specific utilization rate: Topics by Science.gov

Sample records for specific utilization rate

Specification of the utility function in discrete choice experiments.

PubMed

van der Pol, Marjon; Currie, Gillian; Kromm, Seija; Ryan, Mandy

2014-03-01

The specification of the utility function has received limited attention within the discrete choice experiment (DCE) literature. This lack of investigation is surprising given that evidence from the contingent valuation literature suggests that welfare estimates are sensitive to different specifications of the utility function. This study investigates the effect of different specifications of the utility function on results within a DCE. The DCE elicited the public's preferences for waiting time for hip and knee replacement and estimated willingness to wait (WTW). The results showed that the WTW for the different patient profiles varied considerably across the three different specifications of the utility function. Assuming a linear utility function led to much higher estimates of marginal rates of substitution (WTWs) than with nonlinear specifications. The goodness-of-fit measures indicated that nonlinear specifications were superior. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Immigrants' utilization of specialist mental healthcare according to age, country of origin, and migration history: a nation-wide register study in Norway.

PubMed

Abebe, Dawit Shawel; Lien, Lars; Elstad, Jon Ivar

2017-06-01

As the immigrant population rises in Norway, it becomes ever more important to consider the responsiveness of health services to the specific needs of these immigrants. It has been questioned whether access to mental healthcare is adequate among all groups of immigrants. This study aims to examine the use of specialist mental healthcare services among ethnic Norwegians and specific immigrants groups. Register data were used from the Norwegian Patient Registry and Statistics Norway. The sample (age 0-59) consisted of 3.3 million ethnic Norwegians and 200,000 immigrants from 11 countries. Poisson regression models were applied to examine variations in the use of specialist mental healthcare during 2008-2011 according to country of origin, age group, reason for immigration, and length of stay. Immigrant children and adolescents had overall significantly lower use of specialist mental healthcare than ethnic Norwegians of the same age. A distinct exception was the high utilization rate among children and youth from Iran. Among adult immigrants, utilization rates were generally lower than among ethnic Norwegians, particularly those from Poland, Somalia, Sri Lanka, and Vietnam. Adult immigrants from Iraq and Iran, however, had high utilization rates. Refugees had high utilization rates of specialist mental healthcare, while labour immigrants had low use. Utilization rates of specialist mental healthcare are lower among immigrants than Norwegians. Immigrants from Poland, Somalia, Sri Lanka, and Vietnam, had generally quite low rates, while immigrants from Iran had high utilization rates. The findings suggest that specialist mental healthcare in Norway is underutilized among considerable parts of the immigrant population.
Intrinsic kinetic parameters of substrate utilization by immobilized anaerobic sludge.

PubMed

Zaiat, M; Vieira, L G; Foresti, E

1997-01-20

This article presents a method for evaluating the intrinsic kinetic parameters of the specific substrate utilization rate (r) equation and discusses the results obtained for anaerobic sludge-bed samples taken from a horizontal-flow anaerobic immobilized sludge (HAIS) reactor. This method utilizes a differential reactor filled with polyurethane foam matrices containing immobilized anaerobic sludge which is subjected to a range of feeding substrate flow rates. The range of liquid superficial velocities thus obtained are used for generating data of observed specific substrate utilization rates (r(obs)) under a diversity of external mass transfer resistance conditions. The r(obs) curves are then adjusted to permit their extrapolation for the condition of no external mass transfer resistance, and the values determined are used as a test for the condition of absence of limitation of internal mass transfer. The intrinsic parameters r(max), the maximum specific substrate utilization rate, and K(s), the half-velocity coefficient, are evaluated from the r values under no external mass transfer resistance and no internal mass transfer limitation. The application of such a method for anaerobic sludge immobilized in polyurethane foam particles treating a glucose substrate at 30 degrees C resulted in intrinsic r(max) and K(s), respectively, of 0.330 mg chemical oxygen demand (COD) . mg(-1) volatile suspended solids (VSS) . h(-1) and 72 mg COD . L(-1). In comparison with the values found in the literature, intrinsic r(max) is significantly high and intrinsic K(s) is relatively low. (c) 1997 John Wiley & Sons, Inc.
Trends in antibiotic utilization in Vancouver associated with a community education program on antibiotic use.

PubMed

Fuertes, Elaine Isabelle; Henry, Bonnie; Marra, Fawziah; Wong, Hubert; Patrick, David M

2010-01-01

"Do Bugs Need Drugs" (DBND) is a community education program that was implemented in British Columbia (BC) in September 2005 to decrease inappropriate antibiotic use. This study conducted descriptive analyses of the association between DBND and changes in overall, pediatric, drug-specific, and indication-specific antibiotic utilization rates in Vancouver, BC. Utilization data on all oral solid and liquid antibiotics classified as "antibacterials for systemic use" were obtained from BC PharmaNet for the years 1996 to 2008. Utilization data were linked to physician billing data to allow indication-specific analyses. Following conversion to the defined daily dose (DDD), the Holt-Winters exponential smoothing method was used to project expected antibiotic use in the period after implementation based on use prior to implementation. Differences between expected and observed utilization rates were calculated. Overall antibiotic use has stabilized in recent years (16.2 DDD/1000 population/day in 2008). Fluoroquinolone use remains high (1.5 DDD/1000 population/day), as does the steadily increasing use of newer macrolides (1.1 to 2.7 DDD/1000 population/day between 1996 and 2008). Encouraging declines in overall and indication-specific prescription rates among children were observed. Following 3 years of DBND activities, antibiotic use was 5.8% lower than expected and the number of prescriptions dispensed to children was 10.6% lower than expected. This ecological study reports improvements in antibiotic use that occurred simultaneously to the delivery of the DBND program in Vancouver. However, we did not find a lowering of all targeted classes. Policy directives limiting the use of certain antibiotics may be required.
On the Path to SunShot - Utility Regulatory Business Model Reforms forAddressing the Financial Impacts of Distributed Solar on Utilities

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

None, None

Net-energy metering (NEM) with volumetric retail electricity pricing has enabled rapid proliferation of distributed photovoltaics (DPV) in the United States. However, this transformation is raising concerns about the potential for higher electricity rates and cost-shifting to non-solar customers, reduced utility shareholder profitability, reduced utility earnings opportunities, and inefficient resource allocation. Although DPV deployment in most utility territories remains too low to produce significant impacts, these concerns have motivated real and proposed reforms to utility regulatory and business models, with profound implications for future DPV deployment. This report explores the challenges and opportunities associated with such reforms in the context ofmore » the U.S. Department of Energy’s SunShot Initiative. As such, the report focuses on a subset of a broader range of reforms underway in the electric utility sector. Drawing on original analysis and existing literature, we analyze the significance of DPV’s financial impacts on utilities and non-solar ratepayers under current NEM rules and rate designs, the projected effects of proposed NEM and rate reforms on DPV deployment, and alternative reforms that could address utility and ratepayer concerns while supporting continued DPV growth. We categorize reforms into one or more of four conceptual strategies. Understanding how specific reforms map onto these general strategies can help decision makers identify and prioritize options for addressing specific DPV concerns that balance stakeholder interests.« less
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.
Recombinant protein expression in Pichia pastoris strains with an engineered methanol utilization pathway

PubMed Central

2012-01-01

Βackground The methylotrophic yeast Pichia pastoris has become an important host organism for recombinant protein production and is able to use methanol as a sole carbon source. The methanol utilization pathway describes all the catalytic reactions, which happen during methanol metabolism. Despite the importance of certain key enzymes in this pathway, so far very little is known about possible effects of overexpressing either of these key enzymes on the overall energetic behavior, the productivity and the substrate uptake rate in P. pastoris strains. Results A fast and easy-to-do approach based on batch cultivations with methanol pulses was used to characterize different P. pastoris strains. A strain with MutS phenotype was found to be superior over a strain with Mut+ phenotype in both the volumetric productivity and the efficiency in expressing recombinant horseradish peroxidase C1A. Consequently, either of the enzymes dihydroxyacetone synthase, transketolase or formaldehyde dehydrogenase, which play key roles in the methanol utilization pathway, was co-overexpressed in MutS strains harboring either of the reporter enzymes horseradish peroxidase or Candida antarctica lipase B. Although the co-overexpression of these enzymes did not change the stoichiometric yields of the recombinant MutS strains, significant changes in the specific growth rate, the specific substrate uptake rate and the specific productivity were observed. Co-overexpression of dihydroxyacetone synthase yielded a 2- to 3-fold more efficient conversion of the substrate methanol into product, but also resulted in a reduced volumetric productivity. Co-overexpression of formaldehyde dehydrogenase resulted in a 2-fold more efficient conversion of the substrate into product and at least similar volumetric productivities compared to strains without an engineered methanol utilization pathway, and thus turned out to be a valuable strategy to improve recombinant protein production. Conclusions Co-overexpressing enzymes of the methanol utilization pathway significantly affected the specific growth rate, the methanol uptake and the specific productivity of recombinant P. pastoris MutS strains. A recently developed methodology to determine strain specific parameters based on dynamic batch cultivations proved to be a valuable tool for fast strain characterization and thus early process development. PMID:22330134
The Effects of Rising Interest Rates on Electric Utility Stock Prices: Regulatory Considerations and Approaches

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

Kihm, Steve; Satchwell, Andrew; Cappers, Peter

This technical brief identifies conditions under which utility regulators should consider implementing policy approaches that seek to mitigate negative outcomes due to an increase in interest rates. Interest rates are a key factor in determining a utility’s cost of equity and investors find value when returns exceed the cost of equity. Through historical observations of periods of rising and falling interest rates and application of a pro forma financial tool, we identify the key drivers of utility stock valuations and estimate the degree to which those valuations might be affected by increasing interest rates.3 We also analyze the efficacy ofmore » responses by utility regulators to mitigate potential negative financial impacts. We find that regulators have several possible approaches to mitigate a decline in value in an environment of increasing interest rates, though regulators must weigh the tradeoffs of improving investor value with potential increases in customer costs. Furthermore, the range of approaches reflects today’s many different electric utility regulatory models and regulatory responses to a decline in investor value will fit within state-specific models.« less
Organizational Benchmarks for Test Utilization Performance: An Example Based on Positivity Rates for Genetic Tests.

PubMed

Rudolf, Joseph; Jackson, Brian R; Wilson, Andrew R; Smock, Kristi J; Schmidt, Robert L

2017-04-01

Health care organizations are under increasing pressure to deliver value by improving test utilization management. Many factors, including organizational factors, could affect utilization performance. Past research has focused on the impact of specific interventions in single organizations. The impact of organizational factors is unknown. The objective of this study is to determine whether testing patterns are subject to organizational effects, ie, are utilization patterns for individual tests correlated within organizations. Comparative analysis of ordering patterns (positivity rates for three genetic tests) across 659 organizations. Hierarchical regression was used to assess the impact of organizational factors after controlling for test-level factors (mutation prevalence) and hospital bed size. Test positivity rates were correlated within organizations. Organizations have a statistically significant impact on the positivity rate of three genetic tests. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Per capita alcohol consumption and suicide mortality in a panel of US states from 1950 to 2002

PubMed Central

Kerr, William C.; Subbaraman, Meenakshi; Ye, Yu

2011-01-01

Introduction and Aims The relationship between per capita alcohol consumption and suicide rates has been found to vary in significance and magnitude across countries. This study utilizes a panel of time-series measures from the US states to estimate the effects of changes in current and lagged alcohol sales on suicide mortality risk. Design and Methods Generalized least squares estimation utilized 53 years of data from 48 US states or state groups to estimate relationships between total and beverage-specific alcohol consumption measures and age-standardized suicide mortality rates in first-differenced semi-logged models. Results An additional liter of ethanol from total alcohol sales was estimated to increase suicide rates by 2.3% in models utilizing a distributed lag specification while no effect was found in models including only current alcohol consumption. A similar result is found for men, while for women both current and distributed lag measures were found to be significantly related to suicide rates with an effect of about 3.2% per liter from current and 5.8% per liter from the lagged measure. Beverage-specific models indicate that spirits is most closely linked with suicide risk for women while beer and wine are for men. Unemployment rates are consistently positively related to suicide rates. Discussion and Conclusions Results suggest that chronic effects, potentially related to alcohol abuse and dependence, are the main source of alcohol’s impact on suicide rates in the US for men and are responsible for about half of the effect for women. PMID:21896069
Urban Middle School Students' Perceptions of the Value and Difficulty of Inquiry

NASA Astrophysics Data System (ADS)

Sandoval, William A.; Harven, Aletha M.

2011-02-01

Following their participation in a guided-inquiry unit, 129 seventh-graders from five diverse urban middle schools were asked about their perceptions of specific inquiry tasks, from an expectancy-value framework. Students were asked to rate the interest value, utility value, and task difficulty of (a) data collection design; (b) explanation; (c) data analysis; and (d) citing evidence for claims. The utility of all tasks was rated highly, while interest ratings were moderate. Students perceived these tasks as moderately different from their usual work, and not especially difficult. No gender differences were found in students' ratings. Investigation tasks were rated as more interesting and useful than argumentation tasks. Students from lower SES schools found all tasks more useful and interesting than their peers in higher SES schools. Students' justifications for their ratings suggest they valued the utility of knowing how to back up their ideas with evidence.
Predictors of Utilization of an Addiction-Specific Behavioural Couple Therapy in Alcohol Dependence.

PubMed

Schünemann, Olivia; Lindenmeyer, Johannes; Heinrichs, Nina

2018-06-14

The aim of this study was to examine predictors that lead to the utilization of Behavioural Couple Therapy (BCT) for patients with alcohol dependence (AD) in a -European health care system and to identify groups that have a low probability of utilizing BCT. Using routinely collected data from a German rehabilitation clinic, a sample of 1,843 inpatients with AD living in a couple relationship was examined. Each patient could freely choose to participate in an addiction-specific BCT as a voluntary additional intervention during an inpatient treatment program. The logistic regression analysis indicated that female gender, older age and a higher number of comorbid disorders were associated with a decreased probability of utilizing BCT. The decision tree found that for men, the lowest utilization rate was in the age range of 51-54 and from the age of 58 years; women with higher pressure by their partner in combination with more than 1 comorbid mental disorder and women with lower pressure by their partner (regardless of comorbid disorders) showed the lowest utilization rate. Certain subgroups of patients with AD are less likely to participate in BCT during inpatient treatment. © 2018 S. Karger AG, Basel.
Recovery of phenotypes obtained by adaptive evolution through inverse metabolic engineering.

PubMed

Hong, Kuk-Ki; Nielsen, Jens

2012-11-01

In a previous study, system level analysis of adaptively evolved yeast mutants showing improved galactose utilization revealed relevant mutations. The governing mutations were suggested to be in the Ras/PKA signaling pathway and ergosterol metabolism. Here, site-directed mutants having one of the mutations RAS2(Lys77), RAS2(Tyr112), and ERG5(Pro370) were constructed and evaluated. The mutants were also combined with overexpression of PGM2, earlier proved as a beneficial target for galactose utilization. The constructed strains were analyzed for their gross phenotype, transcriptome and targeted metabolites, and the results were compared to those obtained from reference strains and the evolved strains. The RAS2(Lys77) mutation resulted in the highest specific galactose uptake rate among all of the strains with an increased maximum specific growth rate on galactose. The RAS2(Tyr112) mutation also improved the specific galactose uptake rate and also resulted in many transcriptional changes, including ergosterol metabolism. The ERG5(Pro370) mutation only showed a small improvement, but when it was combined with PGM2 overexpression, the phenotype was almost the same as that of the evolved mutants. Combination of the RAS2 mutations with PGM2 overexpression also led to a complete recovery of the adaptive phenotype in galactose utilization. Recovery of the gross phenotype by the reconstructed mutants was achieved with much fewer changes in the genome and transcriptome than for the evolved mutants. Our study demonstrates how the identification of specific mutations by systems biology can direct new metabolic engineering strategies for improving galactose utilization by yeast.
Complete genome sequence, metabolic model construction and phenotypic characterization of Geobacillus LC300, an extremely thermophilic, fast growing, xylose-utilizing bacterium.

PubMed

Cordova, Lauren T; Long, Christopher P; Venkataramanan, Keerthi P; Antoniewicz, Maciek R

2015-11-01

We have isolated a new extremely thermophilic fast-growing Geobacillus strain that can efficiently utilize xylose, glucose, mannose and galactose for cell growth. When grown aerobically at 72 °C, Geobacillus LC300 has a growth rate of 2.15 h(-1) on glucose and 1.52 h(-1) on xylose (doubling time less than 30 min). The corresponding specific glucose and xylose utilization rates are 5.55 g/g/h and 5.24 g/g/h, respectively. As such, Geobacillus LC300 grows 3-times faster than E. coli on glucose and xylose, and has a specific xylose utilization rate that is 3-times higher than the best metabolically engineered organism to date. To gain more insight into the metabolism of Geobacillus LC300 its genome was sequenced using PacBio's RS II single-molecule real-time (SMRT) sequencing platform and annotated using the RAST server. Based on the genome annotation and the measured biomass composition a core metabolic network model was constructed. To further demonstrate the biotechnological potential of this organism, Geobacillus LC300 was grown to high cell-densities in a fed-batch culture, where cells maintained a high xylose utilization rate under low dissolved oxygen concentrations. All of these characteristics make Geobacillus LC300 an attractive host for future metabolic engineering and biotechnology applications. Copyright © 2015 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.
Effects of substrate concentrations on the growth of heterotrophic bacteria and algae in secondary facultative ponds.

PubMed

Kayombo, S; Mbwette, T S A; Katima, J H Y; Jorgensen, S E

2003-07-01

This paper presents the effect of substrate concentration on the growth of a mixed culture of algae and heterotrophic bacteria in secondary facultative ponds (SFPs) utilizing settled domestic sewage as a sole source of organic carbon. The growth of the mixed culture was studied at the concentrations ranging between 200 and 800 mg COD/l in a series of batch chemostat reactors. From the laboratory data, the specific growth rate (micro) was determined using the modified Gompertz model. The maximum specific growth rate ( micro(max)) and half saturation coefficients (K(s)) were calculated using the Monod kinetic equation. The maximum observed growth rate ( micro(max)) for heterotrophic bacteria was 3.8 day(-1) with K(s) of 200 mg COD/l. The micro(max) for algal biomass based on suspended volatile solids was 2.7 day(-1) with K(s) of 110 mg COD/l. The micro(max) of algae based on the chlorophyll-a was 3.5 day(-1) at K(s) of 50mg COD/l. The observed specific substrate removal by heterotrophic bacteria varied between the concentrations of substrate used and the average value was 0.82 (mg COD/mg biomass). The specific substrate utilization rate in the bioreactors was direct proportional to the specific growth rate. Hence, the determined Monod kinetic parameters are useful for the definition of the operation of SFPs.
Development of an algorithm for automatic detection and rating of squeak and rattle events

NASA Astrophysics Data System (ADS)

Chandrika, Unnikrishnan Kuttan; Kim, Jay H.

2010-10-01

A new algorithm for automatic detection and rating of squeak and rattle (S&R) events was developed. The algorithm utilizes the perceived transient loudness (PTL) that approximates the human perception of a transient noise. At first, instantaneous specific loudness time histories are calculated over 1-24 bark range by applying the analytic wavelet transform and Zwicker loudness transform to the recorded noise. Transient specific loudness time histories are then obtained by removing estimated contributions of the background noise from instantaneous specific loudness time histories. These transient specific loudness time histories are summed to obtain the transient loudness time history. Finally, the PTL time history is obtained by applying Glasberg and Moore temporal integration to the transient loudness time history. Detection of S&R events utilizes the PTL time history obtained by summing only 18-24 barks components to take advantage of high signal-to-noise ratio in the high frequency range. A S&R event is identified when the value of the PTL time history exceeds the detection threshold pre-determined by a jury test. The maximum value of the PTL time history is used for rating of S&R events. Another jury test showed that the method performs much better if the PTL time history obtained by summing all frequency components is used. Therefore, r ating of S&R events utilizes this modified PTL time history. Two additional jury tests were conducted to validate the developed detection and rating methods. The algorithm developed in this work will enable automatic detection and rating of S&R events with good accuracy and minimum possibility of false alarm.
Impact of Fast Charging on Life of EV Batteries

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

Neubauer, Jeremy; Wood, Eric; Burton, Evan

2015-05-03

Utilization of public charging infrastructure is heavily dependent on user-specific travel behavior. The availability of fast chargers can positively affect the utility of battery electric vehicles, even given infrequent use. Estimated utilization rates do not appear frequent enough to significantly impact battery life. Battery thermal management systems are critical in mitigating dangerous thermal conditions on long distance tours with multiple fast charge events.
Isolation, identification and growth determination of lactic acid-utilizing yeasts from the ruminal fluid of dairy cattle.

PubMed

Sirisan, V; Pattarajinda, V; Vichitphan, K; Leesing, R

2013-08-01

Ruminal organic acid production, especially lactic acid, can be modified by feeding cattle highly concentrated diets, which have been shown to adversely affect dairy cattle health. Therefore, the use of lactic acid-utilizing organisms is considered to be a potential method for controlling lactic acid levels. This study was conducted to isolate and identify lactic acid-utilizing yeasts from the ruminal fluid of dairy cattle and to determine the specific growth rate and generation time when using lactic acid as a carbon source instead of glucose. Seventeen yeast isolates were examined in this study. Yeasts isolated from dairy cattle that were fed a high cassava pulp diet (HCP) had higher specific growth rates and shorter generation times than yeasts isolated from dairy cattle that were fed a high-concentrate diet (HC) and a mixed diet (M). The three most effective yeasts in terms of specific growth rate and generation time were Pichia kudriavzevii, Candida rugosa and Kodamaea ohmeri, with 99, 100 and 99% nucleotide identities, respectively. These three isolates could be used as potential probiotics in dairy cattle diets. This study demonstrates that yeasts isolated from the ruminal fluid of dairy cattle can utilize lactic acid as a carbon and energy source for growth. The isolated yeasts can be used as probiotic supplements for dairy cattle that are fed highly concentrated diets to reduce ruminal lactic acid production. © 2013 The Society for Applied Microbiology.
Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children.

PubMed

Hendrix, Kristin S; Downs, Stephen M; Brophy, Ginger; Carney Doebbeling, Caroline; Swigonski, Nancy L

2013-01-01

Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost-effectiveness do not show cost-savings. Our objective is to apply state-specific claims data to an existing published model to quickly and inexpensively estimate the cost-savings of a policy consideration to better inform decisions - specifically, to assess whether Indiana Medicaid children's restorative service rates met the threshold to generate cost-savings. Threshold analysis was based on the 2006 model by Quiñonez et al. Simple calculations were used to "align" the Indiana Medicaid data with the published model. Quarterly likelihoods that a child would receive treatment for caries were annualized. The probability of a tooth developing a cavitated lesion was multiplied by the probability of using restorative services. Finally, this rate of restorative services given cavitation was multiplied by 1.5 to generate the threshold to attain cost-savings. Restorative services utilization rates, extrapolated from available Indiana Medicaid claims, were compared with these thresholds. For children 1-2 years old, restorative services utilization was 2.6 percent, which was below the 5.8 percent threshold for cost-savings. However, for children 3-5 years of age, restorative services utilization was 23.3 percent, exceeding the 14.5 percent threshold that suggests cost-savings. Combining a published model with state-specific data, we were able to quickly and inexpensively demonstrate that restorative service utilization rates for children 36 months and older in Indiana are high enough that fluoride varnish regularly applied by physicians to children starting at 9 months of age could save Medicaid funds over a 3-year horizon. © 2013 American Association of Public Health Dentistry.
An appraisal of the utility or futility of ENT consultant postal questionnaires.

PubMed

Ryan, Stephen; Saunders, J; Clarke, E; Fenton, J E

2013-03-01

Despite an increase in ENT postal questionnaires, the quality of their methodology has been questioned (Ramphul et al. in J Laryngol Otol 119:175-178, 1). This retrospective study examined whether quality and utility of such questionnaires published since 2005 has improved. Seventeen consultant postal questionnaires published between 2005 and 2012 were reviewed. Quality of questionnaires was assessed using a 30-point score based on compliance with 15 criteria previously established to evaluate postal questionnaire study-design (Ramphul et al. in J Laryngol Otol 119:175-178, 1). Citation rates were used as an indicator of utility. The specific comments made in each citing paper was reviewed providing information on whether questionnaire findings (a) had an impact on clinical practice, (b) were the citing comments positive, (c) negative or (d) non-specific. Recurrent methodological flaws were identified in all questionnaires. The average score assigned was 44 %, versus 32 % previously reported (Ramphul et al. in J Laryngol Otol 119:175-178, 1) (P < 0.01, Student's t test). The low citation rate demonstrates poor utility for postal questionnaires. Citations were general non-specific referencing with no clear indication that questionnaire findings positively impacted clinical practice. In conclusion, although the quality of ENT postal questionnaire has improved since the original study (Ramphul et al. in J Laryngol Otol 119:175-178, 1), important recurring methodological flaws still exist. The poor utility, based on low citation rates, also reflects the continued deficiencies in design quality. It is recommended that authors of questionnaire-based research should ensure that guidelines for questionnaire design are adhered in order to improve the validity of findings and hence impact on clinical practice.

Use of Direct Behavior Ratings to Collect Functional Assessment Data

ERIC Educational Resources Information Center

Kilgus, Stephen P.; Kazmerski, Jennifer S.; Taylor, Crystal N.; von der Embse, Nathaniel P.

2017-01-01

The purpose of this investigation was to evaluate the utility of Direct Behavior Rating Single Item Scale (DBR-SIS) methodology in collecting functional behavior assessment data. Specific questions of interest pertained to the evaluation of the accuracy of brief DBR-SIS ratings of behavioral consequences and determination of the type of training…
Dementia in Ontario: Prevalence and Health Services Utilization

ERIC Educational Resources Information Center

Tranmer, J. E.; Croxford, R.; Coyte, P. C.

2003-01-01

To understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using…
Analysis of methanogenic activity in a thermophilic-dry anaerobic reactor: use of fluorescent in situ hybridization.

PubMed

Montero, B; García-Morales, J L; Sales, D; Solera, R

2009-03-01

Methanogenic activity in a thermophilic-dry anaerobic reactor was determined by comparing the amount of methane generated for each of the organic loading rates with the size of the total and specific methanogenic population, as determined by fluorescent in situ hybridization. A high correlation was evident between the total methanogenic activity and retention time [-0.6988Ln(x)+2.667] (R(2) 0.8866). The total methanogenic activity increased from 0.04x10(-8) mLCH(4) cell(-1)day(-1) to 0.38x10(-8) mLCH(4) cell(-1)day(-1) while the retention time decreased, augmenting the organic loading rates. The specific methanogenic activities of H(2)-utilizing methanogens and acetate-utilizing methanogens increased until they stabilised at 0.64x10(-8) mLCH(4) cell(-1)day(-1) and 0.33x10(-8) mLCH(4) cell(-1)day(-1), respectively. The methanogenic activity of H(2)-utilizing methanogens was higher than acetate-utilizing methanogens, indicating that maintaining a low partial pressure of hydrogen does not inhibit the acetoclastic methanogenesis or the anaerobic process.
18 CFR 35.1 - Application; obligation to file rate schedules, tariffs and certain service agreements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... specifically setting forth all rates and charges for any transmission or sale of electric energy subject to the... same rate schedule or tariff, each public utility transmitting or selling electric energy subject to... schedule, tariff, or service agreement applicable to a transmission or sale of electric energy, other than...
Economics of regulation: externalities and institutional issues

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

Kahn, A.E.

In two previous articles, ''Can An Economist Find Happiness Setting Public Utility Rates'' and ''Applications of Economics to Public Utility Rate Structures'', appearing in Public Utilities Fortnightly January 5 and January 19, 1978, respectively, the author summarized his experiences in applying elementary economic principles to the regulation of public utilities in New York state, specifically to setting utility rates. In this article, Mr. Kahn discusses second-best considerations and externalities. He points out that opponents of marginal-cost pricing--particularly of electricity--have in recent years become enthusiastic exponents of the theory of second best. What is required, he feels, is an examination ofmore » how other, most directly pertinent prices in the economy do actually stand relative to their marginal costs. These would be the prices of goods and services for which electricity is a substitute; with which electricity is used as a complement; in whose supply electricity is an input; and which themselves constitute inputs in the production and delivery of electricity. Oil and gas are more complicated cases. External costs, such as abatement requirements, are considered when setting rates. The author points out other regulatory issues to be considered in decision making to conclude this series of articles. (MCW)« less
Comparative Analysis of Two Biological Warfare Air Samplers Using Live Surrogate Agents

DTIC Science & Technology

2012-03-01

extensively for Phosphate Buffer Saline (PBS) solution and water , and, to a very limited degree in AF evaluations, for virus preserving media, specifically...or water . Furthermore, viral studies have been conducted comparing the effectiveness of utilizing the reduced secondary flow rate on the XMX/2L...with using bioagent aerosols rated BSL-2 or higher. Male Specific Coliphage 2 (MS2), American Type Culture Collection (ATCC) 15597-B1, was selected
Acetate transport and utilization in the rat brain.

PubMed

Deelchand, Dinesh K; Shestov, Alexander A; Koski, Dee M; Uğurbil, Kâmil; Henry, Pierre-Gilles

2009-05-01

Acetate, a glial-specific substrate, is an attractive alternative to glucose for the study of neuronal-glial interactions. The present study investigates the kinetics of acetate uptake and utilization in the rat brain in vivo during infusion of [2-13C]acetate using NMR spectroscopy. When plasma acetate concentration was increased, the rate of brain acetate utilization (CMR(ace)) increased progressively and reached close to saturation for plasma acetate concentration > 2-3 mM, whereas brain acetate concentration continued to increase. The Michaelis-Menten constant for brain acetate utilization (K(M)(util) = 0.01 +/- 0.14 mM) was much smaller than for acetate transport through the blood-brain barrier (BBB) (K(M)(t) = 4.18 +/- 0.83 mM). The maximum transport capacity of acetate through the BBB (V(max)(t) = 0.96 +/- 0.18 micromol/g/min) was nearly twofold higher than the maximum rate of brain acetate utilization (V(max)(util) = 0.50 +/- 0.08 micromol/g/min). We conclude that, under our experimental conditions, brain acetate utilization is saturated when plasma acetate concentrations increase above 2-3 mM. At such high plasma acetate concentration, the rate-limiting step for glial acetate metabolism is not the BBB, but occurs after entry of acetate into the brain.
Neuron-Type-Specific Utility in a Brain-Machine Interface: a Pilot Study.

PubMed

Garcia-Garcia, Martha G; Bergquist, Austin J; Vargas-Perez, Hector; Nagai, Mary K; Zariffa, Jose; Marquez-Chin, Cesar; Popovic, Milos R

2017-11-01

Firing rates of single cortical neurons can be volitionally modulated through biofeedback (i.e. operant conditioning), and this information can be transformed to control external devices (i.e. brain-machine interfaces; BMIs). However, not all neurons respond to operant conditioning in BMI implementation. Establishing criteria that predict neuron utility will assist translation of BMI research to clinical applications. Single cortical neurons (n=7) were recorded extracellularly from primary motor cortex of a Long-Evans rat. Recordings were incorporated into a BMI involving up-regulation of firing rate to control the brightness of a light-emitting-diode and subsequent reward. Neurons were classified as 'fast-spiking', 'bursting' or 'regular-spiking' according to waveform-width and intrinsic firing patterns. Fast-spiking and bursting neurons were found to up-regulate firing rate by a factor of 2.43±1.16, demonstrating high utility, while regular-spiking neurons decreased firing rates on average by a factor of 0.73±0.23, demonstrating low utility. The ability to select neurons with high utility will be important to minimize training times and maximize information yield in future clinical BMI applications. The highly contrasting utility observed between fast-spiking and bursting neurons versus regular-spiking neurons allows for the hypothesis to be advanced that intrinsic electrophysiological properties may be useful criteria that predict neuron utility in BMI implementation.
The Characteristics and Utilization Pattern of an Admission Cohort of Nursing Home Patients (II).

ERIC Educational Resources Information Center

Liu, Korbin; Manton, Kenneth G.

1984-01-01

Projects utilization history of a synthetic cohort of nursing home admissions in 1976 by normalizing length of stay (LOS) specific discharge rates derived from life tables to an estimated 1.1 million persons. Results focus on the LOS distribution, discharge status, and total days of nursing home care used. (Author/JAC)
75 FR 4498 - Control and Affiliation for Purposes of Market-Based Rate Requirements Under Section 205 of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... decision- making over sales of electric energy. 16. American Public Power Association (APPA) and National... securities of a public utility. Specifically, the Commission proposes to amend Part 33 of its regulations to... than 20 percent, of the outstanding voting securities of a public utility or holding company, where the...
Effect of multiply charged ions on the performance and beam characteristics in annular and cylindrical type Hall thruster plasmas

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

Kim, Holak; Lim, Youbong; Choe, Wonho, E-mail: wchoe@kaist.ac.kr

2014-10-06

Plasma plume and thruster performance characteristics associated with multiply charged ions in a cylindrical type Hall thruster (CHT) and an annular type Hall thruster are compared under identical conditions such as channel diameter, channel depth, propellant mass flow rate. A high propellant utilization in a CHT is caused by a high ionization rate, which brings about large multiply charged ions. Ion currents and utilizations are much different due to the presence of multiply charged ions. A high multiply charged ion fraction and a high ionization rate in the CHT result in a higher specific impulse, thrust, and discharge current.
Electric Utility Rate Design Study: reference manual and procedures for implementing PURPA

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

Not Available

State regulatory commissions will be assisted by using this manual in carrying out their responsibilities under the National Energy Act, specifically under the Public Utilities Regulatory Policies Act (PURPA). The research and materials of the Rate Design Study are basically applicable to Title I of PURPA, and the Manual covers only that part of the Act. The Rate Design Study covers a wide scope of research and professional opinions and are a major reference source for data, information, and divergent views on practically every aspect of electric utility rate design. The introductory part calls attention to particularly important aspects ofmore » responsibilities, authority, and procedures. The second part outlines the specific responsibilities placed by Title I of PURPA on the State commissions. Part 3 discusses some of the procedural and substantive requirements and options of PURPA with particular emphasis on their relation to the Rate Design Study, State law, and State regulatory policies. Part 4 is an independent analysis that includes cross-indexed references to the more than 60 reports prepared by the Rate Design Study and also to other pertinent sources of information and data. Part 5 summarizes a survey conducted in January 1979 of State commission actions related to the matters contained in Title I of PURPA. Part 6 presents the text of the law. Part 7 is the request from NARUC that prompted the preparation of the Manual. (MCW)« less
1-99 W. Hubbard St, May 2018, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation.The count rates in the excavation ranged from 2,100 cpm to 4,200 cpm.No count rates were found at any time that exceeded the instrument specific threshold limits of 7,366 and 6,415 cpm.
U.S. Public Administration Programs: Increasing Academic Achievement by Identifying and Utilizing Student Learning Styles

ERIC Educational Resources Information Center

Naylor, Lorenda A; Wooldridge, Blue; Lyles, Alan

2014-01-01

Global economic shifts are forcing universities to become more competitive and operationally efficient. As a result, universities emphasize access, affordability, and achievement. More specifically, U.S. universities have responded by emphasizing course assessment, retention rates, and graduation rates. Both university administrators and faculty…
Comparative Ratings of the Utility of Portfolio Requirements: Toward Content Validity.

ERIC Educational Resources Information Center

McFarland, Jacqueline; Wisniewski, Shirley; Vermette, Paul

While the value of portfolio learning and assessment has gained much support from the educational community, many questions arise as specific implementations are attempted. This study examined one aspect, namely, the content validity of specific requirements, and addressed the question "How do various constituencies (methods students, student…
The utility of strabismus in adults.

PubMed

Beauchamp, George R; Felius, Joost; Stager, David R; Beauchamp, Cynthia L

2005-01-01

To determine the utility (quality-of-life weight) associated with adult strabismus. Time tradeoff utility values were measured in physician-conducted interviews with 140 adult patients with strabismus in a private practice setting. Patients also completed a questionnaire containing six items that rated the following aspects of disability: specific health problems, problems with tasks of daily living, problems with social interaction, self-image problems, concerns about the future, and job-related problems. Patients were characterized as presurgical or nonsurgical, and their diplopia and asthenopia were rated by the physician on a four-level scale. About 60% of all patients indicated willingness to trade part of their life expectancy in return for being rid of strabismus and its associated effects. The median utility was 0.93 (interquartile range, 0.83 to 1.0). A significantly smaller proportion (44%) of the nonsurgical patients (N = 41) appeared willing to trade time compared with surgical patients (68%; P = .009). Median utility in the presurgical patients was 0.90. Strong relationships were found between utility and the level of diplopia (P < .0001), and between utility and the level of asthenopia (P < .0001). Utility was correlated with all six disability ratings (all P < or = .00062). A majority of the patients interviewed would trade a portion of their life expectancy in return for being rid of strabismus and its associated effects. These results were validated by significant associations with diplopia, asthenopia, and disability.
Utility of the Conners' Adult ADHD Rating Scale validity scales in identifying simulated attention-deficit hyperactivity disorder and random responding.

PubMed

Walls, Brittany D; Wallace, Elizabeth R; Brothers, Stacey L; Berry, David T R

2017-12-01

Recent concern about malingered self-report of symptoms of attention-deficit hyperactivity disorder (ADHD) in college students has resulted in an urgent need for scales that can detect feigning of this disorder. The present study provided further validation data for a recently developed validity scale for the Conners' Adult ADHD Rating Scale (CAARS), the CAARS Infrequency Index (CII), as well as for the Inconsistency Index (INC). The sample included 139 undergraduate students: 21 individuals with diagnoses of ADHD, 29 individuals responding honestly, 54 individuals responding randomly (full or half), and 35 individuals instructed to feign. Overall, the INC showed moderate sensitivity to random responding (.44-.63) and fairly high specificity to ADHD (.86-.91). The CII demonstrated modest sensitivity to feigning (.31-.46) and excellent specificity to ADHD (.91-.95). Sequential application of validity scales had correct classification rates of honest (93.1%), ADHD (81.0%), feigning (57.1%), half random (42.3%), and full random (92.9%). The present study suggests that the CII is modestly sensitive (true positive rate) to feigned ADHD symptoms, and highly specific (true negative rate) to ADHD. Additionally, this study highlights the utility of applying the CAARS validity scales in a sequential manner for identifying feigning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
A mathematical model of the effect of a predator on species diversity

NASA Technical Reports Server (NTRS)

Weston, C. R.; Yang, J. N.

1970-01-01

Mathematical model determines reaction between new predator and microbe competitor when the competitor is the predator's sole nutrient resource. The model utilizes differential equations to describe the interactions with the specific growth rates, and analyzes these growth rates as they are affected by population density and nutrient concentration.
Examining the Validity of Behavioral Self-Regulation Tools in Predicting Preschoolers' Academic Achievement

ERIC Educational Resources Information Center

Schmitt, Sara A.; Pratt, Megan E.; McClelland, Megan M.

2014-01-01

The current study investigated the predictive utility among teacher-rated, observed, and directly assessed behavioral self-regulation skills to academic achievement in preschoolers. Specifically, this study compared how a teacher report, the Child Behavior Rating Scale, an observer report, the Observed Child Engagement Scale, and a direct…
Examining the Validity of Behavioral Self-Regulation Tools in Predicting Preschoolers' Academic Achievement

ERIC Educational Resources Information Center

Schmitt, Sara A.; Pratt, Megan E.; McClelland, Megan M.

2014-01-01

Research Findings: The current study investigated the predictive utility of teacher-rated, observed, and directly assessed behavioral self-regulation skills to academic achievement in preschoolers. Specifically, this study compared how a teacher report (the Child Behavior Rating Scale), an observer report (the Observed Child Engagement Scale), and…

Utilization, Health and Performance of Enlisted Navy Women.

DTIC Science & Technology

1978-02-01

women, the highest rates were evi- denced for abortions, infectious mononucleosis (not included in the table), symptoms referable to the abdomen and...women’s hospitalization rates for specific non- infectious disorders, the highest rates during the past few years were noted for abortions, deliveries...supports other researchers, findings in that younger people have more injuries, accidents, infectious diseases, and adjustment problems than others
Acute care hospital utilization among medical inpatients discharged with a substance use disorder diagnosis.

PubMed

Walley, Alexander Y; Paasche-Orlow, Michael; Lee, Eugene C; Forsythe, Shaula; Chetty, Veerappa K; Mitchell, Suzanne; Jack, Brian W

2012-03-01

Hospital discharge may be an opportunity to intervene among patients with substance use disorders to reduce subsequent hospital utilization. This study determined whether having a substance use disorder diagnosis was associated with subsequent acute care hospital utilization. We conducted an observational cohort study among 738 patients on a general medical service at an urban, academic, safety-net hospital. The main outcomes were rate and risk of acute care hospital utilization (emergency department visit or hospitalization) within 30 days of discharge. The main independent variable was presence of a substance use disorder primary or secondary discharge diagnosis code at the index hospitalization. At discharge, 17% of subjects had a substance use disorder diagnosis. These patients had higher rates of recurrent acute care hospital utilization than patients without substance use disorder diagnoses (0.63 vs 0.32 events per subject at 30 days, P < 0.01) and increased risk of any recurrent acute care hospital utilization (33% vs 22% at 30 days, P < 0.05). In adjusted Poisson regression models, the incident rate ratio at 30 days was 1.49 (95% confidence interval, 1.12-1.98) for patients with substance use disorder diagnoses compared with those without. In subgroup analyses, higher utilization was attributable to those with drug diagnoses or a combination of drug and alcohol diagnoses, but not to those with exclusively alcohol diagnoses. Medical patients with substance use disorder diagnoses, specifically those with drug use-related diagnoses, have higher rates of recurrent acute care hospital utilization than those without substance use disorder diagnoses.
Overcoming Communication Restrictions in Collectives

NASA Technical Reports Server (NTRS)

Tumer, Kagan; Agogino, Adrian K.

2004-01-01

Many large distributed system are characterized by having a large number of components (eg., agents, neurons) whose actions and interactions determine a %orld utility which rates the performance of the overall system. Such collectives are often subject to communication restrictions, making it difficult for components which try to optimize their own private utilities, to take actions that also help optimize the world utility. In this article we address that coordination problem and derive four utility functions which present different compromises between how aligned a component s private utility is with the world utility and how readily that component can determine the actions that optimize its utility. The results show that the utility functions specifically derived to operate under communication restrictions outperform both traditional methods and previous collective-based methods by up to 75%.
Rating scales for musician's dystonia

PubMed Central

Berque, Patrice; Jabusch, Hans-Christian; Altenmüller, Eckart; Frucht, Steven J.

2013-01-01

Musician's dystonia (MD) is a focal adult-onset dystonia most commonly involving the hand. It has much greater relative prevalence than non-musician’s focal hand dystonias, exhibits task specificity at the level of specific musical passages, and is a particularly difficult form of dystonia to treat. For most MD patients, the diagnosis confirms the end of their music performance careers. Research on treatments and pathophysiology is contingent upon measures of motor function abnormalities. In this review, we comprehensively survey the literature to identify the rating scales used in MD and the distribution of their use. We also summarize the extent to which the scales have been evaluated for their clinical utility, including reliability, validity, sensitivity, specificity to MD, and practicality for a clinical setting. Out of 135 publications, almost half (62) included no quantitative measures of motor function. The remaining 73 studies used a variety of choices from among 10 major rating scales. Most used subjective scales involving either patient or clinician ratings. Only 25% (18) of the studies used objective scales. None of the scales has been completely and rigorously evaluated for clinical utility. Whether studies involved treatments or pathophysiologic assays, there was a heterogeneous choice of rating scales used with no clear standard. As a result, the collective interpretive value of those studies is limited because the results are confounded by measurement effects. We suggest that the development and widespread adoption of a new clinically useful rating scale is critical for accelerating basic and clinical research in MD. PMID:23884039
Recovery of Utility Fixed Costs: Utility, Consumer, Environmental and Economist Perspectives

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

Wood, Lisa; Hemphill, Ross; Howat, John

Utilities recover costs for providing electric service to retail customers through a combination of rate components that together comprise customers’ monthly electric bills. Rates and rate designs are set by state regulators and vary by jurisdiction, utility and customer class. In addition to the fundamental tenet of setting fair and reasonable rates, rate design balances economic efficiency, equity and fairness, customer satisfaction, utility revenue stability, and customer price and bill stability.1 At the most basic level, retail electricity bills in the United States typically include a fixed monthly customer charge — a set dollar amount regardless of energy usage —more » and a volumetric energy charge for each kilowatt-hour consumed.2 The energy charge may be flat across all hours, vary by usage level (for example, higher rates at higher levels of usage), or vary based on time of consumption.3 While some utility costs, such as fuel costs, clearly vary according to electricity usage, other costs are “fixed” over the short run — generally, those that do not vary over the course of a year. Depending on your point of view, and whether the state’s electricity industry has been restructured or remains vertically integrated, the set of costs that are “fixed” may be quite limited. Or the set may extend to all capacity costs for generation, transmission and distribution. In the long run, all costs are variable. In the context of flat or declining loads in some regions, utilities are proposing a variety of changes to retail rate designs, particularly for residential customers, to recover fixed costs. In this report, authors representing utility (Chapter 1), consumer (Chapter 2), environmentalist (Chapter 3) and economist (Chapter 4) perspectives discuss fixed costs for electric utilities and set out their principles for recovering those costs. The table on the next page summarizes each author’s relative preferences for various options for fixed cost recovery, some of which may be used in combination.4 The specific design of any ratemaking option matters crucially, so a general preference for a given option does not indicate support for any particular application.« less
Metabolome analysis-based design and engineering of a metabolic pathway in Corynebacterium glutamicum to match rates of simultaneous utilization of D-glucose and L-arabinose.

PubMed

Kawaguchi, Hideo; Yoshihara, Kumiko; Hara, Kiyotaka Y; Hasunuma, Tomohisa; Ogino, Chiaki; Kondo, Akihiko

2018-05-17

L-Arabinose is the second most abundant component of hemicellulose in lignocellulosic biomass, next to D-xylose. However, few microorganisms are capable of utilizing pentoses, and catabolic genes and operons enabling bacterial utilization of pentoses are typically subject to carbon catabolite repression by more-preferred carbon sources, such as D-glucose, leading to a preferential utilization of D-glucose over pentoses. In order to simultaneously utilize both D-glucose and L-arabinose at the same rate, a modified metabolic pathway was rationally designed based on metabolome analysis. Corynebacterium glutamicum ATCC 31831 utilized D-glucose and L-arabinose simultaneously at a low concentration (3.6 g/L each) but preferentially utilized D-glucose over L-arabinose at a high concentration (15 g/L each), although L-arabinose and D-glucose were consumed at comparable rates in the absence of the second carbon source. Metabolome analysis revealed that phosphofructokinase and pyruvate kinase were major bottlenecks for D-glucose and L-arabinose metabolism, respectively. Based on the results of metabolome analysis, a metabolic pathway was engineered by overexpressing pyruvate kinase in combination with deletion of araR, which encodes a repressor of L-arabinose uptake and catabolism. The recombinant strain utilized high concentrations of D-glucose and L-arabinose (15 g/L each) at the same consumption rate. During simultaneous utilization of both carbon sources at high concentrations, intracellular levels of phosphoenolpyruvate declined and acetyl-CoA levels increased significantly as compared with the wild-type strain that preferentially utilized D-glucose. These results suggest that overexpression of pyruvate kinase in the araR deletion strain increased the specific consumption rate of L-arabinose and that citrate synthase activity becomes a new bottleneck in the engineered pathway during the simultaneous utilization of D-glucose and L-arabinose. Metabolome analysis identified potential bottlenecks in D-glucose and L-arabinose metabolism and was then applied to the following rational metabolic engineering. Manipulation of only two genes enabled simultaneous utilization of D-glucose and L-arabinose at the same rate in metabolically engineered C. glutamicum. This is the first report of rational metabolic design and engineering for simultaneous hexose and pentose utilization without inactivating the phosphotransferase system.
Unravelling evolutionary strategies of yeast for improving galactose utilization through integrated systems level analysis.

PubMed

Hong, Kuk-Ki; Vongsangnak, Wanwipa; Vemuri, Goutham N; Nielsen, Jens

2011-07-19

Identification of the underlying molecular mechanisms for a derived phenotype by adaptive evolution is difficult. Here, we performed a systems-level inquiry into the metabolic changes occurring in the yeast Saccharomyces cerevisiae as a result of its adaptive evolution to increase its specific growth rate on galactose and related these changes to the acquired phenotypic properties. Three evolved mutants (62A, 62B, and 62C) with higher specific growth rates and faster specific galactose uptake were isolated. The evolved mutants were compared with a reference strain and two engineered strains, SO16 and PGM2, which also showed higher galactose uptake rate in previous studies. The profile of intermediates in galactose metabolism was similar in evolved and engineered mutants, whereas reserve carbohydrates metabolism was specifically elevated in the evolved mutants and one evolved strain showed changes in ergosterol biosynthesis. Mutations were identified in proteins involved in the global carbon sensing Ras/PKA pathway, which is known to regulate the reserve carbohydrates metabolism. We evaluated one of the identified mutations, RAS2(Tyr112), and this mutation resulted in an increased specific growth rate on galactose. These results show that adaptive evolution results in the utilization of unpredicted routes to accommodate increased galactose flux in contrast to rationally engineered strains. Our study demonstrates that adaptive evolution represents a valuable alternative to rational design in bioengineering of improved strains and, that through systems biology, it is possible to identify mutations in evolved strain that can serve as unforeseen metabolic engineering targets for improving microbial strains for production of biofuels and chemicals.
Racial disparity in hospice use in the United States in 2002.

PubMed

Connor, S R; Elwert, F; Spence, C; Christakis, N A

2008-04-01

We used complete Centers for Disease Control death certificate records and the Centers for Medicare and Medicaid Services 100% Standard Analytic File for hospice claims for 2002 to examine differences in hospice utilization between African-American and white decedents living in the United States. White decedents were more likely to use hospice in the year before their death than African-American decedents (29% vs 22%). Cause-specific hospice utilization rates among women were consistently higher than among men within a given race. African-American decedents were consistently less likely to use hospice than white decedents for almost all conditions. Hospice utilization was lower among African-American than among white decedents in 31 of 40 states. The higher the overall hospice utilization in a state, the less the positive difference between white and African-American usage rates; that is, the more accepted hospice is, as measured by 'market share', the lower the racial disparity in its use.
Utility of de-escalatory confidence-building measures

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

Nation, J.

1989-06-01

This paper evaluates the utility of specific confidence-building de-escalatory measures and pays special attention to the evaluation of measures which place restrictions on or establish procedures for strategic forces. Some measures appear more promising than others. Potentially useful confidence-building measures largely satisfy defined criteria and include the phased return of strategic nuclear forces to peacetime bases and operations, the termination of interference with communications and NTMs (National Technical Means) and the termination of civil defense preparations. Less-promising CBMs include the standing down of supplemental early warning systems, the establishment of SSBN keep-out zones, and decreases in bomber alert rates. Establishmentmore » of SSBN keep-out zones and reduction in bomber rates are difficult to verify, while the standing-down of early warning systems provides little benefit at potentially large costs. Particular confidence-building measures (CBMs) may be most useful in building superpower confidence at specific points in the crisis termination phase. For example, a decrease in strategic bomber alert rates may provide some decrease in perception of the likelihood of war, but its potential costs, particularly in increasing bomber vulnerability, may limit its utility and implementation to the final crisis stages when the risks of re-escalation and surprise attack are lower.« less
Effect of Pediatric Behavioral Health Screening and Colocated Services on Ambulatory and Inpatient Utilization.

PubMed

Hacker, Karen A; Penfold, Robert B; Arsenault, Lisa N; Zhang, Fang; Soumerai, Stephen B; Wissow, Lawrence S

2015-11-01

The study sought to determine the impact of a pediatric behavioral health screening and colocation model on utilization of behavioral health care. In 2003, Cambridge Health Alliance, a Massachusetts public health system, introduced behavioral health screening and colocation of social workers sequentially within its pediatric practices. An interrupted time-series study was conducted to determine the impact on behavioral health care utilization in the 30 months after model implementation compared with the 18 months prior. Specifically, the change in trends of ambulatory, emergency, and inpatient behavioral health utilization was examined. Utilization data for 11,223 children ages ≥4 years 9 months to <18 years 3 months seen from 2003 to 2008 contributed to the study. In the 30 months after implementation of pediatric behavioral health screening and colocation, there was a 20.4% cumulative increase in specialty behavioral health visit rates (trend of .013% per month, p=.049) and a 67.7% cumulative increase in behavioral health primary care visit rates (trend of .019% per month, p<.001) compared with the expected rates predicted by the 18-month preintervention trend. In addition, behavioral health emergency department visit rates increased 245% compared with the expected rate (trend .01% per month, p=.002). After the implementation of a behavioral health screening and colocation model, more children received behavioral health treatment. Contrary to expectations, behavioral health emergency department visits also increased. Further study is needed to determine whether this is an effect of how care was organized for children newly engaged in behavioral health care or a reflection of secular trends in behavioral health utilization or both.
GLOBE Study Culture Clusters: Can They Be Found in Importance Ratings of Managerial Competencies?

ERIC Educational Resources Information Center

Clark, Jeremy Michael; Quast, Louis N.; Jang, Soebin; Wohkittel, Joseph; Center, Bruce; Edwards, Katherine; Bovornusvakool, Witsinee

2016-01-01

Purpose: The purpose of this study is to explore patterns of importance ratings of managerial competencies in 22 countries in different regions around the globe, to guide specificity in assessing and developing managers in multiple geographies. Additionally, this study examined the utility of clustering countries based on shared culture, as…
Black/White Differences in Adolescent Drug Use: A Test of Six Hypotheses

ERIC Educational Resources Information Center

Rote, Sunshine M.; Taylor, John

2014-01-01

Six specific hypotheses have been developed to account for why Caucasians have higher rates of drug use compared to African-Americans. This article utilizes data from a South Florida-based community study of 893 young adults (1998-2002) to test these hypotheses. Specifically, Caucasians (1) initiate drug use at younger ages than African-Americans…
Diagnostic specificity and mental health service utilization among veterans with newly diagnosed anxiety disorders.

PubMed

Barrera, Terri L; Mott, Juliette M; Hundt, Natalie E; Mignogna, Joseph; Yu, Hong-Jen; Stanley, Melinda A; Cully, Jeffrey A

2014-01-01

This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization. This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization. Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29). Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings. Published by Elsevier Inc.
Absence of Diauxie during Simultaneous Utilization of Glucose and Xylose by Sulfolobus acidocaldarius▿ †

PubMed Central

Joshua, Chijioke J.; Dahl, Robert; Benke, Peter I.; Keasling, Jay D.

2011-01-01

Sulfolobus acidocaldarius utilizes glucose and xylose as sole carbon sources, but its ability to metabolize these sugars simultaneously is not known. We report the absence of diauxie during growth of S. acidocaldarius on glucose and xylose as co-carbon sources. The presence of glucose did not repress xylose utilization. The organism utilized a mixture of 1 g/liter of each sugar simultaneously with a specific growth rate of 0.079 h−1 and showed no preference for the order in which it utilized each sugar. The organism grew faster on 2 g/liter xylose (0.074 h−1) as the sole carbon source than on an equal amount of glucose (0.022 h−1). When grown on a mixture of the two carbon sources, the growth rate of the organism increased from 0.052 h−1 to 0.085 h−1 as the ratio of xylose to glucose increased from 0.25 to 4. S. acidocaldarius appeared to utilize a mixture of glucose and xylose at a rate roughly proportional to their concentrations in the medium, resulting in complete utilization of both sugars at about the same time. Gene expression in cells grown on xylose alone was very similar to that in cells grown on a mixture of xylose and glucose and substantially different from that in cells grown on glucose alone. The mechanism by which the organism utilized a mixture of sugars has yet to be elucidated. PMID:21239580
THE UTILITY OF STRABISMUS IN ADULTS

PubMed Central

Beauchamp, George R; Felius, Joost; Stager, David R; Beauchamp, Cynthia L

2005-01-01

Purpose To determine the utility (quality-of-life weight) associated with adult strabismus. Methods Time tradeoff utility values were measured in physician-conducted interviews with 140 adult patients with strabismus in a private practice setting. Patients also completed a questionnaire containing six items that rated the following aspects of disability: specific health problems, problems with tasks of daily living, problems with social interaction, self-image problems, concerns about the future, and job-related problems. Patients were characterized as presurgical or nonsurgical, and their diplopia and asthenopia were rated by the physician on a four-level scale. Results About 60% of all patients indicated willingness to trade part of their life expectancy in return for being rid of strabismus and its associated effects. The median utility was 0.93 (interquartile range, 0.83 to 1.0). A significantly smaller proportion (44%) of the nonsurgical patients (N = 41) appeared willing to trade time compared with surgical patients (68%; P = .009). Median utility in the presurgical patients was 0.90. Strong relationships were found between utility and the level of diplopia (P < .0001), and between utility and the level of asthenopia (P < .0001). Utility was correlated with all six disability ratings (all P ≤ .00062). Conclusion A majority of the patients interviewed would trade a portion of their life expectancy in return for being rid of strabismus and its associated effects. These results were validated by significant associations with diplopia, asthenopia, and disability. PMID:17057800
Health state utility instruments compared: inquiring into nonlinearity across EQ-5D-5L, SF-6D, HUI-3 and 15D.

PubMed

Gamst-Klaussen, Thor; Chen, Gang; Lamu, Admassu N; Olsen, Jan Abel

2016-07-01

Different health state utility (HSU) instruments produce different utilities for the same individuals, thereby compromising the intended comparability of economic evaluations of health care interventions. When developing crosswalks, previous studies have indicated nonlinear relationships. This paper inquires into the degree of nonlinearity across the four most widely used HSU-instruments and proposes exchange rates that differ depending on the severity levels of the health state utility scale. Overall, 7933 respondents from six countries, 1760 in a non-diagnosed healthy group and 6173 in seven disease groups, reported their health states using four different instruments: EQ-5D-5L, SF-6D, HUI-3 and 15D. Quantile regressions investigate the degree of nonlinear relationships between these instruments. To compare the instruments across different disease severities, we split the health state utility scale into utility intervals with 0.2 successive decrements in utility starting from perfect health at 1.00. Exchange rates (ERs) are calculated as the mean utility difference between two utility intervals on one HSU-instrument divided by the difference in mean utility on another HSU-instrument. Quantile regressions reveal significant nonlinear relationships across all four HSU-instruments. The degrees of nonlinearities differ, with a maximum degree of difference in the coefficients along the health state utility scale of 3.34 when SF-6D is regressed on EQ-5D. At the lower end of the health state utility scale, the exchange rate from SF-6D to EQ-5D is 2.11, whilst at the upper end it is 0.38. Comparisons at different utility levels illustrate the fallacy of using linear functions as crosswalks between HSU-instruments. The existence of nonlinear relationships between different HSU-instruments suggests that level-specific exchange rates should be used when converting a change in utility on the instrument used, onto a corresponding utility change had another instrument been used. Accounting for nonlinearities will increase the validity of the comparison for decision makers when faced with a choice between interventions whose calculations of QALY gains have been based on different HSU-instruments.
Participation Rates, Process Monitoring, and Quality Improvement Among Cardiac Rehabilitation Programs in the United States: A NATIONAL SURVEY.

PubMed

Pack, Quinn R; Squires, Ray W; Lopez-Jimenez, Francisco; Lichtman, Steven W; Rodriguez-Escudero, Juan P; Lindenauer, Peter K; Thomas, Randal J

2015-01-01

Although strategies exist for improving cardiac rehabilitation (CR) participation rates, it is unclear how frequently these strategies are used and what efforts are being made by CR programs to improve participation rates. We surveyed all CR program directors in the American Association of Cardiovascular and Pulmonary Rehabilitation's database. Data collection included program characteristics, the use of specific referral and recruitment strategies, and self-reported program participation rates. Between 2007 and 2012, 49% of programs measured referral of inpatients from the hospital, 21% measured outpatient referral from office/clinic, 71% measured program enrollment, and 74% measured program completion rates. Program-reported participation rates (interquartile range) were 68% (32-90) for hospital referral, 35% (15-60) for office/clinic referral, 70% (46-80) for enrollment, and 75% (62-82) for program completion. The majority of programs utilized a hospital-based systematic referral, liaison-facilitated referral, or inpatient CR program referral (64%, 68%, and 60% of the time, respectively). Early appointments (<2 weeks) were utilized by 35%, and consistent phone call appointment reminders were utilized by 50% of programs. Quality improvement (QI) projects were performed by about half of CR programs. Measurement of participation rates was highly correlated with performing QI projects (P < .0001.) : Although programs are aware of participation rate gaps, the monitoring of participation rates is suboptimal, QI initiatives are infrequent, and proven strategies for increasing patient participation are inconsistently utilized. These issues likely contribute to the national CR participation gap and may prove to be useful targets for national QI initiatives.
Kinetic modeling of lactic acid production from batch submerged fermentation of cheese whey

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

Tango, M.S.A.; Ghaly, A.E.

1999-12-01

A kinetic model for the production of lactic acid through batch submerged fermentation of cheese whey using Lactobacillus helveticus was developed. The model accounts for the effect of substrate limitation, substrate inhibition, lactic acid inhibition, maintenance energy and cell death on the cell growth, substrate utilization, and lactic acid production during the fermentation process. The model was evaluated using experimental data from Tango and Ghaly (1999). The predicted results obtained from the model compared well with experimental (R{sup 2} = 0.92--0.98). The model was also used to investigate the effect of the initial substrate concentration on the lag period, fermentationmore » time, specific growth rate, and cell productivity during batch fermentation. The maximum specific growth rate ({micro}{sub m}), the saturation constant (K{sub S}), the substrate inhibition constant (K{sub IS}), and the lactic acid inhibition constant (K{sub IP}) were found to be 0.25h{sup {minus}1}, 0.9 g/L, 250.0 g/L, and 60.0 g/L, respectively. High initial lactose concentration in cheese whey reduced both the specific growth rate and substrate utilization rate due to the substrate inhibition phenomenon. The maximum lactic acid production occurred at about 100 g/L initial lactose concentration after 40 h of fermentation. The maximum lactic acid concentration above which Lactobacillus helveticus did not grow was found to be 80.0 g/L.« less
Use of Pathogen-Specific Antibody Biomarkers to Estimate Waterborne Infections in Population-Based Settings.

PubMed

Exum, Natalie G; Pisanic, Nora; Granger, Douglas A; Schwab, Kellogg J; Detrick, Barbara; Kosek, Margaret; Egorov, Andrey I; Griffin, Shannon M; Heaney, Christopher D

2016-09-01

This review discusses the utility of pathogen-specific antibody biomarkers for improving estimates of the population burden of waterborne infections, assessing the fraction of infections that can be prevented by specific water treatments, and understanding transmission routes and the natural history and ecology of disease in different populations (including asymptomatic infection rates). We review recent literature on the application of pathogen-specific antibody response data to estimate incidence and prevalence of acute infections and their utility to assess the contributions of waterborne transmission pathways. Advantages and technical challenges associated with the use of serum versus minimally invasive salivary antibody biomarkers in cross-sectional and prospective surveys are discussed. We highlight recent advances and challenges and outline future directions for research, development, and application of antibody-based and other immunological biomarkers of waterborne infections.
The resource utilization group system: its effect on nursing home case mix and costs.

PubMed

Thorpe, K E; Gertler, P J; Goldman, P

1991-01-01

Using data from 1985 and 1986, we examine how New York state's prospective payment system affected nursing homes. The system, called Resource Utilization Group (RUG-II), aimed to limit nursing home cost growth and improve access to nursing homes by "heavy-care" patients. As in Medicare's prospective hospital reimbursement system, payments to nursing homes were based on a "price," rather than facility-specific rates. With respect to cost growth, we observed considerable diversity among homes. Specifically, those nursing homes most financially constrained by the RUG-II methodology exhibited the slowest rates of cost growth; we observed higher cost growth among the homes least constrained. This higher rate of cost growth raises a question about the desirability of using a pricing methodology to determine nursing home payment rates. In addition to moderating cost growth, we also observed a significant change in the mix of patients admitted to nursing homes. During the first year of the RUG-II program, nursing homes admitted more heavy-care patients and reduced days of care to lighter-care patients. Thus, through 1986, the RUG-II program appeared to satisfy at least one of its major policy objectives.

[Changes in the rates of glucose consumption and lactate release by cells in perfused and nonperfused cultures].

PubMed

Berestovskaia, N G; Akatov, V S; Lavrovskaia, V P

1993-01-01

The energetic state of Chinese hamster fibroblasts was investigated under stationary cultural conditions and under condition of culture medium perfusion immediately above the cells. Specific rates of glucose utilization and lactate formation under the former conditions (1.88 +/- 0.2) x 10(-13) and (4.3 +/- 0.56) x 10(-13) Mole/cell/h at the logarithmic growth phase, and (0.21 +/- 0.08) x 10(-13) and (0.58 +/- 0.06) x 10(-13) Mole/cell/h at the stationary phase, respectively. In the perfused culture, specific rates of glucose utilization and formation of lactate are (4.86 +/- 0.56) x 10(-13) and (11.0 +/- 1.8) x 10(-13) Mole/cell/h at the logarithmic growth phase, and (1.57 +/- 0.14) x 10(-13) and (4.11 +/- 0.5) x 10(-13) Mole/cell/h at the stationary phase, respectively. It has been proposed that under conditions of stationary culture the fall of the rates, as the culture reaches the survival phase, is due to diffusion-dependent limitations of mass transfer between the medium and the culture. Under perfusion conditions, the fall of the rates can be explained by some deficiency of necessary components and by excessive amounts of metabolic products in the multilayer structure.
Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample.

PubMed

Allen, Junior Lloyd; Mowbray, Orion

2016-04-01

Gay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. Using data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. Findings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. These findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Removal of oxytetracycline (OTC) in a synthetic pharmaceutical wastewater by a sequential anaerobic multichamber bed reactor (AMCBR)/completely stirred tank reactor (CSTR) system: biodegradation and inhibition kinetics.

PubMed

Sponza, Delia Teresa; Çelebi, Hakan

2012-01-01

An anaerobic multichamber bed reactor (AMCBR) was effective in removing both molasses-chemical oxygen demand (COD), and the antibiotic oxytetracycline (OTC). The maximum COD and OTC removals were 99% in sequential AMCBR/completely stirred tank reactor (CSTR) at an OTC concentration of 300 mg L(-1). 51%, 29% and 9% of the total volatile fatty acid (TVFA) was composed of acetic, propionic acid and butyric acids, respectively. The OTC loading rates at between 22.22 and 133.33 g OTC m(-3) d(-1) improved the hydrolysis of molasses-COD (k), the maximum specific utilization of molasses-COD (k(mh)) and the maximum specific utilization rate of TVFA (k(TVFA)). The direct effect of high OTC loadings (155.56 and -177.78 g OTC m(-3) d(-1)) on acidogens and methanogens were evaluated with Haldane inhibition kinetic. A significant decrease of the Haldane inhibition constant was indicative of increases in toxicity at increasing loading rates. Copyright © 2011 Elsevier Ltd. All rights reserved.
Ethanol inhibition kinetics of Kluyveromyces marxianus grown on Jerusalem artichoke juice

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

Bajpai, P.; Margaritis, A.

1982-12-01

The kinetics of ethanol inhibition on cell growth and ethanol production by Kluyveromyces marxianus UCD (FST) 55-82 were studied during batch growth. The liquid medium contained 10% (weight/volume) inulin-type sugars derived from an extract of Jerusalem artichoke (Helianthus tuberosus) tubers, supplemented with small amounts of Tween 80, oleic acid, and corn steep liquor. Initial ethanol concentrations ranging from 0 to 80 g/liter in the liquid medium were used to study the inhibitory effect of ethanol on the following parameters: maximum specific growth rate (mu max), cell and ethanol yields, and sugar utilization. It was found that as the initial ethanolmore » concentration increased from 0 to 80 g/liter, and maximum specific growth rate of K. marxianus cells decreased from 0.42 to 0.09/hour, whereas the ethanol and cell yields and sugar utilization remained almost constant. A simple kinetic model was used to correlate the mu max results and the rates of cell and ethanol production, and the appropriate constants were evaluated. (Refs. 22).« less
Race-ethnicity and gender differences in VA health care service utilization among U.S. veterans of recent conflicts.

PubMed

Koo, Kelly H; Madden, Erin; Maguen, Shira

2015-05-01

The purpose of this study was to compare health care utilization patterns by race-ethnicity and gender among veterans returning from Iraq and Afghanistan. A retrospective analysis was conducted with records from U.S. service members and veterans returning from Iraq and Afghanistan who enrolled in health care through the Veterans Health Administration, who received a psychiatric diagnosis, and who had used primary or mental health outpatient care between October 7, 2001, and December 31, 2012 (N=309,050). Racial-ethnic minority groups were first collapsed together and compared with whites and then separated by racial-ethnic group. Gender was also tested as a moderator of utilization. Although rates of mental health outpatient care, primary care, and emergency service utilization were relatively similar for racial-ethnic minority groups and whites, minority groups were admitted to psychiatric inpatient care at lower rates than whites. When veterans were separately categorized by specific racial-ethnic groups, some differences in utilization rates emerged; most notably, only black and Hispanic men were admitted less frequently to psychiatric inpatient care, and male and female Asian/Pacific Islander veterans used emergency services less, than their white counterparts. Gender moderated the association between race-ethnicity and mental health outpatient use, such that American Indian and Hispanic women used mental health outpatient services less than white women, but American Indian and Hispanic men showed the opposite pattern. Furthermore, black men were more likely than white men to use mental health outpatient services, but there was no difference between these women. Although service utilization rates between minority groups and whites were similar when minority groups were combined, examination of utilization by racial-ethnic groups and by men and women separately yielded more robust findings.
Wind Technology Modeling Within the System Advisor Model (SAM) (Poster)

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

Blair, N.; Dobos, A.; Ferguson, T.

This poster provides detail for implementation and the underlying methodology for modeling wind power generation performance in the National Renewable Energy Laboratory's (NREL's) System Advisor Model (SAM). SAM's wind power model allows users to assess projects involving one or more large or small wind turbines with any of the detailed options for residential, commercial, or utility financing. The model requires information about the wind resource, wind turbine specifications, wind farm layout (if applicable), and costs, and provides analysis to compare the absolute or relative impact of these inputs. SAM is a system performance and economic model designed to facilitate analysismore » and decision-making for project developers, financers, policymakers, and energy researchers. The user pairs a generation technology with a financing option (residential, commercial, or utility) to calculate the cost of energy over the multi-year project period. Specifically, SAM calculates the value of projects which buy and sell power at retail rates for residential and commercial systems, and also for larger-scale projects which operate through a power purchase agreement (PPA) with a utility. The financial model captures complex financing and rate structures, taxes, and incentives.« less
Use of Pathogen-Specific Antibody Biomarkers to Estimate Waterborne Infections in Population-Based Settings

PubMed Central

Exum, Natalie G.; Pisanic, Nora; Granger, Douglas A.; Schwab, Kellogg J.; Detrick, Barbara; Kosek, Margaret; Egorov, Andrey I.; Griffin, Shannon M.; Heaney, Christopher D.

2016-01-01

Purpose of review This review discusses the utility of pathogen-specific antibody biomarkers for improving estimates of the population burden of waterborne infections, assessing the fraction of infections that can be prevented by specific water treatments, and understanding transmission routes and the natural history and ecology of disease in different populations (including asymptomatic infection rates). Recent findings We review recent literature on the application of pathogen-specific antibody response data to estimate incidence and prevalence of acute infections and their utility to assess the contributions of waterborne transmission pathways. Advantages and technical challenges associated with the use of serum versus minimally invasive salivary antibody biomarkers in cross-sectional and prospective surveys are discussed. Summary We highlight recent advances and challenges and outline future directions for research, development, and application of antibody-based and other immunological biomarkers of waterborne infections. PMID:27352014
Utility measures of health-related quality of life in patients treated for benign paroxysmal positional vertigo.

PubMed

Roberts, Richard A; Abrams, Harvey; Sembach, Melanie K; Lister, Jennifer J; Gans, Richard E; Chisolm, Theresa Hnath

2009-06-01

Comparing the effects of different disorders and interventions on health-related quality of life (HRQoL) is important for healthcare policy and accountability. There are two basic approaches to measure HRQoL: questionnaires derived from psychometrics and preference-based measures or utilities derived from econometrics. While disease-specific HRQoL questionnaires, such as the Dizziness Handicap Inventory (DHI), are important because they focus on the impact of a specific problem and its treatments (i.e., vestibular disorders), economic comparisons of the impacts of diseases/disorders and their treatments are typically based on utility assessment. The utility measures for audiology application (UMAA) were developed to measure utilities for various audiologic conditions using a standard computer. The purpose of this study was to determine if the UMAA provides stable, valid, and sensitive utility measures of the effects of benign paroxysmal positional vertigo (BPPV) and its treatment on HRQoL. It was hypothesized that utilities, as measured by the UMAA, would indicate improvement in HRQoL post-treatment for BPPV comparable to a disease-specific health status measure (DHI). The UMAA incorporates three techniques to measure utility: rating scale, standard gamble, and time tradeoff. A utility is a cardinal measure of strength of preference and is measured on a continuum basis from 0.0 (incapacitating dizziness) to 1.0 (no dizziness). Fifty-two adults with BPPV of the posterior semicircular canal completed the UMAA and DHI before treatment and again post-treatment. A subgroup of 15 participants completed the UMAA on two occasions before treatment to assess test-retest stability and to establish critical difference values. Results from this investigation demonstrate that utilities as measured through the UMAA are stable, valid, and comparable to the DHI. Post-treatment utilities were also significantly higher than pretreatment utilities, indicating that the utilities, as measured through the UMAA, are sensitive to improvement in HRQoL after BPPV treatment. Utilities as measured through the UMAA seem sensitive to changes in HRQoL after treatment of BPPV. Since the UMAA can be used to measure patient preference (i.e., utility), it may be useful for comparison of specific audiologic conditions, such as BPPV, to nonaudiologic conditions, such as cardiovascular disease and kidney disease.
How can we maximize the diagnostic utility of uroflow?: ICI-RS 2017.

PubMed

Gammie, Andrew; Rosier, Peter; Li, Rui; Harding, Chris

2018-01-09

To gauge the current level of diagnostic utility of uroflowmetry and to suggest areas needing research to improve this. A summary of the debate held at the 2017 meeting of the International Consultation on Incontinence Research Society, with subsequent analysis by the authors. Limited diagnostic sensitivity and specificity exist for maximum flow rates, multiple uroflow measurements, and flow-volume nomograms. There is a lack of clarity in flow rate curve shape description and uroflow time measurement. There is a need for research to combine uroflowmetry with other non-invasive indicators. Better standardizations of test technique, flow-volume nomograms, uroflow shape descriptions, and time measurements are required. © 2017 Wiley Periodicals, Inc.
Primary zinc-air batteries for space power

NASA Technical Reports Server (NTRS)

Bragg, Bobby J.; Bourland, Deborah S.; Merry, Glenn; Putt, Ron

1992-01-01

Prismatic HR and LC cells and batteries were built and tested, and they performed well with respect to the program goals of high capacity and high rate capability at specific energies. The HR batteries suffered reduced utilizations owing to dryout at the 2 and 3 A rates for the 50 C tests owing to the requirement for forced convection. The LC batteries suffered reduced utilizations under all conditions owing to the chimney effect at 1 G, although this effect would not occur at 0 G. An empirical model was developed which accurately predicted utilizations and average voltages for single cells, although thermal effects encountered during battery testing caused significant deviations, both positive and negative, from the model. Based on the encouraging results of the test program, we believe that the zinc-air primary battery of a flat, stackable configuration can serve as a high performance and safe power source for a range of space applications.
Construction of an alternative glycerol-utilization pathway for improved β-carotene production in Escherichia coli.

