42 CFR 456.523 - Revised UR plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.523 Revised... control over the utilization of services; and (2) Conducts reviews in a way that improves the quality of...

42 CFR 456.201 - UR plan required for inpatient mental hospital services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for...

Sacroiliac joint pain: burden of disease

PubMed Central

Cher, Daniel; Polly, David; Berven, Sigurd

2014-01-01

Objectives The sacroiliac joint (SIJ) is an important and significant cause of low back pain. We sought to quantify the burden of disease attributable to the SIJ. Methods The authors compared EuroQol 5D (EQ-5D) and Short Form (SF)-36-based health state utility values derived from the preoperative evaluation of patients with chronic SIJ pain participating in two prospective clinical trials of minimally invasive SIJ fusion versus patients participating in a nationally representative USA cross-sectional survey (National Health Measurement Study [NHMS]). Comparative analyses controlled for age, sex, and oversampling in NHMS. A utility percentile for each SIJ subject was calculated using NHMS as a reference cohort. Finally, SIJ health state utilities were compared with utilities for common medical conditions that were published in a national utility registry. Results SIJ patients (number [n]=198) had mean SF-6D and EQ-5D utility scores of 0.51 and 0.44, respectively. Values were significantly depressed (0.28 points for the SF-6D utility score and 0.43 points for EQ-5D; both P<0.0001) compared to NHMS controls. SIJ patients were in the lowest deciles for utility compared to the NHMS controls. The SIJ utility values were worse than those of many common, major medical conditions, and similar to those of other common preoperative orthopedic conditions. Conclusion Patients with SIJ pain presenting for minimally invasive surgical care have marked impairment in quality of life that is worse than in many chronic health conditions, and this is similar to other orthopedic conditions that are commonly treated surgically. SIJ utility values are in the lowest two deciles when compared to control populations. PMID:24748825

GrDHP: a general utility function representation for dual heuristic dynamic programming.

PubMed

Ni, Zhen; He, Haibo; Zhao, Dongbin; Xu, Xin; Prokhorov, Danil V

2015-03-01

A general utility function representation is proposed to provide the required derivable and adjustable utility function for the dual heuristic dynamic programming (DHP) design. Goal representation DHP (GrDHP) is presented with a goal network being on top of the traditional DHP design. This goal network provides a general mapping between the system states and the derivatives of the utility function. With this proposed architecture, we can obtain the required derivatives of the utility function directly from the goal network. In addition, instead of a fixed predefined utility function in literature, we conduct an online learning process for the goal network so that the derivatives of the utility function can be adaptively tuned over time. We provide the control performance of both the proposed GrDHP and the traditional DHP approaches under the same environment and parameter settings. The statistical simulation results and the snapshot of the system variables are presented to demonstrate the improved learning and controlling performance. We also apply both approaches to a power system example to further demonstrate the control capabilities of the GrDHP approach.

Dental utilization by active duty Army personnel.

PubMed

Chisick, M C

1993-10-01

In spring 1989, a random, Army-wide sample of 15,364 enlisted and 4,529 officer personnel was surveyed on dental utilization. Results show no difference in annual dental utilization between officer and enlisted personnel when age is controlled. Because annual dental utilization increases with age and enlisted ranks contain a disproportionately large number of younger personnel, a difference in annual dental utilization between enlisted and officer personnel emerges when age is not controlled. Check-ups are the most common reason for dental visits. Nearly all soldiers seek care exclusively in military dental clinics. Non-use is highest among 18- to 19-year-olds (12.2%).

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

Cost-utility of laparoscopic Nissen fundoplication versus proton pump inhibitors for chronic and controlled gastroesophageal reflux disease: a 3-year prospective randomized controlled trial and economic evaluation.

PubMed

Goeree, Ron; Hopkins, Rob; Marshall, John K; Armstrong, David; Ungar, Wendy J; Goldsmith, Charles; Allen, Christopher; Anvari, Mehran

2011-01-01

Very few randomized controlled trials (RCTs) have compared laparoscopic Nissen fundoplication (LNF) to proton pump inhibitors (PPI) medical management for patients with chronic gastroesophageal reflux disease (GERD). Larger RCTs have been relatively short in duration, and have reported mixed results regarding symptom control and effect on quality of life (QOL). Economic evaluations have reported conflicting results. To determine the incremental cost-utility of LNF versus PPI for treating patients with chronic and controlled GERD over 3 years from the societal perspective. Economic evaluation was conducted alongside a RCT that enrolled 104 patients from October 2000 to September 2004. Primary study outcome was GERD symptoms (secondary outcomes included QOL and cost-utility). Resource utilization and QOL data collected at regular follow-up intervals determined incremental cost/QALY gained. Stochastic uncertainty was assessed using bootstrapping and methodologic assumptions were assessed using sensitivity analysis. No statistically significant differences in GERD symptom scores, but LNF did result in fewer heartburn days and improved QOL. Costs were higher for LNF patients by $3205/patient over 3 years but QOL was also higher as measured by either QOL instrument. Based on total costs, incremental cost-utility of LNF was $29,404/QALY gained using the Health Utility Index 3. Cost-utility results were sensitive to the utility instrument used ($29,404/QALY for Health Utility Index 3, $31,117/QALY for the Short Form 6D, and $76,310/QALY for EuroQol 5D) and if current lower prices for PPIs were used in the analysis. Results varied depending on resource use/costs included in the analysis, the QOL instrument used, and the cost of PPIs; however, LNF was generally found to be a cost-effective treatment for patients with symptomatic controlled GERD requiring long-term management. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Operation of a voltage source converter at increased utility voltage

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

Kaura, V.; Blasko, V.

1997-01-01

The operation of a voltage source converter (VSC) with regeneration capability, controllable power factor, and low distortion of utility currents is analyzed at increased utility voltage. Increase in the utility voltage causes a VSC to saturate and enter a nonlinear mode of operation. To operate under elevated utility, two steps are taken: (1) a pulse width modulation (PWM) algorithm is implemented which extends the linear region of operation by 15% and (2) a PWM saturation regulator is used to control the reactive current at higher utility voltages. The PWM algorithm reduces the switching losses by at least 33% and themore » effect of blanking time by one-third. All analytical results are experimentally verified on a 100 kW three-phase VSC.« less

Utilities Expense Report.

ERIC Educational Resources Information Center

Moore, Deborah P.

2001-01-01

Examines how deregulation has affected school district utility costs. Offers ideas that can help school districts save money and energy. Provides several examples of state-wide initiatives intended to help school districts control utility costs. (GR)

Monitoring and control requirement definition study for Dispersed Storage and Generation (DSG). Volume 4, appendix C: Identification from utility visits of present and future approaches to integration of DSG into distribution networks

NASA Technical Reports Server (NTRS)

1980-01-01

Visits to four utilities concerned with the use of DSG power sources on their distribution networks yielded useful impressions of present and future approaches to the integration of DSGs into electrical distribution network. Different approaches to future utility systems with DSG are beginning to take shape. The new DSG sources will be in decentralized locations with some measure of centralized control. The utilities have yet to establish firmly the communication and control means or their organization. For the present, the means for integrating the DSGs and their associated monitoring and control equipment into a unified system have not been decided.

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.

42 CFR 456.437 - Notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... qualified mental retardation professional, if applicable; (d) The Medicaid agency; (e) The recipient; and (f...

