area, and Transitional Millimeter Wave Propagation for 5G Communications

NASA Astrophysics Data System (ADS)

Rappaport, Theodore S.; MacCartney, George R.; Sun, Shu; Yan, Hangsong; Deng, Sijia

2017-12-01

This paper studies radio propagation mechanisms that impact handoffs, air interface design, beam steering, and MIMO for 5G mobile communication systems. Knife edge diffraction (KED) and a creeping wave linear model are shown to predict diffraction loss around typical building objects from 10 to 26 GHz, and human blockage measurements at 73 GHz are shown to fit a double knife-edge diffraction (DKED) model which incorporates antenna gains. Small-scale spatial fading of millimeter wave received signal voltage amplitude is generally Ricean-distributed for both omnidirectional and directional receive antenna patterns under both line-of-sight (LOS) and non-line-of-sight (NLOS) conditions in most cases, although the log-normal distribution fits measured data better for the omnidirectional receive antenna pattern in the NLOS environment. Small-scale spatial autocorrelations of received voltage amplitudes are shown to fit sinusoidal exponential and exponential functions for LOS and NLOS environments, respectively, with small decorrelation distances of 0.27 cm to 13.6 cm (smaller than the size of a handset) that are favorable for spatial multiplexing. Local area measurements using cluster and route scenarios show how the received signal changes as the mobile moves and transitions from LOS to NLOS locations, with reasonably stationary signal levels within clusters. Wideband mmWave power levels are shown to fade from 0.4 dB/ms to 40 dB/s, depending on travel speed and surroundings.

Status of the Direct Data Distribution (D(exp 3)) Experiment

NASA Technical Reports Server (NTRS)

Wald, Lawrence

2001-01-01

NASA Glenn Research Center's Direct Data Distribution (D3) project will demonstrate an advanced, high-performance communications system that transmits information from an advanced technology payload carried by a NASA spacecraft in low Earth orbit (LEO) to a small receiving terminal on Earth. The space-based communications package will utilize a solid-state, K-band phased-array antenna that electronically steers the radiated energy beam toward a low-cost, tracking ground terminal, thereby providing agile, vibration-free, electronic steering at reduced size and weight with increased reliability. The array-based link will also demonstrate new digital processing technology that will allow the transmission of substantially increased amounts of latency-tolerant data collected from the LEO spacecraft directly to NASA field centers, principal investigators, or into the commercial terrestrial communications network. The technologies demonstrated by D3 will facilitate NASA's transition from using Government-owned communication assets to using commercial communication services. The hardware for D3 will incorporate advanced technology components developed under the High Rate Data Delivery (HRDD) Thrust Area of NASA's Office of Aerospace Technology Space Base Program at Glenn's Communications Technology Division. The flight segment components will include the electrically steerable phased-array antenna, which is being built by the Raytheon System Corporation and utilizes monolithic microwave integrated circuit (MMIC) technology operating at 19.05 GHz; and the digital encoder/modulator chipset, which uses four-channel orthogonal frequency division multiplexing (OFDM). The encoder/modulator will use a chipset developed by SICOM, Inc., which is both bandwidth and power efficient. The ground segment components will include a low-cost, open-loop tracking ground terminal incorporating a cryoreceiver to minimize terminal size without compromising receiver capability. The project is planning to hold a critical design review in the second quarter of fiscal year 2002.

PAM4 silicon photonic microring resonator-based transceiver circuits

NASA Astrophysics Data System (ADS)

Palermo, Samuel; Yu, Kunzhi; Roshan-Zamir, Ashkan; Wang, Binhao; Li, Cheng; Seyedi, M. Ashkan; Fiorentino, Marco; Beausoleil, Raymond

2017-02-01

Increased data rates have motivated the investigation of advanced modulation schemes, such as four-level pulseamplitude modulation (PAM4), in optical interconnect systems in order to enable longer transmission distances and operation with reduced circuit bandwidth relative to non-return-to-zero (NRZ) modulation. Employing this modulation scheme in interconnect architectures based on high-Q silicon photonic microring resonator devices, which occupy small area and allow for inherent wavelength-division multiplexing (WDM), offers a promising solution to address the dramatic increase in datacenter and high-performance computing system I/O bandwidth demands. Two ring modulator device structures are proposed for PAM4 modulation, including a single phase shifter segment device driven with a multi-level PAM4 transmitter and a two-segment device driven by two simple NRZ (MSB/LSB) transmitters. Transmitter circuits which utilize segmented pulsed-cascode high swing output stages are presented for both device structures. Output stage segmentation is utilized in the single-segment device design for PAM4 voltage level control, while in the two-segment design it is used for both independent MSB/LSB voltage levels and impedance control for output eye skew compensation. The 65nm CMOS transmitters supply a 4.4Vppd output swing for 40Gb/s operation when driving depletion-mode microring modulators implemented in a 130nm SOI process, with the single- and two-segment designs achieving 3.04 and 4.38mW/Gb/s, respectively. A PAM4 optical receiver front-end is also described which employs a large input-stage feedback resistor transimpedance amplifier (TIA) cascaded with an adaptively-tuned continuous-time linear equalizer (CTLE) for improved sensitivity. Receiver linearity, critical in PAM4 systems, is achieved with a peak-detector-based automatic gain control (AGC) loop.

Ultra-wideband receiver

DOEpatents

McEwan, T.E.

1994-09-06

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, [+-] UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 16 figs.

Ultra-wideband receiver

DOEpatents

McEwan, T.E.

1996-06-04

An ultra-wideband (UWB) receiver utilizes a strobed input line with a sampler connected to an amplifier. In a differential configuration, {+-}UWB inputs are connected to separate antennas or to two halves of a dipole antenna. The two input lines include samplers which are commonly strobed by a gating pulse with a very low duty cycle. In a single ended configuration, only a single strobed input line and sampler is utilized. The samplers integrate, or average, up to 10,000 pulses to achieve high sensitivity and good rejection of uncorrelated signals. 21 figs.

Correlation between fecal calprotectin and inflammation in the surgical specimen of Crohn's disease.

PubMed

Pous-Serrano, Salvador; Frasson, Matteo; Cerrillo, Elena; Beltrán, Belén; Iborra, Marisa; Hervás, David; García-Granero, Eduardo; Nos, Pilar

2017-06-01

An accurate assessment of the inflammatory activity is crucial to establish the most appropriate treatment in Crohn's disease (CD). The present study aimed to evaluate the utility of preoperative fecal calprotectin (FC) measurement in small bowel CD and its relationship with inflammatory activity in surgical pathology specimens. This was a prospective observational study including all the patients with small bowel CD operated on at our center between March 2011 and September 2013. Preoperative laboratory and stool tests were performed. A meticulous exploration of entire small bowel was performed during surgery, and the resected bowel (or a sample of whole intestinal wall, if strictureplasty) was submitted for pathologic analyses. Chiorean's score was used to grade pathologic features (inflammation or fibrosis). In case of multiple lesions, the most inflammatory component was considered. Thirty-eight consecutive patients were included in the study, and 81 small bowel lesions were identified. Among inflammatory markers, only FC was significantly associated with the degree of histologic inflammation in the surgical specimen (P < 0.003). FC reflected histologic inflammatory activity with an area under the receiver-operating characteristic curve of 0.85 (CI: 0.70-0.99; P < 0.001). A cutoff value of 170 μg/g had 81% sensitivity and 85% specificity for diagnosis of moderate or severe inflammation. Ordinal regression analysis showed the probability of a greater or lesser degree of inflammation based on the value of preoperative FC. FC is an excellent biomarker of inflammatory activity in small bowel CD as it correlates with histologic inflammation in the surgical specimen. Copyright © 2017 Elsevier Inc. All rights reserved.

48 CFR 219.001 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF DEFENSE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS 219.001 Definitions. Small disadvantaged business concern is defined: (1) At FAR 52.219-23(a) (i.e., a firm is considered a small disadvantaged business (SDB) concern by receiving certification by the Small Business Administration and meeting the...

77 FR 8020 - Semiannual Regulatory Agenda

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... Size 3245-AG25 Standards for Utilities Industries. 463 Small Business Size 3245-AG26 Standards... Remediation Services Industries. 465 Small Business Size 3245-AG28 Standards: Real Estate, Rental and Leasing Industries. 466 Small Business Size 3245-AG29 Standards: Educational Services Industries. 467 Small Business...

28 CFR 0.18a - Office of Small and Disadvantaged Business Utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... described in paragraph (a) of this section; (d) Provide resource information and technical training and... functions; (e) Assign a small business technical adviser to any Department offices to which the Small...

Shaping-lathe headrig will convert small hardwoods into pallet cants plus flakes for structural exterior flakeboard

Treesearch

Peter Koch

1975-01-01

Virtually all nations have an under-utilized resource of small-diameter, low-grade hardwoods of mixed species in a range of densities. The shaping-lathe headrig, now in the final stages of commercialization, is a key to utilizing these hardwoods for pallets, industrial lumber, and-with further development-railroad crossties. Lathe residues in the form of flakes can be...

Small Claims Court.

ERIC Educational Resources Information Center

McKitric, Eloise; Davis, Janet

The study examined individuals and companies who used small claims courts and the results of decisions reached in small claims cases. A review of studies including an empirical study of two Ohio small claims courts monitored for 12 months made it clear that small claims courts need to be examined to determine if utilization and accessibility to…

77 FR 70210 - Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... Subcontracting Report for Service Disabled Veteran-owned Small Business and Veteran-owned Small Business Concerns) Activities Under OMB Review AGENCY: Office of Small and Disadvantaged Business Utilization, Department of... U.S.C. 3501-3521), this notice announces that the Office of Small and Disadvantaged Business...

Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.

PubMed

van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

2015-02-01

To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

PubMed Central

Flink, Dina M.; Sheeder, Jeanelle

2017-01-01

Purpose: The American Society of Clinical Oncology issued practice guidelines in 2006 to provide critical information about fertility impact to adolescents and young adults (AYA) at the time of cancer diagnosis. Survivors continue to express concerns about their long-term reproductive health after cancer therapy even as treatment options for fertility preservation evolve. An underutilization of fertility preservation methods by cancer patients continues to persist. A review of the literature cites barriers and challenges that limit fertility information and preservation options for AYA cancer patients. Methods: A review of medical literature was conducted to examine current practice for patients receiving fertility information and the barriers to patients receiving fertility preservation services. Results: A total of 69 publications were included in this review. The review summarizes (1) patient experiences with receiving fertility information and (2) patient desires, barriers, and challenges to utilizing fertility preservation services. Conclusions: Despite advances in fertility preservation, there are challenges for patients to utilizing fertility preservation services. Barriers include the following: urgency to initiate treatment, inadequate information, clinic time constraints, and perceptions around patients' gender, age, cost, parity, race, relationship, and sociodemographic status influence whether patients receive fertility preservation consultation. Patients report a lack of adequate information to make informed fertility decisions. PMID:27529573

Low utilization of HIV testing during pregnancy: What are the barriers to HIV testing for women in rural India?

PubMed

Sinha, Gita; Dyalchand, Ashok; Khale, Manisha; Kulkarni, Gopal; Vasudevan, Shubha; Bollinger, Robert C

2008-02-01

Sixty percent of India's HIV cases occur in rural residents. Despite government policy to expand antenatal HIV screening and prevention of maternal-to-child transmission (PMTCT), little is known about HIV testing among rural women during pregnancy. Between January and March 2006, a cross-sectional sample of 400 recently pregnant women from rural Maharashtra was administered a questionnaire regarding HIV awareness, risk, and history of antenatal HIV testing. Thirteen women (3.3%) reported receiving antenatal HIV testing. Neither antenatal care utilization nor history of sexually transmitted infection (STI) symptoms influenced odds of receiving HIV testing. Women who did not receive HIV testing, compared with women who did, were 95% less likely to have received antenatal HIV counseling (odds ratio = 0.05, 95% confidence interval: 0.02 to 0.17) and 80% less aware of an existing HIV testing facility (odds ratio = 0.19, 95% confidence interval: 0.04 to 0.75). Despite measurable HIV prevalence, high antenatal care utilization, and STI symptom history, recently pregnant rural Indian women report low HIV testing. Barriers to HIV testing during pregnancy include lack of discussion by antenatal care providers and lack of awareness of existing testing services. Provider-initiated HIV counseling and testing during pregnancy would optimize HIV prevention for women throughout rural India.

48 CFR 19.705-4 - Reviewing the subcontracting plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-4... involving small business concerns as subcontractors in similar acquisitions; and (3) The relative success of... comply with its obligations under the clause at 52.219-8, Utilization of Small Business Concerns, the...

48 CFR 19.705-4 - Reviewing the subcontracting plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-4... involving small business concerns as subcontractors in similar acquisitions; and (3) The relative success of... comply with its obligations under the clause at 52.219-8, Utilization of Small Business Concerns, the...

48 CFR 19.705-4 - Reviewing the subcontracting plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The Small Business Subcontracting Program 19.705-4... involving small business concerns as subcontractors in similar acquisitions; and (3) The relative success of... comply with its obligations under the clause at 52.219-8, Utilization of Small Business Concerns, the...

Heat transfer analysis of a lab scale solar receiver using the discrete ordinates model

NASA Astrophysics Data System (ADS)

Dordevich, Milorad C. W.

This thesis documents the development, implementation and simulation outcomes of the Discrete Ordinates Radiation Model in ANSYS FLUENT simulating the radiative heat transfer occurring in the San Diego State University lab-scale Small Particle Heat Exchange Receiver. In tandem, it also serves to document how well the Discrete Ordinates Radiation Model results compared with those from the in-house developed Monte Carlo Ray Trace Method in a number of simplified geometries. The secondary goal of this study was the inclusion of new physics, specifically buoyancy. Implementation of an additional Monte Carlo Ray Trace Method software package known as VEGAS, which was specifically developed to model lab scale solar simulators and provide directional, flux and beam spread information for the aperture boundary condition, was also a goal of this study. Upon establishment of the model, test cases were run to understand the predictive capabilities of the model. It was shown that agreement within 15% was obtained against laboratory measurements made in the San Diego State University Combustion and Solar Energy Laboratory with the metrics of comparison being the thermal efficiency and outlet, wall and aperture quartz temperatures. Parametric testing additionally showed that the thermal efficiency of the system was very dependent on the mass flow rate and particle loading. It was also shown that the orientation of the small particle heat exchange receiver was important in attaining optimal efficiency due to the fact that buoyancy induced effects could not be neglected. The analyses presented in this work were all performed on the lab-scale small particle heat exchange receiver. The lab-scale small particle heat exchange receiver is 0.38 m in diameter by 0.51 m tall and operated with an input irradiation flux of 3 kWth and a nominal mass flow rate of 2 g/s with a suspended particle mass loading of 2 g/m3. Finally, based on acumen gained during the implementation and development of the model, a new and improved design was simulated to predict how the efficiency within the small particle heat exchange receiver could be improved through a few simple internal geometry design modifications. It was shown that the theoretical calculated efficiency of the small particle heat exchange receiver could be improved from 64% to 87% with adjustments to the internal geometry, mass flow rate, and mass loading.

GPS Receivers Use-Case Information : GPS Adjacent Band Compatibility Assessment Workshop

DOT National Transportation Integrated Search

2014-09-18

Topics 1. Background. 2. Use Case Template. 3. Description of Submitted UseCases from DOT Extended Pos/Nav Working Group. 4. Utilization of UseCase Information. 5. Request of Information for Additional UseCases from GPS Receiver Manufacturer...

Small Business Specialists.

DTIC Science & Technology

1997-12-01

located throughout the United States. Each service and agency has an Office of the Director of Small and Disadvantaged Business Utilization. They also...have small business specialists at each of their procurement and contract management offices to assist small businesses , small disadvantaged businesses ...and women-owned small businesses firms in marketing their products and services with the DoD. These specialists provide information and guidance on (1

48 CFR 3419.201-70 - Office of Small and Disadvantaged Business Utilization (OSDBU).

Code of Federal Regulations, 2012 CFR

2012-10-01

... facilitating the implementation of the Small Business Act, as described in FAR 19.201. The OSDBU develops rules, policy, procedures, and guidelines for the effective administration of ED's small business program. ...

Ultrastructural liver changes in the experimental thyrotoxicosis.

PubMed

Pasyechko, Nadiya Vasylivna; Kuleshko, Iryna Ihorivna; Kulchinska, Veronika Mykolaiivna; Naumova, Liudmyla Valeriivna; Smachylo, Iryna Volodymyrivna; Bob, Anzhela Olehivna; Radetska, Liudmyla Volodymyrivna; Havryliuk, Mykhailo Yevhenovych; Sopel, Olha Mykolaiivna; Mazur, Liudmyla Petrivna

Aim of the study is to evaluate ultrastructural changes of rat liver in experimental thyrotoxicosis. For the study, 36 male rats have been utilized, weighing approximately 150-190 g, which were divided into three groups: the first, control group (12 animals) was composed of healthy rats that received intragastric sodium chloride 0.9% solution, the second group (12 animals) - animals with experimental thyrotoxicosis, which received intragastric solution of L-thyroxine at the rate of 200 μg/kg for 2 weeks, and the third group (12 animals) - rats with experimental thyrotoxicosis, which received intragastric solution of L-thyroxine at the rate of 200 μg/kg for 4 weeks. For electron-microscopic studies small pieces of liver tissue were taken at the end of the 2nd and 4th weeks of the experiment. The material was studied and documented in electron micrographs by using a TEM-125K electron microscope. In experiment in white male rats the electron-microscopic state of the liver in thyrotoxicosis has been studied. It has been established that thyrotoxicosis is accompanied by the significant changes of the hepatocytes ultrastructure, blood and bile capillaries. Experimental thyrotoxicosis causes significant damage of the liver plasma membranes and intracellular structural components of hepatocytes and endothelial cells. In experimental thyrotoxicosis, on the background of microcirculatory disorders, significant damage of plasmatic and intracellular organoid membranes of hepatocytes in the liver develops, which has an adverse effect on the functionality of the organ. The found ultrastructural changes are aggravated depending on the duration of thyrotoxicosis.

Hospital charge exemptions for the poor in Shandong, China.

PubMed

Meng, Qingyue; Sun, Qiang; Hearst, Norman

2002-12-01

Rapid economic changes in China have produced soaring hospital charges, a breakdown of the old social health insurance system, a resulting crisis in hospital affordability and renewed interest in mechanisms for discounts or exemptions from hospital charges for the poor. Little is known, however, about how effective such systems are in practice. We studied nine public hospitals in Shandong Province that offer discount or exemption mechanisms for the poor. Methods included document review, key informant interviews, detailed review of financial records and focus group discussions. These hospitals receive little government subsidy and must support themselves almost entirely through user fees. Hospital managers saw discount mechanisms primarily as marketing tools and designed them to limit their cost. Only a small fraction of hospital services were eligible for discount, and these were usually low cost or low utilization items. Discounts were generally 10-50% for selected items with very few services exempted from charge. The total value of discounts granted was 1% or less of total hospital operating budgets. Correct identification of indigents was a major difficulty for hospitals. Only a minority of indigents received discounts, the process was sometimes arbitrary and some who received discounts were not really poor. Government policies requiring discounts for the poor were vague and not enforced. The exemption programmes studied do not provide effective protection from hospital charges for the poor. To be effective, exemption mechanisms would likely require both financing and regulation by the government as well as an accurate way to identify the poor.