PubMed

Guo, Jin-Ying; Hu, Kun-Le; Bi, Chang-Hao; Li, Qing-Yan; Zhang, Xue-Li

2018-05-11

Glycerol, which is an inevitable by-product of biodiesel production, is an ideal carbon source for the production of carotenoids due to its low price, good availability and chemically reduced status, which results in a low requirement for additional reducing equivalents. In this study, an alternative carbon-utilization pathway was constructed in Escherichia coli to enable more efficient β-carotene production from glycerol. An aldehyde reductase gene (alrd) and an aldehyde dehydrogenase gene (aldH) from Ralstonia eutropha H16 were integrated into the E. coli chromosome to form a novel glycerol-utilization pathway. The β-carotene specific production value was increased by 50% after the introduction of alrd and aldH. It was found that the glycerol kinase gene (garK), alrd and aldH were the bottleneck of the alternative glycerol metabolic pathway, and modulation of garK gene with an mRS library further increased the β-carotene specific production value by 13%. Finally, co-modulation of genes in the introduced aldH-alrd operon led to 86% more of β-carotene specific production value than that of the strain without the alternative glycerol-utilization pathway and the glycerol-utilization rate was also increased. In this work, β-carotene production of E. coli was significantly improved by constructing and optimizing an alternative glycerol-utilization pathway. This strategy can potentially be used to improve the production of other isoprenoids using glycerol as a cheap and abundant substrate, and therefore has industrial relevance.
Photon up-conversion increases biomass yield in Chlorella vulgaris.

PubMed

Menon, Kavya R; Jose, Steffi; Suraishkumar, Gadi K

2014-12-01

Photon up-conversion, a process whereby lower energy radiations are converted to higher energy levels via the use of appropriate phosphor systems, was employed as a novel strategy for improving microalgal growth and lipid productivity. Photon up-conversion enables the utilization of regions of the solar spectrum, beyond the typical photosynthetically active radiation, that are usually wasted or are damaging to the algae. The effects of up-conversion of red light by two distinct sets of up-conversion phosphors were studied in the model microalgae Chlorella vulgaris. Up-conversion by set 1 phosphors led to a 2.85 fold increase in biomass concentration and a 3.2 fold increase in specific growth rate of the microalgae. While up-conversion by set 2 phosphors resulted in a 30% increase in biomass and 12% increase in specific intracellular neutral lipid, while the specific growth rates were comparable to that of the control. Furthermore, up-conversion resulted in higher levels of specific intracellular reactive oxygen species in C. vulgaris. Up-conversion of red light (654 nm) was shown to improve biomass yields in C. vulgaris. In principle, up-conversion can be used to increase the utilization range of the electromagnetic spectrum for improved cultivation of photosynthetic systems such as plants, algae, and microalgae. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Opportunistic Computing with Lobster: Lessons Learned from Scaling up to 25k Non-Dedicated Cores

NASA Astrophysics Data System (ADS)

Wolf, Matthias; Woodard, Anna; Li, Wenzhao; Hurtado Anampa, Kenyi; Yannakopoulos, Anna; Tovar, Benjamin; Donnelly, Patrick; Brenner, Paul; Lannon, Kevin; Hildreth, Mike; Thain, Douglas

2017-10-01

We previously described Lobster, a workflow management tool for exploiting volatile opportunistic computing resources for computation in HEP. We will discuss the various challenges that have been encountered while scaling up the simultaneous CPU core utilization and the software improvements required to overcome these challenges. Categories: Workflows can now be divided into categories based on their required system resources. This allows the batch queueing system to optimize assignment of tasks to nodes with the appropriate capabilities. Within each category, limits can be specified for the number of running jobs to regulate the utilization of communication bandwidth. System resource specifications for a task category can now be modified while a project is running, avoiding the need to restart the project if resource requirements differ from the initial estimates. Lobster now implements time limits on each task category to voluntarily terminate tasks. This allows partially completed work to be recovered. Workflow dependency specification: One workflow often requires data from other workflows as input. Rather than waiting for earlier workflows to be completed before beginning later ones, Lobster now allows dependent tasks to begin as soon as sufficient input data has accumulated. Resource monitoring: Lobster utilizes a new capability in Work Queue to monitor the system resources each task requires in order to identify bottlenecks and optimally assign tasks. The capability of the Lobster opportunistic workflow management system for HEP computation has been significantly increased. We have demonstrated efficient utilization of 25 000 non-dedicated cores and achieved a data input rate of 30 Gb/s and an output rate of 500GB/h. This has required new capabilities in task categorization, workflow dependency specification, and resource monitoring.
Standby power generation under utility curtailment contract agreements

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

Nolan, G.J.; Puccio, V.J.; Calhoun, C.W.

1995-12-31

Many utilities in the US offer large industrial and commercial customers power sales contracts which have attractive rates under a curtailment requirement. This curtailment requirement allows the utility to require the customer to reduce its power demand to a predetermined level within a specific time period. If the required curtailment is not achieved by the customer within the allocated time period, stiff financial penalties are usually enforced by the utility. The attractiveness of the contract rates usually is proportional to the amount of curtailment required. To take advantage of these attractive rates, a customer must be able to withstand themore » curtailment without supplemental generation or must add standby generation to meet its needs. Obviously, the cost of the curtailments to the customer should not exceed the economic benefits of reduced rates. This paper reviews the alternatives faced by a curtailment contract customer together with potential load shedding and standby generation system designs. An example of implementing a curtailment contract at an existing industrial facility is presented. The example facility, Boeing Helicopters of Philadelphia, Pennsylvania required both load shedding and standby generation. The load shedding scheme is fairly complex and is controlled by a programmable logic controller (PLC). The standby generation and load shedding systems for the example facility are examined in detail. Also, lessons learned from implementing the required modifications to the example facility are discussed.« less
Factors Influencing Intracavitary Electrocardiographic P-Wave Changes during Central Venous Catheter Placement

PubMed Central

Wang, Guorong; Guo, Ling; Jiang, Bin; Huang, Min; Zhang, Jian; Qin, Ying

2015-01-01

Amplitude changes in the P-wave of intracavitary electrocardiography have been used to assess the tip placement of central venous catheters. The research assessed the sensitivity and specificity of this sign in comparison with standard radiographic techniques for tip location, focusing on factors influencing its clinical utility. Both intracavitary electrocardiography guided tip location and X-ray positioning were used to verify catheter tip locations in patients undergoing central venous catheter insertion. Intracavitary electrocardiograms from 1119 patients (of a total 1160 subjects) showed specific amplitude changes in the P-wave. As the results show, compared with X-ray positioning, the sensitivity of electrocardiography-guided tip location was 97.3%, with false negative rate of 2.7%; the specificity was 1, with false positive rate of zero. Univariate analyses indicated that features including age, gender, height, body weight, and heart rate have no statistically significant influence on P-wave amplitude changes (P>0.05). Multivariate logistic regression revealed that catheter insertion routes (OR = 2.280, P = 0.003) and basal P-wave amplitude (OR = 0.553, P = 0.003) have statistically significant impacts on P-wave amplitude changes. As a reliable indicator of tip location, amplitude change in the P-wave has proved of good sensitivity and excellent specificity, and the minor, zero, false positive rate supports the clinical utility of this technique in early recognition of malpositioned tips. A better sensitivity was achieved in placement of centrally inserted central catheters (CICCs) than that of peripherally inserted central catheters (PICCs). In clinical practice, a combination of intracavitary electrocardiography, ultrasonic inspection and the anthropometric measurement method would further improve the accuracy. PMID:25915758
Utility Monitoring and Control System (UMCS) and Utility Metering Plan and Specifications for Fort Leonard Wood, MO

DTIC Science & Technology

2017-06-22

setup” versus “use” issue. What rights does Honeywell need to run the software? We/Honeywell may not know. Discuss with Jabe? We may need to just try...Summary: It appears the direction we are going will be to install new me- ters in buildings, connect them to the Smart Servers, run the data through...damper blade type (check the appropriate item) Flat late Airfoil Calculate the nominal damper face velocity Face velocity = Flow rate ÷ Area
A Novel 24 Ghz One-Shot Rapid and Portable Microwave Imaging System (Camera)

NASA Technical Reports Server (NTRS)

Ghasr, M.T.; Abou-Khousa, M.A.; Kharkovsky, S.; Zoughi, R.; Pommerenke, D.

2008-01-01

A novel 2D microwave imaging system at 24 GHz based on MST techniques. Enhanced sensitivity and SNR by utilizing PIN diode-loaded resonant slots. Specific slot and array design to increase transmission and reduce cross -coupling. Real-time imaging at a rate in excess of 30 images per second. Reflection as well transmission mode capabilities. Utility and application for electric field distribution mapping related to: Nondestructive Testing (NDT), imaging applications (SAR, Holography), and antenna pattern measurements.
Decision analysis defining optimal management of clinical stage 1 high-risk nonseminomatous germ cell testicular cancer with lymphovascular invasion.

PubMed

Avulova, Svetlana; Allen, Clayton; Morgans, Alicia; Moses, Kelvin A

2018-05-10

Risk of recurrent disease for men with clinical stage 1 high-risk nonseminomatous germ cell testicular cancer (CS1 NSGCT) with lymphovascular invasion (LVI) after orchiectomy is 50% and current treatment options (surveillance [S], retroperitoneal lymph node dissection [RPLND], or 1 cycle of BEP [BEP ×1]) are associated with a 99% disease specific survival, therefore practice patterns vary. We performed a decision analysis using updated data of long-term complications for men with CS1 NSGCT with LVI to quantify and assess relative treatment values. Decision analysis included previously defined utilities (via standard gamble) for posttreatment states of living from 0 (death from disease) to 1 (alive in perfect health) and updated morbidity probabilities. We quantified the values of S, RPLND, and BEP ×1 via the rollback method. Sensitivity analyses including a range of orchiectomy cure rates and utility values were performed. Estimated probabilities favoring treatment with RPLND (0.97) or BEP ×1 (0.97) were equivalent and superior to surveillance (0.88). Sensitivity analysis of orchiectomy cure rates (50%-100%) failed to find a cure rate that favored S over BEP ×1 or RPLND. Varying utility values for cure after S from 0.92 (previously defined utility) to 1 (perfect health), failed to find a viable utility state favoring S over BEP ×1 or RPLND. An orchiectomy cure rate of ≥82% would be required for S to equal treatment of either type. We demonstrate that for surveillance to be superior to treatment with BEP ×1 or RPLND, the orchiectomy cure rate must be at least 82%, which is not expected in a patient population with high-risk CS1 NSGCT. Copyright © 2018 Elsevier Inc. All rights reserved.
Effect of florfenicol on performance and microbial community of a sequencing batch biofilm reactor treating mariculture wastewater.

PubMed

Gao, Feng; Li, Zhiwei; Chang, Qingbo; Gao, Mengchun; She, Zonglian; Wu, Juan; Jin, Chunji; Zheng, Dong; Guo, Liang; Zhao, Yangguo; Wang, Sen

2018-02-01

The effects of florfenicol (FF) on the performance, microbial activity and microbial community of a sequencing batch biofilm reactor (SBBR) were evaluated in treating mariculture wastewater. The chemical oxygen demand (COD) and nitrogen removal were inhibited at high FF concentrations. The specific oxygen utilization rate (SOUR), specific ammonium oxidation rate (SAOR), specific nitrite oxidation rate (SNOR) and specific nitrate reduction rate (SNRR) were decreased with an increase in the FF concentration from 0 to 35 mg/L. The chemical compositions of loosely bound extracellular polymeric substances (LB-EPS) and tightly bound EPS (TB-EPS) could be affected with an increase in the FF concentration. The high-throughput sequencing indicated some obvious variations in the microbial community at different FF concentrations. The relative abundance of Nitrosomonas and Nitrospira showed a decreasing tendency with an increase in the FF concentration, suggesting that FF could affect the nitrification process of SBBR. Some genera capable of reducing nitrate to nitrogen gas could be inhibited by the addition of FF in the influent, such as Azospirillum and Hyphomicrobium.
How can survival processing improve memory encoding?

PubMed

Luo, Meng; Geng, Haiyan

2013-11-01

We investigated the psychological mechanism of survival processing advantage from the perspective of false memory in two experiments. Using a DRM paradigm in combination with analysis based on signal detection theory, we were able to separately examine participants' utilization of verbatim representation and gist representation. Specifically, in Experiment 1, participants rated semantically related words in a survival scenario for a survival condition but rated pleasantness of words in the same DRM lists for a non-survival control condition. The results showed that participants demonstrated more gist processing in the survival condition than in the pleasantness condition; however, the degree of item-specific processing in the two encoding conditions did not significantly differ. In Experiment 2, the control task was changed to a category rating task, in which participants were asked to make category ratings of words in the category lists. We found that the survival condition involved more item-specific processing than did the category condition, but we found no significant difference between the two encoding conditions at the level of gist processing. Overall, our study demonstrates that survival processing can simultaneously promote gist and item-specific representations. When the control tasks only promoted either item-specific representation or gist representation, memory advantages of survival processing occurred.

Investigation and modeling of biomass decay rate in the dark and its potential influence on net productivity of solar photobioreactors for microalga Chlamydomonas reinhardtii and cyanobacterium Arthrospira platensis.

PubMed

Le Borgne, François; Pruvost, Jérémy

2013-06-01

Biomass decay rate (BDR) in the dark was investigated for Chlamydomonas reinhardtii (microalga) and Arthrospira platensis (cyanobacterium). A specific setup based on a torus photobioreactor with online gas analysis was validated, enabling us to follow the time course of the specific BDR using oxygen monitoring and mass balance. Various operating parameters that could limit respiration rates, such as culture temperature and oxygen deprivation, were then investigated. C. reinhardtii was found to present a higher BDR in the dark than A. platensis, illustrating here the difference between eukaryotic and prokaryotic cells. In both cases, temperature proved an influential parameter, and the Arrhenius law was found to efficiently relate specific BDR to culture temperature. The utility of decreasing temperature at night to increase biomass productivity in a solar photobioreactor is also illustrated. Copyright © 2013 Elsevier Ltd. All rights reserved.
xylA and xylB overexpression as a successful strategy for improving xylose utilization and poly-3-hydroxybutyrate production in Burkholderia sacchari.

PubMed

Guamán, Linda P; Oliveira-Filho, Edmar R; Barba-Ostria, Carlos; Gomez, José G C; Taciro, Marilda K; da Silva, Luiziana Ferreira

2018-03-01

Despite the versatility and many advantages of polyhydroxyalkanoates as petroleum-based plastic substitutes, their higher production cost compared to petroleum-based polymers has historically limited their large-scale production. One appealing approach to reducing production costs is to employ less expensive, renewable feedstocks. Xylose, for example is an abundant and inexpensive carbon source derived from hemicellulosic residues abundant in agro-industrial waste (sugarcane bagasse hemicellulosic hydrolysates). In this work, the production of poly-3-hydroxybutyrate P(3HB) from xylose was studied to develop technologies for conversion of agro-industrial waste into high-value chemicals and biopolymers. Specifically, this work elucidates the organization of the xylose assimilation operon of Burkholderia sacchari, a non-model bacterium with high capacity for P(3HB) accumulation. Overexpression of endogenous xylose isomerase and xylulokinase genes was successfully assessed, improving both specific growth rate and P(3HB) production. Compared to control strain (harboring pBBR1MCS-2), xylose utilization in the engineered strain was substantially improved with 25% increase in specific growth rate, 34% increase in P(3HB) production, and the highest P(3HB) yield from xylose reported to date for B. sacchari (Y P3HB/Xil = 0.35 g/g). This study highlights that xylA and xylB overexpression is an effective strategy to improve xylose utilization and P(3HB) production in B. sacchari.
Strategic enzyme patterning for microfluidic biofuel cells

NASA Astrophysics Data System (ADS)

Kjeang, E.; Sinton, D.; Harrington, D. A.

The specific character of biological enzyme catalysts enables combined fuel and oxidant channels and simplified non-compartmentalized fuel cell assemblies. In this work, a microstructured enzymatic biofuel cell architecture is proposed, and species transport phenomena combined with consecutive chemical reactions are studied computationally in order to provide guidelines for optimization. This is the first computational study of this technology, and a 2D CFD model for species transport coupled with laminar fluid flow and Michaelis-Menten enzyme kinetics is established. It is shown that the system is reaction rate limited, indicating that enzyme specific turnover numbers are key parameters for biofuel cell performance. Separated and mixed enzyme patterns in different proportions are analyzed for various Peclet numbers. High fuel utilization is achieved in the diffusion dominated and mixed species transport regimes with separated enzymes arranged in relation to individual turnover rates. However, the Peclet number has to be above a certain threshold value to obtain satisfying current densities. The mixed transport regime is particularly attractive while current densities are maintained close to maximum levels. Optimum performance is achieved by mixed enzyme patterning tailored with respect to individual turnover rates, enabling high current densities combined with nearly complete fuel utilization.
A family-specific use of the Measure of Processes of Care for Service Providers (MPOC-SP).

PubMed

Siebes, R C; Nijhuis, B J G; Boonstra, A M; Ketelaar, M; Wijnroks, L; Reinders-Messelink, H A; Postema, K; Vermeer, A

2008-03-01

To examine the validity and utility of the Dutch Measure of Processes of Care for Service Providers (MPOC-SP) as a family-specific measure. A validation study. Five paediatric rehabilitation settings in the Netherlands. The MPOC-SP was utilized in a general (reflecting on services provided for all clients and clients' families) and family-specific way (filled out in reference to a particular child and his or her family). Professionals providing rehabilitation and educational services to children with cerebral palsy. For construct validity, Pearson's product-moment correlation coefficients (r ) between the scales were calculated. The ability of service providers to discriminate between general and family-specific ratings was examined by exploration of absolute difference scores. One hundred and sixteen service professionals filled out 240 family-specific MPOC-SPs. In addition, a subgroup of 81 professionals filled out a general MPOC-SP. For each professional, family-specific and general scores were paired, resulting in 151 general-family-specific MPOC-SP pairs. The construct validity analyses confirmed the scale structure: 21 items (77.8%) loaded highest in the original MPOC-SP factors, and all items correlated best and significantly with their own scale score (r 0.565 to 0.897; P<0.001). Intercorrelations between the scales ranged from r = 0.159 to r = 0.522. In total, 94.4% of the mean absolute difference scores between general and family-specific scale scores were larger than the expected difference. Service providers were able to discriminate between general and family-specific MPOC-SP item ratings. The family-specific MPOC-SP is a valid measure that can be used for individual evaluation of family-centred services and can be the impetus for family-related quality improvement.
The effects of the Balanced Budget Act of 1997 on home health and hospice in older adult cancer patients.

PubMed

Kilgore, Meredith L; Grabowski, David C; Morrisey, Michael A; Ritchie, Christine S; Yun, Huifeng; Locher, Julie L

2009-03-01

Home health and hospice services can constitute important elements in the continuum of care for older adults diagnosed with cancer. The Balanced Budget Act (BBA) of 1997 included provisions affecting those services. The first objective of this study is to assess the effect of the BBA of 1997 on home health and hospice service utilization in older cancer patients. The second objective is to estimate the effect of the BBA of 1997 on costs associated specifically with home health and hospice services and on total costs of care. The final objective is to evaluate the effect of the BBA of 1997 on mortality in these patients. Longitudinal analysis using the Surveillance, Epidemiology, and End Results-Medicare Database, covering a service area that includes 26% of the US population. Community-dwelling Medicare beneficiaries 65 years of age and older. Utilization rates of home health and hospice services; costs associated with those services, and total costs of care; and mortality. Home health utilization rates dropped substantially and hospice utilization rates increased after the BBA. Medicare costs for home health services declined as did total Medicare costs but hospice costs increased. There was no discernable effect on mortality rates. The BBA was successful in containing the costs of home health services and resulted in savings in overall costs of care for older cancer patients. Reduction in utilization of home health services did not seem to negatively affect outcomes. The BBA may have contributed to the trend of increasing use of hospice care.
Identifying Specific Combinations of Multimorbidity that Contribute to Health Care Resource Utilization: An Analytic Approach.

PubMed

Schiltz, Nicholas K; Warner, David F; Sun, Jiayang; Bakaki, Paul M; Dor, Avi; Given, Charles W; Stange, Kurt C; Koroukian, Siran M

2017-03-01

Multimorbidity affects the majority of elderly adults and is associated with higher health costs and utilization, but how specific patterns of morbidity influence resource use is less understood. The objective was to identify specific combinations of chronic conditions, functional limitations, and geriatric syndromes associated with direct medical costs and inpatient utilization. Retrospective cohort study using the Health and Retirement Study (2008-2010) linked to Medicare claims. Analysis used machine-learning techniques: classification and regression trees and random forest. A population-based sample of 5771 Medicare-enrolled adults aged 65 and older in the United States. Main covariates: self-reported chronic conditions (measured as none, mild, or severe), geriatric syndromes, and functional limitations. Secondary covariates: demographic, social, economic, behavioral, and health status measures. Medicare expenditures in the top quartile and inpatient utilization. Median annual expenditures were $4354, and 41% were hospitalized within 2 years. The tree model shows some notable combinations: 64% of those with self-rated poor health plus activities of daily living and instrumental activities of daily living disabilities had expenditures in the top quartile. Inpatient utilization was highest (70%) in those aged 77-83 with mild to severe heart disease plus mild to severe diabetes. Functional limitations were more important than many chronic diseases in explaining resource use. The multimorbid population is heterogeneous and there is considerable variation in how specific combinations of morbidity influence resource use. Modeling the conjoint effects of chronic conditions, functional limitations, and geriatric syndromes can advance understanding of groups at greatest risk and inform targeted tailored interventions aimed at cost containment.
Analysis of Actual Versus Projected Medical Claims Under the First Year of ACA-Mandated Coverage

PubMed Central

McCue, Michael J.; Palazzolo, Jennifer R.

2016-01-01

For the individual market, 2014 was the first year Affordable Care Act medical claims experience data were available to set 2016 rates. Accessing Centers for Medicare and Medicaid Services rate data for 175 state insurers, this study compares projected medical claims with actual medical claims of 2014, as well as the cost and utilization of benefit categories for inpatient, outpatient, professional, and prescription drug spending. Actual costs per member per month (pmpm) were greater than projected in 2014 for inpatient, outpatient, and prescription spending but not for professional care. Overall, actual median medical cost was $443 pmpm, which was significantly higher by $41 than projected cost. Greater utilization of health care was primarily responsible for higher realized medical claims. In terms of the specific benefit categories—inpatient, outpatient, and prescription—actual costs pmpm were significantly higher than projected values. In terms of the drivers of inpatient costs, on an admission basis, higher costs and greater utilization of admissions resulted in higher inpatient costs. For outpatient costs pmpm, higher utilization rather than unit cost per visit drove increased costs. Higher than expected prescription drug costs were driven by both greater utilization and cost per prescription. PMID:27856783
Assessing fidelity in individual and family therapy for adolescent substance abuse.

PubMed

Hogue, Aaron; Dauber, Sarah; Chinchilla, Priscilla; Fried, Adam; Henderson, Craig; Inclan, Jaime; Reiner, Robert H; Liddle, Howard A

2008-09-01

This study introduces an observational measure of fidelity in evidence-based practices for adolescent substance abuse treatment. The Therapist Behavior Rating Scale-Competence (TBRS-C) measures adherence and competence in individual cognitive-behavioral therapy and multidimensional family therapy for adolescent substance abuse. The TBRS-C assesses fidelity to the core therapeutic goals of each approach and also contains global ratings of therapist competence. Study participants were 136 clinically referred adolescents and their families observed in 437 treatment sessions. The TBRS-C demonstrated strong interrater reliability for goal-specific ratings of treatment adherence, and modest reliability for goal-specific and global ratings of therapist competence, evidence of construct validity, and discriminant validity with an observational measure of therapeutic alliance. The utility of the TBRS-C for evaluating treatment fidelity in field settings is discussed.
Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial

PubMed Central

2011-01-01

Background Low back pain (LBP), with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI) of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP. Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days), Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB) and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP) and 12 months (evaluate the outcomes at long term). Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration ISRCTN: ISRCTN58719694 PMID:21859489
Thermophilic anaerobic degradation of butyrate by a butyrate-utilizing bacterium in coculture and triculture with methanogenic bacteria.

PubMed

Ahring, B K; Westermann, P

1987-02-01

We studied syntrophic butyrate degradation in thermophilic mixed cultures containing a butyrate-degrading bacterium isolated in coculture with Methanobacterium thermoautotrophicum or in triculture with M. thermoautotrophicum and the TAM organism, a thermophilic acetate-utilizing methanogenic bacterium. Butyrate was beta-oxidized to acetate with protons as the electron acceptors. Acetate was used concurrently with its production in the triculture. We found a higher butyrate degradation rate in the triculture, in which both hydrogen and acetate were utilized, than in the coculture, in which acetate accumulated. Yeast extract, rumen fluid, and clarified digestor fluid stimulated butyrate degradation, while the effect of Trypticase was less pronounced. Penicillin G, d-cycloserine, and vancomycin caused complete inhibition of butyrate utilization by the cultures. No growth or degradation of butyrate occurred when 2-bromoethanesulfonic acid or chloroform, specific inhibitors of methanogenic bacteria, was added to the cultures and common electron acceptors such as sulfate, nitrate, and fumarate were not used with butyrate as the electron donor. Addition of hydrogen or oxygen to the gas phase immediately stopped growth and butyrate degradation by the cultures. Butyrate was, however, metabolized at approximately the same rate when hydrogen was removed from the cultures and was metabolized at a reduced rate in the cultures previously exposed to hydrogen.
A Report of the Efforts of the Veterans Health Administration National Antimicrobial Stewardship Initiative.

PubMed

Kelly, Allison A; Jones, Makoto M; Echevarria, Kelly L; Kralovic, Stephen M; Samore, Matthew H; Goetz, Matthew B; Madaras-Kelly, Karl J; Simbartl, Loretta A; Morreale, Anthony P; Neuhauser, Melinda M; Roselle, Gary A

2017-05-01

OBJECTIVE To detail the activities of the Veterans Health Administration (VHA) Antimicrobial Stewardship Initiative and evaluate outcomes of the program. DESIGN Observational analysis. SETTING The VHA is a large integrated healthcare system serving approximately 6 million individuals annually at more than 140 medical facilities. METHODS Utilization of nationally developed resources, proportional distribution of antibiotics, changes in stewardship practices and patient safety measures were reported. In addition, inpatient antimicrobial use was evaluated before and after implementation of national stewardship activities. RESULTS Nationally developed stewardship resources were well utilized, and many stewardship practices significantly increased, including development of written stewardship policies at 92% of facilities by 2015 (P<.05). While the proportional distribution of antibiotics did not change, inpatient antibiotic use significantly decreased after VHA Antimicrobial Stewardship Initiative activities began (P<.0001). A 12% decrease in antibiotic use was noted overall. The VHA has also noted significantly declining use of antimicrobials prescribed for resistant Gram-negative organisms, including carbapenems, as well as declining hospital readmission and mortality rates. Concurrently, the VHA reported decreasing rates of Clostridium difficile infection. CONCLUSIONS The VHA National Antimicrobial Stewardship Initiative includes continuing education, disease-specific guidelines, and development of example policies in addition to other highly utilized resources. While no specific ideal level of antimicrobial utilization has been established, the VHA has shown that improving antimicrobial usage in a large healthcare system may be achieved through national guidance and resources with local implementation of antimicrobial stewardship programs. Infect Control Hosp Epidemiol 2017;38:513-520.
Factors associated with free adult preventive health care utilization among physically disabled people in Taiwan: nationwide population-based study.

PubMed

Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

2014-12-05

Few previous studies have specifically addressed the health care utilization situation of the physically disabled. This study aimed to investigate the utilization of free adult preventive health care for physically disabled people and its' affecting factors. The data was obtained from three nationwide databases from 2006 to 2008. This study comprised 329,264 physically disabled people in Taiwan above the age of 40 who had eligible health checks during 2008. We employed descriptive statistics to analyze the use and rate of free preventive health care use by physically disabled adults. Logistic regression analysis was used to explore the factors that affect physically disabled adults' use of free adult preventive health care. 16.37% of the physically disabled adults used free adult preventive health care. Women (17.66%), married (17.16%), a junior high education level (17.89%), and mildly disabled adults (18.77%) had the highest use rate among various participant subgroups. The variables that significantly influenced the use of free adult preventive health care by the physically disabled included gender, age, education, marital status, urbanization of the residence areas, monthly payroll, aboriginal status, catastrophic illnesses status, relevant chronic diseases, and severity of disability. Physically disabled using preventive health care tend to be low. Governments should use the media to reinforce propagation and education of these services to specific, low-utilization groups, and encourage doctors to actively provide preventive health care to communities.
Modular pathway engineering of Corynebacterium glutamicum to improve xylose utilization and succinate production.

PubMed

Jo, Suah; Yoon, Jinkyung; Lee, Sun-Mi; Um, Youngsoon; Han, Sung Ok; Woo, Han Min

2017-09-20

Xylose-negative Corynebacterium glutamicum has been engineered to utilize xylose as the sole carbon source via either the xylose isomerase (XI) pathway or the Weimberg pathway. Heterologous expression of xylose isomerase and overexpression of a gene encoding for xylulose kinase enabled efficient xylose utilization. In this study, we show that two functionally-redundant transcriptional regulators (GntR1 and GntR2) present on xylose repress the pentose phosphate pathway genes. For efficient xylose utilization, pentose phosphate pathway genes and a phosphoketolase gene were overexpressed with the XI pathway in C. glutamicum. Overexpression of the genes encoding for transaldolase (Tal), 6-phosphogluconate dehydrogenase (Gnd), or phosphoketolase (XpkA) enhanced the growth and xylose consumption rates compared to the wild-type with the XI pathway alone. However, co-expression of these genes did not have a synergetic effect on xylose utilization. For the succinate production from xylose, overexpression of the tal gene with the XI pathway in a succinate-producing strain improved xylose utilization and increased the specific succinate production rate by 2.5-fold compared to wild-type with the XI pathway alone. Thus, overexpression of the tal, gnd, or xpkA gene could be helpful for engineering C. glutamicum toward production of value-added chemicals with efficient xylose utilization. Copyright © 2017 Elsevier B.V. All rights reserved.
The Application of the Specific Gage Technique and Aerial Photographs in Kaskaskia River Degradation Studies

NASA Astrophysics Data System (ADS)

Du, X.

2008-12-01

The Kaskaskia River basin contains 136,000 acres of bottomland forest, the largest contiguous tract of bottomland forest remaining in the state of Illinois. Since the 1960's, the Carlyle Lake Dam impoundment and channelization activities have altered the natural hydrologic and ecological equilibrium of the Kaskaskia River. Morphological changes of the river channel have necessitated conservation and restoration efforts to create and maintain the sustainability, diversity, health, and connectivity of the river watershed. This study utilized the specific gage technique and historical aerial photographs to investigate the spatial and temporal changes of the river. Historical daily discharge and daily stage data from the Carlyle (1966 to 2002) and Venedy Station gages (1984 to 2003) were analyzed. Logs of daily discharge data were used to generate annual rating curves. The best fit equations were produced from annual rating regressions. A stage associated with a chosen reference discharge, the minimum available discharge (MAD), was calculated. A stage decreasing/increasing trend was used as a primary indicator of channel bed incision/aggradation. Pseudo specific gage analysis (PSGA) was used to model channel cross sectional geometry changes over time. PSGA applied similar procedures as compared to the specific gage technique. Instead of using the stage variable, PSGA utilized cross sectional width, cross-sectional area, mean velocity and gage height individually. At each gage, the historical change of each cross sectional parameter was plotted against the log of discharge. Ratings of specific stages, specific cross sectional width, specific depth, specific area, and specific velocity associated with the chosen discharge, MAD, were produced. The decreasing/increasing trend of each parameter mentioned above corresponded with changes of channel cross sectional geometries over time. Historical aerial photographs were also used to assess the bankfull channel width changing rates during the pre and post modification period. The statistical significance of the regression trendlines from the specific gage analyses and PSGA was tested. Results suggested that there was no significant channel bed incision trend near the river gages within the studied time period. A statistically significant increase in channel width changing rates was found during post-modification period. Following the channelization and dam construction on the Kaskaskia River, substantial channel bed widening has accelerated bank erosion and associated channel morphology change, which has consequently resulted in a net loss of riparian habitat in this important bottomland forest corridor in southern Illinois, USA.
Patient-reported Outcomes in Practice: Clinicians' Perspectives From an Inpatient Psychiatric Setting.

PubMed

Burr, Sean K; Fowler, James C; Allen, Jon G; Wiltgen, Anika; Madan, Alok

2017-09-01

The use of patient-reported outcomes (PROs) has become increasingly common. They have been used to assess quality of care and to support policy decisions, but the evidence concerning their utility to improve patient outcomes is inconsistent. A better understanding of clinicians' experience with PROs has the potential to improve their effectiveness. This exploratory, quantitative, and qualitative study investigated the perspectives of clinicians (N=70) from multiple disciplines (psychiatrists, psychologists, social workers, and psychiatric nurses) on the utility of PROs in an inpatient psychiatric setting. During scheduled, monthly, discipline-specific administrative meetings, clinicians in attendance completed a 1-time, 5-item survey. The highest rated item related to the frequency of reviewing outcomes reports; this item was rated higher than all other items (mean±SD, 4.5±1.5), which 37.5% of the participants in the overall sample stated they "always" did. The lowest rated item related to the frequency of conveying the results of the outcomes reports to patients (3.3±1.9), which 20% of participants reported "always" doing; this item was rated lower than all other items (P<0.03). Qualitative analyses were based on 30 comments from 22 clinicians, which resulted in the emergence of 6 themes. The 2 themes that received the highest number of comments related to: (1) the sensitivity and specificity of measures across the PROs platform and (2) the value of the reports in directly influencing treatment decisions. Clinicians' relatively favorable perspective of PROs in practice in this study may be related to the assessment-oriented culture at the study institution. Nonetheless, many barriers to the routine use of PROs exist. Addressing clinician concerns has the potential to improve utilization of this facet of good clinical care.
Method for assigning sites to projected generic nuclear power plants

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

Holter, G.M.; Purcell, W.L.; Shutz, M.E.

1986-07-01

Pacific Northwest Laboratory developed a method for forecasting potential locations and startup sequences of nuclear power plants that will be required in the future but have not yet been specifically identified by electric utilities. Use of the method results in numerical ratings for potential nuclear power plant sites located in each of the 10 federal energy regions. The rating for each potential site is obtained from numerical factors assigned to each of 5 primary siting characteristics: (1) cooling water availability, (2) site land area, (3) power transmission land area, (4) proximity to metropolitan areas, and (5) utility plans for themore » site. The sequence of plant startups in each federal energy region is obtained by use of the numerical ratings and the forecasts of generic nuclear power plant startups obtained from the EIA Middle Case electricity forecast. Sites are assigned to generic plants in chronological order according to startup date.« less
Cold and desiccation stress induced changes in the accumulation and utilization of proline and trehalose in seasonal populations of Drosophila immigrans.

PubMed

Tamang, Aditya Moktan; Kalra, Bhawna; Parkash, Ravi

2017-01-01

Changes in the levels of energy metabolites can limit survival ability of Drosophila species under stressful conditions but this aspect has received less attention in wild populations collected in different seasons. We tested cold or desiccation triggered changes in the accumulation or utilization of two energy metabolites (trehalose and proline) in Drosophila immigrans flies reared under season specific environmental conditions. Such D.immigrans populations were subjected to different durations of cold (0°C) or desiccation stress (5% RH) or dual stress. We found stress induced effects of cold vs desiccation on the levels of trehalose as well as for proline. Different durations of cold stress led to accumulation of trehalose while desiccation stress durations revealed utilization of trehalose. In contrast, there was accumulation of proline under desiccation and utilization of proline with cold stress. Since accumulation levels were higher than utilization of each energy metabolite, the effects of dual stress showed additive effect. However, there was no utilization of total body lipids under cold or desiccation stress. We observed significant season specific differences in the amount of energy metabolites but the rate of metabolism did not vary across seasons. Stress triggered changes in trehalose and proline suggest possible link between desiccation and cold tolerance. Finally, stress specific (cold or desiccation) compensatory changes in the levels of trehalose and proline suggest possible energetic homeostasis in D.immigrans living under harsh climatic conditions of montane localities. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Brief antecedent assessment and treatment of tics in the general education classroom: a preliminary investigation.

PubMed

Watson, T Steuart; Dufrene, Brad; Weaver, Adam; Butler, Tonya; Meeks, Caroline

2005-11-01

The purpose of this study was to determine if specific classroom antecedents were associated with motor and vocal tics in two males diagnosed with Tourette's syndrome. A functional assessment consisting of teacher and student interviews, direct observations, brief functional analysis, and confirmatory naturalistic observations indicated that specific antecedents could be identified for each participant. Simplified habit reversal was then implemented only under the antecedent condition that resulted in the highest rate of tics. The rate of tics decreased under the specific antecedent condition as well as at other times as validated by behavioral observations conducted at random times. The discussion focuses on the utility of conducting such assessments, the methodological and applied limitations of the current study, and avenues for further research.
Aldouronate utilization in Paenibacillus sp. strain JDR-2: Physiological and enzymatic evidence for coupling of extracellular depolymerization and intracellular metabolism.

PubMed

Nong, Guang; Rice, John D; Chow, Virginia; Preston, James F

2009-07-01

Paenibacillus sp. strain JDR-2, an aggressively xylanolytic bacterium isolated from decaying sweet gum wood, secretes a multimodular glycohydrolase family GH10 endoxylanase (XynA1) anchored to the cell surface. The gene encoding XynA1 is part of a xylan utilization regulon that includes an aldouronate utilization gene cluster with genes encoding a GH67 alpha-glucuronidase (AguA), a GH10 endoxylanase (XynA2), and a GH43 arabinofuranosidase/beta-xylosidase (XynB). Here we show that this Paenibacillus sp. strain is able to utilize methylglucuronoxylose (MeGAX(1)), an aldobiuronate product that accumulates during acid pretreatment of lignocellulosic biomass, and methylglucuronoxylotriose (MeGAX(3)), the product of the extracellular XynA1 acting on methylglucuronoxylan (MeGAX(n)). The average rates of utilization of MeGAX(n), MeGAX(1), and MeGAX(3) were 149.8, 59.4, and 54.3 microg xylose equivalents.ml(-1).h(-1), respectively, and were proportional to the specific growth rates on the substrates. AguA was active with MeGAX(1) and MeGAX(3), releasing 4-O-methyl-d-glucuronate alpha-1,2 linked to a nonreducing terminal xylose residue. XynA2 converted xylotriose, generated by the action of AguA on MeGAX(3), to xylose and xylobiose. The ability to utilize MeGAX(1) provides a novel metabolic potential for bioconversion of acid hydrolysates of lignocellulosics. The 2.8-fold-greater rate of utilization of polymeric MeGAX(n) than that of MeGAX(3) indicates that there is coupling of extracellular depolymerization, assimilation, and intracellular metabolism, allowing utilization of lignocellulosics with minimal pretreatment. Along with adjacent genes encoding transcriptional regulators and ABC transporter proteins, the aguA and xynA2 genes in the cluster described above contribute to the efficient utilization of aldouronates derived from dilute acid and/or enzyme pretreatment protocols applied to the conversion of hemicellulose to biofuels and chemicals.
Development and verification of a model for estimating the screening utility in the detection of PCBs in transformer oil.

PubMed

Terakado, Shingo; Glass, Thomas R; Sasaki, Kazuhiro; Ohmura, Naoya

2014-01-01

A simple new model for estimating the screening performance (false positive and false negative rates) of a given test for a specific sample population is presented. The model is shown to give good results on a test population, and is used to estimate the performance on a sampled population. Using the model developed in conjunction with regulatory requirements and the relative costs of the confirmatory and screening tests allows evaluation of the screening test's utility in terms of cost savings. Testers can use the methods developed to estimate the utility of a screening program using available screening tests with their own sample populations.

Cancer screening among Vietnamese in Hawaii.

PubMed

Nguyen, Ly T; Withy, Kelley; Nguyen, Michelle M; Yamada, Seiji

2003-07-01

To determine the extent of utilization of cancer screening services by Vietnamese in Hawaii, who had sought medical care from 1996 through 2000. A chart review of 952 adult Vietnamese patients was performed. Of all eligible women, 52% and 26% had Papanicolaou test and mammogram, respectively. Among men age 45 and over, 8.4% had prostate-specific antigen test and 3.4% had digital rectal exam. Flexible sigmoidoscopy and colonoscopy were not utilized by patients. This is the first study to examine the use of cancer screening tests by Vietnamese immigrants in Hawaii. Our findings of lower utilization rates in cancer screening by both male and female strongly support efforts to educate and promote preventive health for this population.
Axial-Compressive Behavior, Including Kink-Band Formation and Propagation, of Single p-Phenylene Terephthalamide (PPTA) Fibers

DTIC Science & Technology

2013-01-01

material models to describe the behavior of fibers and structures under high -rate loading conditions. With the utility of the CAE methods and tools largely...phenylene terephthalamide (PPTA), available commercially as Kevlar, Twaron, Technora, and so forth, are characterized by high specific axial stiffness...and high specific tensile strength. These fibers are often referred to as “ballistic fibers” since they are commonly used in different ballistic- and
Influence of four antimicrobials on methane-producing archaea and sulfate-reducing bacteria in anaerobic granular sludge.

PubMed

Du, Jingru; Hu, Yong; Qi, Weikang; Zhang, Yanlong; Jing, Zhaoqian; Norton, Michael; Li, Yu-You

2015-12-01

The influence of Cephalexin (CLX), Tetracycline (TC), Erythromycin (ERY) and Sulfathiazole (ST) on methane-producing archaea (MPA) and sulfate-reducing bacteria (SRB) in anaerobic sludge was investigated using acetate or ethanol as substrate. With antimicrobial concentrations below 400mgL(-1), the relative specific methanogenic activity (SMA) was above 50%, so that the antimicrobials exerted slight effects on archaea. However ERY and ST at 400mgL(-1) caused a 74.5% and 57.6% inhibition to specific sulfidogenic activity (SSA) when the sludge granules were disrupted and ethanol used as substrate. After disruption, microbial tolerance to antimicrobials decreased, but the rate at which MPA utilized acetate and ethanol increased from 0.95gCOD·(gVSS⋅d)(-1) to 1.45gCOD·(gVSS⋅d)(-1) and 0.90gCOD·(gVSS⋅d)(-1) to 1.15gCOD·(gVSS⋅d)(-1) respectively. The ethanol utilization rate for SRB also increased after disruption from 0.35gCOD·(gVSS⋅d)(-1) to 0.46gCOD·(gVSS⋅d)(-1). Removal rates for CLX approaching 20.0% and 25.0% were obtained used acetate and ethanol respectively. The disintegration of granules improved the CLX removal rate to 65% and 78%, but ST was not removed during this process. Copyright © 2014 Elsevier Ltd. All rights reserved.
Demand-side management glossary

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less
Demand-side management glossary. Final report

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less
Evidence-based nursing practice: both state of the art in general and specific to pressure sores.

PubMed

Buss, I C; Halfens, R J; Abu-Saad, H H; Kok, G

1999-01-01

The importance of research-based practice in nursing has been frequently stressed, and a number of nursing studies have been conducted whose results enable nursing to improve knowledge and practice. This study reports a literature review in which the current status of knowledge and research utilization with regard to pressure sores is described. This review first gives an overview of studies on knowledge utilization in general and shows that the spontaneous diffusion of knowledge is inappropriate. Furthermore, an overview of planned research utilization activities focusing on pressure sore prevention and treatment in nursing is presented. The results of these studies show that planned research utilization activities performed in individual organizations lead to positive outcomes in almost all cases. Therefore, it could be concluded that implementing planned research utilization activities in individual health care institutions seems to be an effective strategy to decrease pressure sore incidence and prevalence rates.
Development and fabrication of patient-specific knee implant using additive manufacturing techniques

NASA Astrophysics Data System (ADS)

Zammit, Robert; Rochman, Arif

2017-10-01

Total knee replacement is the most effective treatment to relief pain and restore normal function in a diseased knee joint. The aim of this research was to develop a patient-specific knee implant which can be fabricated using additive manufacturing techniques and has reduced wear rates using a highly wear resistant materials. The proposed design was chosen based on implant requirements, such as reduction in wear rates as well as strong fixation. The patient-specific knee implant improves on conventional knee implants by modifying the articulating surfaces and bone-implant interfaces. Moreover, tribological tests of different polymeric wear couples were carried out to determine the optimal materials to use for the articulating surfaces. Finite element analysis was utilized to evaluate the stresses sustained by the proposed design. Finally, the patient-specific knee implant was successfully built using additive manufacturing techniques.
Burden of Surgical Site Infections Associated with Arthroplasty and the Contribution of Staphylococcus aureus.

PubMed

Patel, Harshila; Khoury, Hanane; Girgenti, Douglas; Welner, Sharon; Yu, Holly

2016-02-01

Patients undergoing arthroplasty are at considerable risk of experiencing post-operative complications, including surgical site infections (SSIs). In addition to potential economic consequences, SSIs can have a negative impact on patient outcomes and may potentially be life-threatening. Staphylococcus aureus has been consistently shown as the leading cause of SSIs associated with orthopedic surgery, with an important contribution from methicillin-resistant S. aureus (MRSA). This study evaluated the global burden of SSIs among patients undergoing orthopedic surgical procedures, and specifically those undergoing knee and hip arthroplasties. An extensive search of PubMed and recent conference proceedings was conducted. English articles published between 2003 and 2013 pertaining to SSI epidemiology, patient outcomes, and healthcare resource utilization and costs were reviewed. Overall, 81 studies were included, mainly from North America and Europe. Median SSI and S. aureus SSI rates, calculated as percentage of all arthroplasty procedures, were 1.7% (range: 0.25%-4.4%; 15 studies) and 0.6% (range: 0.1%-23%), respectively. Median SSI rates were 1.3% (range: 0.05%-19%; 22 studies) after knee arthroplasty, and 2.1% (range: 0.05%-28%; 24 studies) after hip arthroplasty. S. aureus SSI rates ranged from 0.2%-2.4% and 0.18%-3.8% for patients undergoing knee and hip arthroplasty, respectively. The percentage of S. aureus SSIs because of MRSA varied widely within each patient category. SSI-related mortality data (14 studies) showed that in-hospital mortality rates were low (1.2%-2.5%), but increased with time after index arthroplasty procedure (up to 56% over 1 y). Studies assessing healthcare resource utilization (n = 21) revealed that developing post-orthopedic SSIs resulted in a two- to three-fold increase in length of hospital stay (LOS) compared with non-infected patients (median LOS: 18.9 d vs. 6 d for non-SSI patients). Patients with SSIs because of methicillin-resistant staphylococci incurred greater mean LOS compared with SSIs because of methicillin-sensitive organisms. Readmission rates reported in 11 studies indicate a greater likelihood in the presence of SSIs; comparison across studies was not feasible because of differences in data reporting. Consistent with increased healthcare resource utilization (LOS and readmission) associated with SSIs, cost studies (n = 23) revealed that the presence of SSIs was associated with up to three-fold cost increase compared with the absence of SSI across all orthopedic patient categories assessed. SSIs are associated with increased morbidity, mortality rates, healthcare resource utilization, and costs. Despite the relatively low SSI incidence following orthopedic surgery and specifically arthroplasty, preventive methods, specifically those targeting S. aureus, would serve to minimize costs and improve patient outcomes.
[High utilization of health insurance services by the elderly--analysis of hospital and drug utilization data].

PubMed

Nordheim, Johanna; Maaz, Asja; Winter, Maik H J; Kuhlmey, Adelheid; Hofmann, Werner

2006-01-01

The present contribution discusses the utilization of the healthcare system by elderly patients in Germany. First, the paper focuses on the detailed characterization of a group of people aged 60 years or more (N = 73,454). Second, the objective is to analyze the data for high utilization of healthcare services by older men and women. The analysis is based on data regularly recorded by a German health insurance agency for the year 2000. High utilization is operationalized by a 10% cutoff for users with the highest number of treatments, highest costs and/or other criteria depending on the respective health service sector. The insured group investigated received approximately 1.4 million prescriptions, producing costs of 42 million E. High utilizers account for 32% of all prescriptions and 44% of the costs, respectively. At the same time, the age groups with the highest prescription rates do not cause the highest costs: So the relationship between age and prescription drug expenses as well as between age and prescription rates does not display an arithmetically increasing pattern. Within the timeframe investigated 26,000 hospital treatments were accounted for by 21.75% of the elderly under research. In total, they caused expenses of 88 million E. High utilization in the hospital sector was operationalized by four criteria. Sex- and age-specific analysis of high utilization of hospital treatment revealed that the four different criteria apply to different insured groups. In summary, the high utilization of healthcare services appears to be a multidimensional phenomenon.
Regulation of energy substrate utilization and hepatic insulin sensitivity by phosphatidylcholine transfer protein/StarD2.

PubMed

Scapa, Erez F; Pocai, Alessandro; Wu, Michele K; Gutierrez-Juarez, Roger; Glenz, Lauren; Kanno, Keishi; Li, Hua; Biddinger, Sudha; Jelicks, Linda A; Rossetti, Luciano; Cohen, David E

2008-07-01

Phosphatidylcholine transfer protein (PC-TP, also known as StarD2) is a highly specific intracellular lipid binding protein with accentuated expression in oxidative tissues. Here we show that decreased plasma concentrations of glucose and free fatty acids in fasting PC-TP-deficient (Pctp(-/-)) mice are attributable to increased hepatic insulin sensitivity. In hyperinsulinemic-euglycemic clamp studies, Pctp(-/-) mice exhibited profound reductions in hepatic glucose production, gluconeogenesis, glycogenolysis, and glucose cycling. These changes were explained in part by the lack of PC-TP expression in liver per se and in part by marked alterations in body fat composition. Reduced respiratory quotients in Pctp(-/-) mice were indicative of preferential fatty acid utilization for energy production in oxidative tissues. In the setting of decreased hepatic fatty acid synthesis, increased clearance rates of dietary triglycerides and increased hepatic triglyceride production rates reflected higher turnover in Pctp(-/-) mice. Collectively, these data support a key biological role for PC-TP in the regulation of energy substrate utilization.
Burden of alcohol-related injuries on radiology services at a level I trauma center.

PubMed

Roudsari, Bahman; Psoter, Kevin J; Mack, Christopher; Vavilala, Monica S; Jarvik, Jeffrey G

2012-10-01

The purpose of our study was to evaluate the burden of alcohol-related injuries on a radiology department at a level 1 trauma center. We linked the trauma registry (2005-2009) of Harborview Medical Center to billing department data and extracted patient demographic and injury-related characteristics and the radiology services provided. Multivariate negative binomial analysis was used to evaluate the association between blood alcohol concentration (BAC) and CT and MRI utilization rates. A total of 125,776 CT and 4681 MRI examinations were performed on 27,274 patients during the study period. Higher BAC was generally associated with higher utilization rates for all types of CT even after adjusting for potential confounding variables. Compared with patients with a BAC of 0, the greatest increases in utilization were observed in individuals with a BAC of 240 mg/dL or more for head CT (incidence rate ratio [IRR], 1.43; 95% CI, 1.32-1.54), cervical spine (IRR, 1.45; 95% CI, 1.32-1.58), and maxillofacial (IRR, 1.66; 95% CI, 1.42-1.95), with no increase observed for MRI. This association was more prominent in less severely injured patients with utilization rates for head CT (IRR, 1.83; 95% CI, 1.56-2.13), abdomen (IRR, 1.46; 95% CI, 1.32-1.63), and thorax (IRR, 1.57; 95% CI, 1.30-1.89) in individuals with a BAC of 240 mg/dL or more compared with those with a BAC of 0. Higher BAC was associated with increased CT utilization for most body region-specific CT scans and was more strongly associated in patients with less severe injuries. Any guideline that could potentially decrease unnecessary imaging for patients with alcohol-involved injuries would represent a cost-saving strategy.
Health Service Utilization of Children in Delaware Foster Care, 2013-2014.

PubMed

Knight, Erin K; McDuffie, May Joan; Gifford, Katie; Zorc, Catherine

2016-02-01

Children in foster care represent some of the most vulnerable children in the U.S. Their higher prevalence of a range of physical and behavioral health problems can lead to greater health care utilization and higher costs. However, many children in foster care have undiagnosed conditions and unmet needs. The purpose of this study was to provide a description of health services accessed by children in foster care in Delaware. The data serves as a baseline and informs current efforts to improve the health care of children in foster care. We analyzed rates of emergency room visits, behavioral health visits, hospitalizations, and costs of care for children in foster care and made comparisons with other children participating in Medicaid. We also looked at utilization before and after entry into care and assessed rates of appropriate medical screening for children on entering foster care. This study was conducted as part of a larger analysis guided by the Delaware Task Force on the Health of Children in Foster Care with funding appropriated by the Delaware General Assembly. Using a unique identification number, we linked Medicaid claims data with demographic information and characteristics associated with foster care from the Delaware Department of Services for Children, Youth and Their Families. We examined diagnoses, patterns of utilization, and costs for children in foster care (n = 1,458) and a comparable cohort of other children in Medicaid (n = 124,667) during fiscal years 2013 and 2014. Compared with other children in Medicaid, children in foster care had similar rates of emergency department utilization, but relatively high rates of outpatient behavioral health visits. Similarly, compared with other children in Medicaid, those in foster care had particularly high rates of psychotropic drug utilization. Entry into foster care was associated with increased utilization of overall health care services, including receipt of well-child care. However, just 31 percent of those new to foster care met the recommended guidelines for a preventive screening in their first 30 days. Because of the challenges in meeting screening policies for children entering foster care, collaboration among providers, state administrators, and policymakers is essential to guide improvement. Specifically, stakeholders should look for ways to improve the timeliness of preventive screenings and coordination of care. The high rate of behavioral health visits suggests the need to improve integration of behavioral health care into primary care.
Sensitivity analysis of the add-on price estimate for the edge-defined film-fed growth process

NASA Technical Reports Server (NTRS)

Mokashi, A. R.; Kachare, A. H.

1981-01-01

The analysis is in terms of cost parameters and production parameters. The cost parameters include equipment, space, direct labor, materials, and utilities. The production parameters include growth rate, process yield, and duty cycle. A computer program was developed specifically to do the sensitivity analysis.
Entrepreneurial Alliances: A Study of Entrepreneurship and Strategic Alliances in the Charter School Industry

ERIC Educational Resources Information Center

Washington, Cheryl A.

2012-01-01

This study investigated the practices, processes, and success rates of 15 entrepreneurial alliances in the Texas charter school industry. The research involved interdisciplinary industries (business and education) and focused on how a specific type of alliance structure utilized social innovation to exploit opportunity and impact change in the…
The Influence of Social Norms on Flu Vaccination among African American and White Adults

ERIC Educational Resources Information Center

Quinn, Sandra Crouse; Hilyard, Karen M.; Jamison, Amelia M.; An, Ji; Hancock, Gregory R.; Musa, Donald; Freimuth, Vicki S.

2017-01-01

Adult influenza vaccination rates remain suboptimal, particularly among African Americans. Social norms may influence vaccination behavior, but little research has focused on influenza vaccine and almost no research has focused on racially-specific norms. This mixed methods investigation utilizes qualitative interviews and focus groups (n = 118)…
The Association Between Stimulant, Opioid, and Multiple Drug Use on Behavioral Health Care Utilization in a Safety-Net Health System.

PubMed

Calcaterra, Susan L; Keniston, Angela; Blum, Joshua; Crume, Tessa; Binswanger, Ingrid A

2015-01-01

Prior studies show an association between drug use and health care utilization. The relationship between specific drug type and emergent/urgent, inpatient, outpatient, and behavioral health care utilization has not been examined. We aimed to determine if multiple drug use was associated with increased utilization of behavioral health care. To assess health care utilization, we conducted a retrospective cohort study of patients who accessed health care at a safety-net medical center and affiliated clinics. Using electronic health records, we categorized patients who used stimulants, opioids, or multiple drugs based on urine toxicology screening tests and/or International Classification of Diseases, 9th Revision (ICD-9). Remaining patients were categorized as patients without identified drug use. Health care utilization by drug use group and visit type was determined using a negative binomial regression model. Associations were reported as incidence rate ratios. Utilization was described by rates of health care-related visits for inpatient, emergent/urgent, outpatient, and behavioral health care among patients who used drugs, categorized by drug types, compared with patients without identified drug use. Of 95,198 index visits, 4.6% (n=4340) were by patients who used drugs. Opioid and multiple drug users had significantly higher rates of behavioral health care visits than patients without identified drug use (opioid incidence rate ratio [IRR]=7.2; 95% confidence interval [CI]: 3.8-13.8; multiple drug use IRR=5.6, 95% CI: 3.3-9.7). Patients who used stimulants were less likely to use behavioral health services (IRR=1.3, 95% CI: 0.9-2.0) when compared with opioid and multiple drug users, but were more likely to use inpatient (IRR=1.6, 95% CI: 1.4-1.8) and emergent/urgent care (IRR=1.4, 95% CI: 1.3-1.5) services as compared with patients without identified drug use. Integrated medical and mental health care and drug treatment may reduce utilization of costly health care services and improve patient outcomes. How to capture and deliver primary care and behavioral health care to patients who use stimulants needs further investigation.
Growth characteristics of a new methylomonad.

PubMed Central

Chen, B J; Hirt, W; Lim, H C; Tsao, G T

1977-01-01

A methylomonad culture was isolated from pond water and examined as a potential source of single-cell protein. A medium containing magnesium sulfate, ammonium hydroxide, sodium phosphate, tap water, and methanol supported the growth of the isolate. Optimal growth conditions in batch cultures for the organism were: temperature, 30 to 33 degrees C; pH 7.1; and phosphate concentration, 0.015 M. The minimum doubling time obtained was 1.6 h. The specific growth rate in batch culture was dependent on the methanol concentration, reaching a maximum around 0.2% (wt/vol). Growth inhibition was apparent above 0.3% (wt/vol), and growth was completely inhibited above 4.6% (wt/vol) methanol. Although the inhibitory effect of formaldehyde on the specific growth rate was much greater than that of formate, the organism utilized formaldehyde, but not formate, as a sole carbon and energy source in batch cultures. The isolate was identified primarily by its inability to utilize any carbon source other than methanol and formaldehyde for growth. Although it is capable of rapid growth on methanol, the organism showed a very weak catalase activity. The amino acid content of the cells compared favorably with the reference levels for the essential amino acids specific by the Food and Agricultural Organization of the United Nations. PMID:15510
Utilization of genetic tests: analysis of gene-specific billing in Medicare claims data.

PubMed

Lynch, Julie A; Berse, Brygida; Dotson, W David; Khoury, Muin J; Coomer, Nicole; Kautter, John

2017-08-01

We examined the utilization of precision medicine tests among Medicare beneficiaries through analysis of gene-specific tier 1 and 2 billing codes developed by the American Medical Association in 2012. We conducted a retrospective cross-sectional study. The primary source of data was 2013 Medicare 100% fee-for-service claims. We identified claims billed for each laboratory test, the number of patients tested, expenditures, and the diagnostic codes indicated for testing. We analyzed variations in testing by patient demographics and region of the country. Pharmacogenetic tests were billed most frequently, accounting for 48% of the expenditures for new codes. The most common indications for testing were breast cancer, long-term use of medications, and disorders of lipid metabolism. There was underutilization of guideline-recommended tumor mutation tests (e.g., epidermal growth factor receptor) and substantial overutilization of a test discouraged by guidelines (methylenetetrahydrofolate reductase). Methodology-based tier 2 codes represented 15% of all claims billed with the new codes. The highest rate of testing per beneficiary was in Mississippi and the lowest rate was in Alaska. Gene-specific billing codes significantly improved our ability to conduct population-level research of precision medicine. Analysis of these data in conjunction with clinical records should be conducted to validate findings.Genet Med advance online publication 26 January 2017.
High-Temperature and Pressure Aluminum Reactions in Carbon Dioxide Rich Post-Detonation Environments

NASA Astrophysics Data System (ADS)

Tappan, Bryce; Manner, Virginia; Pemberton, Steven; Lieber, Mark; Johnson, Carl; Sanders, Eric

2013-06-01

Powdered aluminum is a common additive to energetic materials, but little is understood regarding its reaction rate at very high temperatures and pressures in specific oxidizing gases such as carbon dioxide. Aluminum reaction kinetics in carbon dioxide have been studied in various reaction conditions, but difficulties arise in the more specific study of Al oxidation at the high pressures and temperatures in detonation reactions. To study these reactions, small particle size Al or the inert surrogate, LiF, was added to the energetic material benzotrifuroxan (BTF). BTF is a hydrogen-free material that selectively forms CO2 as the major oxidizing species for post-detonation Al oxidation. High-fidelity PDV measurements were utilized for early wall velocity expansion measurements in 12.7 mm copper cylinders. The JWL equation of state was solved to determine temperature, pressure and energies at specific time periods. A genetic algorithm was used in conjunction with a numerical simulation hydrocode, ALE3D, which enables the elucidation of aluminum reaction extent. By comparison of the Al oxidation with LiF, data indicate that Al oxidation occurs on an extremely fast time scale, beginning and completing between 1 and 25 microseconds. Unconfined, 6.4 mm diameter rate-sticks were also utilized to determine the effect of Al compared to LiF on detonation velocity.
High-temperature and pressure aluminum reactions in carbon dioxide rich post-detonation environments

NASA Astrophysics Data System (ADS)

Tappan, B. C.; Hill, L. G.; Manner, V. W.; Pemberton, S. J.; Lieber, M. A.; Johnson, C. E.; Sanders, V. E.

2014-05-01

Powdered aluminum is a common additive to energetic materials, but little is understood regarding its reaction rate at very high temperatures and pressures in specific oxidizing gases such as carbon dioxide. Aluminum reaction kinetics in carbon dioxide have been studied in various reaction conditions, but difficulties arise in the more specific study of Al oxidation at the high pressures and temperatures in detonation reactions. To study these reactions, small particle size Al or the inert surrogate, LiF, was added to the energetic material benzotrifuroxan (BTF). BTF is a hydrogen-free material that selectively forms CO2 as the major oxidizing species for post-detonation Al oxidation. High-fidelity PDV measurements were utilized for early wall velocity expansion measurements in 12.7 mm copper cylinders. The JWL equation of state was solved to determine temperature, pressure and energies at specific time periods. A genetic algorithm was used in conjunction with a numerical simulation hydrocode, ALE3D, which enables the elucidation of aluminum reaction extent. By comparison of the Al oxidation with LiF, data indicate that Al oxidation occurs on an extremely fast time scale, beginning and completing between 1 and 25 microseconds. Unconfined, 6.4 mm diameter rate-sticks were also utilized to determine the effect of Al compared to LiF on detonation velocity.

The impact of macroeconomic conditions on obesity in Canada.

PubMed

Latif, Ehsan

2014-06-01

The paper used longitudinal Canadian data from the National Population Health Survey to estimate the impact of macroeconomic conditions measured by provincial unemployment rate on individual obesity and BMI. To control for individual-specific unobserved heterogeneity, the study utilized the conditional fixed effect logit and fixed effects models. The study found that unemployment rate had a significant positive impact on the probability of being severely obese. The study also found that unemployment rate significantly increased BMI. However, the study did not find any significant impact of unemployment rate on the probability of being overweight or obese. Copyright © 2013 John Wiley & Sons, Ltd.
Formation of extracellular polymeric substances from acidogenic sludge in H2-producing process.

PubMed

Sheng, Guo-Ping; Yu, Han-Qing

2007-02-01

In this study, the formation of extracellular polymeric substances (EPS) and surface characteristics of an acidogenic sludge in anaerobic H(2)-producing process was investigated. Results show that carbohydrates, proteins, and humic substances were the dominant components in bound EPS (BEPS), while in soluble EPS (SEPS), carbohydrates were the main component. The total content of BEPS initially increased but then kept almost unchanged during fermentation from 25 to 35 h; after that, it slightly decreased. The total content of SEPS increased to 172.5 +/- 0.05 mg C g(-1) volatile suspended solid with the time that increased to 23.5 h, and then rapidly decreased until 43 h; thereafter, it kept almost unchanged. The SEPS had good correlations with the specific H(2) production rate, substrate degradation rate, and specific aqueous products formation rate, but the BEPS seemed to have no such correlations with these specific rates. Results also confirm that part of EPS could be utilized by the H(2)-producing sludge. As the substrate was in short supply, the EPS would be hydrolyzed to sever as carbon and energy source.
Variability in imaging utilization in U.S. pediatric hospitals.

PubMed

Arnold, Ryan W; Graham, Dionne A; Melvin, Patrice R; Taylor, George A

2011-07-01

Use of medical imaging is under scrutiny because of rising costs and radiation exposure. We compare imaging utilization and costs across pediatric hospitals to determine their variability and potential determinants. Data were extracted from the Pediatric Health Information System (PHIS) database for all inpatient encounters from 40 U.S. children's hospitals. Imaging utilization and costs were compared by insurance type, geographical region, hospital size, severity of illness, length of stay and type of imaging, all among specific diagnoses. The hospital with the highest utilization performed more than twice as many imaging studies per patient as the hospital with the lowest utilization. Similarly, imaging costs ranged from $154 to $671/patient. Median imaging-utilization rate was 1.7 exams/patient on the ward and increased significantly in the PICU (11.8 exams/patient) and in the NICU (17.7 exams per patient, (P < 0.001). Considerable variability in imaging utilization persisted despite adjustment for case mix index (CMI, range in variation 16.6-25%). We found a significant correlation between imaging utilization and both CMI and length of stay, P < 0.0001). However, only 36% of the variation in imaging utilization could be explained by CMI. Diagnostic imaging utilization and costs vary widely in pediatric hospitals.
Development of a Numerical Method for Patient-Specific Cerebral Circulation Using 1D-0D Simulation of the Entire Cardiovascular System with SPECT Data.

PubMed

Zhang, Hao; Fujiwara, Naoya; Kobayashi, Masaharu; Yamada, Shigeki; Liang, Fuyou; Takagi, Shu; Oshima, Marie

2016-08-01

The detailed flow information in the circle of Willis (CoW) can facilitate a better understanding of disease progression, and provide useful references for disease treatment. We have been developing a one-dimensional-zero-dimensional (1D-0D) simulation method for the entire cardiovascular system to obtain hemodynamics information in the CoW. This paper presents a new method for applying 1D-0D simulation to an individual patient using patient-specific data. The key issue is how to adjust the deviation of physiological parameters, such as peripheral resistance, from literature data when patient-specific geometry is used. In order to overcome this problem, we utilized flow information from single photon emission computed tomography (SPECT) data. A numerical method was developed to optimize physiological parameters by adjusting peripheral cerebral resistance to minimize the difference between the resulting flow rate and the SPECT data in the efferent arteries of the CoW. The method was applied to three cases using different sets of patient-specific data in order to investigate the hemodynamics of the CoW. The resulting flow rates in the afferent arteries were compared to those of the phase-contrast magnetic resonance angiography (PC-MRA) data. Utilization of the SPECT data combined with the PC-MRA data showed a good agreement in flow rates in the afferent arteries of the CoW with those of PC-MRA data for all three cases. The results also demonstrated that application of SPECT data alone could provide the information on the ratios of flow distributions among arteries in the CoW.
Performance of Clarias gariepinus Fed Dried Brewer's Yeast (Saccharomyces cerevisiae) Slurry in Replacement for Soybean Meal.

PubMed

Solomon, Shola Gabriel; Ataguba, Gabriel Arome; Itodo, Gabriel Enemona

2017-01-01

Following disparity of earlier results, this study tested the performance of African catfish Clarias gariepinus fed dried brewer's yeast slurry meal (DBYM) based diets. Fingerlings of C. gariepinus with pooled mean initial weight of 1.58 ± 0.01 g were stocked in hapas (1 m × 1 m × 1 m) immersed in an earthen pond at a density of 15 fish per cage. Five diets with increasing substitution of soybean meal with 25%, 50%, 75%, and 100% of dried brewer's yeast and a control without dried brewer's yeast (0% substitution) were evaluated for 8 weeks. Palatability of diets reduced with increasing levels of DBYM. Growth and utilization parameters such as weight gain, feed conversion ratio, protein efficiency ratio, and specific growth rate differed significantly ( p < 0.05) among treated groups. Specific growth rate decreased with increasing substitution while the best feed conversion ratio was obtained in the diet devoid of DBYM. Protein efficiency and utilization decreased with increasing levels of DBYM. Body composition was also affected by inclusion of DBYM with significant differences ( p < 0.05) being observed across the diets. The trend in body composition follows the utilization of the diets. We conclude that the optimal range of inclusion and substitution of soybean meal with DBYM in C. gariepinus feed is between 1% and 14% of dry matter.
Performance of Clarias gariepinus Fed Dried Brewer's Yeast (Saccharomyces cerevisiae) Slurry in Replacement for Soybean Meal

PubMed Central

Solomon, Shola Gabriel; Itodo, Gabriel Enemona

2017-01-01

Following disparity of earlier results, this study tested the performance of African catfish Clarias gariepinus fed dried brewer's yeast slurry meal (DBYM) based diets. Fingerlings of C. gariepinus with pooled mean initial weight of 1.58 ± 0.01 g were stocked in hapas (1 m × 1 m × 1 m) immersed in an earthen pond at a density of 15 fish per cage. Five diets with increasing substitution of soybean meal with 25%, 50%, 75%, and 100% of dried brewer's yeast and a control without dried brewer's yeast (0% substitution) were evaluated for 8 weeks. Palatability of diets reduced with increasing levels of DBYM. Growth and utilization parameters such as weight gain, feed conversion ratio, protein efficiency ratio, and specific growth rate differed significantly (p < 0.05) among treated groups. Specific growth rate decreased with increasing substitution while the best feed conversion ratio was obtained in the diet devoid of DBYM. Protein efficiency and utilization decreased with increasing levels of DBYM. Body composition was also affected by inclusion of DBYM with significant differences (p < 0.05) being observed across the diets. The trend in body composition follows the utilization of the diets. We conclude that the optimal range of inclusion and substitution of soybean meal with DBYM in C. gariepinus feed is between 1% and 14% of dry matter. PMID:28239492
The utility of kindergarten teacher ratings for predicting low academic achievement in first grade.

PubMed

Teisl, J T; Mazzocco, M M; Myers, G F

2001-01-01

The purpose of this study was to assess the predictive value of kindergarten teachers' ratings of pupils for later first-grade academic achievement. Kindergarten students were rated by their teachers on a variety of variables, including math and reading performance, teacher concerns, and amount of learning relative to peers. These variables were then analyzed with respect to outcome measures for math and reading ability administered in the first grade. The teachers' ratings of academic performance were significantly correlated with scores on the outcome measures. Analyses were also carried out to determine sensitivity, specificity, and predictive values of the different teacher ratings. The results indicated high overall accuracy, sensitivity, specificity, and negative predictive value for the ratings. Positive predictive value tended to be lower. A recommendation to follow from these results is that teacher ratings of this sort be used to determine which children should receive cognitive screening measures to further enhance identification of children at risk for learning disability. However, this recommendation is limited by the lack of empirically supported screening measures for math disability versus well-supported screening tools for reading disability.
National Utility Rate Database: Preprint

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

Ong, S.; McKeel, R.

2012-08-01

When modeling solar energy technologies and other distributed energy systems, using high-quality expansive electricity rates is essential. The National Renewable Energy Laboratory (NREL) developed a utility rate platform for entering, storing, updating, and accessing a large collection of utility rates from around the United States. This utility rate platform lives on the Open Energy Information (OpenEI) website, OpenEI.org, allowing the data to be programmatically accessed from a web browser, using an application programming interface (API). The semantic-based utility rate platform currently has record of 1,885 utility rates and covers over 85% of the electricity consumption in the United States.
Clinical assessment of adventitious movements.

PubMed

Brasić, J R; Barnett, J Y; Sheitman, B B; Lafargue, R T; Ahn, S C

1998-12-01

Many procedures with variable validity and reliability have been developed in research settings to evaluate adventitious movements and related phenomena in specific populations, e.g., people with schizophrenia treated with dopamine antagonists, but these only provide global assessments or rate specific movements. A battery for rating individuals with possible movements disorders in a comprehensive way in clinical settings is needed so a protocol to assess briefly and thoroughly potential movement disorders was videotaped for five prepubertal boys with autistic disorder and severe mental retardation in a clinical trial. Utilizing a Movement Assessment Battery, four raters independently scored videotapes of 10-16 movements assessments of each of the five subjects. Experienced raters attained agreement of 59% to 100% on ratings of tardive dyskinesia and 48% to 100% on tics. Hindrances to reliability included poor quality of some tapes, high activity of subjects, and fatigue of raters.
Illite Dissolution Rates and Equation (100 to 280 dec C)

DOE Data Explorer

Carroll, Susan

2014-10-17

The objective of this suite of experiments was to develop a useful kinetic dissolution expression for illite applicable over an expanded range of solution pH and temperature conditions representative of subsurface conditions in natural and/or engineered geothermal reservoirs. Using our new data, the resulting rate equation is dependent on both pH and temperature and utilizes two specific dissolution mechanisms (a “neutral” and a “basic” mechanism). The form of this rate equation should be easily incorporated into most existing reactive transport codes for to predict rock-water interactions in EGS shear zones.
78 FR 46177 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-30

...The Federal Energy Regulatory Commission (Commission) is revising its regulations to foster competition and transparency in ancillary services markets. The Commission is revising certain aspects of its current market-based rate regulations, ancillary services requirements under the pro forma open-access transmission tariff (OATT), and accounting and reporting requirements. Specifically, the Commission is revising its regulations to reflect reforms to its Avista policy governing the sale of ancillary services at market-based rates to public utility transmission providers. The Commission is also requiring each public utility transmission provider to add to its OATT Schedule 3 a statement that it will take into account the speed and accuracy of regulation resources in its determination of reserve requirements for Regulation and Frequency Response service, including as it reviews whether a self-supplying customer has made ``alternative comparable arrangements'' as required by the Schedule. The final rule also requires each public utility transmission provider to post certain Area Control Error data as described in the final rule. Finally, the Commission is revising the accounting and reporting requirements under its Uniform System of Accounts for public utilities and licensees and its forms, statements, and reports, contained in FERC Form No. 1, Annual Report of Major Electric Utilities, Licensees and Others, FERC Form No. 1-F, Annual Report for Nonmajor Public Utilities and Licensees, and FERC Form No. 3-Q, Quarterly Financial Report of Electric Utilities, Licensees, and Natural Gas Companies, to better account for and report transactions associated with the use of energy storage devices in public utility operations.
Unconventional Gas and Oil Drilling Is Associated with Increased Hospital Utilization Rates.