Wind Generators

NASA Technical Reports Server (NTRS)

1989-01-01

When Enerpro, Inc. president, Frank J. Bourbeau, attempted to file a patent on a system for synchronizing a wind generator to the electric utility grid, he discovered Marshall Space Flight Center's Frank Nola's power factor controller. Bourbeau advanced the technology and received a NASA license and a patent for his Auto Synchronous Controller (ASC). The ASC reduces generator "inrush current," which occurs when large generators are abruptly brought on line. It controls voltage so the generator is smoothly connected to the utility grid when it reaches its synchronous speed, protecting the components from inrush current damage. Generator efficiency is also increased in light winds by applying lower than rated voltage. Wind energy is utilized to drive turbines to generate electricity for utility companies.

Proceedings: 1990 fossil plant cycling conference

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

Not Available

1991-12-01

Fossil plant cycling continues to be a key issue for many electric utilities. EPRI's previous cycling workshops, held in 1983, 1985, and 1987, allowed utilities to benefit from collective industry experience in the conversion of baseload fossil units to cyclic operation. Continued improvements in equipment, retrofits, diagnostics, and controls were highlighted at the 1990 conference. The objective is to provide a forum for utility discussions of the cycling operation of fossil fuel power plants. Potomac Electric Power Company (PEPCO) hosted the 1990 EPRI Fossil Fuel Cycling Conference in Washington, DC, on December 4--6, 1990. More than 130 representatives from utilities,more » vendors, government agencies, universities, and industry associations attended the conference. Following the general session, technical sessions covered such topics as plant modifications, utility retrofit experience, cycling economics, life assessment, controls, environmental controls, and energy storage. Attendees also toured PEPCO's Potomac River generating station, the site of an earlier EPRI cycling conversion study.« less

Effect of hypophysectomy and thiourea treatment on radiophosphorus metabolism in goldfish, Carassius auratus L.

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

Srivastava, P. N.

1963-01-01

Goldfish, Carassius auratus L., were hypophysectomized. One month after the operation, hypophysectomized fish were divided into two groups, one of which was maintained in 0.3% thiourea solution. Control fish were also divided into two groups and maintained in 0.3% thiourea solution and fresh water. After two weeks P/sup 32/ was added in all the aquaria. Hypophysectomized fish maintained in fresh water utilized 39% of the P/sup 32/ in five days and the controls utilized 41% (the difference is not statistically significant). Hypophysectomized fish treated with thiourea utilized only 27% P/sup 32/ whereas the controls maintained in thiourea utilized 53%. Thismore » confirmed that increased P/sup 32/ utilization in thiourea solutions was caused by thyroid stimulation from the increased output of endogenous thyroid-stimulating hormone by the pituitary gland. (M.C.G.)« less

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

PubMed

Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

2017-05-15

To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluating Utility Gloves as a Potential Reservoir for Pathogenic Bacteria.

PubMed

Grant, Kathy L; Naber, E Donald; Halteman, William A

2015-08-01

This pilot study sought to determine the rate and degree to which gram-negative Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa and gram-positive Staphylococcus aureus occurred on the inside of utility gloves used at University of Maine at Augusta, Dental Health Programs' dental hygiene clinic. Five steam autoclave utility gloves were randomly selected to serve as control and a convenience sample of 10 used utility gloves were selected from the sterilization area. A sample was collected from a predetermined surface area from the inside of each steam autoclave utility glove and used utility glove. Each sample was used to inoculate a Petri plate containing 2 types of culture media. Samples were incubated at 37° C for 30 to 36 hours in aerobic conditions. Colony forming units (CFU) were counted. Confidence intervals (CI) estimated the rate of contamination with gram-negative K. pneumoniae, E. coli and P. aeruginosa on the inside of steam autoclave utility gloves to be n=33 95% CL [0.000, 0.049], used utility gloves to be n=70, 95% CL [0.000, 0.0303]. Data estimated the rate of contamination with gram-positive S. aureus on the inside of steam autoclave utility gloves to be n=35, 95% CL [0.233, 0.530], used utility gloves to be n=70, 95% CL [0.2730, 0.4975]. Culture media expressed a wide range of CFU from 0 to over 200. The risk of utility glove contamination with gram-negative bacteria is likely low. The expressed growth of S. aureus from steam autoclave utility gloves controls raises questions about the effectiveness and safety of generally accepted sterilization standards for the governmentally mandated use of utility gloves. Copyright © 2015 The American Dental Hygienists’ Association.

Method and system for controlling a gasification or partial oxidation process

DOEpatents

Rozelle, Peter L; Der, Victor K

2015-02-10

A method and system for controlling a fuel gasification system includes optimizing a conversion of solid components in the fuel to gaseous fuel components, controlling the flux of solids entrained in the product gas through equipment downstream of the gasifier, and maximizing the overall efficiencies of processes utilizing gasification. A combination of models, when utilized together, can be integrated with existing plant control systems and operating procedures and employed to develop new control systems and operating procedures. Such an approach is further applicable to gasification systems that utilize both dry feed and slurry feed.

Correlates of Suicide among Home Health Care Utilizers Who Died by Suicide and Community Controls

ERIC Educational Resources Information Center

Rowe, Jennifer L.; Bruce, Martha L.; Conwell, Yeates

2006-01-01

Home health care patients often have several late-life risk factors for suicide and constitute a high risk group for suicidal behaviors. In this study, we examined the characteristics of 14 older adult home health care utilizers who died by suicide and four community controls who used similar services. Both groups of home health care utilizers had…

42 CFR 456.231 - Continued stay review required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... a review of each recipient's continued stay in the mental hospital to decide whether it is needed...

42 CFR 456.433 - Initial continued stay review date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... after admission, if indicated at the time of admission; and (d) The group performing UR insures that the...

42 CFR 456.433 - Initial continued stay review date.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... after admission, if indicated at the time of admission; and (d) The group performing UR insures that the...

Flow Control Research at NASA Langley in Support of High-Lift Augmentation

NASA Technical Reports Server (NTRS)

Sellers, William L., III; Jones, Gregory S.; Moore, Mark D.

2002-01-01

The paper describes the efforts at NASA Langley to apply active and passive flow control techniques for improved high-lift systems, and advanced vehicle concepts utilizing powered high-lift techniques. The development of simplified high-lift systems utilizing active flow control is shown to provide significant weight and drag reduction benefits based on system studies. Active flow control that focuses on separation, and the development of advanced circulation control wings (CCW) utilizing unsteady excitation techniques will be discussed. The advanced CCW airfoils can provide multifunctional controls throughout the flight envelope. Computational and experimental data are shown to illustrate the benefits and issues with implementation of the technology.

Optimal Reward Functions in Distributed Reinforcement Learning

NASA Technical Reports Server (NTRS)

Wolpert, David H.; Tumer, Kagan

2000-01-01

We consider the design of multi-agent systems so as to optimize an overall world utility function when (1) those systems lack centralized communication and control, and (2) each agents runs a distinct Reinforcement Learning (RL) algorithm. A crucial issue in such design problems is to initialize/update each agent's private utility function, so as to induce best possible world utility. Traditional 'team game' solutions to this problem sidestep this issue and simply assign to each agent the world utility as its private utility function. In previous work we used the 'Collective Intelligence' framework to derive a better choice of private utility functions, one that results in world utility performance up to orders of magnitude superior to that ensuing from use of the team game utility. In this paper we extend these results. We derive the general class of private utility functions that both are easy for the individual agents to learn and that, if learned well, result in high world utility. We demonstrate experimentally that using these new utility functions can result in significantly improved performance over that of our previously proposed utility, over and above that previous utility's superiority to the conventional team game utility.