Reward positivity: Reward prediction error or salience prediction error?

PubMed

Heydari, Sepideh; Holroyd, Clay B

2016-08-01

The reward positivity is a component of the human ERP elicited by feedback stimuli in trial-and-error learning and guessing tasks. A prominent theory holds that the reward positivity reflects a reward prediction error signal that is sensitive to outcome valence, being larger for unexpected positive events relative to unexpected negative events (Holroyd & Coles, 2002). Although the theory has found substantial empirical support, most of these studies have utilized either monetary or performance feedback to test the hypothesis. However, in apparent contradiction to the theory, a recent study found that unexpected physical punishments also elicit the reward positivity (Talmi, Atkinson, & El-Deredy, 2013). The authors of this report argued that the reward positivity reflects a salience prediction error rather than a reward prediction error. To investigate this finding further, in the present study participants navigated a virtual T maze and received feedback on each trial under two conditions. In a reward condition, the feedback indicated that they would either receive a monetary reward or not and in a punishment condition the feedback indicated that they would receive a small shock or not. We found that the feedback stimuli elicited a typical reward positivity in the reward condition and an apparently delayed reward positivity in the punishment condition. Importantly, this signal was more positive to the stimuli that predicted the omission of a possible punishment relative to stimuli that predicted a forthcoming punishment, which is inconsistent with the salience hypothesis. © 2016 Society for Psychophysiological Research.

TmiRUSite and TmiROSite scripts: searching for mRNA fragments with miRNA binding sites with encoded amino acid residues.

PubMed

Berillo, Olga; Régnier, Mireille; Ivashchenko, Anatoly

2014-01-01

microRNAs are small RNA molecules that inhibit the translation of target genes. microRNA binding sites are located in the untranslated regions as well as in the coding domains. We describe TmiRUSite and TmiROSite scripts developed using python as tools for the extraction of nucleotide sequences for miRNA binding sites with their encoded amino acid residue sequences. The scripts allow for retrieving a set of additional sequences at left and at right from the binding site. The scripts presents all received data in table formats that are easy to analyse further. The predicted data finds utility in molecular and evolutionary biology studies. They find use in studying miRNA binding sites in animals and plants. TmiRUSite and TmiROSite scripts are available for free from authors upon request and at https: //sites.google.com/site/malaheenee/downloads for download.

European Training and Research in Peritoneal Dialysis--A Network to Deliver Scientific Peritoneal Dialysis Training to a New Generation of Researchers.

PubMed

Machowska, Anna; van Wier, Tanja; Aufricht, Christoph; Beelen, Rob; Rutherford, Peter

2015-01-01

Peritoneal dialysis (PD) utilization varies across countries, and of the factors that explain the variation, the scientific and clinical knowledge of health care professionals is potentially important. In this paper, we describe a European collaboration--between 8 academic PD research programs, a small-to-medium-sized enterprise, and a large PD product manufacturer--that received significant research funding from the EU commission to establish a training network. European Training and Research in Peritoneal Dialysis (EuTRiPD) is providing training to 12 PhD students who have moved within the European Union and are completing research training. The underlying structure and processes within EuTRiPD (http://www.eutripd. eu) are described, and the benefits of the collaborative approach are discussed. This model could be useful to other research groups and will assist in maintaining and growing scientific expertise in PD research.

Tracing the evolutionary origins of insect renal function.

PubMed

Halberg, Kenneth A; Terhzaz, Selim; Cabrero, Pablo; Davies, Shireen A; Dow, Julian A T

2015-04-21

Knowledge on neuropeptide receptor systems is integral to understanding animal physiology. Yet, obtaining general insight into neuropeptide signalling in a clade as biodiverse as the insects is problematic. Here we apply fluorescent analogues of three key insect neuropeptides to map renal tissue architecture across systematically chosen representatives of the major insect Orders, to provide an unprecedented overview of insect renal function and control. In endopterygote insects, such as Drosophila, two distinct transporting cell types receive separate neuropeptide signals, whereas in the ancestral exopterygotes, a single, general cell type mediates all signals. Intriguingly, the largest insect Order Coleoptera (beetles) has evolved a unique approach, in which only a small fraction of cells are targets for neuropeptide action. In addition to demonstrating a universal utility of this technology, our results reveal not only a generality of signalling by the evolutionarily ancient neuropeptide families but also a clear functional separation of the types of cells that mediate the signal.

Noncoherent Tracking of a Source of a Data-Modulated Signal

NASA Technical Reports Server (NTRS)

Arndt, G. Dickey; Ngo, Phong; Chen, Henry; Phan, Chau T.; Hill, Brent; Bourgeois, Brian; Dusl, John

2003-01-01

A proposed tracking receiver system containing three suitably positioned antenna elements and special signal-processing equipment would determine the direction of incidence of a microwave signal containing spread-spectrum digital data modulation. If the system were to contain two sets of antenna elements separated by a known baseline, it could determine the location of the transmitter as the intersection of the lines of incidence on the two antennas. Such systems could be used for diverse purposes in outer space and on Earth, including tracking astronauts and small robotic spacecraft working outside a spacecraft or space station, and locating cellular telephones from which distress calls have been made. The principle of operation does not require the transmission of a special identifying or distress signal by the cellular telephone or other transmitter to be tracked; instead, the system could utilize the data signal routinely sent by the transmitter, provided that the signal had the characteristics needed for processing.

Development of a CCTV system for welder training and monitoring of Space Shuttle Main Engine welds

NASA Technical Reports Server (NTRS)

Gordon, S. S.; Flanigan, L. A.; Dyer, G. E.

1987-01-01

A Weld Operator's Remote Monitoring System (WORMS) for remote viewing of manual and automatic GTA welds has been developed for use in Space Shuttle Main Engine (SSME) manufacturing. This system utilizes fiberoptics to transmit images from a receiving lens to a small closed-circuit television (CCTV) camera. The camera converts the image to an electronic signal, which is sent to a videotape recorder (VTR) and a monitor. The overall intent of this system is to provide a clearer, more detailed view of welds than is available by direct observation. This system has six primary areas of application: (1) welder training; (2) viewing of joint penetration; (3) viewing visually inaccessible welds; (4) quality control and quality assurance; (5) remote joint tracking and adjustment of variables in machine welds; and (6) welding research and development. This paper describes WORMS and how it applies to each application listed.

Frame Synchronization Without Attached Sync Markers

NASA Technical Reports Server (NTRS)

Hamkins, Jon

2011-01-01

We describe a method to synchronize codeword frames without making use of attached synchronization markers (ASMs). Instead, the synchronizer identifies the code structure present in the received symbols, by operating the decoder for a handful of iterations at each possible symbol offset and forming an appropriate metric. This method is computationally more complex and doesn't perform as well as frame synchronizers that utilize an ASM; nevertheless, the new synchronizer acquires frame synchronization in about two seconds when using a 600 kbps software decoder, and would take about 15 milliseconds on prototype hardware. It also eliminates the need for the ASMs, which is an attractive feature for short uplink codes whose coding gain would be diminished by the overheard of ASM bits. The lack of ASMs also would simplify clock distribution for the AR4JA low-density parity-check (LDPC) codes and adds a small amount to the coding gain as well (up to 0.2 dB).

STARSYS: A view after WARC-92

NASA Astrophysics Data System (ADS)

Kaveeshwar, Ashok; Rodriguez, Raul

1993-01-01

The STARSYS system is aimed at providing low cost global positioning and messaging by satellite. STARSYS is a data only system using very brief message transmission times. Code Division Multiple Access (CDMA) is used for frequency sharing; it enables transmitted data to be coded for unique user identification and also to employ Doppler and radio ranging to determine the geographical location of a transmitting terminal. The STARSYS system is composed of the field receiver/transmitter, the Low Earth Orbit (LEO) satellite constellation and the ground station elements. Each message transmission is able to contain up to thirty two digital characters. Market applications are numerous: theft control, vehicle and logistic tracking and messaging, personal communications, utility and environmental data acquisition and transfer. Co-primary frequency allocation at WARC-92 accelerated interest for potential customers and investors, although the amount of frequency allocation (less than 1 GHz) is small.

A novel radar sensor for the non-contact detection of speech signals.

PubMed

Jiao, Mingke; Lu, Guohua; Jing, Xijing; Li, Sheng; Li, Yanfeng; Wang, Jianqi

2010-01-01

Different speech detection sensors have been developed over the years but they are limited by the loss of high frequency speech energy, and have restricted non-contact detection due to the lack of penetrability. This paper proposes a novel millimeter microwave radar sensor to detect speech signals. The utilization of a high operating frequency and a superheterodyne receiver contributes to the high sensitivity of the radar sensor for small sound vibrations. In addition, the penetrability of microwaves allows the novel sensor to detect speech signals through nonmetal barriers. Results show that the novel sensor can detect high frequency speech energies and that the speech quality is comparable to traditional microphone speech. Moreover, the novel sensor can detect speech signals through a nonmetal material of a certain thickness between the sensor and the subject. Thus, the novel speech sensor expands traditional speech detection techniques and provides an exciting alternative for broader application prospects.

A Novel Radar Sensor for the Non-Contact Detection of Speech Signals

PubMed Central

Jiao, Mingke; Lu, Guohua; Jing, Xijing; Li, Sheng; Li, Yanfeng; Wang, Jianqi

2010-01-01

Different speech detection sensors have been developed over the years but they are limited by the loss of high frequency speech energy, and have restricted non-contact detection due to the lack of penetrability. This paper proposes a novel millimeter microwave radar sensor to detect speech signals. The utilization of a high operating frequency and a superheterodyne receiver contributes to the high sensitivity of the radar sensor for small sound vibrations. In addition, the penetrability of microwaves allows the novel sensor to detect speech signals through nonmetal barriers. Results show that the novel sensor can detect high frequency speech energies and that the speech quality is comparable to traditional microphone speech. Moreover, the novel sensor can detect speech signals through a nonmetal material of a certain thickness between the sensor and the subject. Thus, the novel speech sensor expands traditional speech detection techniques and provides an exciting alternative for broader application prospects. PMID:22399895

Compact imaging spectrometer utilizing immersed gratings

DOEpatents

Lerner, Scott A.

2005-12-20

A compact imaging spectrometer comprising an entrance slit for directing light, lens means for receiving the light, refracting the light, and focusing the light; an immersed diffraction grating that receives the light from the lens means and defracts the light, the immersed diffraction grating directing the detracted light back to the lens means; and a detector that receives the light from the lens means.

Suction-recirculation device for stabilizing particle flows within a solar powered solid particle receiver

DOEpatents

Kolb, Gregory J [Albuquerque, NM

2012-02-07

A suction-recirculation device for stabilizing the flow of a curtain of blackened heat absorption particles falling inside of a solar receiver with an open aperture. The curtain of particles absorbs the concentrated heat from a solar mirror array reflected up to the receiver on a solar power tower. External winds entering the receiver at an oblique angle can destabilize the particle curtain and eject particles. A fan and ductwork is located behind the back wall of the receiver and sucks air out through an array of small holes in the back wall. Any entrained particles are separated out by a conventional cyclone device. Then, the air is recirculated back to the top of the receiver by injecting the recycled air through an array of small holes in the receiver's ceiling and upper aperture front wall. Since internal air is recirculated, heat losses are minimized and high receiver efficiency is maintained. Suction-recirculation velocities in the range of 1-5 m/s are sufficient to stabilize the particle curtain against external wind speeds in excess of 10 m/s.

Patterns of the utilization of prenatal diagnosis services among pregnant women, their satisfaction and its associated factors in Viet Nam.

PubMed

Doan, Duong Thi Thuy; Nguyen, Huong Thi Thu; Bui, Ha Thi Thu

2017-02-01

This study aimed at understanding the patterns of the utilization of prenatal diagnostic (PND) services among pregnant women, their satisfaction and its associated factors at three regional prenatal diagnostic centres in Viet Nam. A cross-sectional design was used, with a consecutive sampling method to recruit pregnant women who used PND services at the three biggest regional PND services centres in Viet Nam between January and June, 2014. A total of 298 participants, about 100 participants per centre were interviewed and included in data analysis. Descriptive analyses and logistic regression methods were applied to identify association between satisfaction of women and their socio-economic characteristics. 80% of pregnant women received counselling on PND services, whilst 90% received ultrasonography services; 65.4% were satisfied with the PND services they used. Pregnant women, who were in a lower income group and received counselling but did not receive ultrasonography, were more likely to have higher satisfaction levels of PND services. A process to ensure that every pregnant woman receives sufficient PND counselling before and after receiving PND testing must be given careful and thorough consideration.

Disparities in the Utilization of Laparoscopic Surgery for Colon Cancer in Rural Nebraska: A Call for Placement and Training of Rural General Surgeons

PubMed Central

Gruber, Kelli; Soliman, Amr S.; Schmid, Kendra; Rettig, Bryan; Ryan, June; Watanabe-Galloway, Shinobu

2015-01-01

Background Advances in medical technology are changing surgical standards for colon cancer treatment. The laparoscopic colectomy is equivalent to the standard open colectomy while providing additional benefits. It is currently unknown what factors influence utilization of laparoscopic surgery in rural areas and if treatment disparities exist. The objectives of this study were to examine demographic and clinical characteristics associated with receiving laparoscopic colectomy and to examine the differences between rural and urban patients who received either procedure. Methods This study utilized a linked dataset of Nebraska Cancer Registry and hospital discharge data on colon cancer patients diagnosed and treated in the entire state of Nebraska from 2008–2011 (N=1,062). Multiple logistic regression analysis was performed to identify predictors of receiving the laparoscopic treatment. Results Rural colon cancer patients were 40% less likely to receive laparoscopic colectomy compared to urban patients. Independent predictors of receiving laparoscopic colectomy were younger age (<60), urban residence, ≥3 comorbidities, elective admission, smaller tumor size, and early stage at diagnosis. Additionally, rural patients varied demographically compared to urban patients. Conclusions Laparoscopic surgery is becoming the new standard of treatment for colon cancer and important disparities exist for rural cancer patients in accessing the specialized treatment. As cancer treatment becomes more specialized, the importance of training and placement of general surgeons in rural communities must be a priority for health care planning and professional training institutions. PMID:25951881

Cost effectiveness of drug eluting coronary artery stenting in a UK setting: cost-utility study.

PubMed

Bagust, A; Grayson, A D; Palmer, N D; Perry, R A; Walley, T

2006-01-01

To assess the cost effectiveness of drug eluting stents (DES) compared with conventional stents for treatment of symptomatic coronary artery disease in the UK. Cost-utility analysis of audit based patient subgroups by means of a simple economic model. Tertiary care. 12 month audit data for 2884 patients receiving percutaneous coronary intervention with stenting at the Cardiothoracic Centre Liverpool between January 2000 and December 2002. Risk of repeat revascularisation within 12 months of index procedure and reduction in risk from use of DES. Economic modelling was used to estimate the cost-utility ratio and threshold price premium. Four factors were identified for patients undergoing elective surgery (n = 1951) and two for non-elective surgery (n = 933) to predict risk of repeat revascularisation within 12 months. Most patients fell within the subgroup with lowest risk (57% of the elective surgery group with 5.6% risk and 91% of the non-elective surgery group with 9.9% risk). Modelled cost-utility ratios were acceptable for only one group of high risk patients undergoing non-elective surgery (only one patient in audit data). Restricting the number of DES for each patient improved results marginally: 4% of stents could then be drug eluting on economic grounds. The threshold price premium justifying 90% substitution of conventional stents was estimated to be 112 pound sterling (212 USD, 162 pound sterling) (sirolimus stents) or 89 pound sterling (167 USD, 130 pound sterling) (paclitaxel stents). At current UK prices, DES are not cost effective compared with conventional stents except for a small minority of patients. Although the technology is clearly effective, general substitution is not justified unless the price premium falls substantially.

External validation and clinical utility of a prediction model for 6-month mortality in patients undergoing hemodialysis for end-stage kidney disease.

PubMed

Forzley, Brian; Er, Lee; Chiu, Helen Hl; Djurdjev, Ognjenka; Martinusen, Dan; Carson, Rachel C; Hargrove, Gaylene; Levin, Adeera; Karim, Mohamud

2018-02-01

End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. We aimed to assess the external validity and clinical utility in an independent cohort in Canada. We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses. Data were derived from a cohort of 374 prevalent dialysis patients in two regions of British Columbia, Canada, which included serum albumin, age, peripheral vascular disease, dementia, and answers to the "the surprise question" ("Would I be surprised if this patient died within the next year?"). The observed mortality in the validation cohort was 11.5% at 6 months. The prediction model had reasonable discrimination (c-stat = 0.70) but poor calibration (calibration-in-the-large = -0.53 (95% confidence interval: -0.88, -0.18); calibration slope = 0.57 (95% confidence interval: 0.31, 0.83)) in our data. Decision curve analysis showed the model only has added value in guiding clinical decision in a small range of threshold probabilities: 8%-20%. Despite reasonable discrimination, the prediction model has poor calibration in this external study cohort; thus, it may have limited clinical utility in settings outside of where it was derived. Decision curve analysis clarifies limitations in clinical utility not apparent by receiver operating characteristic curve analysis. This study highlights the importance of external validation of prediction models prior to routine use in clinical practice.

Usual Course of Treatment and Predictors of Treatment Utilization for Patients with Posttraumatic Stress Disorder

PubMed Central

Nobles, Carrie J.; Valentine, Sarah E.; Zepeda, E. David; Ahles, Emily M.; Shtasel, Derri L.; Marques, Luana

2017-01-01

Objective Posttraumatic stress disorder (PTSD) is a debilitating psychiatric illness that frequently remains undiagnosed and untreated. While extensive research has been conducted among veterans, little research has evaluated course of treatment for PTSD in a general hospital setting. Method We utilized data from the Partners Healthcare Research Patient Database Registry to evaluate mental health treatment utilization, including psychotherapy and pharmacotherapy, by patients with recently diagnosed primary PTSD following Diagnostic and Statistical Manual IV criteria between January 1, 2002 and June 30, 2011. We additionally evaluated predictors of treatment utilization 6 months post-diagnosis. Results Among 2,475 patients with recently diagnosed prim ary PTSD, approximately half (55.7%) had any therapy visit and 10% at least 12 therapy visits in the 6 months following diagnosis. Approximately half (47.0%) received a psychiatric prescription, with 29.3% receiving a selective serotonin reuptake inhibitor (SSRI), 11.8% an atypical antipsychotic and 24.4% a benzodiazepine. Latinos were 25% more likely to have an SSRI prescription, 35% more likely to have an atypical antipsychotic prescription and 28% more likely to have any psychotherapy. Men were 96% more likely to have an atypical antipsychotic prescription. Patients with Medicare were 20% less likely to have any psychotherapy, and patients with Medicaid were 35% less likely to have 12 or more therapy visits. Conclusion Many patients with a primary diagnosis of PTSD do not receive psychotherapy, and psychiatric prescriptions, including atypical antipsychotics and benzodiazepines, are common. Future research is needed to determine quality of care received and explore sub-population specific barriers limiting access to care. PMID:28570794

Rates of glaucoma medication utilization among persons with primary open-angle glaucoma, 1992 to 2002.