PubMed

Jemielita, Thomas; Gerton, George L; Neidell, Matthew; Chillrud, Steven; Yan, Beizhan; Stute, Martin; Howarth, Marilyn; Saberi, Pouné; Fausti, Nicholas; Penning, Trevor M; Roy, Jason; Propert, Kathleen J; Panettieri, Reynold A

2015-01-01

Over the past ten years, unconventional gas and oil drilling (UGOD) has markedly expanded in the United States. Despite substantial increases in well drilling, the health consequences of UGOD toxicant exposure remain unclear. This study examines an association between wells and healthcare use by zip code from 2007 to 2011 in Pennsylvania. Inpatient discharge databases from the Pennsylvania Healthcare Cost Containment Council were correlated with active wells by zip code in three counties in Pennsylvania. For overall inpatient prevalence rates and 25 specific medical categories, the association of inpatient prevalence rates with number of wells per zip code and, separately, with wells per km2 (separated into quantiles and defined as well density) were estimated using fixed-effects Poisson models. To account for multiple comparisons, a Bonferroni correction with associations of p<0.00096 was considered statistically significant. Cardiology inpatient prevalence rates were significantly associated with number of wells per zip code (p<0.00096) and wells per km2 (p<0.00096) while neurology inpatient prevalence rates were significantly associated with wells per km2 (p<0.00096). Furthermore, evidence also supported an association between well density and inpatient prevalence rates for the medical categories of dermatology, neurology, oncology, and urology. These data suggest that UGOD wells, which dramatically increased in the past decade, were associated with increased inpatient prevalence rates within specific medical categories in Pennsylvania. Further studies are necessary to address healthcare costs of UGOD and determine whether specific toxicants or combinations are associated with organ-specific responses.
Systematic donor selection review process improves cardiac transplant volumes and outcomes.

PubMed

Smith, Jason W; O'Brien, Kevin D; Dardas, Todd; Pal, Jay D; Fishbein, Daniel P; Levy, Wayne C; Mahr, Claudius; Masri, Sofia C; Cheng, Richard K; Stempien-Otero, April; Mokadam, Nahush A

2016-01-01

Heart transplant remains the definitive therapy for advanced heart failure patients but is limited by organ availability. We identified a large number of donor hearts from our organ procurement organization (OPO) being exported to other regions. We engaged a multidisciplinary team including transplant surgeons, cardiologists, and our OPO colleagues to identify opportunities to improve our center-specific organ utilization rate. We performed a retrospective analysis of donor offers before and after institution of a novel review process. Each donor offer made to our program was reviewed on a monthly basis from July 2013 to June 2014 and compared with the previous year. This review process resulted in a transplant utilization rate of 28% for period 1 versus 49% for period 2 (P = .007). Limiting the analysis to offers from our local OPO changed our utilization rate from 46% to 75% (P = .02). Transplant volume increased from 22 to 35 between the 2 study periods. Thirty-day and 1-year mortality were unchanged over the 2 periods. A total of 58 hearts were refused by our center and transplanted at other centers. During period 1, the 30-day and 1-year survival rates for recipients of those organs were 98% and 90%, respectively, comparable with our historical survival data. The simple process of systematically reviewing donor turndown events as a group tended to reduce variability, increase confidence in expanded criteria for donors, and resulted in improved donor organ utilization and transplant volumes. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
Impact of Massachusetts Health Reform on Enrollment Length and Health Care Utilization in the Unsubsidized Individual Market.

PubMed

Garabedian, Laura F; Ross-Degnan, Dennis; Soumerai, Stephen B; Choudhry, Niteesh K; Brown, Jeffrey S

2017-06-01

To evaluate the impact of the 2006 Massachusetts health reform, the model for the Affordable Care Act, on short-term enrollment and utilization in the unsubsidized individual health insurance market. Seven years of administrative and claims data from Harvard Pilgrim Health Care. We employed pre-post survival analysis and an interrupted time series design to examine changes in enrollment length, utilization patterns, and use of elective procedures (discretionary inpatient surgeries and infertility treatment) among nonelderly adult enrollees before (n = 6,912) and after (n = 29,207) the MA reform. The probability of short-term enrollment dropped immediately after the reform. Rates of inpatient encounters (HR = 0.83, 95 percent CI: 0.74, 0.93), emergency department encounters (HR = 0.85, 95 percent CI: 0.80, 0.91), and discretionary inpatient surgeries (HR = 0.66 95 percent CI: 0.45, 0.97) were lower in the postreform period, whereas the rate of ambulatory visits was somewhat higher (HR = 1.04, 95 percent CI: 1.00, 1.07). The rate of infertility treatment was higher after the reform (HR = 1.61, 95 percent CI: 1.33, 1.97), driven by women in individual (vs. family) plans. The reform was not associated with increased utilization among short-term enrollees. MA health reform was associated with a decrease in short-term enrollment and changes in utilization patterns indicative of reduced adverse selection in the unsubsidized individual market. Adverse selection may be a problem for specific, high-cost treatments. © Health Research and Educational Trust.
Urban Middle School Students' Perceptions of the Value and Difficulty of Inquiry

ERIC Educational Resources Information Center

Sandoval, William A.; Harven, Aletha M.

2011-01-01

Following their participation in a guided-inquiry unit, 129 seventh-graders from five diverse urban middle schools were asked about their perceptions of specific inquiry tasks, from an expectancy-value framework. Students were asked to rate the interest value, utility value, and task difficulty of (a) data collection design; (b) explanation; (c)…
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.
77 FR 41481 - Integration of Variable Energy Resources

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

...The Federal Energy Regulatory Commission is amending the pro forma Open Access Transmission Tariff to remove unduly discriminatory practices and to ensure just and reasonable rates for Commission- jurisdictional services. Specifically, this Final Rule removes barriers to the integration of variable energy resources by requiring each public utility transmission provider to: offer intra-hourly transmission scheduling; and, incorporate provisions into the pro forma Large Generator Interconnection Agreement requiring interconnection customers whose generating facilities are variable energy resources to provide meteorological and forced outage data to the public utility transmission provider for the purpose of power production forecasting.
Efficient whole cell biocatalyst for formate-based hydrogen production.

PubMed

Kottenhahn, Patrick; Schuchmann, Kai; Müller, Volker

2018-01-01

Molecular hydrogen (H 2 ) is an attractive future energy carrier to replace fossil fuels. Biologically and sustainably produced H 2 could contribute significantly to the future energy mix. However, biological H 2 production methods are faced with multiple barriers including substrate cost, low production rates, and low yields. The C1 compound formate is a promising substrate for biological H 2 production, as it can be produced itself from various sources including electrochemical reduction of CO 2 or from synthesis gas. Many microbes that can produce H 2 from formate have been isolated; however, in most cases H 2 production rates cannot compete with other H 2 production methods. We established a formate-based H 2 production method utilizing the acetogenic bacterium Acetobacterium woodii . This organism can use formate as sole energy and carbon source and possesses a novel enzyme complex, the hydrogen-dependent CO 2 reductase that catalyzes oxidation of formate to H 2 and CO 2 . Cell suspensions reached specific formate-dependent H 2 production rates of 71 mmol g protein -1 h -1 (30.5 mmol g CDW -1 h -1 ) and maximum volumetric H 2 evolution rates of 79 mmol L -1 h -1 . Using growing cells in a two-step closed batch fermentation, specific H 2 production rates reached 66 mmol g CDW -1 h -1 with a volumetric H 2 evolution rate of 7.9 mmol L -1 h -1 . Acetate was the major side product that decreased the H 2 yield. We demonstrate that inhibition of the energy metabolism by addition of a sodium ionophore is suitable to completely abolish acetate formation. Under these conditions, yields up to 1 mol H 2 per mol formate were achieved. The same ionophore can be used in cultures utilizing formate as specific switch from a growing phase to a H 2 production phase. Acetobacterium woodii reached one of the highest formate-dependent specific H 2 productivity rates at ambient temperatures reported so far for an organism without genetic modification and converted the substrate exclusively to H 2 . This makes this organism a very promising candidate for sustainable H 2 production and, because of the reversibility of the A. woodii enzyme, also a candidate for reversible H 2 storage.
Further thoughts on the utility of risk matrices.

PubMed

Ball, David J; Watt, John

2013-11-01

Risk matrices are commonly encountered devices for rating hazards in numerous areas of risk management. Part of their popularity is predicated on their apparent simplicity and transparency. Recent research, however, has identified serious mathematical defects and inconsistencies. This article further examines the reliability and utility of risk matrices for ranking hazards, specifically in the context of public leisure activities including travel. We find that (1) different risk assessors may assign vastly different ratings to the same hazard, (2) even following lengthy reflection and learning scatter remains high, and (3) the underlying drivers of disparate ratings relate to fundamentally different worldviews, beliefs, and a panoply of psychosocial factors that are seldom explicitly acknowledged. It appears that risk matrices when used in this context may be creating no more than an artificial and even untrustworthy picture of the relative importance of hazards, which may be of little or no benefit to those trying to manage risk effectively and rationally. © 2013 Society for Risk Analysis.
Audit of the Federal Energy Regulatory Commission`s Office of Chief Accountant

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

NONE

1995-04-07

The Federal Energy Regulatory Commission`s (Commission) mission is to oversee America`s natural gas and oil pipeline transportation, electric utility, and hydroelectric power industries to ensure that consumers receive adequate energy supplies at just and reasonable rates. To carry out this mission, the Commission issues regulations covering the accounting, reporting, and rate-making requirements of the regulated utility companies. The Commission`s Office of Chief Accountant performs financial related audits at companies to ensure compliance with these regulations. The purpose of this audit was to evaluate the office of Chief Accountant`s audit performance. Specifically, the objectives were to determine if the most appropriatemore » audit approach was used and if a quality assurance process was in place to ensure reports were accurate and supported by the working papers.« less

Predictive beyond-mean-field rate equations for multisite lattice–gas models of catalytic surface reactions: CO oxidation on Pd(100)

DOE PAGES

Liu, Da -Jiang; Zahariev, Federico; Gordon, Mark S.; ...

2016-11-29

Tailored multisite lattice–gas (msLG) models are developed for CO oxidation on Pd(100) at low-pressures. These models include multiple adsorption site types and superlattice adlayer ordering due to short-range exclusion for highly mobile reactant adspecies. However, they are simplified to neglect longer-range weaker adspecies interactions, so that the key energetic parameters are the CO desorption barrier and the reaction barrier. We discuss existing density functional theory results for these energies and present additional analysis for CO adsorption. After also including an appropriate nontrivial specification of the dynamics of adsorption onto mixed reactant adlayers, we develop rate equations for the reaction kinetics.more » Our formulation goes beyond traditional mean-field (MF) Langmuirian treatments by accounting for multiple adsorption sites and for the strong spatial correlations associated with superlattice ordering. Specifically, we utilize factorization approximations based on appropriate site motifs, and also Padé resummation of exact low-coverage expansions for sticking coefficients. Our beyond-MF rate equations are successful in accurately predicting key aspects of reactive steady-state behavior, and thus expand the utility of rate equation formulations in surface chemistry. This is confirmed by comparison with precise kinetic Monte Carlo simulation results. Furthermore, we not only assess bistability and criticality observed for CO oxidation but also find more complex multistability associated with symmetry-breaking transitions in high-coverage CO adlayers.« less
Sugar utilization patterns and respiro-fermentative metabolism in the baker's yeast Torulaspora delbrueckii.

PubMed

Alves-Araújo, C; Pacheco, A; Almeida, M J; Spencer-Martins, I; Leão, C; Sousa, M J

2007-03-01

The highly osmo- and cryotolerant yeast species Torulaspora delbrueckii is an important case study among the non-Saccharomyces yeast species. The strain T. delbrueckii PYCC 5321, isolated from traditional corn and rye bread dough in northern Portugal, is considered particularly interesting for the baking industry. This paper reports the sugar utilization patterns of this strain, using media with glucose, maltose and sucrose, alone or in mixtures. Kinetics of growth, biomass and ethanol yields, fermentation and respiration rates, hydrolase activities and sugar uptake rates were used to infer the potential applied relevance of this yeast in comparison to a conventional baker's strain of Saccharomyces cerevisiae. The results showed that both maltase and maltose transport in T. delbrueckii were subject to glucose repression and maltose induction, whereas invertase was subject to glucose control but not dependent on sucrose induction. A comparative analysis of specific sugar consumption rates and transport capacities suggests that the transport step limits both glucose and maltose metabolism. Specific rates of CO(2) production and O(2) consumption showed a significantly higher contribution of respiration to the overall metabolism in T. delbrueckii than in S. cerevisiae. This was reflected in the biomass yields from batch cultures and could represent an asset for the large-scale production of the former species. This work contributes to a better understanding of the physiology of a non-conventional yeast species, with a view to the full exploitation of T. delbrueckii by the baking industry.
Analysis of factors affecting the accuracy, reproducibility, and interpretation of microbial community carbon source utilization patterns

USGS Publications Warehouse

Haack, S.K.; Garchow, H.; Klug, M.J.; Forney, L.J.

1995-01-01

We determined factors that affect responses of bacterial isolates and model bacterial communities to the 95 carbon substrates in Biolog microliter plates. For isolates and communities of three to six bacterial strains, substrate oxidation rates were typically nonlinear and were delayed by dilution of the inoculum. When inoculum density was controlled, patterns of positive and negative responses exhibited by microbial communities to each of the carbon sources were reproducible. Rates and extents of substrate oxidation by the communities were also reproducible but were not simply the sum of those exhibited by community members when tested separately. Replicates of the same model community clustered when analyzed by principal- components analysis (PCA), and model communities with different compositions were clearly separated un the first PCA axis, which accounted for >60% of the dataset variation. PCA discrimination among different model communities depended on the extent to which specific substrates were oxidized. However, the substrates interpreted by PCA to be most significant in distinguishing the communities changed with reading time, reflecting the nonlinearity of substrate oxidation rates. Although whole-community substrate utilization profiles were reproducible signatures for a given community, the extent of oxidation of specific substrates and the numbers or activities of microorganisms using those substrates in a given community were not correlated. Replicate soil samples varied significantly in the rate and extent of oxidation of seven tested substrates, suggesting microscale heterogeneity in composition of the soil microbial community.
How gender, age, and geography influence the utilization of radiation therapy in the management of malignant melanoma

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

French, John; McGahan, Colleen; Duncan, Graeme

2006-11-15

Purpose: Comparing radiation therapy utilization rates (RTUR) to those predicted by best evidence is a useful measure of the equity and accessibility of service delivery. In this study the RTUR for melanoma was established for British Columbia, Canada, and compared with the rate suggested by the evidence. Demographic variables, specifically age, gender, and geography that influenced the RTUR were examined with a view to identifying methods of improving underutilization. Methods and Materials: The RTUR in the management of malignant melanoma was taken from British Columbia Cancer registry data for 1986 to 1998. Variations in utilization based on age, gender, healthmore » authority, stage of disease, and referral patterns were analyzed. Results: An RTUR of 11% was identified. This was consistent over time. Referral rates decreased between 1986 and 1998. RT is used mostly for later stage disease. Males were more likely to receive RT than females, related to later stage of disease in men. Referral rates decreased, but RTUR for referred cases increased, in health authorities that did not have a cancer center. Conclusions: Use of RT is influenced by age and by stage of disease. Overall RTUR in British Columbia is lower than suggested by best evidence. Referral patterns are influenced by geography. RTUR was higher in males, consistent with a different pattern of disease in males compared with females.« less
The future prospects of supply and demand for urologists in Korea

PubMed Central

2017-01-01

Purpose The purpose of this study was to forecast the future supply and demand for urologists and to discuss the possible policy implications. Materials and Methods A demographic utilization-based model was used to calculate the total urologist requirements for Korea. Utilization rates for ambulatory and inpatient genitourinary specialty services were estimated according to age, sex, and insurance status. These rates were used to estimate genitourinary specialty-specific total service utilization expressed in patient care minutes for future populations and converted to genitourinary physician requirements by applying per-genitourinary-physician productivity estimates. An in-and-out movement model for urologist supply was used. Results Depending on assumptions about data at each step in the method, the supply of urologic surgeons is expected to exceed the demand by 2025 under the current enrollment rate of specialists (43.5% in 2012) when comparing the results of the projections under demand scenarios 3 and 4. However, if the current enrollment rate persists, the imbalance in supply and demand will be not severe by 2030. The degree of imbalance can be alleviated by 2030 by maintaining the current occupancy rate of urologic residents of 43.5%. Conclusions This study shows that the number of residents needs to be reduced according to the supply and demand for urologic surgeons. Moreover, a policy should be established to maintain the current occupancy rate of residents. The factors affecting the supply and demand of urologic surgeons are complicated. Thus, comprehensive policies encompassing these factors should be established with appropriate solutions. PMID:29124238
Determination of motion extrema in multi-satellite systems

NASA Astrophysics Data System (ADS)

Allgeier, Shawn E.

Spacecraft, or satellite formation flight has been a topic of interest dating back to the Gemini program of the 1960s. Traditionally space missions have been designed around large monolithic assets. Recent interest in low cost, rapid call up mission architectures structured around fractionated systems, small satellites, and constellations has spurred renewed efforts in spacecraft relative motion problems. While such fractionated, or multi-body systems may provide benefits in terms of risk mitigation and cost savings, they introduce new technical challenges in terms of satellite coordination. Characterization of satellite formations is a vital requirement for them to have utility to industry and government entities. Satellite formations introduce challenges in the form of constellation maintenance, inter-satellite communications, and the demand for more sophisticated guidance, navigation, and control systems. At the core of these challenges is the orbital mechanics which govern the resulting motion. New applications of algebraic techniques are applied to the formation flight problem, specifically Gröbner basis tools, as a means of determining extrema of certain quantities pertaining to formation flight. Specifically, bounds are calculated for the relative position components, relative speed, relative velocity components, and range rate. The position based metrics are relevant for planning formation geometry, particularly in constellation or Earth observation applications. The velocity metrics are relevant in the design of end game interactions for rendezvous and proximity operations. The range rate of one satellite to another is essential in the design of radio frequency hardware for inter-satellite communications so that the doppler shift can be calculated a priori. Range rate may also have utility in space based surveillance and space situational awareness concerns, such as cross tagging. The results presented constitute a geometric perspective and have utility to mission designers, particularly for missions involving rendezvous and proximity operations.
Utility of Sleep Stage Transitions in Assessing Sleep Continuity

PubMed Central

Laffan, Alison; Caffo, Brian; Swihart, Bruce J.; Punjabi, Naresh M.

2010-01-01

Study Objectives: Sleep continuity is commonly assessed with polysomnographic measures such as sleep efficiency, sleep stage percentages, and the arousal index. The aim of this study was to examine whether the transition rate between different sleep stages could be used as an index of sleep continuity to predict self-reported sleep quality independent of other commonly used metrics. Design and Setting: Analysis of the Sleep Heart Health Study polysomnographic data. Participants: A community cohort. Measurements and Results: Sleep recordings on 5,684 participants were deemed to be of sufficient quality to allow visual scoring of NREM and REM sleep. For each participant, we tabulated the frequency of transitions between wake, NREM sleep, and REM sleep. An overall transition rate was determined as the number of all transitions per hour sleep. Stage-specific transition rates between wake, NREM sleep, and REM sleep were also determined. A 5-point Likert scale was used to assess the subjective experience of restless and light sleep the morning after the sleep study. Multivariable regression models showed that a high overall sleep stage transition rate was associated with restless and light sleep independent of several covariates including total sleep time, percentages of sleep stages, wake time after sleep onset, and the arousal index. Compared to the lowest quartile of the overall transition rate (< 7.76 events/h), the odds ratios for restless sleep were 1.27, 1.42, and 1.38, for the second (7.77–10.10 events/h), third (10.11–13.34 events/h), and fourth (≥ 13.35 events/h) quartiles, respectively. Analysis of stage-specific transition rates showed that transitions between wake and NREM sleep were also independently associated with restless and light sleep. Conclusions: Assessing overall and stage-specific transition rates provides a complementary approach for assessing sleep continuity. Incorporating such measures, along with conventional metrics, could yield useful insights into the significance of sleep continuity for clinical outcomes. Citation: Laffan A; Caffo B; Swihart BJ; Punjabi NM. Utility of sleep stage transitions in assessing sleep continuity. SLEEP 2010;33(12):1681-1686. PMID:21120130
Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia

PubMed Central

Miller, Tamara P.; Seif, Alix E.; Li, Yimei; Huang, Yuan-Shung V.; Fisher, Brian T.; Aplenc, Richard

2018-01-01

Purpose A cohort of pediatric patients with AML treated at hospitals contributing to the Pediatric Health Information System was used to evaluate differences in opioid utilization by sex, age, race, and insurance. Methods Billing data were used to compute the prevalence of opioid exposure and to quantify rates of utilization among those exposed to opioids as days of use per 1000 inpatient days. Multivariable regressions were used to compare opioid prevalence, and rates of utilization among those exposed. Results On average across courses, 95.2% of patients were exposed to analgesics, 84.7% were exposed to non-opioid analgesics and 77.7% were exposed to opioids. The proportion of opioid-exposed patients increased with age, but did not differ by gender, race, or insurance status. Analyses limited to patients exposed to opioids revealed modest differences in days of opioid use among female patients (adjusted rate ratio (aRR) = 1.19, 95% CI: 1.11, 1.28), patients <1 year (aRR = 1.37, 95% CI: 1.21, 1.55) or ≥10 years of age (aRR = 1.63, 95% CI: 1.46, 1.82), whereas Asian patients received fewer days of opioids compared with white patients (aRR = 0.76, 95% CI: 0.61, 0.95). There was moderate hospital-level variability in both the prevalence of opioid utilization overall and preference for specific opioid medications. There was greater inconsistency in practice concerning choices for supplemental and alternative opioids than in first-line opioid utilization. Conclusion Additional work is needed to discern whether observed differences in opioid utilization by age and race reflect a difference in treatment or a difference in the experience of pain. Future studies should also explore the factors which guide decisions on opioid selections in an attempt to explain the variability across institutions. PMID:29420604
Aldouronate Utilization in Paenibacillus sp. Strain JDR-2: Physiological and Enzymatic Evidence for Coupling of Extracellular Depolymerization and Intracellular Metabolism ▿

PubMed Central

Nong, Guang; Rice, John D.; Chow, Virginia; Preston, James F.

2009-01-01

Paenibacillus sp. strain JDR-2, an aggressively xylanolytic bacterium isolated from decaying sweet gum wood, secretes a multimodular glycohydrolase family GH10 endoxylanase (XynA1) anchored to the cell surface. The gene encoding XynA1 is part of a xylan utilization regulon that includes an aldouronate utilization gene cluster with genes encoding a GH67 α-glucuronidase (AguA), a GH10 endoxylanase (XynA2), and a GH43 arabinofuranosidase/β-xylosidase (XynB). Here we show that this Paenibacillus sp. strain is able to utilize methylglucuronoxylose (MeGAX1), an aldobiuronate product that accumulates during acid pretreatment of lignocellulosic biomass, and methylglucuronoxylotriose (MeGAX3), the product of the extracellular XynA1 acting on methylglucuronoxylan (MeGAXn). The average rates of utilization of MeGAXn, MeGAX1, and MeGAX3 were 149.8, 59.4, and 54.3 μg xylose equivalents·ml−1·h−1, respectively, and were proportional to the specific growth rates on the substrates. AguA was active with MeGAX1 and MeGAX3, releasing 4-O-methyl-d-glucuronate α-1,2 linked to a nonreducing terminal xylose residue. XynA2 converted xylotriose, generated by the action of AguA on MeGAX3, to xylose and xylobiose. The ability to utilize MeGAX1 provides a novel metabolic potential for bioconversion of acid hydrolysates of lignocellulosics. The 2.8-fold-greater rate of utilization of polymeric MeGAXn than that of MeGAX3 indicates that there is coupling of extracellular depolymerization, assimilation, and intracellular metabolism, allowing utilization of lignocellulosics with minimal pretreatment. Along with adjacent genes encoding transcriptional regulators and ABC transporter proteins, the aguA and xynA2 genes in the cluster described above contribute to the efficient utilization of aldouronates derived from dilute acid and/or enzyme pretreatment protocols applied to the conversion of hemicellulose to biofuels and chemicals. PMID:19395566
High utilizers of medical care: a crucial subgroup among somatizing patients.

PubMed

Hiller, Wolfgang; Fichter, Manfred M

2004-04-01

Patients with somatoform disorders (SFD) are likely to overutilize healthcare services. This study investigates (a) whether extraordinarily high medical costs can be predicted from patient characteristics or psychopathology, and (b) whether high-utilizing patients respond differently to cognitive-behavioral treatment. We compared 42 SFD high utilizers with 53 SFD average utilizers and 29 patients suffering from other than SFD mental disorders. High utilization was defined by healthcare expenditures of > or = 2500 euros during the past 2 years. Costs were computed from medical and billing records of health insurance companies. Somatization distress, hypochondriasis, depression, dysfunctional cognitions related to bodily symptoms, general psychopathology, personality profiles, and psychosocial disabilities were assessed before treatment. High utilizers had higher levels of self- and observer-rated illness behavior, self-perceived bodily weakness, and psychosocial disabilities. Although they did not report more somatization symptoms, their subjective symptom distress was higher. There were no differences between high and average utilizers concerning general psychopathology, DSM-IV comorbidity, and personality profiles. Treatment improvements were similar. High- and average-utilizing somatizers represent distinguishable subgroups. The results emphasize the importance of mechanisms specifically related to SFD and may enhance the early detection of patients who are likely to develop overutilization. Copyright 2004 Elsevier Inc.
Forecasting the need for physicians in the United States: the Health Resources and Services Administration's physician requirements model.

PubMed Central

Greenberg, L; Cultice, J M

1997-01-01

OBJECTIVE: The Health Resources and Services Administration's Bureau of Health Professions developed a demographic utilization-based model of physician specialty requirements to explore the consequences of a broad range of scenarios pertaining to the nation's health care delivery system on need for physicians. DATA SOURCE/STUDY SETTING: The model uses selected data primarily from the National Center for Health Statistics, the American Medical Association, and the U.S. Bureau of Census. Forecasts are national estimates. STUDY DESIGN: Current (1989) utilization rates for ambulatory and inpatient medical specialty services were obtained for the population according to age, gender, race/ethnicity, and insurance status. These rates are used to estimate specialty-specific total service utilization expressed in patient care minutes for future populations and converted to physician requirements by applying per-physician productivity estimates. DATA COLLECTION/EXTRACTION METHODS: Secondary data were analyzed and put into matrixes for use in the mainframe computer-based model. Several missing data points, e.g., for HMO-enrolled populations, were extrapolated from available data by the project's contractor. PRINCIPAL FINDINGS: The authors contend that the Bureau's demographic utilization model represents improvements over other data-driven methodologies that rely on staffing ratios and similar supply-determined bases for estimating requirements. The model's distinct utility rests in offering national-level physician specialty requirements forecasts. Images Figure 1 PMID:9018213
Category-specificity in sexual interest in gay men and lesbians.

PubMed

Rullo, Jordan E; Strassberg, Donald S; Israel, Esther

2010-08-01

The present study assessed the category-specificity of sexual interest of gay men and lesbians toward an understanding of the possible interaction of sex and sexual orientation that may exist in this phenomenon. Utilizing viewing time as a measure of sexual interest, we had participants (N = 99) rate the sexual appeal of sexually provocative pictures while the amount of time spent viewing each picture was inconspicuously measured. As hypothesized, same-sex oriented individuals demonstrated a category-specific pattern of sexual interest. That is, gay men and lesbians (1) viewed preferred sex pictures (i.e., of same sex) significantly longer than nonpreferred sex pictures (i.e., of opposite sex) and (2) rated preferred sex pictures as significantly more sexually appealing than nonpreferred sex pictures. Additionally, the difference in viewing times between preferred and nonpreferred sexual stimuli was not significantly different for gay men and lesbians, suggesting that lesbians are as category-specific as gay men. The implications of these findings are discussed.
Assessment of economic instruments for countries with low municipal waste management performance: An approach based on the analytic hierarchy process.

PubMed

Kling, Maximilian; Seyring, Nicole; Tzanova, Polia

2016-09-01

Economic instruments provide significant potential for countries with low municipal waste management performance in decreasing landfill rates and increasing recycling rates for municipal waste. In this research, strengths and weaknesses of landfill tax, pay-as-you-throw charging systems, deposit-refund systems and extended producer responsibility schemes are compared, focusing on conditions in countries with low waste management performance. In order to prioritise instruments for implementation in these countries, the analytic hierarchy process is applied using results of a literature review as input for the comparison. The assessment reveals that pay-as-you-throw is the most preferable instrument when utility-related criteria are regarded (wb = 0.35; analytic hierarchy process distributive mode; absolute comparison) mainly owing to its waste prevention effect, closely followed by landfill tax (wb = 0.32). Deposit-refund systems (wb = 0.17) and extended producer responsibility (wb = 0.16) rank third and fourth, with marginal differences owing to their similar nature. When cost-related criteria are additionally included in the comparison, landfill tax seems to provide the highest utility-cost ratio. Data from literature concerning cost (contrary to utility-related criteria) is currently not sufficiently available for a robust ranking according to the utility-cost ratio. In general, the analytic hierarchy process is seen as a suitable method for assessing economic instruments in waste management. Independent from the chosen analytic hierarchy process mode, results provide valuable indications for policy-makers on the application of economic instruments, as well as on their specific strengths and weaknesses. Nevertheless, the instruments need to be put in the country-specific context along with the results of this analytic hierarchy process application before practical decisions are made. © The Author(s) 2016.
A review of intrauterine contraception in the Asia-Pacific region.

PubMed

Bateson, Deborah; Kang, Sukho; Paterson, Helen; Singh, Kuldip

2017-01-01

Across the Asia-Pacific region, approximately 38% of pregnancies are unintended. Long-acting reversible contraception, such as intrauterine contraception (IUC), is effective in reducing unintended pregnancy. This study aims to review access to, uptake of and influencing factors on IUC use in the Asia-Pacific region. We searched PubMed and MEDLINE for articles published between 1990 and 2015. We identified and reviewed primary studies that examined the following points and were relevant to the Asia-Pacific region: available types and utilization rates of IUC and factors that influence these. We also obtained the opinions of local experts to gain a better understanding of the situation in specific countries. Types of IUC used and utilization rates vary widely across the region. Factors influencing rates of utilization relate to healthcare systems, such as government policy on and subsidization of IUC, types of healthcare providers authorized to place IUC and local guidelines on preinsertion screening. Healthcare provider factors include concerns around pelvic inflammatory disease and the suitability of IUC in certain groups of women, whereas end-user factors include lack of awareness of IUC, concerns about safety, cultural or religious attitudes, access to IUC and costs. Across the Asia-Pacific region, clear data gaps and unmet needs exist in terms of access to and uptake of IUC. We believe that several recommendations are necessary to update future practice and policy for enhanced IUC utilization so that women across this region have better access to IUC. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Economic evaluation of prostate cancer screening test as a national cancer screening program in South Korea.

PubMed

Shin, Sangjin; Kim, Youn Hee; Hwang, Jin Sub; Lee, Yoon Jae; Lee, Sang Moo; Ahn, Jeonghoon

2014-01-01

Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.
76 FR 15947 - Endangered and Threatened Wildlife; Notice of 90-Day Finding on a Petition To List the Caribbean...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

..., excessive nutrients, and sea level rise. However, the petition fails to demonstrate to what extent the... other fisheries. It does not appear to be utilized and is discarded at sea, but survivorship rates are... are available from the U.S. east coast and Florida. While specific data are lacking, fishing...
Vertical Compliance Trends in KBOS OPD Arrival Redesign

NASA Technical Reports Server (NTRS)

Stewart, Michael Jeffrey; Matthews, Bryan L.; Feary, Michael S.

2016-01-01

This report is a high-level summary of vertical compliance trends and overall rates of Area Navigation Optimized Profile Descent (RNAV OPD) utilization for Boston Logan International Airport. Specifically, we investigated trends from three RNAV OPDs and the subsequent redesigned iterations of those procedures: OOSHN3 to OOSHN4, ROBUC1 to ROBUC2, and QUABN3 to JFUND1.
Exploring Enrollment Management for an Independent, Faith-Based, Secondary School: A Case Study

ERIC Educational Resources Information Center

McMaster, Jason Andrew

2017-01-01

This single site case study looked specifically at the foundation and the structure of an independent school in California with respect to how it managed its enrollment and retention rates. For context, the institution being studied utilized a high-tuition strategy combined with a strong financial aid program. In 2012, the school peaked in its…
Insights into the Adsorption of Carbon Dioxide in the Presence of Water Vapor Utilizing a Low Molecular Weight Polyethylenimine-Impregnated CARiACT Silica Sorbent

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

Monazam, Esmail R.; Breault, Ronald W.; Fauth, Daniel J.

Thermogravimetric analysis was employed to investigate the CO 2 and H 2O adsorption rates and water vapor equilibrium on anhydrous and pre-hydrate linear polyethylenimine (LPEI) sorbent impregnated within a commercially functional CARiACT G10 (HPV) silica support. Water vapor experiments utilizing specific humidity of 2%, 8%, and 16% in contact with an anhydrous PEI sorbent resulted in proportional quantities of water vapor uptake. Subsequently, both anhydrous and pre-hydrated PEI-impregnated sorbents were made available to identical humidified gaseous streams containing a CO 2 concentration of 10% at 60oC. CO 2 capacity increased dramatically in the presence of different levels of humidity. Variousmore » kinetic models were systematically employed to interpret the experimental data including single and multiple-step models. The rate data was best represented by a reaction mechanism pathway involving the interplay of CO 2 with PEI-impregnated sorbents exhibited a quick adsorption phase followed by a slow approach to equilibrium. Moreover, a phenomenological rate model was developed to describe the dynamic H 2O and CO 2 uptakes at specific humidity levels studied. The kinetic study showed good agreement with experimental data. Furthermore, the effects observed during the adsorption and hydration are shown to be complementary to known chemical and physical transformations within the polyethylenimine’s macromolecule.« less
Insights into the Adsorption of Carbon Dioxide in the Presence of Water Vapor Utilizing a Low Molecular Weight Polyethylenimine-Impregnated CARiACT Silica Sorbent

DOE PAGES

Monazam, Esmail R.; Breault, Ronald W.; Fauth, Daniel J.; ...

2017-07-20

Thermogravimetric analysis was employed to investigate the CO 2 and H 2O adsorption rates and water vapor equilibrium on anhydrous and pre-hydrate linear polyethylenimine (LPEI) sorbent impregnated within a commercially functional CARiACT G10 (HPV) silica support. Water vapor experiments utilizing specific humidity of 2%, 8%, and 16% in contact with an anhydrous PEI sorbent resulted in proportional quantities of water vapor uptake. Subsequently, both anhydrous and pre-hydrated PEI-impregnated sorbents were made available to identical humidified gaseous streams containing a CO 2 concentration of 10% at 60oC. CO 2 capacity increased dramatically in the presence of different levels of humidity. Variousmore » kinetic models were systematically employed to interpret the experimental data including single and multiple-step models. The rate data was best represented by a reaction mechanism pathway involving the interplay of CO 2 with PEI-impregnated sorbents exhibited a quick adsorption phase followed by a slow approach to equilibrium. Moreover, a phenomenological rate model was developed to describe the dynamic H 2O and CO 2 uptakes at specific humidity levels studied. The kinetic study showed good agreement with experimental data. Furthermore, the effects observed during the adsorption and hydration are shown to be complementary to known chemical and physical transformations within the polyethylenimine’s macromolecule.« less

Comparative effectiveness in urology: a state of the art review utilizing a systematic approach.

PubMed

Bandari, Jathin; Wessel, Charles B; Jacobs, Bruce L

2017-07-01

Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals. There have been major advancements in comparative effectiveness research in urology in 2016.
Nowcasting Unemployment Rates with Google Searches: Evidence from the Visegrad Group Countries

PubMed Central

Pavlicek, Jaroslav; Kristoufek, Ladislav

2015-01-01

The online activity of Internet users has repeatedly been shown to provide a rich information set for various research fields. We focus on job-related searches on Google and their possible usefulness in the region of the Visegrad Group - the Czech Republic, Hungary, Poland and Slovakia. Even for rather small economies, the online searches of inhabitants can be successfully utilized for macroeconomic predictions. Specifically, we study unemployment rates and their interconnection with job-related searches. We show that Google searches enhance nowcasting models of unemployment rates for the Czech Republic and Hungary whereas for Poland and Slovakia, the results are mixed. PMID:26001083
Nowcasting unemployment rates with Google searches: evidence from the Visegrad Group countries.

PubMed

Pavlicek, Jaroslav; Kristoufek, Ladislav

2015-01-01

The online activity of Internet users has repeatedly been shown to provide a rich information set for various research fields. We focus on job-related searches on Google and their possible usefulness in the region of the Visegrad Group--the Czech Republic, Hungary, Poland and Slovakia. Even for rather small economies, the online searches of inhabitants can be successfully utilized for macroeconomic predictions. Specifically, we study unemployment rates and their interconnection with job-related searches. We show that Google searches enhance nowcasting models of unemployment rates for the Czech Republic and Hungary whereas for Poland and Slovakia, the results are mixed.
Everything you always wanted to hear about rate making but were afraid to ask

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

Cady, W.A.

1983-08-04

Rate making is a complicated and time-consuming procedure. That it could benefit from judiciously chosen reforms is beyond question. This article covers several major areas of contention within the regulatory arena, all of which have been the subject of considerable debate in recent years. In an effort to find a compromise position between extremes, the author makes three specific suggestions that, if adopted, could enable parties involved to devote their time and resources to more fundamental questions regarding the regulated utility industries. 3 references.
Examining related influential factors for dental calculus scaling utilization among people with disabilities in Taiwan, a nationwide population-based study.

PubMed

Lai, Hsien-Tang; Kung, Pei-Tseng; Su, Hsun-Pi; Tsai, Wen-Chen

2014-09-01

Limited studies with large samples have been conducted on the utilization of dental calculus scaling among people with physical or mental disabilities. This study aimed to investigate the utilization of dental calculus scaling among the national disabled population. This study analyzed the utilization of dental calculus scaling among the disabled people, using the nationwide data between 2006 and 2008. Descriptive analysis and logistic regression were performed to analyze related influential factors for dental calculus scaling utilization. The dental calculus scaling utilization rate among people with physical or mental disabilities was 16.39%, and the annual utilization frequency was 0.2 times. Utilization rate was higher among the female and non-aboriginal samples. Utilization rate decreased with increased age and disability severity while utilization rate increased with income, education level, urbanization of residential area and number of chronic illnesses. Related influential factors for dental calculus scaling utilization rate were gender, age, ethnicity (aboriginal or non-aboriginal), education level, urbanization of residence area, income, catastrophic illnesses, chronic illnesses, disability types, and disability severity significantly influenced the dental calculus scaling utilization rate. Copyright © 2014 Elsevier Ltd. All rights reserved.
Using Technical Performance Measures

NASA Technical Reports Server (NTRS)

Garrett, Christopher J.; Levack, Daniel J. H.; Rhodes, Russel E.

2011-01-01

All programs have requirements. For these requirements to be met, there must be a means of measurement. A Technical Performance Measure (TPM) is defined to produce a measured quantity that can be compared to the requirement. In practice, the TPM is often expressed as a maximum or minimum and a goal. Example TPMs for a rocket program are: vacuum or sea level specific impulse (lsp), weight, reliability (often expressed as a failure rate), schedule, operability (turn-around time), design and development cost, production cost, and operating cost. Program status is evaluated by comparing the TPMs against specified values of the requirements. During the program many design decisions are made and most of them affect some or all of the TPMs. Often, the same design decision changes some TPMs favorably while affecting other TPMs unfavorably. The problem then becomes how to compare the effects of a design decision on different TPMs. How much failure rate is one second of specific impulse worth? How many days of schedule is one pound of weight worth? In other words, how to compare dissimilar quantities in order to trade and manage the TPMs to meet all requirements. One method that has been used successfully and has a mathematical basis is Utility Analysis. Utility Analysis enables quantitative comparison among dissimilar attributes. It uses a mathematical model that maps decision maker preferences over the tradeable range of each attribute. It is capable of modeling both independent and dependent attributes. Utility Analysis is well supported in the literature on Decision Theory. It has been used at Pratt & Whitney Rocketdyne for internal programs and for contracted work such as the J-2X rocket engine program. This paper describes the construction of TPMs and describes Utility Analysis. It then discusses the use of TPMs in design trades and to manage margin during a program using Utility Analysis.
Evaluating Protein Structure and Dynamics Using Co-Solvents, Photochemical Triggers, and Site-Specific Spectroscopic Probes

NASA Astrophysics Data System (ADS)

Abaskharon, Rachel M.

As ubiquitous and diverse biopolymers, proteins are dynamic molecules that are constantly engaging in inter- and intramolecular interactions responsible for their structure, fold, and function. Because of this, gaining a comprehensive understanding of the factors that control protein conformation and dynamics remains elusive as current experimental techniques often lack the ability to initiate and probe a specific interaction or conformational transition. For this reason, this thesis aims to develop methods to control and monitor protein conformations, conformational transitions, and dynamics in a site-specific manner, as well as to understand how specific and non-specific interactions affect the protein folding energy landscape. First, by using the co-solvent, trifluoroethanol (TFE), we show that the rate at which a peptide folds can be greatly impacted and thus controlled by the excluded volume effect. Secondly, we demonstrate the utility of several light-responsive molecules and reactions as methods to manipulate and investigate protein-folding processes. Using an azobenzene linker as a photo-initiator, we are able to increase the folding rate of a protein system by an order of magnitude by channeling a sub-population through a parallel, faster folding pathway. Additionally, we utilize a tryptophan-mediated electron transfer process to a nearby disulfide bond to strategically unfold a protein molecule with ultraviolet light. We also demonstrate the potential of two ruthenium polypyridyl complexes as ultrafast phototriggers of protein reactions. Finally, we develop several site-specific spectroscopic probes of protein structure and environment. Specifically, we demonstrate that a 13C-labeled aspartic acid residue constitutes a useful site-specific infrared probe for investigating salt-bridges and hydration dynamics of proteins, particularly in proteins containing several acidic amino acids. We also show that a proline-derivative, 4-oxoproline, possesses novel infrared properties that can be exploited to monitor the cis-trans isomerization process of individual proline residues in proteins.
Unconventional Gas and Oil Drilling Is Associated with Increased Hospital Utilization Rates

PubMed Central

Neidell, Matthew; Chillrud, Steven; Yan, Beizhan; Stute, Martin; Howarth, Marilyn; Saberi, Pouné; Fausti, Nicholas; Penning, Trevor M.; Roy, Jason; Propert, Kathleen J.; Panettieri, Reynold A.

2015-01-01

Over the past ten years, unconventional gas and oil drilling (UGOD) has markedly expanded in the United States. Despite substantial increases in well drilling, the health consequences of UGOD toxicant exposure remain unclear. This study examines an association between wells and healthcare use by zip code from 2007 to 2011 in Pennsylvania. Inpatient discharge databases from the Pennsylvania Healthcare Cost Containment Council were correlated with active wells by zip code in three counties in Pennsylvania. For overall inpatient prevalence rates and 25 specific medical categories, the association of inpatient prevalence rates with number of wells per zip code and, separately, with wells per km2 (separated into quantiles and defined as well density) were estimated using fixed-effects Poisson models. To account for multiple comparisons, a Bonferroni correction with associations of p<0.00096 was considered statistically significant. Cardiology inpatient prevalence rates were significantly associated with number of wells per zip code (p<0.00096) and wells per km2 (p<0.00096) while neurology inpatient prevalence rates were significantly associated with wells per km2 (p<0.00096). Furthermore, evidence also supported an association between well density and inpatient prevalence rates for the medical categories of dermatology, neurology, oncology, and urology. These data suggest that UGOD wells, which dramatically increased in the past decade, were associated with increased inpatient prevalence rates within specific medical categories in Pennsylvania. Further studies are necessary to address healthcare costs of UGOD and determine whether specific toxicants or combinations are associated with organ-specific responses. PMID:26176544
Development of a Portfolio Management Approach with Case Study of the NASA Airspace Systems Program

NASA Technical Reports Server (NTRS)

Neitzke, Kurt W.; Hartman, Christopher L.

2012-01-01

A portfolio management approach was developed for the National Aeronautics and Space Administration s (NASA s) Airspace Systems Program (ASP). The purpose was to help inform ASP leadership regarding future investment decisions related to its existing portfolio of advanced technology concepts and capabilities (C/Cs) currently under development and to potentially identify new opportunities. The portfolio management approach is general in form and is extensible to other advanced technology development programs. It focuses on individual C/Cs and consists of three parts: 1) concept of operations (con-ops) development, 2) safety impact assessment, and 3) benefit-cost-risk (B-C-R) assessment. The first two parts are recommendations to ASP leaders and will be discussed only briefly, while the B-C-R part relates to the development of an assessment capability and will be discussed in greater detail. The B-C-R assessment capability enables estimation of the relative value of each C/C as compared with all other C/Cs in the ASP portfolio. Value is expressed in terms of a composite weighted utility function (WUF) rating, based on estimated benefits, costs, and risks. Benefit utility is estimated relative to achieving key NAS performance objectives, which are outlined in the ASP Strategic Plan.1 Risk utility focuses on C/C development and implementation risk, while cost utility focuses on the development and implementation portions of overall C/C life-cycle costs. Initial composite ratings of the ASP C/Cs were successfully generated; however, the limited availability of B-C-R information, which is used as inputs to the WUF model, reduced the meaningfulness of these initial investment ratings. Development of this approach, however, defined specific information-generation requirements for ASP C/C developers that will increase the meaningfulness of future B-C-R ratings.
Clinical utility of the mBIAS and NSI validity-10 to detect symptom over-reporting following mild TBI: A multicenter investigation with military service members.

PubMed

Armistead-Jehle, Patrick; Cooper, Douglas B; Grills, Chad E; Cole, Wesley R; Lippa, Sara M; Stegman, Robert L; Lange, Rael T

2018-04-01

Self-report measures are commonly relied upon in military healthcare environments to assess service members following a mild traumatic brain injury (mTBI). However, such instruments are susceptible to over-reporting and rarely include validity scales. This study evaluated the utility of the mild Brain Injury Atypical Symptoms scale (mBIAS) and the Neurobehavioral Symptom Inventory Validity-10 scale to detect symptom over-reporting. A total of 359 service members with a reported history of mTBI were separated into two symptom reporting groups based on MMPI-2-RF validity scales (i.e., non-over-reporting versus symptom over-reporting). The clinical utility of the mBIAS and Validity-10 as diagnostic indicators and screens of symptom over-reporting were evaluated by calculating sensitivity, specificity, positive test rate, positive predictive power (PPP), and negative predictive power (NPP) values. An mBIAS cut score of ≥10 was optimal as a diagnostic indicator, which resulted in high specificity and PPP; however, sensitivity was low. The utility of the mBIAS as a screening instrument was limited. A Validity-10 cut score of ≥33 was optimal as a diagnostic indicator. This resulted in very high specificity and PPP, but low sensitivity. A Validity-10 cut score of ≥7 was considered optimal as a screener, which resulted in moderate sensitivity, specificity, NPP, but relatively low PPP. Owing to low sensitivity, the current data suggests that both the mBIAS and Validity-10 are insufficient as stand-alone measures of symptom over-reporting. However, Validity-10 scores above the identified cut-off of ≥7should be taken as an indication that further evaluation to rule out symptom over-reporting is necessary.
Utilization of smoking cessation informational, interactive, and online community resources as predictors of abstinence: cohort study.

PubMed

An, Lawrence C; Schillo, Barbara A; Saul, Jessie E; Wendling, Ann H; Klatt, Colleen M; Berg, Carla J; Ahulwalia, Jasjit S; Kavanaugh, Annette M; Christenson, Matthew; Luxenberg, Michael G

2008-12-20

The association between greater utilization of Web-assisted tobacco interventions and increased abstinence rates is well recognized. However, there is little information on how utilization of specific website features influences quitting. To determine the association between utilization of informational, interactive, and online community resources (eg. bulletin boards) and abstinence rates, with the broader objective to identify potential strategies for improving outcomes for Web-assisted tobacco interventions. In Spring 2004, a cohort of 607 quitplan.com users consented to participate in an evaluation of quitplan.com, a Minnesota branded version of QuitNet.com. We developed utilization measures for different site features: general information, interactive diagnostic tools and quit planning tools, online expert counseling, passive (ie, reading of bulletin boards) and active (ie, public posting) online community engagement, and one-to-one messaging with other virtual community members. Using bivariate, multivariate, and path analyses, we examined the relationship between utilization of specific site features and 30-day abstinence at 6 months. The most commonly used resources were the interactive quit planning tools (used by 77% of site users). Other informational resources (ie, quitting guides) were used more commonly (60% of users) than passive (38%) or active (24%) community features. Online community engagement through one-to-one messaging was low (11%) as was use of online counseling (5%). The 30-day abstinence rate among study participants at 6 months was 9.7% (95% Confidence Interval [CI] 7.3% - 12.1%). In the logistic regression model, neither the demographic data (eg, age, gender, education level, employment, or insurance status) nor the smoking-related data (eg, cigarettes per day, time to first morning cigarette, baseline readiness to quit) nor use of smoking cessation medications entered the model as significant predictors of abstinence. Individuals who used the interactive quit planning tools once, two to three times, or four or more times had an odds of abstinence of 0.65 (95% Confidence Interval [CI] 0.22 - 1.94), 1.87 (95% CI 0.77 - 4.56), and 2.35 (95% CI 1.0 - 5.58), respectively. The use of one-to-one messages (reference = none vs 1 or more) entered the final model as potential predictor for abstinence, though the significance of this measure was marginal (OR = 1.91, 95% CI 0.92 - 3.97, P = .083). In the path analysis, an apparent association between active online community engagement and abstinence was accounted for in large part by increased use of interactive quitting tools and one-to-one messaging. Use of interactive quitting tools, and perhaps one-to-one messaging with other members of the online community, was associated with increased abstinence rates among quitplan.com users. Designs that facilitate use of these features should be considered.
Optimization of free ammonia concentration for nitrite accumulation in shortcut biological nitrogen removal process.

PubMed

Chung, Jinwook; Shim, Hojae; Park, Seong-Jun; Kim, Seung-Jin; Bae, Wookeun

2006-03-01

A shortcut biological nitrogen removal (SBNR) utilizes the concept of a direct conversion of ammonium to nitrite and then to nitrogen gas. A successful SBNR requires accumulation of nitrite in the system and inhibition of the activity of nitrite oxidizers. A high concentration of free ammonia (FA) inhibits nitrite oxidizers, but unfortunately decreases the ammonium removal rate as well. Therefore, the optimal range of FA concentration is necessary not only to stabilize nitrite accumulation but also to achieve maximum ammonium removal. In order to derive such optimal FA concentrations, the specific substrate utilization rates of ammonium and nitrite oxidizers were measured. The optimal FA concentration range appeared to be 5-10 mg/L for the adapted sludge. The simulated results from the modified inhibition model expressed by FA and ammonium/nitrite concentrations were shown very similar to the experimental results.
Kalman filter based glucose control at small set points during fed-batch cultivation of Saccharomyces cerevisiae.

PubMed

Arndt, Michael; Hitzmann, Bernd

2004-01-01

A glucose control system is presented, which is able to control cultivations of Saccharomyces cerevisiae even at low glucose concentrations. Glucose concentrations are determined using a special flow injection analysis (FIA) system, which does not require a sampling module. An extended Kalman filter is employed for smoothing the glucose measurements as well as for the prediction of glucose and biomass concentration, the maximum specific growth rate, and the volume of the culture broth. The predicted values are utilized for feedforward/feedback control of the glucose concentration at set points of 0.08 and 0.05 g/L. The controller established well-defined conditions over several hours up to biomass concentrations of 13.5 and 20.7 g/L, respectively. The specific glucose uptake rates at both set points were 1.04 and 0.68 g/g/h, respectively. It is demonstrated that during fed-batch cultivation an overall pure oxidative metabolism of glucose is maintained at the lower set point and a specific ethanol production rate of 0.18 g/g/h at the higher set point.
Volumetric measurement of tank volume

NASA Technical Reports Server (NTRS)

Walter, Richard T. (Inventor); Vanbuskirk, Paul D. (Inventor); Weber, William F. (Inventor); Froebel, Richard C. (Inventor)

1991-01-01

A method is disclosed for determining the volume of compressible gas in a system including incompressible substances in a zero-gravity environment consisting of measuring the change in pressure (delta P) for a known volume change rate (delta V/delta t) in the polytrophic region between isothermal and adiabatic conditions. The measurements are utilized in an idealized formula for determining the change in isothermal pressure (delta P sub iso) for the gas. From the isothermal pressure change (delta iso) the gas volume is obtained. The method is also applicable to determination of gas volume by utilizing work (W) in the compression process. In a passive system, the relationship of specific densities can be obtained.
Anatomy-Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence.

PubMed

Locketz, Garrett D; Lui, Justin T; Chan, Sonny; Salisbury, Kenneth; Dort, Joseph C; Youngblood, Patricia; Blevins, Nikolas H

2017-06-01

Objective To evaluate the effect of anatomy-specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance. Study Design Prospective pre- and poststudy of a novel virtual surgical rehearsal platform. Setting Academic otolaryngology-head and neck surgery residency training programs. Subjects and Methods Sixteen otolaryngology-head and neck surgery residents from 2 North American training institutions were recruited. Surveys were administered to assess subjects' baseline confidence in performing 12 subtasks of cortical mastoidectomy with facial recess. A cadaver temporal bone was randomly assigned to each subject. Cadaver specimens were scanned with a clinical computed tomography protocol, allowing the creation of anatomy-specific models for use in a VR surgical rehearsal platform. Subjects then rehearsed a virtual mastoidectomy on data sets derived from their specimens. Surgical confidence surveys were administered again. Subjects then dissected assigned cadaver specimens, which were blindly graded with a modified Welling scale. A final survey assessed the perceived utility of rehearsal on dissection performance. Results Of 16 subjects, 14 (87.5%) reported a significant increase in overall confidence after conducting an anatomy-specific VR rehearsal. A significant correlation existed between perceived utility of rehearsal and confidence improvement. The effect of rehearsal on confidence was dependent on trainee experience and the inherent difficulty of the surgical subtask. Postrehearsal confidence correlated strongly with graded dissection performance. Subjects rated anatomy-specific rehearsal as having a moderate to high contribution to their dissection performance. Conclusion Anatomy-specific virtual rehearsal improves surgeon confidence in performing mastoid dissection, dependent on surgeon experience and task difficulty. The subjective confidence gained through rehearsal correlates positively with subsequent objective dissection performance.
Female breast cancer incidence among Asian and Western populations: more similar than expected.

PubMed

Sung, Hyuna; Rosenberg, Philip S; Chen, Wan-Qing; Hartman, Mikael; Lim, Wei-Yen; Chia, Kee Seng; Wai-Kong Mang, Oscar; Chiang, Chun-Ju; Kang, Daehee; Ngan, Roger Kai-Cheong; Tse, Lap Ah; Anderson, William F; Yang, Xiaohong R

2015-07-01

Previous reports suggested that female breast cancer is associated with earlier ages at onset among Asian than Western populations. However, most studies utilized cross-sectional analyses that may be confounded by calendar-period and/or birth cohort effects. We, therefore, considered a longitudinal (forward-looking) approach adjusted for calendar-period changes and conditioned upon birth cohort. Invasive female breast cancer data (1988-2009) were obtained from cancer registries in China, Hong Kong, South Korea, Taiwan, Singapore, and the United States. Age-period-cohort models were used to extrapolate longitudinal age-specific incidence rates for the 1920, 1944, and 1970 birth cohorts. Cross-sectional age-specific incidence rates rose continuously until age 80 years among US white women, but plateaued or decreased after age 50 years among Asian women. In contrast, longitudinal age-specific rates were proportional (similar) among all Asian countries and the United States with incidence rates rising continuously until age 80 years. The extrapolated estimates for the most recent cohorts in some Asian countries actually showed later ages at onset than in the United States. Additionally, over successive birth cohorts, the incidence rate ratios (IRRs) for the longitudinal curves converged (narrowed) between Asian and US white women. Similar longitudinal age-specific incidence rates along with converging IRRs indicate that the age effects for invasive breast cancer are more similar among Asian and Western populations than might be expected from a solely cross-sectional analysis. Indeed, the Asian breast cancer rates in recent generations are even surpassing the historically high rates in the United States, highlighting an urgent need for efficient prevention and treatment strategies among Asian populations. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
State Performance-Based Regulation Using Multiyear Rate Plans for U.S. Electric Utilities

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

Lowry, Mark Newton; Makos, Matt; Deason, Jeff

Electric utilities today must contain costs at a time when many need to modernize aging systems and all face major changes in technologies, customer preferences and competitive pressures.Most U.S. electric utility facilities are investor-owned, subject to rate and service regulation by state public utility commissions. Regulatory systems under which these utilities operate affect their performance and ability to meet these challenges. In this business environment, multiyear rate plans have some advantages over traditional rate regulation.The report focuses on key design issues and provides case studies of the multiyear rate plan approach, applicable to both vertically integrated and restructured states. Markmore » Newton Lowry and Matt Makos of Pacific Energy Group Research and Jeff Deason of Berkeley Lab authored the report; Lisa Schwartz, Berkeley Lab, was project manager and technical editor.The report is aimed primarily at state utility regulators and stakeholders in the state regulatory process. The multiyear rate approach also provides ideas on how to streamline oversight of public power utilities and rural electric cooperatives for their governing boards.Two key provisions of multiyear rate plans strengthen cost containment incentives and streamline regulation: 1. Reducing frequency of rate cases, typically to every four or five years 2. Using an attrition relief mechanism to escalate rates or revenue between rate cases to address cost pressures such as inflation and growth in number of customers, independently of the utility’s own cost Better utility performance can be achieved under well-designed multiyear rate plans while achieving lower regulatory costs. Benefits can be shared between utilities and their customers. But plans can be complex and involve significant changes in the regulatory system. Designing plans that stimulate utility performance without undue risk and share benefits fairly can be challenging.This report discusses the rationale for multiyear rate plans and their usefulness under modern business conditions. It then explains critical plan design issues and challenges and presents results from numerical research that considers the extra incentive power achieved under different plan provisions. Next, the report presents several case studies of utilities that have operated under formal multiyear rate plans or, for various reasons, have stayed out of rate cases for more than a decade. These studies consider the effect of multiyear rate plans and rate case frequency on utility cost, reliability and other performance dimensions.« less
Emergency medical transport of the elderly: a population-based study.

PubMed

Wofford, J L; Moran, W P; Heuser, M D; Schwartz, E; Velez, R; Mittelmark, M B

1995-05-01

Patterns of utilization of emergency medical services transport (EMS) by the elderly are poorly understood. We determined population-based rates of EMS utilization by the elderly and characterized utilization patterns by age, gender, race, and reason for transport. This observational, population-based study was conducted in Forsyth County, NC, a semi-urban county served by one convalescent ambulance service and one EMS service. Using data on all 1990 EMS transports and the 1990 U.S. census data, age-, gender-, and race-specific transport rates for persons aged 60 or older were calculated. Reasons for transport and frequency of repeat users were established. After exclusion of transports because of an address outside the county, a nonhospital destination, a scheduled transport, or missing data, 4,688 transports (78% of total) remained for analysis. The overall rate of transport was 104/1,000 county residents. Transport rates increased for successively older five-year age groups, demonstrating a 5.7-fold stepwise increase from ages 60-65 to 85+ (51/1,000 to 291/1,000). There was no difference in mean age between patients who were frequent EMS users (more than three transports during the year) (n = 66) and other elderly transportees. Reasons for transport differed little between those 60 to 84 years of age and those 85 years of age and older with the exception of chest pain, cardiac arrest, and seizures, all of which were significantly more prevalent in the younger age group.(ABSTRACT TRUNCATED AT 250 WORDS)
Innovations in Measuring Peer Conflict Resolution Knowledge in Children with LI: Exploring the Accessibility of a Visual Analogue Rating Scale

ERIC Educational Resources Information Center

Campbell, Wenonah N.; Skarakis-Doyle, Elizabeth

2011-01-01

This preliminary study explored peer conflict resolution knowledge in children with and without language impairment (LI). Specifically, it evaluated the utility of a visual analogue scale (VAS) for measuring nuances in such knowledge. Children aged 9-12 years, 26 with typically developing language (TLD) and 6 with LI, completed a training protocol…
A dynamic regression analysis tool for quantitative assessment of bacterial growth written in Python.

PubMed

Hoeflinger, Jennifer L; Hoeflinger, Daniel E; Miller, Michael J

2017-01-01

Herein, an open-source method to generate quantitative bacterial growth data from high-throughput microplate assays is described. The bacterial lag time, maximum specific growth rate, doubling time and delta OD are reported. Our method was validated by carbohydrate utilization of lactobacilli, and visual inspection revealed 94% of regressions were deemed excellent. Copyright © 2016 Elsevier B.V. All rights reserved.

Studying the rapid bioconversion of lignocellulosic sugars into ethanol using high cell density fermentations with cell recycle

PubMed Central

2014-01-01

Background The Rapid Bioconversion with Integrated recycle Technology (RaBIT) process reduces capital costs, processing times, and biocatalyst cost for biochemical conversion of cellulosic biomass to biofuels by reducing total bioprocessing time (enzymatic hydrolysis plus fermentation) to 48 h, increasing biofuel productivity (g/L/h) twofold, and recycling biocatalysts (enzymes and microbes) to the next cycle. To achieve these results, RaBIT utilizes 24-h high cell density fermentations along with cell recycling to solve the slow/incomplete xylose fermentation issue, which is critical for lignocellulosic biofuel fermentations. Previous studies utilizing similar fermentation conditions showed a decrease in xylose consumption when recycling cells into the next fermentation cycle. Eliminating this decrease is critical for RaBIT process effectiveness for high cycle counts. Results Nine different engineered microbial strains (including Saccharomyces cerevisiae strains, Scheffersomyces (Pichia) stipitis strains, Zymomonas mobilis 8b, and Escherichia coli KO11) were tested under RaBIT platform fermentations to determine their suitability for this platform. Fermentation conditions were then optimized for S. cerevisiae GLBRCY128. Three different nutrient sources (corn steep liquor, yeast extract, and wheat germ) were evaluated to improve xylose consumption by recycled cells. Capacitance readings were used to accurately measure viable cell mass profiles over five cycles. Conclusion The results showed that not all strains are capable of effectively performing the RaBIT process. Acceptable performance is largely correlated to the specific xylose consumption rate. Corn steep liquor was found to reduce the deleterious impacts of cell recycle and improve specific xylose consumption rates. The viable cell mass profiles indicated that reduction in specific xylose consumption rate, not a drop in viable cell mass, was the main cause for decreasing xylose consumption. PMID:24847379
Time series modeling for syndromic surveillance.

PubMed

Reis, Ben Y; Mandl, Kenneth D

2003-01-23

Emergency department (ED) based syndromic surveillance systems identify abnormally high visit rates that may be an early signal of a bioterrorist attack. For example, an anthrax outbreak might first be detectable as an unusual increase in the number of patients reporting to the ED with respiratory symptoms. Reliably identifying these abnormal visit patterns requires a good understanding of the normal patterns of healthcare usage. Unfortunately, systematic methods for determining the expected number of (ED) visits on a particular day have not yet been well established. We present here a generalized methodology for developing models of expected ED visit rates. Using time-series methods, we developed robust models of ED utilization for the purpose of defining expected visit rates. The models were based on nearly a decade of historical data at a major metropolitan academic, tertiary care pediatric emergency department. The historical data were fit using trimmed-mean seasonal models, and additional models were fit with autoregressive integrated moving average (ARIMA) residuals to account for recent trends in the data. The detection capabilities of the model were tested with simulated outbreaks. Models were built both for overall visits and for respiratory-related visits, classified according to the chief complaint recorded at the beginning of each visit. The mean absolute percentage error of the ARIMA models was 9.37% for overall visits and 27.54% for respiratory visits. A simple detection system based on the ARIMA model of overall visits was able to detect 7-day-long simulated outbreaks of 30 visits per day with 100% sensitivity and 97% specificity. Sensitivity decreased with outbreak size, dropping to 94% for outbreaks of 20 visits per day, and 57% for 10 visits per day, all while maintaining a 97% benchmark specificity. Time series methods applied to historical ED utilization data are an important tool for syndromic surveillance. Accurate forecasting of emergency department total utilization as well as the rates of particular syndromes is possible. The multiple models in the system account for both long-term and recent trends, and an integrated alarms strategy combining these two perspectives may provide a more complete picture to public health authorities. The systematic methodology described here can be generalized to other healthcare settings to develop automated surveillance systems capable of detecting anomalies in disease patterns and healthcare utilization.
Preparation of rAAV9 to Overexpress or Knockdown Genes in Mouse Hearts

PubMed Central

Ding, Jian; Lin, Zhi-Qiang; Jiang, Jian-Ming; Seidman, Christine E.; Seidman, Jonathan G.; Pu, William T.; Wang, Da-Zhi

2016-01-01

Controlling the expression or activity of specific genes through the myocardial delivery of genetic materials in murine models permits the investigation of gene functions. Their therapeutic potential in the heart can also be determined. There are limited approaches for in vivo molecular intervention in the mouse heart. Recombinant adeno-associated virus (rAAV)-based genome engineering has been utilized as an essential tool for in vivo cardiac gene manipulation. The specific advantages of this technology include high efficiency, high specificity, low genomic integration rate, minimalimmunogenicity, and minimal pathogenicity. Here, a detailed procedure to construct, package, and purify the rAAV9 vectors is described. Subcutaneous injection of rAAV9 into neonatal pups results in robust expression or efficient knockdown of the gene(s) of interest in the mouse heart, but not in the liver and other tissues. Using the cardiac-specific TnnT2 promoter, high expression of GFP gene in the heart was obtained. Additionally, target mRNA was inhibited in the heart when a rAAV9-U6-shRNA was utilized. Working knowledge of rAAV9 technology may be useful for cardiovascular investigations. PMID:28060283
Preparation of rAAV9 to Overexpress or Knockdown Genes in Mouse Hearts.

PubMed

Ding, Jian; Lin, Zhi-Qiang; Jiang, Jian-Ming; Seidman, Christine E; Seidman, Jonathan G; Pu, William T; Wang, Da-Zhi

2016-12-17

Controlling the expression or activity of specific genes through the myocardial delivery of genetic materials in murine models permits the investigation of gene functions. Their therapeutic potential in the heart can also be determined. There are limited approaches for in vivo molecular intervention in the mouse heart. Recombinant adeno-associated virus (rAAV)-based genome engineering has been utilized as an essential tool for in vivo cardiac gene manipulation. The specific advantages of this technology include high efficiency, high specificity, low genomic integration rate, minimal immunogenicity, and minimal pathogenicity. Here, a detailed procedure to construct, package, and purify the rAAV9 vectors is described. Subcutaneous injection of rAAV9 into neonatal pups results in robust expression or efficient knockdown of the gene(s) of interest in the mouse heart, but not in the liver and other tissues. Using the cardiac-specific TnnT2 promoter, high expression of GFP gene in the heart was obtained. Additionally, target mRNA was inhibited in the heart when a rAAV9-U6-shRNA was utilized. Working knowledge of rAAV9 technology may be useful for cardiovascular investigations.
Impact of pharmacy benefit design on prescription drug utilization: a fixed effects analysis of plan sponsor data.

PubMed

Roebuck, M Christopher; Liberman, Joshua N

2009-06-01

To study the impact of various elements of pharmacy benefit design on both the absolute and relative utilization of generics, brands, retail pharmacy, and mail service. Panel data on 1,074 plan sponsors covering 21.6 million individuals over 12 calendar quarters (2005-2007). A retrospective analysis of pharmacy claims. To control for potential endogeneity, linear fixed effects models were estimated for each of six dependent variables: the generic utilization rate, the brand utilization rate, the generic dispensing rate (GDR), the retail pharmacy utilization rate, the mail service utilization rate, and the mail distribution rate. Most member cost-share variables were nonlinearly associated with changes in prescription drug utilization. Marginal effects were generally greater in magnitude for brand out-of-pocket costs than for generic out-of-pocket costs. Time dummies, as well as other pharmacy benefit design elements, also yielded significant results. Prior estimates of the effect of member cost sharing on prescription drug utilization may be biased if complex benefit designs, mail service fulfillment, and unmeasured factors such as pharmaceutical pipelines are not accounted for. Commonly cited relative utilization metrics, such as GDR, may be misleading if not examined alongside absolute prescription drug utilization.
Economics of Utility Scale Photovoltaics at Purdue University

NASA Astrophysics Data System (ADS)

Arnett, William

The research for this case study shows that utility scale solar photovoltaics has become a competitive energy investment option, even when a campus operates a power plant at low electricity rates. To evaluate this an economic model called SEEMS (Solar Economic Evaluation Modelling Spreadsheets) was developed to evaluate a number of financial scenarios in Real Time Pricing for universities. The three main financing structures considered are 1) land leasing, 2) university direct purchase, and 3) third party purchase. Unlike other commercially available models SEEMS specifically accounts for real time pricing, where the local utility provides electricity at an hourly rate that changes with the expected demand. In addition, SEEMS also includes a random simulation that allows the model to predict the likelihood of success for a given solar installation strategy. The research showed that there are several options for utility scale solar that are financially attractive. The most practical financing structure is with a third party partnership because of the opportunity to take advantage of tax incentives. Other options could become more attractive if non-financial benefits are considered. The case study for this research, Purdue University, has a unique opportunity to integrate utility-scale solar electricity into its strategic planning. Currently Purdue is updating its master plan which will define how land is developed. Purdue is also developing a sustainability plan that will define long term environmental goals. In addition, the university is developing over 500 acres of land west of campus as part of its Aerospace Innovation District. This research helps make the case for including utility-scale solar electricity as part of the university's strategic planning.
Directions for Optimization of Photosynthetic Carbon Fixation: RuBisCO's Efficiency May Not Be So Constrained After All.

PubMed

Cummins, Peter L; Kannappan, Babu; Gready, Jill E

2018-01-01

The ubiquitous enzyme Ribulose 1,5-bisphosphate carboxylase-oxygenase (RuBisCO) fixes atmospheric carbon dioxide within the Calvin-Benson cycle that is utilized by most photosynthetic organisms. Despite this central role, RuBisCO's efficiency surprisingly struggles, with both a very slow turnover rate to products and also impaired substrate specificity, features that have long been an enigma as it would be assumed that its efficiency was under strong evolutionary pressure. RuBisCO's substrate specificity is compromised as it catalyzes a side-fixation reaction with atmospheric oxygen; empirical kinetic results show a trend to tradeoff between relative specificity and low catalytic turnover rate. Although the dominant hypothesis has been that the active-site chemistry constrains the enzyme's evolution, a more recent study on RuBisCO stability and adaptability has implicated competing selection pressures. Elucidating these constraints is crucial for directing future research on improving photosynthesis, as the current literature casts doubt on the potential effectiveness of site-directed mutagenesis to improve RuBisCO's efficiency. Here we use regression analysis to quantify the relationships between kinetic parameters obtained from empirical data sets spanning a wide evolutionary range of RuBisCOs. Most significantly we found that the rate constant for dissociation of CO 2 from the enzyme complex was much higher than previous estimates and comparable with the corresponding catalytic rate constant. Observed trends between relative specificity and turnover rate can be expressed as the product of negative and positive correlation factors. This provides an explanation in simple kinetic terms of both the natural variation of relative specificity as well as that obtained by reported site-directed mutagenesis results. We demonstrate that the kinetic behaviour shows a lesser rather than more constrained RuBisCO, consistent with growing empirical evidence of higher variability in relative specificity. In summary our analysis supports an explanation for the origin of the tradeoff between specificity and turnover as due to competition between protein stability and activity, rather than constraints between rate constants imposed by the underlying chemistry. Our analysis suggests that simultaneous improvement in both specificity and turnover rate of RuBisCO is possible.
A Cost-Utility Analysis of Prostate Cancer Screening in Australia.

PubMed

Keller, Andrew; Gericke, Christian; Whitty, Jennifer A; Yaxley, John; Kua, Boon; Coughlin, Geoff; Gianduzzo, Troy

2017-02-01

The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. A decision model that incorporated Markov processes was developed from a health system perspective. The base-case scenario compared a population-based screening programme with current opportunistic screening practices. Costs, utility values, treatment patterns and background mortality rates were derived from Australian data. All costs were adjusted to reflect July 2015 Australian dollars (A$). An alternative scenario compared systematic with opportunistic screening but with optimisation of active surveillance (AS) uptake in both groups. A discount rate of 5 % for costs and benefits was utilised. Univariate and probabilistic sensitivity analyses were performed to assess the effect of variable uncertainty on model outcomes. Our model very closely replicated the number of deaths from both prostate cancer and background mortality in the Göteborg study. The incremental cost per quality-adjusted life-year (QALY) for PSA screening was A$147,528. However, for years of life gained (LYGs), PSA-based screening (A$45,890/LYG) appeared more favourable. Our alternative scenario with optimised AS improved cost utility to A$45,881/QALY, with screening becoming cost effective at a 92 % AS uptake rate. Both modelled scenarios were most sensitive to the utility of patients before and after intervention, and the discount rate used. PSA-based screening is not cost effective compared with Australia's assumed willingness-to-pay threshold of A$50,000/QALY. It appears more cost effective if LYGs are used as the relevant outcome, and is more cost effective than the established Australian breast cancer screening programme on this basis. Optimised utilisation of AS increases the cost effectiveness of prostate cancer screening dramatically.
Regulatory Incentives and Disincentives for Utility Investments in Grid Modernization

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

Kihm, Steve; Beecher, Janice; Lehr, Ronald L.

Electric power is America's most capital-intensive industry, with more than $100 billion invested each year in energy infrastructure. Investment needs are likely to grow as electric utilities make power systems more reliable and resilient, deploy advanced digital technologies, and facilitate new services to meet some consumers' expectations for greater choice and control. But do current regulatory approaches provide the appropriate incentives for grid modernization investments? This report presents three perspectives: -Financial analyst Steve Kihm begins by explaining that any major investor-owned electric utility that wants to raise capital today can do so at a reasonable cost. The question is whethermore » utility managers want to raise capital for grid modernization. Specifically, they look for investments that create the most value for their existing shareholders. In cases where grid modernization investments are not the best choice in terms of shareholder value, Kihm describes shareholder incentive mechanisms that regulators could consider to encourage such investments when they are in the public interest. -From an institutional perspective, Dr. Janice Beecher finds that the traditional rate-base/rate of return regulatory model provides powerful incentives for utilities to pursue investments, cost control, efficiency and even innovation, and it is well suited to the policy objectives of grid modernization. Prudence of grid modernization investments (fair returns) depends on careful evaluation of the specific asset, and any special incentives (bonus returns) should be used only if they promote economic efficiency consistent with the core goals of economic regulation. According to Beecher, realizing the promises of grid modernization depends on effective implementation of the traditional regulatory model and ratemaking tools to serve the public interest. -Conversely, former commissioner and clean energy consultant Ron Lehr says that rapid electric industry changes require a better alignment of utility investment incentives with changes challenging the electricity sector, emerging grid modernization options and benefits, and public policies. For example, investor-owned utilities typically have an incentive to make capital investments, but rarely to employ expense-based solutions, since utilities do not earn profits on expenses. Further, Lehr cites a variety of factors that stand in the way of creating well targeted and well aligned utility incentives, including litigated regulatory processes. These may be a poor choice for finding the right balance among competing interests, establishing rules of prospective application, justifying demonstrations of new technologies and approaches to meeting emerging consumer demands, and keeping pace with rapid change.« less
Calculating utilization rates for rubber tired grapple skidders in the Southern United States

Treesearch

Jason D. Thompson

2001-01-01

Utilization rate is an important factor in calculating machine rates for forest harvesting machines. Machine rates allow an evaluation of harvesting system costs and facilitate comparisons between different systems and machines. There are many factors that affect utilization rate. These include mechanical delays, non-mechanical delays, operational lost time, and...
Molecular analysis of tumor margins by MALDI mass spectrometry in renal carcinoma.