MERCURY CONTROL IN MUNICIPAL WASTE COMBUSTORS AND COAL-FIRED UTILITIES

EPA Science Inventory

Control of mercury (Hg) emissions from municipal waste combustors (MWCs) and coal-fired utilities has attracted attention due to current and potential regulations. Among several techniques evaluated for Hg control, dry sorbent injection (primarily injection of activated carbon) h...

CONTROL OF NOX EMISSIONS FROM U.S. COAL-FIRED ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper discusses the control of nitrogen oxide (NOx) emissions from U.S. coal-fired electric utility boilers. (NOTE: In general, NOx control technologies are categorized as being either primary or secondary control technologies. Primary technologies reduce the amount of NOx pr...

42 CFR 456.180 - Individual written plan of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.180 Individual written plan of care. (a) Before admission to a mental hospital or...

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

Utility interconnection issues for wind power generation

NASA Technical Reports Server (NTRS)

Herrera, J. I.; Lawler, J. S.; Reddoch, T. W.; Sullivan, R. L.

1986-01-01

This document organizes the total range of utility related issues, reviews wind turbine control and dynamic characteristics, identifies the interaction of wind turbines to electric utility systems, and identifies areas for future research. The material is organized at three levels: the wind turbine, its controls and characteristics; connection strategies as dispersed or WPSs; and the composite issue of planning and operating the electric power system with wind generated electricity.

42 CFR 456.245 - Number of studies required to be performed.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... mental hospital must, at least, have one study in progress at any time and complete one study each...

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... least every 90 days each time it decides under § 456.236 that the continued stay is needed; and (c) The...

42 CFR 456.245 - Number of studies required to be performed.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... mental hospital must, at least, have one study in progress at any time and complete one study each...

42 CFR 456.145 - Number of studies required to be performed.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan..., at least, have one study in progress at any time and complete one study each calendar year. ...

42 CFR 456.145 - Number of studies required to be performed.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan..., at least, have one study in progress at any time and complete one study each calendar year. ...

42 CFR 478.10 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement... procedures for— (a) Reconsiderations conducted by a Utilization and Quality Control Quality Improvement...

42 CFR 478.10 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement... procedures for— (a) Reconsiderations conducted by a Utilization and Quality Control Quality Improvement...

42 CFR 478.10 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement... procedures for— (a) Reconsiderations conducted by a Utilization and Quality Control Quality Improvement...

42 CFR 478.10 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement... procedures for— (a) Reconsiderations conducted by a Utilization and Quality Control Quality Improvement...

42 CFR 478.10 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement... procedures for— (a) Reconsiderations conducted by a Utilization and Quality Control Quality Improvement...

Conference on asbestos control and replacement for electric utilities: Proceedings

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

Not Available

An EPRI conference on Asbestos Control and Replacement for Electric Utilities was held April 9, 1992 in conjunction with the National Asbestos Council's Environmental Management 192 Conference and Exposition. The high cost and potential liabilities of asbestos removal projects, compounded by concerns over the health effects of asbestos replacement materials, was the main motivation for the conference. The objective of the conference was to assemble guidance and information that will help utilities manage asbestos and to effectively prioritize EPRI research in this area. Ten papers covered such topics as computer-aided asbestos management, utility experience with asbestos management, asbestos monitoring andmore » disposal, and asbestos replacement materials. Utility feedback received at the conference indicates that present and planned EPRI research activities in this area will effectively meet industry needs.« less

Integration of SPS with utility system networks

NASA Technical Reports Server (NTRS)

Kaupang, B. M.

1980-01-01

The integration of Satellite Power System (SPS) power in electric utility power systems is discussed. Specifically, the nature of the power output variations from the spacecraft to the rectenna, the operational characteristics of the rectenna power, and the impacts on the electric utility system from utilizing SPS power to serve part of the system load are treated. It is concluded that if RF beam control is an acceptable method for power control, and that the site distribution of SPS rectennas do not cause a very high local penetration (40 to 50%), SPS may be integrated into electric utility system with a few negative impacts. Increased regulating duty on the conventional generation, and a potential impact on system reliability for SPS penetration in excess of about 25% appear to be two areas of concern.

Technology evaluation of control/monitoring systems for MIUS application. [utility services management

NASA Technical Reports Server (NTRS)

Pringle, L. M., Jr.

1974-01-01

Potential ways of providing control and monitoring for the Modular Integrated Utility System (MIUS) program are elaborated. Control and monitoring hardware and operational systems are described. The requirements for the MIUS program and the development requirements are discussed.

Director of Small and Disadvantaged Business Utilization

DTIC Science & Technology

1989-03-17

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

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2011 CFR

2011-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2013 CFR

2013-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2014 CFR

2014-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2012 CFR

2012-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

Financial and clinical characteristics of fibromyalgia: a case-control comparison.

PubMed

Palacio, Ana; Uribe, Claudia L; Li, Hua; Hanna, John; Deminski, Michael; Alvir, Jose; Chandran, Arthi; Sanchez, Robert

2010-05-01

To compare healthcare utilization and costs between subjects with and without fibromyalgia (FM) using claims data from a large health benefits company in the United States. Retrospective cohort. We analyzed 24 months of medical and pharmacy claims data comparing healthcare utilization and costs among Humana members diagnosed with FM to a propensity score matched control group without a diagnosis for FM. FM cases were identified as members aged 18 years and older, with at least 2 medical claims for International Classification of Diseases, Ninth Revision, Clinical Modification codes 729.0 and/or 729.1. The first medical claim for FM was utilized as the index date. A total of 9988 FM cases and 9988 controls were included in the analysis. Compared with controls, the use of pain-related medications by FM cases was approximately 2 times higher with opioids being used most commonly. FM cases utilized a mean (SD) of 22.5 (23.9) and 31.1 (26.6) outpatient services per year in the prediagnosis and postdiagnosis periods, respectively, compared with 14.8 (20.5) and 16.3 (24.5) among controls (P <.01). Office visits, tests, and procedures represented the majority of utilization. During the postdiagnosis period, the mean per-patient per-month costs for outpatient services among FM cases was $377 ($760) and $217 ($740.87) among controls (P <.01). FM cases had significantly higher utilization and costs compared with controls. Office visits, tests and procedures, and the use of pain-related medications accounted for the largest absolute differences between the 2 groups.

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare fiscal...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare fiscal...

42 CFR 456.652 - Requirements for an effective utilization control program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... To Make a Satisfactory Showing of an Effective Institutional Utilization Control Program § 456.652... reduction in FFP, the Medicaid agency must make a satisfactory showing to the Administrator, in each quarter...

Utility-based early modulation of processing distracting stimulus information.

PubMed

Wendt, Mike; Luna-Rodriguez, Aquiles; Jacobsen, Thomas

2014-12-10

Humans are selective information processors who efficiently prevent goal-inappropriate stimulus information to gain control over their actions. Nonetheless, stimuli, which are both unnecessary for solving a current task and liable to cue an incorrect response (i.e., "distractors"), frequently modulate task performance, even when consistently paired with a physical feature that makes them easily discernible from target stimuli. Current models of cognitive control assume adjustment of the processing of distractor information based on the overall distractor utility (e.g., predictive value regarding the appropriate response, likelihood to elicit conflict with target processing). Although studies on distractor interference have supported the notion of utility-based processing adjustment, previous evidence is inconclusive regarding the specificity of this adjustment for distractor information and the stage(s) of processing affected. To assess the processing of distractors during sensory-perceptual phases we applied EEG recording in a stimulus identification task, involving successive distractor-target presentation, and manipulated the overall distractor utility. Behavioral measures replicated previously found utility modulations of distractor interference. Crucially, distractor-evoked visual potentials (i.e., posterior N1) were more pronounced in high-utility than low-utility conditions. This effect generalized to distractors unrelated to the utility manipulation, providing evidence for item-unspecific adjustment of early distractor processing to the experienced utility of distractor information. Copyright © 2014 the authors 0270-6474/14/3416720-06$15.00/0.