PubMed

Stein, Joshua D; Ayyagari, Padmaja; Sloan, Frank A; Lee, Paul P

2008-08-01

To determine the percentage of Medicare beneficiaries with primary open-angle glaucoma (POAG) treated medically or surgically, utilization rates for each major class of glaucoma medication, and factors influencing treatment. Longitudinal observational study using data from the Medicare Current Beneficiary Survey (MCBS). Persons age 65 and older with POAG, 1992 to 2002 (N = 6446). By using MCBS data merged with Medicare claims, rates of medical and surgical treatment for participants with POAG were determined. Logistic analysis was used to assess factors associated with use of care. Receipt/nonreceipt of medical or surgical therapy in a year and rates of drug utilization by class and of surgery by type among persons who did not receive medical therapy in a year. On average from 1992 to 2002, 27.4% of persons diagnosed with POAG received no medical or surgical treatment. Rates of nonuse increased by 3% annually (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05). Beneficiaries with Medicaid were 43% more likely not to receive care for POAG in a year (OR, 1.43; 95% CI, 1.20-1.70). Hispanic, Asian, and beneficiaries of other race/ethnicity were less likely to receive treatment than were whites. Use of beta-blockers and miotics decreased, but utilization rates increased substantially for alpha-agonists, combination beta-blocker-carbonic anhydrase inhibitors, and especially prostaglandin analogs. Despite availability of more efficacious glaucoma medication classes with few side effects and findings of clinical trials underscoring the importance of intraocular pressure reduction in POAG patients, many patients with POAG continue to go untreated.

Identifying barriers to receiving preventive dental services: expanding access to preventive dental hygiene services through affiliated practice.

PubMed

Gross-Panico, Michelle L; Freeman, Wilbur K

2012-01-01

Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.

Evaluation of a Shared Decision-Making Intervention on the Utilization of Evidence-Based Psychotherapy in a VA Outpatient PTSD Clinic.

PubMed

Hessinger, Jonathan D; London, Melissa J; Baer, Sheila M

2017-03-13

The Veterans Health Administration (VHA) has continued to emphasize the availability, access, and utilization of high quality mental health care particularly in the treatment of posttraumatic stress disorder (PTSD). While dissemination and availability of evidence-based psychotherapies (EBPs) have only increased, treatment engagement and utilization have continued to be oft-noted challenges. Administrators, researchers, and individual clinicians have continued to develop and explore novel systemic and individualized interventions to address these issues. Pilot studies utilizing shared decision-making models to aid in veteran treatment selection have demonstrated the impact this approach may have on selection of and engagement in EBPs for PTSD. Based on these promising studies, a Department of Veterans Affairs (VA) outpatient PTSD clinic began to implement a shared-decision making intervention as part of a clinic redesign. In seeking to evaluate the impact of this intervention, archival clinical data from 1,056 veterans were reviewed by the authors for rates of treatment selection, EBP initiation, session attendance, and EBP completion. Time elapsed from consult until EBP initiation was also computed by the authors. These variables were then compared on the basis of whether the veteran received the shared-decision making intervention. Veterans who received the intervention were more likely to select and thus initiate an EBP for PTSD sooner than veterans who did not receive this intervention. Veterans, whether receiving the intervention or not, did not differ in therapy session attendance and completion. Implications of these findings and directions for future study are further discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Clinician-delivered contingency management increases engagement and attendance in drug and alcohol treatment.

PubMed

Fitzsimons, Heather; Tuten, Michelle; Borsuk, Courtney; Lookatch, Samantha; Hanks, Lisa

2015-07-01

This study examined the impact of a low-cost contingency management (CM) delivered by program clinicians on treatment attendance and utilization for patients enrolled in outpatient psychosocial substance abuse treatment. The study used a pre-posttest design to compare substance abuse patients who received Reinforcement-Based Treatment (RBT) plus low cost CM (n=130; RBT+CM) to patients who received RBT only (n=132, RBT). RBT+CM participants received a $10 incentive for returning to treatment the day following intake assessment (day one), and a $15 incentive for attending treatment on day five following admission. RBT clients received standard care intervention without the addition of the CM procedures. Groups were compared on proportion of participants who returned to treatment on day one, mean days of treatment attendance, individual sessions attended, and treatment utilization during the first week and the first month following treatment admission. Both the RBT+CM and RBT group participants returned to the clinic on day one at high rates (95% versus 89%, respectively). However, the RBT group participants were more likely to attend the intake assessment only (i.e., never return to treatment) compared to the RBT+CM participants. Additionally, the RBT+CM participants attended significantly more treatment days, attended more individual counseling sessions, and had higher rates of overall treatment utilization compared to the RBT participants during the one week and one month following treatment admission. Findings support the feasibility and effectiveness of a CM intervention delivered by clinicians for increasing treatment attendance and utilization in a community substance abuse program. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sociodemographic characterization of ECT utilization in Hawaii.

PubMed

Ona, Celia M; Onoye, Jane M; Goebert, Deborah; Hishinuma, Earl; Bumanglag, R Janine; Takeshita, Junji; Carlton, Barry; Fukuda, Michael

2014-03-01

Minimal research has been done on sociodemographic differences in utilization of electroconvulsive therapy (ECT) for refractory depression, especially among Asian Americans and Pacific Islanders. This study examined sociodemographic and diagnostic variables using retrospective data from Hawaii, an island state with predominantly Asian Americans and Pacific Islanders. Retrospective data were obtained from an inpatient and outpatient database of ECT patients from 2008 to 2010 at a tertiary care community hospital on O'ahu, Hawaii. There was a significant increase in overall ECT utilization from 2008 to 2009, with utilization remaining stable from 2009 to 2010. European Americans (41%) and Japanese Americans (29%) have relatively higher rates of receiving ECT, and Filipino Americans and Native Hawaiians have relatively lower rates in comparison with their population demographics. Japanese Americans received significantly more ECT procedures than European Americans. Electroconvulsive therapy is underutilized by certain sociodemographic groups that may benefit most from the treatment. There are significant differences in ECT usage based on ethnicity. Such differences may be related to help-seeking behavior, economic differences, and/or attitudes regarding mental illness. Further research is needed to elucidate the reasons for differences in utilization.

Patterns of mental health service utilization.

PubMed

Howard, K I; Cornille, T A; Lyons, J S; Vessey, J T; Lueger, R J; Saunders, S M

1996-08-01

How many and which individuals, with which psychiatric disorders, receive (and do not receive) mental health services from which professionals in what settings? This question falls within the purview of mental health services research, which is a multidisciplinary field that brings together the methodologies of epidemiology, econometrics, and clinical research. First, in this article, we present an explication of what is known about those individuals in need of psychotherapy and how they access services. Next, we describe the numbers, professional affiliations, and service sites of professionals who are engaged in the practice of psychotherapy. We summarize our current knowledge about the actual utilization of psychotherapy services relative to the needs of patients and the professional background of therapists. Finally, we identify aspects of psychotherapy service utilization that are, as yet, unaddressed.

Philippines: Small-scale renewable energy update

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

NONE

1997-12-01

This paper gives an overview of the application of small scale renewable energy sources in the Philippines. Sources looked at include solar, biomass, micro-hydroelectric, mini-hydroelectric, wind, mini-geothermal, and hybrid. A small power utilities group is being spun off the major utility, to provide a structure for developing rural electrification programs. In some instances, private companies have stepped forward, avoiding what is perceived as overwhelming beaurocracy, and installed systems with private financing. The paper provides information on survey work which has been done on resources, and the status of cooperative programs to develop renewable systems in the nation.

Direct measurements of fluorine atom concentration, gain length and small signal gain in an hydrogen fluoride overtone laser

NASA Astrophysics Data System (ADS)

Wisniewski, Charles F.; Hewett, Kevin B.; Manke, Gerald C., II; Randall Truman, C.; Hager, Gordon D.

2003-03-01

Experimental techniques have been developed to directly measure the concentration of fluorine atoms, the gain length and the small signal gain in a hydrogen fluoride 5 cm slit nozzle laser. A gas phase titration technique was utilized to measure the fluorine atom concentration using HCl as the titrant. The gain length was measured using a pitot probe to locate the interface of the primary flow with the high Mach number shroud flows. A tunable diode laser was utilized to perform small signal gain measurements on HF overtone ( ν=2→0) transitions.

Modeling opportunities and feasibility of siting wood-fired electrical generating facilities to facilitate landscape-scale fuel treatment with FIA BioSum.

Treesearch

Jeremy S. Fried; Glenn Christensen; Dale Weyermann; R. Jamie Barbour; Roger Fight; Bruce Hiserote; Guy Pinjuv

2005-01-01

Utilization of small diameter trees is viewed by many as the key to making landscape-scale fuel treatment financially feasible. But little capacity currently exists for utilizing such material and capacity of sufficient scale to have a significant impact on the economics of small diameter removals will only be added if predictable feedstocks can be assured. The FIA...

National Hydroelectric Power Resources Study: Environmental Assessment. Volume 8

DTIC Science & Technology

1981-09-01

hydropower developers were initiated as a result of the Public Utility Regulatory Policies Act ( PURPA ) and the Energy Security Act. Those acts and...1980a). With the passage of The Public Utilities Regulatory Policy Act ( PURPA ), DOE was authorized to promote small-scale hydropower. Under its Small...requested. In addition, OMB has decided not to request the $300 million construction loan appropriation authorized under the PURPA because OMB

Assessing the influence of forest ownership type and location on roundwood utilization at the stump and top in a region with small-diameter markets

Treesearch

Matthew Bumgardner; Scott Bowe; Janice Wiedenbeck

2013-01-01

Research conducted in a variety of hardwood regions across the United States has indicated that utilization of small-diameter roundwood is hindered by a lack of markets. Efficient removal of such material could enable silvicultural practices to improve stand conditions and economic return for landowners. However, evidence from other studies has suggested that markets...

Small fish models for identifying carcinogens in the aqueous environment

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

Hawkins, W.E.; Overstreet, R.M.; Walker, W.W.

1988-10-01

Contaminants in water and sediments can be carcinogenic to aquatic wildlife as well as humans. Identifying those carcinogens, however, is difficult because they often occur in low concentrations and exert their effects over a large part of the life span of affected organisms. Furthermore, the carcinogens are often components of complex mixtures. Recent studies suggest that laboratory-reared fish species might be well suited for testing water-associated and other carcinogens. Here, we review the principal carcinogen exposure methods that utilize small fish species or can be adapted to utilize small fish species to detect carcinogens in aqueous environments. Emphasis is placedmore » on methods for which the end-point is tumor induction. The methods discussed are dietary exposures, skin painting, embryo microinjection, early life stage (pulse) exposures, static water exposures, flow-through exposures, and controlled field exposures. Early life stage exposures seem to have the greatest utility with regard to carcinogen sensitivity, ease of administration, disposal of test compounds, and economy of materials and effort. For certain types of carcinogens, however, long-term flow-through exposures are probably required. In summary, small fish carcinogenesis models offer an array of methodologies that can be utilized in a variety of combinations depending on compounds tested, exposure parameters employed, and end point sought.« less

Antidepressant Medication Management among Older Patients Receiving Home Health Care

PubMed Central

Bao, Yuhua; Shao, Huibo; Bruce, Martha L.; Press, Matthew J.

2014-01-01

Objective Antidepressant management for older patients receiving home health care (HHC) may occur through two pathways: nurse-physician collaboration (without patient visits to the physician) and physician management through office visits. This study examines the relative contribution of the two pathways and how they interplay. Methods Retrospective analysis was conducted using Medicare claims of 7,389 depressed patients 65 or older who received HHC in 2006–7 and who possessed antidepressants at the start of HHC. A change in antidepressant therapy (vs. discontinuation or refill) was the main study outcome and could take the form of a change in dose, switch to a different antidepressant, or augmentation (addition of a new antidepressant). Logistic regressions were estimated to examine how use of home health nursing care, patient visits to physicians, and their interactions predict a change in antidepressant therapy. Results About 30% of patients experienced a change in antidepressants versus 51% who refilled and 18% who discontinued. Receipt of mental health specialty care was associated with a statistically significant, 10–20 percentage-point increase in the probability of antidepressant change; receipt of primary care was associated with a small and statistically significant increase in the probability of antidepressant change among patients with no mental health specialty care and above-average utilization of nursing care. Increased home health nursing care in absence of physician visits was not associated with increased antidepressant change. Conclusions Active antidepressant management resulting in a change in medication occurred on a limited scale among older patients receiving HHC. Addressing knowledge and practice gaps in antidepressant management by primary care providers and home health nurses and improving nurse-physician collaboration will be promising areas for future interventions. PMID:25158915

78 FR 36715 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 74 RIN 2900-AO63 VA Veteran-Owned Small Business (VOSB... Department of Veterans Affairs (VA) amended its Veteran-Owned Small Business (VOSB) Verification Guidelines... Office of Small and Disadvantaged Business Utilization (00SB), Department of Veterans Affairs, 810...

48 CFR 570.701 - FAR provisions and clauses.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-1Small Business Program Representations. 52.219-28Post-Award Small Business Program Rerepresentation (use...-5Women-Owned Business (Other than Small Business). 52.209-5Certification Regarding Debarment, Suspension...-8Utilization of Small Business Concerns. 52.223-6Drug-Free Workplace. 52.233-2Service of Protest. (g) the...

48 CFR 570.701 - FAR provisions and clauses.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-1Small Business Program Representations. 52.219-28Post-Award Small Business Program Rerepresentation (use...-5Women-Owned Business (Other than Small Business). 52.209-5Certification Regarding Debarment, Suspension...-8Utilization of Small Business Concerns. 52.223-6Drug-Free Workplace. 52.233-2Service of Protest. (g) the...

48 CFR 570.701 - FAR provisions and clauses.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-1Small Business Program Representations. 52.219-28Post-Award Small Business Program Rerepresentation (use...-5Women-Owned Business (Other than Small Business). 52.209-5Certification Regarding Debarment, Suspension...-8Utilization of Small Business Concerns. 52.223-6Drug-Free Workplace. 52.233-2Service of Protest. (g) the...

48 CFR 570.701 - FAR provisions and clauses.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-1Small Business Program Representations. 52.219-28Post-Award Small Business Program Rerepresentation (use...-5Women-Owned Business (Other than Small Business). 52.209-5Certification Regarding Debarment, Suspension...-8Utilization of Small Business Concerns. 52.223-6Drug-Free Workplace. 52.233-2Service of Protest. (g) the...

77 FR 3470 - Combined Notice of Filings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-24

... that the Commission has received the following Natural Gas Pipeline Rate and Refund Report filings... LLC, Missouri Joint Municipal Electric Util., City of Independence, Missouri, Kansas Power Pool... Municipal Electric Utility Commission, the City of Independence, Missouri, Kansas Power Pool and Kansas City...

18 CFR 292.304 - Rates for purchases.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small... reasonable to the electric consumer of the electric utility and in the public interest; and (ii) Not... requires any electric utility to pay more than the avoided costs for purchases. (b) Relationship to avoided...

Challenges of Communications and Tracking for Solar System Small Body Exploration

NASA Technical Reports Server (NTRS)

Rush, John J.; Lichten, Stephen M.; Srinivasan, Jeffrey M.

2011-01-01

This presentation will address: (1) Communications capabilities that will be needed for space missions for Small Planetary Body exploration (2) Utilization of large ground-based radar capabilities for Small Body remote sensing and mission planning

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

This paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility strives to use spot prices which maximize itsmore » revenues from any given Small Power Producing Facility, SPPF, a schedule while respecting the general regulatory and contractual framework. the proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

The present paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility will strive to use spot prices whichmore » maximize its revenues from any given Small Power Producing Facility, SPPF, schedule while respecting the general regulatory and contractual framework. The proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

7 CFR 4288.134 - Refunds and interest payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment... advanced biofuel producer who receives payments under this subpart may be required to refund such payments... General for appropriate action. (a) An eligible advanced biofuel producer receiving payments under this...

Binary processing and display concepts for low-cost Omega receivers. [airborne systems simulation

NASA Technical Reports Server (NTRS)

Lilley, R. W.

1974-01-01

A description is given of concepts related to plans for developing a low-cost, all-digital Omega receiver capable of offering to the small-aircraft pilot a reliable and accurate navigation aid. The receiver base considered includes a receiver front-end module, a receiver control module, a memory-aided phase-locked loop module, a housekeeping timer module, and a synthesizer module.

Hospital characteristics related to the hospital length of stay among inpatients receiving invasive cervical discectomy due to road traffic accidents under automobile insurance in South Korea.

PubMed

Shin, Kyoung Won; Lee, Hyo Jung; Nam, Chung Mo; Moon, Ki Tae; Park, Eun-Cheol

2017-08-16

In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. Insurance claims data from 158 hospitals were used. The study included 850 inpatients who were involved in automobile accidents in 2014 and 2015 and who underwent invasive cervical discectomy. Poisson regression analysis was performed to examine the associations between the LOS and hospital-level characteristics. The mean LOS for inpatients covered by automobile insurance was 25.75 days. A higher proportion of inpatients with automobile insurance were associated with a longer LOS (rate ratio [RR]: 1.027 per 1% increase, 95% confidence interval [CI]: 1.012-1.042). A higher hospital volume of invasive cervical discectomy (RR: 0.970 per 10 case increase, 95% CI: 0.945-0.997), bed turnover rate (RR: 0.988 per 1 increase, 95% CI: 0.979-0.997), and number of neurosurgeons or orthopedic specialists (RR: 0.930 per 1/100 beds increase, 95% CI: 0.876-0.987) were associated with a shorter LOS. Our findings suggest that inpatients covered by automobile insurance were associated with a longer LOS when treated at small-sized, low-provider, and low-volume hospitals with high proportions of such patients. Based on these findings, policymakers and healthcare professionals ought to consider improved strategies for efficient management of automobile insurance for inpatients in small-sized hospitals.