PubMed

Oppenheimer, Stacey R; Mi, Deming; Sanders, Melinda E; Caprioli, Richard M

2010-05-07

The rate of tumor recurrence post resection suggests that there are underlying molecular changes in nearby histologically normal tissue that go undetected by conventional diagnostic methods that utilize contrast agents and immunohistochemistry. MALDI MS is a molecular technology that has the specificity and sensitivity to monitor and identify molecular species indicative of these changes. The current study utilizes this technology to assess molecular distributions within a tumor and adjacent normal tissue in clear cell renal cell carcinoma biopsies. Results indicate that the histologically normal tissue adjacent to the tumor expresses many of the molecular characteristics of the tumor. Proteins of the mitochondrial electron transport system are examples of such distributions. This work demonstrates the utility of MALDI MS for the analysis of tumor tissue in the elucidation of aberrant molecular changes in the tumor microenvironment.
Utilization of counseling services at one medical school.

PubMed

Chang, Elaine; Eddins-Folensbee, Florence; Porter, Ben; Coverdale, John

2013-08-01

The purpose of this study was to assess the usage of mental health counseling services by medical students. Medical students experience high rates of burnout, depression, and suicidal ideation. Our medical school (Baylor) provides free professional counseling services. The authors administered a survey that included a burnout scale; a depression screen; and questions about demographics, usage of counseling services, and helpful coping mechanisms for 526 first-through third-year students (336 respondents) at one school. Approximately 24% of students with high rates of burnout and 24% of students with depressive symptoms took advantage of counseling services at least once. Of the students who had not used counseling services, approximately 49% were found to have high rates of burnout in the domain of emotional exhaustion. Similarly, of the students who had not accessed counseling services, 56% had depressive symptoms. A large percentage of medical students across three classes did not use mental health counseling services provided by the school. Students should be clearly informed about the availability of counseling services and their potential utility. In addition, specific barriers to attendance should be identified and reduced.
Hybrid cooperative spectrum sharing for cognitive radio networks: A contract-based approach

NASA Astrophysics Data System (ADS)

Zhang, Songwei; Mu, Xiaomin; Wang, Ning; Zhang, Dalong; Han, Gangtao

2018-06-01

In order to improve the spectral efficiency, a contract-based hybrid cooperative spectrum sharing approach is proposed in this paper, in which multiple primary users (PUs) and multiple secondary users (SUs) share the primary channels in a hybrid manner. Specifically, the SUs switch their transmission mode between underlay and overlay based on the second-order statistics of the primary links. The average transmission rates of PUs and SUs are analyzed for the two transmission modes, and an optimization problem is formulated to maximize the utility of PUs under the constraint that the utility of SUs is nonnegative, which is further solved by a contract-based approach in global statistical channel statistical information (S-CSI) scenarios and local S-CSI scenarios, individually. Numerical results show that the average transmission rate of the PUs is significantly improved by using the proposed method in both of the two scenarios, and in the meantime, the SUs can achieve a good average rate, especially while the SUs have the same number of the PUs in the local S-CSI scenarios.
Utilization rates of knee-arthroplasty in OECD countries.

PubMed

Pabinger, C; Lothaller, H; Geissler, A

2015-10-01

The number of knee arthroplasties and the prevalence of obesity are increasing exponentially. To date there have been no published reviews on utilization rates of knee arthroplasty in OECD countries. We analysed economic, medical and population data relating to knee arthroplasty surgeries performed in OECD countries. Gross domestic product (GDP), health expenditures, obesity prevalence, knee arthroplasty utilization rates and growth in knee arthroplasty rates per 100,000 population were assessed for total population, for patients aged 65 years and over, and patients aged 64 years and younger. Obesity prevalence and utilization of knee arthroplasty have increased significantly in the past. The mean utilization rate of knee arthroplasty was 150 (22-235) cases per 100,000 total population in 2011. The strongest annual increase (7%) occurred in patients 64 years and under. Differences between individual countries can be explained by economic and medical patterns, with countries with higher medical expenditures and obesity prevalence having significantly higher utilization rates. Countries with lower utilization rates have significantly higher growth in utilization rates. The future demand for knee prostheses will increase x-fold by 2030, with exact rates dependant upon economic, social and medical factors. We observed a 10-fold variation in the utilization of knee arthroplasty among OECD countries. A significant and strong correlation of GDP, health expenditures and obesity prevalence with utilization of knee arthroplasty was found. Patients aged 64 years and younger show a two-fold higher growth rate in knee arthroplasty compared to the older population. This trend could result in a four-fold demand for knee arthroplasty in OECD countries by 2030. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Rhode Island. Preliminary background report

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

Feurer, D A; Weaver, C L; Gallagher, K C

1980-01-01

The Rhode Island statutes vest in the Public Utility Commission and the Division of Public Utilities the exclusive power and authority to regulate public utility companies in that state. Both bodies have been established within the Department of Business Regulation but are independent of the Department's director and are not under his jurisdiction. The jurisdiction to regulate utilities is shared by the Commission and the Division. The Commission serves as a quasi-judicial tribunal with jurisdiction, powers, and duties to hold investigations and hearings involving rates, sufficiency and resonableness of facilities, gas, electric, water, and pipeline public utilities. The administrator, whomore » is chief executive officer of the Division, is responsible for exercising the jurisdiction, supervision, powers, and duties not specifically assigned to the Commission. By virtue of his office, the chairman of the Commission serves also as the administrator and he supervises and directs the execution of all laws relating to public utilities and carriers and all regulations and orders of the Commission governing the conduct and charges of public utilities. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.« less
Hydrogen in thin Pd-based layers deposited on reticulated vitreous carbon-A new system for electrochemical capacitors

NASA Astrophysics Data System (ADS)

Łukaszewski, M.; Żurowski, A.; Czerwiński, A.

Reticulated vitreous carbon (RVC) has been used as a matrix for electrodeposition of thin layers of Pd and Pd-rich Pd-Rh alloys. It was found that RVC substrate does not affect qualitatively hydrogen absorption behavior of Pd-based deposits. Similarly to thin Pd or Pd alloy layers deposited on Au wires, the α-β phase transition controls the overall rate of hydrogen absorption and desorption into/from Pd-based/RVC electrodes. The possibility of the application of these materials as phase charging-discharging systems was investigated. The values of specific pseudocapacitance, specific power and specific energy were comparable with those for supercapacitors utilizing various redox reactions.
Health care utilization in patients with gout: a prospective multicenter cohort study.

PubMed

Singh, Jasvinder A; Bharat, Aseem; Khanna, Dinesh; Aquino-Beaton, Cleopatra; Persselin, Jay E; Duffy, Erin; Elashoff, David; Khanna, Puja P

2017-05-31

All published studies of health care utilization in gout have been cross-sectional to date, and most used a patient-reported diagnosis of gout. Our objective was to assess health care utilization and its predictors in patients with physician-confirmed gout in a prospective cohort study. In a multi-center prospective cohort study of U.S. veterans with rheumatologist-confirmed gout (N = 186; two centers), we assessed patient self-reported overall and gout-specific health care utilization with the Gout Assessment Questionnaire (GAQ) every 3-months for a 9-month period. Comparisons were made using the student's t test or the chi-square, Wilcoxon rank sum test or Fisher exact test, as appropriate. Mixed effects Poisson regression was used to assess potential correlates of gout-related health care utilization. Mean age was 64.6 years, 98% were men, 13% Hispanic or Latino, 32% were African-American, 6% did not graduate high school, mean serum urate was 8.3 and mean Deyo-Charlson score was 3.1. During the past year, mean gout-related visits were as follows: rheumatologist, 1.5; primary care physician, 2 visits; ≥1 inpatient visits, 7%; ≥1 ER visits, 26%; and urgent care/walk-in visit, 33%. In longitudinal analyses, African-American race and gout flares in the last 3 months were associated with significantly higher rate ratio of gout-related outpatient visits. African-American race and lack of college education were associated with significantly higher rate ratio for gout-related urgent visits and overnight stays. African-American race and recent gout flares were associated with higher outpatient utilization and African-American race and no college education with higher urgent or inpatient utilization. Future studies should examine whether modifiable predictors of utilization can be targeted to reduce healthcare utilization in patients with gout.
Utilization rates of hip arthroplasty in OECD countries.

PubMed

Pabinger, C; Geissler, A

2014-06-01

Hip arthroplasty and revision surgery is growing exponentially in OECD countries, but rates vary between countries. We extracted economic data and utilization rates data about hip arthroplasty done in OECD countries between 1990 and 2011. Absolute number of implantations and compound annual growth rates were computed per 100,000 population and for patients aged 65 years old and over and for patients aged 64 years and younger. In the majority of OECD countries, there has been a significant increase in the utilization of total hip arthroplasty in the last 10 years, but rates vary to a great extent: In the United States, Switzerland, and Germany the utilization rate exceeds 200/100,000 population whereas in Spain and Mexico rates are 102 and 8, respectively. There is a strong correlation between gross domestic product (GDP) and health care expenditures per capita with utilization rate. Utilization rates in all age groups have continued to rise up to present day. A seven fold higher growth rate was seen in patients aged 64 years and younger as compared to older patients. We observed a 38-fold variation in the utilization of hip arthroplasty among OECD countries, correlating with GDP and health care expenditures. Over recent years, there has been an increase in the utilization rate in most countries. This was particularly evident in the younger patients. Due to increasing life expectancy and the disproportionally high use of arthroplasty in younger patients we expect an exponential increase of revision rate in the future. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Is aceticlastic methanogen composition in full-scale anaerobic processes related to acetate utilization capacity?

PubMed

Yilmaz, Vedat; Ince-Yilmaz, Ebru; Yilmazel, Yasemin Dilsad; Duran, Metin

2014-06-01

In this study, biomass samples were obtained from six municipal and nine industrial full-scale anaerobic processes to investigate whether the aceticlastic methanogen population composition is related to acetate utilization capacity and the nature of the wastewater treated, i.e. municipal sludge or industrial wastewater. Batch serum bottle tests were used to determine the specific acetate utilization rate (AUR), and a quantitative real-time polymerase chain reaction protocol was used to enumerate the acetate-utilizing Methanosaeta and Methanosarcina populations in the biomass samples. Methanosaeta was the dominant aceticlastic methanogen in all samples, except for one industrial wastewater-treating anaerobic process. However, Methanosarcina density in industrial biomass samples was higher than the Methanosarcina density in the municipal samples. The average AUR values of municipal and industrial wastewater treatment plant biomass samples were 10.49 and 10.65 mg CH3COO(-)/log(aceticlastic methanogen gene copy).d, respectively. One-way ANOVA test and principle component analysis showed that the acetate utilization capacities and aceticlastic methanogen community composition did not show statistically significant correlation among the municipal digesters and industrial wastewater-treating processes investigated.
Mental Health Needs and Service Utilization by Hispanic Immigrants Residing in Mid-Southern United States

PubMed Central

Bridges, Ana J.; Andrews, Arthur R.; Deen, Tisha L.

2014-01-01

Purpose This study assessed mental health needs and service utilization patterns in a convenience sample of Hispanic immigrants. Design and Method A total of 84 adult Hispanic participants completed a structured diagnostic interview and a semistructured service utilization interview with trained bilingual research assistants. Results In the sample, 36% met diagnostic criteria for at least one mental disorder. Although 42% of the sample saw a physician in the prior year, mental health services were being rendered primarily by religious leaders. The most common barriers to service utilization were cost (59%), lack of health insurance (35%), and language (31%). Although more women than men met criteria for a disorder, service utilization rates were comparable. Participants with a mental disorder were significantly more likely to have sought medical, but not psychiatric, services in the prior year and faced significantly more cost barriers than participants without a mental disorder. Conclusions Findings suggest that Hispanic immigrants, particularly those with a mental illness, need to access services but face numerous systemic barriers. The authors recommend specific ways to make services more affordable and linguistically accessible. PMID:22802297

Development and utilization of extracorporeal regional complexing hemodialysis as a means of mobilizing and enhancing the excretion of methylmercury in the dog. [N-acetylcysteine; N-acetylpenicillamine; 2,3-dimercaptosuccinic acid

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

Kostyniak, P.J.

1975-01-01

The present investigation was directed at developing and testing a new procedure for increasing methylmercury excretion in the dog. The procedure utilizes hemodialysis in conjunction with the extracorporeal reversal of protein binding of methylmercury in blood by the presence of low molecular weight sulfhydryl containing complexing agents (cysteine, N-acetylcysteine, penicillamine, N-acetylpenicillamine, 2,3-dimercaptosuccinic acid) having a high chemical affinity for methylmercury. Using such a procedure, the complexed methylmercury and the free complexing agent were found to be readily removed from blood by the dialyzer. Unlike chelation therapy, this procedure does not rely on the attainment of high systemic concentrations of complexingmore » agent in order to attain enhanced excretion by normal routes. It rather introduces into the circulatory system a shunt designed specifically for methylmercury extraction from blood. In vitro testing of this procedure revealed that methylmercury removal from blood was dependent upon the concentration of complexing agent in blood and the dialyzer blood flow rate. In vivo testing of the procedure in the dog utilized a standard hemodialyzer with infusion of complexing agent into the arterial dialyzer blood line. The rate of methylmercury removal from the dog during the treatment procedures were as high as 400 times the excretion rate of mercury in untreated dogs.« less
Dynamic shear deformation in high purity Fe

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

Cerreta, Ellen K; Bingert, John F; Trujillo, Carl P

2009-01-01

The forced shear test specimen, first developed by Meyer et al. [Meyer L. et al., Critical Adiabatic Shear Strength of Low Alloyed Steel Under Compressive Loading, Metallurgical Applications of Shock Wave and High Strain Rate Phenomena (Marcel Decker, 1986), 657; Hartmann K. et al., Metallurgical Effects on Impact Loaded Materials, Shock Waves and High Strain rate Phenomena in Metals (Plenum, 1981), 325-337.], has been utilized in a number of studies. While the geometry of this specimen does not allow for the microstructure to exactly define the location of shear band formation and the overall mechanical response of a specimen ismore » highly sensitive to the geometry utilized, the forced shear specimen is useful for characterizing the influence of parameters such as strain rate, temperature, strain, and load on the microstructural evolution within a shear band. Additionally, many studies have utilized this geometry to advance the understanding of shear band development. In this study, by varying the geometry, specifically the ratio of the inner hole to the outer hat diameter, the dynamic shear localization response of high purity Fe was examined. Post mortem characterization was performed to quantify the width of the localizations and examine the microstructural and textural evolution of shear deformation in a bcc metal. Increased instability in mechanical response is strongly linked with development of enhanced intergranular misorientations, high angle boundaries, and classical shear textures characterized through orientation distribution functions.« less
Decentralization and equity of resource allocation: evidence from Colombia and Chile.

PubMed Central

Bossert, Thomas J.; Larrañaga, Osvaldo; Giedion, Ursula; Arbelaez, José Jesus; Bowser, Diana M.

2003-01-01

OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes. PMID:12751417
College Health Surveillance Network: Epidemiology and Health Care Utilization of College Students at US 4-Year Universities.

PubMed

Turner, James C; Keller, Adrienne

2015-01-01

This description of the College Health Surveillance Network (CHSN) includes methodology, demography, epidemiology, and health care utilization. Twenty-three universities representing approximately 730,000 enrolled students contributed data from January 1, 2011, through May 31, 2014. Participating schools uploaded de-identified electronic health records from student health services monthly. During this study, just over 800,000 individuals used the health centers, comprising 4.17 million patient encounters. Sixty percent of visits included primary care, 13% mental health, 9% vaccination, and 31% other miscellaneous services. The 5 most common specific diagnostic categories (with annual rates per 100 enrolled students) were preventive (16); respiratory (12); skin, hair, and nails; infectious non-sexually transmitted infection (5 each); and mental health (4). Utilization and epidemiologic trends are identified among subpopulations of students. CHSN data establish trends in utilization and epidemiologic patterns by college students and the importance of primary and behavioral health care services on campuses.
Quality of life assessment software for computer-inexperienced older adults: multimedia utility elicitation for activities of daily living.

PubMed Central

Goldstein, M. K.; Miller, D. E.; Davies, S.; Garber, A. M.

2002-01-01

Functional status as measured by dependencies in the Activities of Daily Living (ADLs) is an important indicator of overall health for older adults. Methodologies for outcomes-based medical-decision-making for public policy, such as decision modeling and cost-effectiveness analysis, require utilities for outcome health states. Utilities have been reported for many disease states, but have not been indexed by functional status, which is a strong predictor of outcome in geriatrics. We describe here a utility elicitation program developed specifically for use with computer-inexperienced older adults: Functional Limitation And Independence Rating (FLAIR1). FLAIR1 design features address common physical problems of the aged and computer attitudes of inexperienced users that could impede computer acceptance. We interviewed 400 adults ages 65 years and older with FLAIR1. In exit interviews with 154 respondents, 118 (76%) found FLAIR1 easy to use. Design features in FLAIR1 can be applied to other software for older adults PMID:12463834
College Health Surveillance Network: Epidemiology and Health Care Utilization of College Students at US 4-Year Universities

PubMed Central

Turner, James C.; Keller, Adrienne

2015-01-01

Abstract Objective: This description of the College Health Surveillance Network (CHSN) includes methodology, demography, epidemiology, and health care utilization. Participants: Twenty-three universities representing approximately 730,000 enrolled students contributed data from January 1, 2011, through May 31, 2014. Methods: Participating schools uploaded de-identified electronic health records from student health services monthly. Results: During this study, just over 800,000 individuals used the health centers, comprising 4.17 million patient encounters. Sixty percent of visits included primary care, 13% mental health, 9% vaccination, and 31% other miscellaneous services. The 5 most common specific diagnostic categories (with annual rates per 100 enrolled students) were preventive (16); respiratory (12); skin, hair, and nails; infectious non–sexually transmitted infection (5 each); and mental health (4). Utilization and epidemiologic trends are identified among subpopulations of students. Conclusions: CHSN data establish trends in utilization and epidemiologic patterns by college students and the importance of primary and behavioral health care services on campuses. PMID:26086428
Utilizing a one-dimensional multispecies model to simulate the nutrient reduction and biomass structure in two types of H2-based membrane-aeration biofilm reactors (H2-MBfR): model development and parametric analysis.

PubMed

Wang, Zuowei; Xia, Siqing; Xu, Xiaoyin; Wang, Chenhui

2016-02-01

In this study, a one-dimensional multispecies model (ODMSM) was utilized to simulate NO3(-)-N and ClO4(-) reduction performances in two kinds of H2-based membrane-aeration biofilm reactors (H2-MBfR) within different operating conditions (e.g., NO3(-)-N/ClO4(-) loading rates, H2 partial pressure, etc.). Before the simulation process, we conducted the sensitivity analysis of some key parameters which would fluctuate in different environmental conditions, then we used the experimental data to calibrate the more sensitive parameters μ1 and μ2 (maximum specific growth rates of denitrification bacteria and perchlorate reduction bacteria) in two H2-MBfRs, and the diversity of the two key parameters' values in two types of reactors may be resulted from the different carbon source fed in the reactors. From the simulation results of six different operating conditions (four in H2-MBfR 1 and two in H2-MBfR 2), the applicability of the model was approved, and the variation of the removal tendency in different operating conditions could be well simulated. Besides, the rationality of operating parameters (H2 partial pressure, etc.) could be judged especially in condition of high nutrients' loading rates. To a certain degree, the model could provide theoretical guidance to determine the operating parameters on some specific conditions in practical application.
Cross-temporal and cross-national poverty and mortality rates among developed countries.

PubMed

Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

2013-01-01

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes.
Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries

PubMed Central

Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

2013-01-01

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes. PMID:23840235
Exploring Geographic Variation of Mental Health Risk and Service Utilization of Doctors and Hospitals in Toronto: A Shared Component Spatial Modeling Approach

PubMed Central

Perlman, Christopher

2018-01-01

Mental Health has been known to vary geographically. Different rates of utilization of mental health services in local areas reflect geographic variation of mental health and complexity of health care. Variations and inequalities in how the health care system addresses risks are two critical issues for addressing population mental health. This study examines these issues by analyzing the utilization of mental health services in Toronto at the neighbourhood level. We adopted a shared component spatial modeling approach that allows simultaneous analysis of two main health service utilizations: doctor visits and hospitalizations related to mental health conditions. Our results reflect a geographic variation of both types of mental health service utilization across neighbourhoods in Toronto. We identified hot and cold spots of mental health risks that are common to both or specific to only one type of health service utilization. Based on the evidence found, we discuss intervention strategies, focusing on the hotspots and provision of health services about doctors and hospitals, to improve mental health for the neighbourhoods. Limitations of the study and further research directions are also discussed. PMID:29587426
Using Relative Statistics and Approximate Disease Prevalence to Compare Screening Tests.

PubMed

Samuelson, Frank; Abbey, Craig

2016-11-01

Schatzkin et al. and other authors demonstrated that the ratios of some conditional statistics such as the true positive fraction are equal to the ratios of unconditional statistics, such as disease detection rates, and therefore we can calculate these ratios between two screening tests on the same population even if negative test patients are not followed with a reference procedure and the true and false negative rates are unknown. We demonstrate that this same property applies to an expected utility metric. We also demonstrate that while simple estimates of relative specificities and relative areas under ROC curves (AUC) do depend on the unknown negative rates, we can write these ratios in terms of disease prevalence, and the dependence of these ratios on a posited prevalence is often weak particularly if that prevalence is small or the performance of the two screening tests is similar. Therefore we can estimate relative specificity or AUC with little loss of accuracy, if we use an approximate value of disease prevalence.
Patient-specific positioning guides versus manual instrumentation for total knee arthroplasty: an intraoperative comparison.

PubMed

Kassab, Safa; Pietrzak, William S

2014-01-01

Traditional manual instruments for total knee arthroplasty are associated with a malalignment rate of nearly 30%. Patient-specific positioning guides, developed to help address alignment, may also influence other intraoperative factors. This study compared a consecutive series of 270 Vanguard total knee replacements performed with Signature patient-specific positioning guides (study group) to a consecutive series of 595 similar knee replacements performed with manual instrumentation (control group). The study group averaged 16.7 fewer minutes in the operating room (p < .001), utilized tibial inserts that averaged 0.4 mm thinner with a smaller proportion of "thick" tibial inserts (14-18 mm) (p < .001), and required fewer transfusions (p = .022). The Signature-derived surgical plan accurately predicted correct femoral and tibial component sizes in 86.3% and 70.3% of the cases, respectively. These rates increased to 99.3% and 99.2%, respectively, for accuracy to within one size of the surgical plan, similar to published values for manual instrumentation.
Investigation of the Usability of Computerized Critical Care Information Systems in Germany.

PubMed

von Dincklage, Falk; Suchodolski, Klaudiusz; Lichtner, Gregor; Friesdorf, Wolfgang; Podtschaske, Beatrice; Ragaller, Maximilian

2017-01-01

The term "usability" describes how effectively, efficiently, and with what level of user satisfaction an information system can be used to accomplish specific goals. Computerized critical care information systems (CCISs) with high usability increase quality of care and staff satisfaction, while reducing medication errors. Conversely, systems lacking usability can interrupt clinical workflow, facilitate errors, and increase charting time. The aim of this study was to investigate and compare usability across CCIS currently used in Germany. In this study, German intensive care unit (ICU) nurses and physicians completed a specialized, previously validated, web-based questionnaire. The questionnaire assessed CCIS usability based on three rating models: an overall rating of the systems, a model rating technical usability, and a model rating task-specific usability. We analyzed results from 535 survey participants and compared eight different CCIS commonly used in Germany. Our results showed that usability strongly differs across the compared systems. The system ICUData had the best overall rating and technical usability, followed by the platforms ICM and MetaVision. The same three systems performed best in the rating of task-specific usability without significant differences between each other. Across all systems, overall ratings were more dependent on ease-of-use aspects than on aspects of utility/functionality, and the general scope of the functions offered was rated better than how well the functions are realized. Our results suggest that manufacturers should shift some of their effort away from the development of new features and focus more on improving the ease-of-use and quality of existing features.
Criterion Validity and Practical Utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in Assessments of Police Officer Candidates.

PubMed

Tarescavage, Anthony M; Corey, David M; Gupton, Herbert M; Ben-Porath, Yossef S

2015-01-01

Minnesota Multiphasic Personality Inventory-2-Restructured Form scores for 145 male police officer candidates were compared with supervisor ratings of field performance and problem behaviors during their initial probationary period. Results indicated that the officers produced meaningfully lower and less variant substantive scale scores compared to the general population. After applying a statistical correction for range restriction, substantive scale scores from all domains assessed by the inventory demonstrated moderate to large correlations with performance criteria. The practical significance of these results was assessed with relative risk ratio analyses that examined the utility of specific cutoffs on scales demonstrating associations with performance criteria.
Predicting SF-6D utility scores from the Neck Disability Index and Numeric Rating Scales for Neck and Arm Pain

PubMed Central

Carreon, Leah Y.; Anderson, Paul A.; McDonough, Christine M.; Djurasovic, Mladen; Glassman, Steven D.

2010-01-01

Study Design Cross-sectional cohort Objective This study aims to provide an algorithm estimate SF-6D utilities using data from the NDI, neck pain and arm pain scores. Summary of Background Data Although cost-utility analysis is increasingly used to provide information about the relative value of alternative interventions, health state values or utilities are rarely available from clinical trial data. The Neck Disability Index (NDI) and numeric rating scales for neck and arm pain, are widely used disease-specific measures of symptoms, function and disability in patients with cervical degenerative disorders. The purpose of this study is to provide an algorithm to allow estimation of SF-6D utilities using data from the NDI, and numeric rating scales for neck and arm pain. Methods SF-36, NDI, neck and arm pain rating scale scores were prospectively collected pre-operatively, at 12 and 24 months post-operatively in 2080 patients undergoing cervical fusion for degenerative disorders. SF-6D utilities were computed and Spearman correlation coefficients were calculated for paired observations from multiple time points between NDI, neck and arm pain scores and SF-6D utility scores. SF-6D scores were estimated from the NDI, neck and arm pain scores using a linear regression model. Using a separate, independent dataset of 396 patients in which and NDI scores were available SF-6D was estimated for each subject and compared to their actual SF-6D. Results The mean age for those in the development sample, was 50.4 ± 11.0 years and 33% were male. In the validation sample the mean age was 53.1 ± 9.9 years and 35% were male. Correlations between the SF-6D and the NDI, neck and arm pain scores were statistically significant (p<0.0001) with correlation coefficients of 0.82, 0.62, and 0.50 respectively. The regression equation using NDI alone to predict SF-6D had an R2 of 0.66 and a root mean square error (RMSE) of 0.056. In the validation analysis, there was no statistically significant difference (p=0.961) between actual mean SF-6D (0.49 ± 0.08) and the estimated mean SF-6D score (0.49 ± 0.08) using the NDI regression model. Conclusion This regression-based algorithm may be a useful tool to predict SF-6D scores in studies of cervical degenerative disease that have collected NDI but not utility scores. PMID:20847713
Individual discount rates and smoking: evidence from a field experiment in Denmark.

PubMed

Harrison, Glenn W; Lau, Morten I; Rutström, E Elisabet

2010-09-01

We elicit measures of individual discount rates from a representative sample of the Danish population and test two substantive hypotheses. The first hypothesis is that smokers have higher individual discount rates than non-smokers. The second hypothesis is that smokers are more likely to have time inconsistent preferences than non-smokers, where time inconsistency is indicated by a hyperbolic discounting function. We control for the concavity of the utility function in our estimates of individual discount rates and find that male smokers have significantly higher discount rates than male non-smokers. However, smoking has no significant association with discount rates among women. This result is robust across exponential and hyperbolic discounting functions. We consider the sensitivity of our conclusions to a statistical specification that allows each observation to potentially be generated by more than one latent data-generating process. Copyright 2010 Elsevier B.V. All rights reserved.
Photoexcitation of lasers and chemical reactions for NASA missions: A theoretical study. [optical pumping in high pressure gas

NASA Technical Reports Server (NTRS)

Javan, A.; Guerra, M.

1981-01-01

The possibility of obtaining CW laser oscillation by optical pumping in the infrared at an elevated gas pressure is reviewed. A specific example utilizing a mixture of CO and NO gases is included. The gas pressures considered are in excess of several atmospheres. Laser frequency tuning over a broad region becomes possible at such elevated gas pressures due to collisional broadening of the amplifying transitions. The prior-rate and surprisal analysis are applied to obtain detailed VV and VT rates for CO and NO molecules and the transfer rates in a CO-NO gas mixture. The analysis is capable of giving temperature dependence of the rate constants. Computer estimates of the rates are presented for vibrational levels up to v = 50. The results show that in the high-lying vibrational states the VV transfer rates with Delta nu = 2 become appreciable.
Perceptions of climate-related risk among water sector professionals in Africa-Insights from the 2016 African Water Association Congress.

PubMed

Connolly, Katherine; Mbutu, Mwaura; Bartram, Jamie; Fuente, David

2018-06-01

The ability of water and wastewater utilities to provide safe and reliable water and sanitation services now and in the future will be determined, in part, by their resilience to climate change. Investment in infrastructure, planning, and operational practices that increase resilience are affected, in turn, by how water sector professionals perceive the risks posed to utilities by climate change and its related impacts. We surveyed water sector professionals at the 2016 African Water Association's Congress in Nairobi, Kenya to assess their perceptions of climate-specific and general risks that may disrupt utility service. We find that water sector professionals are most concerned about climate-specific and general risks that affect utility water supplies (quantity), followed by adequacy of utility infrastructure. We also find that professionals tend to rank climate-specific risks as less concerning than general risks facing utilities. Furthermore, non-utility professionals are more concerned about climate-specific risks and climate change in general than utility professionals. These findings highlight the multiple, competing risks utilities face and the need for adaptation strategies that simultaneously address climate-specific and general concerns of utilities. Copyright © 2018 Elsevier GmbH. All rights reserved.
78 FR 36768 - Battery Utility of Ohio, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER13-1667-000] Battery Utility of Ohio, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for... Battery Utility of Ohio, LLC's application for market-based rate authority, with an accompanying rate...
Suicide Among Veterans in 16 States, 2005 to 2008: Comparisons Between Utilizers and Nonutilizers of Veterans Health Administration (VHA) Services Based on Data From the National Death Index, the National Violent Death Reporting System, and VHA Administrative Records

PubMed Central

Katz, Ira R.; Ignacio, Rosalinda V.; Kemp, Janet

2012-01-01

Objectives. We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Methods. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Results. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. Conclusions.The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide. PMID:22390582

Co-Flow Hollow Cathode Technology

NASA Technical Reports Server (NTRS)

Hofer, Richard R.; Goebel, Dan M.

2011-01-01

Hall thrusters utilize identical hollow cathode technology as ion thrusters, yet must operate at much higher mass flow rates in order to efficiently couple to the bulk plasma discharge. Higher flow rates are necessary in order to provide enough neutral collisions to transport electrons across magnetic fields so that they can reach the discharge. This higher flow rate, however, has potential life-limiting implications for the operation of the cathode. A solution to the problem involves splitting the mass flow into the hollow cathode into two streams, the internal and external flows. The internal flow is fixed and set such that the neutral pressure in the cathode allows for a high utilization of the emitter surface area. The external flow is variable depending on the flow rate through the anode of the Hall thruster, but also has a minimum in order to suppress high-energy ion generation. In the co-flow hollow cathode, the cathode assembly is mounted on thruster centerline, inside the inner magnetic core of the thruster. An annular gas plenum is placed at the base of the cathode and propellant is fed throughout to produce an azimuthally symmetric flow of gas that evenly expands around the cathode keeper. This configuration maximizes propellant utilization and is not subject to erosion processes. External gas feeds have been considered in the past for ion thruster applications, but usually in the context of eliminating high energy ion production. This approach is adapted specifically for the Hall thruster and exploits the geometry of a Hall thruster to feed and focus the external flow without introducing significant new complexity to the thruster design.
Cross-Sectional Study of Unmet Mental Health Need in 5- to 7-Year Old Latino Children in the United States: Do Teachers and Parents Make a Difference in Service Utilization?

PubMed

Toppelberg, Claudio O; Hollinshead, Marisa O; Collins, Brian A; Nieto-Castañon, Alfonso

2013-06-01

The aim of the study is to examine the rates of mental health service utilization in young Latino children of immigrants in relation to maternal and teacher reports of child mental health need. Specific knowledge is lacking about gaps in service utilization among young Latino children, the fastest growing and possibly the most underserved segment of the US child population. The associations of mental health service utilization (Service Assessment for Children and Adolescents) and mental health need (clinical levels of internalizing, externalizing, or total problems reported by mothers [Child Behavior Checklist] and teachers [Teacher's Report Form]) were examined in a community sample of young Latino children of immigrants ( n = 228; mean age = 6) and compared across mothers' and teachers' responses. Mother-teacher agreement was also studied. Sixty-five children (28.5 %) had a mental health need; most (76.9 %) of these received no services. For all types of mental health need, service utilization was more likely when need was reported by mothers rather than teachers ( p = .03). Teachers' reports were not associated with service utilization. Mother-teacher agreement was low for externalizing ( r = .23; p ≤ 0.01) and total problems ( r = .21; p ≤ 0.05), and nonsignificant for internalizing problems. This study is the first in the United States to document, in such a young Latino group, high rates of unmet need comparable to those among older Latino youth; low or no mother-teacher agreement on which children had a mental health need; low utilization of school-based services; and a lack of association between service utilization and teacher-reported mental health need-both for externalizing and internalizing problems. These findings suggest that schools are not effectively leveraging mental health services for young Latino children. Potential factors responsible for the findings are discussed.
Some case studies of ocean wave physical processes utilizing the GSFC airborne radar ocean wave spectrometer

NASA Technical Reports Server (NTRS)

Jackson, F. C.

1984-01-01

The NASA K sub u band Radar Ocean Wave Spectrometer (ROWS) is an experimental prototype of a possible future satellite instrument for low data rate global waves measurements. The ROWS technique, which utilizes short pulse radar altimeters in a conical scan mode near vertical incidence to map the directional slope spectrum in wave number and azimuth, is briefly described. The potential of the technique is illustrated by some specific case studies of wave physical processes utilizing the aircraft ROWS data. These include: (1) an evaluation of numerical hindcast model performance in storm sea conditions, (2) a study of fetch limited wave growth, and (3) a study of the fully developed sea state. Results of these studies, which are briefly summarized, show how directional wave spectral observations from a mobile platform can contribute enormously to our understanding of wave physical processes.
Analysis of PURPA and solar energy

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

Rice, M.

The Public Utility Regulatory Policies Act of 1978 (PURPA) is designed to promote energy conservation, the efficient use of utility resources, and equitable rates. PURPA specifically directs the Federal Energy Regulatory Commission (FERC) to encourage small power production from renewable resources (and also cogeneration of electric energy as well as heat) by setting standards under which facilities qualify for interconnection, and guidelines for sales between utilities and independent facilities. The way FERC carries out this mandate may critically affect the development of solar alternatives to electric power production from fossil and nuclear resources. This report comments on proposed FERC regulationsmore » and suggests ways to encourage small power production within the PURPA mandate. In addition, some internal strains within PURPA are analyzed that seem to limit the effectiveness with which FERC can encourage independent facilities, and possible modifications to PURPA are suggested. 255 references.« less
Magnetospheric Multiscale (MMS) Mission Attitude Ground System Design

NASA Technical Reports Server (NTRS)

Sedlak, Joseph E.; Superfin, Emil; Raymond, Juan C.

2011-01-01

This paper presents an overview of the attitude ground system (AGS) currently under development for the Magnetospheric Multiscale (MMS) mission. The primary responsibilities for the MMS AGS are definitive attitude determination, validation of the onboard attitude filter, and computation of certain parameters needed to improve maneuver performance. For these purposes, the ground support utilities include attitude and rate estimation for validation of the onboard estimates, sensor calibration, inertia tensor calibration, accelerometer bias estimation, center of mass estimation, and production of a definitive attitude history for use by the science teams. Much of the AGS functionality already exists in utilities used at NASA's Goddard Space Flight Center with support heritage from many other missions, but new utilities are being created specifically for the MMS mission, such as for the inertia tensor, accelerometer bias, and center of mass estimation. Algorithms and test results for all the major AGS subsystems are presented here.
Polysaccharides and Proteins Added to Flowing Drinking Water at Microgram-per-Liter Levels Promote the Formation of Biofilms Predominated by Bacteroidetes and Proteobacteria

PubMed Central

Sack, Eveline L. W.; van der Kooij, Dick

2014-01-01

Biopolymers are important substrates for heterotrophic bacteria in (ultra)oligotrophic freshwater environments, but information about their utilization at microgram-per-liter levels by attached freshwater bacteria is lacking. This study aimed at characterizing biopolymer utilization in drinking-water-related biofilms by exposing such biofilms to added carbohydrates or proteins at 10 μg C liter−1 in flowing tap water for up to 3 months. Individually added amylopectin was not utilized by the biofilms, whereas laminarin, gelatin, and caseinate were. Amylopectin was utilized during steady-state biofilm growth with simultaneously added maltose but not with simultaneously added acetate. Biofilm formation rates (BFR) at 10 μg C liter−1 per substrate were ranked as follows, from lowest to highest: blank or amylopectin (≤6 pg ATP cm−2 day−1), gelatin or caseinate, laminarin, maltose, acetate alone or acetate plus amylopectin, and maltose plus amylopectin (980 pg ATP cm−2 day−1). Terminal restriction fragment length polymorphism (T-RFLP) and 16S rRNA gene sequence analyses revealed that the predominant maltose-utilizing bacteria also dominated subsequent amylopectin utilization, indicating catabolic repression and (extracellular) enzyme induction. The accelerated BFR with amylopectin in the presence of maltose probably resulted from efficient amylopectin binding to and hydrolysis by inductive enzymes attached to the bacterial cells. Cytophagia, Flavobacteriia, Gammaproteobacteria, and Sphingobacteriia grew during polysaccharide addition, and Alpha-, Beta-, and Gammaproteobacteria, Cytophagia, Flavobacteriia, and Sphingobacteriia grew during protein addition. The succession of bacterial populations in the biofilms coincided with the decrease in the specific growth rate during biofilm formation. Biopolymers can clearly promote biofilm formation at microgram-per-liter levels in drinking water distribution systems and, depending on their concentrations, might impair the biological stability of distributed drinking water. PMID:24487544
Racial Differences in Chronic Conditions and Sociodemographic Characteristics Among High-Utilizing Veterans.

PubMed

Breland, Jessica Y; Chee, Christine Pal; Zulman, Donna M

2015-06-01

African-Americans are disproportionally represented among high-risk, high-utilizing patients. To inform program development for this vulnerable population, the current study describes racial variation in chronic conditions and sociodemographic characteristics among high-utilizing patients in the Veterans Affairs Healthcare System (VA). We identified the 5 % most costly Veterans who used inpatient or outpatient care at the VA during fiscal year 2010 (N = 237,691) based on costs of inpatient and outpatient care, pharmacy services, and VA-sponsored contract care. Patient costs and characteristics were abstracted from VA outpatient and inpatient data files. Racial differences in sociodemographic characteristics (age, sex, marital support, homelessness, and health insurance status) were assessed with chi-square tests. Racial differences in 32 chronic condition diagnoses were calculated as relative risk ratios. African-Americans represented 21 % of high-utilizing Veterans. African-Americans had higher rates of homelessness (26 vs. 10 %, p < 0.001) and lower rates of supplemental health insurance (44 vs. 58 %, p < 0.001). The mean number of chronic conditions was similar across race. However, there were racial differences in the prevalence of specific chronic conditions, including a higher prevalence of HIV/AIDS (95 % confidence interval (CI) 4.86, 5.50) and schizophrenia (95 % CI 1.94, 2.07) and a lower prevalence of ischemic heart disease (95 % CI 0.57, 0.59) and bipolar disorder (95 % CI 0.78, 0.85) among African-American high-utilizing Veterans. Racial disparities among high-utilizing Veterans may differ from those found in the general population. Interventions should devote attention to social, environmental, and mental health issues in order to reduce racial disparities in this vulnerable population.
Polysaccharides and proteins added to flowing drinking water at microgram-per-liter levels promote the formation of biofilms predominated by bacteroidetes and proteobacteria.

PubMed

Sack, Eveline L W; van der Wielen, Paul W J J; van der Kooij, Dick

2014-04-01

Biopolymers are important substrates for heterotrophic bacteria in (ultra)oligotrophic freshwater environments, but information about their utilization at microgram-per-liter levels by attached freshwater bacteria is lacking. This study aimed at characterizing biopolymer utilization in drinking-water-related biofilms by exposing such biofilms to added carbohydrates or proteins at 10 μg C liter(-1) in flowing tap water for up to 3 months. Individually added amylopectin was not utilized by the biofilms, whereas laminarin, gelatin, and caseinate were. Amylopectin was utilized during steady-state biofilm growth with simultaneously added maltose but not with simultaneously added acetate. Biofilm formation rates (BFR) at 10 μg C liter(-1) per substrate were ranked as follows, from lowest to highest: blank or amylopectin (≤6 pg ATP cm(-2) day(-1)), gelatin or caseinate, laminarin, maltose, acetate alone or acetate plus amylopectin, and maltose plus amylopectin (980 pg ATP cm(-2) day(-1)). Terminal restriction fragment length polymorphism (T-RFLP) and 16S rRNA gene sequence analyses revealed that the predominant maltose-utilizing bacteria also dominated subsequent amylopectin utilization, indicating catabolic repression and (extracellular) enzyme induction. The accelerated BFR with amylopectin in the presence of maltose probably resulted from efficient amylopectin binding to and hydrolysis by inductive enzymes attached to the bacterial cells. Cytophagia, Flavobacteriia, Gammaproteobacteria, and Sphingobacteriia grew during polysaccharide addition, and Alpha-, Beta-, and Gammaproteobacteria, Cytophagia, Flavobacteriia, and Sphingobacteriia grew during protein addition. The succession of bacterial populations in the biofilms coincided with the decrease in the specific growth rate during biofilm formation. Biopolymers can clearly promote biofilm formation at microgram-per-liter levels in drinking water distribution systems and, depending on their concentrations, might impair the biological stability of distributed drinking water.
Patterns of Mental Health Care Utilization Among Sexual Orientation Minority Groups.

PubMed

Platt, Lisa F; Wolf, Julia Kay; Scheitle, Christopher P

2018-01-01

Prior studies of the utilization of mental health professionals by sexual minority populations have relied on data that are now dated or not nationally representative. These studies have also provided mixed findings regarding gender differences in the utilization of mental health professionals among sexual minority individuals. Using data from the 2013-2015 National Health Interview Surveys, this study investigates (1) how sexual minority individuals compare to heterosexual participants in their utilization of mental health professionals; and (2) gender differences in that utilization. The results indicate sexual minority individuals utilize mental health care professionals at higher rates than heterosexual individuals even after controlling for measures of mental health and other demographic characteristics; this is true for both men and women. However, gender moderates the sexual minority effect on utilization rates. Sexual minority men utilize mental health professionals at a high rate, such that their utilization rates are similar to sexual minority women, contrary to the gender gap seen among heterosexuals.
Energy Edge Post-Occupancy Evaluation Project: The Emerald People's Utility District Building (EPUD) Eugene, Oregon

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

Not Available

1990-06-01

The Workspace Satisfaction Survey measures occupant satisfaction with the thermal, lighting, acoustical, and air quality aspects of the work environment. In addition to ratings of these ambient environmental features, occupants also rate their satisfaction with a number of functional and aesthetic features of the office environment as well as their satisfaction with specific kinds of workspaces (e.g., computer rooms, the lobby, employee lounge, etc.). Each section on ambient conditions includes questions on the frequency with which people experience particular kinds of discomforts or problems, how much the discomfort bothers them, and how much it interferes with their work. Occupants aremore » also asked to identify how they cope with discomfort or environmental problems, and to what extent these behaviors enable them to achieve more satisfactory conditions. This report documents the results of this survey of the occupants of the Emerald People's Utility District office building in Eugene, Oregon.« less
Compendium of information on identification and testing of materials for plastic solar thermal collectors

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

McGinniss, V.D.; Sliemers, F.A.; Landstrom, D.K.

1980-07-31

This report is intended to organize and summarize prior and current literature concerning the weathering, aging, durability, degradation, and testing methodologies as applied to materials for plastic solar thermal collectors. Topics covered include (1) rate of aging of polymeric materials; (2) environmental factors affecting performance; (3) evaluation and prediction of service life; (4) measurement of physical and chemical properties; (5) discussion of evaluation techniques and specific instrumentation; (6) degradation reactions and mechanisms; (7) weathering of specific polymeric materials; and (8) exposure testing methodology. Major emphasis has been placed on defining the current state of the art in plastics degradation andmore » on identifying information that can be utilized in applying appropriate and effective aging tests for use in projecting service life of plastic solar thermal collectors. This information will also be of value where polymeric components are utilized in the construction of conventional solar collectors or any application where plastic degradation and weathering are prime factors in material selection.« less
Linear and nonlinear ARMA model parameter estimation using an artificial neural network

NASA Technical Reports Server (NTRS)

Chon, K. H.; Cohen, R. J.

1997-01-01

This paper addresses parametric system identification of linear and nonlinear dynamic systems by analysis of the input and output signals. Specifically, we investigate the relationship between estimation of the system using a feedforward neural network model and estimation of the system by use of linear and nonlinear autoregressive moving-average (ARMA) models. By utilizing a neural network model incorporating a polynomial activation function, we show the equivalence of the artificial neural network to the linear and nonlinear ARMA models. We compare the parameterization of the estimated system using the neural network and ARMA approaches by utilizing data generated by means of computer simulations. Specifically, we show that the parameters of a simulated ARMA system can be obtained from the neural network analysis of the simulated data or by conventional least squares ARMA analysis. The feasibility of applying neural networks with polynomial activation functions to the analysis of experimental data is explored by application to measurements of heart rate (HR) and instantaneous lung volume (ILV) fluctuations.
Metabolic behavior and enzymatic aspects of denitrifying EBPR sludge in a continuous-flow anaerobic-anoxic system.

PubMed

Zafiriadis, Ilias; Ntougias, Spyridon; Kapagiannidis, Anastasios G; Aivasidis, Alexander

2013-10-01

The metabolic aspects of enhanced biological phosphorus removal (EBPR) were investigated for the first time in a continuous-flow anaerobic-anoxic plant fed with acetate, propionate, or substrates which are involved in the tricarboxylic acid and/or glyoxylate cycle, i.e., fumarate, malate, or oxaloacetate, as the sole carbon source. Although the polyphosphate-accumulating organisms (PAOs) population remained stable with any carbon source examined, no typical EBPR metabolism was observed during fumarate, malate, or oxaloacetate utilization. Specific enzymatic activities related to EBPR were determined in activated sludge homogenates and directly correlated with the nutrient metabolic rates. The experimental results indicated the direct involvement of alkaline phosphatase, pyrophosphatase, and exopolyphosphatase in the denitrifying EBPR process. Metabolic aspects of glyoxylate cycle enzymes are discussed with regard to the biomass anaerobic and anoxic activity. Process performance was highly influenced by the kind of substrate utilized, indicating that specific metabolic pathways should be followed to favor efficient EBPR.
Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample.

PubMed

Dakanalis, Antonios; Alix Timko, C; Colmegna, Fabrizia; Riva, Giuseppe; Clerici, Massimo

2018-04-01

We examined the validity and utility of the DSM-5 severity ratings for anorexia nervosa (AN) in a clinical (treatment-seeking) sample (N = 273; 95.6% women). Participants classified with mild, moderate, severe, and extreme severity of AN based on their measured body mass index, differed significantly from each other in eating disorder features, putative maintenance factors, and illness-specific functional impairment (medium effect sizes). However, they were statistically indistinguishable in psychiatric-disorder comorbidity and distress, demographics, and age-of-AN onset. The implications of our findings, providing limited support for the DSM-5 severity ratings for AN, and directions for future research are outlined. Copyright © 2018 Elsevier B.V. All rights reserved.
Rate-dependent inverse-addition beta-selective mannosylation and contiguous sequential glycosylation involving beta-mannosidic bond formation.

PubMed

Chang, Shih-Sheng; Shih, Che-Hao; Lai, Kwun-Cheng; Mong, Kwok-Kong Tony

2010-05-03

The beta-selectivity of mannosylation has been found to be dependent on the addition rate of the mannosyl trichloroacetimidate donor in an inverse-addition (I-A) procedure. This rate dependent I-A procedure can improve the selectivity of direct beta-mannosylation and is applicable to orthogonal glycosylations of thioglycoside acceptors. Further elaboration of this novel procedure enables the development of the contiguous sequential glycosylation strategy, which streamlines the preparation of oligosaccharides invoking beta-mannosidic bond formation. The synthetic utility of the contiguous glycosylation strategy was demonstrated by the preparation of the trisaccharide core of human N-linked glycoproteins and the trisaccharide repeating unit of the O-specific polysaccharide found in the cellular capsule of Salmonelle bacteria.
Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents

PubMed Central

Nestor, Bridget A.; Cheek, Shayna M.; Liu, Richard T.

2016-01-01

Background This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents. Method Data were drawn from the National Survey on Drug Use and Health. Participants included 4,176 depressed adolescents with suicidal ideation and behavior in the previous year. Weighted logistic regressions were estimated to examine whether adolescent racial/ethnic minorities had lower rates of past-year treatment for suicidal ideation and behavior in inpatient or outpatient settings, while adjusting for age, depressive symptom severity, family income, and health insurance status. Results Among adolescents with any suicidal ideation and behavior, and suicide attempts specifically, non-Hispanic blacks and Native Americans were less likely than whites to receive outpatient treatment, and multiracial adolescents were less likely to be admitted to inpatient facilities. Apart from Hispanics, racial/ethnic minorities were generally less likely to receive mental health care for suicidal ideation, particularly within psychiatric outpatient settings. A pattern emerged with racial/ethnic differences in treatment receipt being greatest for adolescents with the least severe suicidal ideation and behavior. Limitations The cross-sectional data limits our ability to form causal inferences. Conclusion Strikingly low rates of treatment utilization for suicidal ideation and behavior were observed across all racial/ethnic groups. Certain racial/ethnic minorities may be less likely to seek treatment for suicidal ideation and behavior when symptoms are less severe, with this gap in treatment use narrowing as symptom severity increases. Native Americans were among the racial/ethnic groups with lowest treatment utilization, but also among the highest for rates of suicide attempts, highlighting the pressing need for strategies to increase mental health service use in this particularly vulnerable population. PMID:27262642
Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents.

PubMed

Nestor, Bridget A; Cheek, Shayna M; Liu, Richard T

2016-09-15

This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents. Data were drawn from the National Survey on Drug Use and Health. Participants included 4176 depressed adolescents with suicidal ideation and behavior in the previous year. Weighted logistic regressions were estimated to examine whether adolescent racial/ethnic minorities had lower rates of past-year treatment for suicidal ideation and behavior in inpatient or outpatient settings, while adjusting for age, depressive symptom severity, family income, and health insurance status. Among adolescents with any suicidal ideation and behavior, and suicide attempts specifically, non-Hispanic blacks and Native Americans were less likely than whites to receive outpatient treatment, and multiracial adolescents were less likely to be admitted to inpatient facilities. Apart from Hispanics, racial/ethnic minorities were generally less likely to receive mental health care for suicidal ideation, particularly within psychiatric outpatient settings. A pattern emerged with racial/ethnic differences in treatment receipt being greatest for adolescents with the least severe suicidal ideation and behavior. The cross-sectional data limits our ability to form causal inferences. Strikingly low rates of treatment utilization for suicidal ideation and behavior were observed across all racial/ethnic groups. Certain racial/ethnic minorities may be less likely to seek treatment for suicidal ideation and behavior when symptoms are less severe, with this gap in treatment use narrowing as symptom severity increases. Native Americans were among the racial/ethnic groups with lowest treatment utilization, but also among the highest for rates of suicide attempts, highlighting the pressing need for strategies to increase mental health service use in this particularly vulnerable population. Copyright © 2016 Elsevier B.V. All rights reserved.
Should the gap be filled between guidelines and actual practice for management of low back pain in primary care? The Quebec experience.

PubMed

Rossignol, M; Abenhaim, L; Bonvalot, Y; Gobeille, D; Shrier, I

1996-12-15

A prospective cohort study. To describe health services utilization for low back pain in the province of Quebec, Canada, and to compare it with North American guidelines. The Quebec Task Force and the Agency for Health Care Planning and Research (United States) published guidelines for the management of low back pain in 1987 and 1994, respectively. A cohort of 2147 adults with low back pain identified at the Quebec Worker's Compensation Board were selected randomly and observed over 2 years' time for their health care utilization profile. During the study period, 57.8% of the workers still under active care 7 weeks after their back injury had not yet been referred to a specialist. Specialized imaging techniques were obtained by 4.5% of the patients, with a delay of 7 weeks or more in 66% of them. Surgery was performed on 1.6% of the patients. The presence of an initial specific diagnosis and proximity to a university hospital significantly increased utilization rate and reduced the delays. Health services utilization for back pain in Quebec was equal or lower to what currently is practiced elsewhere, but access to specialists was not meeting the current recommendations. This would represent a 12% net increase in new specialist contacts and a quicker access in 39% who saw a specialist. Before such an effort can be considered, health care planners will need a better definition of the role of the specialist consultation in the guidelines and scientific evidence specifically addressing their benefit in primary care, especially in the absence of a specific diagnosis.
Temperature Dependence of Inorganic Nitrogen Uptake: Reduced Affinity for Nitrate at Suboptimal Temperatures in Both Algae and Bacteria

PubMed Central

Reay, David S.; Nedwell, David B.; Priddle, Julian; Ellis-Evans, J. Cynan

1999-01-01

Nitrate utilization and ammonium utilization were studied by using three algal isolates, six bacterial isolates, and a range of temperatures in chemostat and batch cultures. We quantified affinities for both substrates by determining specific affinities (specific affinity = maximum growth rate/half-saturation constant) based on estimates of kinetic parameters obtained from chemostat experiments. At suboptimal temperatures, the residual concentrations of nitrate in batch cultures and the steady-state concentrations of nitrate in chemostat cultures both increased. The specific affinity for nitrate was strongly dependent on temperature (Q10 ≈ 3, where Q10 is the proportional change with a 10°C temperature increase) and consistently decreased at temperatures below the optimum temperature. In contrast, the steady-state concentrations of ammonium remained relatively constant over the same temperature range, and the specific affinity for ammonium exhibited no clear temperature dependence. This is the first time that a consistent effect of low temperature on affinity for nitrate has been identified for psychrophilic, mesophilic, and thermophilic bacteria and algae. The different responses of nitrate uptake and ammonium uptake to temperature imply that there is increasing dependence on ammonium as an inorganic nitrogen source at low temperatures. PMID:10347046
Lithium-ion capacitors using carbide-derived carbon as the positive electrode - A comparison of cells with graphite and Li4Ti5O12 as the negative electrode

NASA Astrophysics Data System (ADS)

Rauhala, Taina; Leis, Jaan; Kallio, Tanja; Vuorilehto, Kai

2016-11-01

The use of carbide-derived carbon (CDC) as the positive electrode material for lithium-ion capacitors (LICs) is investigated. CDC based LIC cells are studied utilizing two different negative electrode materials: graphite and lithium titanate Li4Ti5O12 (LTO). The graphite electrodes are prelithiated before assembling the LICs, and LTO containing cells are studied with and without prelithiation. The rate capability and cycle life stability during 1000 cycles are evaluated by galvanostatic cycling at current densities of 0.4-4 mA cm-2. The CDC shows a specific capacitance of 120 F g-1 in the organic lithium-containing electrolyte, and the LICs demonstrate a good stability over 1000 charge-discharge cycles. The choice of the negative electrode is found to have an effect on the utilization of the CDC positive electrode during cycling and on the specific energy of the device. The graphite/CDC cell delivers a maximum specific discharge energy of 90 Wh kg-1 based on the total mass of active material in the cell. Both the prelithiated and non-prelithiated LTO/CDC cells show a specific energy of around 30 Wh kg-1.

Portable Brain-Computer Interface for the Intensive Care Unit Patient Communication Using Subject-Dependent SSVEP Identification.

PubMed

Dehzangi, Omid; Farooq, Muhamed

2018-01-01

A major predicament for Intensive Care Unit (ICU) patients is inconsistent and ineffective communication means. Patients rated most communication sessions as difficult and unsuccessful. This, in turn, can cause distress, unrecognized pain, anxiety, and fear. As such, we designed a portable BCI system for ICU communications (BCI4ICU) optimized to operate effectively in an ICU environment. The system utilizes a wearable EEG cap coupled with an Android app designed on a mobile device that serves as visual stimuli and data processing module. Furthermore, to overcome the challenges that BCI systems face today in real-world scenarios, we propose a novel subject-specific Gaussian Mixture Model- (GMM-) based training and adaptation algorithm. First, we incorporate subject-specific information in the training phase of the SSVEP identification model using GMM-based training and adaptation. We evaluate subject-specific models against other subjects. Subsequently, from the GMM discriminative scores, we generate the transformed vectors, which are passed to our predictive model. Finally, the adapted mixture mean scores of the subject-specific GMMs are utilized to generate the high-dimensional supervectors. Our experimental results demonstrate that the proposed system achieved 98.7% average identification accuracy, which is promising in order to provide effective and consistent communication for patients in the intensive care.
Road map to Title I of the Public Utility Regulatory Policies Act of 1978

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

Partridge, W.

1979-01-18

Within the next two years all electric utilities retailing over 500 million kilowatts per year will be forced into rate-making proceedings or public hearings to meet the requirements of Title I of the Public Utility Regulatory Policies Act of 1978. In these proceedings they will be required to consider the application of Federal requirements for lifeline rates, class rates based on cost of service, declining block rates, time-of-day rates, seasonal rates, interruptible rates, load management techniques, prohibitions on master metering, restrictions on use of automatic adjustment clauses, provision of consumer information, termination procedures, and restrictions on advertising. The act hasmore » immediate, significant implications for electric utility management.« less
In situ characterization of charge rate dependent stress and structure changes in V2O5 cathode prepared by atomic layer deposition

NASA Astrophysics Data System (ADS)

Jung, Hyun; Gerasopoulos, Konstantinos; Talin, A. Alec; Ghodssi, Reza

2017-02-01

The insertion/extraction of lithium into/from various host materials is the basic process by which lithium-ion batteries reversible store charge. This process is generally accompanied by strain in the host material, inducing stress which can lead to capacity loss. Therefore, understanding of both the structural changes and the associated stress - investigated almost exclusively separate to date - is a critical factor for developing high-performance batteries. Here, we report an in situ method, which utilizes Raman spectroscopy in parallel with optical interferometry to study effects of varying charging rates (C-rates) on the structure and stress in a V2O5 thin film cathode. Abrupt stress changes at specific crystal phase transitions in the Lisbnd Vsbnd O system are observed and the magnitude of the stress changes with the amount of lithium inserted into the electrode are correlated. A linear increase in the stress as a function of x in LixV2O5 is observed, indicating that C-rate does not directly contribute to larger intercalation stress. However, a more rapid increase in disorder within the LixV2O5 layers is correlated with higher C-rate. Ultimately, these experiments demonstrate how the simultaneous stress/Raman in situ approach can be utilized as a characterization platform for investigating various critical factors affecting lithium-ion battery performance.
Learning from the implementation of residential optional time of use pricing in the United States electricity industry

NASA Astrophysics Data System (ADS)

Li, Xibao

Residential time-of-use (TOU) rates have been in practice in the U.S. since the 1970s. However, for institutional, political, and regulatory reasons, only a very small proportion of residential customers are actually on these schedules. In this thesis, I explore why this is the case by empirically investigating two groups of questions: (1) On the "supply" side: Do utilities choose to offer TOU rates in residential sectors on their own initiative if state commissions do not order them to do so? Since utilities have other options, what is the relationship between the TOU rate and other alternatives? To answer these questions, I survey residential tariffs offered by more than 100 major investor-owned utilities, study the impact of various factors on utilities' rate-making behavior, and examine utility revealed preferences among four rate options: seasonal rates, inverted block rates, demand charges, and TOU rates. Estimated results suggest that the scale of residential sectors and the revenue contribution from residential sectors are the only two significant factors that influence utility decisions on offering TOU rates. Technical and economic considerations are not significant statistically. This implies that the little acceptance of TOU rates is partly attributed to utilities' inadequate attention to TOU rate design. (2) On the "demand" side: For utilities offering TOU tariffs, why do only a very small proportion of residential customers choose these tariffs? What factors influence customer choices? Unlike previous studies that used individual-level experimental data, this research employs actual aggregated information from 29 utilities offering optional TOU rates. By incorporating neo-classical demand analysis into an aggregated random coefficient logit model, I investigate the impact of both price and non-price tariff characteristics and non-tariff factors on customer choice behavior. The analysis indicates that customer pure tariff preference (which captures the effect of all unincluded factors) is a crucial obstacle to the public acceptance of TOU tariffs. Besides rate levels, non-price tariff characteristics and non-tariff factors are also important in influencing customer choice. It is observed that high income home owners have very different preferences than others.
DOE Office of Scientific and Technical Information (OSTI.GOV)

None

This bibliography provides documentation for use by state public utility commissions and major nonregulated utilities in evaluating the applicability of a wide range of electric utility rate design and regulatory concepts in light of certain regulatory objectives. Part I, Utility Regulatory Objectives, contains 2084 citations on conservation of energy and capital; efficient use of facilities and resources; and equitable rates to electricity consumers. Part II, Rate Design Concepts, contains 1238 citations on time-of-day rates; seasonally-varying rates; cost-of-service rates; interruptible rates (including the accompanying use of load management techniques); declining block rates; and lifeline rates. Part III, Regulatory Concepts, contains 1282more » references on restrictions on master metering; procedures for review of automatic adjustment clauses; prohibitions of rate or regulatory discrimination against solar, wind, or other small energy systems; treatment of advertising expenses; and procedures to protect ratepayers from abrupt termination of service.« less
Areas with High Rates of Police-Reported Violent Crime Have Higher Rates of Childhood Asthma Morbidity.

PubMed

Beck, Andrew F; Huang, Bin; Ryan, Patrick H; Sandel, Megan T; Chen, Chen; Kahn, Robert S

2016-06-01

To assess whether population-level violent (and all) crime rates were associated with population-level child asthma utilization rates and predictive of patient-level risk of asthma reutilization after a hospitalization. A retrospective cohort study of 4638 pediatric asthma-related emergency department visits and hospitalizations between 2011 and 2013 was completed. For population-level analyses, census tract asthma utilization rates were calculated by dividing the number of utilization events within a tract by the child population. For patient-level analyses, hospitalized patients (n = 981) were followed until time of first asthma-related reutilization. The primary predictor was the census tract rate of violent crime as recorded by the police; the all crime (violent plus nonviolent) rate was also assessed. Census tract-level violent and all crime rates were significantly correlated with asthma utilization rates (both P < .0001). The violent crime rate explained 35% of the population-level asthma utilization variance and remained associated with increased utilization after adjustment for census tract poverty, unemployment, substandard housing, and traffic exposure (P = .002). The all crime rate explained 28% of the variance and was similarly associated with increased utilization after adjustment (P = .02). Hospitalized children trended toward being more likely to reutilize if they lived in higher violent (P = .1) and all crime areas (P = .01). After adjustment, neither relationship was significant. Crime data could help facilitate early identification of potentially toxic stressors relevant to the control of asthma for populations and patients. Copyright © 2016 Elsevier Inc. All rights reserved.
Areas with high rates of police-reported violent crime have higher rates of childhood asthma morbidity

PubMed Central

Beck, Andrew F.; Huang, Bin; Ryan, Patrick H.; Sandel, Megan T.; Chen, Chen; Kahn, Robert S.

2016-01-01

Objectives To assess whether population-level violent (and all) crime rates were associated with population-level child asthma utilization rates and predictive of patient-level risk of asthma reutilization after a hospitalization. Study design A retrospective cohort study of 4,638 pediatric asthma-related emergency department visits and hospitalizations between 2011 and 2013 was completed. For population-level analyses, census tract asthma utilization rates were calculated by dividing the number of utilization events within a tract by the child population. For patient-level analyses, hospitalized patients (n=981) were followed until time of first asthma-related reutilization. The primary predictor was the census tract rate of violent crime as recorded by the police; the all crime (violent plus non-violent) rate was also assessed. Results Census tract-level violent and all crime rates were significantly correlated with asthma utilization rates (both p<.0001). The violent crime rate explained 35% of the population-level asthma utilization variance and remained associated with increased utilization after adjustment for census tract poverty, unemployment, substandard housing, and traffic exposure (p=.002). The all crime rate explained 28% of the variance and was similarly associated with increased utilization after adjustment (p=.02). Hospitalized children trended toward being more likely to reutilize if they lived in higher violent (p=.1) and all crime areas (p=.01). After adjustment, neither relationship was significant. Conclusions Crime data could help facilitate early identification of potentially toxic stressors relevant to the control of asthma for populations and patients. PMID:26960918
Sizing Single Cantilever Beam Specimens for Characterizing Facesheet/Core Peel Debonding in Sandwich Structure

NASA Technical Reports Server (NTRS)

Ratcliffe, James G.

2010-01-01

This paper details part of an effort focused on the development of a standardized facesheet/core peel debonding test procedure. The purpose of the test is to characterize facesheet/core peel in sandwich structure, accomplished through the measurement of the critical strain energy release rate associated with the debonding process. The specific test method selected for the standardized test procedure utilizes a single cantilever beam (SCB) specimen configuration. The objective of the current work is to develop a method for establishing SCB specimen dimensions. This is achieved by imposing specific limitations on specimen dimensions, with the objectives of promoting a linear elastic specimen response, and simplifying the data reduction method required for computing the critical strain energy release rate associated with debonding. The sizing method is also designed to be suitable for incorporation into a standardized test protocol. Preliminary application of the resulting sizing method yields practical specimen dimensions.
Lot quality assurance sampling for monitoring immunization programmes: cost-efficient or quick and dirty?

PubMed

Sandiford, P

1993-09-01

In recent years Lot quality assurance sampling (LQAS), a method derived from production-line industry, has been advocated as an efficient means to evaluate the coverage rates achieved by child immunization programmes. This paper examines the assumptions on which LQAS is based and the effect that these assumptions have on its utility as a management tool. It shows that the attractively low sample sizes used in LQAS are achieved at the expense of specificity unless unrealistic assumptions are made about the distribution of coverage rates amongst the immunization programmes to which the method is applied. Although it is a very sensitive test and its negative predictive value is probably high in most settings, its specificity and positive predictive value are likely to be low. The implications of these strengths and weaknesses with regard to management decision-making are discussed.
Juvenile Psychopathic Personality Traits are Associated with Poor Reading Achievement

PubMed Central

DeLisi, Matt; Beaver, Kevin M.; Wexler, Jade; Barth, Amy; Fletcher, Jack

2011-01-01

The current study sought to further the understanding of the linkage between maladaptive behavior and cognitive problems by examining the relations between psychopathic personality traits and reading comprehension performance. Data were derived from a study of 432 predominately African-American and Hispanic middle-school students. Dependent variables consisted of three measures of reading comprehension. Psychopathy measures included the Inventory of Callous-Unemotional traits (ICU—teacher rated) and the self-reported Youth Psychopathic traits Inventory (YPI). Findings from regression models indicated that self-report and teacher ratings of psychopathy were statistically significant inverse predictors of reading performance. Specifically, affective facets of psychopathy were potent predictors of reading comprehension over and above ADHD, IQ, and an impulsivity component of psychopathy. Study results extend the utility of psychopathy construct generally and affective traits specifically to reading achievement, which has broad implications. Findings are discussed with respect to future research and prevention. PMID:20957434
Identification of reduced-order thermal therapy models using thermal MR images: theory and validation.

PubMed

Niu, Ran; Skliar, Mikhail

2012-07-01

In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate.
Size-Dependent Specific Surface Area of Nanoporous Film Assembled by Core-Shell Iron Nanoclusters

DOE PAGES

Antony, Jiji; Nutting, Joseph; Baer, Donald R.; ...

2006-01-01

Nmore » anoporous films of core-shell iron nanoclusters have improved possibilities for remediation, chemical reactivity rate, and environmentally favorable reaction pathways. Conventional methods often have difficulties to yield stable monodispersed core-shell nanoparticles. We produced core-shell nanoclusters by a cluster source that utilizes combination of Fe target sputtering along with gas aggregations in an inert atmosphere at 7 ∘ C . Sizes of core-shell iron-iron oxide nanoclusters are observed with transmission electron microscopy (TEM). The specific surface areas of the porous films obtained from Brunauer-Emmett-Teller (BET) process are size-dependent and compared with the calculated data.« less
Energy utilization rates during shuttle extravehicular activities.

PubMed

Waligora, J M; Kumar, K V

1995-01-01

The work rates or energy utilization rates during EVA are major factors in sizing of life support systems. These rates also provide a measure of ease of EVA and its cost in crew fatigue. From the first Shuttle EVA on the STS-6 mission in 1983, we have conducted 59 man-EVA and 341 man-hours of EVA. Energy utilization rates have been measured on each of these EVA. Metabolic rate was measured during each EVA using oxygen utilization corrected for suit leakage. From 1981-1987, these data were available for average data over the EVA or over large segments of the EVA. Since 1987, EVA oxygen utilization data were available at 2-minute intervals. The average metabolic rate on Shuttle EVA (194 kcal/hr.) has been significantly lower than metabolic rates during Apollo and Skylab missions. Peak rates have been below design levels, infrequent, and of short duration. The data suggest that the energy cost of tasks may be inversely related to the degree of training for the task. The data provide insight on the safety margins provided by life support designs and on the energy cost of Station construction EVA.
State formulating lifeline program

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

Not Available

1978-09-01

The Board of Public Utilities (BPU) of New Jersey is formulating a lifeline program which would provide low-income and elderly customers with reduced utility rates. It is estimated that 30% of the households in New Jersey will qualify for the program. While the legislation calls for the lowest effective rate of any customer class, each utility would have its own lifeline program because of differing rates among utility companies. Eligibility requirements would be applied statewide. The utilities will fund the new program by restructuring the existing rates for regular customers. In which case lifeline recipients' rate would decrease while regularmore » customers' bills would increase. Eventually, the BPU expects to fund about 10% of the senior citizens' portion of the program with the state's casino gambling revenues.« less
Inpatients hypospadias care: trends and outcomes from the American nationwide inpatient sample.

PubMed

Meyer, Christian; Sukumar, Shyam; Sood, Akshay; Hanske, Julian; Vetterlein, Malte; Elder, Jack S; Fisch, Margit; Trinh, Quoc-Dien; Friedman, Ariella A

2015-08-01

Hypospadias is the most common congenital penile anomaly. Information about current utilization patterns of inpatient hypospadias repair as well as complication rates remain poorly evaluated. The Nationwide Inpatient Sample was used to identify all patients undergoing inpatient hypospadias repair between 1998 and 2010. Patient and hospital characteristics were attained and outcomes of interest included intra- and immediate postoperative complications. Utilization was evaluated temporally and also according to patient and hospital characteristics. Predictors of complications and excess length of stay were evaluated by logistic regression models. A weighted 10,201 patients underwent inpatient hypospadias repair between 1998 and 2010. Half were infants (52.2%), and were operated in urban and teaching hospitals. Trend analyses demonstrated a decline in incidence of inpatient hypospadias repair (estimated annual percentage change, -6.80%; range, -0.51% to -12.69%; p=0.037). Postoperative complication rate was 4.9% and most commonly wound-related. Hospital volume was inversely related to complication rates. Specifically, higher hospital volume (>31 cases annually) was the only variable associated with decreased postoperative complications. Inpatient hypospadias repair have substantially decreased since the late 1990's. Older age groups and presumably more complex procedures constitute most of the inpatient procedures nowadays.
Application of a single area array detector for acquistion, tracking and point-ahead in space optical communications

NASA Technical Reports Server (NTRS)

Clark, D. L.; Cosgrove, M.; Vanvranken, R.; Park, H.; Fitzmaurice, M.

1989-01-01

Functions of acquisition, tracking, and point-ahead in space optical communications are being combined into a single system utilizing an area array detector. An analysis is presented of the feasibility concept. The key parameters are: optical power less than 1 pW at 0.86 micrometer, acquisition in less than 30 seconds in an acquisition field of view (FOV) of 1 mrad, tracking with 0.5 microrad rms noise at 1000 Hz update rate, and point ahead transfer function precision of 0.25 microrad over a region of 150 microrad. Currently available array detectors were examined. The most demanding specifications are low output noise, a high detection efficiency, a large number of pixels, and frame rates over 1kHz. A proof of concept (POC) demonstration system is currently being built utilizing the Kodak HS-40 detector (a 128 x 128 photodiode array with a 64 channel CCD readout architecture which can be operated at frame rates as high as 40,000/sec). The POC system implements a windowing scheme and special purpose digital signal processing electronic for matched filter acquisition and tracking algorithms.
Novel hierarchically porous carbon materials obtained from natural biopolymer as host matrixes for lithium-sulfur battery applications.

PubMed

Zhang, Bin; Xiao, Min; Wang, Shuanjin; Han, Dongmei; Song, Shuqin; Chen, Guohua; Meng, Yuezhong

2014-08-13

Novel hierarchically porous carbon materials with very high surface areas, large pore volumes and high electron conductivities were prepared from silk cocoon by carbonization with KOH activation. The prepared novel porous carbon-encapsulated sulfur composites were fabricated by a simple melting process and used as cathodes for lithium sulfur batteries. Because of the large surface area and hierarchically porous structure of the carbon material, soluble polysulfide intermediates can be trapped within the cathode and the volume expansion can be alleviated effectively. Moreover, the electron transport properties of the carbon materials can provide an electron conductive network and promote the utilization rate of sulfur in cathode. The prepared carbon-sulfur composite exhibited a high specific capacity and excellent cycle stability. The results show a high initial discharge capacity of 1443 mAh g(-1) and retain 804 mAh g(-1) after 80 discharge/charge cycles at a rate of 0.5 C. A Coulombic efficiency retained up to 92% after 80 cycles. The prepared hierarchically porous carbon materials were proven to be an effective host matrix for sulfur encapsulation to improve the sulfur utilization rate and restrain the dissolution of polysulfides into lithium-sulfur battery electrolytes.
The diagnostic utility of the Rarely Missed Index of the Wechsler Memory Scale-Third Edition in detecting response bias in an adult male incarcerated setting.

PubMed

D'Amato, Christopher P; Denney, Robert L

2008-09-01

The purpose of this study was to utilize a known-group research design to evaluate the diagnostic utility of the Rarely Missed Index (RMI) of the Wechsler Memory Scale-Third Edition [Wechsler, D. (1997). Wechsler Adult Intelligence Test-3rd Edition. San Antonio, TX: The Psychological Corporation] in assessing response bias in an adult male incarcerated setting. Archival data from a sample of 60 adult male inmates who presented for neuropsychological testing were reviewed. Evaluees were assigned to one of two groups; probable malingerers (PM; n=30) and a group of valid test responders (n=30) (1999). Using the recommended cut-off score of 136 or less, the sensitivity of the RMI was extremely low at 33%. Its specificity was 83%. The positive predictive power of the RMI with the published base rate of 22.8 was 38%; with a negative predictive power of 81%. The positive predictive power of the RMI with a published base rate of 70.5 was 82%. The negative predictive power using a base rate of 70.5% was 34%. Results of the receiver operating characteristics (ROC) analysis indicated that the RMI score with a cut-off 136 or less performed only slightly better than chance in delineating probable malingerers from valid responders in this setting. Overall, the findings suggest that the RMI may not be a reliable index for detecting response bias in this setting and perhaps in similar settings.
Assessment of depression in epilepsy: the utility of common and disease-specific self-report depression measures.