A Method of Maximum Power Control in Single-phase Utility Interactive Photovoltaic Generation System by using PWM Current Source Inverter

NASA Astrophysics Data System (ADS)

Neba, Yasuhiko

This paper deals with a maximum power point tracking (MPPT) control of the photovoltaic generation with the single-phase utility interactive inverter. The photovoltaic arrays are connected by employing the PWM current source inverter to the utility. The use of the pulsating dc current and voltage allows the maximum power point to be searched. The inverter can regulate the array voltage and keep the arrays to the maximum power. This paper gives the control method and the experimental results.

Examination of psychosocial predictors of Virginia pharmacists' intention to utilize a prescription drug monitoring program using the theory of planned behavior.

PubMed

Gavaza, Paul; Fleming, Marc; Barner, Jamie C

2014-01-01

Little is known about the main drivers of pharmacists' intention to utilize prescription drug monitoring programs (PDMPs) when making care decisions and the actual contribution of these factors in explaining intention and behavior. This study examined what theory of planned behavior (TPB) model constructs (i.e., attitude, subjective norm [SN], perceived behavioral control [PBC]), past utilization behavior (PUB) and perceived moral obligation (PMO) were significant predictors of Virginia community pharmacists' intention to utilize a PDMP. A cover letter with a link to a 28-item online survey was e-mailed to 600 members of the Virginia Pharmacists Association. Multiple regression analyses were used to determine the association between pharmacists' intention to utilize the PDMP database and attitude, SN, PBC, PUB and PMO. Ninety-seven usable responses were received, for a response rate of 16.2%. A majority of the respondents were Caucasian (96.4%), female (50.5%), working in independent community pharmacies (60.4%) with an average age of 49.5 ± 13.4 years. Overall, pharmacists intended to utilize a PDMP (mean = 5.3 ± 4.6; possible range: -9 to 9), had a positive attitude toward utilizing PDMP (mean = 6.3 ± 5.3; possible range: -12 to 12), perceived that others wanted them to utilize a PDMP (SN score = 3.7 ± 2.4; range: -6 to 6), and believed that they had control over utilization behavior (PBC score = 4.5 ± 4.0; range: -9 to 9). Attitude (β = 0.723, P < 0.001), SN (β = 0.230, P = 0.014) and PBC (β = -0.215, P = 0.026) significantly predicted pharmacists' intent, accounting for 56.7% of the variance in intention to utilize the PDMP database (P < 0.001). The addition of PMO (P < 0.001) significantly contributed to explaining the variance in intention but PUB did not. Members of the Virginia Pharmacists Association who responded to the survey showed a strong positive intent to utilize PDMP database. Pharmacists' attitudes, subjective norm, perceived behavioral control and perceived moral obligation were significant predictors of intention but past utilization behavior was not. The TPB is a useful theoretical framework when predicting PDMP utilization behavior of community pharmacists, accounting for 56.7% of the variance in intention. Copyright © 2014 Elsevier Inc. All rights reserved.

Estimating mean QALYs in trial-based cost-effectiveness analysis: the importance of controlling for baseline utility.

PubMed

Manca, Andrea; Hawkins, Neil; Sculpher, Mark J

2005-05-01

In trial-based cost-effectiveness analysis baseline mean utility values are invariably imbalanced between treatment arms. A patient's baseline utility is likely to be highly correlated with their quality-adjusted life-years (QALYs) over the follow-up period, not least because it typically contributes to the QALY calculation. Therefore, imbalance in baseline utility needs to be accounted for in the estimation of mean differential QALYs, and failure to control for this imbalance can result in a misleading incremental cost-effectiveness ratio. This paper discusses the approaches that have been used in the cost-effectiveness literature to estimate absolute and differential mean QALYs alongside randomised trials, and illustrates the implications of baseline mean utility imbalance for QALY calculation. Using data from a recently conducted trial-based cost-effectiveness study and a micro-simulation exercise, the relative performance of alternative estimators is compared, showing that widely used methods to calculate differential QALYs provide incorrect results in the presence of baseline mean utility imbalance regardless of whether these differences are formally statistically significant. It is demonstrated that multiple regression methods can be usefully applied to generate appropriate estimates of differential mean QALYs and an associated measure of sampling variability, while controlling for differences in baseline mean utility between treatment arms in the trial. Copyright 2004 John Wiley & Sons, Ltd

A Decade in Dental Care Utilization among Adults and Children (2001–2010)

PubMed Central

Vujicic, Marko; Nasseh, Kamyar

2014-01-01

Objective To decompose the change in pediatric and adult dental care utilization over the last decade. Data 2001 through 2010 Medical Expenditure Panel Survey. Study Design The Blinder-Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care utilization were attributed to changes in explained covariates and changes due to movements in estimated coefficients. Controlling for demographics, overall health status, and dental benefits variables, we estimated year-specific logistic regression models. Outputs from these models were used to compute the Blinder-Oaxaca decomposition. Principal Findings Dental care utilization decreased from 40.5 percent in 2001 to 37.0 percent in 2010 for adults and increased from 43.2 percent in 2001 to 46.3 percent in 2010 for children (p < .05). Among adults, changes in insurance status, race, and income contributed to a decline in adult dental care utilization (−0.018, p < .01). Among children, changes in controlled factors did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences. Conclusions Dental care utilization for adults has declined, especially among the poor and uninsured. Without further policy intervention, disadvantaged adults face increasing barriers to dental care. PMID:24299620

Automotive gas turbine fuel control

NASA Technical Reports Server (NTRS)

Gold, H. (Inventor)

1978-01-01

A fuel control system is reported for automotive-type gas turbines and particulary advanced gas turbines utilizing variable geometry components to improve mileage and reduce pollution emission. The fuel control system compensates for fuel density variations, inlet temperature variations, turbine vane actuation, acceleration, and turbine braking. These parameters are utilized to control various orifices, spool valves and pistons.

42 CFR 456.238 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Review of Need for Continued Stay § 456.238 Time limits for...

42 CFR 456.60 - Certification and recertification of need for inpatient care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control... services in a hospital are or were needed. (2) The certification must be made at the time of admission or...

42 CFR 456.60 - Certification and recertification of need for inpatient care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control... services in a hospital are or were needed. (2) The certification must be made at the time of admission or...

42 CFR 476.83 - Initial denial determinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

....83 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 476.100 - Use of norms and criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

Conference on asbestos control and replacement for electric utilities: Proceedings

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

Not Available

An EPRI conference on Asbestos Control and Replacement for Electric Utilities was held April 9, 1992 in conjunction with the National Asbestos Council`s Environmental Management 192 Conference and Exposition. The high cost and potential liabilities of asbestos removal projects, compounded by concerns over the health effects of asbestos replacement materials, was the main motivation for the conference. The objective of the conference was to assemble guidance and information that will help utilities manage asbestos and to effectively prioritize EPRI research in this area. Ten papers covered such topics as computer-aided asbestos management, utility experience with asbestos management, asbestos monitoring andmore » disposal, and asbestos replacement materials. Utility feedback received at the conference indicates that present and planned EPRI research activities in this area will effectively meet industry needs.« less

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

PubMed

Choi, Sam

2015-01-01

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

Impact of a complex chronic care patient case conference on quality and utilization.