Hardware, software, and scanning issues encountered during small animal imaging of photodynamic therapy in the athymic nude rat

NASA Astrophysics Data System (ADS)

Cross, Nathan; Sharma, Rahul; Varghai, Davood; Spring-Robinson, Chandra; Oleinick, Nancy L.; Muzic, Raymond F., Jr.; Dean, David

2007-02-01

Small animal imaging devices are now commonly used to study gene activation and model the effects of potential therapies. We are attempting to develop a protocol that non-invasively tracks the affect of Pc 4-mediated photodynamic therapy (PDT) in a human glioma model using structural image data from micro-CT and/or micro-MR scanning and functional data from 18F-fluorodeoxy-glucose (18F-FDG) micro-PET imaging. Methods: Athymic nude rat U87-derived glioma was imaged by micro-PET and either micro-CT or micro-MR prior to Pc 4-PDT. Difficulty insuring animal anesthesia and anatomic position during the micro-PET, micro-CT, and micro-MR scans required adaptation of the scanning bed hardware. Following Pc 4-PDT the animals were again 18F-FDG micro-PET scanned, euthanized one day later, and their brains were explanted and prepared for H&E histology. Histology provided the gold standard for tumor location and necrosis. The tumor and surrounding brain functional and structural image data were then isolated and coregistered. Results: Surprisingly, both the non-PDT and PDT groups showed an increase in tumor functional activity when we expected this signal to disappear in the group receiving PDT. Co-registration of the functional and structural image data was done manually. Discussion: As expected, micro-MR imaging provided better structural discrimination of the brain tumor than micro-CT. Contrary to expectations, in our preliminary analysis 18F-FDG micro-PET imaging does not readily discriminate the U87 tumors that received Pc 4-PDT. We continue to investigate the utility of micro-PET and other methods of functional imaging to remotely detect the specificity and sensitivity of Pc 4-PDT in deeply placed tumors.

One-year outcomes with the Taxus Liberté stent in the real world: the Taxus Olympia registry (phase I).

PubMed

Ahmed, Waqar Habib; Zambahari, Robaayah; Al-Rashdan, Ibrahim; Al Naeemi, Abdullah; Saeed, Fuad A; Mascioli, Stephen

2008-12-01

The Taxus Olympia registry is a prospective, postapproval registry collecting clinical outcomes data on patients receiving the Taxus Liberté paclitaxel-eluting stent during routine interventional cardiology practice. Between February and July 2005, 529 patients receiving the Taxus Liberté stent at 16 centers in the Middle East, South/Central America, and Asia/Pacific regions were enrolled in Phase I of Olympia. The primary end-point was Taxus Liberté stent-related cardiac events (cardiac death, MI, and revascularization) at 30 days postimplant. Additional clinical assessment was conducted at 6 and 12 months. Olympia phases II and III are in clinical follow-up and will be reported separately. One-year clinical follow-up is available for 98% of patients. Complex patients and lesions were prevalent, including: 50% diabetes mellitus, 49% multivessel disease, 30% multiple stenting, 48% AHA/ACC type B2/C lesions, 19% long lesions (>26 mm), and 40% small vessels (30 days postprocedure. One-year cardiac event rates among complex subpopulations (diabetics 5.0%, multiple stents 3.8%, long lesions 3.1%, and small vessels 2.9%) were comparable to the overall study population. In conclusion, this first report of real-world experience with the Taxus Liberté stent demonstrates the safety and clinical utility of this stent in the broader spectrum of coronary disease treated in everyday practice.

Tolerability and Healthcare Utilization in Maintenance Hemodialysis Patients Undergoing Treatment for Tuberculosis-Related Conditions.

PubMed

Hamadah, Abdurrahman M; Beaulieu, Lynn M; Wilson, John W; Aksamit, Timothy R; Gregoire, James R; Williams, Amy W; Dillon, John J; Albright, Robert C; Onuigbo, Macaulay; Iyer, Venkateshwaran K; Hickson, LaTonya J

2016-01-01

The incidence of tuberculosis (TB) in end-stage renal disease is significantly higher than that in the general population. Among those with kidney dysfunction, anti-TB treatment is associated with increased side effects, but the effect on healthcare utilization is unknown. Methods/Aim: To assess patient-reported symptoms, adverse effects and describe changes in healthcare utilization patterns during treatment for TB, we conducted a case series (n = 12) of patients receiving maintenance hemodialysis (HD) from Mayo Clinic Dialysis Services and concurrent drug therapy for TB from January 2002 through May 2014. Healthcare utilization (hospitalizations and emergency department (ED) visits independent of hospital admission) was compared before and during treatment. Patients were treated for latent (n = 7) or active (n = 5) TB. The majority of patients with latent disease were treated with isoniazid (n = 5, 71%), while active-disease patients received a 4-drug regimen. Adverse effects were reported in 83% of patients. Compared to measurements prior to drug initiation, serum albumin and dialysis weights were similar at 3 months. Commonly reported anti-TB drug toxicities were described. More than half (58%) of the patients were hospitalized at least once. No ED or hospital admissions occurred in the period prior to drug therapy, but healthcare utilization increased during treatment in the latent disease group (hospitalization rate per person-month: pre 0 vs. post 1). Among HD patients, anti-TB therapy is associated with frequently reported symptoms and increased healthcare utilization. Among this subset, patients receiving treatment for latent disease may be those with greatest increase in healthcare use. Careful monitoring and early complication detection may help optimize medication adherence and minimize hospitalizations. © 2016 S. Karger AG, Basel.

Tolerability and Healthcare Utilization in Maintenance Hemodialysis Patients Undergoing Treatment for Tuberculosis-Related Conditions

PubMed Central

Hamadah, Abdurrahman M.; Beaulieu, Lynn M.; Wilson, John W.; Aksamit, Timothy R.; Gregoire, James R.; Williams, Amy W.; Dillon, John J.; Albright, Robert C.; Onuigbo, Macaulay; Iyer, Venkateshwaran K.; Hickson, LaTonya J.

2016-01-01

Background The incidence of tuberculosis in end-stage renal disease is significantly higher than the general population. Among those with kidney dysfunction, anti-tuberculosis treatment is associated with increased side effects, but the effect on healthcare utilization is unknown. Methods/Aim To assess patient-reported symptoms, adverse effects and describe changes in healthcare utilization patterns during treatment for tuberculosis, we conducted a case series (n=12) of patients receiving maintenance hemodialysis from Mayo Clinic Dialysis Services and concurrent drug therapy for tuberculosis from January 2002 through May 2014. Healthcare utilization (hospitalizations and emergency department visits independent of hospital admission) was compared before and during treatment. Results Patients were treated for latent (n=7) or active (n=5) tuberculosis. The majority of patients with latent disease were treated with isoniazid (n=5, 71%), while active-disease patients received a 4-drug regimen. Adverse effects were reported in 83% of patients. Compared to measurements prior to drug initiation, serum albumin and dialysis weights were similar at 3 months. Commonly reported anti-tuberculosis drug toxicities were described. More than half (58%) of patients were hospitalized at least once. No emergency department or hospital admissions occurred in the period prior to drug therapy, but healthcare utilization increased during treatment in the latent disease group (hospitalization rate per person-month: pre, 0 vs. post, 1). Conclusions Among hemodialysis patients, anti-tuberculosis therapy is associated with frequent patient-reported symptoms and increased healthcare utilization. Patients receiving treatment for latent disease may have the greatest increase in healthcare use. Careful monitoring and early complication detection may help optimize medication adherence and minimize hospitalizations. PMID:26859893

Frailty and its prediction of disability and health care utilization: the added value of interviews and physical measures following a self-report questionnaire.

PubMed

Gobbens, Robbert J J; van Assen, Marcel A L M

2012-01-01

To establish whether the prediction of the adverse outcomes disability and six indicators of health care utilization one and two years later by the three frailty domains (physical, psychological, social) of the Tilburg Frailty Indicator (TFI) is improved by adding interview and physical measures of frailty. A representative sample of 245 Dutch community-dwelling persons aged 75 years and older (response rate 53%) participated in 2008, one year later in 2009 (n=179, 73%) and again two years later in 2010 (n=141, 58%). Frailty was assessed with the TFI, an easy to administer self-report measure. Disability was measured using the Groningen Activity Restriction Scale (GARS). Indicators of health care utilization were: visit to a general practitioner (gp), contacts with health care professionals (hcps), hospital admission, receiving personal care, receiving nursing care, and receiving informal care. After controlling for background characteristics, the TFI predicted disability and the indicators of health care utilization. Interviews and physical measures of frailty improved the prediction of disability. The Hospital Anxiety and Depression Scale (HADS-A) improved the prediction of contacts with hcps, but the interview and physical measures of frailty did not improve the predictions of the other indicators of health care utilization. Assessment by the self-report TFI is sufficient for predicting six indicators of health care utilization, but for predicting disability the use of both the TFI and the Timed Up & Go (TUG) test is recommended. It is advisable assessing all three frailty domains when examining frailty and its prediction of adverse outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

High-temperature solar receiver integrated with a short-term storage system

NASA Astrophysics Data System (ADS)

Giovannelli, Ambra; Bashir, Muhammad Anser; Archilei, Erika Maria

2017-06-01

Small-Scale Concentrated Solar Power Plants could have a potential market for off-grid applications in rural contexts with limited access to the electrical grid and favorable environmental characteristics. Some Small-Scale plants have already been developed, like the 25-30 kWe Dish-Stirling engine. Other ones are under development as, for example, plants based on Parabolic Trough Collectors coupled with Organic Rankine Cycles. Furthermore, the technological progress achieved in the development of new small high-temperature solar receiver, makes possible the development of interesting systems based on Micro Gas Turbines coupled with Dish collectors. Such systems could have several advantages in terms of costs, reliability and availability if compared with Dish-Stirling plants. In addition, Dish-Micro Gas Turbine systems are expected to have higher performance than Solar Organic Rankine Cycle plants. The present work focuses the attention on some challenging aspects related to the design of small high-temperature solar receivers for Dish-Micro Gas Turbine systems. Natural fluctuations in the solar radiation can reduce system performance and damage seriously the Micro Gas Turbine. To stabilize the system operation, the solar receiver has to assure a proper thermal inertia. Therefore, a solar receiver integrated with a short-term storage system based on high-temperature phase-change materials is proposed in this paper. Steady-state and transient analyses (for thermal storage charge and discharge phases) have been carried out using the commercial CFD code Ansys-Fluent. Results are presented and discussed.

National Small Business Conference

DTIC Science & Technology

2005-06-02

Untitled Document 2005 National Small Business Conference.html[8/30/2016 1:07:10 PM] National Small Business Conference “Opening New Frontiers...Through Effective Partnering” Los Angeles, CA 31 May - 2 June 2005 AGENDA Wednesday, 23 March 2005 Small Business and the Defense Industrial Base, Mr...Frank Ramos, Director, Office of Small and Disadvantaged Business Utilization, DoD The Hill: How It Can Help Your Small Business , Mr. Ron Perlman

Multi-wavelength time-coincident optical communications system and methods thereof

NASA Technical Reports Server (NTRS)

Lekki, John (Inventor); Nguyen, Quang-Viet (Inventor)

2009-01-01

An optical communications transmitter includes a oscillator source, producing a clock signal, a data source, producing a data signal, a modulating circuit for modulating the clock signal using the data signal to produce modulating signals, optical drivers, receiving the modulating signals and producing optical driving signals based on the modulating signals and optical emitters, producing small numbers of photons based on the optical driving signals. The small numbers of photons are time-correlated between at least two separate optical transmission wavelengths and quantum states and the small number of photons can be detected by a receiver to reform the data signal.

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140 How does a school qualify for a Small School Adjustment? A school will receive a small school...

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140 How does a school qualify for a Small School Adjustment? A school will receive a small school...

Regional variation in post-stroke multidisciplinary rehabilitation care among veteran residents in community nursing homes.

PubMed

Jia, Huanguang; Pei, Qinglin; Sullivan, Charles T; Cowper Ripley, Diane C; Wu, Samuel S; Vogel, W Bruce; Wang, Xinping; Bidelspach, Douglas E; Hale-Gallardo, Jennifer L; Bates, Barbara E

2017-01-01

Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors' functional recovery and daily living activities. The US Department of Veterans Affairs (VA) places veterans needing post-acute institutional care in private community nursing homes (CNHs). These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans' health services as well as the geographic variation of the service utilization. The aims of this study were to determine rehabilitation therapy and restorative nursing care utilization by veterans with stroke in VA-contracted CNHs and to assess risk-adjusted regional variations in the utilization of rehabilitation therapy and restorative nursing care. This retrospective study included all veterans diagnosed with stroke residing in VA-contracted CNHs between 2006 and 2009. Minimum Dataset (a health status assessment tool for CNH residents) for the study CNHs was linked with veterans' inpatient and outpatient data within the VA health care system. CNHs were grouped into five VA-defined geographic regions: the North Atlantic, Southeast, Midwest, Continental, and Pacific regions. A two-part model was applied estimating risk-adjusted utilization probability and average weekly utilization days. Two dependent variables were rehabilitation therapy and restorative nursing care utilization by veterans during their CNH stays. The study comprised 6,206 veterans at 2,511 CNHs. Rates for utilization of rehabilitation therapy and restorative nursing care were 75.7% and 30.1%, respectively. Veterans in North Atlantic and Southeast CNHs were significantly ( p <0.001) more likely to receive rehabilitation therapies than veterans from other regions. However, veterans in Southeast CNHs were significantly ( p <0.001) less likely to receive restorative nursing care compared with veterans in all other regions, before and after risk adjustment. The majority of veterans with stroke received rehabilitation therapy, and about one-third had restorative nursing care during their stay at VA-contracted CNHs. Significant regional variations in weekly days for rehabilitation therapy and restorative nursing care utilization were observed even after adjusting for potential risk factors.

Matched Field Processing Based on Least Squares with a Small Aperture Hydrophone Array.

PubMed

Wang, Qi; Wang, Yingmin; Zhu, Guolei

2016-12-30

The receiver hydrophone array is the signal front-end and plays an important role in matched field processing, which usually covers the whole water column from the sea surface to the bottom. Such a large aperture array is very difficult to realize. To solve this problem, an approach called matched field processing based on least squares with a small aperture hydrophone array is proposed, which decomposes the received acoustic fields into depth function matrix and amplitudes of the normal modes at the beginning. Then all the mode amplitudes are estimated using the least squares in the sense of minimum norm, and the amplitudes estimated are used to recalculate the received acoustic fields of the small aperture array, which means the recalculated ones contain more environmental information. In the end, lots of numerical experiments with three small aperture arrays are processed in the classical shallow water, and the performance of matched field passive localization is evaluated. The results show that the proposed method can make the recalculated fields contain more acoustic information of the source, and the performance of matched field passive localization with small aperture array is improved, so the proposed algorithm is proved to be effective.

Matched Field Processing Based on Least Squares with a Small Aperture Hydrophone Array

PubMed Central

Wang, Qi; Wang, Yingmin; Zhu, Guolei

2016-01-01

The receiver hydrophone array is the signal front-end and plays an important role in matched field processing, which usually covers the whole water column from the sea surface to the bottom. Such a large aperture array is very difficult to realize. To solve this problem, an approach called matched field processing based on least squares with a small aperture hydrophone array is proposed, which decomposes the received acoustic fields into depth function matrix and amplitudes of the normal modes at the beginning. Then all the mode amplitudes are estimated using the least squares in the sense of minimum norm, and the amplitudes estimated are used to recalculate the received acoustic fields of the small aperture array, which means the recalculated ones contain more environmental information. In the end, lots of numerical experiments with three small aperture arrays are processed in the classical shallow water, and the performance of matched field passive localization is evaluated. The results show that the proposed method can make the recalculated fields contain more acoustic information of the source, and the performance of matched field passive localization with small aperture array is improved, so the proposed algorithm is proved to be effective. PMID:28042828

LETTER TO EDITOR REGARDING "ARSENIC CHALLENGES FOR WATER UTILITIES"

EPA Science Inventory

The two part series on "Arsenic Challenges for Water Utilities" have provided useful information for the many small water utilities faced with arsenic problems. Part II states that treatment options fall into six major categories and then proceeds to provide a short summary on e...

18 CFR 292.310 - Procedures for utilities requesting termination of obligation to purchase from qualifying...

Code of Federal Regulations, 2010 CFR

2010-04-01

....310 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 REGULATIONS UNDER SECTIONS... PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small...

Utilization of neoadjuvant intensity-modulated radiation therapy and proton beam therapy for esophageal cancer in the United States

PubMed Central

Haque, Waqar; Verma, Vivek; Butler, E. Brian

2018-01-01

Background Randomized esophageal cancer (EC) trials have utilized two- or three-dimensional conformal radiotherapy (3DCRT). Advanced radiotherapy (RT) techniques [(ARTs): intensity-modulated radiotherapy (IMRT) and proton beam therapy (PBT)] may have benefits, but are relatively unproven. This is the first study to date evaluating utilization of ARTs versus 3DCRT in the trimodality setting in the United States. Methods The National Cancer Data Base (NCDB) was queried (2004–2013) for newly-diagnosed cT1b-T4bN0/N+M0 EC receiving neoadjuvant CRT followed by esophagectomy. The primary objective was to assess temporal trends, with multivariable logistic regression analysis assessing factors predictive of receiving ARTs. Secondarily, Kaplan-Meier analysis evaluated overall survival (OS), Cox proportional hazards modeling determined variables associated with OS, and postoperative complications were compared between cohorts. Results Altogether, 3,138 patients met criteria; 1,398 (45%) received 3DCRT, and 1,740 (55%) received ARTs (99% IMRT, 1% PBT). Temporally, utilization of ARTs is steadily rising in the United States, from 20% in 2004 to 69% in 2013, corresponding with a progressive decrease in utilization of 3DCRT. ARTs were more often delivered with advancing age, squamous cell histology, N2+ disease, and at academic centers (P<0.05 for all). Centers in the Southwest were more likely to use ARTs, and those in the Midwest least likely (P<0.05 for both). As expected, there were no OS differences (P=0.8477); there were also no differences in postoperative events (P>0.05 for all). Treatment at an academic center independently correlated with improved OS (P<0.001). Conclusions Utilization of ARTs (IMRT in the vast majority) is steadily rising in the United States; 3DCRT is now used in a minority of patients. This has implications for payers and insurance coverage. ART use is impacted by not only age and disease factors, but also regional and facility differences. Treatment at an academic facility independently correlated with higher survival, which has implications for patient counseling. PMID:29755767

Utilization of neoadjuvant intensity-modulated radiation therapy and proton beam therapy for esophageal cancer in the United States.