PubMed

Strober, Lauren B; Chapin, Jessica; Spirou, Angela; Tesar, George; Viguera, Adele; Najm, Imad; Busch, Robyn M

2018-05-01

Depression is common in epilepsy, with rates ranging from 20 to 55% in most samples and reports as high as 70% in patients with intractable epilepsy. However, some contend that depression may be over- and/or under-reported and treated in this population. This may be due to the use of common self-report depression measures that fail to take into account the overlap of disease and depressive symptoms and also the host of side effects associated with antiepileptic medication, which may also be construed as depression. The present study examined the utility of common self-report depression measures and those designed specifically for the medically ill, including a proposed new measure, to determine which may be more appropriate for use among people with epilepsy. We found that common self-report depression measures are useful for screening depression in epilepsy, particularly with a raised cutoff for one, with sensitivities ranging from .91 to .96. A measure designed for the medically ill obtained the greatest specificity of .91, suggesting its use as a diagnostic tool with a slightly raised cutoff. The positive likelihood ratio of this latter measure was 8.76 with an overall classification accuracy of 88%. Assessment of depression in epilepsy can be improved when utilizing self-report measures that better differentiate disease symptoms from neurovegetative symptoms of depression (e.g. fatigue, sleep disturbance). This was demonstrated in the present study. Clinical implications are discussed.
Mental health, concurrent disorders, and health care utilization in homeless women.

PubMed

Strehlau, Verena; Torchalla, Iris; Kathy, Li; Schuetz, Christian; Krausz, Michael

2012-09-01

This study assessed lifetime and current prevalence rates of mental disorders and concurrent mental and substance use disorders in a sample of homeless women. Current suicide risk and recent health service utilization were also examined in order to understand the complex mental health issues of this population and to inform the development of new treatment strategies that better meet their specific needs. A cross-sectional survey of 196 adult homeless women in three different Canadian cities was done. Participants were assessed using DSM-IV-based structured clinical interviews. Current diagnoses were compared to available mental health prevalence rates in the Canadian female general population. Current prevalence rates were 63% for any mental disorder, excluding substance use disorders; 17% for depressive episode; 10% for manic episode; 7% for psychotic disorder; 39% for anxiety disorders, 28% for posttraumatic stress disorder; and 19% for obsessive-compulsive disorder; 58% had concurrent substance dependence and mental disorders. Lifetime prevalence rates were notably higher. Current moderate or high suicide risk was found in 22% of the women. Participants used a variety of health services, especially emergency rooms, general practitioners, and walk-in clinics. Prevalence rates of mental disorders among homeless participants were substantially higher than among women from the general Canadian population. The percentage of participants with moderate or high suicide risk and concurrent disorders indicates a high severity of mental health symptomatology. Treatment and housing programs need to be accompanied by multidisciplinary, specialized interventions that account for high rates of complex mental health conditions.

Anaerobic degradation of aircraft deicing fluid (ADF) in upflow anaerobic sludge blanket (UASB) reactors and the fate of ADF additives

NASA Astrophysics Data System (ADS)

Pham, Thi Tham

2002-11-01

A central composite design was employed to methodically investigate anaerobic treatment of aircraft deicing fluid (ADF) in bench-scale Upflow Anaerobic Sludge Blanket (UASB) reactors. A total of 23 runs at 17 different operating conditions were conducted in continuous mode. The development of four empirical models describing process responses (i.e., chemical oxygen demand (COD) removal efficiency, biomass specific acetoclastic activity, methane production rate, and methane production potential) as functions of ADF concentration, hydraulic retention time (HRT), and biomass concentration is presented. Model verification indicated that predicted responses (COD removal efficiencies, biomass specific acetoclastic activity, and methane production rates and potential) were in good agreement with experimental results. Biomass specific acetoclastic activity was improved by almost two-fold during ADF treatment in UASB reactors. For the design window, COD removal efficiencies were higher than 90%. Predicted methane production potentials were close to theoretical values, and methane production rates increased as the organic loading rate (OLR) was increased. ADF toxicity effects were evident for 1.6% ADF at medium specific organic loadings (SOLR above 0.5 g COD/g VSS/d). In contrast, good reactor stability and excellent removal efficiencies were achieved at 1.2% ADF for reactor loadings approaching that of highly loaded systems (0.73 g COD/g VSS/d). Acclimation to ADF resulted in an initial reduction in the biomass settling velocity. The fate of ADF additives was also investigated. There was minimal sorption of benzotriazole (BT), 5-methyl-1 H-benzotriazole (MeBT), and 5,6-dimethyl-1 H-benzotriazole (DiMeBT) to anaerobic granules. A higher sorption capacity was measured for NP. Active transport may be one of the mechanisms for NP sorption. Ethylene glycol degradation experiments indicated that BT, MeBT, DiMeBT, and the nonionic surfactant Tergitol NP-4 had no significant effects on acidogenesis and methanogenesis at the concentration levels studied. A significant inhibition of acetoclastic activity was observed for NP at 100 mg/L, with acetic acid consumption rate at 38% of that for controls. No evidence for anaerobic degradation of benzotriazole and its derivatives was observed; however, both batch and continuous experiments suggested that anaerobic degradation of NP occurred. Kinetic analysis of operational data obtained for the anaerobic treatment of ADF in UASB reactors indicated that the substrate utilization rate was independent of the reactor biomass concentration. The maximum rate of substrate utilization and the half-velocity constants for ADF treatment were 28.4 g COD/L/d and 648 mg COD/L, respectively. For 1.2% ADF, the biomass yield and endogenous decay coefficients were 0.027 g VSS/g COD and 0.012 d-1 , respectively.
Photovoltaic-system evaluation at the Northeast Residential Experiment Station

NASA Astrophysics Data System (ADS)

Russell, M. C.

1983-01-01

Five residential photovoltaic systems were tested and the systems' performance and cost was evaluated. The five systems each consist of an unoccupied structure employing a roof mounted photovoltaic array and a utility connected power inverter capable of sending excess PV generated energy to the local utility system. The photovoltaic systems are designed to meet at least 50% of the total annual electrical demand of residences in the cold climate regions of the country. The following specific issues were investigated: photovoltaic array and inverter system power rating and performance characterization, system energy production, reliability and system cost/worth. Summary load data from five houses in the vicinity of the Northeast Residential Experiment Station, and meteorological data from the station's weather station are also presented.
NREL/SCE High Penetration PV Integration Project: FY13 Annual Report

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

Mather, B. A.; Shah, S.; Norris, B. L.

2014-06-01

In 2010, the National Renewable Energy Laboratory (NREL), Southern California Edison (SCE), Quanta Technology, Satcon Technology Corporation, Electrical Distribution Design (EDD), and Clean Power Research (CPR) teamed to analyze the impacts of high penetration levels of photovoltaic (PV) systems interconnected onto the SCE distribution system. This project was designed specifically to benefit from the experience that SCE and the project team would gain during the installation of 500 megawatts (MW) of utility-scale PV systems (with 1-5 MW typical ratings) starting in 2010 and completing in 2015 within SCE's service territory through a program approved by the California Public Utility Commissionmore » (CPUC). This report provides the findings of the research completed under the project to date.« less
Evaluation of the utility of conventional polymerase chain reaction for detection and species differentiation in human hookworm infections.

PubMed

Chidambaram, Meenachi; Parija, Subhash Chandra; Toi, Pampa Ch; Mandal, Jharna; Sankaramoorthy, Dhanalakshmi; George, Santosh; Natarajan, Mailan; Padukone, Shashiraja

2017-01-01

Human hookworm infection is caused mainly by Necator americanus and Ancylostoma duodenale . Among the zoonotic hookworm species, only Ancylostoma ceylanicum causes potent human infections where dogs and cats act as reservoir of infection. Hence, species differentiation is imperative because the eradication of both anthroponotic and zoonotic hookworm depends on the concurrent human and animal health programs, hygienic practices, and mass drug administration for humans and dogs. This study was performed to evaluate the utility of polymerase chain reaction (PCR) for detection of hookworm infections. A total of 209 stool samples were collected and subjected to stool microscopy, Kato-Katz method to identify the intensity of the infection, coproculture for L3 larval identification and species differentiation and semi-nested PCR with sequencing. The prevalence of hookworm was estimated as 7.6%. Highest hookworm prevalence was seen in 20-30 years of age group. Majority of the infections were mild intensity infections. Sensitivity of stool microscopy was found to be 81.2% and the specificity was 100%. Sensitivity of Kato-Katz method was 87.5% and specificity was 100%. True positivity by agar plate culture was 83.3% and false positivity rate was 16.6%. Stool microscopy is the major mode of detection, but it has a higher false negative rate. Coproculture is time-consuming and needs the expertise to differentiate the species. On the other hand, PCR is known to be a sensitive, specific, and a reliable investigative tool which can help in diagnosis as well as in species differentiation.
Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers.

PubMed

Fortes, Matthew B; Owen, Julian A; Raymond-Barker, Philippa; Bishop, Claire; Elghenzai, Salah; Oliver, Samuel J; Walsh, Neil P

2015-03-01

Dehydration in older adults contributes to increased morbidity and mortality during hospitalization. As such, early diagnosis of dehydration may improve patient outcome and reduce the burden on healthcare. This prospective study investigated the diagnostic accuracy of routinely used physical signs, and noninvasive markers of hydration in urine and saliva. Prospective diagnostic accuracy study. Hospital acute medical care unit and emergency department. One hundred thirty older adults [59 males, 71 females, mean (standard deviation) age = 78 (9) years]. Participants with any primary diagnosis underwent a hydration assessment within 30 minutes of admittance to hospital. Hydration assessment comprised 7 physical signs of dehydration [tachycardia (>100 bpm), low systolic blood pressure (<100 mm Hg), dry mucous membrane, dry axilla, poor skin turgor, sunken eyes, and long capillary refill time (>2 seconds)], urine color, urine specific gravity, saliva flow rate, and saliva osmolality. Plasma osmolality and the blood urea nitrogen to creatinine ratio were assessed as reference standards of hydration with 21% of participants classified with water-loss dehydration (plasma osmolality >295 mOsm/kg), 19% classified with water-and-solute-loss dehydration (blood urea nitrogen to creatinine ratio >20), and 60% classified as euhydrated. All physical signs showed poor sensitivity (0%-44%) for detecting either form of dehydration, with only low systolic blood pressure demonstrating potential utility for aiding the diagnosis of water-and-solute-loss dehydration [diagnostic odds ratio (OR) = 14.7]. Neither urine color, urine specific gravity, nor saliva flow rate could discriminate hydration status (area under the receiver operating characteristic curve = 0.49-0.57, P > .05). In contrast, saliva osmolality demonstrated moderate diagnostic accuracy (area under the receiver operating characteristic curve = 0.76, P < .001) to distinguish both dehydration types (70% sensitivity, 68% specificity, OR = 5.0 (95% confidence interval 1.7-15.1) for water-loss dehydration, and 78% sensitivity, 72% specificity, OR = 8.9 (95% confidence interval 2.5-30.7) for water-and-solute-loss dehydration). With the exception of low systolic blood pressure, which could aid in the specific diagnosis of water-and-solute-loss dehydration, physical signs and urine markers show little utility to determine if an elderly patient is dehydrated. Saliva osmolality demonstrated superior diagnostic accuracy compared with physical signs and urine markers, and may have utility for the assessment of both water-loss and water-and-solute-loss dehydration in older individuals. It is particularly noteworthy that saliva osmolality was able to detect water-and-solute-loss dehydration, for which a measurement of plasma osmolality would have no diagnostic utility. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Differences in metabolite-mediated toxicity of tamoxifen in rodents versus humans elucidated with DNA/microsome electro-optical arrays and nanoreactors.

PubMed

Zhao, Linlin; Krishnan, Sadagopan; Zhang, Yun; Schenkman, John B; Rusling, James F

2009-02-01

Tamoxifen, a therapeutic and chemopreventive breast cancer drug, was chosen as a model compound because of acknowledged species specific toxicity differences. Emerging approaches utilizing electro-optical arrays and nanoreactors based on DNA/microsome films were used to compare metabolite-mediated toxicity differences of tamoxifen in rodents versus humans. Hits triggered by liver enzyme metabolism were first provided by arrays utilizing a DNA damage end point. The arrays feature thin-film spots containing an electrochemiluminescent (ECL) ruthenium polymer ([Ru(bpy)(2)PVP(10)](2+); PVP, polyvinylpyridine), DNA, and liver microsomes. When DNA damage resulted from reactions with tamoxifen metabolites, it was detected by an increase in light from the oxidation of the damaged DNA by the ECL metallopolymer. The slope of ECL generation versus enzyme reaction time correlated with the rate of DNA damage. An approximate 2-fold greater ECL turnover rate was observed for spots with rat liver microsomes compared to that with human liver microsomes. These results were supported by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis of reaction products using nanoreactors featuring analogous films on silica nanoparticles, allowing the direct measurement of the relative formation rate for alpha-(N(2)-deoxyguanosinyl)tamoxifen. We observed 2-5-fold more rapid formation rates for three major metabolites, i.e., alpha-hydroxytamoxifen, 4-hydroxytamoxifen, and tamoxifen N-oxide, catalyzed by rat liver microsomes compared to human liver microsomes. Comparable formation rates were observed for N-desmethyl tamoxifen with rat and human liver microsomes. A better detoxifying capacity for human liver microsomes than rat liver microsomes was confirmed utilizing glucuronyltransferase in microsomes together with UDP-glucuronic acid. Taken together, lower genotoxicity and higher detoxication rates presented by human liver microsomes correlate with the lower risk of tamoxifen in causing liver carcinoma in humans, provided the glucuronidation pathway is active.
Methods for measuring utilization of mental health services in two epidemiologic studies

PubMed Central

NOVINS, DOUGLAS K.; BEALS, JANETTE; CROY, CALVIN; MANSON, SPERO M.

2015-01-01

Objectives of Study Psychiatric epidemiologic studies often include two or more sets of questions regarding service utilization, but the agreement across these different questions and the factors associated with their endorsement have not been examined. The objectives of this study were to describe the agreement of different sets of mental health service utilization questions that were included in the American Indian Service Utilization Psychiatric Epidemiology Risk and Protective Factors Project (AI-SUPERPFP), and compare the results to similar questions included in the baseline National Comorbidity Survey (NCS). Methods Responses to service utilization questions by 2878 AI-SUPERPFP and 5877 NCS participants were examined by calculating estimates of service use and agreement (κ) across the different sets of questions. Logistic regression models were developed to identify factors associated with endorsement of specific sets of questions. Results In both studies, estimates of mental health service utilization varied across the different sets of questions. Agreement across the different question sets was marginal to good (κ = 0.27–0.69). Characteristics of identified service users varied across the question sets. Limitations Neither survey included data to examine the validity of participant responses to service utilization questions. Recommendations for Further Research Question wording and placement appear to impact estimates of service utilization in psychiatric epidemiologic studies. Given the importance of these estimates for policy-making, further research into the validity of survey responses as well as impacts of question wording and context on rates of service utilization is warranted. PMID:18767205
Experiences of Vulnerable Residential Customer Subpopulations with Critical Peak Pricing

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

Cappers, Peter; Spurlock, C. Anna; Todd, Annika

DOE decided to co-fund ten utilities to undertake eleven experimentally-designed Consumer Behavior Studies (CBS) that proposed to examine a wide range of the topics of interest to the electric utility industry. Each chosen utility was to design, implement and evaluate their own study in order to address questions of interest both to itself and to its applicable regulatory authority, whose approval was generally necessary for the study to proceed. The DOE Office of Energy Delivery and Electricity Reliability (OE), however, did set guidelines, both in the FOA and subsequently during the contracting period, for what would constitute an acceptable studymore » under the Grant. To assist in ensuring these guidelines were adhered to, OE requested that LBNL act as project manager for these Consumer Behavior Studies to achieve consistency of experimental design and adherence to data collection and reporting protocols across the ten utilities. As part of its role, LBNL formed technical advisory groups (TAG) to separately assist each of the utilities by providing technical assistance in all aspects of the design, implementation and evaluation of their studies. LBNL was also given a unique opportunity to perform a comprehensive, cross-study analysis that uses the customer-level interval meter and demographic data made available by these utilities due to SGIG-imposed reporting requirements, in order to analyze critical policy issues associated with AMI-enabled rates and control/information technology. LBNL will publish the results of these analyses in a series of research reports, of which this is one, that attempt to address critical policy issues relating to a variety of topics including customer acceptance, retention and load response to time-based rates and various forms of enabling control and information technologies. This report extends the existing empirical literature on the experiences of low-income customers exposed to critical peak pricing, and provides the first glimpses into the experiences of the elderly and those who reported being chronically ill. Specifically, we analyzed two of the time-based rate consumer behavior studies, which were co-funded by the Department of Energy as part of the Smart Grid Investment Grant program.« less
Full-dimensional quantum dynamics study on the mode-specific unimolecular dissociation reaction of HFCO

NASA Astrophysics Data System (ADS)

Yamamoto, Takeshi; Kato, Shigeki

2000-05-01

The mode specificity of the unimolecular reaction of HFCO is studied by six-dimensional quantum dynamics calculations. The energy and mode dependency of the dissociation rate is examined by propagating a number of wave packets with a small energy dispersion representing highly excited states with respect to a specific vibrational mode. The wave packets are generated by applying a set of filter operators onto a source vibrational state. All the information necessary for propagating the wave packets is obtained from a single propagation of the source state, thus allowing a significant decrease of computational effort. The relevant spectral peaks are assigned using the three-dimensional CH chromophore Hamiltonian. The resulting dissociation rate of the CH stretching excited state is in agreement with that obtained from a statistical theory, while the rates of the out-of-plane bending excited states are about one order of magnitude smaller than the statistical rates. A local-mode analysis also shows that the relaxation of the out-of-plane excitation proceeds very slowly within 3 ps. These results clearly indicate weak couplings of the out-of-plane bending excited states with other in-plane vibrational states, which is in qualitative agreement with experimental findings. From a computational point of view, a parallel supercomputer is utilized efficiently to handle an ultra large basis set of an order of 108, and 200 Gflops rate on average is achieved in the dynamics calculations.
Calibration of polyurethane foam (PUF) disk passive air samplers for quantitative measurement of polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs): factors influencing sampling rates.

PubMed

Hazrati, Sadegh; Harrad, Stuart

2007-03-01

PUF disk passive air samplers are increasingly employed for monitoring of POPs in ambient air. In order to utilize them as quantitative sampling devices, a calibration experiment was conducted. Time integrated indoor air concentrations of PCBs and PBDEs were obtained from a low volume air sampler operated over a 50 d period alongside the PUF disk samplers in the same office microenvironment. Passive sampling rates for the fully-sheltered sampler design employed in our research were determined for the 51 PCB and 7 PBDE congeners detected in all calibration samples. These values varied from 0.57 to 1.55 m3 d(-1) for individual PCBs and from 1.1 to 1.9 m3 d(-1) for PBDEs. These values are appreciably lower than those reported elsewhere for different PUF disk sampler designs (e.g. partially sheltered) employed under different conditions (e.g. in outdoor air), and derived using different calibration experiment configurations. This suggests that sampling rates derived for a specific sampler configuration deployed under specific environmental conditions, should not be extrapolated to different sampler configurations. Furthermore, our observation of variable congener-specific sampling rates (consistent with other studies), implies that more research is required in order to understand fully the factors that influence sampling rates. Analysis of wipe samples taken from the inside of the sampler housing, revealed evidence that the housing surface scavenges particle bound PBDEs.
Age and racial/ethnic disparities in arthritis-related hip and knee surgeries.

PubMed

Dunlop, Dorothy D; Manheim, Larry M; Song, Jing; Sohn, Min-Woong; Feinglass, Joseph M; Chang, Huan J; Chang, Rowland W

2008-02-01

Nearly 18 million Americans experience limitations due to their arthritis. Documented disparities according to racial/ethnic groups in the use of surgical interventions such as knee and hip arthroplasty are largely based on data from Medicare beneficiaries age 65 or older. Whether there are disparities among younger adults has not been previously addressed. This study assesses age-specific racial/ethnic differences in arthritis-related knee and hip surgeries. Longitudinal (1998-2004) Health and Retirement Study. National probability sample of US community-dwelling adults. A total of 2262 black, 1292 Hispanic, and 13,159 white adults age 51 and older. The outcome is self-reported 2-year use of arthritis-related hip or knee surgery. Independent variables are demographic (race/ethnicity, age, gender), health needs (arthritis, chronic diseases, obesity, physical activity, and functional limitations), and medical access (income, wealth, education, and health insurance). Longitudinal data methods using discrete survival analysis are used to validly account for repeated (biennial) observations over time. Analyses use person-weights, stratum, and sampling error codes to provide valid inferences to the US population. Black adults under the age of 65 years report similar age/gender adjusted rates of hip/knee arthritis surgeries [hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 0.87-2.38] whereas older blacks (age 65+) have significantly lower rates (HR = 0.38, CI = 0.16-0.55) compared with whites. These relationships hold controlling for health and economic differences. Both under age 65 years (HR = 0.64, CI = 0.12-1.44) and older (age 65+) Hispanic adults (HR = 0.60, CI = 0.32-1.10) report lower utilization rates, although not statistically different than whites. A large portion of the Hispanic disparity is explained by economic differences. These national data document lower rates of arthritis-related hip/knee surgeries for older black versus white adults age 65 or above, consistent with other national studies. However, utilization rates for black versus white under age 65 do not differ. Lower utilization among Hispanics versus whites in both age groups is largely explained by medical access factors. National utilization patterns may vary by age and merit further investigation.
Compliance Patterns and Utilization of e-Health for Glucose Monitoring: Standalone Internet Gateway and Tablet Device.

PubMed

Rho, Mi Jung; Kim, Hun-Sung; Yoon, Kun-Ho; Choi, In Young

2017-04-01

Knowledge regarding compliance patterns and service utilization in e-health is important for the development of effective services. To develop proper e-health, the characteristics of compliance patterns and utilization of e-health should be studied. We studied these for glucose monitoring of diabetic patients from primary clinics. Data were collected from 160 outpatients who participated in e-health for glucose monitoring funded by the Korean government. Specifically, this study focused on two device types: a standalone Internet gateway and a tablet device. The SPSS 18.0 software was used for statistical analyses of demographic characteristics, survival data, and Cox proportional hazards regression model. Standalone Internet gateway users demonstrated a more stable compliance pattern than did tablet device users. The compliance rate differed according to the device type. Typically, compliance decreases considerably around 8 months. In these results, standalone Internet gateway users utilized the service for longer periods than tablet device users. Gateway type and location also influenced utilization (p < 0.05). The service should be designed according to the device type to develop appropriate service models. Thus, service designers should understand the different characteristics of service devices. This study provides insight into compliance patterns and utilization to develop appropriate service models and service interventions depending on the device.
Disparate rates of acute rejection and donor-specific antibodies among high-immunologic risk renal transplant subgroups receiving antithymocyte globulin induction.

PubMed

Patel, Samir J; Suki, Wadi N; Loucks-DeVos, Jennifer; Graviss, Edward A; Nguyen, Duc T; Knight, Richard J; Kuten, Samantha A; Moore, Linda W; Teeter, Larry D; Gaber, Lillian W; Gaber, A Osama

2016-08-01

Lymphocyte-depleting induction lowers acute rejection (AR) rates among high-immunologic risk (HIR) renal transplant recipients, including African Americans (AAs), retransplants, and the sensitized. It is unclear whether different HIR subgroups experience similarly low rates of AR. We aimed to describe the incidence of AR and de novo donor-specific antibody (dnDSA) among HIR recipients categorized by age, race, or donor type. All received antithymocyte globulin (ATG) induction and triple maintenance immunosuppression. A total of 464 HIR recipients from 2007 to 2014 were reviewed. AR and dnDSA rates at 1 year for the entire population were 14% and 27%, respectively. AR ranged from 6.7% among living donor (LD) recipients to 30% in younger AA deceased donor (DD) recipients. De novo donor-specific antibody at 1 year ranged from 7% in older non-AA LD recipients to 32% in AAs. AA race remained as an independent risk factor for AR among DD recipients and for dnDSA among all HIR recipients. Development of both AR and dnDSA within the first year was associated with a 54% graft survival at 5 years and was an independent risk factor for graft loss. Despite utilization of recommended immunosuppression for HIR recipients, substantial disparities exist among subgroups, warranting further consideration of individualized immunosuppression in certain HIR subgroups. © 2016 Steunstichting ESOT.
Cost Avoidance vs. Utility Bill Accounting - Explaining theDiscrepancy Between Guaranteed Savings in ESPC Projects and UtilityBills

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

Kumar, S.; Sartor, D.

2005-08-15

Federal agencies often ask if Energy Savings PerformanceContracts (ESPCs) result in the energy and cost savings projected duringthe project development phase. After investing in ESPCs, federal agenciesexpect a reduction in the total energy use and energy cost at the agencylevel. Such questions about the program are common when implementing anESPC project. But is this a fair or accurate perception? Moreimportantly, should the federal agencies evaluate the success or failureof ESPCs by comparing the utility costs before and after projectimplementation?In fact, ESPC contracts employ measurement andverification (M&V) protocols to measure and ensure kilowatt-hour orBTU savings at the project level. In mostmore » cases, the translation toenergy cost savings is not based on actual utility rate structure, but acontracted utility rate that takes the existing utility rate at the timethe contract is signed with a clause to escalate the utility rate by afixed percentage for the duration of the contract. Reporting mechanisms,which advertise these savings in dollars, may imply an impact to budgetsat a much higher level depending on actual utility rate structure. FEMPhas prepared the following analysis to explain why the utility billreduction may not materialize, demonstrate its larger implication onagency s energy reduction goals, and advocate setting the rightexpectations at the outset to preempt the often asked question why I amnot seeing the savings in my utility bill?« less
Assessing Applications of GPM and IMERG Passive Microwave Rain Rates in Modeling and Operational Forecasting

NASA Astrophysics Data System (ADS)

Zavodsky, B.; Le Roy, A.; Smith, M. R.; Case, J.

2016-12-01

In support of NASA's recently launched GPM `core' satellite, the NASA-SPoRT project is leveraging experience in research-to-operations transitions and training to provide feedback on the operational utility of GPM products. Thus far, SPoRT has focused on evaluating the Level 2 GPROF passive microwave and IMERG rain rate estimates. Formal evaluations with end-users have occurred, as well as internal evaluations of the datasets. One set of end users for these products is National Weather Service Forecast Offices (WFOs) and National Weather Service River Forecast Centers (RFCs), comprising forecasters and hydrologists. SPoRT has hosted a series of formal assessments to determine uses and utility of these datasets for NWS operations at specific offices. Forecasters primarily have used Level 2 swath rain rates to observe rainfall in otherwise data-void regions and to confirm model QPF for their nowcasting or short-term forecasting. Hydrologists have been evaluating both the Level 2 rain rates and the IMERG rain rates, including rain rate accumulations derived from IMERG; hydrologists have used these data to supplement gauge data for post-event analysis as well as for longer-term forecasting. Results from specific evaluations will be presented. Another evaluation of the GPM passive microwave rain rates has been in using the data within other products that are currently transitioned to end-users, rather than as stand-alone observations. For example, IMERG Early data is being used as a forcing mechanism in the NASA Land Information System (LIS) for real-time soil moisture product over eastern Africa. IMERG is providing valuable precipitation information to LIS in an otherwise data-void region. Results and caveats will briefly be discussed. A third application of GPM data is using the IMERG Late and Final products for model verification in remote regions where high-quality gridded precipitation fields are not readily available. These datasets can now be used to verify NWP model forecasts over Eastern Africa using the SPoRT-MET scripts verification package, a wrapper around the NCAR Model Evaluation Toolkit (MET) verification software.
Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India.

PubMed

Roy, Kakoli; Chaudhuri, Anoshua

2008-05-01

Empirical studies from developed countries observe that women report worse health and higher healthcare utilization than men, but the health disadvantage diminishes with age; gender differences in self-rated health often vanish or are reversed in older ages. Comparable assessments of health during later life from developing countries are limited because of the lack of large-scale surveys that include older women. Our study attempts to address the shortage of developing country studies by examining gender differences in health and healthcare utilization among older adults in India. Both ordered and binary logit specifications were used to assess significant gender differences in subjective and objective health, and healthcare utilization after controlling for demographics, medical conditions, traditional indicators of socioeconomic status like education and income, and additional wealth indicators. The wealth indicators, measured by property ownership and economic independence, are regarded as financially empowering older adults to exercise greater control over their health and well-being. Data are drawn from a nationally representative decennial socioeconomic and health survey of 120,942 Indian households conducted during 1995-1996. The study sample comprises 34,086 older men and women aged >or= 60 years. Our results indicate that older women report worse self-rated health, higher prevalence of disabilities, marginally lower chronic conditions, and lower healthcare utilization than men. The health disadvantage and lower utilization among women cannot be explained by demographics and the differential distribution of medical conditions. While successive controls for education, income, and property ownership narrows the gender gap in both health and healthcare utilization, significant differentials still persist. Upon controlling for economic independence, gender differentials disappear or are reversed, with older women having equal or better health than otherwise similar men. Financial empowerment might confer older women the health advantage reflected in developed societies by enhancing a woman's ability to undertake primary and secondary prevention during the life course.
Changes in methanogenic substrate utilization and communities with depth in a salt-marsh, creek sediment in southern England

NASA Astrophysics Data System (ADS)

John Parkes, R.; Brock, Fiona; Banning, Natasha; Hornibrook, Edward R. C.; Roussel, Erwan G.; Weightman, Andrew J.; Fry, John C.

2012-01-01

A combined biogeochemical and molecular genetic study of creek sediments (down to 65 cm depth) from Arne Peninsula salt-marsh (Dorset, UK) determined the substrates used for methanogenesis and the distribution of the common methanogens, Methanosarcinales and Methanomicrobiales capable of metabolising these substrates. Methane concentrations increased by 11 cm, despite pore water sulphate not being removed until 45 cm. Neither upward methane diffusion or anaerobic oxidation of methane seemed to be important in this zone. In the near-surface sulphate-reduction zone (5-25 cm) turnover time to methane for the non-competitive methanogenic substrate trimethylamine was most rapid (80 days), and were much longer for acetate (7900 days), methanol (40,500 days) and bicarbonate (361,600 days). Methylamine-utilizing Methanosarcinales were the dominant (60-95%) methanogens in this zone. In deeper sediments rates of methanogenesis from competitive substrates increased substantially, with acetate methanogenic rates becoming ˜100 times greater than H 2/CO 2 methanogenesis below 50 cm. In addition, there was a dramatic change in methanogen diversity with obligate acetate-utilizing, Methanosaeta related sequences being dominant. At a similar depth methanol turnover to methane increased to its most rapid (1700 days). This activity pattern is consistent with deeper methanogen populations (55 cm) being dominated by acetate-utilizing Methanosaeta with H 2/CO 2 and alcohol-utilizing Methanomicrobiales also present. Hence, there is close relationship between the depth distribution of methanogenic substrate utilization and specific methanogens that can utilize these compounds. It is unusual for acetate to be the dominant methanogenic substrate in coastal sediments and δ13C-CH 4 values (-74 to -71‰) were atypical for acetate methanogenesis, suggesting that common stable isotope proxy models may not apply well in this type of dynamic anoxic sediment, with multiple methanogenic substrates.
A case study in electricity regulation: Theory, evidence, and policy

NASA Astrophysics Data System (ADS)

Luk, Stephen Kai Ming

This research provides a thorough empirical analysis of the problem of excess capacity found in the electricity supply industry in Hong Kong. I utilize a cost-function based temporary equilibrium framework to investigate empirically whether the current regulatory scheme encourages the two utilities to overinvest in capital, and how much consumers would have saved if the underutilized capacity is eliminated. The research is divided into two main parts. The first section attempts to find any evidence of over-investment in capital. As a point of departure from traditional analysis, I treat physical capital as quasi-fixed, which implies a restricted cost function to represent the firm's short-run cost structure. Under such specification, the firm minimizes the cost of employing variable factor inputs subject to predetermined levels of quasi-fixed factors. Using a transcendental logarithmic restricted cost function, I estimate the cost-side equivalent of marginal product of capital, or commonly referred to as "shadow values" of capital. The estimation results suggest that the two electric utilities consistently over-invest in generation capacity. The second part of this research focuses on the economies of capital utilization, and the estimation of distortion cost in capital investment. Again, I utilize a translog specification of the cost function to estimate the actual cost of the excess capacity, and to find out how much consumers could have saved if the underutilized generation capacity were brought closer to the international standard. Estimation results indicate that an increase in the utilization rate can significantly reduce the costs of both utilities. And if the current excess capacity were reduced to the international standard, the combined savings in costs for both firms will reach 4.4 billion. This amount of savings, if redistributed to all consumers evenly, will translate into a 650 rebate per capita. Finally, two policy recommendations: a more stringent policy towards capacity expansion and the creation of a reimbursement program, are discussed.
Age-specific vibrissae growth rates: a tool for determining the timing of ecologically important events in Steller sea lions

USGS Publications Warehouse

Rea, L.D.; Christ, A.M.; Hayden, A.B.; Stegall, V.K.; Farley, S.D.; Stricker, Craig A.; Mellish, J.E.; Maniscalco, John M.; Waite, J.N.; Burkanov, V.N.; Pitcher, K.W.

2015-01-01

Steller sea lions (SSL; Eumetopias jubatus) grow their vibrissae continually, providing a multiyear record suitable for ecological and physiological studies based on stable isotopes. An accurate age-specific vibrissae growth rate is essential for registering a chronology along the length of the record, and for interpreting the timing of ecologically important events. We utilized four methods to estimate the growth rate of vibrissae in fetal, rookery pup, young-of-the-year (YOY), yearling, subadult, and adult SSL. The majority of vibrissae were collected from SSL live-captured in Alaska and Russia between 2000 and 2013 (n = 1,115), however, vibrissae were also collected from six adult SSL found dead on haul-outs and rookeries during field excursions to increase the sample size of this underrepresented age group. Growth rates of vibrissae were generally slower in adult (0.44 ± 0.15 cm/mo) and subadult (0.61 ± 0.10 cm/mo) SSL than in YOY (0.87 ± 0.28 cm/mo) and fetal (0.73 ± 0.05 cm/mo) animals, but there was high individual variability in these growth rates within each age group. Some variability in vibrissae growth rates was attributed to the somatic growth rate of YOY sea lions between capture events (P = 0.014, r2 = 0.206, n = 29).
Minimum intravenous thrombolysis utilization rates in acute ischemic stroke to achieve population effects on disability: A discrete-event simulation model.

PubMed

Hoffmeister, Lorena; Lavados, Pablo M; Mar, Javier; Comas, Merce; Arrospide, Arantzazu; Castells, Xavier

2016-06-15

The only pharmacological treatment with proven cost-effectiveness in reducing acute ischemic stroke (AIS) associated disability is intravenous thrombolysis with recombinant tissue plasminogen activator but it's utilization rate is still low in most of the world. We estimated the minimum thrombolysis utilization rate needed to decrease the prevalence of stroke-related disability at a population level by using a discrete-event simulation model. The model included efficacy according to time to treatment up to 4.5h, and four scenarios for the utilization of intravenous thrombolysis in eligible patients with AIS: a) 2%; b) 12% c) 25% and d) 40%. We calculated the prevalence of AIS related disability in each scenario, using population based data. The simulation was performed from 2002 to 2017 using the ARENA software. A 2% utilization rate yielded a prevalence of disability of 359.1 per 100,000. Increasing thrombolysis to 12% avoided 779 disabled patients. If the utilization rate was increased to 25%, 1783 disabled patients would be avoided. The maximum scenario of 40% decreased disability to 335.7 per 100,000, avoiding 17% of AIS-related disability. The current utilization rate of intravenous thrombolysis of 2% has minimal population impact. Increasing the rate of utilization to more than 12% is the minimum to have a significant population effect on disability and should be a public policy aim. Copyright © 2016 Elsevier B.V. All rights reserved.

Screening of transporters to improve xylodextrin utilization in the yeast Saccharomyces cerevisiae.

PubMed

Zhang, Chenlu; Acosta-Sampson, Ligia; Yu, Vivian Yaci; Cate, Jamie H D

2017-01-01

The economic production of cellulosic biofuel requires efficient and full utilization of all abundant carbohydrates naturally released from plant biomass by enzyme cocktails. Recently, we reconstituted the Neurospora crassa xylodextrin transport and consumption system in Saccharomyces cerevisiae, enabling growth of yeast on xylodextrins aerobically. However, the consumption rate of xylodextrin requires improvement for industrial applications, including consumption in anaerobic conditions. As a first step in this improvement, we report analysis of orthologues of the N. crassa transporters CDT-1 and CDT-2. Transporter ST16 from Trichoderma virens enables faster aerobic growth of S. cerevisiae on xylodextrins compared to CDT-2. ST16 is a xylodextrin-specific transporter, and the xylobiose transport activity of ST16 is not inhibited by cellobiose. Other transporters identified in the screen also enable growth on xylodextrins including xylotriose. Taken together, these results indicate that multiple transporters might prove useful to improve xylodextrin utilization in S. cerevisiae. Efforts to use directed evolution to improve ST16 from a chromosomally-integrated copy were not successful, due to background growth of yeast on other carbon sources present in the selection medium. Future experiments will require increasing the baseline growth rate of the yeast population on xylodextrins, to ensure that the selective pressure exerted on xylodextrin transport can lead to isolation of improved xylodextrin transporters.
The use of food wastes as feed ingredients for culturing grass carp (Ctenopharyngodon idellus) in Hong Kong.

PubMed

Choi, W M; Lam, C L; Mo, W Y; Wong, M H

2016-04-01

Different types of food wastes, e.g., meats, bones, cereals, fruits, and vegetables, were collected from hotels in Hong Kong, mixed in different ratio, and processed into feed pellets (food wastes (FWs) A, B, and C) for feeding trials in aquaculture species. Grass carp fed with cereal-dominant feed (FW A) showed the best growth (in terms of specific growth rate, relative weight gain, and protein efficiency ratio), among all food waste feeds. However, the growth rates of food waste groups especially the meat product-contained feeds (FW B and FW C) were lower than the commercial feed, Jinfeng(®) 613 formulation (control). The results indicated that grass carp utilized plant proteins better than animal proteins and preferred carbohydrate as a major energy source than lipid. The high-lipid content in feed containing meat products was also a possible reason for hindering growth and resulted high body lipid. It is suggested that lipid should be removed in the preparation of food waste feed or further investigations by implementing supplements, e.g., enzymes in feed to enhance lipid or protein utilization by fish. This utilization of food waste could be an effective and practical way to deal with these wastes in this densely populated city.
Enhancing substrate utilization and power production of a microbial fuel cell with nitrogen-doped carbon aerogel as cathode catalyst.

PubMed

Tardy, Gábor Márk; Lóránt, Bálint; Lóka, Máté; Nagy, Balázs; László, Krisztina

2017-07-01

Catalytic efficiency of a nitrogen-doped, mesoporous carbon aerogel cathode catalyst was investigated in a two-chambered microbial fuel cell (MFC) applying graphite felt as base material for cathode and anode, utilizing peptone as carbon source. This mesoporous carbon aerogel containing catalyst layer on the cathode increased the maximum power density normalized to the anode volume to 2.7 times higher compared to the maximum power density obtained applying graphite felt cathode without the catalyst layer. At high (2 and 3) cathode/anode volume ratios, maximum power density exceeded 40 W m -3 . At the same time, current density and specific substrate utilization rate increased by 58% resulting in 31.9 A m -3 and 18.8 g COD m -3 h -1 , respectively (normalized to anode volume). Besides the increase of the power and the rate of biodegradation, the investigated catalyst decreased the internal resistance from the range of 450-600 to 350-370 Ω. Although Pt/C catalyst proved to be more efficient, a considerable decrease in the material costs might be achieved by substituting it with nitrogen-doped carbon aerogel in MFCs. Such cathode still displays enhanced catalytic effect.
Asthma and asthma-related health care utilization among people without disabilities and people with physical disabilities.

PubMed

Stransky, Michelle L; McGrath, Robert; Reichard, Amanda; McClain, Monica; Phillips, Kimberly G; Houtenville, Andrew; Drum, Charles E

2016-10-01

Previous research has shown that people with disabilities have higher rates of some chronic diseases and receive poorer disease-specific care than their counterparts without disabilities. Yet, little is known about the relationship between asthma and disability. This study examines whether differences in the prevalence of asthma, asthma flare, and asthma-related measures of health care quality, utilization and cost exist among people with physical limitations (PL) and without any limitations. Data from the 2004-2010 Medical Expenditure Panel Survey were pooled to compare outcomes for working-age adults (18-64) with PL to those with no limitations. People with PL had higher rates of asthma (13.8% vs. 5.9%, p < 0.001) and recent asthma flare (52.6% vs. 39.6%, p < 0.001) than people without limitations. There were no differences in health care quality, utilization or cost between people with PL and people without limitations in multivariate analyses. Although there are no differences in asthma-related quality or utilization of health care, people with PL have poorer asthma control than people without limitations. Research is needed to determine what factors (e.g., focus on other acute ailments, perceptions that asthma control cannot improve) are related to this outcome. Future research must also examine differences in asthma severity, and its impact on asthma control and health care-related outcomes, among people with and without disabilities. Copyright © 2016 Elsevier Inc. All rights reserved.
Changing Utilization of Noninvasive Diagnostic Imaging Over 2 Decades: An Examination Family-Focused Analysis of Medicare Claims Using the Neiman Imaging Types of Service Categorization System.

PubMed

Rosman, David A; Duszak, Richard; Wang, Wenyi; Hughes, Danny R; Rosenkrantz, Andrew B

2018-02-01

The objective of our study was to use a new modality and body region categorization system to assess changing utilization of noninvasive diagnostic imaging in the Medicare fee-for-service population over a recent 20-year period (1994-2013). All Medicare Part B Physician Fee Schedule services billed between 1994 and 2013 were identified using Physician/Supplier Procedure Summary master files. Billed codes for diagnostic imaging were classified using the Neiman Imaging Types of Service (NITOS) coding system by both modality and body region. Utilization rates per 1000 beneficiaries were calculated for families of services. Among all diagnostic imaging modalities, growth was greatest for MRI (+312%) and CT (+151%) and was lower for ultrasound, nuclear medicine, and radiography and fluoroscopy (range, +1% to +31%). Among body regions, service growth was greatest for brain (+126%) and spine (+74%) imaging; showed milder growth (range, +18% to +67%) for imaging of the head and neck, breast, abdomen and pelvis, and extremity; and showed slight declines (range, -2% to -7%) for cardiac and chest imaging overall. The following specific imaging service families showed massive (> +100%) growth: cardiac CT, cardiac MRI, and breast MRI. NITOS categorization permits identification of temporal shifts in noninvasive diagnostic imaging by specific modality- and region-focused families, providing a granular understanding and reproducible analysis of global changes in imaging overall. Service family-level perspectives may help inform ongoing policy efforts to optimize imaging utilization and appropriateness.
Economically dispatching cogeneration facilities

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

Hernandez, E.

Economic dispatching has been used by utilities to meet the energy demands of their customers for decades. The objective was to first load those units which cost the least to run and slowly increase the loading of more expensive units as the incremental energy price increased. Although this concept worked well for utility based systems where incremental costs rose with peak demand, the independent power producers(IPPs) and the power purchase agreements (PPAs) have drastically changed this notion. Most PPAs structured for the IPP environment have negotiated rates which remain the same during peak periods and base their electrical generation onmore » specific process steam requirements. They also must maintain the required production balance of process steam and electrical load in order to qualify as a Public Utility Regulatory Policies Act (PURPA) facility. Consequently, economically dispatching Cogeneration facilities becomes an exercise in adhering to contractual guidelines while operating the equipment in the most efficient manner possible for the given condition. How then is it possible to dispatch a Cogeneration facility that maintains the electrical load demand of JFK Airport while satisfying all of its heating and cooling needs? Contractually, Kennedy International Airport Cogen (KIAC) has specific obligations concerning electrical and thermal energy exported to JFK Airport. The facility`s impressive array of heating and cooling apparatuses together with the newly installed cogen fulfilled the airport`s needs by utilizing an endless combination of new and previously installed equipment. Moreover, in order to economically operate the plant a well structured operating curriculum was necessary.« less
Factors influencing the mammography utilization among Taiwanese women with intellectual disabilities, a nationwide population-based study.

PubMed

Lai, Hsien-Tang; Kung, Pei-Tseng; Tsai, Wen-Chen

2014-12-01

Women with intellectual disabilities (ID) have cognitive impairment and communication difficulties; for both caregivers and clinical personnel, discovering the early symptoms of breast cancer among women with ID is challenging. The mammography utilization rate of women with ID was significantly lower than that of women in the general population. This study employed a 2008 database of people with disabilities in Taiwan as a research target and analyzed the mammography utilization rate of women with ID aged 50–69 years. In addition, relevant factors influencing mammography utilization among women with ID were also investigated. A total of 4370 participants were recruited and the majority were illiterate or had elementary-level educations (82.27%). The majority of the participants had ID that was more severe than mild (83.80%). The mammography utilization rate of women with ID was 4.32%, which was significantly lower than that of women in the general population (12%). The mammography utilization rate among women with ID who were married, had higher education levels, and had been diagnosed with cancer, diabetes, or mild ID was significantly higher. However, the mammography utilization rate among women with ID, who had elementary-level educations or were illiterate, was only 4.03%. The utilization rate among women with profound ID was only 2.65%. Women with ID who had undergone pap smears or had utilized adult preventive health services demonstrated a significantly higher mammography utilization rate. This study identified that education level, a diagnosis of diabetes, and the application of pap smears or adult preventive health services were primary factors that influenced the mammography utilization rate among women with ID. This study also observed that in Taiwan, the mammography utilization rate of women with ID was lower than that of pap smears and adult preventive health services, and was only half of that of people with disabilities. An unequal situation existed in regard to the acceptance of breast cancer screening among women with ID, and a different form of strategic planning must be adopted in public health policy. Because ID differs from other disabilities and most women with ID are illiterate, tailored courses are required to train primary caregivers and clinical personnel in providing knowledge and services. The objectives are to diagnose breast cancer at an early stage to decrease the risk of mortality and ensure their rights to health.
WTG Energy Systems' Rotor: Steel at 80 Feet

NASA Technical Reports Server (NTRS)

Barrows, R. E.

1979-01-01

The design, specifications, and performance of the 80 foot diameter fixed pitch rotor operating on the MP1-200 wind turbine generator installed as part of the Island of Cuttyhunk's electric power utility grid system are described. This synchronous generating system rated 200 kilowatts at 28 mph wind velocity, and produces constant 60 Hz, 480 VAC current at +/- 1 percent accuracy throughout the machine's operating range. Future R & D requirements and suggestions are included with cost data.
Improving the Selection, Classification, and Utilization of Army Enlisted Personnel. Annual Report, 1985 Fiscal Year. Supplement

DTIC Science & Technology

1987-10-01

PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT, PROJECT, TASK Human Resources Research Organization 2 P 3 QA2 79 9"INiTNUMBERS 1100...classification tests which will validly predict carefully developed measures of job performance . The project addresses the 675,000-person enlisted personnel...are to include both Army-wide job performance measures based on newly developed rating scales, and direct hands-on measures of MOS-specific task
Understanding the factors that effect maximal fat oxidation.

PubMed

Purdom, Troy; Kravitz, Len; Dokladny, Karol; Mermier, Christine

2018-01-01

Lipids as a fuel source for energy supply during submaximal exercise originate from subcutaneous adipose tissue derived fatty acids (FA), intramuscular triacylglycerides (IMTG), cholesterol and dietary fat. These sources of fat contribute to fatty acid oxidation (FAox) in various ways. The regulation and utilization of FAs in a maximal capacity occur primarily at exercise intensities between 45 and 65% VO 2max , is known as maximal fat oxidation (MFO), and is measured in g/min. Fatty acid oxidation occurs during submaximal exercise intensities, but is also complimentary to carbohydrate oxidation (CHOox). Due to limitations within FA transport across the cell and mitochondrial membranes, FAox is limited at higher exercise intensities. The point at which FAox reaches maximum and begins to decline is referred to as the crossover point. Exercise intensities that exceed the crossover point (~65% VO 2max ) utilize CHO as the predominant fuel source for energy supply. Training status, exercise intensity, exercise duration, sex differences, and nutrition have all been shown to affect cellular expression responsible for FAox rate. Each stimulus affects the process of FAox differently, resulting in specific adaptions that influence endurance exercise performance. Endurance training, specifically long duration (>2 h) facilitate adaptations that alter both the origin of FAs and FAox rate. Additionally, the influence of sex and nutrition on FAox are discussed. Finally, the role of FAox in the improvement of performance during endurance training is discussed.
Differential utilization of enzyme-substrate interactions for acylation but not deacylation during the catalytic cycle of Kex2 protease.

PubMed

Rockwell, N C; Fuller, R S

2001-10-19

Kex2 protease from Saccharomyces cerevisiae is the prototype for a family of eukaryotic proprotein processing proteases belonging to the subtilase superfamily of serine proteases. Kex2 can be distinguished from degradative subtilisins on the basis of stringent substrate specificity and distinct pre-steady-state behavior. To better understand these mechanistic differences, we have examined the effects of substrate residues at P(1) and P(4) on individual steps in the Kex2 catalytic cycle with a systematic series of isosteric peptidyl amide and ester substrates. The results demonstrate that substrates based on known, physiological cleavage sites exhibit high acylation rates (> or =550 s(-1)) with Kex2. Substitution of Lys for the physiologically correct Arg at P(1) resulted in a > or =200-fold drop in acylation rate with almost no apparent effect on binding or deacylation. In contrast, substitution of the physiologically incorrect Ala for Nle at P(4) resulted in a much smaller defect in acylation and a modest but significant effect on binding with Lys at P(1). This substitution also had no effect on deacylation. These results demonstrate that Kex2 utilizes enzyme-substrate interactions in different ways at different steps in the catalytic cycle, with the S(1)-P(1) contact providing a key specificity determinant at the acylation step.
Herpes zoster vaccine (HZV): utilization and coverage 2009 - 2013, Alberta, Canada.

PubMed

Liu, Xianfang C; Simmonds, Kimberley A; Russell, Margaret L; Svenson, Lawrence W

2014-10-23

Herpes zoster vaccine (HZV) is not publicly funded in the province of Alberta, Canada. We estimated vaccine coverage among those aged 60 years or older for 2013, as well as vaccine utilization rates per hundred thousand population over the period 2009 - 2013. We explored for factors associated with HZV dispensing rates. We used administrative data from the Alberta Pharmaceutical Information Network (PIN) database to identify unique persons for whom HZV had been dispensed from community pharmacies over 2009 - 2013. PIN data were also used to estimate the pharmacy/population ratios for rural and urban Alberta over the period. Denominators for rates were estimated using mid-year population estimates from the Alberta Health Care Insurance Plan Registry. Income quintile data were estimated from the 2006 Census of Canada. Crude, age, sex, geographic (rural vs. urban), income-quintile and year specific rates of HZV vaccine dispensing were estimated per 100,000 population. Rates were adjusted for pharmacy/population ratio. Vaccine coverage for persons aged 60 years or older was estimated using counts of all unique persons for whom the vaccine was dispensed over the period in the numerator and a 2013 mid- year population denominator. HZV dispensing rates rose annually from 2009 - 2013. Vaccine coverage was estimated to be 8.4% among persons aged 60 years or older. Rates of dispensing were highest for persons aged 60-69 years and were higher for females than males and for persons from higher compared to lower income quintiles. Dispensing rates were lower for rural than for urban residents. About 2% of vaccine was dispensed for persons aged less than 50 years. Rates of HZV dispensing are increasing rapidly in Alberta despite a lack of public funding. A small proportion of the vaccine may be dispensed off-label.
Illness Severity and Psychiatric Hospitalization Rates Among Asian Americans and Pacific Islanders

PubMed Central

Sentell, Tetine; Unick, George Jay; Ahn, Hyeong Jun; Braun, Kathryn L.; Miyamura, Jill; Shumway, Martha

2015-01-01

Objective The study objective was to fill research gaps about inpatient psychiatric service utilization among Asian Americans and Pacific Islanders (AA/PIs). Methods Rates of psychiatric hospitalization, illness severity, and length of stay were compared among AA/PI adults overall and across diagnoses (schizophrenia, depression, bipolar, anxiety, and other psychiatric disorders identified by All Patient Refined Diagnosis Related Groups) by using discharge data from all hospitalizations in Hawaii from December 2006 to 2010. Multivariable models adjusted for gender, age, payer, and residence. Results In multivariable analyses of total psychiatric hospitalizations, Chinese (rate ratio [RR]=.22), Japanese (RR=.23), Filipinos (RR=.30), and Native Hawaiians (RR=.37) had significantly lower rates than whites. Native Hawaiians had significantly higher hospitalization rates compared with other AA/PI groups. Length of stay was significantly longer for Chinese (length of stay ratio [LOSR]=1.53), Filipinos (LOSR=1.20), and Japanese (LOSR=1.19) compared with whites, whereas severity of illness was significantly higher for Japanese (odds ratio [OR]=1.36) and Filipinos (OR=1.30). Within specific diagnoses, Native Hawaiians had higher hospitalization rates than other AA/PI groups for depression, bipolar disorder, and anxiety disorder. Chinese, Japanese, and Filipinos had significantly higher illness severity or longer stays than whites for at least one diagnostic category. Conclusions AA/PI subgroups had lower psychiatric hospitalization rates than whites, but rates varied across AA/PI subgroups. Native Hawaiians had higher hospitalization rates for many diagnoses. Chinese, Japanese, and Filipinos had greater illness severity or longer stays than whites overall and for some diagnoses, whereas Native Hawaiians did not. Disaggregating AA/PI groups provides important insight into mental health services utilization and need. PMID:23945849
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.

PubMed

Sentell, Tetine; Unick, George Jay; Ahn, Hyeong Jun; Braun, Kathryn L; Miyamura, Jill; Shumway, Martha

2013-11-01

OBJECTIVE The study objective was to fill research gaps about inpatient psychiatric service utilization among Asian Americans and Pacific Islanders (AA/PIs). METHODS Rates of psychiatric hospitalization, illness severity, and length of stay were compared among AA/PI adults overall and across diagnoses (schizophrenia, depression, bipolar, anxiety, and other psychiatric disorders identified by All Patient Refined Diagnosis Related Groups) by using discharge data from all hospitalizations in Hawaii from December 2006 to 2010. Multivariable models adjusted for gender, age, payer, and residence. RESULTS In multivariable analyses of total psychiatric hospitalizations, Chinese (rate ratio [RR]=.22), Japanese (RR=.23), Filipinos (RR=.30), and Native Hawaiians (RR=.37) had significantly lower rates than whites. Native Hawaiians had significantly higher hospitalization rates compared with other AA/PI groups. Length of stay was significantly longer for Chinese (length of stay ratio [LOSR]=1.53), Filipinos (LOSR=1.20), and Japanese (LOSR=1.19) compared with whites, whereas severity of illness was significantly higher for Japanese (odds ratio [OR]=1.36) and Filipinos (OR=1.30). Within specific diagnoses, Native Hawaiians had higher hospitalization rates than other AA/PI groups for depression, bipolar disorder, and anxiety disorder. Chinese, Japanese, and Filipinos had significantly higher illness severity or longer stays than whites for at least one diagnostic category. CONCLUSIONS AA/PI subgroups had lower psychiatric hospitalization rates than whites, but rates varied across AA/PI subgroups. Native Hawaiians had higher hospitalization rates for many diagnoses. Chinese, Japanese, and Filipinos had greater illness severity or longer stays than whites overall and for some diagnoses, whereas Native Hawaiians did not. Disaggregating AA/PI groups provides important insight into mental health services utilization and need.
Comparison of slope instability screening tools following a large storm event and application to forest management and policy

NASA Astrophysics Data System (ADS)

Whittaker, Kara A.; McShane, Dan

2012-04-01

The objective of this study was to assess and compare the ability of two slope instability screening tools developed by the Washington State Department of Natural Resources (WDNR) to assess landslide risks associated with forestry activities. HAZONE is based on a semi-quantitative method that incorporates the landslide frequency rate and landslide area rate for delivery of mapped landforms. SLPSTAB is a GIS-based model of inherent landform characteristics that utilizes slope geometry derived from DEMs and climatic data. Utilization of slope instability screening tools by geologists, land managers, and regulatory agencies can reduce the frequency and magnitude of landslides. Aquatic habitats are negatively impacted by elevated rates and magnitudes of landslides associated with forest management practices due to high sediment loads and alteration of stream channels and morphology. In 2007 a large storm with heavy rainfall impacted southwestern Washington State trigging over 2500 landslides. This storm event and accompanying landslides provides an opportunity to assess the slope stability screening tools developed by WDNR. Landslide density (up to 6.5 landslides per km2) from the storm was highest in the areas designated by the screening tools as high hazard areas, and both of the screening tools were equal in their ability to predict landslide locations. Landslides that initiated in low hazard areas may have resulted from a variety of site-specific factors that deviated from assumed model values, from the inadequate identification of potentially unstable landforms due to low resolution DEMs, or from the inadequate implementation of the state Forest Practices Rules. We suggest that slope instability screening tools can be better utilized by forest management planners and regulators to meet policy goals regarding minimizing landslide rates and impacts to sensitive aquatic species.
[Key physical parameters of hawthorn leaf granules by stepwise regression analysis method].

PubMed

Jiang, Qie-Ying; Zeng, Rong-Gui; Li, Zhe; Luo, Juan; Zhao, Guo-Wei; Lv, Dan; Liao, Zheng-Gen

2017-05-01

The purpose of this study was to investigate the effect of key physical properties of hawthorn leaf granule on its dissolution behavior. Hawthorn leaves extract was utilized as a model drug. The extract was mixed with microcrystalline cellulose or starch with the same ratio by using different methods. Appropriate amount of lubricant and disintegrating agent was added into part of the mixed powder, and then the granules were prepared by using extrusion granulation and high shear granulation. The granules dissolution behavior was evaluated by using equilibrium dissolution quantity and dissolution rate constant of the hypericin as the indicators. Then the effect of physical properties on dissolution behavior was analyzed through the stepwise regression analysis method. The equilibrium dissolution quantity of hypericin and adsorption heat constant in hawthorn leaves were positively correlated with the monolayer adsorption capacity and negatively correlated with the moisture absorption rate constant. The dissolution rate constants were decreased with the increase of Hausner rate, monolayer adsorption capacity and adsorption heat constant, and were increased with the increase of Carr index and specific surface area. Adsorption heat constant, monolayer adsorption capacity, moisture absorption rate constant, Carr index and specific surface area were the key physical properties of hawthorn leaf granule to affect its dissolution behavior. Copyright© by the Chinese Pharmaceutical Association.
Rating counselor-client behavior in online counseling: development and preliminary psychometric properties of the Counseling Progress and Depth Rating Instrument.

PubMed

Bagraith, Karl; Chardon, Lydia; King, Robert John

2010-11-01

Although there are widely accepted and utilized models and frameworks for nondirective counseling (NDC), there is little in the way of tools or instruments designed to assist in determining whether or not a specific episode of counseling is consistent with the stated model or framework. The Counseling Progress and Depth Rating Instrument (CPDRI) was developed to evaluate counselor integrity in the use of Egan's skilled helper model in online counseling. The instrument was found to have sound internal consistency, good interrater reliability, and good face and convergent validity. The CPDRI is, therefore, proposed as a useful tool to facilitate investigation of the degree to which counselors adhere to and apply a widely used approach to NDC.
Use of an iodide-specific electrode to study lactoperoxidase-catalyzed iodination of l-tyrosine.

PubMed

Threatte, R M; Fregly, M J; Field, F P; Jones, P K

1979-12-01

An in vitro method employing an iodide-specific electrode for monitoring lactoperoxidase-catalyzed iodination is described. The method utilized lactoperoxidase, potassium iodide, and a glucose--glucose oxidase system for the generation of hydrogen peroxide and l-tyrosine. As iodination of l-tyrosine proceeded, the free iodide concentration in solution decreased and was monitored by an iodide-specific electrode. The iodide electrode was reliable when compared to a 131I-method for measuring free iodide changes in solution. Increasing concentrations of resorcinol, a well-known inhibitor of thyroid peroxidase-catalyzed iodination, in the reaction mixture resulted in graded inhibition of the initial rate of lactoperoxidase-catalyzed l-tyrosine iodination. This in vitro system can be used to assess inhibitory activity of various antithyroid substances.
Growth of the extremophilic Deinococcus geothermalis DSM 11302 using co-substrate fed-batch culture.

PubMed

Bornot, Julie; Molina-Jouve, Carole; Uribelarrea, Jean-Louis; Gorret, Nathalie

2014-02-01

Deinococcus geothermalis metabolism has been scarcely studied to date, although new developments on its utilization for bioremediation have been carried out. So, large-scale production of this strain and a better understanding of its physiology are required. A fed-batch experiment was conducted to achieve a high cell density non-limiting culture of D. geothermalis DSM 11302. A co-substrate nutritional strategy using glucose and yeast extract was carried out in a 20-L bioreactor in order to maintain a non-limited growth at a maximal growth rate of 1 h(-1) at 45 °C. Substrate supplies were adjusted by monitoring online culture parameters and physiological data (dissolved oxygen, gas analyses, respiratory quotient, biomass concentration). The results showed that yeast extract could serve as both carbon and nitrogen sources, although glucose and ammonia were consumed too. Yeast extract carbon-specific uptake rate reached a value 4.5 times higher than glucose carbon-specific uptake rate. Cell concentration of 9.6 g L(-1) dry cell weight corresponding to 99 g of biomass was obtained using glucose and yeast extract as carbon and nitrogen sources.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Parmesano, Hethie; Kury, Theodore J.

The price of CO{sub 2} emissions allowances affects the structure of the utility's costs, which has implications for rate design and load management programs. Depending on the design of the program to recover these costs, utility total revenue requirements - and the rate design utilized to recover these requirements - may be impacted. A new way to think about rate design may be required. (author)

Healthcare Utilization Rates after Oregon's 2008 Medicaid Expansion: Within-and between-group differences over time among New, Returning, and Continuously Insured Enrollees

PubMed Central

O'Malley, Jean P.; Rosetti, Maureen O'Keeffe; Lowe, Robert A.; Angier, Heather; Gold, Rachel; Marino, Miguel; Hatch, Brigit; Hoopes, Megan; Bailey, Steffani R.; Heintzman, John; Gallia, Charles; DeVoe, Jennifer E.

2016-01-01

Background Although past research demonstrated that Medicaid expansions were associated with increased emergency department (ED) and primary care (PC) utilization, little is known about how long this increased utilization persists or whether post-coverage utilization is affected by prior insurance status. Objectives (1) To assess changes in ED, PC, mental and behavioral health care (MBHC), and specialty care visit rates among individuals gaining Medicaid over 24 months post-insurance gain; (2) To evaluate the association of previous insurance with utilization. Methods Using claims data, we conducted a retrospective cohort analysis of adults insured for 24 months following Oregon's 2008 Medicaid expansion. Utilization rates among 1,124 new and 1,587 returning enrollees were compared to those among 5,126 enrollees with continuous Medicaid coverage (≥1 year pre-expansion). Visit rates were adjusted for propensity score classes and geographic region. Results PC visit rates in both newly and returning insured individuals significantly exceeded those in the continuously insured in months four through 12, but were not significantly elevated in the second year. In contrast, ED utilization rates were significantly higher in returning insured compared to newly or continuously insured individuals and remained elevated over time. New visits to PC and specialist care were higher among those who gained Medicaid compared to the continuously insured throughout the study period. Conclusions Predicting the effect of insurance expansion on healthcare utilization should account for the prior coverage history of new enrollees. Additionally, utilization of outpatient services changes with time after insurance, so expansion evaluations should allow for rate stabilization. PMID:27547943
Changes in morbidity and medical care utilization after the recent economic crisis in the Republic of Korea.

PubMed

Kim, Hanjoong; Chung, Woo Jin; Song, Young Jong; Kang, Dae Ryong; Yi, Jee Jeon; Nam, Chung Mo

2003-01-01

To examine and quantify the impact of the recent economic crisis on morbidity and medical care utilization in the Republic of Korea. 22 675 people from 6791 households and 43 682 people from 12 283 households were questioned for two nationwide surveys that took place in 1995 and 1998, respectively. A separate sample pretest-posttest design was used and we conducted c2 test and logistic regression analysis after controlling for the maturation effect of the morbidity and medical care utilization. The morbidity rates of chronic disease and acute disease increased significantly by 27.1% and 9.5%, respectively, whereas the utilization rates of outpatient and inpatient services decreased by 15.1% and 5.2%, respectively. In particular, the pace of decline in the utilization rate of outpatient services varied depending on the type of disease: morbidity rates for mental and behavioural disorders were 13.7%; for cardiovascular disease, 7.1%; and for injury, 31.6%. After the Republic of Korean economic crisis, the morbidity and medical care utilization rates changed significantly but the degree of change depended on the type of disease or service. The time-dependent relationship between the national economy and the morbidity and medical care utilization rates needs to be further investigated.
Impact of the hydrogen partial pressure on lactate degradation in a coculture of Desulfovibrio sp. G11 and Methanobrevibacter arboriphilus DH1.

PubMed

Junicke, H; Feldman, H; van Loosdrecht, M C M; Kleerebezem, R

2015-04-01

In this study, the impact of the hydrogen partial pressure on lactate degradation was investigated in a coculture of Desulfovibrio sp. G11 and Methanobrevibacter arboriphilus DH1. To impose a change of the hydrogen partial pressure, formate was added to the reactor. Hydrogen results from the bioconversion of formate besides lactate in the liquid phase. In the presence of a hydrogen-consuming methanogen, this approach allows for a better estimation of low dissolved hydrogen concentrations than under conditions where hydrogen is supplied externally from the gas phase, resulting in a more accurate determination of kinetic parameters. A change of the hydrogen partial pressure from 1,200 to 250 ppm resulted in a threefold increase of the biomass-specific lactate consumption rate. The 50 % inhibition constant of hydrogen on lactate degradation was determined as 0.692 ± 0.064 μM dissolved hydrogen (831 ± 77 ppm hydrogen in the gas phase). Moreover, for the first time, the maximum biomass-specific lactate consumption rate of Desulfovibrio sp. G11 (0.083 ± 0.006 mol-Lac/mol-XG11/h) and the affinity constant for hydrogen uptake of Methanobrevibacter arboriphilus DH1 (0.601 ± 0.022 μM dissolved hydrogen) were determined. Contrary to the widely established view that the biomass-specific growth rate of a methanogenic coculture is determined by the hydrogen-utilizing partner; here, it was found that the hydrogen-producing bacterium determined the biomass-specific growth rate of the coculture grown on lactate and formate.
Performance comparison of biofilm and suspended sludge from a sequencing batch biofilm reactor treating mariculture wastewater under oxytetracycline stress.

PubMed

Zheng, Dong; Gao, Mengchun; Wang, Zhe; She, Zonglian; Jin, Chunji; Chang, Qingbo

2016-09-01

The performance, extracellular polymeric substances (EPS) and microbial community of a sequencing batch biofilm reactor (SBBR) were investigated in treating mariculture wastewater under oxytetracycline stress. The chemical oxygen demand and [Formula: see text]-N removal efficiencies of the SBBR decreased with the increase of oxytetracycline concentration, and no obvious [Formula: see text]-N and [Formula: see text]-N accumulation in the effluent appeared at less than 10 mg L(-1) oxytetracycline. The specific oxygen utilization rate of the suspended sludge was more than that of the biofilm at different oxytetracycline concentrations. The specific ammonium oxidation rate (SAOR) of the biofilm was more easily affected by oxytetracycline than that of the suspended sludge, whereas the effect of oxytetracycline on the specific nitrite oxidation rate (SNOR) of the biofilm was less than that of the suspended sludge. The specific nitrate reduction rate of both the biofilm and suspended sludge was higher than the sum of the SAOR and SNOR at different oxytetracycline concentrations. The protein and polysaccharide contents in the EPS of the biofilm and suspended sludge increased with the increase of oxytetracycline concentration. The appearance of oxytetracycline in the influent could affect the chemical composition of the loosely bound EPS and tightly bound EPS. The amino, carboxyl and hydroxyl groups might be involved with interaction between EPS and oxytetracycline. The denaturing gradient gel electrophoresis profiles indicated that the variation of oxytetracycline concentration in the influent could affect the microbial communities of both the biofilm and suspended sludge.
An economy-ralated equity analysis of health service utilization by women in economically underdeveloped regions of western China.

PubMed

Qian, Yuyan; Zhou, Zhongliang; Yan, Ju'e; Gao, Jianmin; Wang, Yuping; Yang, Xiaowei; Xu, Yongjian; Li, Yanli

2017-10-27

The Chinese government has long been committed to eliminating the inequality in the utilization of health services; however, it still lacks an analysis or measurement of the economy-related inequality in the utilization of women's health services. The economy-related utilization of health services in women aged 15 years and above was assessed by the horizontal inequity index of a two-week outpatient rate and annual inpatient rate from the 5th National Health Service Survey of Shaanxi Province. The concentration index of each factor was decomposed into the contribution of each factor to the economic-related inequality of health service utilization based on the Probit regression model. The horizontal inequity indexes of the two-week outpatient rate was 0.0493, and the horizontal inequity indexes of the annual impatient rate was 0.0869. The contributions of economic status to the two indexes were 190.71% and 115.80%, respectively. Economic status, age, basic medical insurance, educational status, marital status, urban/rural area, and self-rated health were the main impact factors that affected the inequality in women's health services utilization in Shaanxi. Health service utilization was different between women with different social demographic characteristics, and unequal health service utilization is evident among women in Shaanxi.
Utility and work productivity data for economic evaluation of breast cancer therapies in the Netherlands and Sweden.

PubMed

Frederix, Gerardus W J; Quadri, Nuz; Hövels, Anke M; van de Wetering, Fleur T; Tamminga, Hans; Schellens, Jan H M; Lloyd, Andrew J

2013-04-01

This study aimed to estimate utility values in laypeople and productivity loss for women with breast cancer in Sweden and the Netherlands. To capture utilities, validated health state vignettes were used, which were translated into Dutch and Swedish. They described progressive disease, stable disease, and 7 grade 3/4 adverse events. One hundred members of the general public in each country rated the states using the visual analog scale and time trade-off method. To assess productivity, women who had recently completed or were currently receiving treatment for early or advanced breast cancer (the Netherlands, n = 161; Sweden, n = 52) completed the Work Productivity and Activity Impairment-General Health (WPAI-GH) questionnaire. Data were analyzed using means (SD). The utility study showed that the Swedish sample rated progressive and stable disease (mean, 0.61 [0.07] and 0.81 [0.05], respectively) higher than did the Dutch sample (0.49 [0.06] and 0.69 [0.05]). The health states incorporating the toxicities in both countries produced similar mean scores. Results of the WPAI-GH showed that those currently receiving treatment reported productivity reductions of 69% (the Netherlands) and 72% (Sweden); those who had recently completed therapy reported reductions of 41% (the Netherlands) and 40% (Sweden). The differences in the utility scores between the 2 countries underline the importance of capturing country-specific values. The significant impact of adverse events on health-related quality of life was also highlighted. The WPAI-GH results demonstrated how the negative impact of breast cancer on productivity persists after women have completed their treatment. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.
Batch Tests To Determine Activity Distribution and Kinetic Parameters for Acetate Utilization in Expanded-Bed Anaerobic Reactors

PubMed Central

Fox, Peter; Suidan, Makram T.

1990-01-01

Batch tests to measure maximum acetate utilization rates were used to determine the distribution of acetate utilizers in expanded-bed sand and expanded-bed granular activated carbon (GAC) reactors. The reactors were fed a mixture of acetate and 3-ethylphenol, and they contained the same predominant aceticlastic methanogen, Methanothrix sp. Batch tests were performed both on the entire reactor contents and with media removed from the reactors. Results indicated that activity was evenly distributed within the GAC reactors, whereas in the sand reactor a sludge blanket on top of the sand bed contained approximately 50% of the activity. The Monod half-velocity constant (Ks) for the acetate-utilizing methanogens in two expanded-bed GAC reactors was searched for by combining steady-state results with batch test data. All parameters necessary to develop a model with Monod kinetics were experimentally determined except for Ks. However, Ks was a function of the effluent 3-ethylphenol concentration, and batch test results demonstrated that maximum acetate utilization rates were not a function of the effluent 3-ethylphenol concentration. Addition of a competitive inhibition term into the Monod expression predicted the dependence of Ks on the effluent 3-ethylphenol concentration. A two-parameter search determined a Ks of 8.99 mg of acetate per liter and a Ki of 2.41 mg of 3-ethylphenol per liter. Model predictions were in agreement with experimental observations for all effluent 3-ethylphenol concentrations. Batch tests measured the activity for a specific substrate and determined the distribution of activity in the reactor. The use of steady-state data in conjunction with batch test results reduced the number of unknown kinetic parameters and thereby reduced the uncertainty in the results and the assumptions made. PMID:16348175
Batch tests to determine activity distribution and kinetic parameters for acetate utilization in expanded-bed anaerobic reactors.

PubMed

Fox, P; Suidan, M T

1990-04-01

Batch tests to measure maximum acetate utilization rates were used to determine the distribution of acetate utilizers in expanded-bed sand and expanded-bed granular activated carbon (GAC) reactors. The reactors were fed a mixture of acetate and 3-ethylphenol, and they contained the same predominant aceticlastic methanogen, Methanothrix sp. Batch tests were performed both on the entire reactor contents and with media removed from the reactors. Results indicated that activity was evenly distributed within the GAC reactors, whereas in the sand reactor a sludge blanket on top of the sand bed contained approximately 50% of the activity. The Monod half-velocity constant (K(s)) for the acetate-utilizing methanogens in two expanded-bed GAC reactors was searched for by combining steady-state results with batch test data. All parameters necessary to develop a model with Monod kinetics were experimentally determined except for K(s). However, K(s) was a function of the effluent 3-ethylphenol concentration, and batch test results demonstrated that maximum acetate utilization rates were not a function of the effluent 3-ethylphenol concentration. Addition of a competitive inhibition term into the Monod expression predicted the dependence of K(s) on the effluent 3-ethylphenol concentration. A two-parameter search determined a K(s) of 8.99 mg of acetate per liter and a K(i) of 2.41 mg of 3-ethylphenol per liter. Model predictions were in agreement with experimental observations for all effluent 3-ethylphenol concentrations. Batch tests measured the activity for a specific substrate and determined the distribution of activity in the reactor. The use of steady-state data in conjunction with batch test results reduced the number of unknown kinetic parameters and thereby reduced the uncertainty in the results and the assumptions made.
Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

PubMed

Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

2012-04-30

The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.
The outweigh of toxicity versus risk of recurrence for adjuvant interferon therapy: a survey in German melanoma patients and their treating physicians.