PubMed

Weppner, William G; Davis, Kyle; Tivis, Rick; Willis, Janet; Fisher, Amber; King, India; Smith, C Scott

2018-05-23

There is need for effective venues to allow teams to coordinate care for high-risk or high-need patients. In addition, health systems need to assess the impact of such approaches on outcomes related to chronic health conditions and patient utilization. We evaluate the clinical impact of a novel case conference involving colocated trainees and supervisors in an interprofessional academic primary care clinic. The study utilized a prospective cohort with control group. Intervention patients (N = 104) were matched with controls (N = 104) from the same provider's panel using propensity scores based on age, gender, risk predictors, and prior utilization patterns. Clinical outcomes and subsequent utilization patterns were compared prior to and up to 6 months following the conference. In terms of utilization, intervention patients demonstrated increased visits with primary care team members (p = .0002) compared with controls, without a corresponding increase in the number of primary care providers' visits. There was a trend towards decreased urgent care and emergency visits (p = .07) and a significant decrease in the rate of hospitalizations (p = .04). Patients with poorly-controlled hypertension saw significant decreases in mean systolic blood pressure from 167 to 146 mm Hg. However, there were no differences between the intervention and control groups. Intervention patients with diabetes demonstrated a nonsignificant trend towards decreased hemoglobin A1c from 9.8 to 9.4, when compared with controls. Interprofessional case conferences have potential to improve care coordination and may be associated with improved disease management, decreased unplanned care, and overall reduced hospitalizations.

Optimization of hybrid power system composed of SMES and flywheel MG for large pulsed load

NASA Astrophysics Data System (ADS)

Niiyama, K.; Yagai, T.; Tsuda, M.; Hamajima, T.

2008-09-01

A superconducting magnetic storage system (SMES) has some advantages such as rapid large power response and high storage efficiency which are superior to other energy storage systems. A flywheel motor generator (FWMG) has large scaled capacity and high reliability, and hence is broadly utilized for a large pulsed load, while it has comparatively low storage efficiency due to high mechanical loss compared with SMES. A fusion power plant such as International Thermo-Nuclear Experimental Reactor (ITER) requires a large and long pulsed load which causes a frequency deviation in a utility power system. In order to keep the frequency within an allowable deviation, we propose a hybrid power system for the pulsed load, which equips the SMES and the FWMG with the utility power system. We evaluate installation cost and frequency control performance of three power systems combined with energy storage devices; (i) SMES with the utility power, (ii) FWMG with the utility power, (iii) both SMES and FWMG with the utility power. The first power system has excellent frequency power control performance but its installation cost is high. The second system has inferior frequency control performance but its installation cost is the lowest. The third system has good frequency control performance and its installation cost is attained lower than the first power system by adjusting the ratio between SMES and FWMG.

PROCEEDINGS: SEVENTH SYMPOSIUM ON THE TRANSFER AND UTILIZATION OF PARTICULATE CONTROL TECHNOLOGY. VOLUME 1

EPA Science Inventory

The proceedings document presentations from the seventh symposium on the transfer and utilization of particulate control technology, March 22-25, 1988, in Nashville, TN. Objectives of the symposium were to encourage the exchange of new knowledge in the particulate control field b...

40 CFR 420.21 - Specialized definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... control system that utilizes filters to remove iron-bearing particles (fines) from blast furnace or... level is 10 pg/L per EPA Method 1613B for water and wastewater samples. (d) The term pg/L means... pollution control system means an emission control system that utilizes water to clean process or furnace...

40 CFR 420.21 - Specialized definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control system that utilizes filters to remove iron-bearing particles (fines) from blast furnace or... level is 10 pg/L per EPA Method 1613B for water and wastewater samples. (d) The term pg/L means... pollution control system means an emission control system that utilizes water to clean process or furnace...

40 CFR 420.21 - Specialized definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission control system that utilizes filters to remove iron-bearing particles (fines) from blast furnace...-tetrachlorodibenzofuran, the minimum level is 10 pg/L per EPA Method 1613B for water and wastewater samples. (d) The term... term wet air pollution control system means an emission control system that utilizes water to clean...

40 CFR 420.21 - Specialized definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... control system that utilizes filters to remove iron-bearing particles (fines) from blast furnace or... level is 10 pg/L per EPA Method 1613B for water and wastewater samples. (d) The term pg/L means... pollution control system means an emission control system that utilizes water to clean process or furnace...

42 CFR 456.213 - Confidentiality.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Confidentiality. 456.213 Section 456.213 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... Quality Control Quality Improvement Organization (QIO) (or the review component of a QIO subcontractor) in... sought under Title XVIII of the Act. Aggregate statistical data means any utilization, admission...

42 CFR 476.70 - Statutory bases and applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 476.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions § 476...

42 CFR 476.76 - Cooperation with health care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions...

Aggregate modeling of fast-acting demand response and control under real-time pricing

DOE PAGES

Chassin, David P.; Rondeau, Daniel

2016-08-24

This paper develops and assesses the performance of a short-term demand response (DR) model for utility load control with applications to resource planning and control design. Long term response models tend to underestimate short-term demand response when induced by prices. This has two important consequences. First, planning studies tend to undervalue DR and often overlook its benefits in utility demand management program development. Second, when DR is not overlooked, the open-loop DR control gain estimate may be too low. This can result in overuse of load resources, control instability and excessive price volatility. Our objective is therefore to develop amore » more accurate and better performing short-term demand response model. We construct the model from first principles about the nature of thermostatic load control and show that the resulting formulation corresponds exactly to the Random Utility Model employed in economics to study consumer choice. The model is tested against empirical data collected from field demonstration projects and is shown to perform better than alternative models commonly used to forecast demand in normal operating conditions. Finally, the results suggest that (1) existing utility tariffs appear to be inadequate to incentivize demand response, particularly in the presence of high renewables, and (2) existing load control systems run the risk of becoming unstable if utilities close the loop on real-time prices.« less

Aggregate modeling of fast-acting demand response and control under real-time pricing

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

Chassin, David P.; Rondeau, Daniel

This paper develops and assesses the performance of a short-term demand response (DR) model for utility load control with applications to resource planning and control design. Long term response models tend to underestimate short-term demand response when induced by prices. This has two important consequences. First, planning studies tend to undervalue DR and often overlook its benefits in utility demand management program development. Second, when DR is not overlooked, the open-loop DR control gain estimate may be too low. This can result in overuse of load resources, control instability and excessive price volatility. Our objective is therefore to develop amore » more accurate and better performing short-term demand response model. We construct the model from first principles about the nature of thermostatic load control and show that the resulting formulation corresponds exactly to the Random Utility Model employed in economics to study consumer choice. The model is tested against empirical data collected from field demonstration projects and is shown to perform better than alternative models commonly used to forecast demand in normal operating conditions. Finally, the results suggest that (1) existing utility tariffs appear to be inadequate to incentivize demand response, particularly in the presence of high renewables, and (2) existing load control systems run the risk of becoming unstable if utilities close the loop on real-time prices.« less

Aggregate modeling of fast-acting demand response and control under real-time pricing

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

Chassin, David P.; Rondeau, Daniel

This paper develops and assesses the performance of a short-term demand response (DR) model for utility load control with applications to resource planning and control design. Long term response models tend to underestimate short-term demand response when induced by prices. This has two important consequences. First, planning studies tend to undervalue DR and often overlook its benefits in utility demand management program development. Second, when DR is not overlooked, the open-loop DR control gain estimate may be too low. This can result in overuse of load resources, control instability and excessive price volatility. Our objective is therefore to develop amore » more accurate and better performing short-term demand response model. We construct the model from first principles about the nature of thermostatic load control and show that the resulting formulation corresponds exactly to the Random Utility Model employed in economics to study consumer choice. The model is tested against empirical data collected from field demonstration projects and is shown to perform better than alternative models commonly used to forecast demand in normal operating conditions. The results suggest that (1) existing utility tariffs appear to be inadequate to incentivize demand response, particularly in the presence of high renewables, and (2) existing load control systems run the risk of becoming unstable if utilities close the loop on real-time prices.« less

Odor Control Test Report of the Urine Containment Bag (UCB) for Orion Utilization

NASA Technical Reports Server (NTRS)

Casper, Stephanie; Williams, Nichole M. M.