PubMed

Haque, Waqar; Verma, Vivek; Butler, E Brian; Teh, Bin S

2018-04-01

Randomized esophageal cancer (EC) trials have utilized two- or three-dimensional conformal radiotherapy (3DCRT). Advanced radiotherapy (RT) techniques [(ARTs): intensity-modulated radiotherapy (IMRT) and proton beam therapy (PBT)] may have benefits, but are relatively unproven. This is the first study to date evaluating utilization of ARTs versus 3DCRT in the trimodality setting in the United States. The National Cancer Data Base (NCDB) was queried (2004-2013) for newly-diagnosed cT1b-T4bN0/N+M0 EC receiving neoadjuvant CRT followed by esophagectomy. The primary objective was to assess temporal trends, with multivariable logistic regression analysis assessing factors predictive of receiving ARTs. Secondarily, Kaplan-Meier analysis evaluated overall survival (OS), Cox proportional hazards modeling determined variables associated with OS, and postoperative complications were compared between cohorts. Altogether, 3,138 patients met criteria; 1,398 (45%) received 3DCRT, and 1,740 (55%) received ARTs (99% IMRT, 1% PBT). Temporally, utilization of ARTs is steadily rising in the United States, from 20% in 2004 to 69% in 2013, corresponding with a progressive decrease in utilization of 3DCRT. ARTs were more often delivered with advancing age, squamous cell histology, N2+ disease, and at academic centers (P<0.05 for all). Centers in the Southwest were more likely to use ARTs, and those in the Midwest least likely (P<0.05 for both). As expected, there were no OS differences (P=0.8477); there were also no differences in postoperative events (P>0.05 for all). Treatment at an academic center independently correlated with improved OS (P<0.001). Utilization of ARTs (IMRT in the vast majority) is steadily rising in the United States; 3DCRT is now used in a minority of patients. This has implications for payers and insurance coverage. ART use is impacted by not only age and disease factors, but also regional and facility differences. Treatment at an academic facility independently correlated with higher survival, which has implications for patient counseling.

Washington | Solar Research | NREL

Science.gov Websites

. Utilities offer varied loans and incentives to their renewable energy customers. Net Metering All customer is allowed for up to 100 kW per customer Interconnection Washington's adopted standardized Department of Revenue and local utilities Customer-owned renewable energy generation systems can receive

48 CFR 970.5232-6 - Work for others funding authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... uncollectible receivables resulting from the Contractor utilizing contractor corporate funding for reimbursable... provide advance payment utilizing contractor corporate funds for reimbursable work to be performed by the... Laws, regulations, and DOE directives clause of this contract and such advance cannot be obtained. The...

Recent and lifetime utilization of health care services by children and adolescent suicide victims: a case-control study.

PubMed

Renaud, Johanne; Berlim, Marcelo T; Séguin, Monique; McGirr, Alexander; Tousignant, Michel; Turecki, Gustavo

2009-10-01

In the present paper we describe a case-control study on the utilization of health care services prior to suicide (across different time periods) among children and adolescents aged 11 to 18 years in the Province of Quebec, Canada and matched healthy controls. Utilization of services (i.e., contact with general practitioners, mental health professionals, psychiatrists and/or youth protection groups) was examined at different time periods in 55 child and adolescent suicide victims and 54 matched community controls using proxy-based interviews and questionnaires. In addition, we examined the rates of detection of psychopathology by health care professionals, the use of psychotropic medications and the subjects' compliance with treatment. Although more than 90% of child and adolescent suicide completers in our sample suffered from mental disorders, a significant proportion of them were left without appropriate healthcare support (including psychiatric consultation) in the period preceding their suicide. Also, 20% of suicide completers and no control subject made prior suicide attempts. More specifically, over two-thirds of suicide completers had no treatment contact within the month prior to the completion, while only 12.7% (n=7) of them were in contact with psychiatric services during that same period. Moreover, 56.4% (n=31) of the suicide completers had not been diagnosed as having a mental disorder at the time of their death, and 54.5% of the subjects' that received treatment (12 out of 22) were considered poorly compliant or not compliant at all according to their medical/psychosocial records. Finally, we also found that females seemed to have more psychiatric and mental health service contacts in the past month, that subjects with depressive and anxious disorders received more psychiatric and general mental health services in the past year, and that past month hospitalization was more often associated with alcohol abuse and psychosis. Relatively small sample size, and cross-sectional design. Our findings indicate the need for an overall increase in the rates of healthcare services delivered to young subjects at risk for suicide, as well as better training of health professionals in detecting and treating youth psychopathology.

Teaching alternatives to the standard inferior alveolar nerve block in dental education: outcomes in clinical practice.

PubMed

Johnson, Thomas M; Badovinac, Rachel; Shaefer, Jeffry

2007-09-01

Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only. At the 95 percent confidence level, we estimated that between 3.7 percent and 16.1 percent (mean=8.5 percent) of clinicians trained in using the Gow-Gates technique use this injection technique primarily, and between 35.4 percent and 56.3 percent (mean=47.5 percent) of those trained in the Gow-Gates method never use this technique. At the same confidence level, between 0.0 percent and 3.8 percent (mean=0.0 percent) of clinicians trained in using the Akinosi technique use this injection clinical technique primarily, and between 62.2 percent and 81.1 percent (mean=72.3 percent) of those trained in the Akinosi method never use this technique. No control group that was completely untrained in the Gow-Gates or Akinosi techniques was available for comparison. However, we presume that zero percent of clinicians who have not been trained in a given technique will use the technique in clinical practice. The confidence interval for the Gow-Gates method excludes this value, while the confidence interval for the Akinosi technique includes zero percent. We conclude that, in the study population, formal clinical training in the Gow-Gates and Akinosi injection techniques lead to a small but significant increase in current primary utilization of the Gow-Gates technique. No significant increase in current primary utilization of the Akinosi technique was found.

48 CFR 1519.201 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SMALL BUSINESS PROGRAMS Policies 1519.201 Policy. Each program's Assistant or Associate Administrator... developed in collaboration with the supporting Chiefs of Contracting Offices and the local Small Business Specialist (SBS), and the Office of Small and Disadvantaged Business Utilization (OSDBU). The goals will be...

Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

PubMed Central

Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

2011-01-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

PubMed

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

The cost-effectiveness of solifenacin vs. trospium in the treatment of patients with overactive bladder in the German National Health Service.

PubMed

Nazir, J; Hart, W M

2014-06-01

To carry out a cost-utility analysis comparing initial treatment of patients with overactive bladder (OAB) with solifenacin 5 mg/day versus either trospium 20 mg twice a day or trospium 60 mg/day from the perspective of the German National Health Service. A decision analytic model with a 3 month cycle was developed to follow a cohort of OAB patients treated with either solifenacin or trospium during a 1 year period. Costs and utilities were accumulated as patients transitioned through the four cycles in the model. Some of the solifenacin patients were titrated from 5 mg to 10 mg/day at 3 months. Utility values were obtained from the published literature and pad use was based on a US resource utilization study. Adherence rates for individual treatments were derived from a United Kingdom general practitioner database review. The change in the mean number of urgency urinary incontinence episodes/day from after 12 weeks was the main outcome measure. Baseline effectiveness values for solifenacin and trospium were calculated using the Poisson distribution. Patients who failed second-line therapy were referred to a specialist visit. Results were expressed in terms of incremental cost-utility ratios. Total annual costs for solifenacin, trospium 20 mg and trospium 60 mg were €970.01, €860.05 and €875.05 respectively. Drug use represented 43%, 28% and 29% of total costs and pad use varied between 45% and 57%. Differences between cumulative utilities were small but favored solifenacin (0.6857 vs. 0.6802 to 0.6800). The baseline incremental cost-effectiveness ratio ranged from €16,657 to €19,893 per QALY. The difference in cumulative utility favoring solifenacin was small (0.0055-0.0057 QALYs). A small absolute change in the cumulative utilities can have a marked impact on the overall incremental cost-effectiveness ratios (ICERs) and care should be taken when interpreting the results. Solifenacin would appear to be cost-effective with an ICER of no more than €20,000/QALY. However, small differences in utility between the alternatives means that the results are sensitive to adjustments in the values of the assigned utilities, effectiveness and discontinuation rates.

Growth Hormone Utilization Review in a Pediatric Primary Care Setting.

PubMed

Sayarifard, Fatemeh; Imcheh, Fereshteh Bakhshi; Badri, Shirinsadat; Faghihi, Toktam; Qorbani, Mostafa; Radfar, Mania

2017-01-01

One of the main problems facing public health providers and administrators in many countries is ensuring the rational use of high-cost drugs. In this regard, on-going process of medication use evaluation can be considered as a useful tool. In this study, we evaluated certain usage aspects of a highly-cost medication, that is, recombinant growth hormone (GH). This cross-sectional study conducted from August 2012 to August 2014. Children receiving GH ± gonadotropin releasing hormone (GnRH) analogs were included in the study. A researcher-designed checklist was developed to evaluate the GH utilization in these patients. Baseline demographic characteristics and background clinical and growth data, as well as any aspects of drug therapy including indications, dosing, monitoring, and discontinuation were collected from the patients' medical records. Seventy children receiving GH entered the study, of which 23 patients (32.85%) received GH and GnRH analogs simultaneously. At the baseline, 67 children (95.7%) had GH stimulation test, whereas serum insulin-like growth factor-1 (IGF-1) levels were measured in 63 (90%) patients. Sixty-seven patients (95.71%) had thyroid function test, whereas bone age was determined in 68 children (97.14%). The mean ± standard deviation of GH dose for idiopathic short stature, GH deficiency, Turner's syndrome and born small for gestational age in our study was 0.22 ± 0.025 mg/kg/week, 0.23 ± 0.04 mg/kg/week, 0.22 ± 0.015 mg/kg/week, and 0.23 ± 0.02 mg/kg/week, respectively. Height and weight of all patients were followed every 3-6 months, regularly. Thirty patients were treated with GH for at least 1 year, of which thyroid hormones and IGF-1 levels were measured annually in 25 (83.33%) and 26 (86.66%) patients, respectively; while bone age was evaluated in 13 (43.33%) children, annually. GH treatment was discontinued in 15 patients (21.42%), while financial problem was the major reason. Diagnostic tests and monitoring of height, weight, IGF-1 level and thyroid function was properly performed in this setting. However, a number of patients with ISS and Turner's syndrome were under-dosed.

76 FR 71432 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... comments received will advance three objectives: (i) Reduce reporting burdens; (ii) ensure that it... any correspondence submitted. FRA will summarize comments received in response to this notice in a... functions, including whether the activities will have practical utility; (ii) the accuracy of FRA's...

Contraceptive prescriptions for US servicewomen, 2008-2013.

PubMed

Witkop, Catherine T; Webber, Bryant J; Chu, Kasi M; Clark, Leslie L

2017-07-01

To determine the proportion and characteristics of US servicewomen who were prescribed contraception between 2008 and 2013 and to estimate the prevalence of contraceptive utilization among women who deployed during the surveillance period. This is a descriptive study of all servicewomen of child-bearing potential serving in the active component of the US armed forces at any time between 2008 and 2013. We estimated contraceptive utilization status using pharmacy, procedural and diagnostic codes as recorded in the Defense Medical Surveillance System and Pharmacy Data Transaction Service. Estimates of contraceptive utilization were compared by demographic and military variables, including deployment status. Poisson regression with robust error variance was used to estimate adjusted prevalence ratios and 95% confidence intervals. Among eligible servicewomen (N=375,847), 68.7% received at least one form of contraception during the surveillance period. Contraceptive methods included short acting only (55.6%), long-acting (11.9%), permanent (1.0%) and barrier methods (0.2%). An additional 8.2% received counseling services only without an associated procedure or prescription. After adjusting by several demographic variables, receipt of contraception was highest among women aged 25-29 years and lowest among those aged 17-19 and 45-49 years. Receipt of any contraception was similar across racial/ethnic groups, although Hispanic and black, non-Hispanic women were more likely to receive long-acting reversible contraception. Of those who deployed (N=131,597), 53.6% received contraception before or during their deployment, with 7.9% using long-acting contraception. US servicewomen utilize contraception at high levels, with few demographic disparities. Gaps still exist, especially among the youngest women and around the time of deployment. US servicewomen are prescribed contraception at high levels, but utilization is lower in the youngest servicewomen and around the time of deployment. Such data provide opportunities for development and evaluation of interventions designed to improve access to contraceptive services for all servicewomen and to reduce the rate of unintended pregnancy. Published by Elsevier Inc.

Utilization of rehabilitation services for inpatient with cancer in Taiwan: a descriptive analysis from national health insurance database

PubMed Central

2012-01-01

Background Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients’ functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Methods Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. Results The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). Conclusions In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients remain unmet. PMID:22898402

Ten tips for receiving feedback effectively in clinical practice

PubMed Central

Algiraigri, Ali H.

2014-01-01

Background Despite being recognized as a fundamental part of the educational process and emphasized for several decades in medical education, the influence of the feedback process is still suboptimal. This may not be surprising, because the focus is primarily centered on only one half of the process – the teachers. The learners are the targets of the feedback process and improvement needs to be shifted. Learners need to be empowered with the skills needed to receive and utilize feedback and compensate for less than ideal feedback delivery due to the busy clinical environment. Methods Based on the available feedback literature and clinical experience regarding feedback, the author developed 10 tips to empower learners with the necessary skills to seek, receive, and handle feedback effectively, regardless of how it is delivered. Although, most of the tips are directed at the individual clinical trainee, this model can be utilized by clinical educators involved in learner development and serve as a framework for educational workshops or curriculum. Results Ten practical tips are identified that specifically address the learner's role in the feedback process. These tips not only help the learner to ask, receive, and handle the feedback, but will also ease the process for the teachers. Collectively, these tips help to overcome most, if not all, of the barriers to feedback and bridge the gaps in busy clinical practices. Conclusions Feedback is a crucial element in the educational process and it is shown that we are still behind in the optimal use of it; thus, learners need to be taught how to better receive and utilize feedback. The focus in medical education needs to balance the two sides of the feedback process. It is time now to invest on the learner's development of skills that can be utilized in a busy day-to-day clinical practice. PMID:25079664

High-dose accelerated hypofractionated three-dimensional conformal radiotherapy (at 3 Gy/fraction) with concurrent vinorelbine and carboplatin chemotherapy in locally advanced non-small-cell lung cancer: a feasibility study.

PubMed

Liu, Yue-E; Lin, Qiang; Meng, Fan-Jie; Chen, Xue-Ji; Ren, Xiao-Cang; Cao, Bin; Wang, Na; Zong, Jie; Peng, Yu; Ku, Ya-Jun; Chen, Yan

2013-08-11

Increasing the radiotherapy dose can result in improved local control for non-small-cell lung cancer (NSCLC) and can thereby improve survival. Accelerated hypofractionated radiotherapy can expose tumors to a high dose of radiation in a short period of time, but the optimal treatment regimen remains unclear. The purpose of this study was to evaluate the feasibility of utilizing high-dose accelerated hypofractionated three-dimensional conformal radiotherapy (at 3 Gy/fraction) with concurrent vinorelbine (NVB) and carboplatin (CBP) chemotherapy for the treatment of local advanced NSCLC. Untreated patients with unresectable stage IIIA/IIIB NSCLC or patients with a recurrence of NSCLC received accelerated hypofractionated three-dimensional conformal radiotherapy. The total dose was greater than or equal to 60 Gy. The accelerated hypofractionated radiotherapy was conducted once daily at 3 Gy/fraction with 5 fractions per week, and the radiotherapy was completed in 5 weeks. In addition to radiotherapy, the patients also received at least 1 cycle of a concurrent two-drug chemotherapy regimen of NVB and CBP. A total of 26 patients (19 previously untreated cases and 7 cases of recurrent disease) received 60Gy-75Gy radiotherapy with concurrent chemotherapy. All of the patients underwent evaluations for toxicity and preliminary therapeutic efficacy. There were no treatment-related deaths within the entire patient group. The major acute adverse reactions were radiation esophagitis (88.5%) and radiation pneumonitis (42.3%). The percentages of grade III acute radiation esophagitis and grade III radiation pneumonitis were 15.4% and 7.7%, respectively. Hematological toxicities were common and did not significantly affect the implementation of chemoradiotherapy after supportive treatment. Two patients received high dose of 75 Gy had grade III late esophageal toxicity, and none had grade IV and above. Grade III and above late lung toxicity did not occur. High-dose accelerated hypofractionated three-dimensional conformal radiotherapy with a dose of 60 Gy or greater with concurrent NVB and CBP chemotherapy might be feasible. However esophagus toxicity needs special attention. A phase I trial is recommended to obtain the maximum tolerated radiation dose of accelerated hypofractionated radiotherapy with concurrent chemotherapy.

High-dose accelerated hypofractionated three-dimensional conformal radiotherapy (at 3 Gy/fraction) with concurrent vinorelbine and carboplatin chemotherapy in locally advanced non-small-cell lung cancer: a feasibility study

PubMed Central

2013-01-01

Background Increasing the radiotherapy dose can result in improved local control for non-small-cell lung cancer (NSCLC) and can thereby improve survival. Accelerated hypofractionated radiotherapy can expose tumors to a high dose of radiation in a short period of time, but the optimal treatment regimen remains unclear. The purpose of this study was to evaluate the feasibility of utilizing high-dose accelerated hypofractionated three-dimensional conformal radiotherapy (at 3 Gy/fraction) with concurrent vinorelbine (NVB) and carboplatin (CBP) chemotherapy for the treatment of local advanced NSCLC. Methods Untreated patients with unresectable stage IIIA/IIIB NSCLC or patients with a recurrence of NSCLC received accelerated hypofractionated three-dimensional conformal radiotherapy. The total dose was greater than or equal to 60 Gy. The accelerated hypofractionated radiotherapy was conducted once daily at 3 Gy/fraction with 5 fractions per week, and the radiotherapy was completed in 5 weeks. In addition to radiotherapy, the patients also received at least 1 cycle of a concurrent two-drug chemotherapy regimen of NVB and CBP. Results A total of 26 patients (19 previously untreated cases and 7 cases of recurrent disease) received 60Gy-75Gy radiotherapy with concurrent chemotherapy. All of the patients underwent evaluations for toxicity and preliminary therapeutic efficacy. There were no treatment-related deaths within the entire patient group. The major acute adverse reactions were radiation esophagitis (88.5%) and radiation pneumonitis (42.3%). The percentages of grade III acute radiation esophagitis and grade III radiation pneumonitis were 15.4% and 7.7%, respectively. Hematological toxicities were common and did not significantly affect the implementation of chemoradiotherapy after supportive treatment. Two patients received high dose of 75 Gy had grade III late esophageal toxicity, and none had grade IV and above. Grade III and above late lung toxicity did not occur. Conclusion High-dose accelerated hypofractionated three-dimensional conformal radiotherapy with a dose of 60 Gy or greater with concurrent NVB and CBP chemotherapy might be feasible. However esophagus toxicity needs special attention. A phase I trial is recommended to obtain the maximum tolerated radiation dose of accelerated hypofractionated radiotherapy with concurrent chemotherapy. PMID:23937855

Habitat utilization, density, and growth of steelhead trout, coho salmon, and Pacific giant salamander in relation to habitat types in a small coastal redwood stream

Treesearch

Michael Roy Lau

1994-01-01

Abstract - Small Pacific northwestern coastal streams are nurseries for populations of young of the year coho salmon, steelhead trout, and the Pacific giant salamander larvae. Previous field studies suggest that the habitats of the juveniles of these species were similar to one another. Few habitat utilization studies focus on the juvenile stages of these species...