PubMed

Kähler, Katharina C; Blome, Christine; Forschner, Andrea; Gutzmer, Ralf; Hauschild, Axel; Heinzerling, Lucie; Livingstone, Elisabeth; Loquai, Carmen; Müller-Brenne, Tina; Schadendorf, Dirk; Utikal, Jochen; Wagner, Tobias; Augustin, Matthias

2018-05-25

After more than two decades with interferon alfa-2a and 2b (IFN) as the only approved drugs in the adjuvant setting for melanoma, new treatment approaches like immune checkpoint inhibitors and BRAF-MEK inhibitors improve the progression free survival (PFS) and also the overall survival (OS). We compared physicians' preferences ("utilities") for health states associated with IFN therapy to their patients' preferences. Utilities describe a preference for a specific health state on a scale of 0 (as bad as death) to 1.0 (perfect health). We assessed utilities for health states associated with adjuvant IFN using the standard gamble technique in 108 physicians and 130 melanoma patients. Four IFN toxicity scenarios and three outcome scenarios were given to the participants. Both groups were asked for the 5-year disease free survival (DFS) they would need to accept the described IFN-related side effects. In both groups, utilities for melanoma relapse were significantly lower than for IFN side effects, showing that toxicity was more acceptable than relapse. Physicians indicated higher utilities for each scenario and needed lower 5-year DFS both in case of mild-to-moderate and severe side effects. Patients were willing to tolerate mild-to-moderate and severe toxicity for a 50% and 75% chance of 5-year DFS, while physicians only required a chance of 40% and 50%, respectively. Both physicians and patients rated melanoma recurrence much lower than even severe IFN side effects. In direct comparison, physicians rated cancer-related scenarios more positively and accepted IFN toxicity for an even lower treatment benefit.
Hualapai Tribal Utility Development Project

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

Hualapai Tribal Nation

The first phase of the Hualapai Tribal Utility Development Project (Project) studied the feasibility of establishing a tribally operated utility to provide electric service to tribal customers at Grand Canyon West (see objective 1 below). The project was successful in completing the analysis of the energy production from the solar power systems at Grand Canyon West and developing a financial model, based on rates to be charged to Grand Canyon West customers connected to the solar systems, that would provide sufficient revenue for a Tribal Utility Authority to operate and maintain those systems. The objective to establish a central powermore » grid over which the TUA would have authority and responsibility had to be modified because the construction schedule of GCW facilities, specifically the new air terminal, did not match up with the construction schedule for the solar power system. Therefore, two distributed systems were constructed instead of one central system with a high voltage distribution network. The Hualapai Tribal Council has not taken the action necessary to establish the Tribal Utility Authority that could be responsible for the electric service at GCW. The creation of a Tribal Utility Authority (TUA) was the subject of the second objective of the project. The second phase of the project examined the feasibility and strategy for establishing a tribal utility to serve the remainder of the Hualapai Reservation and the feasibility of including wind energy from a tribal wind generator in the energy resource portfolio of the tribal utility (see objective 2 below). It is currently unknown when the Tribal Council will consider the implementation of the results of the study. Objective 1 - Develop the basic organizational structure and operational strategy for a tribally controlled utility to operate at the Tribe’s tourism enterprise district, Grand Canyon West. Coordinate the development of the Tribal Utility structure with the development of the Grand Canyon West Power Project construction of the power infrastructure at Grand Canyon West. Develop the maintenance and operations capacity necessary to support utility operations. Develop rates for customers on the Grand Canyon West “mini-grid” sufficient for the tribal utility to be self-sustaining. Establish an implementation strategy for tribal utility service at Grand Canyon West Objective 2 - Develop a strategy for tribal utility takeover of electric service on the Reservation. Perform a cost analysis of Reservation electrical service. Develop an implementation strategy for tribal takeover of Reservation electrical service. Examine options and costs associated with integration of the Tribe’s wind resources.« less
[Ophthalmologic healthcare utilization of people in need of long-term care : Analyses of health insurance data of the AOK Baden-Württemberg].

PubMed

Schuster, Alexander K; Pick, Julia; Saalmann, Frauke; Pfeiffer, Norbert

2018-04-10

Eye diseases causing visual impairment increase with age. Thus, seeking eye care has a higher probability in older people. In this study, the rate of utilization of outpatient eye care services in Germany was analyzed. The analyses focused on older persons and persons in need of either home-based or facility-based long-term care. A descriptive secondary data analysis of health insurance data of the AOK Baden-Württemberg from 2016 was conducted. The study population comprised all insured persons on 1 January 2016. The cohort of older persons (60 years+) was further stratified by the type of care (home-based/facility-based) and the level of care (0-3). The utilization of outpatient eye care services was defined by the reimbursement for an ophthalmologist's provision of service. While 39.3% of the study population 60+ years old sought eye care, the utilization rate was lower among people in need of home-based (33.0%) and facility-based care (19.3%). The utilization rates showed comparable age-dependent patterns, except for persons in need of facility-based care where rates were similar for all age groups. Utilization rates were negatively associated with increasing care levels. Only people with care level 0 showed lower utilization rates than people with care level 1. Utilization rates of eye healthcare services among older persons are considerably influenced by the need of long-term care, by the form of care as well as by the level of care.
When the 'soft-path' gets hard: demand management and financial instability for water utilities

NASA Astrophysics Data System (ADS)

Zeff, H. B.; Characklis, G. W.

2014-12-01

In the past, cost benefit analysis (CBA) has been viewed as an effective means of evaluating water utility strategies, particularly those that were dependent on the construction of new supply infrastructure. As water utilities have begun to embrace 'soft-path' approaches as a way to reduce the need for supply-centric development, CBA fails to recognize some important financial incentives affected by reduced water consumption. Demand management, both as a short-term response to drought and in longer-term actions to accommodate demand growth, can introduce revenue risks that adversely affect a utility's ability to repay debt, re-invest in aging infrastructure, or maintain reserve funds for use in a short-term emergency. A utility that does not generate sufficient revenue to support these functions may be subject to credit rating downgrades, which in turn affect the interest rate it pays on its debt. Interest rates are a critical consideration for utility managers in the capital-intensive water sector, where debt payments for infrastructure often account for a large portion of a utility's overall costs. Even a small increase in interest rates can add millions of dollars to the cost of new infrastructure. Recent studies have demonstrated that demand management techniques can lead to significant revenue variability, and credit rating agencies have begun to take notice of drought response plans when evaluating water utility credit ratings, providing utilities with a disincentive to fully embrace soft-path approaches. This analysis examines the impact of demand management schemes on key credit rating metrics for a water utility in Raleigh, North Carolina. The utility's consumer base is currently experiencing rapid population growth, and demand management has the potential to reduce the dependence on costly new supply infrastructure but could lead to financial instability that will significantly increase the costs of financing future projects. This work analyzes how 'soft-path' approaches might be more efficiently integrated with investment in supply-side infrastructure and suggests how financial hedging tools could be used to improve long-term utility planning objectives.
The mean time-limited crash rate of stock price

NASA Astrophysics Data System (ADS)

Li, Yun-Xian; Li, Jiang-Cheng; Yang, Ai-Jun; Tang, Nian-Sheng

2017-05-01

In this article we investigate the occurrence of stock market crash in an economy cycle. Bayesian approach, Heston model and statistical-physical method are considered. Specifically, Heston model and an effective potential are employed to address the dynamic changes of stock price. Bayesian approach has been utilized to estimate the Heston model's unknown parameters. Statistical physical method is used to investigate the occurrence of stock market crash by calculating the mean time-limited crash rate. The real financial data from the Shanghai Composite Index is analyzed with the proposed methods. The mean time-limited crash rate of stock price is used to describe the occurrence of stock market crash in an economy cycle. The monotonous and nonmonotonous behaviors are observed in the behavior of the mean time-limited crash rate versus volatility of stock for various cross correlation coefficient between volatility and price. Also a minimum occurrence of stock market crash matching an optimal volatility is discovered.
Temporal Trends in the Utilization of Noninvasive Diagnostic Tests for Coronary Artery Disease in Ontario Between 2008 and 2014: A Population-Based Study.

PubMed

Roifman, Idan; Wijeysundera, Harindra C; Austin, Peter C; Maclagan, Laura C; Rezai, Mohammad R; Wright, Graham A; Tu, Jack V

2017-02-01

The proliferation of cardiac diagnostic tests over the past few decades has received substantial attention from policymakers. However, contemporary population-based temporal trends of the utilization of noninvasive cardiac diagnostic tests for coronary artery disease are not known. Our objective was to examine the temporal trends in the utilization of coronary computed tomography angiography (CCTA), myocardial perfusion imaging (MPI), exercise stress testing (GXT), and stress echocardiography between 2008 and 2014. We performed a population-based repeated cross-sectional study of the adult population of Ontario between January 1, 2008 and December 31, 2014. Annual utilization rates of noninvasive cardiac diagnostic tests were computed. For each cardiac testing modality, a negative binomial regression model was used to assess temporal changes in test utilization. GXT and MPI collectively accounted for 88% of all cardiac noninvasive diagnostic tests throughout our study period. Age- and sex-standardized rates of GXT declined from 26.7/1000 adult population to 21.6/1000 adult population (mean annual reduction of 3.4%; P < 0.001). MPI rates declined from 21.1/1000 adult population to 19.5/1000 adult population (mean annual reduction of 1.3%; P < 0.001). Although utilization rates for both CCTA and stress echocardiography increased over time, the combined rate of all available tests decreased from 50.8/1000 adult population to 49.1/1000 adult population (mean annual reduction of 1.1%; P < 0.001). In conclusion, utilization rates for the most prevalent noninvasive cardiac diagnostic tests-GXT and MPI-declined over our study period. Furthermore, the overall test utilization rate also declined over time. We believe our findings are encouraging from a health policy perspective. Nonetheless, rising utilization rates for CCTA and stress echocardiography will need to be monitored in the future. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
The relationship between motivation, monetary compensation, and data quality among US- and India-based workers on Mechanical Turk.

PubMed

Litman, Leib; Robinson, Jonathan; Rosenzweig, Cheskie

2015-06-01

In this study, we examined data quality among Amazon Mechanical Turk (MTurk) workers based in India, and the effect of monetary compensation on their data quality. Recent studies have shown that work quality is independent of compensation rates, and that compensation primarily affects the quantity but not the quality of work. However, the results of these studies were generally based on compensation rates below the minimum wage, and far below a level that was likely to play a practical role in the lives of workers. In this study, compensation rates were set around the minimum wage in India. To examine data quality, we developed the squared discrepancy procedure, which is a task-based quality assurance approach for survey tasks whose goal is to identify inattentive participants. We showed that data quality is directly affected by compensation rates for India-based participants. We also found that data were of a lesser quality among India-based than among US participants, even when optimal payment strategies were utilized. We additionally showed that the motivation of MTurk users has shifted, and that monetary compensation is now reported to be the primary reason for working on MTurk, among both US- and India-based workers. Overall, MTurk is a constantly evolving marketplace where multiple factors can contribute to data quality. High-quality survey data can be acquired on MTurk among India-based participants when an appropriate pay rate is provided and task-specific quality assurance procedures are utilized.
In situ characterization of charge rate dependent stress and structure changes in V 2O 5 cathode prepared by atomic layer deposition

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

Jung, Hyun; Gerasopoulos, Konstantinos; Talin, Albert Alec

Here, the insertion/extraction of lithium into/from various host materials is the basic process by which lithium-ion batteries reversible store charge. This process is generally accompanied by strain in the host material, inducing stress which can lead to capacity loss. Therefore, understanding of both the structural changes and the associated stress – investigated almost exclusively separate to date – is a critical factor for developing high-performance batteries. Here, we report an in situ method, which utilizes Raman spectroscopy in parallel with optical interferometry to study effects of varying charging rates (C-rates) on the structure and stress in a V 2O 5more » thin film cathode. Abrupt stress changes at specific crystal phase transitions in the Li—V—O system are observed and the magnitude of the stress changes with the amount of lithium inserted into the electrode are correlated. A linear increase in the stress as a function of x in Li xV 2O 5 is observed, indicating that C-rate does not directly contribute to larger intercalation stress. However, a more rapid increase in disorder within the Li xV 2O 5 layers is correlated with higher C-rate. Ultimately, these experiments demonstrate how the simultaneous stress/Raman in situ approach can be utilized as a characterization platform for investigating various critical factors affecting lithium-ion battery performance.« less
In situ characterization of charge rate dependent stress and structure changes in V 2O 5 cathode prepared by atomic layer deposition

DOE PAGES

Jung, Hyun; Gerasopoulos, Konstantinos; Talin, Albert Alec; ...

2016-11-22

Here, the insertion/extraction of lithium into/from various host materials is the basic process by which lithium-ion batteries reversible store charge. This process is generally accompanied by strain in the host material, inducing stress which can lead to capacity loss. Therefore, understanding of both the structural changes and the associated stress – investigated almost exclusively separate to date – is a critical factor for developing high-performance batteries. Here, we report an in situ method, which utilizes Raman spectroscopy in parallel with optical interferometry to study effects of varying charging rates (C-rates) on the structure and stress in a V 2O 5more » thin film cathode. Abrupt stress changes at specific crystal phase transitions in the Li—V—O system are observed and the magnitude of the stress changes with the amount of lithium inserted into the electrode are correlated. A linear increase in the stress as a function of x in Li xV 2O 5 is observed, indicating that C-rate does not directly contribute to larger intercalation stress. However, a more rapid increase in disorder within the Li xV 2O 5 layers is correlated with higher C-rate. Ultimately, these experiments demonstrate how the simultaneous stress/Raman in situ approach can be utilized as a characterization platform for investigating various critical factors affecting lithium-ion battery performance.« less
DXA utilization between 2006 and 2012 in commercially insured younger postmenopausal women

PubMed Central

Overman, Robert A.; Farley, Joel F.; Curtis, Jeffrey R.; Zhang, Jie; Gourlay, Margaret L.; Deal, Chad L.

2015-01-01

Introduction Reimbursement for dual energy x-ray absorptiometry (DXA) scans in the outpatient setting has declined significantly since 2006. Research through 2011 has suggested reimbursement reductions for DXA scans have corresponded with an overall decreased utilization of DXA. This study updates utilization estimates for DXAs through 2012 in patients with commercial insurance and compares DXA rates before and after reimbursement changes. Methods We evaluated DXA utilization for women age 50–64 from Marketscan Commercial Claims and Encounter database between January 2006 and December 2012 based on CPT codes. We estimated utilization rates per 1,000 person years. We also employed segmented regression analysis of monthly rates to evaluate the change in utilization rates after a proposed reimbursement reduction in July 2009. Results In women aged 50–64; 451,656 DXAs were performed in 2006, a rate of 144 DXAs per 1,000 person years. This rate increased to 149 DXAs per 1,000 person years in 2009 before decreasing to 110 DXAs per 1,000 person years or 667,982 scans in 2012. DXA utilization increased by 2.24 per 1,000 person years until July 2009 then declined by 12.98 DXAs per 1,000 persons, resulting in 37.5 DXAs per person year fewer performed in 2012 compared to 2006. Conclusion Since July 2009 a significant decline in DXA utilization occurred in a younger postmenopausal commercially insured population. This decline corresponds with a time period of reductions in Medicare DXA reimbursement. PMID:25700662
Investigating why recycling gravity harvested algae increases harvestability and productivity in high rate algal ponds.

PubMed

Park, J B K; Craggs, R J; Shilton, A N

2013-09-15

It has previously been shown that recycling gravity harvested algae promotes Pediastrum boryanum dominance and improves harvestability and biomass production in pilot-scale High Rate Algal Ponds (HRAPs) treating domestic wastewater. In order to confirm the reproducibility of these findings and investigate the mechanisms responsible, this study utilized twelve 20 L outdoor HRAP mesocosms operated with and without algal recycling. It then compared the recycling of separated solid and liquid components of the harvested biomass against un-separated biomass. The work confirmed that algal recycling promoted P. boryanum dominance, improved 1 h-settleability by >20% and increased biomass productivity by >25% compared with controls that had no recycling. With regard to the improved harvestability, of particular interest was that recycling the liquid fraction alone caused a similar improvement in settleability as recycling the solid fraction. This may be due to the presence of extracellular polymeric substances in the liquid fraction. While there are many possible mechanisms that could account for the increased productivity with algal recycling, all but two were systematically eliminated: (i) the mean cell residence time was extended thereby increasing the algal concentration and more fully utilizing the incident sunlight and, (ii) the relative proportions of algal growth stages (which have different specific growth rates) was changed, resulting in a net increase in the overall growth rate of the culture. Copyright © 2013 Elsevier Ltd. All rights reserved.

Recent Trends in Imaging Use in Hospital Settings: Implications for Future Planning.

PubMed

Levin, David C; Parker, Laurence; Rao, Vijay M

2017-03-01

To compare trends in utilization rates of imaging in the three hospital-based settings where imaging is conducted. The nationwide Medicare Part B databases for 2004-2014 were used. All discretionary noninvasive diagnostic imaging (NDI) CPT codes were selected and grouped by modality. Procedure volumes of each code were available from the databases and converted to utilization rates per 1,000 Medicare enrollees. Medicare's place-of-service codes were used to identify imaging examinations done in hospital inpatients, hospital outpatient departments (HOPDs), and emergency departments (EDs). Trends were observed over the life of the study. Trendlines were strongly affected by code bundling in echocardiography in 2009, nuclear imaging in 2010, and CT in 2011. However, even aside from these artifactual effects, important trends could be discerned. Inpatient imaging utilization rates of all modalities are trending downward. In HOPDs, the utilization rate of conventional radiographic examinations (CREs) is declining but rates of CT, MRI, echocardiography, and noncardiac ultrasound (US) are increasing. In EDs, utilization rates of CREs, CT, and US are increasing. In the 3 years after 2011, when no further code bundling occurred, the total inpatient NDI utilization rate dropped 15%, whereas the rate in EDs increased 12% and that in HOPDs increased 1%. The trends in utilization of NDI in the three hospital-based settings where imaging occurs are distinctly different. Radiologists and others who are involved in deciding what kinds of equipment to purchase and where to locate it should be cognizant of these trends in making their decisions. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Suicide in the United States Air Force: Relationship Among Marital Status and Life Stressors, Communication of Distress, and Helping Services Utilization

DTIC Science & Technology

2009-09-01

included factors such as age at the time of death, sex , race, and religion. Military specific information consisted of factors such as rank, job 21...alcohol problems were included (e.g., missing work due to drinking, excessive drinking known to others, underage drinking, public intoxication, or...Health and Human Services [DHHS]. (2007). Table 46. Death rates for 54 suicide, by sex , race, Hispanic origin, and age: United States, selected
Exploring galaxy evolution with latent space walks

NASA Astrophysics Data System (ADS)

Schawinski, Kevin; Turp, Dennis; Zhang, Ce

2018-01-01

We present a new approach using artificial intelligence to perform data-driven forward models of astrophysical phenomena. We describe how a variational autoencoder can be used to encode galaxies to latent space, independently manipulate properties such as the specific star formation rate, and return it to real space. Such transformations can be used for forward modeling phenomena using data as the only constraints. We demonstrate the utility of this approach using the question of the quenching of star formation in galaxies.
Development of Li-S Battery With Improved Sulphur Utilization and Cyclic Stability

DTIC Science & Technology

2017-12-04

blade technique and dried overnight at 80 °C in vacuum oven. The dried sample was cut into 12 mm electrode disks. The 2032 coin assembly has been done...capability up to 2C as shown in Fig. 8(c), after running cell at high current and going back to lower 0.1C the cell shows the specific...shows a high rate capability up to 2C. And after running cell at high current and reverse back to lower 0.1
Electronic and Photoelectron Spectroscopy of Toluene

NASA Astrophysics Data System (ADS)

Gardner, Adrian M.; Green, Alistair M.; Tame-Reyes, Victor; Wright, Timothy G.

2012-06-01

Electronic and photoelectron spectra of toluene are presented and discussed. The utilization of a recently reported scheme for assigning the normal vibrations of substituted benzenes allows these spectra to be compared to those of other molecules with unprecedented clarity. Changes in vibrational activity within a series of substituted benzene molecules will be discussed, specifically the increased rate of intramolecular vibrational energy redistribution observed in molecules where the substituent is a methyl group. A. M. Gardner and T. G. Wright, J. Chem. Phys., 135, 114305 (2011)
Electronic health record use among cancer patients: Insights from the Health Information National Trends Survey.

PubMed

Strekalova, Yulia A

2017-04-01

Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute's Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access. Specifically, higher income, prior online information seeking, interest in accessing health information online, and normative beliefs were predictive of electronic health record access. Conversely, poorer general health status and lack of health care provider encouragement to use electronic health records were associated with lower utilization rates. The current findings provide theory-based evidence that contributes to the understanding of the explanatory factors of electronic health record use and suggest future directions for research and practice.
Health literacy and health care spending and utilization in a consumer-driven health plan.

PubMed

Hardie, Nancy A; Kyanko, Kelly; Busch, Susan; Losasso, Anthony T; Levin, Regina A

2011-01-01

We examined health literacy and health care spending and utilization by linking responses of three health literacy questions to 2006 claims data of enrollees new to consumer-driven health plans (n = 4,130). Better health literacy on all four health literacy measures (three item responses and their sum) was associated with lower total health care spending, specifically, lower emergency department and inpatient admission spending (p < .05). Similarly, fewer inpatient admissions and emergency department visits were associated with higher adequate health literacy scores and better self-reports of the ability to read and learn about medical conditions (p-value <.05). Members with lower health literacy scores appear to use services more appropriate for advanced health conditions, although office visit rates were similar across the range of health literacy scores.
Solid State Remote Power Controllers for high voltage DC distribution systems

NASA Technical Reports Server (NTRS)

Billings, W. W.; Sundberg, G. R.

1977-01-01

Presently, hybrid Remote Power Controllers (RPC's) are in production and prototype units are available for systems utilizing 28VDC, 120VDC, 115VAC/400 Hz and 230VAC/400 Hz. This paper describes RPC development in a new area of application: HVDC distribution systems utilizing 270/300VDC. Two RPC current ratings, 1 amp and 2 amps, were selected for development as they are adequate to control 90% of projected system loads. The various aspects and trade-offs encountered in circuit development are discussed with special focus placed on the circuits that see the duress of the high dc potentials. The comprehensive evaluation tests are summarized which confirmed the RPC compliance with the specification and with system/load compatibility requirements. In addition, present technology status and new applications are summarized.
A technical evaluation of the Nucletron FIRST system: conformance of a remote afterloading brachytherapy seed implantation system to manufacturer specifications and AAPM Task Group report recommendations.

PubMed

Rivard, Mark J; Evans, Dee-Ann Radford; Kay, Ian

2005-01-01

The Fully Integrated Real-time Seed Treatment (FIRST) system by Nucletron has been available in Europe since November 2001 and is being used more and more in Canada and the United States. Like the conventional transrectal ultrasound implant procedure, the FIRST system utilizes an ultrasound probe, needles, and brachytherapy seeds. However, this system is unique in that it (1) utilizes a low-dose-rate brachytherapy seed remote afterloader (the seedSelectron), (2) utilizes 3D image reconstruction acquired from electromechanically controlled, nonstepping rotation of the ultrasound probe, (3) integrates the control of a remote afterloader with electromechanical control of the ultrasound probe for integrating the clinical procedure into a single system, and (4) automates the transfer of planning information and seed delivery to improve quality assurance and radiation safety. This automated delivery system is specifically intended to address reproducibility and accuracy of seed positioning during implantation. The FIRST computer system includes two software environments: SPOT PRO and seedSelectron; both are used to facilitate treatment planning and brachytherapy seed implantation from beginning to completion of the entire procedure. In addition to these features, the system is reported to meet certain product specifications for seed delivery positioning accuracy and reproducibility, seed calibration accuracy and reliability, and brachytherapy dosimetry calculations. Consequently, a technical evaluation of the FIRST system was performed to determine adherence to manufacturer specifications and to the American Association of Physicists in Medicine (AAPM) Task Group Reports 43, 53, 56, 59, and 64 and recommendations of the American Brachytherapy Society (ABS). The United States Nuclear Regulatory Commission (NRC) has recently added Licensing Guidance for the seedSelectron system under 10 CFR 35.1000. Adherence to licensing guidance is made by referencing applicable AAPM Task Group recommendations. In general, results of this evaluation indicated that the system met its claimed specifications as well as the applicable recommendations outlined in the AAPM and ABS reports.
Direct measures of mechanical energy for knife mill size reduction of switchgrass, wheat straw, and corn stover.

PubMed

Bitra, Venkata S P; Womac, Alvin R; Igathinathane, C; Miu, Petre I; Yang, Yuechuan T; Smith, David R; Chevanan, Nehru; Sokhansanj, Shahab

2009-12-01

Lengthy straw/stalk of biomass may not be directly fed into grinders such as hammer mills and disc refiners. Hence, biomass needs to be preprocessed using coarse grinders like a knife mill to allow for efficient feeding in refiner mills without bridging and choking. Size reduction mechanical energy was directly measured for switchgrass (Panicum virgatum L.), wheat straw (Triticum aestivum L.), and corn stover (Zea mays L.) in an instrumented knife mill. Direct power inputs were determined for different knife mill screen openings from 12.7 to 50.8 mm, rotor speeds between 250 and 500 rpm, and mass feed rates from 1 to 11 kg/min. Overall accuracy of power measurement was calculated to be +/-0.003 kW. Total specific energy (kWh/Mg) was defined as size reduction energy to operate mill with biomass. Effective specific energy was defined as the energy that can be assumed to reach the biomass. The difference is parasitic or no-load energy of mill. Total specific energy for switchgrass, wheat straw, and corn stover chopping increased with knife mill speed, whereas, effective specific energy decreased marginally for switchgrass and increased for wheat straw and corn stover. Total and effective specific energy decreased with an increase in screen size for all the crops studied. Total specific energy decreased with increase in mass feed rate, but effective specific energy increased for switchgrass and wheat straw, and decreased for corn stover at increased feed rate. For knife mill screen size of 25.4 mm and optimum speed of 250 rpm, optimum feed rates were 7.6, 5.8, and 4.5 kg/min for switchgrass, wheat straw, and corn stover, respectively, and the corresponding total specific energies were 7.57, 10.53, and 8.87 kWh/Mg and effective specific energies were 1.27, 1.50, and 0.24 kWh/Mg for switchgrass, wheat straw, and corn stover, respectively. Energy utilization ratios were calculated as 16.8%, 14.3%, and 2.8% for switchgrass, wheat straw, and corn stover, respectively. These data will be useful for preparing the feed material for subsequent fine grinding operations and designing new mills.
Milestones: Critical Elements in Clinical Informatics Fellowship Programs

PubMed Central

Lehmann, Christoph U.; Munger, Benson

2016-01-01

Summary Background Milestones refer to points along a continuum of a competency from novice to expert. Resident and fellow assessment and program evaluation processes adopted by the ACGME include the mandate that programs report the educational progress of residents and fellows twice annually utilizing Milestones developed by a specialty specific ACGME working group of experts. Milestones in clinical training programs are largely unmapped to specific assessment tools. Residents and fellows are mainly assessed using locally derived assessment instruments. These assessments are then reviewed by the Clinical Competency Committee which assigns and reports trainee ratings using the specialty specific reporting Milestones. Methods and Results The challenge and opportunity facing the nascent specialty of Clinical Informatics is how to optimally utilize this framework across a growing number of accredited fellowships. The authors review how a mapped milestone framework, in which each required sub-competency is mapped to a single milestone assessment grid, can enable the use of milestones for multiple uses including individualized learning plans, fellow assessments, and program evaluation. Furthermore, such a mapped strategy will foster the ability to compare fellow progress within and between Clinical Informatics Fellowships in a structured and reliable fashion. Clinical Informatics currently has far less variability across programs and thus could easily utilize a more tightly defined set of milestones with a clear mapping to sub-competencies. This approach would enable greater standardization of assessment instruments and processes across programs while allowing for variability in how those sub-competencies are taught. Conclusions A mapped strategy for Milestones offers significant advantages for Clinical Informatics programs. PMID:27081414
Encapsulation of S/SWNT with PANI Web for Enhanced Rate and Cycle Performance in Lithium Sulfur Batteries

PubMed Central

Kim, Joo Hyun; Fu, Kun; Choi, Junghyun; Kil, Kichun; Kim, Jeonghyun; Han, Xiaogang; Hu, Liangbing; Paik, Ungyu

2015-01-01

Lithium-sulfur batteries show great potential to compete with lithium-ion batteries due to the fact that sulfur can deliver a high theoretical capacity of 1672 mAh/g and a high theoretical energy density of 2500 Wh/kg. But it has several problems to be solved in order to achieve high sulfur utilization with high Coulombic efficiency and long cycle life of Li-S batteries. These problems are mainly caused by the dissoluble polysulfide species, which are a series of complex reduced sulfur products, associating with shuttle effect between electrodes as well as side reactions on lithium metal anode. To alleviate these challenges, we developed a sulfur-carbon nanotube (S/SWNT) composite coated with polyaniline (PANI) polymer as polysulfide block to achieve high sulfur utilization, high Coulombic efficiency, and long cycle life. The PANI coated S/SWNT composite showed a superior specific capacity of 1011 mAh/g over 100 cycles and a good rate retention, demonstrating the synergic contribution of porous carbon and conducting polymer protection to address challenges underlying sulfur cathode. PMID:25752298
Performance processes within affect-related performance zones: a multi-modal investigation of golf performance.

PubMed

van der Lei, Harry; Tenenbaum, Gershon

2012-12-01

Individual affect-related performance zones (IAPZs) method utilizing Kamata et al. (J Sport Exerc Psychol 24:189-208, 2002) probabilistic model of determining the individual zone of optimal functioning was utilized as idiosyncratic affective patterns during golf performance. To do so, three male golfers of a varsity golf team were observed during three rounds of golf competition. The investigation implemented a multi-modal assessment approach in which the probabilistic relationship between affective states and both, performance process and performance outcome, measures were determined. More specifically, introspective (i.e., verbal reports) and objective (heart rate and respiration rate) measures of arousal were incorporated to examine the relationships between arousal states and both, process components (i.e., routine consistency, timing), and outcome scores related to golf performance. Results revealed distinguishable and idiosyncratic IAPZs associated with physiological and introspective measures for each golfer. The associations between the IAPZs and decision-making or swing/stroke execution were strong and unique for each golfer. Results are elaborated using cognitive and affect-related concepts, and applications for practitioners are provided.
Electroconvulsive therapy: a Canadian perspective.

PubMed

Smith, W E; Richman, A

1984-12-01

Recent ECT practices in Canada are reviewed from a historical perspective with respect to specific criticisms. Utilization is decreasing; utilization rates vary widely between Provinces and between regions; disproportionate numbers of females have been receiving ECT; a substantial group of patients diagnosed as neurotic and schizophrenic continue to receive ECT; criteria and guidelines for its use are not consistently applied. Expected rates of ECT used are estimated, based on theory and practice as well as on published data on the epidemiology of affective disorders. Data on actual Canadian usage are reviewed and compared with an estimated minimum ratio of 30-45+ cases per year of non bi-polar depression per 100,000 population requiring ECT. Results show that there may be a substantial number of patients in some Provinces for whom ECT is the best available treatment and who are not receiving it. There is some ethical concern associated with possible under-use of ECT as the best therapy available for certain patient groups. Clinical cases and patterns of care should be reviewed at the hospital level to determine how best to effect improvements in the use of this treatment.
Utility of Teacher-Report Assessments of Autistic Severity in Japanese School Children

PubMed Central

Moriwaki, Aiko; Inada, Naoko

2013-01-01

Recent studies suggest that many children with milder autism spectrum disorder (ASD) are undiagnosed, untreated, and being educated in mainstream classes without support and that school teachers might be the best persons to identify a child's social deviance. At present, only a few screening measures using teacher ratings of ASD have been validated. The aim of this study was to examine the utility of teacher ratings on the Social Responsiveness Scale (SRS), a quantitative measure of ASD. We recruited 130 participants aged 4 to 17 years from local schools or local pediatric outpatient clinics specializing in neurodevelopmental disorders that included 70 children with ASD. We found that the teacher-report SRS can be reliably and validly applied to children as a screening tool or for other research purposes, and it also has cross-cultural comparability. Although parent-teacher agreement was satisfactory overall, a discrepancy existed for children with ASD, especially for girls with ASD. To improve sensitivity in children at higher risk, especially girls, we cannot overstate the importance of using standardized norms specific to gender, informant, and culture. PMID:24392224
Optimizing high performance computing workflow for protein functional annotation.

PubMed

Stanberry, Larissa; Rekepalli, Bhanu; Liu, Yuan; Giblock, Paul; Higdon, Roger; Montague, Elizabeth; Broomall, William; Kolker, Natali; Kolker, Eugene

2014-09-10

Functional annotation of newly sequenced genomes is one of the major challenges in modern biology. With modern sequencing technologies, the protein sequence universe is rapidly expanding. Newly sequenced bacterial genomes alone contain over 7.5 million proteins. The rate of data generation has far surpassed that of protein annotation. The volume of protein data makes manual curation infeasible, whereas a high compute cost limits the utility of existing automated approaches. In this work, we present an improved and optmized automated workflow to enable large-scale protein annotation. The workflow uses high performance computing architectures and a low complexity classification algorithm to assign proteins into existing clusters of orthologous groups of proteins. On the basis of the Position-Specific Iterative Basic Local Alignment Search Tool the algorithm ensures at least 80% specificity and sensitivity of the resulting classifications. The workflow utilizes highly scalable parallel applications for classification and sequence alignment. Using Extreme Science and Engineering Discovery Environment supercomputers, the workflow processed 1,200,000 newly sequenced bacterial proteins. With the rapid expansion of the protein sequence universe, the proposed workflow will enable scientists to annotate big genome data.
Optimizing high performance computing workflow for protein functional annotation

PubMed Central

Stanberry, Larissa; Rekepalli, Bhanu; Liu, Yuan; Giblock, Paul; Higdon, Roger; Montague, Elizabeth; Broomall, William; Kolker, Natali; Kolker, Eugene

2014-01-01

Functional annotation of newly sequenced genomes is one of the major challenges in modern biology. With modern sequencing technologies, the protein sequence universe is rapidly expanding. Newly sequenced bacterial genomes alone contain over 7.5 million proteins. The rate of data generation has far surpassed that of protein annotation. The volume of protein data makes manual curation infeasible, whereas a high compute cost limits the utility of existing automated approaches. In this work, we present an improved and optmized automated workflow to enable large-scale protein annotation. The workflow uses high performance computing architectures and a low complexity classification algorithm to assign proteins into existing clusters of orthologous groups of proteins. On the basis of the Position-Specific Iterative Basic Local Alignment Search Tool the algorithm ensures at least 80% specificity and sensitivity of the resulting classifications. The workflow utilizes highly scalable parallel applications for classification and sequence alignment. Using Extreme Science and Engineering Discovery Environment supercomputers, the workflow processed 1,200,000 newly sequenced bacterial proteins. With the rapid expansion of the protein sequence universe, the proposed workflow will enable scientists to annotate big genome data. PMID:25313296
Utilization and value of personal digital assistants on an epidemiology final examination.

PubMed

Lawler, Frank H; Cacy, Jim

2005-01-01

The utility of personal digital assistants (PDAs) in basic science medical education is uncertain. Student outcomes on an epidemiology course final examination for academic years 2003 and 2004 were examined. Students were given permission to use PDAs on the final examination, and self-selected whether these instruments were used. Performance on the examination based on use of a PDA and whether students thought it was useful for the examination was compared. A total of 389 students took the final examination, with an 88% response rate to the survey questions. No statistically significant differences were found on final examination scores. No trends toward significance were found on analyses of the total examination, specific topical domains, or on specific questions where a PDA might be expected to be especially useful. From this study, it can be concluded that use of PDAs and whether students thought they might be helpful had no measurable effect on performance on an epidemiology final examination. Further delineation of the possible use of PDAs in a basic science course and on the final examination is indicated.
Rapid prenatal diagnosis of chromosomal aneuploidies by fluorescence in situ hybridization: clinical experience with 4,500 specimens.

PubMed Central

Ward, B E; Gersen, S L; Carelli, M P; McGuire, N M; Dackowski, W R; Weinstein, M; Sandlin, C; Warren, R; Klinger, K W

1993-01-01

Detection of chromosome aneuploidies in uncultured amniocytes is possible using fluorescence in situ hybridization (FISH). We herein describe the results of the first clinical program which utilized FISH for the rapid detection of chromosome aneuploidies in uncultured amniocytes. FISH was performed on physician request, as an adjunct to cytogenetics in 4,500 patients. Region-specific DNA probes to chromosomes 13, 18, 21, X, and Y were used to determine ploidy by analysis of signal number in hybridized nuclei. A sample was considered to be euploid when all autosomal probes generated two hybridization signals and when a normal sex chromosome pattern was observed in greater than or equal to 80% of hybridized nuclei. A sample was considered to be aneuploid when greater than or equal to 70% of hybridized nuclei displayed the same abnormal hybridization pattern for a specific probe. Of the attempted analyses, 90.2% met these criteria and were reported as informative to referring physicians within 2 d of receipt. Based on these reporting parameters, the overall detection rate for aneuploidies was 73.3% (107/146), with an accuracy of informative results for aneuploidies of 93.9% (107/114). Compared to cytogenetics, the accuracy of all informative FISH results, euploid and aneuploid, was 99.8%, and the specificity was 99.9%. In those pregnancies where fetal abnormalities had been observed by ultrasound, referring physicians requested FISH plus cytogenetics at a significantly higher rate than they requested cytogenetics alone. The current prenatal FISH protocol is not designed to detect all chromosome abnormalities and should only be utilized as an adjunctive test to cytogenetics. This experience demonstrates that FISH can provide a rapid and accurate clinical method for prenatal identification of chromosome aneuploidies. PMID:8488836
Health-related quality of life measured using the EQ-5D-5L: South Australian population norms.

PubMed

McCaffrey, Nikki; Kaambwa, Billingsley; Currow, David C; Ratcliffe, Julie

2016-09-20

Although a five level version of the widely-used EuroQol 5 dimensions (EQ-5D) instrument has been developed, population norms are not yet available for Australia to inform the future valuation of health in economic evaluations. The aim of this study was to estimate HrQOL normative values for the EQ-5D-5L preference-based measure in a large, randomly selected, community sample in South Australia. The EQ-5D-5L instrument was included in the 2013 South Australian Health Omnibus Survey, an interviewer-administered, face-to-face, cross-sectional survey. Respondents rated their level of impairment across dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and global health rating on a visual analogue scale (EQ-VAS). Utility scores were derived using the newly-developed UK general population-based algorithm and relationships between utility and EQ-VAS scores and socio-demographic factors were also explored using multivariate regression analyses. Ultimately, 2,908 adults participated in the survey (63.4 % participation rate). The mean utility and EQ-VAS scores were 0.91 (95 CI 0.90, 0.91) and 78.55 (95 % CI 77.95, 79.15), respectively. Almost half of respondents reported no problems across all dimensions (42.8 %), whereas only 7.2 % rated their health >90 on the EQ-VAS (100 = the best health you can imagine). Younger age, male gender, longer duration of education, higher annual household income, employment and marriage/de facto relationships were all independent, statistically significant predictors of better health status (p < 0.01) measured with the EQ-VAS. Only age and employment status were associated with higher utility scores, indicating fundamental differences between these measures of health status. This is the first Australian study to apply the EQ-5D-5L in a large, community sample. Overall, findings are consistent with EQ-5D-5L utility and VAS scores reported for other countries and indicate that the majority of South Australian adults report themselves in full health. When valuing health in Australian economic evaluations, the utility population norms can be used to estimate HrQOL. More generally, the EQ-VAS score may be a better measure of population health given the smaller ceiling effect and broader coverage of HrQOL dimensions. Further research is recommended to update EQ-5D-5L population norms using the Australian general population specific scoring algorithm once this becomes publically available.

The economic impact of state ordered avoided cost rates for photovoltaic generated electricity

NASA Astrophysics Data System (ADS)

Bottaro, D.; Wheatley, N. J.

Various methods the states have devised to implement federal policy regarding the Public Utility Regulatory Policies Act (PURPA) of 1978, which requires that utilities pay their full 'avoided costs' to small power producers for the energy and capacity provided, are examined. The actions of several states are compared with rates estimated using utility expansion and rate-setting models, and the potential break-even capital costs of a photovoltaic system are estimated using models which calculate photovoltaic worth. The potential for the development of photovoltaics has been increased by the PURPA regulations more from the guarantee of utility purchase of photovoltaic power than from the high buy-back rates paid. The buy-back rate is high partly because of the surprisingly high effective capacity of photovoltaic systems in some locations.
Quinone-based stable isotope probing for assessment of 13C substrate-utilizing bacteria

NASA Astrophysics Data System (ADS)

Kunihiro, Tadao; Katayama, Arata; Demachi, Toyoko; Veuger, Bart; Boschker, Henricus T. S.; van Oevelen, Dick

2015-04-01

In this study, we attempted to establish quinone-stable-isotope probing (SIP) technique to link substrate-utilizing bacterial group to chemotaxonomic group in bacterial community. To identify metabolically active bacterial group in various environments, SIP techniques combined with biomarkers have been widely utilized as an attractive method for environmental study. Quantitative approaches of the SIP technique have unique advantage to assess substrate-incorporation into bacteria. As a most major quantitative approach, SIP technique based on phospholipid-derived fatty acids (PLFA) have been applied to simultaneously assess substrate-incorporation rate into bacteria and microbial community structure. This approach is powerful to estimate the incorporation rate because of the high sensitivity due to the detection by a gas chromatograph-combustion interface-isotope ratio mass spectrometer (GC-c-IRMS). However, its phylogenetic resolution is limited by specificity of a compound-specific marker. We focused on respiratory quinone as a biomarker. Our previous study found a good correlation between concentrations of bacteria-specific PLFAs and quinones over several orders of magnitude in various marine sediments, and the quinone method has a higher resolution (bacterial phylum level) for resolving differences in bacterial community composition more than that of bacterial PLFA. Therefore, respiratory quinones are potentially good biomarkers for quantitative approaches of the SIP technique. The LC-APCI-MS method as molecular-mass based detection method for quinone was developed and provides useful structural information for identifying quinone molecular species in environmental samples. LC-MS/MS on hybrid triple quadrupole/linear ion trap, which enables to simultaneously identify and quantify compounds in a single analysis, can detect high molecular compounds with their isotope ions. Use of LC-MS/MS allows us to develop quinone-SIP based on molecular mass differences due to 13C abundance in the quinone. In this study, we verified carbon stable isotope of quinone compared with bulk carbon stable isotope of bacterial culture. Results indicated a good correlation between carbon stable isotope of quinone compared with bulk carbon stable isotope. However, our measurement conditions for detection of quinone isotope-ions incurred underestimation of 13C abundance in the quinone. The quinone-SIP technique needs further optimization for measurement conditions of LC-MS/MS.
Glucose predictability, blood capillary permeability, and glucose utilization rate in subcutaneous, skeletal muscle, and visceral fat tissues.

PubMed

Koutny, Tomas

2013-11-01

This study suggests an approach for the comparison and evaluation of particular compartments with modest experimental setup costs. A glucose level prediction model was used to evaluate the compartment's glucose transport rate across the blood capillary membrane and the glucose utilization rate by the cells. The glucose levels of the blood, subcutaneous tissue, skeletal muscle tissue, and visceral fat were obtained in experiments conducted on hereditary hypertriglyceridemic rats. After the blood glucose level had undergone a rapid change, the experimenter attempted to reach a steady blood glucose level by manually correcting the glucose infusion rate and maintaining a constant insulin infusion rate. The interstitial fluid glucose levels of subcutaneous tissue, skeletal muscle tissue, and visceral fat were evaluated to determine the reaction delay compared with the change in the blood glucose level, the interstitial fluid glucose level predictability, the blood capillary permeability, the effect of the concentration gradient, and the glucose utilization rate. Based on these data, the glucose transport rate across the capillary membrane and the utilization rate in a particular tissue were determined. The rates obtained were successfully verified against positron emission tomography experiments. The subcutaneous tissue exhibits the lowest and the most predictable glucose utilization rate, whereas the skeletal muscle tissue has the greatest glucose utilization rate. In contrast, the visceral fat is the least predictable and has the shortest reaction delay compared with the change in the blood glucose level. The reaction delays obtained for the subcutaneous tissue and skeletal muscle tissue were found to be approximately equal using a metric based on the time required to reach half of the increase in the interstitial fluid glucose level. © 2013 Published by Elsevier Ltd.
Cost, healthcare resource utilization, and adherence of individuals with diabetes using U-500 or U-100 insulin: a retrospective database analysis.

PubMed

Eby, Elizabeth L; Wang, Ping; Curtis, Bradley H; Xie, Jin; Haldane, Diane C; Idris, Iskandar; Peters, Anne L; Hood, Robert C; Jackson, Jeffrey A

2013-01-01

To describe costs, healthcare resource utilization, and adherence of US patients receiving human regular U-500 insulin (U-500R), compared to patients receiving high-dose (>200 units/day) U-100 insulins (U-100) by subcutaneous injection for the treatment of diabetes. A retrospective analysis of data from Thomson Reuters MarketScan Research Databases (7/1/2008 to 12/31/2010). Difference-in-differences analyses were conducted on cost (medical, pharmacy, and overall costs) and on healthcare resource utilization variables (overall, diabetes-related, and non-diabetes-related medical visits). Adherence rates to the index insulins were assessed by proportion of days covered (PDC). Seven hundred and eleven (19%) patients in the U-500R cohort and 1508 (6%) patients in the U-100 cohort met selection criteria. Propensity score matching resulted in 684 matched pairs. Mean change in annualized pharmacy costs was in favor of the U-500R vs the U-100 cohort (-$1258 vs $3345, a difference of -$4603, p < 0.0001). Mean overall cost increase in the U-500R vs the U-100 cohort was also lower ($1999 vs $9104, a difference of -$7105, p = 0.005). The proportion of patients with at least one coded hypoglycemic event during the 12-month post-index period was higher in the U-500R vs the U-100 cohort (17.1% vs 11.7%, p < 0.005), but neither hypoglycemia rate (2.73 vs 2.90 events per person) nor hypoglycemia-specific costs (mean $1669 vs $1543) were significantly different. No significant differences were noted between cohorts for change (post-pre) in any resource utilization category. PDC was greater in the U-500R vs the U-100 cohort (65.2% vs 39.5%, p < 0.0001). Claims data are not as accurate as empirical evaluation by a clinician. Glycemic control data were not available for this analysis. In patients requiring high-dose insulin, treatment with U-500R vs high-dose U-100 insulins is associated with significant decreases in pharmacy and overall costs, slightly higher hypoglycemia incidence, no difference in hypoglycemia-specific costs or in resource utilization, and better adherence.
An assessment of schoolyard renovation strategies to encourage children's physical activity

PubMed Central

2011-01-01

Background Children in poor and minority neighborhoods often lack adequate environmental support for healthy physical development and community interventions designed to improve physical activity resources serve as an important approach to addressing obesity. In Denver, the Learning Landscapes (LL) program has constructed over 98 culturally-tailored schoolyard play spaces at elementary schools with the goal to encourage utilization of play spaces and physical activity. In spite of enthusiasm about such projects to improve urban environments, little work has evaluated their impact or success in achieving their stated objectives. This study evaluates the impacts of LL construction and recency of renovation on schoolyard utilization and the physical activity rates of children, both during and outside of school, using an observational study design. Methods This study employs a quantitative method for evaluating levels of physical activity of individuals and associated environmental characteristics in play and leisure environments. Schools were selected on the basis of their participation in the LL program, the recency of schoolyard renovation, the size of the school, and the social and demographic characteristics of the school population. Activity in the schoolyards was measured using the System for Observing Play and Leisure Activity (SOPLAY), a validated quantitative method for evaluating levels of physical activity of individuals in play and leisure environments. Trained observers collected measurements before school, during school recess, after school, and on weekends. Overall utilization (the total number of children observed on the grounds) and the rate of activity (the percentage of children observed who were physically active) were analyzed. Observations were compared using t-tests and the data were stratified by gender for further analysis. In order to assess the impacts of LL renovation, recently-constructed LL schoolyards were compared to LL schoolyards with older construction, as well as un-renovated schoolyards. Results Overall utilization was significantly higher at LL schools than at un-renovated schools for most observation periods. Notably, LL renovation had no impact on girl's utilization on the weekends, although differences were observed for all other periods. There were no differences in rates of activity for any comparison. With the exception of the number of boys observed, there was no statistically significant difference in activity when recently-constructed LL schools are compared to LL schools with older construction dates and there was no difference observed in comparisons of older LL with unrenovated sites. Conclusions While we observed greater utilization and physical activity in schools with LL, the impact of specific features of LL renovation is not clear. However, schoolyard renovation and programs to encourage schoolyard use before and after school may offer a means to encourage greater physical activity among children, and girls in particular. Additional study of schoolyard renovation may shed light on the specific reasons for these findings or suggest effective policies to improve the physical activity resources of poor and minority neighborhoods. PMID:21477325
Reliability analysis of a robotic system using hybridized technique

NASA Astrophysics Data System (ADS)

Kumar, Naveen; Komal; Lather, J. S.

2017-09-01

In this manuscript, the reliability of a robotic system has been analyzed using the available data (containing vagueness, uncertainty, etc). Quantification of involved uncertainties is done through data fuzzification using triangular fuzzy numbers with known spreads as suggested by system experts. With fuzzified data, if the existing fuzzy lambda-tau (FLT) technique is employed, then the computed reliability parameters have wide range of predictions. Therefore, decision-maker cannot suggest any specific and influential managerial strategy to prevent unexpected failures and consequently to improve complex system performance. To overcome this problem, the present study utilizes a hybridized technique. With this technique, fuzzy set theory is utilized to quantify uncertainties, fault tree is utilized for the system modeling, lambda-tau method is utilized to formulate mathematical expressions for failure/repair rates of the system, and genetic algorithm is utilized to solve established nonlinear programming problem. Different reliability parameters of a robotic system are computed and the results are compared with the existing technique. The components of the robotic system follow exponential distribution, i.e., constant. Sensitivity analysis is also performed and impact on system mean time between failures (MTBF) is addressed by varying other reliability parameters. Based on analysis some influential suggestions are given to improve the system performance.
UceWeb: a web-based collaborative tool for collecting and sharing quality of life data.

PubMed

Parimbelli, E; Sacchi, L; Rubrichi, S; Mazzanti, A; Quaglini, S

2015-01-01

This work aims at building a platform where quality-of-life data, namely utility coefficients, can be elicited not only for immediate use, but also systematically stored together with patient profiles to build a public repository to be further exploited in studies on specific target populations (e.g. cost/utility analyses). We capitalized on utility theory and previous experience to define a set of desirable features such a tool should show to facilitate sound elicitation of quality of life. A set of visualization tools and algorithms has been developed to this purpose. To make it easily accessible for potential users, the software has been designed as a web application. A pilot validation study has been performed on 20 atrial fibrillation patients. A collaborative platform, UceWeb, has been developed and tested. It implements the standard gamble, time trade-off and rating-scale utility elicitation methods. It allows doctors and patients to choose the mode of interaction to maximize patients’ comfort in answering difficult questions. Every utility elicitation may contribute to the growth of the repository. UceWeb can become a unique source of data allowing researchers both to perform more reliable comparisons among healthcare interventions and build statistical models to gain deeper insight into quality of life data.
Inpatients hypospadias care: Trends and outcomes from the American nationwide inpatient sample

PubMed Central

Sukumar, Shyam; Sood, Akshay; Hanske, Julian; Vetterlein, Malte; Elder, Jack S.; Fisch, Margit; Trinh, Quoc-Dien; Friedman, Ariella A.

2015-01-01

Purpose Hypospadias is the most common congenital penile anomaly. Information about current utilization patterns of inpatient hypospadias repair as well as complication rates remain poorly evaluated. Materials and Methods The Nationwide Inpatient Sample was used to identify all patients undergoing inpatient hypospadias repair between 1998 and 2010. Patient and hospital characteristics were attained and outcomes of interest included intra- and immediate postoperative complications. Utilization was evaluated temporally and also according to patient and hospital characteristics. Predictors of complications and excess length of stay were evaluated by logistic regression models. Results A weighted 10,201 patients underwent inpatient hypospadias repair between 1998 and 2010. Half were infants (52.2%), and were operated in urban and teaching hospitals. Trend analyses demonstrated a decline in incidence of inpatient hypospadias repair (estimated annual percentage change, -6.80%; range, -0.51% to -12.69%; p=0.037). Postoperative complication rate was 4.9% and most commonly wound-related. Hospital volume was inversely related to complication rates. Specifically, higher hospital volume (>31 cases annually) was the only variable associated with decreased postoperative complications. Conclusions Inpatient hypospadias repair have substantially decreased since the late 1990's. Older age groups and presumably more complex procedures constitute most of the inpatient procedures nowadays. PMID:26279829
Robust and Accurate Anomaly Detection in ECG Artifacts Using Time Series Motif Discovery

PubMed Central

Sivaraks, Haemwaan

2015-01-01

Electrocardiogram (ECG) anomaly detection is an important technique for detecting dissimilar heartbeats which helps identify abnormal ECGs before the diagnosis process. Currently available ECG anomaly detection methods, ranging from academic research to commercial ECG machines, still suffer from a high false alarm rate because these methods are not able to differentiate ECG artifacts from real ECG signal, especially, in ECG artifacts that are similar to ECG signals in terms of shape and/or frequency. The problem leads to high vigilance for physicians and misinterpretation risk for nonspecialists. Therefore, this work proposes a novel anomaly detection technique that is highly robust and accurate in the presence of ECG artifacts which can effectively reduce the false alarm rate. Expert knowledge from cardiologists and motif discovery technique is utilized in our design. In addition, every step of the algorithm conforms to the interpretation of cardiologists. Our method can be utilized to both single-lead ECGs and multilead ECGs. Our experiment results on real ECG datasets are interpreted and evaluated by cardiologists. Our proposed algorithm can mostly achieve 100% of accuracy on detection (AoD), sensitivity, specificity, and positive predictive value with 0% false alarm rate. The results demonstrate that our proposed method is highly accurate and robust to artifacts, compared with competitive anomaly detection methods. PMID:25688284
Anisotropic constitutive model for nickel base single crystal alloys: Development and finite element implementation

NASA Technical Reports Server (NTRS)

Dame, L. T.; Stouffer, D. C.

1986-01-01

A tool for the mechanical analysis of nickel base single crystal superalloys, specifically Rene N4, used in gas turbine engine components is developed. This is achieved by a rate dependent anisotropic constitutive model implemented in a nonlinear three dimensional finite element code. The constitutive model is developed from metallurigical concepts utilizing a crystallographic approach. A non Schmid's law formulation is used to model the tension/compression asymmetry and orientation dependence in octahedral slip. Schmid's law is a good approximation to the inelastic response of the material in cube slip. The constitutive equations model the tensile behavior, creep response, and strain rate sensitivity of these alloys. Methods for deriving the material constants from standard tests are presented. The finite element implementation utilizes an initial strain method and twenty noded isoparametric solid elements. The ability to model piecewise linear load histories is included in the finite element code. The constitutive equations are accurately and economically integrated using a second order Adams-Moulton predictor-corrector method with a dynamic time incrementing procedure. Computed results from the finite element code are compared with experimental data for tensile, creep and cyclic tests at 760 deg C. The strain rate sensitivity and stress relaxation capabilities of the model are evaluated.
Carbon-Coated, Diatomite-Derived Nanosilicon as a High Rate Capable Li-ion Battery Anode.

PubMed

Campbell, Brennan; Ionescu, Robert; Tolchin, Maxwell; Ahmed, Kazi; Favors, Zachary; Bozhilov, Krassimir N; Ozkan, Cengiz S; Ozkan, Mihrimah

2016-10-07

Silicon is produced in a variety of ways as an ultra-high capacity lithium-ion battery (LIB) anode material. The traditional carbothermic reduction process required is expensive and energy-intensive; in this work, we use an efficient magnesiothermic reduction to convert the silica-based frustules within diatomaceous earth (diatomite, DE) to nanosilicon (nanoSi) for use as LIB anodes. Polyacrylic acid (PAA) was used as a binder for the DE-based nanoSi anodes for the first time, being attributed for the high silicon utilization under high current densities (up to 4C). The resulting nanoSi exhibited a high BET specific surface area of 162.6 cm 2 g -1 , compared to a value of 7.3 cm 2 g -1 for the original DE. DE contains SiO 2 architectures that make ideal bio-derived templates for nanoscaled silicon. The DE-based nanoSi anodes exhibit good cyclability, with a specific discharge capacity of 1102.1 mAh g -1 after 50 cycles at a C-rate of C/5 (0.7 A g Si -1 ) and high areal loading (2 mg cm -2 ). This work also demonstrates the fist rate capability testing for a DE-based Si anode; C-rates of C/30 - 4C were tested. At 4C (14.3 A g Si -1 ), the anode maintained a specific capacity of 654.3 mAh g -1 - nearly 2x higher than graphite's theoretical value (372 mAh g -1 ).
Predicting SF-6D utility scores from the Oswestry disability index and numeric rating scales for back and leg pain.

PubMed

Carreon, Leah Y; Glassman, Steven D; McDonough, Christine M; Rampersaud, Raja; Berven, Sigurd; Shainline, Michael

2009-09-01

Cross-sectional cohort. The purpose of this study is to provide a model to allow estimation of utility from the Short Form (SF)-6D using data from the Oswestry Disability Index (ODI), Back Pain Numeric Rating Scale (BPNRS), and the Leg Pain Numeric Rating Scale (LPNRS). Cost-utility analysis provides important information about the relative value of interventions and requires a measure of utility not often available from clinical trial data. The ODI and numeric rating scales for back (BPNRS) and leg pain (LPNRS), are widely used disease-specific measures for health-related quality of life in patients with lumbar degenerative disorders. The purpose of this study is to provide a model to allow estimation of utility from the SF-6D using data from the ODI, BPNRS, and the LPNRS. SF-36, ODI, BPNRS, and LPNRS were prospectively collected before surgery, at 12 and 24 months after surgery in 2640 patients undergoing lumbar fusion for degenerative disorders. Spearman correlation coefficients for paired observations from multiple time points between ODI, BPNRS, and LPNRS, and SF-6D utility scores were determined. Regression modeling was done to compute the SF-6D score from the ODI, BPNRS, and LPNRS. Using a separate, independent dataset of 2174 patients in which actual SF-6D and ODI scores were available, the SF-6D was estimated for each subject and compared to their actual SF-6D. In the development sample, the mean age was 52.5 +/- 15 years and 34% were male. In the validation sample, the mean age was 52.9 +/- 14.2 years and 44% were male. Correlations between the SF-6D and the ODI, BPNRS, and LPNRS were statistically significant (P < 0.0001) with correlation coefficients of 0.82, 0.78, and 0.72, respectively. The regression equation using ODI, BPNRS,and LPNRS to predict SF-6D had an R of 0.69 and a root mean square error of 0.076. The model using ODI alone had an R of 0.67 and a root mean square error of 0.078. The correlation coefficient between the observed and estimated SF-6D score was 0.80. In the validation analysis, there was no statistically significant difference (P = 0.11) between actual mean SF-6D (0.55 +/- 0.12) and the estimated mean SF-6D score (0.55 +/- 0.10) using the ODI regression model. This regression-based algorithm may be used to predict SF-6D scores in studies of lumbar degenerative disease that have collected ODI but not utility scores.
Multiple paths in complex tasks

NASA Technical Reports Server (NTRS)

Galanter, Eugene; Wiegand, Thomas; Mark, Gloria

1987-01-01

The relationship between utility judgments of subtask paths and the utility of the task as a whole was examined. The convergent validation procedure is based on the assumption that measurements of the same quantity done with different methods should covary. The utility measures of the subtasks were obtained during the performance of an aircraft flight controller navigation task. Analyses helped decide among various models of subtask utility combination, whether the utility ratings of subtask paths predict the whole tasks utility rating, and indirectly, whether judgmental models need to include the equivalent of cognitive noise.
Rates of catheter-associated urinary tract infection in tertiary care hospitals in 3 Arabian Gulf countries: A 6-year surveillance study.

PubMed

Al Nasser, Wafa; El-Saed, Aiman; Al-Jardani, Amina; Althaqafi, Abdulhakeem; Alansari, Huda; Alsalman, Jameela; Maskari, Zaina Al; El Gammal, Ayman; Al-Abri, Seif S; Balkhy, Hanan H

2016-12-01

The true burden of catheter-associated urinary tract infections (CAUTIs) remains largely unknown because of a lack of national and regional surveillance reports in Gulf Cooperation Council (GCC) countries. The purpose of this study was to estimate location-specific CAUTI rates in the GCC region and to compare them with published reports from the U.S. National Healthcare Safety Network (NHSN) and the International Nosocomial Infection Control Consortium (INICC). CAUTI rates and urinary catheter utilization between 2008 and 2013 were calculated using NHSN methodology pooled from 6 hospitals in 3 GCC countries: Saudi Arabia, Oman, and Bahrain. The standardized infection ratios of the CAUTIs were compared with published reports of the NHSN and INICC. A total of 286 CAUTI events were diagnosed during 6 years of surveillance, covering 89,254 catheter days and 113,807 patient days. The overall CAUTI rate was 3.2 per 1,000 catheter days (95% confidence interval, 2.8-3.6), with an overall urinary catheter utilization of 0.78. The CAUTI rates showed a wide variability between participating hospitals, with approximately 80% reduction during the study. The overall compliance with the urinary catheter bundle implementation during the second half of the study was 65%. The risk of CAUTI in GCC hospitals was 35% higher than the NHSN hospitals, but 37% lower than the INICC hospitals. CAUTI rates pooled from a sample of GCC hospitals are quite different from rates in both developing and developed countries. Copyright Â© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Microbial utilization of dissolved organic matter from leaves of the red mangrove, Rhizophora mangle, in the Fresh Creek estuary, Bahamas

NASA Astrophysics Data System (ADS)

Benner, Ronald; Peele, Emily R.; Hodson, Robert E.

1986-11-01

Dissolved organic matter was leached from [ 14C]labeled leaves of the red mangrove, Rhizophora mangle, and used in studies to determine the rates and efficiencies of microbial utilization of the water-soluble components of mangrove leaves in the Fresh Creek estuary, Bahamas. Rates of microbial utilization (assimilation plus mineralization) of mangrove leachate ranged from 0·022 to 4·675 μg ml -1 h -1 depending on the concentration of leachate and the size or diversity of microbial populations. Microflora associated with decaying mangrove leaves utilized mangrove leachate at rates up to 18-fold higher than rates of leachate utilization by planktonic microflora. Chemical analyses indicated that tannins and other potentially inhibitory phenolic compounds made up a major fraction (18%) of the dissolved organic matter in mangrove leachate. Mangrove leachate did not appear to be inhibitory to the microbial uptake of leachate or the microbial degradation of the lignocellulosic component of mangrove leaves except at high concentrations (mg ml -1). The availability of molecular oxygen also was an important parameter affecting rates of leachate utilization; rates of microbial utilization of leachate were up to 8-fold higher under aerobic rather than anaerobic conditions. The overall efficiency of conversion of mangrove leachate into microbial biomass was high and ranged from 64% to 94%. As much as 42% of the added leachate was utilized during 2 to 12 h incubations, indicating that a major fraction of the leachable material from mangrove leaves is incorporated into microbial biomass, and thus available to animals in the estuarine food web.
Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

PubMed

Sheingold, Steven; Nguyen, Nguyen Xuan

2014-01-01

This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.
Effect of lactose concentration on batch production of ethanol from cheese whey using Candida pseudotropicalis

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

Ghaly, A.E.; El-Taweel, A.A.

1995-07-01

The effect of lactose concentration on growth of Candida pseudotropicalis and ethanol production from cheese whey under batch conditions was investigated. Four initial lactose concentrations ranging from 50 to 200 g/L (5 to 20% wt/vol) were used. High concentration of lactose had an inhibitory effect on the specific growth rate, lactose utilization rate, and ethanol production rate. The maximum cell concentration was influenced by the initial substrate concentration as well as ethanol concentration. Inhibition of ethanol production was more pronounced at higher initial lactose concentrations. The maximum ethanol yield (96.6% of the theoretical yield) was achieved with the 100 g/Lmore » initial substrate concentration. The results indicated that pH control during alcohol fermentation of cheese whey is not necessary. 41 refs., 12 figs., 1 tab.« less
Guide to purchasing electricity and gas

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

Cunningham, P.R.; Burrell, D.

1999-09-01

An issue which now faces all energy users is understanding the specifics of the impact of the deregulation of the electric and natural gas industries. This book was written to help one understand the forces behind deregulation, and how one can use this knowledge now to negotiate lower utility rates, even if deregulation has not been fully implemented in one`s area. Readers will learn how coordinating new rate packages with the management of in-house loads can multiply savings. Essential ingredients to successful negotiation are clearly outlined, including assessing the alternatives for both load management and supply, understanding interruptible rate options,more » doing homework on ongoing deregulation activities, finding out who makes the decisions and working directly with them, and hands-on involvement in fine tuning the final contract. Case studies are also included.« less
The relationship between retirement life cycle changes and older men's labor force participation rates.

PubMed

Hayward, M D; Crimmins, E M; Wray, L A

1994-09-01

This study probes the utility of older men's labor force participation rates (LFPRs) as indicators of the work-to-retirement transition. Specific attention is directed at how shifts in the retirement life cycle are related to LFPRs. Based on Current Population Survey data for the 1970s, a life table modeling approach showed that LFPRs are relatively weak indicators of the work-to-retirement transition. This was demonstrated by the relative stability in older men's age profiles of LFPRs despite significant changes in the timing and "organization" of the work-to-retirement transition. The 1970s evidenced a contraction of the main career and the expansion of both post-retirement work activity and retirement, yet none of these changes substantially altered the age profiles of older men's labor force participation rates.
An Evaluation of Economists’ Influence on Electric Utility Rate Reforms,

DTIC Science & Technology

1982-01-01

PURPA ) of 1978 required all 50 state utility commissions and more than 150 other jurisdictions regulating electric utility rates to con- sider the...complex rate structure). The "cost effectiveness" language of PURPA suggests such an evaluation criterion based on long term considerations without...detailing the components of benefit; see Joskow. Individual hearings under PURPA have generally employed three standards: fuel or energy savings (if a TOU

Hospital Evaluations by Social Media: A Comparative Analysis of Facebook Ratings among Performance Outliers.

PubMed

Glover, McKinley; Khalilzadeh, Omid; Choy, Garry; Prabhakar, Anand M; Pandharipande, Pari V; Gazelle, G Scott

2015-10-01

An increasing number of hospitals and health systems utilize social media to allow users to provide feedback and ratings. The correlation between ratings on social media and more conventional hospital quality metrics remains largely unclear, raising concern that healthcare consumers may make decisions on inaccurate or inappropriate information regarding quality. The purpose of this study was to examine the extent to which hospitals utilize social media and whether user-generated metrics on Facebook(®) correlate with a Hospital Compare(®) metric, specifically 30-day all cause unplanned hospital readmission rates. This was a retrospective cross-sectional study conducted among all U.S. hospitals performing outside the confidence interval for the national average on 30-day hospital readmission rates as reported on Hospital Compare. Participants were 315 hospitals performing better than U.S. national rate on 30-day readmissions and 364 hospitals performing worse than the U.S. national rate. The study analyzed ratings of hospitals on Facebook's five-star rating scale, 30-day readmission rates, and hospital characteristics including beds, teaching status, urban vs. rural location, and ownership type. Hospitals performing better than the national average on 30-day readmissions were more likely to use Facebook than lower-performing hospitals (93.3 % vs. 83.5 %; p < 0.01). The average rating for hospitals with low readmission rates (4.15 ± 0.31) was higher than that for hospitals with higher readmission rates (4.05 ± 0.41, p < 0.01). Major teaching hospitals were 14.3 times more likely to be in the high readmission rate group. A one-star increase in Facebook rating was associated with increased odds of the hospital belonging to the low readmission rate group by a factor of 5.0 (CI: 2.6-10.3, p < 0.01), when controlling for hospital characteristics and Facebook-related variables. Hospitals with lower rates of 30-day hospital-wide unplanned readmissions have higher ratings on Facebook than hospitals with higher readmission rates. These findings add strength to the concept that aggregate measures of patient satisfaction on social media correlate with more traditionally accepted measures of hospital quality.
Anxiety, depression, and PTSD following cardiac arrest: a systematic review of the literature.

PubMed

Wilder Schaaf, Kathryn P; Artman, Laura K; Peberdy, Mary Ann; Walker, William C; Ornato, Joseph P; Gossip, Michelle R; Kreutzer, Jeffrey S

2013-07-01

Identify the occurrence rate of post-arrest psychological distress; evaluate methodological approaches; suggest future research priorities; address clinical implications. The electronic databases PubMed/MEDLINE and PsychInfo/APA PsycNET were utilized to search for terms including 'Cardiac Arrest', 'Therapeutic Hypothermia' and 'Depression', 'Anxiety', 'Quality of Life', 'Posttraumatic Stress Disorder (PTSD)', 'Psychological Outcomes', 'Hospital Anxiety and Depression Scale (HADS)', and 'Beck Depression Inventory (BDI)'. High rates of psychological distress have been reported after OHCA. Specifically, incidence rates of depression have ranged from 14% to 45%; anxiety rates have ranged from 13% to 61%; PTSD rates reportedly range from 19% to 27%. Variability between studies is likely attributable to methodological variations relating to measures used, time since arrest, and research setting. Given the occurrence rate of psychological distress after OHCA, psychological screening and early intervention seems indicated in the cardiac arrest population. Further studies are needed to better establish occurrence rates in both inpatient and outpatient settings, determine appropriate measures and normative cut off scores, and decide on the most appropriate method of intervention. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
A forward error correction technique using a high-speed, high-rate single chip codec

NASA Astrophysics Data System (ADS)

Boyd, R. W.; Hartman, W. F.; Jones, Robert E.

The authors describe an error-correction coding approach that allows operation in either burst or continuous modes at data rates of multiple hundreds of megabits per second. Bandspreading is low since the code rate is 7/8 or greater, which is consistent with high-rate link operation. The encoder, along with a hard-decision decoder, fits on a single application-specific integrated circuit (ASIC) chip. Soft-decision decoding is possible utilizing applique hardware in conjunction with the hard-decision decoder. Expected coding gain is a function of the application and is approximately 2.5 dB for hard-decision decoding at 10-5 bit-error rate with phase-shift-keying modulation and additive Gaussian white noise interference. The principal use envisioned for this technique is to achieve a modest amount of coding gain on high-data-rate, bandwidth-constrained channels. Data rates of up to 300 Mb/s can be accommodated by the codec chip. The major objective is burst-mode communications, where code words are composed of 32 n data bits followed by 32 overhead bits.
Parent Caregiver Self-Efficacy and Child Reactions to Pediatric Cancer Treatment Procedures

PubMed Central

Peterson, Amy M.; Harper, Felicity W. K.; Albrecht, Terrance L.; Taub, Jeffrey W.; Orom, Heather; Phipps, Sean; Penner, Louis A.

2014-01-01

This study examined how parents’ sense of self-efficacy specific to caregiving for their child during cancer treatment procedures affected children’s distress and cooperation during procedures. Potential correlates of caregiver self-efficacy (ie, demographics, child clinical characteristics, parent dispositional attributes, and social support) were also examined. Participants were 119 children undergoing cancer treatment procedures and their parents. Parents’ self-efficacy about 6 procedure-specific caregiver tasks was measured. Parents, children, nurses, and observers rated child distress and parents, nurses and observers rated child cooperation during procedures. Higher parent self-efficacy about keeping children calm during procedures predicted lower child distress and higher child cooperation during procedures. Parent dispositional attributes (eg, enduring positive mood, empathy) and social support predicted self-efficacy. Parent caregiver self-efficacy influences child distress and cooperation during procedures and is associated with certain parent attributes. Findings suggest the utility of identifying parents who would benefit from targeted interventions to increase self-efficacy about caregiving during treatment procedures. PMID:24378818
Microscale oxygraphy reveals OXPHOS impairment in MRC mutant cells

PubMed Central

Invernizzi, F.; D'Amato, I.; Jensen, P.B.; Ravaglia, S.; Zeviani, M.; Tiranti, V.

2012-01-01

Given the complexity of the respiratory chain structure, assembly and regulation, the diagnostic workout for the identification of defects of oxidative phosphorylation (OXPHOS) is a major challenge. Spectrophotometric assays, that measure the activity of individual respiratory complexes in tissue and cell homogenates or isolated mitochondria, are highly specific, but their utilization is limited by the availability of sufficient biological material and intrinsic sensitivity. A further limitation is tissue specificity, which usually determines attenuation, or disappearance, in cultured fibroblasts, of defects detected in muscle or liver. We used numerous fibroblast cell lines derived from patients with OXPHOS deficiencies to set up experimental protocols required for the direct readout of cellular respiration using the Seahorse XF96 apparatus, which measures oxygen consumption rate (OCR) and extra-cellular acidification rate (ECAR) in 96 well plates. Results demonstrate that first level screening based on microscale oxygraphy is more sensitive, cheaper and rapid than spectrophotometry for the biochemical evaluation of cells from patients with suspected mitochondrial disorders. PMID:22310368
The impact of payer-specific hospital case mix on hospital costs and revenues for third-party patients.

PubMed

Lee, Keon-Hyung; Roh, M P H Chul-Young

2007-02-01

Competition among hospitals and managed care have forced hospital industry to be more efficient. With higher degrees of hospital competition and managed care penetration, hospitals have argued that the rate of increase in hospital cost is greater than the rate of increase in hospital revenue. By developing a payer-specific case mix index (CMI) for third-party patients, this paper examined the effect of hospital case mix on hospital cost and revenue for third-party patients in California using the hospital financial and utilization data covering 1986-1998. This study found that the coefficients for CMIs in the third-party hospital revenue model were greater than those in the hospital cost model until 1995. Since 1995, however, the coefficients for CMIs in the third-party hospital revenue model have been less than those in hospital cost models. Over time, the differences in coefficients for CMIs in hospital revenue and cost models for third-party patients have become smaller and smaller although those differences are statistically insignificant.
Derivation and application of the energy dissipation factor in the design of fishways

USGS Publications Warehouse

Towler, Brett; Mulligan, Kevin; Haro, Alexander J.

2015-01-01

Reducing turbulence and associated air entrainment is generally considered advantageous in the engineering design of fish passage facilities. The well-known energy dissipation factor, or EDF, correlates with observations of the phenomena. However, inconsistencies in EDF forms exist and the bases for volumetric energy dissipation rate criteria are often misunderstood. A comprehensive survey of EDF criteria is presented. Clarity in the application of the EDF and resolutions to these inconsistencies are provided through formal derivations; it is demonstrated that kinetic energy represents only 1/3 of the total energy input for the special case of a broad-crested weir. Specific errors in published design manuals are identified and resolved. New, fundamentally sound, design equations for culvert outlet pools and standard Denil Fishway resting pools are developed. The findings underscore the utility of EDF equations, demonstrate the transferability of volumetric energy dissipation rates, and provide a foundation for future refinement of component-, species-, and life-stage-specific EDF criteria.
Identification of Reduced-Order Thermal Therapy Models Using Thermal MR Images: Theory and Validation

PubMed Central

2013-01-01

In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate. PMID:22531754
Development under elevated pCO2 conditions does not affect lipid utilization and protein content in early life-history stages of the purple sea urchin, Strongylocentrotus purpuratus.

PubMed

Matson, Paul G; Yu, Pauline C; Sewell, Mary A; Hofmann, Gretchen E

2012-12-01

Ocean acidification (OA) is expected to have a major impact on marine species, particularly during early life-history stages. These effects appear to be species-specific and may include reduced survival, altered morphology, and depressed metabolism. However, less information is available regarding the bioenergetics of development under elevated CO(2) conditions. We examined the biochemical and morphological responses of Strongylocentrotus purpuratus during early development under ecologically relevant levels of pCO(2) (365, 1030, and 1450 μatm) that may occur during intense upwelling events. The principal findings of this study were (1) lipid utilization rates and protein content in S. purpuratus did not vary with pCO(2); (2) larval growth was reduced at elevated pCO(2) despite similar rates of energy utilization; and (3) relationships between egg phospholipid content and larval length were found under control but not high pCO(2) conditions. These results suggest that this species may either prioritize endogenous energy toward development and physiological function at the expense of growth, or that reduced larval length may be strictly due to higher costs of growth under OA conditions. This study highlights the need to further expand our knowledge of the physiological mechanisms involved in OA response in order to better understand how present populations may respond to global environmental change.
Erythrocyte Sedimentation Rate and C-reactive Protein Measurements and Their Relevance in Clinical Medicine.