2010-01-01

The purpose of this report is to summarize the conclusions for the odor control test of the Urine Containment Bag (UCB), P/N SDD46107234-306 in an environment simulating a space craft capsule. JSC 65891, Odor Control Test Plan of the Urine Containment Bag (UCB) for Orion Utilization, documents the test plan. The details of the test set-up and data reduction are detailed in the WSTF test report for this test WSTF #10-44500, Odor Control Test Plan of the Urine Containment Bag (UCB) for Orion Utilization,. This document outlines the project conclusions and forward plans with regard to trash containment for Constellation.

Cue Utilization and Cognitive Load in Novel Task Performance

PubMed Central

Brouwers, Sue; Wiggins, Mark W.; Helton, William; O’Hare, David; Griffin, Barbara

2016-01-01

This study was designed to examine whether differences in cue utilization were associated with differences in performance during a novel, simulated rail control task, and whether these differences reflected a reduction in cognitive load. Two experiments were conducted, the first of which involved the completion of a 20-min rail control simulation that required participants to re-route trains that periodically required a diversion. Participants with a greater level of cue utilization recorded a consistently greater response latency, consistent with a strategy that maintained accuracy, but reduced the demands on cognitive resources. In the second experiment, participants completed the rail task, during which a concurrent, secondary task was introduced. The results revealed an interaction, whereby participants with lesser levels of cue utilization recorded an increase in response latency that exceeded the response latency recorded for participants with greater levels of cue utilization. The relative consistency of response latencies for participants with greater levels of cue utilization, across all blocks, despite the imposition of a secondary task, suggested that those participants with greater levels of cue utilization had adopted a strategy that was effectively minimizing the impact of additional sources of cognitive load on their performance. PMID:27064669

Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post-lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis.

PubMed

Manchikanti, Laxmaiah; Helm, Standiford; Pampati, Vidyasagar; Racz, Gabor B

2015-06-01

The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost-effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high-quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome or lumbar central spinal stenosis. This analysis is based on 2 previously published controlled studies. To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post-lumbar surgery syndrome and lumbar central spinal stenosis. A private, specialty referral interventional pain management center in the United States. Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post-lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2-year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status. The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2-year follow-up with the actual reimbursement data showed cost utility for 1 year of quality-adjusted life year (QALY) of USD $2,652 for post-lumbar surgery syndrome and USD $2,649 for lumbar central spinal stenosis. The results of this assessment show that the cost utility of managing chronic, intractable low back pain with percutaneous adhesiolysis at a QALY that is similar or lower in price than medical therapy only, physical therapy, manipulation, spinal cord stimulation, and surgery. The limitations of this cost utility analysis are that it is a single-center evaluation, with the inclusion of costs of adhesiolysis procedures in an ambulatory surgery center and physician visits, rather than all related costs including drug therapy and costs of disability in multiple settings. This cost utility analysis of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome and lumbar central spinal stenosis shows the clinical effectiveness and cost utility of these procedures at USD $2,650 per one year of QALY when performed in an ambulatory surgery center. © 2014 World Institute of Pain.

Chapter 9.5: Electromagnetic induction to manage cattle feedlot waste

USDA-ARS?s Scientific Manuscript database

This book chapter summarizes results of waste management research that utilized electromagnetic induction (EMI) tools for the purposes of: 1) collection of solid waste from feedlot surfaces to be utilized by crops 2) control and utilization of nutrient laden liquid runoff, and 3) feedlot surface man...

47 CFR 1.1402 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... controlled by a utility. (c) With respect to poles, the term usable space means the space on a utility pole... equipment, and which includes space occupied by the utility. With respect to conduit, the term usable space... together with their supporting infrastructure. (k) The term duct means a single enclosed raceway for...

47 CFR 1.1402 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... controlled by a utility. (c) With respect to poles, the term usable space means the space on a utility pole... equipment, and which includes space occupied by the utility. With respect to conduit, the term usable space... together with their supporting infrastructure. (k) The term duct means a single enclosed raceway for...

47 CFR 1.1402 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... controlled by a utility. (c) With respect to poles, the term usable space means the space on a utility pole... equipment, and which includes space occupied by the utility. With respect to conduit, the term usable space... together with their supporting infrastructure. (k) The term duct means a single enclosed raceway for...

77 FR 67380 - Submission for OMB Review; Comment Request: Ethical Dilemmas in Surgery and Utilization of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

...; Comment Request: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A..., unless it displays a currently valid OMB control number. Proposed Collection: Title: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A Survey. Type of Information Collection...

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.

Study on the Potential Development of Rainwater Utilization in the Hilly City of Southern China

NASA Astrophysics Data System (ADS)

Fu, Xiaoran; Liu, Jiahong; Shao, Weiwei; Zhang, Haixing

2017-12-01

Aimed at the current flood problems and the contradiction between supply and demand of water resources in the southern cities of China, the comprehensive utilization of Urban Rainwater Resources (URRs) is a significant solution. At present, the research on the comprehensive utilization system of urban rainwater resources in China is still immature, especially the lack of a comprehensive method for the comprehensive utilization of the rainwater and flood resources in the south. Based on the current mode for utilization of URRs at home and abroad, Fenghuang County in Hunan Province was taken as a case of study, which is a typical mountainous city in the southern China. And the potential development of URRs was simulated and evaluated with a comparison of before and after the exploitation and utilization of URRs in this paper. The reduction effect of flood and waterlogging on the ancient city area is analyzed from SWMM. The simulation results show that the potential of exploitation and utilization of URRs in Fenghuang county is remarkable under the mode of exploitation and utilization which is given priority to flood prevention and control, and the annual development potential is 4.865×105 m3. The rainwater utilization measures of flood control effect is obvious with this mode, and the relevant research results can provide theoretical and technical support for enhancing urban water security capability, water conservation capacity, and disaster mitigation of urban flood.

An integrated utility-based model of conflict evaluation and resolution in the Stroop task.

PubMed

Chuderski, Adam; Smolen, Tomasz

2016-04-01

Cognitive control allows humans to direct and coordinate their thoughts and actions in a flexible way, in order to reach internal goals regardless of interference and distraction. The hallmark test used to examine cognitive control is the Stroop task, which elicits both the weakly learned but goal-relevant and the strongly learned but goal-irrelevant response tendencies, and requires people to follow the former while ignoring the latter. After reviewing the existing computational models of cognitive control in the Stroop task, its novel, integrated utility-based model is proposed. The model uses 3 crucial control mechanisms: response utility reinforcement learning, utility-based conflict evaluation using the Festinger formula for assessing the conflict level, and top-down adaptation of response utility in service of conflict resolution. Their complex, dynamic interaction led to replication of 18 experimental effects, being the largest data set explained to date by 1 Stroop model. The simulations cover the basic congruency effects (including the response latency distributions), performance dynamics and adaptation (including EEG indices of conflict), as well as the effects resulting from manipulations applied to stimulation and responding, which are yielded by the extant Stroop literature. (c) 2016 APA, all rights reserved).