The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery: a prospective randomized, double-blinded controlled, multi-center trial.

PubMed

Cheng, D C; Newman, M F; Duke, P; Wong, D T; Finegan, B; Howie, M; Fitch, J; Bowdle, T A; Hogue, C; Hillel, Z; Pierce, E; Bukenya, D

2001-05-01

We compared (a) the perioperative complications; (b) times to eligibility for, and actual time of the following: extubation, less intense monitoring, intensive care unit (ICU), and hospital discharge; and (c) resource utilization of nursing ratio for patients receiving either a typical fentanyl/isoflurane/propofol regimen or a remifentanil/isoflurane/propofol regimen for fast-track cardiac anesthesia in 304 adults by using a prospective randomized, double-blinded, double-dummy trial. There were no differences in demographic data, or perioperative mortality and morbidity between the two study groups. The mini-mental status examination at postoperative Days 1 to 3 were similar between the two groups. The eligible and actual times for extubation, less intense monitoring, ICU discharge, and hospital discharge were not significantly different. Further analyses revealed no differences in times for extubation and resource utilization after stratification by preoperative risk scores, age, and country. The nurse/patient ratio was similar between the remifentanil/isoflurane/propofol and fentanyl/isoflu-rane/propofol groups during the initial ICU phase and less intense monitoring phase. Increasing preoperative risk scores and older age (>70 yr) were associated with longer times until extubation (eligible), ICU discharge (eligible and actual), and hospital discharge (eligible and actual). Times until extubation (eligible and actual) and less intense monitoring (eligible) were significantly shorter in Canadian patients than United States' patients. However, there was no difference in hospital length of stay in Canadian and United States' patients. We conclude that both anesthesia techniques permit early and similar times until tracheal extubation, less intense monitoring, ICU and hospital discharge, and reduced resource utilization after coronary artery bypass graft surgery. An ultra-short opioid technique was compared with a standard fast-track small-dose opioid technique in coronary artery bypass graft patients in a prospective randomized, double-blinded controlled study. The postoperative recovery and resource utilization, including stratification of preoperative risk score, age, and country, were analyzed.

Coherent and Noncoherent Joint Processing of Sonar for Detection of Small Targets in Shallow Water.

PubMed

Pan, Xiang; Jiang, Jingning; Li, Si; Ding, Zhenping; Pan, Chen; Gong, Xianyi

2018-04-10

A coherent-noncoherent joint processing framework is proposed for active sonar to combine diversity gain and beamforming gain for detection of a small target in shallow water environments. Sonar utilizes widely-spaced arrays to sense environments and illuminate a target of interest from multiple angles. Meanwhile, it exploits spatial diversity for time-reversal focusing to suppress reverberation, mainly strong bottom reverberation. For enhancement of robustness of time-reversal focusing, an adaptive iterative strategy is utilized in the processing framework. A probing signal is firstly transmitted and echoes of a likely target are utilized as steering vectors for the second transmission. With spatial diversity, target bearing and range are estimated using a broadband signal model. Numerical simulations show that the novel sonar outperforms the traditional phased-array sonar due to benefits of spatial diversity. The effectiveness of the proposed framework has been validated by localization of a small target in at-lake experiments.

Efficacy of a "small-changes" workplace weight loss initiative on weight and productivity outcomes.

PubMed

Zinn, Caryn; Schofield, Grant M; Hopkins, Will G

2012-10-01

The effect of weight reduction on workplace productivity is unknown. We have investigated a "small-changes" workplace weight loss intervention on weight and productivity outcomes. Overweight/obese employees at two New Zealand worksites (n = 102) received the 12-week intervention. One site received an extra 9-month weight-maintenance component. Magnitudes of effects on weight and productivity were assessed via standardization. Both groups reduced weight at 12 weeks and maintained lost weight at 12 months. There were small possible improvements in productivity at one worksite and trivial reductions at the other by 12 weeks, with little subsequent change during maintenance in either group. At an individual level, weight change was associated with at most only small improvements or small reductions in productivity. Workplace weight loss initiatives may need to be more intensive or multidimensional to enhance productivity.

Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.

PubMed

Goode, Adam P; Richardson, William J; Schectman, Robin M; Carey, Timothy S

2014-09-01

Nationwide estimates examining bone morphogenetic protein (BMP) use with cervical spine fusions have been limited to perioperative outcomes. To determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization. A retrospective cohort study from 2002 to 2009 using a nationwide claims database. There were 61,937 primary cervical spine fusions of which 1,677 received BMP. Complications, revision fusions, 30-day hospital readmission, and health care utilization. Data for these analyses come from the Thomson Reuters MarketScan Commercial Claims and Encounters Database 2010. Patients were aged 18 to 64 years, receiving and not receiving BMP with a primary (C2-C7) cervical spine fusion. All outcomes were defined by International Classification of Diseases, 9th edition Clinical Modification and Current Procedural and Terminology, 4th edition codes. Complications were analyzed as any complication and stratified by nervous system, wound, and dysphagia or hoarseness. Cervical revision fusions were determined in the 1-year follow-up. Hospital readmission discharge records defined 30-day hospital readmission and reason for the readmission. The utilization of at least one health care service of cervical spine imaging, epidural usage or rehabilitation service was examined. Poisson regression models were used to estimate the relative risk and 95% confidence interval (CI). Linear regression was used to determine the time to hospital readmission. Results were stratified by anterior or posterior and circumferential approaches. Patients receiving BMP were 29% more likely to have a complication (adjusted relative risk [aRR]=1.29 [95% CI, 1.14-1.46]) and a nervous system complication (aRR=1.42 [95% CI, 1.10-1.83]). Cervical revision fusions were more likely among patients receiving BMP (aRR=1.69 [95% CI, 1.35-2.13]). The risk of 30-day readmission was greater with BMP use (aRR=1.37 [95% CI, 1.07-1.73]) and readmission occurred 27.4% sooner on an average. Patients receiving BMP were more likely to receive computed tomography scans (aRR=1.34 [95% CI, 1.06-1.70]) and epidurals with anterior surgical approaches (aRR=1.29 [95% CI, 1.00-1.65]). These findings question both the safety and effectiveness of off-label BMP use in primary cervical spine fusions. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 45847 - Vendor Outreach Workshop for Small Businesses in New Mexico of the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... DEPARTMENT OF THE INTERIOR Office of the Secretary Vendor Outreach Workshop for Small Businesses...: The Office of Small and Disadvantaged Business Utilization of the Department of the Interior and the Department of Agriculture are hosting a Vendor Outreach Workshop for small businesses in the State of New...

76 FR 81521 - Vendor Outreach Workshop for Historically Underutilized Business (HUB) Zone Small Businesses

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... Underutilized Business (HUB) Zone Small Businesses AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: The Office of Small and Disadvantaged Business Utilization of the Department of the Interior are hosting a Vendor Outreach Workshop for HUB Zone small businesses that are interested in doing business...

48 CFR 570.601 - FAR provisions and clauses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Records—Negotiation. 52.219-8Utilization of Small Business Concerns. 52.223-6Drug-Free Workplace. 52.233... participation of small disadvantaged business concerns in accordance with FAR 19.12 52.219-24Small Disadvantaged... exceeds $2,500 52.204-3Taxpayer Identification.52.219-1Small Business Program Representations. 52.222...

Pediatric medical device development by surgeons via capstone engineering design programs.

PubMed

Sack, Bryan S; Elizondo, Rodolfo A; Huang, Gene O; Janzen, Nicolette; Espinoza, Jimmy; Sanz-Cortes, Magdalena; Dietrich, Jennifer E; Hakim, Julie; Richardson, Eric S; Oden, Maria; Hanks, John; Haridas, Balakrishna; Hury, James F; Koh, Chester J

2018-03-01

There is a need for pediatric medical devices that accommodate the unique physiology and anatomy of pediatric patients that is increasingly receiving more attention. However, there is limited literature on the programs within children's hospitals and academia that can support pediatric device development. We describe our experience with pediatric device design utilizing collaborations between a children's hospital and two engineering schools. Utilizing the academic year as a timeline, unmet pediatric device needs were identified by surgical faculty and matched with an engineering mentor and a team of students within the Capstone Engineering Design programs at two universities. The final prototypes were showcased at the end of the academic year and if appropriate, provisional patent applications were filed. All twelve teams successfully developed device prototypes, and five teams obtained provisional patents. The prototypes that obtained provisional patents included a non-operative ureteral stent removal system, an evacuation device for small kidney stone fragments, a mechanical leech, an anchoring system of the chorio-amniotic membranes during fetal surgery, and a fetal oxygenation monitor during fetoscopic procedures. Capstone Engineering Design programs in partnership with surgical faculty at children's hospitals can play an effective role in the prototype development of novel pediatric medical devices. N/A - No clinical subjects or human testing was performed. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of solifenacin on resource utilization, work productivity and health utility in overactive bladder patients switching from tolterodine ER.

PubMed

Zinner, Norman; Noe, Les; Rasouliyan, Lawrence; Marshall, Thomas; Seifeldin, Raafat

2008-06-01

Assess changes in resource utilization, work and activity impairment, and health utility among OAB patients continuing to have urgency symptoms with tolterodine ER 4 mg and willing to try solifenacin 5/10 mg. This was an open-label, non-comparative, flexible-dosing, multicenter, 12-week study assessing the efficacy and safety of solifenacin 5/10 mg/day. Patients receiving tolterodine ER 4 mg/day for >/=4 weeks but continuing to experience residual urgency symptoms (>/=3 urgency episodes/24 h) were enrolled into the study. After a 14-day washout, patients began treatment with solifenacin 5 mg/day with dosing adjustments allowed at Weeks 4 and 8. Outcomes were assessed using the Work Productivity and Activity Impairment Questionnaire - Specific Health Problem (WPAI-SHP), Health Utilities Index (HUI), and a resource utilization questionnaire administered at Pre-Washout and Week 12. Patients (n=440) reported significantly fewer physician office visits (p<0.0001), UTIs (p<0.0001), and pads/diapers (p=0.0009) during the study period while receiving solifenacin 5/10 mg/day, compared with the Pre-Washout period when receiving tolterodine ER 4 mg/day. After 12 weeks of treatment with solifenacin 5/10 mg/day, patients reported a reduction in work time missed (p=0.0017), less impairment while working (p<0.0001), less overall work impairment (p<0.0001) and a reduction in activity impairment (p<0.0001) compared to Pre-Washout. There was no significant difference in health utility scores. Treatment-emergent adverse events were mostly anticholinergic in nature, and were mild to moderate in severity. Overall, solifenacin 5/10 mg/day improved work productivity, activity participation, and reduced medical care use in OAB patients who continued to have urgency symptoms with tolterodine ER 4 mg/day and wished to switch to solifenacin 5/10 mg. This was an open-label, non-comparative study; therefore, further research is needed to confirm these results.

Business Models and Regulation | Distributed Generation Interconnection

Science.gov Websites

@nrel.gov 303-384-4641 Utilities and regulators are responding to the growth of distributed generation with new business models and approaches. The growing role of distributed resources in the electricity Electric Cooperative, Groton Utilities Distributed Solar for Small Utilities A recording of the webinar is

Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn's Disease.

PubMed

Bruining, David H; Zimmermann, Ellen M; Loftus, Edward V; Sandborn, William J; Sauer, Cary G; Strong, Scott A

2018-03-01

Computed tomography and magnetic resonance enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and magnetic resonance enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented. © 2018, RSNA, AGA Institute, and Society of Abdominal Radiology This article is being published jointly in Radiology and Gastroenterology.

Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn's Disease.

PubMed

Bruining, David H; Zimmermann, Ellen M; Loftus, Edward V; Sandborn, William J; Sauer, Cary G; Strong, Scott A

2018-03-01

Computed tomography and magnetic resonance enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and magnetic resonance enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented. Copyright © 2018 AGA Institute, RSNA, and Society of Abdominal Radiology. Published by Elsevier Inc. All rights reserved.

Biotelemetry

NASA Technical Reports Server (NTRS)

Mundt, C.

1999-01-01

Sensors 2000! is developing pill-shaped biotelemeters for measuring physiological parameters during space flight life sciences experiments using rodents aboard the ISS Gravitational Biology Facility, with the additional capability for monitoring the health of astronauts in the Human Research Facility. The first "pill transmitter" is capable of measuring pressure and temperature for up to 10 months. The NASA objective is to utilize these devices. The pill-transmitters can also be used by non-NASA users for medical applications. One application is fetal surgery. The 44pill" is small enough to be endoscopically placed into the womb through a tube used during surgeries to correct fetal defects before birth. After surgery, the pill-transmitter will continue to monitor body temperature, pressure and other vital signs in the womb, radioing results to physicians. It will help them to detect preterm-labor, a serious problem after fetal surgery. The pill is about one-third-of-an-inch across and one-and-one-third-inches long. Future pill-versions will include pH, heartrate, and ECG. A pH-pill prototype is currently being tested. Sensors 2000! has also designed and built a 2-channel biotelemetry receiver and has developed data acquisition software to display and record the measured physiological parameters. A DSP-base hand-held receiver (trisponder) is currently under development.

Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students

PubMed Central

Chamberlain, Neal R.; Stuart, Melissa K.; Singh, Vineet K.; Sargentini, Neil J.

2012-01-01

Background Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) Methods Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Results Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Conclusion Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians. PMID:22435014

Short-wavelength cone-opponent retinal ganglion cells in mammals.

PubMed

Marshak, David W; Mills, Stephen L

2014-03-01

In all of the mammalian species studied to date, the short-wavelength-sensitive (S) cones and the S-cone bipolar cells that receive their input are very similar, but the retinal ganglion cells that receive synapses from the S-cone bipolar cells appear to be quite different. Here, we review the literature on mammalian retinal ganglion cells that respond selectively to stimulation of S-cones and respond with opposite polarity to longer wavelength stimuli. There are at least three basic mechanisms to generate these color-opponent responses, including: (1) opponency is generated in the outer plexiform layer by horizontal cells and is conveyed to the ganglion cells via S-cone bipolar cells, (2) inputs from bipolar cells with different cone inputs and opposite response polarity converge directly on the ganglion cells, and (3) inputs from S-cone bipolar cells are inverted by S-cone amacrine cells. These are not mutually exclusive; some mammalian ganglion cells that respond selectively to S-cone stimulation seem to utilize at least two of them. Based on these findings, we suggest that the small bistratified ganglion cells described in primates are not the ancestral type, as proposed previously. Instead, the known types of ganglion cells in this pathway evolved from monostratified ancestral types and became bistratified in some mammalian lineages.

Workshop in a Box: Sustainable Management of Rural and Small Water and Wastewater Systems Workshops

EPA Pesticide Factsheets

A resource to help rural and small systems and communities to conduct workshops, either for an individual system or for a group of systems, based on the Rural and Small Systems Guidebook to Sustainable Utility Management.

Differences in self-monitored, blood glucose test strip utilization by therapy for type 2 diabetes mellitus.

PubMed

Tavares, Ruben; Duclos, Marc; Brabant, Marie-Josée; Checchin, Daniella; Bosnic, Nevzeta; Turvey, Katherine; Terres, Jorge Alfonso Ross

2016-06-01

To determine whether blood glucose test strip (BGTS) utilization in patients with type 2 diabetes (T2D) is associated with the type of diabetes therapy, classified according to hypoglycemic risk. A retrospective, longitudinal (2006-2012) study of Canadian private drug plans (PDP) and Ontario Public Drug Programs (OPDP) prescription claims was conducted. Analyses were restricted to patients with T2D with or without a claim for BGTS. Daily BGTS utilization (TS/patient/day) was evaluated by diabetes therapy classified by hypoglycemic risk. Multivariate analyses were conducted to identify determinants of BGTS utilization. The T2D cohort comprised 5,759,591 observations from 1,949,129 claimants. Mean BGTS utilization was 0.84 TS/patient/day and differed between PDP and OPDP (0.66 vs. 1.00). Daily utilization was greatest in patients receiving therapy associated with a pre-defined high risk of hypoglycemia [insulin: basal + bolus (2.16), premixed (1.65), basal (1.16), other insulin regimens (2.13), and sulfonylureas (0.74)] versus non-sulfonylurea non-insulin-based regimens (0.52). For non-insulin therapy, BGTS utilization was greater for patients on multiple non-insulin therapies versus monotherapy (0.74 vs. 0.53 TS/patient/day). In multivariate analyses, drivers for BGTS utilization included insulin use, previous BGTS use, and female gender. Previous diabetes therapy and duration of therapy were negatively correlated with BGTS utilization. BGTS utilization varies depending on the type of therapy used to treat T2D according to hypoglycemic risk. Decision making regarding BGTS needs to account for robust analyses of current utilization and its value in those settings, including in patients not receiving diabetes therapy and the prevalence of circumstances conducive to more intensive monitoring.

Predisposing characteristics, enabling resources and need as predictors of utilization and clinical outcomes for veterans receiving mental health services.

PubMed

Fasoli, DiJon R; Glickman, Mark E; Eisen, Susan V

2010-04-01

Though demand for mental health services (MHS) among US veterans is increasing, MHS utilization per veteran is decreasing. With health and social service needs competing for limited resources, it is important to understand the association between patient factors, MHS utilization, and clinical outcomes. We use a framework based on Andersen's behavioral model of health service utilization to examine predisposing characteristics, enabling resources, and clinical need as predictors of MHS utilization and clinical outcomes. This was a prospective observational study of veterans receiving inpatient or outpatient MHS through Veterans Administration programs. Clinician ratings (Global Assessment of Functioning [GAF]) and self-report assessments (Behavior and Symptom Identification Scale-24) were completed for 421 veterans at enrollment and 3 months later. Linear and logistic regression analyses were conducted to examine: (1) predisposing characteristics, enabling resources, and need as predictors of MHS inpatient, residential, and outpatient utilization and (2) the association between individual characteristics, utilization, and clinical outcomes. Being older, female, having greater clinical need, lack of enabling resources (employment, stable housing, and social support), and easy access to treatment significantly predicted greater MHS utilization at 3-month follow-up. Less clinical need and no inpatient psychiatric hospitalization predicted better GAF and Behavior and Symptom Identification Scale-24 scores. White race and residential treatment also predicted better GAF scores. Neither enabling resources, nor number of outpatient mental health visits predicted clinical outcomes. This application of Andersen's behavioral model of health service utilization confirmed associations between some predisposing characteristics, need, and enabling resources on MHS utilization but only predisposing characteristics, need, and utilization were associated with clinical outcomes.