PubMed

Bray, Christopher; Bell, Lauren N; Liang, Hong; Haykal, Rasha; Kaiksow, Farah; Mazza, Joseph J; Yale, Steven H

2016-12-01

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are widely used laboratory markers of systemic inflammation. A thorough understanding of the similarities and differences between these two serological markers, including factors that affect measurements, is necessary for the proper utilization and interpretation of ESR and CRP. This review summarizes the current published literature (searched on MEDLINE through February 2016) surrounding the history and utilization of ESR and CRP, and examines factors that affect ESR and CRP measurements and discordance amongst these two inflammatory markers. As ESR and CRP lack sensitivity or specificity, these tests should be used only in combination with clinical history and physical exam for diagnosis and monitoring of pathological conditions. The clinical application of these tests in diagnosis is best applied to conditions in which there is high or low clinical probability of disease. Importantly, discrepancies between ESR and CRP measurements commonly have been reported in both inpatient and outpatient settings and this problem may be particularly prevalent in chronic inflammatory diseases. Numerous physiological factors, including noninfectious conditions and resolution of inflammation can contribute to abnormally high ESR/low CRP readings or vice versa. Although discordance may be encountered in certain settings, proper utilization of ESR and CRP measurements continues to play an important role in clinical management of many inflammatory and other conditions.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Thompson, J.; Chassy, B.M.; Egan, W.

A mutant of Streptococcus lactis 133 has been isolated that lacks both glucokinase and phosphoenolpyruvate-dependent mannose- phosphotransferase (mannose-PTS) activities. The double mutant S. lactis 133 mannose-PTSd GK- is unable to utilize either exogenously supplied or intracellularly generated glucose for growth. Fluorographic analyses of metabolites formed during the metabolism of (/sup 14/C)lactose labeled specifically in the glucose or galactosyl moiety established that the cells were unable to phosphorylate intracellular glucose. However, cells of S. lactis 133 mannose-PTSd GK- readily metabolized intracellular glucose 6-phosphate, and the growth rates and cell yield of the mutant and parental strains on sucrose were the same.more » During growth on lactose, S. lactis 133 mannose-PTSd GK- fermented only the galactose moiety of the disaccharide, and 1 mol of glucose was generated per mol of lactose consumed. For an equivalent concentration of lactose, the cell yield of the mutant was 50% that of the wild type. The specific rate of lactose utilization by growing cells of S. lactis 133 mannose-PTSd GK- was ca. 50% greater than that of the wild type, but the cell doubling times were 70 and 47 min, respectively. High-resolution /sup 31/P nuclear magnetic resonance studies of lactose transport by starved cells of S. lactis 133 and S. lactis 133 mannose-PTSd GK- showed that the latter cells contained elevated lactose-PTS activity. Throughout exponential growth on lactose, the mutant maintained an intracellular steady-state glucose concentration of 100 mM.« less
Utility of hepatic transaminases in children with concern for abuse.

PubMed

Lindberg, Daniel M; Shapiro, Robert A; Blood, Emily A; Steiner, R Daryl; Berger, Rachel P

2013-02-01

Routine testing of hepatic transaminases, amylase, and lipase has been recommended for all children evaluated for physical abuse, but rates of screening are widely variable, even among abuse specialists, and data for amylase and lipase testing are lacking. A previous study of screening in centers that endorsed routine transaminase screening suggested that using a transaminase threshold of 80 IU/L could improve injury detection. Our objectives were to prospectively validate the test characteristics of the 80-IU/L threshold and to determine the utility of amylase and lipase to detect occult abdominal injury. This was a retrospective secondary analysis of the Examining Siblings To Recognize Abuse research network, a multicenter study in children younger than 10 years old who underwent subspecialty evaluation for physical abuse. We determined rates of identified abdominal injuries and results of transaminase, amylase, and lipase testing. Screening studies were compared by using basic test characteristics (sensitivity, specificity) and the area under the receiver operating characteristic curve. Abdominal injuries were identified in 82 of 2890 subjects (2.8%; 95% confidence interval: 2.3%-3.5%). Hepatic transaminases were obtained in 1538 (53%) subjects. Hepatic transaminases had an area under the receiver operating characteristic curve of 0.87. A threshold of 80 IU/L yielded sensitivity of 83.8% and specificity of 83.1%. The areas under the curve for amylase and lipase were 0.67 and 0.72, respectively. Children evaluated for physical abuse with transaminase levels >80 IU/L should undergo definitive testing for abdominal injury.
TAKING THE PULSE OF PROLONGED EXPOSURE THERAPY: PHYSIOLOGICAL REACTIVITY TO TRAUMA IMAGERY AS AN OBJECTIVE MEASURE OF TREATMENT RESPONSE.

PubMed

Wangelin, Bethany C; Tuerk, Peter W

2015-12-01

Physiological reactivity to trauma-related cues is a primary symptom of PTSD and can be assessed objectively using script-driven imagery paradigms. However, subjective self-reported symptom measures are the most common outcome indices utilized in PTSD treatment trials and clinic settings. We examined physiological reactivity during a short trauma imagery task as an objective index of response to PTSD treatment, optimized for use in routine clinical care settings. Participants were 35 male combat veterans receiving prolonged exposure (PE) therapy in a Veterans Affairs outpatient clinic. In addition to traditional subjective self-reported and clinician-rated symptom measures, patients also completed a script-driven imagery task in which heart rate (HR) and skin conductance (SC) were recorded at three assessment points across treatment. We examined changes in subjective symptom measures and objective trauma-specific physiological reactivity over the course of PE, and investigated the association between pretreatment physiological reactivity and treatment response. Patients who completed PE showed significantly diminished HR and SC reactivity to trauma imagery across therapy. Additionally, individuals showing greater trauma-specific HR reactivity at pretreatment showed greater reductions in subjectively reported PTSD symptoms at posttreatment. Findings support the utility of physiological reactivity during trauma imagery as an objective outcome measure that has the potential to be incorporated into evidence-based PTSD treatment in routine clinical settings, or prospective studies related to the individualization of care at pretreatment. © 2015 Wiley Periodicals, Inc.
Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention

PubMed Central

Heiderscheit, Bryan C.; Sherry, Marc A.; Silder, Amy; Chumanov, Elizabeth S.; Thelen, Darryl G.

2010-01-01

Synopsis Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Moreover, nearly one-third of these injuries recur within the first year following a return to sport, with subsequent injuries often being more severe than the original. This high reinjury rate suggests that commonly utilized rehabilitation programs may be inadequate at resolving possible muscular weakness, reduced tissue extensibility, and/or altered movement patterns associated with the injury. Further, the traditional criteria used to determine the readiness of the athlete to return to sport may be insensitive to these persistent deficits, resulting in a premature return. There is mounting evidence that the risk of reinjury can be minimized by utilizing rehabilitation strategies that incorporate neuromuscular control exercises and eccentric strength training, combined with objective measures to assess musculotendon recovery and readiness to return to sport. In this paper, we first describe the diagnostic examination of an acute hamstring strain injury, including discussion of the value of determining injury location in estimating the duration of the convalescent period. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring injuries including specific criteria for treatment progression and return to sport. Finally, we describe directions for future research including injury-specific rehabilitation programs, objective measures to assess reinjury risk, and strategies to prevent injury occurrence. Level of evidence: Diagnosis/therapy, level 5. PMID:20118524
RECAPDOC - a questionnaire for the documentation of rehabilitation care utilization in individuals with disorders of consciousness in long-term care in Germany: development and pretesting.

PubMed

Klingshirn, Hanna; Mittrach, Rene; Braitmayer, Kathrin; Strobl, Ralf; Bender, Andreas; Grill, Eva; Müller, Martin

2018-05-04

A multitude of different rehabilitation interventions and other specific health care services are offered for individuals with disorders of consciousness in long-term care settings. To investigate the association of those services and patient-relevant outcomes, a specific instrument to document the utilization of those services is needed. The purpose of this study was to develop such a questionnaire administered to caregivers in epidemiological studies or patient registries in Germany. The development process of the RECAPDOC questionnaire was carried out in three steps. Step 1 consisted of a systematic literature review and an online-based expert survey to define the general content. Step 2 was an expert interview to evaluate the preliminary content of the questionnaire. Step 3 was a pretest including cognitive interviews with caregivers. After each step, the results were combined into a new version of the questionnaire. The first version of the questionnaire included items on utilization of medical care, medical aids, nursing and therapeutic care. The results of the expert interview led to the integration of five new items and the modification of six other items. The pretest led to some minor modifications of the questionnaire since it was rated as feasible and acceptable. The final questionnaire consisted of 29 items covering the domains "living situation", "social insurance status", "utilisation of home health care", "domestic services", "outpatient health care", "specific diagnostic measures", "adaptive technologies", "medical aids" and "utilization of therapies". Also the experience of family support and multidisciplinary collaboration of health professionals is covered. The developed questionnaire is a first step to make the situation of patients with disorders of consciousness in the long-term care setting accessible for evaluation in epidemiological studies and in the context of patient registries. However, further reliability and validity studies are needed.
The value of residential photovoltaic systems: A comprehensive assessment

NASA Technical Reports Server (NTRS)

Borden, C. S.

1983-01-01

Utility-interactive photovoltaic (PV) arrays on residential rooftops appear to be a potentially attractive, large-scale application of PV technology. Results of a comprehensive assessment of the value (i.e., break-even cost) of utility-grid connected residential photovoltaic power systems under a variety of technological and economic assumptions are presented. A wide range of allowable PV system costs are calculated for small (4.34 kW (p) sub ac) residential PV systems in various locales across the United States. Primary factor in this variation are differences in local weather conditions, utility-specific electric generation capacity, fuel types, and customer-load profiles that effect purchase and sell-back rates, and non-uniform state tax considerations. Additional results from this analysis are: locations having the highest insolation values are not necessary the most economically attractive sites; residential PV systems connected in parallel to the utility demonstrate high percentages of energy sold back to the grid, and owner financial and tax assumptions cause large variations in break-even costs. Significant cost reduction and aggressive resolution of potential institutional impediments (e.g., liability, standards, metering, and technical integration) are required for a residential PV marker to become a major electric-grid-connected energy-generation source.
The value of residential photovoltaic systems: A comprehensive assessment

NASA Astrophysics Data System (ADS)

Borden, C. S.

1983-09-01

Utility-interactive photovoltaic (PV) arrays on residential rooftops appear to be a potentially attractive, large-scale application of PV technology. Results of a comprehensive assessment of the value (i.e., break-even cost) of utility-grid connected residential photovoltaic power systems under a variety of technological and economic assumptions are presented. A wide range of allowable PV system costs are calculated for small (4.34 kW (p) sub ac) residential PV systems in various locales across the United States. Primary factor in this variation are differences in local weather conditions, utility-specific electric generation capacity, fuel types, and customer-load profiles that effect purchase and sell-back rates, and non-uniform state tax considerations. Additional results from this analysis are: locations having the highest insolation values are not necessary the most economically attractive sites; residential PV systems connected in parallel to the utility demonstrate high percentages of energy sold back to the grid, and owner financial and tax assumptions cause large variations in break-even costs. Significant cost reduction and aggressive resolution of potential institutional impediments (e.g., liability, standards, metering, and technical integration) are required for a residential PV marker to become a major electric-grid-connected energy-generation source.
Measuring impairment when diagnosing adolescent ADHD: Differentiating problems due to ADHD versus other sources.

PubMed

Vazquez, Alejandro L; H Sibley, Margaret; Campez, Mileini

2018-06-01

The DSM-5 requires clinicians to link ADHD symptoms to clinically meaningful impairments in daily life functioning. Measuring impairment during ADHD assessments may be particularly challenging in adolescence, when ADHD is often not the sole source of a youth's difficulties. Existing impairment rating scales are criticized for not specifying ADHD as the source of impairment in their instructions, leading to potential problems with rating scale specificity. The current study utilized a within subjects design (N = 107) to compare parent report of impairment on two versions of a global impairment measure: one that specified ADHD as the source of impairment (Impairment Rating Scale-ADHD) and a standard version that did not (Impairment Rating Scale). On the standard family impairment item, parents endorsed greater impairment as compared to the IRS-ADHD. This finding was particularly pronounced when parents reported high levels of parenting stress. More severe ADHD symptoms were associated with greater concordance between the two versions. Findings indicate that adolescent family related impairments reported during ADHD assessments may be due to sources other than ADHD symptoms, such as developmental maladjustment. To prevent false positive diagnoses, symptom-specific wording may optimize impairment measures when assessing family functioning in diagnostic assessments for adolescents with ADHD. Copyright © 2018 Elsevier B.V. All rights reserved.
Oral cancer screening: serum Raman spectroscopic approach

NASA Astrophysics Data System (ADS)

Sahu, Aditi K.; Dhoot, Suyash; Singh, Amandeep; Sawant, Sharada S.; Nandakumar, Nikhila; Talathi-Desai, Sneha; Garud, Mandavi; Pagare, Sandeep; Srivastava, Sanjeeva; Nair, Sudhir; Chaturvedi, Pankaj; Murali Krishna, C.

2015-11-01

Serum Raman spectroscopy (RS) has previously shown potential in oral cancer diagnosis and recurrence prediction. To evaluate the potential of serum RS in oral cancer screening, premalignant and cancer-specific detection was explored in the present study using 328 subjects belonging to healthy controls, premalignant, disease controls, and oral cancer groups. Spectra were acquired using a Raman microprobe. Spectral findings suggest changes in amino acids, lipids, protein, DNA, and β-carotene across the groups. A patient-wise approach was employed for data analysis using principal component linear discriminant analysis. In the first step, the classification among premalignant, disease control (nonoral cancer), oral cancer, and normal samples was evaluated in binary classification models. Thereafter, two screening-friendly classification approaches were explored to further evaluate the clinical utility of serum RS: a single four-group model and normal versus abnormal followed by determining the type of abnormality model. Results demonstrate the feasibility of premalignant and specific cancer detection. The normal versus abnormal model yields better sensitivity and specificity rates of 64 and 80% these rates are comparable to standard screening approaches. Prospectively, as the current screening procedure of visual inspection is useful mainly for high-risk populations, serum RS may serve as a useful adjunct for early and specific detection of oral precancers and cancer.
Probabilistic estimation of residential air exchange rates for ...

EPA Pesticide Factsheets

Residential air exchange rates (AERs) are a key determinant in the infiltration of ambient air pollution indoors. Population-based human exposure models using probabilistic approaches to estimate personal exposure to air pollutants have relied on input distributions from AER measurements. An algorithm for probabilistically estimating AER was developed based on the Lawrence Berkley National Laboratory Infiltration model utilizing housing characteristics and meteorological data with adjustment for window opening behavior. The algorithm was evaluated by comparing modeled and measured AERs in four US cities (Los Angeles, CA; Detroit, MI; Elizabeth, NJ; and Houston, TX) inputting study-specific data. The impact on the modeled AER of using publically available housing data representative of the region for each city was also assessed. Finally, modeled AER based on region-specific inputs was compared with those estimated using literature-based distributions. While modeled AERs were similar in magnitude to the measured AER they were consistently lower for all cities except Houston. AERs estimated using region-specific inputs were lower than those using study-specific inputs due to differences in window opening probabilities. The algorithm produced more spatially and temporally variable AERs compared with literature-based distributions reflecting within- and between-city differences, helping reduce error in estimates of air pollutant exposure. Published in the Journal of

Pichia pastoris Exhibits High Viability and a Low Maintenance Energy Requirement at Near-Zero Specific Growth Rates

PubMed Central

Rebnegger, Corinna; Vos, Tim; Graf, Alexandra B.; Valli, Minoska; Pronk, Jack T.

2016-01-01

ABSTRACT The yeast Pichia pastoris is a widely used host for recombinant protein production. Understanding its physiology at extremely low growth rates is a first step in the direction of decoupling product formation from cellular growth and therefore of biotechnological relevance. Retentostat cultivation is an excellent tool for studying microbes at extremely low specific growth rates but has so far not been implemented for P. pastoris. Retentostat feeding regimes were based on the maintenance energy requirement (mS) and maximum biomass yield on glucose (YX/Smax) estimated from steady-state glucose-limited chemostat cultures. Aerobic retentostat cultivation enabled reproducible, smooth transitions from a specific growth rate (μ) of 0.025 h−1 to near-zero specific growth rates (μ < 0.001 h−1). At these near-zero specific growth rates, viability remained at least 97%. The value of mS at near-zero growth rates was 3.1 ± 0.1 mg glucose per g biomass and h, which was 3-fold lower than the mS estimated from faster-growing chemostat cultures. This difference indicated that P. pastoris reduces its maintenance energy requirement at extremely low μ, a phenomenon not previously observed in eukaryotes. Intracellular levels of glycogen and trehalose increased, while μ progressively declined during retentostat cultivation. Transcriptional reprogramming toward zero growth included the upregulation of many transcription factors as well as stress-related genes and the downregulation of cell cycle genes. This study underlines the relevance of comparative analysis of maintenance energy metabolism, which has an important impact on large-scale industrial processes. IMPORTANCE The yeast Pichia pastoris naturally lives on trees and can utilize different carbon sources, among them glucose, glycerol, and methanol. In biotechnology, it is widely used for the production of recombinant proteins. For both the understanding of life in its natural habitat and optimized production processes, a better understanding of cell physiology at an extremely low growth rate would be of extraordinary value. Therefore, we have grown P. pastoris in a retentostat, which allows the cultivation of metabolically active cells even at zero growth. Here we reached doubling times as long as 38 days and found that P. pastoris decreases its maintenance energy demand 3-fold during very slow growth, which enables it to survive with a much lower substrate supply than baker's yeast. PMID:27208115
18 CFR 35.23 - General provisions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... sale of electric energy in a coordination transaction by a public utility if that sale requires the use... filing must apply consistent treatment to all coordination rate schedules. If the filing does not apply consistent rate treatment, the public utility must explain why it does not do so. (3) If a public utility...
18 CFR 35.23 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... sale of electric energy in a coordination transaction by a public utility if that sale requires the use... filing must apply consistent treatment to all coordination rate schedules. If the filing does not apply consistent rate treatment, the public utility must explain why it does not do so. (3) If a public utility...
18 CFR 35.23 - General provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... sale of electric energy in a coordination transaction by a public utility if that sale requires the use... filing must apply consistent treatment to all coordination rate schedules. If the filing does not apply consistent rate treatment, the public utility must explain why it does not do so. (3) If a public utility...
FEASIBILITY OF MATCHING STUDY PARTICIPANT RESIDENCE WITH SPECIFIC WATER UTILITY TRIHALOMETHANE (THM) DATA IN EPIDEMIOLOGIC STUDIES

EPA Science Inventory

Many epidemiologic studies concerning by-products of water disinfection use utility monitoring data to estimate exposure. Use of such data requires linkage of residence location to a specific water utility and associated monitoring data during a given exposure period. The inabil...
Screening Brazilian Macrophomina phaseolina isolates for alkaline lipases and other extracellular hydrolases.

PubMed

Schinke, Claudia; Germani, José C

2012-03-01

Macrophomina phaseolina, phylum Ascomycota, is a phytopathogenic fungus distributed worldwide in hot dry areas. There are few studies on its secreted lipases and none on its colony radial growth rate, an indicator of fungal ability to use nutrients for growth, on media other than potato-dextrose agar. In this study, 13 M. phaseolina isolates collected in different Brazilian regions were screened for fast-growth and the production of hydrolases of industrial interest, especially alkaline lipases. Hydrolase detection and growth rate determination were done on citric pectin, gelatin, casein, soluble starch, and olive oil as substrates. Ten isolates were found to be active on all substrates tested. The most commonly detected enzymes were pectinases, amylases, and lipases. The growth rate on pectin was significantly higher (P < 0.05), while the growth rates on the different media identified CMM 2105, CMM 1091, and PEL as the fastest-growing isolates. The lipase activity of four isolates grown on olive oil was followed for 4 days by measuring the activity in the cultivation broth. The specific lipolytic activity of isolate PEL was significantly higher at 96 h (130 mU mg protein(-1)). The broth was active at 37 °C, pH 8, indicating the potential utility of the lipases of this isolate in mild alkaline detergents. There was a strong and positive correlation (0.86) between radial growth rate and specific lipolytic activity.
Effects of growth rate, size, and light availability on tree survival across life stages: a demographic analysis accounting for missing values and small sample sizes.

PubMed

Moustakas, Aristides; Evans, Matthew R

2015-02-28

Plant survival is a key factor in forest dynamics and survival probabilities often vary across life stages. Studies specifically aimed at assessing tree survival are unusual and so data initially designed for other purposes often need to be used; such data are more likely to contain errors than data collected for this specific purpose. We investigate the survival rates of ten tree species in a dataset designed to monitor growth rates. As some individuals were not included in the census at some time points we use capture-mark-recapture methods both to allow us to account for missing individuals, and to estimate relocation probabilities. Growth rates, size, and light availability were included as covariates in the model predicting survival rates. The study demonstrates that tree mortality is best described as constant between years and size-dependent at early life stages and size independent at later life stages for most species of UK hardwood. We have demonstrated that even with a twenty-year dataset it is possible to discern variability both between individuals and between species. Our work illustrates the potential utility of the method applied here for calculating plant population dynamics parameters in time replicated datasets with small sample sizes and missing individuals without any loss of sample size, and including explanatory covariates.
Area-Specific Marginal Costing for Electric Utilities: a Case Study of Transmission and Distribution Costs

NASA Astrophysics Data System (ADS)

Orans, Ren

1990-10-01

Existing procedures used to develop marginal costs for electric utilities were not designed for applications in an increasingly competitive market for electric power. The utility's value of receiving power, or the costs of selling power, however, depend on the exact location of the buyer or seller, the magnitude of the power and the period of time over which the power is used. Yet no electric utility in the United States has disaggregate marginal costs that reflect differences in costs due to the time, size or location of the load associated with their power or energy transactions. The existing marginal costing methods used by electric utilities were developed in response to the Public Utilities Regulatory Policy Act (PURPA) in 1978. The "ratemaking standards" (Title 1) established by PURPA were primarily concerned with the appropriate segmentation of total revenues to various classes-of-service, designing time-of-use rating periods, and the promotion of efficient long-term resource planning. By design, the methods were very simple and inexpensive to implement. Now, more than a decade later, the costing issues facing electric utilities are becoming increasingly complex, and the benefits of developing more specific marginal costs will outweigh the costs of developing this information in many cases. This research develops a framework for estimating total marginal costs that vary by the size, timing, and the location of changes in loads within an electric distribution system. To complement the existing work at the Electric Power Research Institute (EPRI) and Pacific Gas and Electric Company (PGandE) on estimating disaggregate generation and transmission capacity costs, this dissertation focuses on the estimation of distribution capacity costs. While the costing procedure is suitable for the estimation of total (generation, transmission and distribution) marginal costs, the empirical work focuses on the geographic disaggregation of marginal costs related to electric utility distribution investment. The study makes use of data from an actual distribution planning area, located within PGandE's service territory, to demonstrate the important characteristics of this new costing approach. The most significant result of this empirical work is that geographic differences in the cost of capacity in distribution systems can be as much as four times larger than the current system average utility estimates. Furthermore, lumpy capital investment patterns can lead to significant cost differences over time.
Osteoporosis management and fractures in the Métis of Ontario, Canada.

PubMed

Jandoc, Racquel; Jembere, Nathaniel; Khan, Saba; Russell, Storm J; Allard, Yvon; Cadarette, Suzanne M

2015-01-01

Half of Métis citizens, compared to less than 10 % of the general population of Ontario, reside in northern regions, with little access to bone mineral density (BMD) testing. Métis citizens had lower sex-specific and age-standardized rates of BMD testing, yet similar rates of fracture (both sexes) and pharmacotherapy (women only). To examine osteoporosis management and common osteoporosis-related fractures among Métis citizens compared to the general population of older adults residing in Ontario. We linked healthcare (medical and pharmacy) utilization and administrative (demographic) databases with the Métis Nation of Ontario citizenship registry to estimate osteoporosis management (bone mineral density [BMD] testing, pharmacotherapy) and fractures (hip, humerus, radius/ulna) among adults aged ≥50 years, from April 1, 2006 to March 31, 2011. Pharmacotherapy data were limited to residents aged ≥65 years. Sex-specific and age-standardized rates were compared between the Métis and the general population. Multivariable logistic regression was used to compare rates of BMD testing after controlling for differences in age and region of residence between the Métis and the general population. We studied 4219 Métis citizens (55 % men), and 140 (3 %) experienced a fracture. Half of Métis citizens, compared to less than 10 % of the general population of Ontario, resided in northern regions. We identified significantly lower sex-specific and age-standardized rates of BMD testing among Métis compared to the general population, yet found little difference in fracture rates (both sexes) or pharmacotherapy (women only). Differences in BMD testing disappeared after adjusting for region of residence among women yet remained significant among men. Despite finding significantly lower rates of osteoporosis management among men, Métis men and women were found to have similar age-standardized fracture rates to the general population.
Predictors of family caregiver ratings of patient quality of life in Alzheimer disease: cross-sectional results from the Canadian Alzheimer's Disease Quality of Life Study.

PubMed

Naglie, Gary; Hogan, David B; Krahn, Murray; Black, Sandra E; Beattie, B Lynn; Patterson, Christopher; Macknight, Chris; Freedman, Morris; Borrie, Michael; Byszewski, Anna; Bergman, Howard; Streiner, David; Irvine, Jane; Ritvo, Paul; Comrie, Janna; Kowgier, Matthew; Tomlinson, George

2011-10-01

To assess whether the core symptoms of Alzheimer disease (AD) and caregiver factors consistently predict family caregiver ratings of patient quality of life (QOL) as assessed by a variety of QOL measures in a large national sample. : Cross-sectional. Fifteen dementia and geriatric clinics across Canada. : Family caregivers (n = 412) of community-living patients with AD of all severities. Caregiver ratings of patient QOL using three utility indexes, the European Quality of Life-5 Dimensions, Quality of Well-Being Scale and Health Utilities Index; a global QOL visual analogue scale; a disease-specific measure, the Quality of Life-Alzheimer's Disease; and a generic health status measure, the Short Form-36. Patient cognition was assessed with the cognitive subscale of the Alzheimer's Disease Assessment Scale and Mini-Mental State Examination, function with the Disability Assessment for Dementia, and behavioral and psychological symptoms with the Neuropsychiatric Inventory and the Geriatric Depression Scale. Caregiver burden was assessed with the Zarit Burden Interview and caregiver depression with the Center for Epidemiologic Studies Depression scale. One-way analysis of variance and fully adjusted multiple linear regression were used to assess the relationship between patient dementia symptom and caregiver variables with QOL ratings. In multivariable analyses, caregiver ratings of patient function and depressive symptoms were the only consistent independent predictors of caregiver-rated QOL across the QOL measures. Caregiver ratings of patient function and depression were consistent independent predictors of caregiver-rated QOL, using a spectrum of QOL measures, while measures of patient cognition and caregiver burden and depression were not. These findings support the continued use of caregiver ratings as an important source of information about patient QOL and endorse the inclusion in AD clinical trials of caregiver-rated measures of patient function, depression, and QOL.
Assessment of exposure to radio frequency electromagnetic fields from smart utility meters in GB; part II) numerical assessment of induced SAR within the human body.

PubMed

Qureshi, Muhammad R A; Alfadhl, Yasir; Chen, Xiaodong; Peyman, Azadeh; Maslanyj, Myron; Mann, Simon

2018-04-01

Human body exposure to radiofrequency electromagnetic waves emitted from smart meters was assessed using various exposure configurations. Specific energy absorption rate distributions were determined using three anatomically realistic human models. Each model was assigned with age- and frequency-dependent dielectric properties representing a collection of age groups. Generalized exposure conditions involving standing and sleeping postures were assessed for a home area network operating at 868 and 2,450 MHz. The smart meter antenna was fed with 1 W power input which is an overestimation of what real devices typically emit (15 mW max limit). The highest observed whole body specific energy absorption rate value was 1.87 mW kg -1 , within the child model at a distance of 15 cm from a 2,450 MHz device. The higher values were attributed to differences in dimension and dielectric properties within the model. Specific absorption rate (SAR) values were also estimated based on power density levels derived from electric field strength measurements made at various distances from smart meter devices. All the calculated SAR values were found to be very small in comparison to International Commission on Non-Ionizing Radiation Protection limits for public exposure. Bioelectromagnetics. 39:200-216, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Design of a photovoltaic system for a southeast all-electric residence

NASA Astrophysics Data System (ADS)

Mehalick, E. M.; Tully, G. F.; Johnson, J.; Truncellito, N.; Schaeffer, R.; Parker, J.

1982-01-01

A photovoltaic system was developed and integrated into a single-story residence suitable for the Southeast region of the country. The design addresses an integral mounted array which displaces conventional roof sheathing, roofing felt and shingles. The array has a rated power output of 5.6 kW and covers 86 sq.m. of roof area. A 6 kW utility-tied inverter is used in the power conversion subsystem, representative of a lower cost version, currently available hardware. The system provides feedback of excess energy to the utility, which is the most promising approach for grid-connected systems in the mid-1980's. The complete system and house design are described, including all the pertinent installation and construction drawings. Specific performance results are presented for the Miami, Florida, and Charleston, SC, regions.
Guidance and navigation requirements for unmanned flyby and swingby missions to the outer planets. Volume 4: High thrust mission, part 2, phase C

NASA Technical Reports Server (NTRS)

1971-01-01

The guidance and navigation requirements for a set of impulsive thrust missions involving one or more outer planets or comets. Specific missions considered include two Jupiter entry missions of 800 and 1200 day duration, two multiple swingby missions with the sequences Jupiter-Uranus-Neptune and Jupiter-Saturn-Pluto, and two comets rendezvous missions involving the short period comets P/Tempel 2 and P/Tuttle-Giacobini-Kresak. Results show the relative utility of onboard and Earth-based DSN navigation. The effects of parametric variations in navigation accuracy, measurement rate, and miscellaneous constraints are determined. The utility of a TV type onboard navigation sensor - sighting on planetary satellites and comets - is examined. Velocity corrections required for the nominal and parametrically varied cases are tabulated.
Grid-connected distributed solar power systems

NASA Astrophysics Data System (ADS)

Moyle, R.; Chernoff, H.; Schweizer, T.

This paper discusses some important, though often ignored, technical and economic issues of distributed solar power systems: protection of the utility system and nonsolar customers requires suitable interfaced equipment. Purchase criteria must mirror reality; most analyses use life-cycle costing with low discount rates - most buyers use short payback periods. Distributing, installing, and marketing small, distributed solar systems is more costly than most analyses estimate. Results show that certain local conditions and uncommon purchase considerations can combine to make small, distributed solar power attractive, but lower interconnect costs (per kW), lower marketing and product distribution costs, and more favorable purchase criteria make large, centralized solar energy more attractive. Specifically, the value of dispersed solar systems to investors and utilities can be higher than $2000/kw. However, typical residential owners place a value of well under $1000 on the installed system.
Force-controlled inorganic crystallization lithography.

PubMed

Cheng, Chao-Min; LeDuc, Philip R

2006-09-20

Lithography plays a key role in integrated circuits, optics, information technology, biomedical applications, catalysis, and separation technologies. However, inorganic lithography techniques remain of limited utility for applications outside of the typical foci of integrated circuit manufacturing. In this communication, we have developed a novel stamping method that applies pressure on the upper surface of the stamp to regulate the dewetting process of the inorganic buffer and the evaporation rate of the solvent in this buffer between the substrate and the surface of the stamp. We focused on generating inorganic microstructures with specific locations and also on enabling the ability to pattern gradients during the crystallization of the inorganic salts. This approach utilized a combination of lithography with bottom-up growth and assembly of inorganic crystals. This work has potential applications in a variety of fields, including studying inorganic material patterning and small-scale fabrication technology.
Maximum demand charge rates for commercial and industrial electricity tariffs in the United States

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

McLaren, Joyce; Gagnon, Pieter; Zimny-Schmitt, Daniel

NREL has assembled a list of U.S. retail electricity tariffs and their associated demand charge rates for the Commercial and Industrial sectors. The data was obtained from the Utility Rate Database. Keep the following information in mind when interpreting the data: (1) These data were interpreted and transcribed manually from utility tariff sheets, which are often complex. It is a certainty that these data contain errors, and therefore should only be used as a reference. Actual utility tariff sheets should be consulted if an action requires this type of data. (2) These data only contains tariffs that were entered intomore » the Utility Rate Database. Since not all tariffs are designed in a format that can be entered into the Database, this list is incomplete - it does not contain all tariffs in the United States. (3) These data may have changed since this list was developed (4) Many of the underlying tariffs have additional restrictions or requirements that are not represented here. For example, they may only be available to the agricultural sector or closed to new customers. (5) If there are multiple demand charge elements in a given tariff, the maximum demand charge is the sum of each of the elements at any point in time. Where tiers were present, the highest rate tier was assumed. The value is a maximum for the year, and may be significantly different from demand charge rates at other times in the year. Utility Rate Database: https://openei.org/wiki/Utility_Rate_Database« less
A Critical Assessment of Bias in Survey Studies Using Location-Based Sampling to Recruit Patrons in Bars

PubMed Central

Morrison, Christopher; Lee, Juliet P.; Gruenewald, Paul J.; Marzell, Miesha

2015-01-01

Location-based sampling is a method to obtain samples of people within ecological contexts relevant to specific public health outcomes. Random selection increases generalizability, however in some circumstances (such as surveying bar patrons) recruitment conditions increase risks of sample bias. We attempted to recruit representative samples of bars and patrons in six California cities, but low response rates precluded meaningful analysis. A systematic review of 24 similar studies revealed that none addressed the key shortcomings of our study. We recommend steps to improve studies that use location-based sampling: (i) purposively sample places of interest, (ii) utilize recruitment strategies appropriate to the environment, and (iii) provide full information on response rates at all levels of sampling. PMID:26574657
High porous bio-nanocarbons prepared by carbonization and NaOH activation of polysaccharides for electrode material of EDLC

NASA Astrophysics Data System (ADS)

Takeuchi, Kenji; Fujishige, Masatsugu; Ishida, Nobuaki; Kunieda, Yoshihiro; Kato, Yosuke; Tanaka, Yusuke; Ochi, Toshiyuki; Shirotori, Hisashi; Uzuhashi, Yuji; Ito, Suguru; Oshida, Kyo-ichi; Endo, Morinobu

2018-07-01

Carbonization and post-activation of polysaccharides (utilized as food residue) created new bio-nanocarbons for the electrode of electric double layer capacitors (EDLC). Large specific capacitance (46.1 F/g, 26.4 F/cm3) and high rate performance was confirmed under optimized conditions of carbonization temperature (600 °C) and supplied amount of sodium hydroxide in NaOH-activation process (250 wt %). The capacitance and rate performance were larger than the reported values, 42.9 F/g, 19.7 F/cm3 of currently used activated carbon MSP-20. The feature that NaOH is usable as the activation agent, instead of KOH, is advantageous for reducing the cost of EDLC.
Landsat image data quality studies

NASA Technical Reports Server (NTRS)

Schueler, C. F.; Salomonson, V. V.

1985-01-01

Preliminary results of the Landsat-4 Image Data Quality Analysis (LIDQA) program to characterize the data obtained using the Thematic Mapper (TM) instrument on board the Landsat-4 and Landsat-5 satellites are reported. TM design specifications were compared to the obtained data with respect to four criteria, including spatial resolution; geometric fidelity; information content; and image relativity to Multispectral Scanner (MSS) data. The overall performance of the TM was rated excellent despite minor instabilities and radiometric anomalies in the data. Spatial performance of the TM exceeded design specifications in terms of both image sharpness and geometric accuracy, and the image utility of the TM data was at least twice as high as MSS data. The separability of alfalfa and sugar beet fields in a TM image is demonstrated.
An annual quasidifference approach to water price elasticity

NASA Astrophysics Data System (ADS)

Bell, David R.; Griffin, Ronald C.

2008-08-01

The preferred price specification for retail water demand estimation has not been fully settled by prior literature. Empirical consistency of price indices is necessary to enable testing of competing specifications. Available methods of unbiasing the price index are summarized here. Using original rate information from several hundred Texas utilities, new indices of marginal and average price change are constructed. Marginal water price change is shown to explain consumption variation better than average water price change, based on standard information criteria. Annual change in quantity consumed per month is estimated with differences in climate variables and the new quasidifference marginal price index. As expected, the annual price elasticity of demand is found to vary with daily high and low temperatures and the frequency of precipitation.

The Relationship Between Homework Compliance and Therapy Outcomes: An Updated Meta-Analysis.

PubMed

Mausbach, Brent T; Moore, Raeanne; Roesch, Scott; Cardenas, Veronica; Patterson, Thomas L

2010-10-01

The current study was an updated meta-analysis of manuscripts since the year 2000 examining the effects of homework compliance on treatment outcome. A total of 23 studies encompassing 2,183 subjects were included. Results indicated a significant relationship between homework compliance and treatment outcome suggesting a small to medium effect (r = .26; 95% CI = .19-.33). Moderator analyses were conducted to determine the differential effect size of homework on treatment outcome by target symptoms (e.g., depression; anxiety), source of homework rating (e.g., client; therapist), timing of homework rating (e.g., retroactive vs. contemporaneous), and type of homework rating (e.g., Likert; total homeworks completed). Results indicated that effect sizes were robust across target symptoms, but differed by source of homework rating, timing of homework rating, and type of homework rating. Specifically, studies utilizing combined client and therapist ratings of compliance had significantly higher mean effect size relative to those using therapist only assessments and those using objective assessments. Further, studies that rated the percentage of homeworks completed had a significantly lower mean effect size compared to studies using Likert ratings, and retroactive assessments had higher effect size than contemporaneous assessments.
The Relationship Between Homework Compliance and Therapy Outcomes: An Updated Meta-Analysis

PubMed Central

Moore, Raeanne; Roesch, Scott; Cardenas, Veronica; Patterson, Thomas L.

2010-01-01

The current study was an updated meta-analysis of manuscripts since the year 2000 examining the effects of homework compliance on treatment outcome. A total of 23 studies encompassing 2,183 subjects were included. Results indicated a significant relationship between homework compliance and treatment outcome suggesting a small to medium effect (r = .26; 95% CI = .19–.33). Moderator analyses were conducted to determine the differential effect size of homework on treatment outcome by target symptoms (e.g., depression; anxiety), source of homework rating (e.g., client; therapist), timing of homework rating (e.g., retroactive vs. contemporaneous), and type of homework rating (e.g., Likert; total homeworks completed). Results indicated that effect sizes were robust across target symptoms, but differed by source of homework rating, timing of homework rating, and type of homework rating. Specifically, studies utilizing combined client and therapist ratings of compliance had significantly higher mean effect size relative to those using therapist only assessments and those using objective assessments. Further, studies that rated the percentage of homeworks completed had a significantly lower mean effect size compared to studies using Likert ratings, and retroactive assessments had higher effect size than contemporaneous assessments. PMID:20930925
Determining the ventilation and aerosol deposition rates from routine indoor-air measurements.

PubMed

Halios, Christos H; Helmis, Costas G; Deligianni, Katerina; Vratolis, Sterios; Eleftheriadis, Konstantinos

2014-01-01

Measurement of air exchange rate provides critical information in energy and indoor-air quality studies. Continuous measurement of ventilation rates is a rather costly exercise and requires specific instrumentation. In this work, an alternative methodology is proposed and tested, where the air exchange rate is calculated by utilizing indoor and outdoor routine measurements of a common pollutant such as SO2, whereas the uncertainties induced in the calculations are analytically determined. The application of this methodology is demonstrated, for three residential microenvironments in Athens, Greece, and the results are also compared against ventilation rates calculated from differential pressure measurements. The calculated time resolved ventilation rates were applied to the mass balance equation to estimate the particle loss rate which was found to agree with literature values at an average of 0.50 h(-1). The proposed method was further evaluated by applying a mass balance numerical model for the calculation of the indoor aerosol number concentrations, using the previously calculated ventilation rate, the outdoor measured number concentrations and the particle loss rates as input values. The model results for the indoors' concentrations were found to be compared well with the experimentally measured values.
Neuroimaging correlates of parent ratings of working memory in typically developing children

PubMed Central

Mahone, E. Mark; Martin, Rebecca; Kates, Wendy R.; Hay, Trisha; Horská, Alena

2009-01-01

The purpose of the present study was to investigate construct validity of parent ratings of working memory in children, using a multi-trait/multi-method design including neuroimaging, rating scales, and performance-based measures. Thirty-five typically developing children completed performance-based tests of working memory and nonexecutive function (EF) skills, received volumetric MRI, and were rated by parents on both EF-specific and broad behavior rating scales. After controlling for total cerebral volume and age, parent ratings of working memory were significantly correlated with frontal gray, but not temporal, parietal, or occipital gray, or any lobar white matter volumes. Performance-based measures of working memory were also moderately correlated with frontal lobe gray matter volume; however, non-EF parent ratings and non-EF performance-based measures were not correlated with frontal lobe volumes. Results provide preliminary support for the convergent and discriminant validity of parent ratings of working memory, and emphasize their utility in exploring brain–behavior relationships in children. Rating scales that directly examine EF skills may potentially have ecological validity, not only for “everyday” function, but also as correlates of brain volume. PMID:19128526
Growth Kinetics for Microalgae Grown in Palm Oil Mill Effluent (POME) medium at various CO2 Levels

NASA Astrophysics Data System (ADS)

Razali, S.; Salihon, J.; Ahmad, M. A.

2018-05-01

This paper sought to find the growth kinetic data of maximum specific growth rate (μmax) and substrate saturation constant (KS) for a microalgal reaction system over various dissolved CO2 levels (0.04, 0.1, 0.3, 0.5, 0.8, 1.0, 5.0, 10.0% v/v) at a constant sparging rate of 1.2 vvm, by using logistic model and Monod kinetics. The reaction system consisted of microalgae growing in palm oil mill effluent (POME) medium in 1 L flask with constant light illumination and sparged with the specified CO2 gas mixture. It is found from the experimental works that the values of μmax and KS to be at 0.04958 h-1 and 0.03523% (v/v) respectively. The results also showed that utilizing CO2 levels (v/v) in the sparging gas mixture more than 1% (v/v) would not improve microalgae growth significantly as expressed in the values of specific growth rate µ. These data and information are critically important for bioreactor scaling up purposes, especially bioreactor system dedicated for microalgae products and CO2 sequestration.
A simple model-based control for Pichia pastoris allows a more efficient heterologous protein production bioprocess.

PubMed

Cos, Oriol; Ramon, Ramon; Montesinos, José Luis; Valero, Francisco

2006-09-05

A predictive control algorithm coupled with a PI feedback controller has been satisfactorily implemented in the heterologous Rhizopus oryzae lipase production by Pichia pastoris methanol utilization slow (Mut(s)) phenotype. This control algorithm has allowed the study of the effect of methanol concentration, ranging from 0.5 to 1.75 g/L, on heterologous protein production. The maximal lipolytic activity (490 UA/mL), specific yield (11,236 UA/g(biomass)), productivity (4,901 UA/L . h), and specific productivity (112 UA/g(biomass)h were reached for a methanol concentration of 1 g/L. These parameters are almost double than those obtained with a manual control at a similar methanol set-point. The study of the specific growth, consumption, and production rates showed different patterns for these rates depending on the methanol concentration set-point. Results obtained have shown the need of implementing a robust control scheme when reproducible quality and productivity are sought. It has been demonstrated that the model-based control proposed here is a very efficient, robust, and easy-to-implement strategy from an industrial application point of view. (c) 2006 Wiley Periodicals, Inc.
Deriving temperature and age appropriate heart rate centiles for children with acute infections.

PubMed

Thompson, M; Harnden, A; Perera, R; Mayon-White, R; Smith, L; McLeod, D; Mant, D

2009-05-01

To describe the reference range for heart rate in children aged 3 months-10 years presenting to primary care with self-limiting infections. Cross-sectional study of children presenting to primary care with suspected acute infection. Heart rate was measured using a pulse oximeter and axillary temperature using an electronic thermometer. Centile charts of heart rates expected at given temperatures for children with self-limiting infections were calculated. Ten general practice surgeries and two out-of-hours centres in England. 1933 children presenting with suspected acute infections were recruited from in-hours general practice surgeries (1050 or 54.3%) or out-of-hours centres (883 or 45.7%). After excluding children who subsequently attended hospital and those without a final diagnosis of acute infection, 1589 children were used to create the centile charts of whom (859 or 54.1%) had upper respiratory tract infections and (215 or 13.5%) non-specific viral illness. Median, 75th, 90th and 97th centiles of heart rate at each temperature level. Heart rate increased by 9.9-14.1 bpm with each 1 degrees C increment in temperature. The 50th, 75th, 90th and 97th centiles of heart rate at each temperature level are presented graphically. Age-specific centile charts of heart rates expected at different temperatures should be used by clinicians in the initial assessment of children with acute infections. The charts will identify children who have a heart rate higher than expected for a given temperature and facilitate the interpretation of changes in heart rate on reassessment. Further research on the predictive value of the centile charts is needed to optimise their diagnostic utility.
Laminar and turbulent heating predictions for mars entry vehicles

NASA Astrophysics Data System (ADS)

Wang, Xiaoyong; Yan, Chao; Zheng, Weilin; Zhong, Kang; Geng, Yunfei

2016-11-01

Laminar and turbulent heating rates play an important role in the design of Mars entry vehicles. Two distinct gas models, thermochemical non-equilibrium (real gas) model and perfect gas model with specified effective specific heat ratio, are utilized to investigate the aerothermodynamics of Mars entry vehicle named Mars Science Laboratory (MSL). Menter shear stress transport (SST) turbulent model with compressible correction is implemented to take account of the turbulent effect. The laminar and turbulent heating rates of the two gas models are compared and analyzed in detail. The laminar heating rates predicted by the two gas models are nearly the same at forebody of the vehicle, while the turbulent heating environments predicted by the real gas model are severer than the perfect gas model. The difference of specific heat ratio between the two gas models not only induces the flow structure's discrepancy but also increases the heating rates at afterbody of the vehicle obviously. Simple correlations for turbulent heating augmentation in terms of laminar momentum thickness Reynolds number, which can be employed as engineering level design and analysis tools, are also developed from numerical results. At the time of peak heat flux on the +3σ heat load trajectory, the maximum value of momentum thickness Reynolds number at the MSL's forebody is about 500, and the maximum value of turbulent augmentation factor (turbulent heating rates divided by laminar heating rates) is 5 for perfect gas model and 8 for real gas model.
Utility of NIST Whole-Genome Reference Materials for the Technical Validation of a Multigene Next-Generation Sequencing Test.

PubMed

Shum, Bennett O V; Henner, Ilya; Belluoccio, Daniele; Hinchcliffe, Marcus J

2017-07-01

The sensitivity and specificity of next-generation sequencing laboratory developed tests (LDTs) are typically determined by an analyte-specific approach. Analyte-specific validations use disease-specific controls to assess an LDT's ability to detect known pathogenic variants. Alternatively, a methods-based approach can be used for LDT technical validations. Methods-focused validations do not use disease-specific controls but use benchmark reference DNA that contains known variants (benign, variants of unknown significance, and pathogenic) to assess variant calling accuracy of a next-generation sequencing workflow. Recently, four whole-genome reference materials (RMs) from the National Institute of Standards and Technology (NIST) were released to standardize methods-based validations of next-generation sequencing panels across laboratories. We provide a practical method for using NIST RMs to validate multigene panels. We analyzed the utility of RMs in validating a novel newborn screening test that targets 70 genes, called NEO1. Despite the NIST RM variant truth set originating from multiple sequencing platforms, replicates, and library types, we discovered a 5.2% false-negative variant detection rate in the RM truth set genes that were assessed in our validation. We developed a strategy using complementary non-RM controls to demonstrate 99.6% sensitivity of the NEO1 test in detecting variants. Our findings have implications for laboratories or proficiency testing organizations using whole-genome NIST RMs for testing. Copyright © 2017 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.
Aquifer response to stream-stage and recharge variations. II. Convolution method and applications

USGS Publications Warehouse

Barlow, P.M.; DeSimone, L.A.; Moench, A.F.

2000-01-01

In this second of two papers, analytical step-response functions, developed in the companion paper for several cases of transient hydraulic interaction between a fully penetrating stream and a confined, leaky, or water-table aquifer, are used in the convolution integral to calculate aquifer heads, streambank seepage rates, and bank storage that occur in response to streamstage fluctuations and basinwide recharge or evapotranspiration. Two computer programs developed on the basis of these step-response functions and the convolution integral are applied to the analysis of hydraulic interaction of two alluvial stream-aquifer systems in the northeastern and central United States. These applications demonstrate the utility of the analytical functions and computer programs for estimating aquifer and streambank hydraulic properties, recharge rates, streambank seepage rates, and bank storage. Analysis of the water-table aquifer adjacent to the Blackstone River in Massachusetts suggests that the very shallow depth of water table and associated thin unsaturated zone at the site cause the aquifer to behave like a confined aquifer (negligible specific yield). This finding is consistent with previous studies that have shown that the effective specific yield of an unconfined aquifer approaches zero when the capillary fringe, where sediment pores are saturated by tension, extends to land surface. Under this condition, the aquifer's response is determined by elastic storage only. Estimates of horizontal and vertical hydraulic conductivity, specific yield, specific storage, and recharge for a water-table aquifer adjacent to the Cedar River in eastern Iowa, determined by the use of analytical methods, are in close agreement with those estimated by use of a more complex, multilayer numerical model of the aquifer. Streambank leakance of the semipervious streambank materials also was estimated for the site. The streambank-leakance parameter may be considered to be a general (or lumped) parameter that accounts not only for the resistance of flow at the river-aquifer boundary, but also for the effects of partial penetration of the river and other near-stream flow phenomena not included in the theoretical development of the step-response functions.Analytical step-response functions, developed for several cases of transient hydraulic interaction between a fully penetrating stream and a confined, leaky, or water-table aquifer, are used in the convolution integral to calculate aquifer heads, streambank seepage rates, and bank storage that occur in response to stream-stage fluctuations and basinwide recharge or evapotranspiration. Two computer programs developed on the basis of these step-response functions and the convolution integral are applied to the analysis of hydraulic interaction of two alluvial stream-aquifer systems. These applications demonstrate the utility of the analytical functions and computer programs for estimating aquifer and streambank seepage rates and bank storage.
In vivo study of flow-rate accuracy of the MedStream Programmable Infusion System.

PubMed

Venugopalan, Ramakrishna; Ginggen, Alec; Bork, Toralf; Anderson, William; Buffen, Elaine

2011-01-01

Flow-rate accuracy and precision are important parameters to optimizing the efficacy of programmable intrathecal (IT) infusion pump delivery systems. Current programmable IT pumps are accurate within ±14.5% of their programmed infusion rate when assessed under ideal environmental conditions and specific flow-rate settings in vitro. We assessed the flow-rate accuracy of a novel programmable pump system across its entire flow-rate range under typical conditions in sheep (in vivo) and nominal conditions in vitro. The flow-rate accuracy of the MedStream Programmable Pump was assessed in both the in vivo and in vitro settings. In vivo flow-rate accuracy was assessed in 16 sheep at various flow-rates (producing 90 flow intervals) more than 90 ± 3 days. Pumps were then explanted, re-sterilized and in vitro flow-rate accuracy was assessed at 37°C and 1013 mBar (80 flow intervals). In vivo (sheep body temperatures 38.1°C-39.8°C), mean ± SD flow-rate error was 9.32% ± 9.27% and mean ± SD leak-rate was 0.028 ± 0.08 mL/day. Following explantation, mean in vitro flow-rate error and leak-rate were -1.05% ± 2.55% and 0.003 ± 0.004 mL/day (37°C, 1013 mBar), respectively. The MedStream Programmable Pump demonstrated high flow-rate accuracy when tested in vivo and in vitro at normal body temperature and environmental pressure as well as when tested in vivo at variable sheep body temperature. The flow-rate accuracy of the MedStream Programmable Pump across its flow-rate range, compares favorably to the accuracy of current clinically utilized programmable IT infusion pumps reported at specific flow-rate settings and conditions. © 2011 International Neuromodulation Society.
Quantitative measurements of regional glucose utilization and rate of valine incorporation into proteins by double-tracer autoradiography in the rat brain tumor model

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

Kirikae, M.; Diksic, M.; Yamamoto, Y.L.

1989-02-01

We examined the rate of glucose utilization and the rate of valine incorporation into proteins using 2-(/sup 18/F)fluoro-2-deoxyglucose and L-(1-14C)-valine in a rat brain tumor model by quantitative double-tracer autoradiography. We found that in the implanted tumor the rate of valine incorporation into proteins was about 22 times and the rate of glucose utilization was about 1.5 times that in the contralateral cortex. (In the ipsilateral cortex, the tumor had a profound effect on glucose utilization but no effect on the rate of valine incorporation into proteins.) Our findings suggest that it is more useful to measure protein synthesis thanmore » glucose utilization to assess the effectiveness of antitumor agents and their toxicity to normal brain tissue. We compared two methods to estimate the rate of valine incorporation: kinetic (quantitation done using an operational equation and the average brain rate coefficients) and washed slices (unbound labeled valine removed by washing brain slices in 10% trichloroacetic acid). The results were the same using either method. It would seem that the kinetic method can thus be used for quantitative measurement of protein synthesis in brain tumors and normal brain tissue using (/sup 11/C)-valine with positron emission tomography.« less
A review of screening mammography participation and utilization in Canada.

PubMed

Doyle, G P; Major, D; Chu, C; Stankiewicz, A; Harrison, M L; Pogany, L; Mai, V M; Onysko, J

2011-09-01

Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. Canada's screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored.
The Utility of Thin Slice Ratings for Predicting Language Growth in Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Walton, Katherine M.; Ingersoll, Brooke R.

2016-01-01

Literature on "Thin Slice" ratings indicates that a number of personality characteristics and behaviors can be accurately predicted by ratings of very short segments (<5?min) of behavior. This study examined the utility of Thin Slice ratings of young children with autism spectrum disorder for predicting developmental skills and…
Statistical testing and power analysis for brain-wide association study.

PubMed

Gong, Weikang; Wan, Lin; Lu, Wenlian; Ma, Liang; Cheng, Fan; Cheng, Wei; Grünewald, Stefan; Feng, Jianfeng

2018-04-05

The identification of connexel-wise associations, which involves examining functional connectivities between pairwise voxels across the whole brain, is both statistically and computationally challenging. Although such a connexel-wise methodology has recently been adopted by brain-wide association studies (BWAS) to identify connectivity changes in several mental disorders, such as schizophrenia, autism and depression, the multiple correction and power analysis methods designed specifically for connexel-wise analysis are still lacking. Therefore, we herein report the development of a rigorous statistical framework for connexel-wise significance testing based on the Gaussian random field theory. It includes controlling the family-wise error rate (FWER) of multiple hypothesis testings using topological inference methods, and calculating power and sample size for a connexel-wise study. Our theoretical framework can control the false-positive rate accurately, as validated empirically using two resting-state fMRI datasets. Compared with Bonferroni correction and false discovery rate (FDR), it can reduce false-positive rate and increase statistical power by appropriately utilizing the spatial information of fMRI data. Importantly, our method bypasses the need of non-parametric permutation to correct for multiple comparison, thus, it can efficiently tackle large datasets with high resolution fMRI images. The utility of our method is shown in a case-control study. Our approach can identify altered functional connectivities in a major depression disorder dataset, whereas existing methods fail. A software package is available at https://github.com/weikanggong/BWAS. Copyright © 2018 Elsevier B.V. All rights reserved.
A flexible statistical model for alignment of label-free proteomics data – incorporating ion mobility and product ion information

PubMed Central

2013-01-01

Background The goal of many proteomics experiments is to determine the abundance of proteins in biological samples, and the variation thereof in various physiological conditions. High-throughput quantitative proteomics, specifically label-free LC-MS/MS, allows rapid measurement of thousands of proteins, enabling large-scale studies of various biological systems. Prior to analyzing these information-rich datasets, raw data must undergo several computational processing steps. We present a method to address one of the essential steps in proteomics data processing - the matching of peptide measurements across samples. Results We describe a novel method for label-free proteomics data alignment with the ability to incorporate previously unused aspects of the data, particularly ion mobility drift times and product ion information. We compare the results of our alignment method to PEPPeR and OpenMS, and compare alignment accuracy achieved by different versions of our method utilizing various data characteristics. Our method results in increased match recall rates and similar or improved mismatch rates compared to PEPPeR and OpenMS feature-based alignment. We also show that the inclusion of drift time and product ion information results in higher recall rates and more confident matches, without increases in error rates. Conclusions Based on the results presented here, we argue that the incorporation of ion mobility drift time and product ion information are worthy pursuits. Alignment methods should be flexible enough to utilize all available data, particularly with recent advancements in experimental separation methods. PMID:24341404
A flexible statistical model for alignment of label-free proteomics data--incorporating ion mobility and product ion information.

PubMed

Benjamin, Ashlee M; Thompson, J Will; Soderblom, Erik J; Geromanos, Scott J; Henao, Ricardo; Kraus, Virginia B; Moseley, M Arthur; Lucas, Joseph E

2013-12-16

The goal of many proteomics experiments is to determine the abundance of proteins in biological samples, and the variation thereof in various physiological conditions. High-throughput quantitative proteomics, specifically label-free LC-MS/MS, allows rapid measurement of thousands of proteins, enabling large-scale studies of various biological systems. Prior to analyzing these information-rich datasets, raw data must undergo several computational processing steps. We present a method to address one of the essential steps in proteomics data processing--the matching of peptide measurements across samples. We describe a novel method for label-free proteomics data alignment with the ability to incorporate previously unused aspects of the data, particularly ion mobility drift times and product ion information. We compare the results of our alignment method to PEPPeR and OpenMS, and compare alignment accuracy achieved by different versions of our method utilizing various data characteristics. Our method results in increased match recall rates and similar or improved mismatch rates compared to PEPPeR and OpenMS feature-based alignment. We also show that the inclusion of drift time and product ion information results in higher recall rates and more confident matches, without increases in error rates. Based on the results presented here, we argue that the incorporation of ion mobility drift time and product ion information are worthy pursuits. Alignment methods should be flexible enough to utilize all available data, particularly with recent advancements in experimental separation methods.
Characteristics of NIH- and industry-sponsored head and neck cancer clinical trials.

PubMed

Devaiah, Anand; Murchison, Charles

2016-09-01

Compare U.S. clinical trials sponsored by the National Institutes of Health (NIH) and industry, especially with regard to trial design, interventions studied, and results reporting rates. U.S. head and neck cancer clinical trials. We used information from ClinicalTrials.gov to compare NIH- and industry-sponsored head and neck cancer clinical trials, specifically analyzing differences in trial design and interventions studied. We examined publication rates and positive results rates using PubMed.gov. About 50% of NIH- and industry-sponsored clinical trials have their results reported in peer-reviewed literature. Industry-sponsored trials had higher rates of positive results than NIH-sponsored trials. NIH- and industry-sponsored clinical trials had similar trial designs, although industry-sponsored trials had significantly lower rates of randomization. Industry trials utilized radiation in 19% of trials and surgery in 2% of trials. NIH trials also had low utilization of both radiation and surgery (27% and 12% of trials, respectively). NIH- and industry-sponsored trials published their results in journals with comparable impact factors. There is significant underreporting of results in U.S. head and neck cancer clinical trials, whether sponsored by NIH or industry. Industry trials have significantly higher rates of positive results, although it is unclear what contributes to this. Both NIH- and industry-sponsored trials underutilize surgery and radiation as treatment modalities, despite the fact that these are standard-of-care therapies for head and neck cancer. We recommend that the NIH and industry report all results from clinical trials and use surgery and radiation as treatment arms in order to arrive at more balanced therapeutic recommendations. N/A. Laryngoscope, 126:E300-E303, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Using a Novel Absolute Ontogenetic Age Determination Technique to Calculate the Timing of Tooth Eruption in the Saber-Toothed Cat, Smilodon fatalis.

PubMed

Wysocki, M Aleksander; Feranec, Robert S; Tseng, Zhijie Jack; Bjornsson, Christopher S

2015-01-01

Despite the superb fossil record of the saber-toothed cat, Smilodon fatalis, ontogenetic age determination for this and other ancient species remains a challenge. The present study utilizes a new technique, a combination of data from stable oxygen isotope analyses and micro-computed tomography, to establish the eruption rate for the permanent upper canines in Smilodon fatalis. The results imply an eruption rate of 6.0 millimeters per month, which is similar to a previously published average enamel growth rate of the S. fatalis upper canines (5.8 millimeters per month). Utilizing the upper canine growth rate, the upper canine eruption rate, and a previously published tooth replacement sequence, this study calculates absolute ontogenetic age ranges of tooth development and eruption in S. fatalis. The timing of tooth eruption is compared between S. fatalis and several extant conical-toothed felids, such as the African lion (Panthera leo). Results suggest that the permanent dentition of S. fatalis, except for the upper canines, was fully erupted by 14 to 22 months, and that the upper canines finished erupting at about 34 to 41 months. Based on these developmental age calculations, S. fatalis individuals less than 4 to 7 months of age were not typically preserved at Rancho La Brea. On the whole, S. fatalis appears to have had delayed dental development compared to dental development in similar-sized extant felids. This technique for absolute ontogenetic age determination can be replicated in other ancient species, including non-saber-toothed taxa, as long as the timing of growth initiation and growth rate can be determined for a specific feature, such as a tooth, and that growth period overlaps with the development of the other features under investigation.
Stratified cost-utility analysis of C-Leg versus mechanical knees: Findings from an Italian sample of transfemoral amputees.

PubMed

Cutti, Andrea Giovanni; Lettieri, Emanuele; Del Maestro, Martina; Radaelli, Giovanni; Luchetti, Martina; Verni, Gennero; Masella, Cristina

2017-06-01

The fitting rate of the C-Leg electronic knee (Otto-Bock, D) has increased steadily over the last 15 years. Current cost-utility studies, however, have not considered the patients' characteristics. To complete a cost-utility analysis involving C-Leg and mechanical knee users; "age at the time of enrollment," "age at the time of first prosthesis," and "experience with the current type of prosthesis" are assumed as non-nested stratification parameters. Cohort retrospective. In all, 70 C-Leg and 57 mechanical knee users were selected. For each stratification criteria, we evaluated the cost-utility of C-Leg versus mechanical knees by computing the incremental cost-utility ratio, that is, the ratio of the "difference in cost" and the "difference in utility" of the two technologies. Cost consisted of acquisition, maintenance, transportation, and lodging expenses. Utility was measured in terms of quality-adjusted life years, computed on the basis of participants' answers to the EQ-5D questionnaire. Patients over 40 years at the time of first prosthesis were the only group featuring an incremental cost-utility ratio (88,779 €/quality-adjusted life year) above the National Institute for Health and Care Excellence practical cost-utility threshold (54,120 €/quality-adjusted live year): C-Leg users experience a significant improvement of "mobility," but limited outcomes on "usual activities," "self-care," "depression/anxiety," and reduction of "pain/discomfort." The stratified cost-utility results have relevant clinical implications and provide useful information for practitioners in tailoring interventions. Clinical relevance A cost-utility analysis that considered patients characteristics provided insights on the "affordability" of C-Leg compared to mechanical knees. In particular, results suggest that C-Leg has a significant impact on "mobility" for first-time prosthetic users over 40 years, but implementation of specific low-cost physical/psychosocial interventions is required to retun within cost-utility thresholds.

Young adults' health care utilization and expenditures prior to the Affordable Care Act.

PubMed

Lau, Josephine S; Adams, Sally H; Boscardin, W John; Irwin, Charles E

2014-06-01

To examine young adults' health care utilization and expenditures prior to the Affordable Care Act. We used 2009 Medical Expenditure Panel Survey to (1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and (2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other sociodemographic factors, including race/ethnicity and income. Young adults had (1) significantly lower rates of overall utilization (72%) than other age groups (83%-88%, p < .001), (2) the lowest rate of office-based utilization (55% vs. 67%-77%, p < .001) and (3) higher rate of emergency room visits compared with adolescents (15% vs. 12%, p < .01). Uninsured young adults had high out-of-pocket expenses. Compared with the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/person, p < .001) but essentially the same out-of-pocket expenses ($403 vs. $380/person, p = .57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language, and sex. Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of emergency room visits. The Affordable Care Act provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address noninsurance barriers and ensure equal access to health services. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Young Adults' Health Care Utilization and Expenditures Prior to the Affordable Care Act

PubMed Central

Lau, Josephine S.; Adams, Sally H.; Boscardin, W. John; Irwin, Charles E.

2014-01-01

Purpose Examine young adults' health care utilization and expenditures prior to the ACA. Methods We used 2009 Medical Expenditure Panel Survey (MEPS) to 1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and 2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other socio-demographic factors, including race/ethnicity and income. Results Young adults had: 1) significantly lower rates of overall utilization (72%) than other age groups (83-88%, P<.001) and 2), the lowest rate of office-based utilization (55% vs. 67-77%, P<.001) and higher rate of ER visits compared to adolescents (15% v. 12%, P<.01). Uninsured young adults had high out-of-pocket expenses. Compared to the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/ person, P<.001), but essentially the same out-of-pocket expenses ($403 vs. $380/person, p =.57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language and sex. Conclusions Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of ER visits. The ACA provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address non-insurance barriers and ensure equal access to health services. PMID:24702839
The effect of mineral-based alkaline water on hydration status and the metabolic response to short-term anaerobic exercise.

PubMed

Chycki, Jakub; Zając, Tomasz; Maszczyk, Adam; Kurylas, Anna

2017-09-01

Previously it was demonstrated that mineralization and alkalization properties of mineral water are important factors influencing acid-base balance and hydration in athletes. The purpose of this study was to investigate the effects of drinking different types of water on urine pH, specific urine gravity, and post-exercise lactate utilization in response to strenuous exercise. Thirty-six male soccer players were divided into three intervention groups, consuming around 4.0 l/day of different types of water for 7 days: HM (n=12; highly mineralized water), LM (n=12; low mineralized water), and CON (n=12; table water). The athletes performed an exercise protocol on two occasions (before and after intervention). The exercise protocol consisted of 5 bouts of intensive 60-s (120% VO 2max ) cycling separated by 60 s of passive rest. Body composition, urinalysis and lactate concentration were evaluated - before (t0), immediately after (t1), 5' (t2), and 30' (t3) after exercise. Total body water and its active transport (TBW - total body water / ICW - intracellular water / ECW - extracellular water) showed no significant differences in all groups, at both occasions. In the post-hydration state we found a significant decrease of specific urine gravity in HM (1021±4.2 vs 1015±3.8 g/L) and LM (1022±3.1 vs 1008±4.2 g/L). We also found a significant increase of pH and lactate utilization rate in LM. In conclusion, the athletes hydrated with alkaline, low mineralized water demonstrated favourable changes in hydration status in response to high-intensity interval exercise with a significant decrease of specific urine gravity, increased urine pH and more efficient utilization of lactate after supramaximal exercise.
The Marine Resources Experiment Program (MAREX)

NASA Technical Reports Server (NTRS)

1982-01-01

The Satellite Ocean Color Science Working Group was established to consider the scientific utility of repeated satellite measurements of ocean color, especially for measuring global ocean chlorophyll and for studying the fate of global primary productivity in the sea. Results of the group's deliberations are presented. The scientific requirements are given for ocean color data from a CZCS follow on sensor in order to address global primary productivity, fishery, and carbon storage problems. Some specific experiments, called the marine resource experiment and designed to determine critical nutrient fluxes, photosynthetic rates, and primary productivity and biomass, are outlined.
Mortality sensitivity in life-stage simulation analysis: A case study of southern sea otters

USGS Publications Warehouse

Gerber, L.R.; Tinker, M.T.; Doak, D.F.; Estes, J.A.; Jessup, David A.

2004-01-01

Currently, there are no generally recognized approaches for linking detailed mortality and pathology data to population-level analyses of extinction risk. We used a combination of analytical and simulation-based analyses to examine 20 years of age- and sex-specific mortality data for southern sea otters (Enhydra lutris), and we applied results to project the efficacy of alternative conservation strategies. Population recovery of the southern sea otter has been slow (rate of population increase ?? = 1.05) compared to other recovering populations (?? = 1.17-1.20), and the population declined (?? = 0.975) between 1995 and 1999. Age-based Leslie matrices were developed to explore explanations for the slow recovery and recent decline in the southern sea other population. An elasticity analysis was performed to predict effects of proportional changes in stage-specific reproductive or survival rates on the rate of population increase. A life-stage simulation analysis (LSA) was developed to evaluate the impact of changing age- and cause-specific mortality rates on ??. The information used to develop these models was derived from death assemblage, pathology, and live population census data to examine the sensitivity of sea otter population growth to different sources of mortality (e.g., disease and starvation, direct human take [fisheries, gun shot, boat strike, oil pollution], mating trauma and intraspecific aggression, shark bites, and unknown). We used resampling simulations to generate random combinations of vital rates for a large number of matrix replicates and drew on these to estimate potential effects of mortality sources on population growth (??). Our analyses suggest management actions that are likely and unlikely to promote recovery of the southern sea otter and more broadly indicate a methodology to better utilize cause-of-death data in conservation decision-making.
Sex-specific divergence for adaptations to dehydration stress in Drosophila kikkawai.

PubMed

Parkash, Ravi; Ranga, Poonam

2013-09-01

Several studies on diverse Drosophila species have reported higher desiccation resistance of females, but the physiological basis of such sex-specific differences has received less attention. We tested whether sex-specific differences in cuticular traits (melanic females and non-melanic males) of Drosophila kikkawai correspond with divergence in their water balance mechanisms. Our results are interesting in several respects. First, positive clinal variation in desiccation resistance was correlated with cuticular melanisation in females but with changes in cuticular lipid mass in males, despite a lack of differences between the sexes for the rate of water loss. Second, a comparative analysis of water budget showed that females of the northern population stored more body water as well as hemolymph content and exhibited greater dehydration tolerance than flies from the southern tropics. In contrast, we found no geographical variation in the males for water content and dehydration tolerance. Third, an ~10-fold increase in the rate of water loss after organic solvent treatment of male D. kikkawai suggested a role of cuticular lipids in cuticular transpiration, but had no effect in the females. Fourth, geographical differences in the storage of carbohydrate content (metabolic fuel) were observed in females but not in males. Interestingly, in females, the rate of utilization of carbohydrates did not vary geographically, but males from drier localities showed a 50% reduction compared with wetter localities. Thus, body melanisation, increased body water, hemolymph, carbohydrate content and greater dehydration tolerance confer greater desiccation resistance in females, but a reduced rate of water loss is the only possible mechanism to cope with drought stress in males. Finally, acclimated females showed a significant increase in drought resistance associated with higher trehalose content as well as dehydration tolerance, while males showed no acclimation response. Thus, sex-specific differences in desiccation resistance of D. kikkawai are associated with divergence in some water balance strategies, despite a lack of differences in the rate of water loss between the two sexes.
Pre-equilibrium competitive library screening for tuning inhibitor association rate and specificity toward serine proteases.

PubMed

Cohen, Itay; Naftaly, Si; Ben-Zeev, Efrat; Hockla, Alexandra; Radisky, Evette S; Papo, Niv

2018-04-16

High structural and sequence similarity within protein families can pose significant challenges to the development of selective inhibitors, especially toward proteolytic enzymes. Such enzymes usually belong to large families of closely similar proteases and may also hydrolyze, with different rates, protein- or peptide-based inhibitors. To address this challenge, we employed a combinatorial yeast surface display library approach complemented with a novel pre-equilibrium, competitive screening strategy for facile assessment of the effects of multiple mutations on inhibitor association rates and binding specificity. As a proof of principle for this combined approach, we utilized this strategy to alter inhibitor/protease association rates and to tailor the selectivity of the amyloid β-protein precursor Kunitz protease inhibitor domain (APPI) for inhibition of the oncogenic protease mesotrypsin, in the presence of three competing serine proteases, anionic trypsin, cationic trypsin and kallikrein-6. We generated a variant, designated APPI P13W/M17G/I18F/F34V , with up to 30-fold greater specificity relative to the parental APPI M17G/I18F/F34V protein, and 6500- to 230 000-fold improved specificity relative to the wild-type APPI protein in the presence of the other proteases tested. A series of molecular docking simulations suggested a mechanism of interaction that supported the biochemical results. These simulations predicted that the selectivity and specificity are affected by the interaction of the mutated APPI residues with nonconserved enzyme residues located in or near the binding site. Our strategy will facilitate a better understanding of the binding landscape of multispecific proteins and will pave the way for design of new drugs and diagnostic tools targeting proteases and other proteins. © 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.
An equity analysis of health examination service utilization by women from underdeveloped areas in western China

PubMed Central

Gao, Jianmin; Zhou, Zhongliang; Yan, Ju’e; Xu, Yongjian; Yang, Xiaowei; Li, Yanli

2017-01-01

Objective This study sought to examine the sources of inequity in health examination service utilization by women from underdeveloped areas in western China. Methods Based on data from the 5th National Health Service Survey in Shaanxi province, women’s utilization of health examination services was examined according to gynecological, cervical smear, and breast examination rates. The equity of health examination service utilization by 15- to 64-year-old women and the factors contributing to inequity were determined using the health concentration index, decomposition of the concentration index, and the horizontal inequity index. Results The examination rates for gynecological, cervical smear, and breast exams for 15- to 64-year-old women in Shaanxi province were 40.61%, 27.08%, and 24.59%, respectively. The horizontal inequity indices of gynecological, cervical smear, and breast examination rates were 0.0480, 0.0423, and 0.0764, respectively, and each examination rate was higher for wealthy individuals. The contribution rates of economic status to the inequalities in gynecological, cervical smear, and breast examination rates were 65.80%, 74.31%, and 56.49%, respectively. The contribution rates of educational status to the inequalities in gynecological, cervical smear, and breast examination rates were 21.01%, 14.83% and 30.00%, respectively. The contribution rates of age to the inequalities in gynecological, cervical smear, and breast examination rates were 25.77%, 26.55%, and 18.40%, respectively. Conclusions Women’s health examination rates differed between populations with different socio-demographic characteristics. There is pro-wealth inequality in each examination rate. This study found that financial status, age, and education level were the main reasons for the unequal utilization of health examination services. PMID:29065129
The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks.

PubMed

Bech, Mickael; Christiansen, Terkel; Dunham, Kelly; Lauridsen, Jørgen; Lyttkens, Carl Hampus; McDonald, Kathryn; McGuire, Alistair

2009-10-01

The Technological Change in Health Care Research Network collected unique patient-level data on three procedures for treatment of heart attack patients (catheterization, coronary artery bypass grafts and percutaneous transluminal coronary angioplasty) for 17 countries over a 15-year period to examine the impact of economic and institutional factors on technology adoption. Specific institutional factors are shown to be important to the uptake of these technologies. Health-care systems characterized as public contract systems and reimbursement systems have higher adoption rates than public-integrated health-care systems. Central control of funding of investments is negatively associated with adoption rates and the impact is of the same magnitude as the overall health-care system classification. GDP per capita also has a strong role in initial adoption. The impact of income and institutional characteristics on the utilization rates of the three procedures diminishes over time.
Anaerobic digestion of municipal solid waste: Utility of process residues as a soil amendment

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

Rivard, C.J.; Nagle, N.J.; Kay, B.D.