42 CFR 456.411 - Recipient information required for UR.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care...) The name of the recipient's physician. (c) The name of the qualified mental retardation professional... mental retardation professional believes continued stay is necessary. (h) Other supporting material that...

Improved Training Program for Fall Prevention of Warfighters with Lower Extremity Trauma

DTIC Science & Technology

2016-10-01

productive, active civilian life. The training program utilizes a microprocessor -controlled treadmill designed to deliver task- specific training...National Military Medical Center (WRNMMC), and Mayo. The fall prevention training program utilizes a microprocessor -controlled treadmill to deliver

42 CFR 476.82 - Continuation of functions not assumed by QIOs.

Code of Federal Regulations, 2010 CFR

2010-10-01

....82 Section 476.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

42 CFR 476.80 - Coordination with Medicare fiscal intermediaries and carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and carriers. 476.80 Section 476.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement...

Proceedings: Conference on asbestos control and replacement for electric utilities

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

Not Available

An EPRI conference on Asbestos Control and Replacement for Electric Utilities was held April 6--7, 1993 in conjunction with the Environmental Information Association`s (formerly National Asbestos Council) Environmental Management `93 Conference and Exposition. The high cost and potential liabilities of asbestos removal projects, compounded by concerns over the health effects of asbestos replacement materials, was the main motivation for the conference. The objective of the conference was to assemble guidance and information that will help utilities manage asbestos and to effectively prioritize EPRI research in this area. Eleven papers covered such topics as changes in the Environmental Protection Agency`s (EPA)more » ban on asbestos, utility experience with asbestos management and abatement, asbestos monitoring and disposal, and asbestos replacement materials. Utility feedback received at the conference indicates that present and planned EPRI research activities in this area will effectively meet industry needs.« less

Perspectives on the future of the electric utility industry

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

Tonn, B.; Schaffhauser, A.

1994-04-01

This report offers perspectives on the future of the electric utility industry. These perspectives will be used in further research to assess the prospects for Integrated Resource Planning (IRP). The perspectives are developed first by examining economic, political and regulatory, societal, technological, and environmental trends that are (1) national and global in scope and (2) directly related to the electric utility industry. Major national and global trends include increasing global economic competition, increasing political and ethnic strife, rapidly changing technologies, and increasing worldwide concern about the environment. Major trends in the utility industry include increasing competition in generation; changing patternsmore » of electricity demand; increasing use of information technology to control power systems; and increasing implementation of environmental controls. Ways in which the national and global trends may directly affect the utility industry are also explored. The trends are used to construct three global and national scenarios- ``business as usual,`` ``technotopia future,`` and ``fortress state`` -and three electric utility scenarios- ``frozen in headlights,`` ``megaelectric,`` and ``discomania.`` The scenarios are designed to be thought provoking descriptions of potential futures, not predictions of the future, although three key variables are identified that will have significant impacts on which future evolves-global climate change, utility technologies, and competition. While emphasis needs to be placed on understanding the electric utility scenarios, the interactions between the two sets of scenarios is also of interest.« less

[Application of multiple-attribute utility technology (MAUT) to decisions about a work-site stress-control intervention for public-sector office workers].

PubMed

Hagihara, Akihito; Tarumi, Kimio

2013-01-01

The reasons behind the establishment of particular health-promotion programs in community or work settings are often unclear, and such programs are rarely evaluated from a broad perspective after they are implemented. Thus, multiattribute utility technology (MAUT) was used to design a work-site stress-control program. The sample consisted of public-sector workers in B City in Japan. Stakeholders in the work-site stress-control program included employers (municipal authorities), employees (public workers), and healthcare personnel. Six goals and three strategies (i.e., personnel, self-care, and staff) related to stress-control programs were considered. The results showed that the self-care strategy received the highest score for overall utility (i.e., 96.2), and the overall-utility score for the remaining two strategies was approximately 70. The self-care strategy emerged as the most useful of the three strategies for developing a stress-control program in a target work place. The application of MAUT may be useful for developing an effective stress-control program in occupational settings.

Virtual reality body motion induced navigational controllers and their effects on simulator sickness and pathfinding.

PubMed

Aldaba, Cassandra N; White, Paul J; Byagowi, Ahmad; Moussavi, Zahra

2017-07-01

Virtual reality (VR) navigation is usually constrained by plausible simulator sickness (SS) and intuitive user interaction. The paper reports on the use of four different degrees of body motion induced navigational VR controllers, a TiltChair, omni-directional treadmill, a manual wheelchair joystick (VRNChair), and a joystick in relation to a participant's SS occurrence and a controller's intuitive utilization. Twenty young adult participants utilized all controllers to navigate through the same VR task environment in separate sessions. Throughout the sessions, SS occurrence was measured from a severity score by a standard SS questionnaire and from body sway by a center of pressure path length with eyes opened and closed. SS occurrence did not significantly differ among the controllers. However, time spent in VR significantly contributed to SS occurrence; hence, a few breaks to minimize SS should be interjected throughout a VR task. For all task trials, we recorded the participant's travel trajectories to investigate each controller's intuitive utilization from a computed traversed distance. Shorter traversed distances indicated that participants intuitively utilized the TiltChair with a slower speed; while longer traversed distances indicated participants struggled to utilize the omni-directional treadmill with a unnaturalistic stimulation of gait. Therefore, VR navigation should use technologies best suited for the intended age group that minimizes SS, and produces intuitive interactions for the participants.

42 CFR 456.212 - Records and reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Records and reports. 456.212 Section 456.212 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan...

42 CFR 456.237 - Notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Notification of adverse decision. 456.237 Section 456.237 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.205 - UR committee required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false UR committee required. 456.205 Section 456.205 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan...

42 CFR 456.436 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities... mentally retarded, the recipient's qualified mental retardation professional, within 1 working day of its... final decision on the need for the continued stay; (g) If the attending physician or qualified mental...

42 CFR 456.151 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Definitions. 456.151 Section 456.151 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals § 456.151 Definitions. As used...

Utilization of an introduced weed biological control agent by a native parasitoid

USDA-ARS?s Scientific Manuscript database

A native parasitoid, Kalopolynema ema (Schauff and Grissell) (Hymenoptera, Mymaridae), that usually parasitizes the eggs of Megamelus davisi VanDuzee (Hemiptera, Delphacidae), has begun utilizing a new host, Megamelus scutellaris (Berg) (Hemiptera, Delphacidae), the introduced biological control age...

42 CFR 456.21 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Scope. 456.21 Section 456.21 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: All Medicaid Services § 456.21 Scope. This...

42 CFR 456.51 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals § 456.51 Definitions. As used in this... institution for mental disease, as defined in § 440.10; (2) [Reserved] (3) Services provided in specialty...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2012 CFR

2012-10-01

....236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... physician members of the committee, one of whom is knowledgeable in the treatment of mental diseases, review...

42 CFR 456.51 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals § 456.51 Definitions. As used in this... institution for mental disease, as defined in § 440.10; (2) [Reserved] (3) Services provided in specialty...

42 CFR 456.51 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals § 456.51 Definitions. As used in this... institution for mental disease, as defined in § 440.10; (2) [Reserved] (3) Services provided in specialty...

42 CFR 456.51 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals § 456.51 Definitions. As used in this... institution for mental disease, as defined in § 440.10; (2) [Reserved] (3) Services provided in specialty...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2014 CFR

2014-10-01

....236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... physician members of the committee, one of whom is knowledgeable in the treatment of mental diseases, review...