7 CFR 4290.700 - Requirements concerning types of Enterprises to receive Financing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Requirements concerning types of Enterprises to receive Financing. 4290.700 Section 4290.700 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE RURAL...

75 FR 51975 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... practical utility; (b) the accuracy of the agency's estimate of burden including the validity of the... orchards and owners of fruit tree nurseries to receive compensation under certain circumstances. Owners of commercial stone fruit orchards may receive compensation for losses associated with trees destroyed to...

SYSTEM FOR AND METHOD OF DETERMINING RANGE

DOEpatents

Horrell, M.W.; Sanders, E.R.

1963-11-01

A system and method for indicating a predetermined altitude of an object or aircraft is described. The device utilizes a pulse transmit-receive system wherein pulses of predetermined width are transmitted towards the ground and the reflected pulses received gating only pulses having a predetermined width. (AEC)

76 FR 70532 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

... comments received will advance three objectives: (i) Reduce reporting burdens; (ii) ensure that it... correspondence submitted. FRA will summarize comments received in response to this notice in a subsequent notice... functions, including whether the activities will have practical utility; (ii) the accuracy of FRA's...

78 FR 76190 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... received will advance three objectives: (i) reduce reporting burdens; (ii) ensure that it organizes.... FRA will summarize comments received in response to this notice in a subsequent notice and include... functions, including whether the activities will have practical utility; (ii) the accuracy of FRA's...

75 FR 3275 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... comments received will advance three objectives: (i) Reduce reporting burdens; (ii) ensure that it... submitted. FRA will summarize comments received in response to this notice in a subsequent notice and... functions, including whether the activities will have practical utility; (ii) the accuracy of FRA's...

78 FR 59086 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... comments received will advance three objectives: (i) Reduce reporting burdens; (ii) ensure that it... correspondence submitted. FRA will summarize comments received in response to this notice in a subsequent notice... functions, including whether the activities will have practical utility; (ii) the accuracy of FRA's...

SAW correlator spread spectrum receiver

DOEpatents

Brocato, Robert W

2014-04-01

A surface acoustic wave (SAW) correlator spread-spectrum (SS) receiver is disclosed which utilizes a first demodulation stage with a chip length n and a second demodulation stage with a chip length m to decode a transmitted SS signal having a code length l=n.times.m which can be very long (e.g. up to 2000 chips or more). The first demodulation stage utilizes a pair of SAW correlators which demodulate the SS signal to generate an appropriate code sequence at an intermediate frequency which can then be fed into the second demodulation stage which can be formed from another SAW correlator, or by a digital correlator. A compound SAW correlator comprising two input transducers and a single output transducer is also disclosed which can be used to form the SAW correlator SS receiver, or for use in processing long code length signals.

Optimal Energy Efficiency Fairness of Nodes in Wireless Powered Communication Networks.

PubMed

Zhang, Jing; Zhou, Qingjie; Ng, Derrick Wing Kwan; Jo, Minho

2017-09-15

In wireless powered communication networks (WPCNs), it is essential to research energy efficiency fairness in order to evaluate the balance of nodes for receiving information and harvesting energy. In this paper, we propose an efficient iterative algorithm for optimal energy efficiency proportional fairness in WPCN. The main idea is to use stochastic geometry to derive the mean proportionally fairness utility function with respect to user association probability and receive threshold. Subsequently, we prove that the relaxed proportionally fairness utility function is a concave function for user association probability and receive threshold, respectively. At the same time, a sub-optimal algorithm by exploiting alternating optimization approach is proposed. Through numerical simulations, we demonstrate that our sub-optimal algorithm can obtain a result close to optimal energy efficiency proportional fairness with significant reduction of computational complexity.

Optimal Energy Efficiency Fairness of Nodes in Wireless Powered Communication Networks

PubMed Central

Zhou, Qingjie; Ng, Derrick Wing Kwan; Jo, Minho

2017-01-01

In wireless powered communication networks (WPCNs), it is essential to research energy efficiency fairness in order to evaluate the balance of nodes for receiving information and harvesting energy. In this paper, we propose an efficient iterative algorithm for optimal energy efficiency proportional fairness in WPCN. The main idea is to use stochastic geometry to derive the mean proportionally fairness utility function with respect to user association probability and receive threshold. Subsequently, we prove that the relaxed proportionally fairness utility function is a concave function for user association probability and receive threshold, respectively. At the same time, a sub-optimal algorithm by exploiting alternating optimization approach is proposed. Through numerical simulations, we demonstrate that our sub-optimal algorithm can obtain a result close to optimal energy efficiency proportional fairness with significant reduction of computational complexity. PMID:28914818

Hydrogen sulfide production by sulfate-reducing bacteria utilizing additives eluted from plastic resins.

PubMed

Tsuchida, Daisuke; Kajihara, Yusuke; Shimidzu, Nobuhiro; Hamamura, Kengo; Nagase, Makoto

2011-06-01

In the present study it was demonstrated that organic additives eluted from plastic resins could be utilized as substrates by sulfate-reducing bacteria. Two laboratory-scale experiments, a microcosm experiment and a leaching experiment, were conducted using polyvinyl chloride (PVC) as a model plastic resin. In the former experiment, the conversion of sulfate to sulfide was evident in microcosms that received plasticized PVC as the sole carbon source, but not in those that received PVC homopolymer. Additionally, dissolved organic carbon accumulated only in microcosms that received plasticized PVC, indicating that the dissolved organic carbon originated from additives. In the leaching experiment, phenol and bisphenol A were found in the leached solutions. These results suggest that the disposal of waste plastics in inert waste landfills may result in the production of H(2)S.

Social factors, treatment, and survival in early-stage non-small cell lung cancer.

PubMed Central

Greenwald, H P; Polissar, N L; Borgatta, E F; McCorkle, R; Goodman, G

1998-01-01

OBJECTIVES: This study assessed the importance of socioeconomic status, race, and likelihood of receiving surgery in explaining mortality among patients with stage-I non-small cell lung cancer. METHODS: Analyses focused on Black and White individuals 75 years of age and younger (n = 5189) diagnosed between 1980 and 1982 with stage-I non-small cell lung cancer in Detroit, San Francisco, and Seattle. The main outcome measure was months of survival after diagnosis. RESULTS: Patients in the highest income decile were 45% more likely to receive surgical treatment and 102% more likely to attain 5-year survival than those in the lowest decile. Whites were 20% more likely to undergo surgery than Blacks and 31% more likely to survive 5 years. Multivariate procedures controlling for age and sex confirmed these observations. CONCLUSIONS: Socioeconomic status and race appear to independently influence likelihood of survival. Failure to receive surgery explains much excess mortality. PMID:9807536

Dental Treatment and Expenditures Under General Anesthesia Among Medicaid-Enrolled Children in North Carolina.

PubMed

Meyer, Beau D; Lee, Jessica Y; Casey, Mark W

2017-11-01

Many studies reporting dental utilization under general anesthesia (GA) are dated. The purpose of this study was to provide contemporaneous data about children receiving dental GA by: (1) determining trends in utilization and associated expenditures; and (2) examining the effects of provider distribution. This time series cross-sectional study of Medicaid-eligible children ages zero to eight years old in North Carolina used aggregate Medicaid claims from State Fiscal Years (SFY) 2011 to 2015 to collect demographic and dental treatment information. Descriptive statistics were stratified by age and year to examine trends over time. Panel analysis techniques were used to explore regional effects of provider distribution on dental GA utilization. For SFY 2011 to 2015, the overall dental utilization rate was 517.1 per 1,000 (total enrolled equals 632,941 children/year), and the dental GA utilization rate was 15.8 per 1,000. Total dental expenditures averaged $113 million per year, and dental GA averaged $16.7 million per year. The dental GA proportion of expenditures increased over time (P<.001). Provider distribution did not affect dental GA utilization rate (P=.178) but did increase the number of children receiving dental GA (P<.001). Utilization and expenditures associated with dental treatment under general anesthesia continue to increase. While this reflects increased access to care, interventions should be examined to provide preventive care earlier in a child's life.

Fiber-based free-space optical coherent receiver with vibration compensation mechanism.

PubMed

Zhang, Ruochi; Wang, Jianmin; Zhao, Guang; Lv, Junyi

2013-07-29

We propose a novel fiber-based free-space optical (FSO) coherent receiver for inter-satellite communication. The receiver takes advantage of established fiber-optic components and utilizes the fine-pointing subsystem installed in FSO terminals to minimize the influence of satellite platform vibrations. The received beam is coupled to a single-mode fiber, and the coupling efficiency of the system is investigated both analytically and experimentally. A receiving sensitivity of -38 dBm is obtained at the forward error correction limit with a transmission rate of 22.4 Gbit/s. The proposed receiver is shown to be a promising component for inter-satellite optical communication.

Resource Allocation in Dynamic Environments

DTIC Science & Technology

2012-10-01

Utility Curve for the TOC Camera 42 Figure 20: Utility Curves for Ground Vehicle Camera and Squad Camera 43 Figure 21: Facial - Recognition Utility...A Facial - Recognition Server (FRS) can receive images from smartphones the squads use, compare them to a local database, and then return the...fallback. In addition, each squad has the ability to capture images with a smartphone and send them to a Facial - Recognition Server in the TOC to

Tisseel utilized as hemostatic in spine surgery impacts time to drain removal and length of stay.

PubMed

Epstein, Nancy E

2014-01-01

Although fibrin sealants (FSs) and fibrin glues (FGs) are predominantly utilized to strengthen repairs of cerebrospinal fluid (CSF) fistulas (deliberate/traumatic) during spinal surgery, they are also increasingly utilized to achieve hemostasis. Here, we investigated whether adding Tisseel (Baxter International Inc., Westlake Village, CA, USA), utilized to address increased bleeding during multilevel lumbar laminectomies with non-instrumented fusions, would reduce or equalize the time to drain removal and length of stay (LOS) without contributing to infections or prolonging time to fusion. Prospectively, 39 patients underwent multilevel laminectomies and 1-2 level non-instrumented (in situ) fusions to address stenosis/olisthesis; 22 who demonstrated increased intraoperative bleeding received Tisseel, while 17 without such bleeding did not. The 22 receiving versus 17 not receiving Tisseel, with similar clinical parameters, underwent comparable average multilevel laminectomies (4.36 and 4.25) and 1-2 level fusions (1.4 vs. 1.29 levels). As anticipated, for those receiving Tisseel, the average intraoperative estimated blood loss (EBL), total postoperative blood loss, and total perioperative transfusion requirements [red blood cells (RBC), fresh frozen plasma (FFP), platelets] were higher. However, Tisseel had the added benefit of equalizing the time to postoperative drain removal [e.g. 3.41 days (with) vs. 3.38 days (without)] and LOS [e.g. 5.86 days (with) vs. 5.82 days (without)] without increasing the infection rates (e.g. one superficial infection per group) or average times to fusion (e.g. 5.9 vs. 5.5 months). Adding Tisseel for increased bleeding during multilevel laminectomies/in situ fusions contributed to hemostasis by equalizing the average times to drain removal/LOS compared to patients without increased bleeding and not requiring Tisseel.

Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.

PubMed

Berger, Ariel; Bozic, Kevin; Stacey, Brett; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

2011-08-01

To examine patterns of pharmacotherapy and health care utilization and costs prior to total knee replacement (TKR) or total hip replacement (THR) in patients with osteoarthritis (OA). Using a large US health insurance claims database, we identified all patients with OA who were ages ≥40 years and had undergone TKR or THR between January 1, 2006 and December 31, 2007. Patients with <2 years of complete data prior to TKR or THR were excluded, as were those with evidence of other conditions for which TKR or THR may be performed (e.g., rheumatoid arthritis). We then examined patterns of health care utilization and costs over the 2-year period preceding surgery. A total of 16,527 patients met all study entry criteria. Their mean ± SD age was 56.6 ± 6.1 years, and 56% of them were women. In the 2 years preceding surgery, 55% of patients received prescription nonsteroidal antiinflammatory drugs, 58% received opioids, and 50% received injections of corticosteroids. The numbers of patients receiving these drugs increased steadily during the presurgery period. The mean ± SD total health care costs in the 2 years preceding surgery were $19,466 ± 29,869, of which outpatient care, inpatient care, and pharmacotherapy represented 45%, 20%, and 20%, respectively. Costs increased from $2,094 in the eighth calendar quarter prior to surgery to $3,100 in the final quarter. Patients with OA who undergo THR or TKR have relatively high levels of use of pain-related pharmacotherapy and high total health care costs in the 2-year period preceding surgery. Levels of utilization and cost increase as the date of surgery approaches. Copyright © 2011 by the American College of Rheumatology.

Health and functional status and utilization of health care services among holocaust survivors and their counterparts in Israel.

PubMed

Iecovich, Esther; Carmel, Sara

2010-01-01

To examine differences in health and functional status and in utilization of health services between holocaust survivors and their counterparts; and (b) to investigate if holocaust survivor status is a significant predictor of health status, functional status, and utilization of health services. The study included 1255 respondents of whom 272 were holocaust survivors. Interviews were conducted face-to-face at the respondents' homes. Participants were asked about their health (self-rated health and comorbidity) and functional (ADL and IADL) status, utilization of inpatient and outpatient health care services, age, gender, education, marital status, length of residence in Israel, and if they were holocaust survivors. Holocaust survivors, who were frailer and more chronically ill compared to their counterparts, visited their family physician and the nurse at the health care clinic more often than their counterparts did, and received more homecare services. Yet, there were no differences between them in the utilization of other health care services such as visits to specialists, emergency department, and hospitalizations. Holocaust survivors are more homebound due to more morbidity and functional limitations and therefore receive more health home care services that offset the utilization of other health services. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

High Power Microwave Emission of Large and Small Orbit Gyrotron Devices in Rectangular Interaction Structures

NASA Astrophysics Data System (ADS)

Hochman, J. M.; Gilgenbach, R. M.; Jaynes, R. L.; Rintamaki, J. I.; Luginsland, J. W.; Lau, Y. Y.; Spencer, T. A.

1996-11-01

Experiments utilize large and small orbit e-beam gyrotron devices in a rectangular-cross-section (RCS) gyrotron. This device is being explored to examine polarization control. Other research issues include pulse shortening, and mode competition. MELBA generates electron beams with parameters of: -800kV, 1-10kA diode current, and 0.5-1.0 μ sec pulselengths. The small orbit gyrotron device is converted to a large orbit experiment by running MELBA's annular electron beam through a magnetic cusp. Initial experiments showed an increase in beam alpha (V_perp/V_par) of a factor of ~ 4 between small and large orbit devices. Experimental results from the RCS gyrotron will be compared for large-orbit and small-orbit electron beams. Beam transport data and frequency measurements will be presented. Computer modeling utilizing the MAGIC and E-gun codes will be shown.

Screening of Small Molecule Interactor Library by Using In-Cell NMR Spectroscopy (SMILI-NMR)

PubMed Central

Xie, Jingjing; Thapa, Rajiv; Reverdatto, Sergey; Burz, David S.; Shekhtman, Alexander

2011-01-01

We developed an in-cell NMR assay for screening small molecule interactor libraries (SMILI-NMR) for compounds capable of disrupting or enhancing specific interactions between two or more components of a biomolecular complex. The method relies on the formation of a well-defined biocomplex and utilizes in-cell NMR spectroscopy to identify the molecular surfaces involved in the interaction at atomic scale resolution. Changes in the interaction surface caused by a small molecule interfering with complex formation are used as a read-out of the assay. The in-cell nature of the experimental protocol insures that the small molecule is capable of penetrating the cell membrane and specifically engaging the target molecule(s). Utility of the method was demonstrated by screening a small dipeptide library against the FKBP–FRB protein complex involved in cell cycle arrest. The dipeptide identified by SMILI-NMR showed biological activity in a functional assay in yeast. PMID:19422228

A redox-active, compact molecule for cross-linking amyloidogenic peptides into nontoxic, off-pathway aggregates: In vitro and in vivo efficacy and molecular mechanisms

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

Derrick, Jeffrey S.; Kerr, Richard A.; Nam, Younwoo

Chemical reagents targeting and controlling amyloidogenic peptides have received much attention for helping identify their roles in the pathogenesis of protein-misfolding disorders. In this paper, we report a novel strategy for redirecting amyloidogenic peptides into nontoxic, off-pathway aggregates, which utilizes redox properties of a small molecule (DMPD, N,N-dimethyl- p-phenylenediamine) to trigger covalent adduct formation with the peptide. In addition, for the first time, biochemical, biophysical, and molecular dynamics simulation studies have been performed to demonstrate a mechanistic understanding for such an interaction between a small molecule (DMPD) and amyloid-β (Aβ) and its subsequent anti-amyloidogenic activity, which, upon its transformation, generatesmore » ligand–peptide adducts via primary amine-dependent intramolecular cross-linking correlated with structural compaction. Furthermore, in vivo efficacy of DMPD toward amyloid pathology and cognitive impairment was evaluated employing 5xFAD mice of Alzheimer’s disease (AD). Such a small molecule (DMPD) is indicated to noticeably reduce the overall cerebral amyloid load of soluble Aβ forms and amyloid deposits as well as significantly improve cognitive defects in the AD mouse model. Altogether our in vitro and in vivo studies of DMPD toward Aβ with the first molecular-level mechanistic investigations present the feasibility of developing new, innovative approaches that employ redox-active compounds without the structural complexity as next-generation chemical tools for amyloid management.« less

A Redox-Active, Compact Molecule for Cross-Linking Amyloidogenic Peptides into Nontoxic, Off-Pathway Aggregates: In Vitro and In Vivo Efficacy and Molecular Mechanisms

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

Derrick, Jeffrey S.; Kerr, Richard A.; Nam, Younwoo

Chemical reagents targeting and controlling amyloidogenic peptides have received much attention for helping identify their roles in the pathogenesis of protein-misfolding disorders. Herein, we report a novel strategy for redirecting amyloidogenic peptides into nontoxic, off-pathway aggregates, which utilizes redox properties of a small molecule (DMPD, N,N-dimethyl-p-phenylenediamine) to trigger covalent adduct formation with the peptide. In addition, for the first time, biochemical, biophysical, and molecular dynamics simulation studies have been performed to demonstrate a mechanistic understanding for such an interaction between a small molecule (DMPD) and amyloid-β (Aβ) and its subsequent anti-amyloidogenic activity, which, upon its transformation, generates ligand–peptide adducts viamore » primary amine-dependent intramolecular cross-linking correlated with structural compaction. Furthermore, in vivo efficacy of DMPD toward amyloid pathology and cognitive impairment was evaluated employing 5xFAD mice of Alzheimer’s disease (AD). Such a small molecule (DMPD) is indicated to noticeably reduce the overall cerebral amyloid load of soluble Aβ forms and amyloid deposits as well as significantly improve cognitive defects in the AD mouse model. Overall, our in vitro and in vivo studies of DMPD toward Aβ with the first molecular-level mechanistic investigations present the feasibility of developing new, innovative approaches that employ redox-active compounds without the structural complexity as next-generation chemical tools for amyloid management.« less

Blood detection in wireless capsule endoscopy using expectation maximization clustering

NASA Astrophysics Data System (ADS)

Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

2006-03-01

Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

A redox-active, compact molecule for cross-linking amyloidogenic peptides into nontoxic, off-pathway aggregates: In vitro and in vivo efficacy and molecular mechanisms

DOE PAGES

Derrick, Jeffrey S.; Kerr, Richard A.; Nam, Younwoo; ...