1995-12-31

Tuna processing wastes (sludges high in fat, oil, and grease [FOG]) and municipal solid waste (MSW) generated on Tutuila Island, American Samoa, represent an ongoing disposal challenge. The biological conversion of the organic fraction of these wastes to useful products, including methane and fertilizer-grade residue, through anaerobic high-solids digestion is currently in scale-up development. The suitability of the anaerobic digestion residues as a soil amendment was evaluated through extensive chemical analysis and greenhouse studies using corn as an indicator crop. Additionally, native Samoan soil was used to evaluate the specific application rates for the compost. Experiments established that anaerobic residuesmore » increase crop yields in direct proportion to increases in the application rate. Additionally, nutrient saturation was not demonstrated within the range of application rates evaluated for the Samoan soil. Beyond nutrient supplementation, organic residue amendment to Samoan soil imparts enhanced water and nutrient-binding capacities.« less
Resting-state qEEG predicts rate of second language learning in adults.

PubMed

Prat, Chantel S; Yamasaki, Brianna L; Kluender, Reina A; Stocco, Andrea

2016-01-01

Understanding the neurobiological basis of individual differences in second language acquisition (SLA) is important for research on bilingualism, learning, and neural plasticity. The current study used quantitative electroencephalography (qEEG) to predict SLA in college-aged individuals. Baseline, eyes-closed resting-state qEEG was used to predict language learning rate during eight weeks of French exposure using an immersive, virtual scenario software. Individual qEEG indices predicted up to 60% of the variability in SLA, whereas behavioral indices of fluid intelligence, executive functioning, and working-memory capacity were not correlated with learning rate. Specifically, power in beta and low-gamma frequency ranges over right temporoparietal regions were strongly positively correlated with SLA. These results highlight the utility of resting-state EEG for studying the neurobiological basis of SLA in a relatively construct-free, paradigm-independent manner. Published by Elsevier Inc.
Prediction of Surface and pH-Specific Binding of Peptides to Metal and Oxide Nanoparticles

NASA Astrophysics Data System (ADS)

Heinz, Hendrik; Lin, Tzu-Jen; Emami, Fateme Sadat; Ramezani-Dakhel, Hadi; Naik, Rajesh; Knecht, Marc; Perry, Carole C.; Huang, Yu

2015-03-01

The mechanism of specific peptide adsorption onto metallic and oxidic nanostructures has been elucidated in atomic resolution using novel force fields and surface models in comparison to measurements. As an example, variations in peptide adsorption on Pd and Pt nanoparticles depending on shape, size, and location of peptides on specific bounding facets are explained. Accurate computational predictions of reaction rates in C-C coupling reactions using particle models derived from HE-XRD and PDF data illustrate the utility of computational methods for the rational design of new catalysts. On oxidic nanoparticles such as silica and apatites, it is revealed how changes in pH lead to similarity scores of attracted peptides lower than 20%, supported by appropriate model surfaces and data from adsorption isotherms. The results demonstrate how new computational methods can support the design of nanoparticle carriers for drug release and the understanding of calcification mechanisms in the human body.
The effect of new and continuing prescription drug use on cost: a longitudinal analysis of chronic and seasonal utilization.

PubMed

Fairman, K A

2000-05-01

To provide basic information about 2 factors contributing to rising prescription drug costs--utilization trends and product selection. Prescription drug costs have risen sharply in recent years, and continued growth is expected. There is little consensus about appropriate cost-management strategies, in part because quantitative data on the causes and implications of increased drug costs are lacking. This study followed 463,820 continuously enrolled adult (> or = 18 years of age on January 1, 1996) utilizers of 15 chronic or seasonal therapeutic classes for 2.5 years (January 1996 through June 1998) using a pharmacy benefit manager's multiple-payer claims database. Outcome measures included (1) change in utilization rate, (2) relationship between new use and utilization growth, (3) stability of the treated population (ie, mostly long-term use vs high rates of turnover), and (4) product mix changes (ie, cost per dispensed day for 1996 vs 1997 and for new vs continuing users, controlling for inflation). Of the 463,820 utilizers, 97% were commercially insured and 3% enrolled in Medicare risk plans; 40% were enrolled in managed care and the remainder covered by indemnity insurance. Rates of growth and turnover varied substantially by class. The highest 2-year utilization rate change was 66.7% for antihyperlipidemic agents; change was < 10% in only 3 classes. Across classes, an average of 38.7% of 1997 users were new (ie, no use in 1996) and an average of 34.0% of 1996 users were dropouts (ie, no use in 1997). Utilization growth depended heavily on treatment continuation; classes with high dropout rates (eg, antirheumatic, antiasthmatic) did not have high growth rates, even with high rates of new use. In most classes, costs were not higher for new than for continuing users. In some classes, however (eg, antipsychotic, antidiabetic), both new and continuing users increased their use of newer, more expensive products. Because factors underlying rising prescription drug costs vary by therapeutic class, cost-containment strategies should address these differences. Further research is needed to assess the clinical and economic costs and benefits of rapid growth in the utilization of certain therapeutic classes.
Elucidating Microbial Species-Specific Effects on Organic Matter Transformation in Marine Sediments

NASA Astrophysics Data System (ADS)

Mahmoudi, N.; Enke, T. N.; Beaupre, S. R.; Teske, A.; Cordero, O. X.; Pearson, A.

2017-12-01

Microbial transformation and decomposition of organic matter in sediments constitutes one of the largest fluxes of carbon in marine environments. Mineralization of sedimentary organic matter by microorganisms results in selective degradation such that bioavailable or accessible compounds are rapidly metabolized while more recalcitrant, complex compounds are preserved and buried in sediment. Recent studies have found that the ability to use different carbon sources appears to vary among microorganisms, suggesting that the availability of certain pools of carbon can be specific to the taxa that utilize the pool. This implies that organic matter mineralization in marine environments may depend on the metabolic potential of the microbial populations that are present and active. The goal of our study was to investigate the extent to which organic matter availability and transformation may be species-specific using sediment from Guaymas Basin (Gulf of California). We carried out time-series incubations using bacterial isolates and sterilized sediment in the IsoCaRB system which allowed us to measure the production rates and natural isotopic signatures (δ13C and Δ14C) of microbially-respired CO2. Separate incubations using two different marine bacterial isolates (Vibrio sp. and Pseudoalteromonas sp.) and sterilized Guaymas Basin sediment under oxic conditions showed that the rate and total quantity of organic matter metabolized by these two species differs. Approximately twice as much CO2 was collected during the Vibrio sp. incubation compared to the Pseudoalteromonas sp. incubation. Moreover, the rate at which organic matter was metabolized by the Vibrio sp. was much higher than the Pseudoalteromonas sp. indicating the intrinsic availability of organic matter in sediments may depend on the species that is present and active. Isotopic analyses of microbially respired CO2 will be used to constrain the type and age of organic matter that is accessible to each species. Moreover, molecular analysis of subsamples collected from each incubation will link carbon utilization with the underlying gene expression. Our study sheds light on the degree to which the metabolic capacities of microorganisms affect carbon transformation in sedimentary environments.
Cooperative Drought Adaptation: Integrating Infrastructure Development, Conservation, and Water Transfers into Adaptive Policy Pathways

NASA Astrophysics Data System (ADS)

Zeff, H. B.; Characklis, G. W.; Reed, P. M.; Herman, J. D.

2015-12-01

Water supply policies that integrate portfolios of short-term management decisions with long-term infrastructure development enable utilities to adapt to a range of future scenarios. An effective mix of short-term management actions can augment existing infrastructure, potentially forestalling new development. Likewise, coordinated expansion of infrastructure such as regional interconnections and shared treatment capacity can increase the effectiveness of some management actions like water transfers. Highly adaptable decision pathways that mix long-term infrastructure options and short-term management actions require decision triggers capable of incorporating the impact of these time-evolving decisions on growing water supply needs. Here, we adapt risk-based triggers to sequence a set of potential infrastructure options in combination with utility-specific conservation actions and inter-utility water transfers. Individual infrastructure pathways can be augmented with conservation or water transfers to reduce the cost of meeting utility objectives, but they can also include cooperatively developed, shared infrastructure that expands regional capacity to transfer water. This analysis explores the role of cooperation among four water utilities in the 'Research Triangle' region of North Carolina by formulating three distinct categories of adaptive policy pathways: independent action (utility-specific conservation and supply infrastructure only), weak cooperation (utility-specific conservation and infrastructure development with regional transfers), and strong cooperation (utility specific conservation and jointly developed of regional infrastructure that supports transfers). Results suggest that strong cooperation aids the utilities in meeting their individual objections at substantially lower costs and with fewer irreversible infrastructure options.
Regional differences of maternal health care utilization in China.

PubMed

Tang, Mengsha; Wang, Debin; Hu, Hong; Wang, Guoping; Li, Rongjie

2015-03-01

To describe regional differences in maternal health care (MHC) utilization in China. Cross-sectional comparisons of 4 MHC utilization indicators, namely, early (13 weeks within pregnancy) examinations rate (EER), prenatal examination (>4 times) rate (PER), hospital delivery rate (HDR), and postnatal visit (>1 time) rate (PVR), using index of dissimilarity (ID), linear correlation analysis, and geographical mapping. Significant differences existed across regions in all the indicators (P < .01). All the IDs for rural areas were higher than that for urban areas. The IDs for major regions ranged from 0.01 to 0.27. Linear correlation coefficients between MHC utilization indicators by regions varied from 0.007 to 0.889 (in absolute value, P < .05). Characteristic formats of geographical distribution were found with PER, EER, HDR, and PVR being in "high-plateau," "low-plateau," and "shifting" patterns, respectively. There exist substantial regional discrepancies in MHC utilization in China and future MHC-related policies should take account regional context. © 2013 APJPH.
Employee assistance programs, drug testing, and workplace injury.

PubMed

Waehrer, Geetha M; Miller, Ted R; Hendrie, Delia; Galvin, Deborah M

2016-06-01

Little is known about the effects of employee assistance programs (EAPs) on occupational injuries. Multivariate regressions probed a unique data set that linked establishment information about workplace anti-drug programs in 1988 with occupational injury rates for 1405 establishments. EAPs were associated with a significant reduction in both no-lost-work and lost-work injuries, especially in the manufacturing and transportation, communication and public utilities industries (TCPU). Lost-work injuries were more responsive to specific EAP characteristics, with lower rates associated with EAPs staffed by company employees (most likely onsite). Telephone hotline services were associated with reduced rates of lost-work injuries in manufacturing and TCPU. Drug testing was associated with reductions in the rate of minor injuries with no lost work, but had no significant relationship with lost-work injuries. This associational study suggests that EAPs, especially ones that are company-staffed and ones that include telephone hotlines, may prevent workplace injuries. Copyright © 2016. Published by Elsevier Ltd.
An Archival COS Study of Multi-phase Galactic Outflows and Their Dependence on Host Galaxy Properties

NASA Astrophysics Data System (ADS)

Chisholm, John

2013-10-01

Galactic outflows have become vital for understanding galaxy evolution. Outflows have been used to explain the mass-metallicity relation, the star formation history of the universe, and the shape of the baryonic mass function. However, few studies have focused on the basic question of how outflow velocities depend upon the physical properties of their host galaxies. Here we propose an archival project utilizing 52 COS spectra of local star-forming galaxies spanning four decades of star formation rate, and stellar mass. We will preform a self-consistent analysis of trends between galactic properties {star formation rate, stellar mass, specific star formation rate and star formation rate surface density} and outflow velocities measured from interstellar metal absorption lines {e.g., CII 1335}. We will extend this analysis to different gas phases - cold, warm, and hot - to gain a more comprehensive understanding of the physics of multi-phase outflows. The trends we observe will provide insights into the feedback process and will be crucial new benchmarks for simulations.
Perceived Utility of Pharmacy Licensure Examination Preparation Tools

PubMed Central

Peak, Amy Sutton; Sheehan, Amy Heck; Arnett, Stephanie

2006-01-01

Objectives To identify board examination preparation tools most commonly used by recent pharmacy graduates and determine which tools are perceived as most valuable and representative of the actual content of licensure examinations. Methods An electronic survey was sent to all 2004 graduates of colleges of pharmacy in Indiana. Participants identified which specific preparation tools were used and rated tools based on usefulness, representativeness of licensure examination, and monetary value, and provided overall recommendations to future graduates. Results The most commonly used preparation tools were the Pharmacy Law Review Session offered by Dr. Thomas Wilson at Purdue University, the Complete Review for Pharmacy, Pre-NAPLEX, PharmPrep, and the Kaplan NAPLEX Review. Tools receiving high ratings in all categories included Dr. Wilson's Pharmacy Law Review Session, Pre-NAPLEX, Comprehensive Pharmacy Review, Kaplan NAPLEX Review, and Review of Pharmacy. Conclusions Although no preparation tool was associated with a higher examination pass rate, certain tools were clearly rated higher than others by test takers. PMID:17149406
Study of the Interrelationships between Minimum Flow Release Policies and Hydroelectric Power Development in New England.

DTIC Science & Technology

1981-06-01

available information from Public Utilities comaissions responsible for establishing PURPA rates in each state. 1.4 PRINCIPAL FINDINGS The direct effect all... PURPA rates. However, many of those categorized as private and public developers are private and public utilities. This reflects the interest in hydro...The Public Utility Regulatory Policies Act ( PURPA ) of 1978 empowered FERC to prescribe rules requiring utilities to purchase power from and sell power

Using Medical Claims for Policy Effectiveness Surveillance: Reimbursement and Utilization of Abdomen/Pelvis Computed Tomography Scans.

PubMed

Horný, Michal; Morgan, Jake R; Merker, Vanessa L

2015-12-01

To quantify changes in private insurance payments for and utilization of abdominal/pelvic computed tomography scans (CTs) after 2011 changes in CPT coding and Medicare reimbursement rates, which were designed to reduce costs stemming from misvalued procedures. TruvenHealth Analytics MarketScan Commercial Claims and Encounters database. We used difference-in-differences models to compare combined CTs of the abdomen/pelvis to CTs of the abdomen or pelvis only. Our main outcomes were inflation-adjusted log payments per procedure, daily utilization rates, and total annual payments. Claims data were extracted for all abdominal/pelvic CTs performed in 2009-2011 within noncapitated, employer-sponsored private plans. Adjusted payments per combined CTs of the abdomen/pelvis dropped by 23.8 percent (p < .0001), and their adjusted daily utilization rate accelerated by 0.36 percent (p = .034) per month after January 2011. Utilization rate of abdominal-only or pelvic-only CTs dropped by 5.0 percent (p < .0001). Total annual payments for combined CTs of the abdomen/pelvis decreased in 2011 despite the increased utilization. Private insurance payments for combined CTs of the abdomen/pelvis declined and utilization accelerated significantly after 2011 policy changes. While growth in total annual payments was contained in 2011, it may not be sustained if 2011 utilization trends persist. © Health Research and Educational Trust.
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
Carbon-Coated, Diatomite-Derived Nanosilicon as a High Rate Capable Li-ion Battery Anode

PubMed Central

Campbell, Brennan; Ionescu, Robert; Tolchin, Maxwell; Ahmed, Kazi; Favors, Zachary; Bozhilov, Krassimir N.; Ozkan, Cengiz S.; Ozkan, Mihrimah

2016-01-01

Silicon is produced in a variety of ways as an ultra-high capacity lithium-ion battery (LIB) anode material. The traditional carbothermic reduction process required is expensive and energy-intensive; in this work, we use an efficient magnesiothermic reduction to convert the silica-based frustules within diatomaceous earth (diatomite, DE) to nanosilicon (nanoSi) for use as LIB anodes. Polyacrylic acid (PAA) was used as a binder for the DE-based nanoSi anodes for the first time, being attributed for the high silicon utilization under high current densities (up to 4C). The resulting nanoSi exhibited a high BET specific surface area of 162.6 cm2 g−1, compared to a value of 7.3 cm2 g−1 for the original DE. DE contains SiO2 architectures that make ideal bio-derived templates for nanoscaled silicon. The DE-based nanoSi anodes exhibit good cyclability, with a specific discharge capacity of 1102.1 mAh g−1 after 50 cycles at a C-rate of C/5 (0.7 A gSi−1) and high areal loading (2 mg cm−2). This work also demonstrates the fist rate capability testing for a DE-based Si anode; C-rates of C/30 - 4C were tested. At 4C (14.3 A gSi−1), the anode maintained a specific capacity of 654.3 mAh g−1 – nearly 2x higher than graphite’s theoretical value (372 mAh g−1). PMID:27713474
Carbon-Coated, Diatomite-Derived Nanosilicon as a High Rate Capable Li-ion Battery Anode

NASA Astrophysics Data System (ADS)

Campbell, Brennan; Ionescu, Robert; Tolchin, Maxwell; Ahmed, Kazi; Favors, Zachary; Bozhilov, Krassimir N.; Ozkan, Cengiz S.; Ozkan, Mihrimah

2016-10-01

Silicon is produced in a variety of ways as an ultra-high capacity lithium-ion battery (LIB) anode material. The traditional carbothermic reduction process required is expensive and energy-intensive; in this work, we use an efficient magnesiothermic reduction to convert the silica-based frustules within diatomaceous earth (diatomite, DE) to nanosilicon (nanoSi) for use as LIB anodes. Polyacrylic acid (PAA) was used as a binder for the DE-based nanoSi anodes for the first time, being attributed for the high silicon utilization under high current densities (up to 4C). The resulting nanoSi exhibited a high BET specific surface area of 162.6 cm2 g-1, compared to a value of 7.3 cm2 g-1 for the original DE. DE contains SiO2 architectures that make ideal bio-derived templates for nanoscaled silicon. The DE-based nanoSi anodes exhibit good cyclability, with a specific discharge capacity of 1102.1 mAh g-1 after 50 cycles at a C-rate of C/5 (0.7 A gSi-1) and high areal loading (2 mg cm-2). This work also demonstrates the fist rate capability testing for a DE-based Si anode; C-rates of C/30 - 4C were tested. At 4C (14.3 A gSi-1), the anode maintained a specific capacity of 654.3 mAh g-1 - nearly 2x higher than graphite’s theoretical value (372 mAh g-1).
24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the energy conservation measures and other direct costs related to the energy project under the... for energy conservation/rate reduction. 990.185 Section 990.185 Housing and Urban Development... Calculating Formula Expenses § 990.185 Utilities expense level: Incentives for energy conservation/rate...
24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the energy conservation measures and other direct costs related to the energy project under the... for energy conservation/rate reduction. 990.185 Section 990.185 Housing and Urban Development... Calculating Formula Expenses § 990.185 Utilities expense level: Incentives for energy conservation/rate...
24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the energy conservation measures and other direct costs related to the energy project under the... for energy conservation/rate reduction. 990.185 Section 990.185 Housing and Urban Development... Calculating Formula Expenses § 990.185 Utilities expense level: Incentives for energy conservation/rate...
Pre-soaking of the feed pellets: a trick for successful feed utilization in juvenile green turtles (Chelonia mydas Linnaeus, 1758).

PubMed

Kanghae, H; Thongprajukaew, K; Phromkunthong, W; Plangsri, S; Jatupornpitukchat, S; Kittiwattanawong, K

2017-04-01

Pre-soaking of the feed pellets in water can improve feed utilization in juvenile green turtles (Chelonia mydas Linnaeus, 1758), but the pre-soaking has not previously been optimized. This study aimed to optimize the water amount used for pre-soaking the pellets. The experiments followed a completely randomized design with three replications of each dietary treatment group. Initially 10-day-old green turtles (20-22 g body weight) were treated in an indoor aquaculture system for 3 months. The dietary treatment pellets were pre-soaked with 0.3, 0.5 or 0.7 (v/w) relative amounts of water that are here termed soaking ratios. At the end of experiment, there were no significant differences in survival (96% on average) and growth (average body weight 75.34 g and specific growth rate 2%/day, on average) of turtles in three dietary treatments (p > 0.05). Feed utilization was the best in turtles fed with 0.7 pre-soaked ratio, as indicated by significant reductions (p < 0.05) in the feeding rate (7.44% body weight/day) and the feed conversion ratio (1.12 g feed/g gain). Digestion was also improved by the induction of faecal digestive enzymes as well as the faecal thermal properties. The rapid growth did not negatively affect the general haematological parameters of reared turtles. These findings indicate that the pre-soaking of feed pellets at the optimal soaking ratio (1:0.7 w/v of pellet to water) can contribute through improved feed utilization of green turtles. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.
Holistic assessment of a landfill mining pilot project in Austria: Methodology and application.

PubMed

Hermann, Robert; Baumgartner, Rupert J; Vorbach, Stefan; Wolfsberger, Tanja; Ragossnig, Arne; Pomberger, Roland

2016-07-01

Basic technical and economic examinations of Austrian mass waste landfills, concerning the recovery of secondary raw materials, have been carried out by the 'LAMIS - Landfill Mining Austria' pilot project for the first time in Austria. A main focus of the research - the subject of this article - was the first devotion of a pilot landfill to an integrated ecological and economic assessment so that its feasibility could be verified before a landfill mining project commenced. A Styrian mass waste landfill had been chosen for this purpose that had been put into operation in 1979 and received mechanically-biologically pre-treated municipal waste till 2012. The whole assessment procedure was divided into preliminary and main assessment phases to evaluate the general suitability of a landfill mining project with little financial and human resource expense. A portfolio chart, based on a questionnaire, was created for the preliminary assessment that, as a result, has provided a recommendation for subsequent investigation - the main assessment phase. In this case, specific economic criteria were assessed by net present value calculation, while ecological or socio-economic criteria were rated by utility analysis, transferring the result into a utility-net present value chart. In the case of the examined pilot landfill, assessing the landfill mining project produced a higher utility but a lower net present value than a landfill leaving-in for aftercare. Since no clearly preferable scenario could be identified this way, a cost-revenue analysis was carried out in addition that determined a dimensionless ratio: the 'utility - net present value quotient' of both scenarios. Comparing this quotient showed unmistakably that in the overall assessment, 'leaving the landfill in aftercare' was preferable to a 'landfill mining project' in that specific case. © The Author(s) 2016.
Enantiomeric Degradation of 2-(4-Sulfophenyl)Butyrate via 4-Sulfocatechol in Delftia acidovorans SPB1

PubMed Central

Schulz, Saskia; Dong, Wenbo; Groth, Ulrich; Cook, Alasdair M.

2000-01-01

Enrichment cultures with enantiomeric 2-(4-sulfophenyl)butyrate (SPB) as the sole added source(s) of carbon and energy for growth yielded a pure culture of a degradative bacterium, which was identified as Delftia acidovorans SPB1. The organism utilized the enantiomers sequentially. R-SPB was utilized first (specific growth rate [μ] = 0.28 h−1), with transient excretion of an unknown intermediate, which was identified as 4-sulfocatechol (4SC). Utilization of S-SPB was slower (μ = 0.016 h−1) and was initiated only after the first enantiomer was exhausted. Suspensions of cells grown in S-SPB excreted 4SC, so metabolism of the two enantiomers converged at 4SC. The latter was degraded by ortho cleavage via 3-sulfo-cis,cis-muconate. Strain SPB1 grew with 4SC and with 1-(4-sulfophenyl)octane (referred to herein as model LAS) but not with commercial linear alkylbenzenesulfonate (LAS) surfactant, which is subterminally substituted but nontoxic. It would appear that metabolism of the model LAS does not represent metabolism of commercial LAS. PMID:10788358
Innovative applications of energy storage in a restructured electricity marketplace : Phase III final report : a study for the DOE Energy Storage Systems Program.

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

Eyer, James M.; Erdman, Bill; Iannucci, Joseph J., Jr.

2005-03-01

This report describes Phase III of a project entitled Innovative Applications of Energy Storage in a Restructured Electricity Marketplace. For this study, the authors assumed that it is feasible to operate an energy storage plant simultaneously for two primary applications: (1) energy arbitrage, i.e., buy-low-sell-high, and (2) to reduce peak loads in utility ''hot spots'' such that the utility can defer their need to upgrade transmission and distribution (T&D) equipment. The benefits from the arbitrage plus T&D deferral applications were estimated for five cases based on the specific requirements of two large utilities operating in the Eastern U.S. A numbermore » of parameters were estimated for the storage plant ratings required to serve the combined application: power output (capacity) and energy discharge duration (energy storage). In addition to estimating the various financial expenditures and the value of electricity that could be realized in the marketplace, technical characteristics required for grid-connected distributed energy storage used for capacity deferral were also explored.« less
Impact of Lactic Acid and Hydrogen Ion on the Simultaneous Fermentation of Glucose and Xylose by the Carbon Catabolite Derepressed Lactobacillus brevis ATCC 14869.

PubMed

Jeong, Kyung Hun; Israr, Beenish; Shoemaker, Sharon P; Mills, David A; Kim, Jaehan

2016-07-28

Lactobacillus brevis ATCC 14869 exhibited a carbon catabolite de-repressed (CCR) phenotype which has ability to consume fermentable sugar simultaneously with glucose. To evaluate this unusual phenotype under harsh conditions during fermentation, the effect of lactic acid and hydrogen ion concentrations on L. brevis ATCC 14869 were examined. Kinetic equations describing the relationship between specific cell growth rate and lactic acid or hydrogen ion concentration has been reduced. The change of substrate utilization and product formation according to lactic acid and hydrogen ion concentration in the media were quantitatively described. Moreover; utilization of other compounds were also observed along with hydrogen ion and lactic acid concentration simultaneously. It has been found that substrate preference changes significantly regarding to utilization of compounds in media. That could result into formation of two-carbon products. In particular, acetic acid present in the media as sodium acetate were consumed by L. brevis ATCC 14869 under extreme pH of both acid and alkaline conditions.
Different Perspectives on Technology Acceptance: The Role of Technology Type and Age

NASA Astrophysics Data System (ADS)

Arning, Katrin; Ziefle, Martina

Although eHealth technologies offer an enormous potential to improve healthcare, the knowledge about key determinants of acceptance for eHealth technology is restricted. While the underlying technology of eHealth technologies and Information and Communication technology (ICT) is quite similar, utilization contexts and using motives are quite different. In order to explore the role of technology type on acceptance, we contrasted central application characteristics of both technology types using the scenario technique. A questionnaire was administered (n = 104) measuring individual variables (age, gender) and attitudes regarding an eHealth application (blood sugar meter) in contrast to an ICT device (Personal Digital Assistant, PDA). Older users basically approved the utilization of health-related technologies and perceived lower usability barriers. In addition, we identified main utilization motives of eHealth technology and technology-specific acceptance patterns, especially regarding issues of data safety in the eHealth context. Effects of age and gender in acceptance ratings suggest a differential perspective on eHealth acceptance. Finally, practical interventions were derived in order to support eHealth device design and to promote acceptance of eHealth technology.
Predictors of Army National Guard and Reserve members' use of Veteran Health Administration health care after demobilizing from OEF/OIF deployment.

PubMed

Harris, Alex H S; Chen, Cheng; Mohr, Beth A; Adams, Rachel Sayko; Williams, Thomas V; Larson, Mary Jo

2014-10-01

This study described rates and predictors of Army National Guard and Army Reserve members' enrollment in and utilization of Veteran Health Administration (VHA) services in the 365 days following demobilization from an index deployment. We also explored regional and VHA facility variation in serving eligible members in their catchment areas. The sample included 125,434 Army National Guard and 48,423 Army Reserve members who demobilized after a deployment ending between FY 2008 and FY 2011. Demographic, geographic, deployment, and Military Health System eligibility were derived from Defense Enrollment Eligibility Reporting System and "Contingency Tracking System" data. The VHA National Patient Care Databases were used to ascertain VHA utilization and status (e.g., enrollee, TRICARE). Logistic regression models were used to evaluate predictors of VHA utilization as an enrollee in the year following demobilization. Of the study members demobilizing during the observation period, 56.9% of Army National Guard members and 45.7% of Army Reserve members utilized VHA as an enrollee within 12 months. Demographic, regional, health coverage, and deployment-related factors were associated with VHA enrollment and utilization, and significant variation by VHA facility was found. These findings can be useful in the design of specific outreach efforts to improve linkage from the Military Health System to the VHA. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Relations between Municipal Water Use and Selected Meteorological Parameters and Drought Indices, East-Central and Northeast Florida

USGS Publications Warehouse

Murray, Louis C.

2009-01-01

Water-use data collected between 1992 and 2006 at eight municipal water-supply utilities in east-central and northeast Florida were analyzed to identify seasonal trends in use and to quantify monthly variations. Regression analyses were applied to identify significant correlations between water use and selected meteorological parameters and drought indices. Selected parameters and indices include precipitation (P), air temperature (T), potential evapotranspiration (PET), available water (P-PET), monthly changes in these parameters (Delta P, Delta T, Delta PET, Delta(P-PET), the Palmer Drought Severity Index (PDSI), and the Standardized Precipitation Index (SPI). Selected utilities include the City of Daytona Beach (Daytona), the City of Eustis (Eustis), Gainesville Regional Utilities (GRU), Jacksonville Electric Authority (JEA), Orange County Utilities (OCU), Orlando Utilities Commission (OUC), Seminole County Utilities (SCU), and the City of St. Augustine (St. Augustine). Water-use rates at these utilities in 2006 ranged from about 3.2 million gallons per day at Eustis to about 131 million gallons per day at JEA. Total water-use rates increased at all utilities throughout the 15-year period of record, ranging from about 4 percent at Daytona to greater than 200 percent at OCU and SCU. Metered rates, however, decreased at six of the eight utilities, ranging from about 2 percent at OCU and OUC to about 17 percent at Eustis. Decreases in metered rates occurred because the number of metered connections increased at a greater rate than did total water use, suggesting that factors other than just population growth may play important roles in water-use dynamics. Given the absence of a concurrent trend in precipitation, these decreases can likely be attributed to changes in non-climatic factors such as water-use type, usage of reclaimed water, water-use restrictions, demographics, and so forth. When averaged for the eight utilities, metered water-use rates depict a clear seasonal pattern in which rates were lowest in the winter and greatest in the late spring. Averaged water-use rates ranged from about 9 percent below the 15-year daily mean in January to about 11 percent above the daily mean in May. Water-use rates were found to be statistically correlated to meteorological parameters and drought indices, and to be influenced by system memory. Metered rates (in gallons per day per active metered connection) were consistently found to be influenced by P, T, PET, and P-PET and changes in these parameters that occurred in prior months. In the single-variant analyses, best correlations were obtained by fitting polynomial functions to plots of metered rates versus moving-averaged values of selected parameters (R2 values greater than 0.50 at three of eight sites). Overall, metered water-use rates were best correlated with the 3- to 4-month moving average of Delta T or Delta PET (R2 values up to 0.66), whereas the full suite of meteorological parameters was best correlated with metered rates at Daytona and least correlated with rates at St. Augustine. Similarly, metered rates were substantially better correlated with moving-averaged values of precipitation (significant at all eight sites) than with single (current) monthly values (significant at only three sites). Total and metered water-use rates were positively correlated with T, PET, Delta P, Delta T, and Delta PET, and negatively correlated with P, P-PET, Delta (P-PET), PDSI, and SPI. The drought indices were better correlated with total water-use rates than with metered rates, whereas metered rates were better correlated with meteorological parameters. Multivariant analyses produced fits of the data that explained a greater degree of the variance in metered rates than did the single-variant analyses. Adjusted R2 values for the 'best' models ranged from 0.79 at JEA to 0.29 at St. Augustine and exceeded 0.60 at five of eight sites. The amount of available water (P-PET) was the si
Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial.

PubMed

Kearns, Patrick

2017-10-01

PURPOSE: Health services research evaluates redesign models for primary care. Care management is one alternative. Evaluation includes resource utilization as a criterion. Compare the impact of care-manager teams on resource utilization. The comparison includes entire panes of patients and the subset of patients with diabetes. DESIGN: Randomized, prospective, cohort study comparing change in utilization rates between groups, pre- and post-intervention. METHODOLOGY: Ten primary care physician panels in a safety-net setting. Ten physicians were randomized to either a care-management approach (Group 1) or a traditional approach (Group 2). Care managers focused on diabetes and the cardiovascular cluster of diseases. Analysis compared rates of hospitalization, 30-day readmission, emergency room visits, and urgent care visits. Analysis compared baseline rates to annual rates after a yearlong run-in for entire panels and the subset of patients with diabetes. RESULTS: Resource utilization showed no statistically significant change between baseline and Year 3 (P=.79). Emergency room visits and hospital readmission increased for both groups (P=.90), while hospital admissions and urgent care visits decreased (P=.73). Similarly, utilization was not significantly different for patients with diabetes (P=.69). CONCLUSIONS: A care-management team approach failed to improve resource utilization rates by entire panels and the subset of diabetic patients compared to traditional care. This reinforces the need for further evidentiary support for the care-management model's hypothesis in the safety net.
On the Path to SunShot. Utility Regulatory and Business Model Reforms for Addressing the Financial Impacts of Distributed Solar on Utilities

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

Barbose, Galen; Miller, John; Sigrin, Ben

Net-energy metering (NEM) has helped drive the rapid growth of distributed PV (DPV) but has raised concerns about electricity cost shifts, utility financial losses, and inefficient resource allocation. These concerns have motivated real and proposed reforms to utility regulatory and business models. This report explores the challenges and opportunities associated with such reforms in the context of the U.S. Department of Energy's SunShot Initiative. Most of the reforms to date address NEM concerns by reducing the benefits provided to DPV customers and thus constraining DPV deployment. Eliminating NEM nationwide, by compensating exports of PV electricity at wholesale rather than retailmore » rates, could cut cumulative DPV deployment by 20% in 2050 compared with a continuation of current policies. This would slow the PV cost reductions that arise from larger scale and market certainty. It could also thwart achievement of the SunShot deployment goals even if the initiative's cost targets are achieved. This undesirable prospect is stimulating the development of alternative reform strategies that address concerns about distributed PV compensation without inordinately harming PV economics and growth. These alternatives fall into the categories of facilitating higher-value DPV deployment, broadening customer access to solar, and aligning utility profits and earnings with DPV. Specific strategies include utility ownership and financing of DPV, community solar, distribution network operators, services-driven utilities, performance-based incentives, enhanced utility system planning, pricing structures that incentivize high-value DPV configurations, and decoupling and other ratemaking reforms that reduce regulatory lag. These approaches represent near- and long-term solutions for preserving the legacy of the SunShot Initiative.« less
Link Adaptation for Mitigating Earth-To-Space Propagation Effects on the NASA SCaN Testbed

NASA Technical Reports Server (NTRS)

Kilcoyne, Deirdre K.; Headley, William C.; Leffke, Zach J.; Rowe, Sonya A.; Mortensen, Dale J.; Reinhart, Richard C.; McGwier, Robert W.

2016-01-01

In Earth-to-Space communications, well-known propagation effects such as path loss and atmospheric loss can lead to fluctuations in the strength of the communications link between a satellite and its ground station. Additionally, the typically unconsidered effect of shadowing due to the geometry of the satellite and its solar panels can also lead to link degradation. As a result of these anticipated channel impairments, NASA's communication links have been traditionally designed to handle the worst-case impact of these effects through high link margins and static, lower rate, modulation formats. The work presented in this paper aims to relax these constraints by providing an improved trade-off between data rate and link margin through utilizing link adaptation. More specifically, this work provides a simulation study on the propagation effects impacting NASA's SCaN Testbed flight software-defined radio (SDR) as well as proposes a link adaptation algorithm that varies the modulation format of a communications link as its signal-to-noise ratio fluctuates. Ultimately, the models developed in this work will be utilized to conduct real-time flight experiments on-board the NASA SCaN Testbed.
Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients

PubMed Central

Stoicea, Nicoleta; You, Tian; Eiterman, Andrew; Hartwell, Clifton; Davila, Victor; Marjoribanks, Stephen; Florescu, Cristina; Bergese, Sergio Daniel; Rogers, Barbara

2017-01-01

Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality. PMID:29230400
Mapping of Fab-1:VEGF Interface Using Carboxyl Group Footprinting Mass Spectrometry

NASA Astrophysics Data System (ADS)

Wecksler, Aaron T.; Kalo, Matt S.; Deperalta, Galahad

2015-12-01

A proof-of-concept study was performed to demonstrate that carboxyl group footprinting, a relatively simple, bench-top method, has utility for first-pass analysis to determine epitope regions of therapeutic mAb:antigen complexes. The binding interface of vascular endothelial growth factor (VEGF) and the Fab portion of a neutralizing antibody (Fab-1) was analyzed using carboxyl group footprinting with glycine ethyl ester (GEE) labeling. Tryptic peptides involved in the binding interface between VEGF and Fab-1 were identified by determining the specific GEE-labeled residues that exhibited a reduction in the rate of labeling after complex formation. A significant reduction in the rate of GEE labeling was observed for E93 in the VEGF tryptic peptide V5, and D28 and E57 in the Fab-1 tryptic peptides HC2 and HC4, respectively. Results from the carboxyl group footprinting were compared with the binding interface identified from a previously characterized crystal structure (PDB: 1BJ1). All of these residues are located at the Fab-1:VEGF interface according to the crystal structure, demonstrating the potential utility of carboxyl group footprinting with GEE labeling for mapping epitopes.

Model-based intensification of a fed-batch microbial process for the maximization of polyhydroxybutyrate (PHB) production rate.

PubMed

Penloglou, Giannis; Vasileiadou, Athina; Chatzidoukas, Christos; Kiparissides, Costas

2017-08-01

An integrated metabolic-polymerization-macroscopic model, describing the microbial production of polyhydroxybutyrate (PHB) in Azohydromonas lata bacteria, was developed and validated using a comprehensive series of experimental measurements. The model accounted for biomass growth, biopolymer accumulation, carbon and nitrogen sources utilization, oxygen mass transfer and uptake rates and average molecular weights of the accumulated PHB, produced under batch and fed-batch cultivation conditions. Model predictions were in excellent agreement with experimental measurements. The validated model was subsequently utilized to calculate optimal operating conditions and feeding policies for maximizing PHB productivity for desired PHB molecular properties. More specifically, two optimal fed-batch strategies were calculated and experimentally tested: (1) a nitrogen-limited fed-batch policy and (2) a nitrogen sufficient one. The calculated optimal operating policies resulted in a maximum PHB content (94% g/g) in the cultivated bacteria and a biopolymer productivity of 4.2 g/(l h), respectively. Moreover, it was demonstrated that different PHB grades with weight average molecular weights of up to 1513 kg/mol could be produced via the optimal selection of bioprocess operating conditions.
Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients.

PubMed

Stoicea, Nicoleta; You, Tian; Eiterman, Andrew; Hartwell, Clifton; Davila, Victor; Marjoribanks, Stephen; Florescu, Cristina; Bergese, Sergio Daniel; Rogers, Barbara

2017-01-01

Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.
Biodegradation during contaminant transport in porous media: 1. mathematical analysis of controlling factors

NASA Astrophysics Data System (ADS)

Brusseau, Mark L.; Xie, Lily H.; Li, Li

1999-04-01

Interest in coupled biodegradation and transport of organic contaminants has expanded greatly in the past several years. In a system in which biodegradation is coupled with solute transport, the magnitude and rate of biodegradation is influenced not only by properties of the microbial population and the substrate, but also by hydrodynamic properties (e.g., residence time, dispersivity). By nondimensionalizing the coupled-process equations for transport and nonlinear biodegradation, we show that transport behavior is controlled by three characteristic parameters: the effective maximum specific growth rate, the relative half-saturation constant, and the relative substrate-utilization coefficient. The impact on biodegradation and transport of these parameters, which constitute various combinations of factors reflecting the influences of biotic and hydraulic properties of the system, are examined numerically. A type-curve diagram based on the three characteristic parameters is constructed to illustrate the conditions under which steady and non-steady transport is observed, and the conditions for which the linear, first-order approximation is valid for representing biodegradation. The influence of constraints to microbial growth and substrate utilization on contaminant transport is also briefly discussed. Additionally, the impact of biodegradation, with and without biomass growth, on spatial solute distribution and moments is examined.
Mechanistic modeling study on process optimization and precursor utilization with atmospheric spatial atomic layer deposition

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

Deng, Zhang; He, Wenjie; Duan, Chenlong

2016-01-15

Spatial atomic layer deposition (SALD) is a promising technology with the aim of combining the advantages of excellent uniformity and conformity of temporal atomic layer deposition (ALD), and an industrial scalable and continuous process. In this manuscript, an experimental and numerical combined model of atmospheric SALD system is presented. To establish the connection between the process parameters and the growth efficiency, a quantitative model on reactant isolation, throughput, and precursor utilization is performed based on the separation gas flow rate, carrier gas flow rate, and precursor mass fraction. The simulation results based on this model show an inverse relation betweenmore » the precursor usage and the carrier gas flow rate. With the constant carrier gas flow, the relationship of precursor usage and precursor mass fraction follows monotonic function. The precursor concentration, regardless of gas velocity, is the determinant factor of the minimal residual time. The narrow gap between precursor injecting heads and the substrate surface in general SALD system leads to a low Péclet number. In this situation, the gas diffusion act as a leading role in the precursor transport in the small gap rather than the convection. Fluid kinetics from the numerical model is independent of the specific structure, which is instructive for the SALD geometry design as well as its process optimization.« less
Comparison between fluorimetry and oximetry techniques to measure photosynthesis in the diatom Skeletonema costatum cultivated under simulated seasonal conditions.

PubMed

Lefebvre, Sébastien; Mouget, Jean-Luc; Loret, Pascale; Rosa, Philippe; Tremblin, Gérard

2007-02-01

This study reports comparison of two techniques measuring photosynthesis in the ubiquitous diatom Skeletonema costatum, i.e., the classical oximetry and the recent modulated fluorimetry. Microalgae in semi-continuous cultures were exposed to five different environmental conditions simulating a seasonal effect with co-varying temperature, photoperiod and incident light. Photosynthesis was assessed by gross rate of oxygen evolution (P(B)) and the electron transport rate (ETR) measurements. The two techniques were linearly related within seasonal treatments along the course of the P/E curves. The light saturation intensity parameters (Ek and Ek(ETR)), and the maximum electron transport rate increased significantly with the progression of the season while the maximum light utilization efficiency for ETR (alpha(ETR)) was constant. By contrast, the maximum gross oxygen photosynthetic capacity (Pmax(B)) and the maximum light utilization efficiency for P(B) (alpha(B)) increased from December to May treatment but decreased from May to July treatment. Both techniques showed clear photoacclimation in microalgae with the progression of the season, as illustrated by changes in photosynthetic parameters. The relationship between the two techniques changed when high temperature, photoperiod and incident light were combined, possibly due to an overestimation of the PAR--averaged chlorophyll-specific absorption cross-section. Despite this change, our results illustrate the strong suitability of in vivo chlorophyll fluorimetry to estimate primary production in the field.
Lightweight linear alternators with and without capacitive tuning

NASA Astrophysics Data System (ADS)

Niedra, Janis M.

1993-06-01

Permanent magnet excited linear alternators rated tens of kW and coupled to free-piston Stirling engines are presently viewed as promising candidates for long term generation of electric power in both space and terrestrial applications. Series capacitive cancellation of the internal inductive reactance of such alternators was considered a viable way to both increase power extraction and to suppress unstable modes of the thermodynamic oscillation. Idealized toroidal and cylindrical alternator geometries are used for a comparative study of the issues of specific mass and capacitive tuning, subject to stability criteria. The analysis shows that the stator mass of an alternator designed to be capacitively tuned is always greater than the minimum achievable stator mass of an alternator designed with no capacitors, assuming equal utilization of materials ratings and the same frequency and power to a resistive load. This conclusion is not substantially altered when the usually lesser masses of the magnets and of any capacitors are added. Within the reported stability requirements and under circumstances of normal materials ratings, this study finds no clear advantage to capacitive tuning. Comparative plots of the various constituent masses are presented versus the internal power factor taken as a design degree of freedom. The explicit formulas developed for stator core, coil, capacitor, and magnet masses and for the degree of magnet utilization provide useful estimates of scaling effects.
Effects of a Prophylactic Knee Sleeve on Anterior Cruciate Ligament Loading During Sport Specific Movements.

PubMed

Sinclair, Jonathan; Taylor, Paul John

2017-07-17

Prophylactic knee bracing is extensively utilized in athletic populations, to reduce the high risk from knee injuries, but their role in the attenuation of anterior cruciate ligament (ACL) pathologies is not well understood. The aim of the current investigation was to investigate the effects of a prophylactic knee sleeve on ACL loading parameters linked to the aetiology of injury in recreational athletes. Laboratory. Repeated measures. Thirteen healthy male recreational athletes. Intervention Participants performed run, cut and single leg hop movements under two conditions; prophylactic knee sleeve and no-sleeve. Biomechanical data was captured using an eight-camera 3D motion capture system and a force platform. Peak ACL force, average ACL load rate and instantaneous ACL load rate were quantified using a musculoskeletal modelling approach. The results showed that both average and instantaneous ACL load rates were significantly reduced when wearing the knee sleeve in the hop (sleeve = 612.45/ 1286.39N/kg/s & no-sleeve = 743.91/ 1471.42 N/kg/s) and cut (sleeve = 222.55/ 1058.02 N/kg/s & no-sleeve = 377.38/ 1183.01 N/kg/s) movements. Given the biomechanical association between ACL loading and the aetiology of ACL injuries, it is proposed that athletes may be able to attenuate their risk from injury during cut and hop movements through utilization of a prophylactic knee sleeve.
Lightweight linear alternators with and without capacitive tuning

NASA Technical Reports Server (NTRS)

Niedra, Janis M.

1993-01-01

Permanent magnet excited linear alternators rated tens of kW and coupled to free-piston Stirling engines are presently viewed as promising candidates for long term generation of electric power in both space and terrestrial applications. Series capacitive cancellation of the internal inductive reactance of such alternators was considered a viable way to both increase power extraction and to suppress unstable modes of the thermodynamic oscillation. Idealized toroidal and cylindrical alternator geometries are used for a comparative study of the issues of specific mass and capacitive tuning, subject to stability criteria. The analysis shows that the stator mass of an alternator designed to be capacitively tuned is always greater than the minimum achievable stator mass of an alternator designed with no capacitors, assuming equal utilization of materials ratings and the same frequency and power to a resistive load. This conclusion is not substantially altered when the usually lesser masses of the magnets and of any capacitors are added. Within the reported stability requirements and under circumstances of normal materials ratings, this study finds no clear advantage to capacitive tuning. Comparative plots of the various constituent masses are presented versus the internal power factor taken as a design degree of freedom. The explicit formulas developed for stator core, coil, capacitor, and magnet masses and for the degree of magnet utilization provide useful estimates of scaling effects.
Feasibility of partial replacement of fishmeal with proteins from different sources in diets of Korean rockfish ( Sebastes schlegeli)

NASA Astrophysics Data System (ADS)

Yan, Quangen; Zhu, Xiaoming; Yang, Yunxia; Han, Dong; Xie, Shouqi

2014-12-01

An 8-week feeding experiment was conducted in an indoor recirculation seawater system to investigate the effects of partial replacement of dietary fishmeal with proteins from five sources on the growth performance and feed utilization of Sebastes schlegeli. Six isonitrogenous and isoenergetic diets were formulated using fishmeal (FM, the control) as sole protein source, or proteins from five sources including poultry by-product meal (PBM), meat and bone meal (MBM), soybean meal (SBM), cottonseed meal (CSM) and canola meal (CNM). Fifteen percent of the crude protein provided by fish meal was replaced, respectively. The results showed that the differences in specific growth rate (SGR) and survival rate (SR) among fish fed PBM, MBM, SBM, CSM and whole FM diets were not significant. However, SGR and SR of fish fed CNM diet was significantly lower than that of other treatments. Feeding rate, feed conversion, nutrient retention showed similar patterns to that of growth. Fish fed CSM and CNM showed significantly lower apparent digestibility coefficient (ADC) of dry matter and gross energy than those fed others while fish fed CNM showed lower ADC of crude protein than those fed others ( P<0.05). These results suggested that it was feasible to substitute 15% dietary protein provided by fishmeal with PBM, MBM, SBM and CSM, respectively, but not with CNM as the replacement with CNM reduced fish growth and feed utilization.
Serotype determination of Salmonella by xTAG assay.

PubMed

Zheng, Zhibei; Zheng, Wei; Wang, Haoqiu; Pan, Jincao; Pu, Xiaoying

2017-10-01

Currently, no protocols or commercial kits are available to determine the serotypes of Salmonella by using Luminex MAGPIX®. In this study, an xTAG assay for serotype determination of Salmonella suitable for Luminex MAGPIX® is described and 228 Salmonella isolates were serotype determined by this xTAG assay. The xTAG assay consists of two steps: 1) Multiplex PCR to amplify simultaneously O, H and Vi antigen genes of Salmonella, and 2) Magplex-TAG™ microsphere hybridization to identify accurately the specific PCR products of different antigens. Compared with the serotyping results of traditional serum agglutination test, the sensitivity and specificity of the xTAG assay were 95.1% and 100%, respectively. The agreement rate of these two assays was 95.2%. Compared with Luminex xMAP® Salmonella Serotyping Assay (SSA) kit, the advantages of this xTAG assay are: First, the magnetic beads make it applicable to both the Luminex®100/200™ and MAGPIX® systems. Second, only primers rather than both primers and probes are needed in the xTAG assay, and the process of coupling antigen-specific oligonucleotide probes to beads is circumvented, which make the xTAG assay convenient to be utilized by other laboratories. The xTAG assay may serve as a rapid alternative or complementary method for traditional Salmonella serotyping tests, especially for laboratories that utilize the MAGPIX® systems. Copyright © 2017 Elsevier B.V. All rights reserved.
Standby Rates for Combined Heat and Power Systems

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

Sedano, Richard; Selecky, James; Iverson, Kathryn

2014-02-01

Improvements in technology, low natural gas prices, and more flexible and positive attitudes in government and utilities are making distributed generation more viable. With more distributed generation, notably combined heat and power, comes an increase in the importance of standby rates, the cost of services utilities provide when customer generation is not operating or is insufficient to meet full load. This work looks at existing utility standby tariffs in five states. It uses these existing rates and terms to showcase practices that demonstrate a sound application of regulatory principles and ones that do not. The paper also addresses areas formore » improvement in standby rates.« less
Judging Statistical Models of Individual Decision Making under Risk Using In- and Out-of-Sample Criteria

PubMed Central

Drichoutis, Andreas C.; Lusk, Jayson L.

2014-01-01

Despite the fact that conceptual models of individual decision making under risk are deterministic, attempts to econometrically estimate risk preferences require some assumption about the stochastic nature of choice. Unfortunately, the consequences of making different assumptions are, at present, unclear. In this paper, we compare three popular error specifications (Fechner, contextual utility, and Luce error) for three different preference functionals (expected utility, rank-dependent utility, and a mixture of those two) using in- and out-of-sample selection criteria. We find drastically different inferences about structural risk preferences across the competing functionals and error specifications. Expected utility theory is least affected by the selection of the error specification. A mixture model combining the two conceptual models assuming contextual utility provides the best fit of the data both in- and out-of-sample. PMID:25029467
Judging statistical models of individual decision making under risk using in- and out-of-sample criteria.

PubMed

Drichoutis, Andreas C; Lusk, Jayson L

2014-01-01

Despite the fact that conceptual models of individual decision making under risk are deterministic, attempts to econometrically estimate risk preferences require some assumption about the stochastic nature of choice. Unfortunately, the consequences of making different assumptions are, at present, unclear. In this paper, we compare three popular error specifications (Fechner, contextual utility, and Luce error) for three different preference functionals (expected utility, rank-dependent utility, and a mixture of those two) using in- and out-of-sample selection criteria. We find drastically different inferences about structural risk preferences across the competing functionals and error specifications. Expected utility theory is least affected by the selection of the error specification. A mixture model combining the two conceptual models assuming contextual utility provides the best fit of the data both in- and out-of-sample.
Burdensome and Unnecessary Reporting Requirements of the Public Utility Regulatory Policies Act Need to be Changed.

DTIC Science & Technology

1981-09-14

Commissioners PURPA Public Utility Regulatory Policies Act %GLOSSAk(¥ Aavertising standard As aefineu oy PUijA, no electric utility may recover from any per- son...systems in 4o States, vuerto kico, (uam, and virgin Islanus. Automatic adjustment As detined by PURPA , no electric clause stanuard utility may increase any...Interruptiole rate standard As defined by PURPA , a rate oftereu to eacn industrial and commercial * electric consumer tnat snail retiect the cost of
42 CFR 413.220 - Methodology for calculating the per-treatment base rate under the ESRD prospective payment system...

Code of Federal Regulations, 2010 CFR

2010-10-01

... patient utilization calendar year as identified from Medicare claims is calendar year 2007. (4) Wage index... calculating the per-treatment base rate for 2011 are as follows: (1) Per patient utilization in CY 2007, 2008..., 2008 or 2009 to determine the year with the lowest per patient utilization. (2) Update of per treatment...
Pediatric ambulatory care sensitive conditions: Birth cohorts and the socio-economic gradient.

PubMed

Roos, Leslie L; Dragan, Roxana; Schroth, Robert J

2017-09-14

This study examines the socio-economic gradient in utilization and the risk factors associated with hospitalization for four pediatric ambulatory care sensitive conditions (dental conditions, asthma, gastroenteritis, and bacterial pneumonia). Dental conditions, where much care is provided by dentists and insurance coverage varies among different population segments, present special issues. A population registry, provider registry, physician ambulatory claims, and hospital discharge abstracts from 28 398 children born in 2003-2006 in urban centres in Manitoba, Canada were the main data sources. Physician visits and hospitalizations were compared across neighbourhood income groupings using rank correlations and logistic regressions. Very strong relationships between neighbourhood income and utilization were highlighted. Additional variables - family on income assistance, mother's age at first birth, breastfeeding - helped predict the probability of hospitalization. Despite the complete insurance coverage (including visits to dentists and physicians and for hospitalizations) provided, receiving income assistance was associated with higher probabilities of hospitalization. We found a socio-economic gradient in utilization for pediatric ambulatory care sensitive conditions, with higher rates of ambulatory visits and hospitalizations in the poorest neighbourhoods. Insurance coverage which varies between different segments of the population complicates matters. Providing funding for dental care for Manitobans on income assistance has not prevented physician visits or intensive treatment in high-cost facilities, specifically treatment under general anesthesia. When services from one type of provider (dentist) are not universally insured but those from another type (physician) are, using rates of hospitalization to indicate problems in the organization of care seems particularly difficult.
Exploring transduction mechanisms of protein transduction domains (PTDs) in living cells utilizing single-quantum dot tracking (SQT) technology.

PubMed

Suzuki, Yasuhiro

2012-01-01

Specific protein domains known as protein transduction domains (PTDs) can permeate cell membranes and deliver proteins or bioactive materials into living cells. Various approaches have been applied for improving their transduction efficacy. It is, therefore, crucial to clarify the entry mechanisms and to identify the rate-limiting steps. Because of technical limitations for imaging PTD behavior on cells with conventional fluorescent-dyes, how PTDs enter the cells has been a topic of much debate. Utilizing quantum dots (QDs), we recently tracked the behavior of PTD that was derived from HIV-1 Tat (TatP) in living cells at the single-molecule level with 7-nm special precision. In this review article, we initially summarize the controversy on TatP entry mechanisms; thereafter, we will focus on our recent findings on single-TatP-QD tracking (SQT), to identify the major sequential steps of intracellular delivery in living cells and to discuss how SQT can easily provide direct information on TatP entry mechanisms. As a primer for SQT study, we also discuss the latest findings on single particle tracking of various molecules on the plasma membrane. Finally, we discuss the problems of QDs and the challenges for the future in utilizing currently available QD probes for SQT. In conclusion, direct identification of the rate-limiting steps of PTD entry with SQT should dramatically improve the methods for enhancing transduction efficiency.
Mitochondrial proteomic analysis reveals deficiencies in oxygen utilization in medullary thick ascending limb of Henle in the Dahl salt-sensitive rat

PubMed Central

Zheleznova, Nadezhda N.; Yang, Chun; Ryan, Robert P.; Halligan, Brian D.; Liang, Mingyu; Greene, Andrew S.

2012-01-01

The renal medullary thick ascending limb (mTAL) of the Dahl salt-sensitive (SS) rat is the site of enhanced NaCl reabsorption and excess superoxide production. In the present studies we isolated mitochondria from mTAL of SS and salt-resistant control strain SS.13BN rats on 0.4 and 8% salt diet for 7 days and performed a proteomic analysis. Purity of mTAL and mitochondria isolations exceeded 93.6 and 55%, respectively. Using LC/MS spectral analysis techniques we identified 96 mitochondrial proteins in four biological mTAL mitochondria samples, run in duplicate, as defined by proteins with a false discovery rate <5% and scan count ≥2. Seven of these 96 proteins, including IDH2, ACADM, SCOT, Hsp60, ATPA, EFTu, and VDAC2 were differentially expressed between the two rat strains. Oxygen consumption and high-resolution respirometry analyses showed that mTAL cells and the mitochondria in the outer medulla of SS rats fed high-salt diet exhibited lower rates of oxygen utilization compared with those from SS.13BN rats. These studies advance the conventional proteomic paradigm of focusing exclusively upon whole tissue homogenates to a focus upon a single cell type and specific subcellular organelle. The results reveal the importance of a largely unexplored role for deficiencies of mTAL mitochondrial metabolism and oxygen utilization in salt-induced hypertension and renal medullary oxidative stress. PMID:22805345
Attitudes toward the physical examination: a comparison of U.S. and Dominican medical students.

PubMed

Fagan, Mark J; Lucero, Monica L; Wu, Edward H; Diaz, Joseph A; Reinert, Steven E

2006-01-01

Little information exists regarding whether medical students learning in relatively resource-scarce countries develop greater confidence in their physical examination skills or whether, compared to U.S. medical students, they have more positive attitudes regarding the utility of the physical examination. To compare U.S. And Dominican medical students' attitudes toward the physical examination. We surveyed final-year students at 1 medical school in the United States and 1 in the Dominican Republic regarding self-confidence in and perceived utility of the physical examination. Using 5-point Likert-type scales with response choices ranging from 1 (not at all confident) to 5 (very confident) and 1 (not at all useful) to 5 (very useful), respondents reported their attitudes toward the physical examination overall and toward 14 specific physical examination skills. The survey response rate was 117/164 (71%). Students at the Dominican school, compared to students at the U.S. school, reported significantly greater confidence in their overall physical examination skill (mean response 4.27 vs. 3.79, respectively, p < .001) and more positive views about the utility of the physical examination overall for providing diagnostically useful information (mean response 4.78 vs. 4.42, respectively, p < .001). Results for the specific skills also showed more positive attitudes in the students from the Dominican medical school. Students at a Dominican medical school reported more positive attitudes toward the physical examination than students at a U.S. medical school.
The use and utility of specific nonpharmacological interventions for behavioral symptoms in dementia: an exploratory study.

PubMed

Cohen-Mansfield, Jiska; Marx, Marcia S; Dakheel-Ali, Maha; Thein, Khin

2015-02-01

This study compares different nonpharmacological interventions for persons with behavioral symptoms and dementia on frequency of use and perceived efficacy in terms of change in behavior and interest. Participants were 89 nursing home residents from six Maryland nursing homes with a mean age of 85.9 years (SD: 8.6 years). Research assistants presented interventions tailored to the participants' needs and preferences in a pre-intervention trial phase and in an intervention phase. The impact of each intervention on behavioral symptoms and on the person's interest was rated immediately after the intervention by a research assistant. The most utilized interventions in both trial and treatment phases were the social intervention of one-on-one interaction, simulated social interventions such as a lifelike doll and respite video, the theme intervention of magazine, and the sensory stimulation intervention of music. In contrast, the least utilized interventions in both phases were sewing, fabric book, and flower arrangement. Interventions with the highest impact on behavioral symptoms included one-on-one social interaction, hand massage, music, video, care, and folding towels. Other high impact interventions included walking, going outside, flower arranging, food or drink, sewing, group activity, book presentation, ball toss, coloring or painting, walking, and family video. The results provide initial directions for choosing specific interventions for persons with dementia and also demonstrate a methodology for increasing knowledge through ongoing monitoring of practice. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Perception of risks from electromagnetic fields: A psychometric evaluation of a risk-communication approach

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

MacGregor, D.G.; Slovic, P.; Morgan, M.G.

Potential health risks from exposure to power-frequency electromagnetic fields (EMF) have become an issue of significant public concern. This study evaluates a brochure designed to communicate EMF health risks from a scientific perspective. The study utilized a pretest-posttest design in which respondents judged various sources of EMF (and other) health and safety risks, both before reaching the brochure and after. Respondents assessed risks on dimensions similar to those utilized in previous studies of risk perception. In addition, detailed ratings were made that probed respondents' beliefs about the possible causal effects of EMF exposure. The findings suggest that naive beliefs aboutmore » the potential of EMF exposure to cause harm were highly influenced by specific content elements of the brochure. The implications for using risk-communication approaches based on communicating scientific uncertainty are discussed. 19 refs., 1 fig., 11 tabs.« less
Study on the application of NASA energy management techniques for control of a terrestrial solar water heating system

NASA Technical Reports Server (NTRS)

Swanson, T. D.; Ollendorf, S.

1979-01-01

This paper addresses the potential for enhanced solar system performance through sophisticated control of the collector loop flow rate. Computer simulations utilizing the TRNSYS solar energy program were performed to study the relative effect on system performance of eight specific control algorithms. Six of these control algorithms are of the proportional type: two are concave exponentials, two are simple linear functions, and two are convex exponentials. These six functions are typical of what might be expected from future, more advanced, controllers. The other two algorithms are of the on/off type and are thus typical of existing control devices. Results of extensive computer simulations utilizing actual weather data indicate that proportional control does not significantly improve system performance. However, it is shown that thermal stratification in the liquid storage tank may significantly improve performance.
Analysis of the financial factors governing the profitability of lunar helium-3

NASA Technical Reports Server (NTRS)

Kulcinski, G. L.; Thompson, H.; Ott, S.

1989-01-01

Financial factors influencing the profitability of the mining and utilization of lunar helium-3 are examined. The analysis addressed the following questions: (1) which financial factors have the greatest leverage on the profitability of He-3; (2) over what range can these factors be varied to keep the He-3 option profitable; and (3) what ultimate effect could this energy source have on the price of electricity for U.S. consumers. Two complementary methods of analysis were used in the assessment: rate of return on incremental investment required and reduction revenue requirements (total cost to customers) achieved. Some of the factors addressed include energy demand, power generation costs with and without fusion, profitability for D-He(3) fusion, annual capital and operating costs, launch mass and costs, He-3 price, and government funding. Specific conclusions are made with respect to each of the companies considered: utilities, lunar mining company, and integrated energy company.
Influence of temperature on flavour compound production from citrate by Lactobacillus rhamnosus ATCC 7469.

PubMed

De Figueroa, R M; Oliver, G; Benito de Cárdenas, I L

2001-03-01

The citrate utilization by Lactobacillus rhamnosus ATCC 7469 was found to be temperature-dependent. The maximum citrate utilization and incorporation of [1,5-14C]citrate rate were observed at 37 degreesC. At this temperature, maximum citrate lyase activity and specific diacetyl and acetoin production (Y(DA%)) were observed. The high levels of alpha-acetolactate synthase and low levels of diacetyl reductase, acetoin reductase and L-lactate dehydrogenase found at 37 degreesC led to an accumulation of diacetyl and acetoin. Optimum lactic acid production was observed at 45 degreesC, according to the high lactate dehydrogenase activity. The NADH oxidase activity increased with increasing culture temperature from 22 degreesC to 37 degreesC. Thus there are greater quantities of pyruvate available for the production of alpha-acetolactate, diacetyl and aceotin, and less diacetyl and acetoin are reduced.
Customer and service profitability

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

Ballaban, M.; Kelly, K.; Wisniewski, L.

1996-03-01

The rapid pace of competitive change in the generation sector has pushed electric utilities to rethink the concept of being obligated to serve all customers and with this change, the notion of measuring customer profitability is also being redefined. Traditionally, uniform services were provided to all customers. Rates were based on each customer classes` contribution to average costs, and consequently return was equally allocated across all customer segments. Profitability was defined strictly on an aggregate basis. The increasing demand for choice by electric customers will require electricity providers to redefine if not who they serve, than certainly how they providemore » differentiated services tailored to specific customer segments. Utilities are beginning to analyze the value, or profitability, of offering these services. Aggregate data no longer provides an accurate assessment of how resources should be allocated most efficiently. As services are unbundled, so too must costs be disaggregated to effectively measure the profitability of various options.« less
STARR: shortwave-targeted agile Raman robot for the detection and identification of emplaced explosives

NASA Astrophysics Data System (ADS)

Gomer, Nathaniel R.; Gardner, Charles W.

2014-05-01

In order to combat the threat of emplaced explosives (land mines, etc.), ChemImage Sensor Systems (CISS) has developed a multi-sensor, robot mounted sensor capable of identification and confirmation of potential threats. The system, known as STARR (Shortwave-infrared Targeted Agile Raman Robot), utilizes shortwave infrared spectroscopy for the identification of potential threats, combined with a visible short-range standoff Raman hyperspectral imaging (HSI) system for material confirmation. The entire system is mounted onto a Talon UGV (Unmanned Ground Vehicle), giving the sensor an increased area search rate and reducing the risk of injury to the operator. The Raman HSI system utilizes a fiber array spectral translator (FAST) for the acquisition of high quality Raman chemical images, allowing for increased sensitivity and improved specificity. An overview of the design and operation of the system will be presented, along with initial detection results of the fusion sensor.
Species-specific preferences of German recreational anglers for freshwater fishing experiences, with emphasis on the intrinsic utilities of fish stocking and wild fishes.

PubMed

Arlinghaus, R; Beardmore, B; Riepe, C; Meyerhoff, J; Pagel, T

2014-12-01

To answer the question, whether anglers have an intrinsic preference for stocking or a preference for catch outcomes (e.g. catch rates) believed to be maintained by stocking, a discrete choice experiment was conducted among a sample of anglers (n = 1335) in Lower Saxony, Germany. After controlling for catch aspects of the fishing experience, no significant influence of two stocking attributes (stocking frequency and composition of the catch in terms of wild v. hatchery fishes) on the utility gained from fishing was found for any of the freshwater species that were studied. It was concluded that the previously documented large appreciation of fish stocking by anglers may be indicative of an underlying preference for sufficiently high catches rather than reflect an intrinsic preference for stocking or the catching of wild fishes per se. © 2014 The Fisheries Society of the British Isles.
Catalyst Residence Time Distributions in Riser Reactors for Catalytic Fast Pyrolysis. Part 2: Pilot-Scale Simulations and Operational Parameter Study

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

Foust, Thomas D.; Ziegler, Jack L.; Pannala, Sreekanth

2017-02-21

Here, wsing the validated simulation model developed in part one of this study for biomass catalytic fast pyrolysis (CFP), we assess the functional utility of using this validated model to assist in the development of CFP processes in fluidized catalytic cracking (FCC) reactors to a commercially viable state. Specifically, we examine the effects of mass flow rates, boundary conditions (BCs), pyrolysis vapor molecular weight variation, and the impact of the chemical cracking kinetics on the catalyst residence times. The factors that had the largest impact on the catalyst residence time included the feed stock molecular weight and the degree ofmore » chemical cracking as controlled by the catalyst activity. Lastly, because FCC reactors have primarily been developed and utilized for petroleum cracking, we perform a comparison analysis of CFP with petroleum and show the operating regimes are fundamentally different.« less
The Balancing Act: How Utility Rates Are Decided. Teacher/Facilitator's Guide.

ERIC Educational Resources Information Center

American Gas Association, Arlington, VA. Educational Services.

Designed for secondary level students, this guide describes the process of establishing utility rates for gas, electricity, telephone, or water services. Insights are presented into the parties and interests involved in rate changes, along with procedures and issues that influence decision-making. The goals of this teaching guide include: (1)…
BLAST for Behind-the-Meter Applications Lite Tool | Transportation Research

Science.gov Websites

provided by NREL's PV Watts calculator. A generic utility rate structure framework makes it possible to the BLAST documentation for proper CSV formatting. Rate structure values Define demand charges and energy costs to best represent your utility rate structure of interest. Demand charges and energy costs
41 CFR 102-82.20 - What are Executive agencies' rate intervention responsibilities?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What are Executive agencies' rate intervention responsibilities? 102-82.20 Section 102-82.20 Public Contracts and Property... PROPERTY 82-UTILITY SERVICES Utility Services § 102-82.20 What are Executive agencies' rate intervention...
41 CFR 102-82.20 - What are Executive agencies' rate intervention responsibilities?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What are Executive agencies' rate intervention responsibilities? 102-82.20 Section 102-82.20 Public Contracts and Property... PROPERTY 82-UTILITY SERVICES Utility Services § 102-82.20 What are Executive agencies' rate intervention...
41 CFR 102-82.20 - What are Executive agencies' rate intervention responsibilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are Executive agencies' rate intervention responsibilities? 102-82.20 Section 102-82.20 Public Contracts and Property... PROPERTY 82-UTILITY SERVICES Utility Services § 102-82.20 What are Executive agencies' rate intervention...
41 CFR 102-82.20 - What are Executive agencies' rate intervention responsibilities?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What are Executive agencies' rate intervention responsibilities? 102-82.20 Section 102-82.20 Public Contracts and Property... PROPERTY 82-UTILITY SERVICES Utility Services § 102-82.20 What are Executive agencies' rate intervention...
41 CFR 102-82.20 - What are Executive agencies' rate intervention responsibilities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What are Executive agencies' rate intervention responsibilities? 102-82.20 Section 102-82.20 Public Contracts and Property... PROPERTY 82-UTILITY SERVICES Utility Services § 102-82.20 What are Executive agencies' rate intervention...
Screening for Social, Emotional, and Behavioral Problems at Kindergarten Entry: Utility and Incremental Validity of Parent Report

ERIC Educational Resources Information Center

Owens, Julie Sarno; Storer, Jennifer; Holdaway, Alex S.; Serrano, Verenea J.; Watabe, Yuko; Himawan, Lina K.; Krelko, Rebecca E.; Vause, Katherine J.; Girio-Herrera, Erin; Andrews, Nina

2015-01-01

The current study examined the utility and incremental validity of parent ratings on the Strengths and Difficulties Questionnaire and Disruptive Behavior Disorders rating scale completed at kindergarten registration in identifying risk status as defined by important criterion variables (teacher ratings, daily behavioral performance, and quarterly…
Closed-Loop Control of Chemical Injection Rate for a Direct Nozzle Injection System.

PubMed

Cai, Xiang; Walgenbach, Martin; Doerpmond, Malte; Schulze Lammers, Peter; Sun, Yurui

2016-01-20

To realize site-specific and variable-rate application of agricultural pesticides, accurately metering and controlling the chemical injection rate is necessary. This study presents a prototype of a direct nozzle injection system (DNIS) by which chemical concentration transport lag was greatly reduced. In this system, a rapid-reacting solenoid valve (RRV) was utilized for injecting chemicals, driven by a pulse-width modulation (PWM) signal at 100 Hz, so with varying pulse width the chemical injection rate could be adjusted. Meanwhile, a closed-loop control strategy, proportional-integral-derivative (PID) method, was applied for metering and stabilizing the chemical injection rate. In order to measure chemical flow rates and input them into the controller as a feedback in real-time, a thermodynamic flowmeter that was independent of chemical viscosity was used. Laboratory tests were conducted to assess the performance of DNIS and PID control strategy. Due to the nonlinear input-output characteristics of the RRV, a two-phase PID control process obtained better effects as compared with single PID control strategy. Test results also indicated that the set-point chemical flow rate could be achieved within less than 4 s, and the output stability was improved compared to the case without control strategy.
FACTORS ASSOCIATED WITH HEALTHCARE UTILIZATION AMONG ARAB IMMIGRANTS AND REFUGEES

PubMed Central

2015-01-01

Background Arab migrants are exposed to pre- and post migration stressors that increase their risk for health problems. However, little is known regarding healthcare utilization rates or factors associated with healthcare utilization among Arab immigrants and refugees. Methods 590 participants were interviewed 1 year post-migration to the United States Factors associated with healthcare utilization including stress coping mechanisms were examined using binary logistic regressions. Results Compared to national healthcare utilization data, immigrants had significantly lower and refugees had significantly higher rates. Being a refugee, married, and having health insurance were significantly associated with medical service utilization. None of the immigrants in this study had utilized psychological services. Among refugees, the use of medications and having strategies for dealing with stress were inversely associated with utilization of psychological services. Discussion (Conclusion) Healthcare utilization was significantly higher among refugees, who also reported a greater need for services than immigrants. PMID:25331684
A review of chamber experiments for determining specific emission rates and investigating migration pathways of flame retardants

NASA Astrophysics Data System (ADS)

Rauert, Cassandra; Lazarov, Borislav; Harrad, Stuart; Covaci, Adrian; Stranger, Marianne

2014-01-01

The widespread use of flame retardants (FRs) in indoor products has led to their ubiquitous distribution within indoor microenvironments with many studies reporting concentrations in indoor air and dust. Little information is available however on emission of these compounds to air, particularly the measurement of specific emission rates (SERs), or the migration pathways leading to dust contamination. Such knowledge gaps hamper efforts to develop understanding of human exposure. This review summarizes published data on SERs of the following FRs released from treated products: polybrominated diphenyl ethers (PBDEs), hexabromocyclododecanes (HBCDs), tetrabromobisphenol-A (TBBPA), novel brominated flame retardants (NBFRs) and organophosphate flame retardants (PFRs), including a brief discussion of the methods used to derive these SERs. Also reviewed are published studies that utilize emission chambers for investigations/measurements of mass transfer of FRs to dust, discussing the chamber configurations and methods used for these experiments. A brief review of studies investigating correlations between concentrations detected in indoor air/dust and possible sources in the microenvironment is included along with efforts to model contamination of indoor environments. Critical analysis of the literature reveals that the major limitations with utilizing chambers to derive SERs for FRs arise due to the physicochemical properties of FRs. In particular, increased partitioning to chamber surfaces, airborne particles and dust, causes loss through “sink” effects and results in long times to reach steady state conditions inside the chamber. The limitations of chamber experiments are discussed as well as their potential for filling gaps in knowledge in this area.
Recovered eating disorder therapists using their experiential knowledge in therapy: A qualitative examination of the therapists’ and the patients’ view

PubMed Central

de Vos, Jan Alexander; Netten, Carmen; Noordenbos, Greta

2016-01-01

ABSTRACT In the eating disorder (ED) field there is a lack of guidelines regarding the utilization of recovered therapists and the experiential knowledge they can bring to therapy. In this study, a qualitative design was used to examine recovered eating disorder therapists using their experiential knowledge and how this influences therapy and the patients they treat. Respectively, 205 patients (response rate 57%), and 26 recovered therapists (response rate 75%) completed a questionnaire about advantages and disadvantages of the utilization of experiential knowledge in therapy. Results showed that using experiential knowledge can have several advantages and disadvantages in therapy. Therapists can use this knowledge as a therapeutic intervention with specific goals, such as providing the patient with insight into the recovery process, establishing a working relationship, and enhancing hope for recovery. To be effective, self-disclosure and experiential knowledge need to be shared thoughtfully, and should not include specific details about ED symptoms. Other factors noted that enhanced the benefits of experiential knowledge included therapist self-insight and self-care, adequate training and guidance, and a safe work environment. Patients stated that being treated by a recovered therapist had a positive effect on their recovery process. It is advised to establish guidelines in the ED field about working with recovered therapists and the experiential knowledge they might use in therapy. Further research is needed on the process of when, how, and which experiential knowledge is shared by recovered therapists in therapy, and the effects of these interventions on patients and their treatment outcomes. PMID:26467023

Some links on this page may take you to non-federal websites. Their policies may differ from this site.