2015-11-17

Chemical reagents targeting and controlling amyloidogenic peptides have received much attention for helping identify their roles in the pathogenesis of protein-misfolding disorders. In this paper, we report a novel strategy for redirecting amyloidogenic peptides into nontoxic, off-pathway aggregates, which utilizes redox properties of a small molecule (DMPD, N,N-dimethyl- p-phenylenediamine) to trigger covalent adduct formation with the peptide. In addition, for the first time, biochemical, biophysical, and molecular dynamics simulation studies have been performed to demonstrate a mechanistic understanding for such an interaction between a small molecule (DMPD) and amyloid-β (Aβ) and its subsequent anti-amyloidogenic activity, which, upon its transformation, generatesmore » ligand–peptide adducts via primary amine-dependent intramolecular cross-linking correlated with structural compaction. Furthermore, in vivo efficacy of DMPD toward amyloid pathology and cognitive impairment was evaluated employing 5xFAD mice of Alzheimer’s disease (AD). Such a small molecule (DMPD) is indicated to noticeably reduce the overall cerebral amyloid load of soluble Aβ forms and amyloid deposits as well as significantly improve cognitive defects in the AD mouse model. Altogether our in vitro and in vivo studies of DMPD toward Aβ with the first molecular-level mechanistic investigations present the feasibility of developing new, innovative approaches that employ redox-active compounds without the structural complexity as next-generation chemical tools for amyloid management.« less

Propulsive Small Expendable Deployer System (ProSEDS)

NASA Technical Reports Server (NTRS)

Curtis, Leslie; Johnson, Les; Brown, Norman S. (Technical Monitor)

2002-01-01

The Propulsive Small Expendable Deployer System (ProSEDS) space experiment will demonstrate the use of an electrodynamic tether propulsion system to generate thrust in space by decreasing the orbital altitude of a Delta 11 Expendable Launch Vehicle second stage. ProSEDS, which is planned on an Air Force GPS Satellite replacement mission in June 2002, will use the flight proven Small Expendable Deployer System (SEDS) to deploy a tether (5 km bare wire plus 10 km non-conducting Dyneema) from a Delta 11 second stage to achieve approx. 0.4N drag thrust. ProSEDS will utilize the tether-generated current to provide limited spacecraft power. The ProSEDS instrumentation includes Langmuir probes and Differential Ion Flux Probes, which will determine the characteristics of the ambient ionospheric plasma. Two Global Positioning System (GPS) receivers will be used (one on the Delta and one on the endmass) to help determine tether dynamics and to limit transmitter operations to occasions when the spacecraft is over selected ground stations. The flight experiment is a precursor to the more ambitious electrodynamic tether upper stage demonstration mission, which will be capable of orbit raising, lowering and inclination changes-all using electrodynamic thrust. An immediate application of ProSEDS technology is for the removal of spent satellites for orbital debris mitigation. In addition to the use of this technology to provide orbit transfer and debris mitigation it may also be an attractive option for future missions to Jupiter and any other planetary body with a magnetosphere.

Propulsive Small Expendable Deployer System (ProSEDS)

NASA Technical Reports Server (NTRS)

Ballance, Judy; Johnson, Les; Rogacki, John R. (Technical Monitor)

2000-01-01

The Propulsive Small Expendable Deployer System (ProSEDS) space experiment will demonstrate the use of an electrodynamic tether propulsion system to generate thrust in space by decreasing the orbital altitude of a Delta II Expendable Launch Vehicle (ELV) second stage. ProSEDS, which is planned to fly in 2001, will use the flight proven Small Expendable Deployer System (SEDS) to deploy a tether (5km bare wire plus 10 km spectra or dyneema) from a Delta II second stage to achieve approximately 0.4N drag thrust. ProSEDS will utilize the tether-generated current to provide limited spacecraft power. The ProSEDs instrumentation includes a Langmuir probe and Differential Ion Flux Probe, which will determine the characteristics of the ambient ionospheric plasma. Two Global Positioning System (GPS) receivers will be used (one on the Delta and one on the endmass) to help determine tether dynamics and to limit transmitter operations to occasions when the spacecraft is over selected ground stations, The flight experiment is a precursor to the more ambitious electrodynamic tether upper stage demonstration mission, which will be capable of orbit raising, lowering and inclination changes-all using electrodynamic thrust. An immediate application of ProSEDS technology is for the deorbit of spent satellites for orbital debris mitigation. In addition to the use of this technology to provide orbit transfer and debris mitigation it may also be an attractive option for future missions to Jupiter and any other planetary body with a magnetosphere.

Lung Radiofrequency Ablation for the Treatment of Unresectable Recurrent Non-Small-Cell Lung Cancer After Surgical Intervention

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

Kodama, Hiroshi, E-mail: h-kodama@clin.medic.mie-u.ac.jp; Yamakado, Koichiro; Takaki, Haruyuki

Purpose: A retrospective evaluation was done of clinical utility of lung radiofrequency (RF) ablation in recurrent non-small-cell lung cancer (NSCLC) after surgical intervention. Methods: During May 2003 to October 2010, 44 consecutive patients (26 male and 18 female) received curative lung RF ablation for 51 recurrent NSCLC (mean diameter 1.7 {+-} 0.9 cm, range 0.6 to 4.0) after surgical intervention. Safety, tumor progression rate, overall survival, and recurrence-free survival were evaluated. Prognostic factors were evaluated in multivariate analysis. Results: A total of 55 lung RF sessions were performed. Pneumothorax requiring pluerosclerosis (n = 2) and surgical suture (n = 1)more » were the only grade 3 or 4 adverse events (5.5%, 3 of 55). During mean follow-up of 28.6 {+-} 20.3 months (range 1 to 98), local tumor progression was found in 5 patients (11.4%, 5 of 44). The 1-, 3-, and 5-year overall survival rates were 97.7, 72.9, and 55.7%, respectively. The 1- and 3-year recurrence-free survival rates were 76.7 and 41.1%, respectively. Tumor size and sex were independent significant prognostic factors in multivariate analysis. The 5-year survival rates were 73.3% in 18 women and 60.5% in 38 patients who had small tumors measuring {<=}3 cm. Conclusion: Our results suggest that lung RF ablation is a safe and useful therapeutic option for obtaining long-term survival in treated patients.« less

Field support activity aerospace manpower transfer to small business enterprises

NASA Technical Reports Server (NTRS)

Green, M. K.

1972-01-01

This report reiterates the major findings of the original study on the utilization of unemployed aerospace professionals in small businesses, and also provides a definition of three programs which, as a result of this study and other research into this problem, offer great potential in providing for better utilization of the nation's technically trained personal and technology resources. Details of these three programs are provided along with a recommended plan of action for their implementation.

Diagnostic Utility of the Social Skills Improvement System Performance Screening Guide

ERIC Educational Resources Information Center

Krach, S. Kathleen; McCreery, Michael P.; Wang, Ye; Mohammadiamin, Houra; Cirks, Christen K.

2017-01-01

Researchers investigated the diagnostic utility of the Social Skills Improvement System: Performance Screening Guide (SSIS-PSG). Correlational, regression, receiver operating characteristic (ROC), and conditional probability analyses were run to compare ratings on the SSIS-PSG subscales of Prosocial Behavior, Reading Skills, and Math Skills, to…

18 CFR 367.1430 - Account 143, Other accounts receivable.

Code of Federal Regulations, 2010 CFR

2010-04-01

... REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT TO THE PROVISIONS OF THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL...

Learners' Experiences of Learning Support in Selected Western Cape Schools

ERIC Educational Resources Information Center

Bojuwoye, Olaniyi; Moletsane, Mokgadi; Stofile, Sindiswa; Moolla, Nadeen; Sylvester, Fredrick

2014-01-01

The study explored Western Cape primary and secondary school learners' experiences regarding the provision and utilization of support services for improving learning. A qualitative interpretive approach was adopted and data gathered through focus group interviews involving 90 learners. Results revealed that learners received and utilized various…

87. ARAIII. GCRE reactor building (ARA608) Mechanical equipment room. Utility ...

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

87. ARA-III. GCRE reactor building (ARA-608) Mechanical equipment room. Utility air receiver, dryer, and compressor sit on their foundations prior to grouting. December 22, 1958. Ineel photo no. 58-6429. Photographer: Ken Mansfield. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms

ERIC Educational Resources Information Center

Boswell, James F.; McAleavey, Andrew A.; Castonguay, Louis G.; Hayes, Jeffrey A.; Locke, Benjamin D.

2012-01-01

Although a potentially important factor in case conceptualization and treatment planning, the impact of previous treatment on subsequent counseling response has received little empirical attention. Using archival data, this study aimed to (a) report the prevalence of previous treatment utilization in a counseling population, (b) examine potential…

Spectrum/Orbit-Utilization Program

NASA Technical Reports Server (NTRS)

Miller, Edward F.; Sawitz, Paul; Zusman, Fred

1988-01-01

Interferences among geostationary satellites determine allocations. Spectrum/Orbit Utilization Program (SOUP) is analytical computer program for determining mutual interferences among geostationary-satellite communication systems operating in given scenario. Major computed outputs are carrier-to-interference ratios at receivers at specified stations on Earth. Information enables determination of acceptability of planned communication systems. Written in FORTRAN.

Coffee Enema for Preparation for Small Bowel Video Capsule Endoscopy: A Pilot Study

PubMed Central

Kim, Eun Sun; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

2014-01-01

Coffee enemas are believed to cause dilatation of bile ducts and excretion of bile through the colon wall. Proponents of coffee enemas claim that the cafestol palmitate in coffee enhances the activity of glutathione S-transferase, an enzyme that stimulates bile excretion. During video capsule endoscopy (VCE), excreted bile is one of the causes of poor preparation of the small bowel. This study aimed to evaluate the feasibility and effect of coffee enema for preparation of the small bowel during VCE. In this pilot study, 17 of 34 patients were assigned to the coffee enema plus polyethylene glycol (PEG) 2 L ingestion group, whereas the 17 remaining control patients received 2 L of PEG only. The quality of bowel preparation was evaluated in the two patient groups. Bowel preparations in the proximal segments of small bowel were not differ between two groups. In the mid and distal segments of the small intestine, bowel preparations tend to be better in patients who received coffee enemas plus PEG than in patients who received PEG only. The coffee enema group did not experience any complications or side effects. Coffee enemas may be a feasible option, and there were no clinically significant adverse events related to coffee enemas. More prospective randomized studies are warranted to improve small bowel preparation for VCE. PMID:25136541

The Impact of Hospice Patient Disease Type and Length of Stay on Caregiver Utilization of Grief Counseling: A 10-Year Retrospective Study.

PubMed

Palmer, William W; Yuen, Francis K

2017-11-01

This investigation explored the relationship between hospice patient disease type, length of stay (LOS) in hospice, and caregiver utilization of grief counseling in bereavement. A 10-year retrospective study was conducted utilizing data from caregivers associated with hospice patients who died between 2004 and 2014. A threshold of inclusion for disease type (≥1.00% of hospice admissions) resulted in a sample size of 3704 patients, comprising 19 different disease types and 348 associated caregivers who received counseling. Replicating a previous study, brain cancer, lung cancer, and renal failure were among the top 4 disease types associated with higher-than-average utilization of bereavement services among caregivers, regardless of the patient's LOS. This finding may be related to factors such as the duration of the disease, the deterioration of the patient, the absence of symptom control, and secondary losses. LOS as a predictor of whether counseling will be utilized by hospice caregivers was unsupported by this study, as the percentage of caregivers receiving counseling closely paralleled the patient's LOS across 4 cohorts (1-30 days, 31-60 days, 61-90 days, and 91+ days). However, among the caregivers who utilized counseling, the LOS was a statistically significant predictor of the number of counseling sessions utilized. For caregivers who utilized only 1 counseling session, the associated patient median LOS was 21.5 days. For caregivers who utilized 5 or more counseling sessions, the associated patient median LOS dropped to 12 days, suggesting an inverted relationship between hospice patient LOS and the duration of counseling in bereavement.

Support System for Solar Receivers

NASA Technical Reports Server (NTRS)

Kiceniuk, T.

1985-01-01

Hinged split-ring mounts insure safe support of heavy receivers. In addition to safer operation and damage-free mounting system provides more accurate focusing, and small incremental adjustments of ring more easily made.

18 CFR 292.208 - Special requirements for hydroelectric small power production facilities located at a new dam or...

Code of Federal Regulations, 2010 CFR

2010-04-01

... for hydroelectric small power production facilities located at a new dam or diversion. 292.208 Section... 201 AND 210 OF THE PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Qualifying Cogeneration and Small Power Production Facilities § 292.208 Special...

18 CFR 292.208 - Special requirements for hydroelectric small power production facilities located at a new dam or...

Code of Federal Regulations, 2011 CFR

2011-04-01

... for hydroelectric small power production facilities located at a new dam or diversion. 292.208 Section... 201 AND 210 OF THE PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Qualifying Cogeneration and Small Power Production Facilities § 292.208 Special...

76 FR 32986 - Vendor Outreach Workshop for Small Businesses in the Texas Intermountain Region of the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-07

... small business interested in working with the Department, we urge you to register online at: http://www... DEPARTMENT OF THE INTERIOR Office of the Secretary Vendor Outreach Workshop for Small Businesses.... ACTION: Notice. SUMMARY: The Office of Small and Disadvantaged Business Utilization of the Department of...

75 FR 48986 - Vendor Outreach Workshop for Small Businesses in the National Capitol Region of the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

.... If you are a small business interested in working with the Department, we urge you to register online... DEPARTMENT OF THE INTERIOR Office of the Secretary Vendor Outreach Workshop for Small Businesses...: Notice. SUMMARY: The Office of Small and Disadvantaged Business Utilization of the Department of the...

Applying Bayesian Modeling and Receiver Operating Characteristic Methodologies for Test Utility Analysis

ERIC Educational Resources Information Center

Wang, Qiu; Diemer, Matthew A.; Maier, Kimberly S.

2013-01-01

This study integrated Bayesian hierarchical modeling and receiver operating characteristic analysis (BROCA) to evaluate how interest strength (IS) and interest differentiation (ID) predicted low–socioeconomic status (SES) youth's interest-major congruence (IMC). Using large-scale Kuder Career Search online-assessment data, this study fit three…

Reflection: A Link between Receiving and Using Assessment Feedback

ERIC Educational Resources Information Center

Sargeant, Joan M.; Mann, Karen V.; van der Vleuten, Cees P.; Metsemakers, Job F.

2009-01-01

Problem statement and background: Feedback is essential to learning and practice improvement, yet challenging both to provide and receive. The purpose of this paper was to explore reflective processes which physicians described as they considered their assessment feedback and the perceived utility of that reflective process. Methods: This is a…

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

Assessing the Social Acceptability of the Functional Analysis of Problem Behavior

ERIC Educational Resources Information Center

Langthorne, Paul; McGill, Peter

2011-01-01

Although the clinical utility of the functional analysis is well established, its social acceptability has received minimal attention. The current study assessed the social acceptability of functional analysis procedures among 10 parents and 3 teachers of children who had recently received functional analyses. Participants completed a 9-item…

Phase 1 of the First Solar Small Power System Experiment (experimental System No. 1). Volume 3: Appendix E - N

NASA Technical Reports Server (NTRS)

Clark, T. B. (Editor)

1979-01-01

The design of a solar electric power plant for a small community is reported. Topics covered include: (1) control configurations and interface requirements for the baseline power system; (2) annual small power system output; (3) energy requirements for operation of the collectors and control building; (4) life cycle costs and reliability predictions; (5) thermal conductivities and costs of receiver insulation materials; (6) transient thermal modelling for the baseline receiver/thermal transport system under normal and inclement operating conditions; (7) high temperature use of sodium; (8) shading in a field of parabolic collectors; and (9) buffer storage materials.

Retroperitoneal Metastasis Abutting Small Bowel: A Novel Magnetic Resonance-Guided Radiation Approach

PubMed Central

Glide-Hurst, Carri; Siddiqui, M.Salim; Chetty, Indrin J; Movsas, Benjamin

2018-01-01

Stereotactic body radiation therapy (SBRT) is an option for selected patients with metastatic disease. However, sometimes these lesions are located in such close proximity to critical normal structures that the use of safe tumoricidal SBRT doses is not achievable. Here we present a case in which real-time imaging and tracking with a magnetic resonance linear accelerator (MR-LINAC) provided a novel treatment approach and enabled safe treatment of the tumor using SBRT. Our case is a 69-year-old female who presented with localized recurrent small cell lung cancer with a retroperitoneal (FDG-avid) soft tissue lesion measuring 2.4 x 4.1 cm that was causing pain and right hydronephrosis. A Food and Drug Administration (FDA)-approved MR-LINAC system was utilized for planning and the delivery of 21 Gy in three fractions to the retroperitoneal lesion planning target volume (PTV), limited by the neighboring small bowel tolerance. The gross tumor volume (GTV) itself received 27 Gy (9 Gy per fraction). Simulation was performed using a volumetric MR imaging study in treatment position co-registered to a 4D-computed tomography (CT) image set for contouring of the target and organs at risk (OAR). Treatment planning was performed using the primary CT dataset. We developed a reasonable SBRT treatment plan to deliver the prescribed dose without exceeding tolerance doses to the right kidney, the small bowel and all other OAR’s. Real-time MR imaging and tracking during treatment delivery enabled assessment of respiratory-induced target movement in relation to the small bowel and kidney. Gating was performed to halt treatment when PTV movement exceeded the 2-mm range as specified by the treating physician. The treatment course was concluded successfully. The patient denied any acute gastrointestinal or genitourinary toxicity. The pain was significantly improved within a short time following treatment. Follow-up CT showed a near complete response of the mass with total restoration of renal functions, allowing the ureteric stent to be removed. This response has been maintained for five months till the last follow-up. In conclusion, MR-guided planning and delivery using real-time MR imaging and tracking facilitated the treatment of the retroperitoneal mass accurately and efficiently with excellent clinical and radiological response and minimal to no toxicity. We would not discern it safe to treat this mass utilizing SBRT without this ability to accurately visualize the tumor boundary using magnetic resonance imaging (MRI), and offer tracking of the target within the millimeter of surrounding critical OAR’s. PMID:29872593