42 CFR 476.73 - Notification of QIO designation and implementation of review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of review. 476.73 Section 476.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement...

Assessing Somatosensory Utilization during Unipedal Postural Control.

PubMed

Goel, Rahul; De Dios, Yiri E; Gadd, Nichole E; Caldwell, Erin E; Peters, Brian T; Reschke, Millard F; Bloomberg, Jacob J; Oddsson, Lars I E; Mulavara, Ajitkumar P

2017-01-01

Multisensory-visual, vestibular and somatosensory information is integrated for appropriate postural control. The primary goal of this study was to assess somatosensory utilization during a functional motor task of unipedal postural control, in normal healthy adults. Assessing individual bias in the utilization of individual sensory contributions during postural control may help customization of rehabilitation protocols. In this study, a test paradigm of unipedal stance control in supine orientation with and without vision was assessed. Postural control in this test paradigm was hypothesized to utilize predominantly contributions of somatosensory information from the feet and ankle joint, with minimal vestibular input. Fourteen healthy subjects "stood" supine on their dominant leg while strapped to a backpack frame that was freely moving on air-bearings, to remove available otolith tilt cues with respect to gravity that influences postural control when standing upright. The backpack was attached through a cable to a pneumatic cylinder that provided a gravity-like load. Subjects performed three trials each with Eyes-open (EO) and Eyes-closed (EC) while loaded with 60% body weight. There was no difference in unipedal stance time (UST) across the two conditions with EC condition challenging the postural control system greater than the EO condition. Stabilogram-diffusion analysis (SDA) indicated that the critical mean square displacement was significantly different between the two conditions. Vestibular cues, both in terms of magnitude and the duration for which relevant information was available for postural control in this test paradigm, were minimized. These results support our hypothesis that maintaining unipedal stance in supine orientation without vision, minimizes vestibular contribution and thus predominantly utilizes somatosensory information for postural control.

Assessing Somatosensory Utilization during Unipedal Postural Control

PubMed Central

Goel, Rahul; De Dios, Yiri E.; Gadd, Nichole E.; Caldwell, Erin E.; Peters, Brian T.; Reschke, Millard F.; Bloomberg, Jacob J.; Oddsson, Lars I. E.; Mulavara, Ajitkumar P.

2017-01-01

Multisensory—visual, vestibular and somatosensory information is integrated for appropriate postural control. The primary goal of this study was to assess somatosensory utilization during a functional motor task of unipedal postural control, in normal healthy adults. Assessing individual bias in the utilization of individual sensory contributions during postural control may help customization of rehabilitation protocols. In this study, a test paradigm of unipedal stance control in supine orientation with and without vision was assessed. Postural control in this test paradigm was hypothesized to utilize predominantly contributions of somatosensory information from the feet and ankle joint, with minimal vestibular input. Fourteen healthy subjects “stood” supine on their dominant leg while strapped to a backpack frame that was freely moving on air-bearings, to remove available otolith tilt cues with respect to gravity that influences postural control when standing upright. The backpack was attached through a cable to a pneumatic cylinder that provided a gravity-like load. Subjects performed three trials each with Eyes-open (EO) and Eyes-closed (EC) while loaded with 60% body weight. There was no difference in unipedal stance time (UST) across the two conditions with EC condition challenging the postural control system greater than the EO condition. Stabilogram-diffusion analysis (SDA) indicated that the critical mean square displacement was significantly different between the two conditions. Vestibular cues, both in terms of magnitude and the duration for which relevant information was available for postural control in this test paradigm, were minimized. These results support our hypothesis that maintaining unipedal stance in supine orientation without vision, minimizes vestibular contribution and thus predominantly utilizes somatosensory information for postural control. PMID:28443004

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

41 CFR 101-42.1102-5 - Drugs, biologicals, and reagents other than controlled substances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... UTILIZATION AND DISPOSAL 42-UTILIZATION AND DISPOSAL OF HAZARDOUS MATERIALS AND CERTAIN CATEGORIES OF PROPERTY... are subject to the provisions of § 101-42.1102-3. (a) Utilization requirements. Excess drugs... Scientific Coordination Staff, ACFA-CF-30, located in the appropriate FDA district office, of surplus...

Resource utilization after introduction of a standardized clinical assessment and management plan.

PubMed

Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

2010-01-01

A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

Multimodal Pain Management Protocol Versus Patient Controlled Narcotic Analgesia for Postoperative Pain Control after Shoulder Arthroplasty.

PubMed

Nicholson, Thema; Maltenfort, Mitchell; Getz, Charles; Lazarus, Mark; Williams, Gerald; Namdari, Surena

2018-05-01

Our institution's traditional pain management strategy after shoulder arthroplasty has involved the utilization of postoperative patient-controlled narcotic analgesia. More recently, we have implemented a protocol (TLC) that utilizes a multimodal approach. The purpose of this study was to determine whether this change has improved pain control and decreased narcotic utilization. Patients undergoing primary total shoulder or reverse arthroplasty were retrospectively studied. All patients underwent interscalene brachial plexus blockade. "Traditional" patients were provided a patient-controlled analgesic pump postoperatively. TLC patients were given preoperative and postoperative multimodal, non-narcotic analgesic medications and breakthrough narcotics. Morphine equivalent units (MEU) consumed and Visual Analog Scale (VAS) scores for pain (0, 8, 16, and 24 hours) were considered. There were 108 patients in each group. Total postoperative narcotic consumption in the first 24 postoperative hours was 38.5 +/- 81.1 MEU in the "Traditional group" compared to 59.3 +/- 59.1 MEU in the TLC group ( P<0.001 ). Of patients in the TLC group, 88% utilized breakthrough narcotics. VAS pain was significantly higher in the "Traditional group" at 16 hours (4.1 +/- 2.9 vs 3.2 +/- 2.7, P=0.020 ) and 24 hours (4.8 +/- 2.7 vs 3.7 +/- 2.6, P=0.004 ). Those treated with the TLC protocol had greater narcotic utilization but better VAS pain scores at 24 hours after surgery. Both groups experienced rebound pain. While the TLC protocol led to an improved pain experience, further modification of the currently protocol may be necessary to reduce overall narcotic utilization.

Magnitude and Variability of Controllable Charge Capacity Provided by Grid Connected Plug-in Electric Vehicles

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

Scoffield, Don R; Smart, John; Salisbury, Shawn

2015-03-01

As market penetration of plug-in electric vehicles (PEV) increases over time, the number of PEVs charging on the electric grid will also increase. As the number of PEVs increases, their ability to collectively impact the grid increases. The idea of a large body of PEVs connected to the grid presents an intriguing possibility. If utilities can control PEV charging, it is possible that PEVs could act as a distributed resource to provide grid services. The technology required to control charging is available for modern PEVs. However, a system for wide-spread implementation of controllable charging, including robust communication between vehicles andmore » utilities, is not currently present. Therefore, the value of controllable charging must be assessed and weighed against the cost of building and operating such as system. In order to grasp the value of PEV charge control to the utility, the following must be understood: 1. The amount of controllable energy and power capacity available to the utility 2. The variability of the controllable capacity from day to day and as the number of PEVs in the market increases.« less

Incremental healthcare resource utilization and costs in US patients with Cushing's disease compared with diabetes mellitus and population controls.

PubMed

Broder, Michael S; Neary, Maureen P; Chang, Eunice; Ludlam, William H

2015-12-01

Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs. Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs. There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001). CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.

Multiple Signals Govern Utilization of a Polysaccharide in the Gut Bacterium Bacteroides thetaiotaomicron.

PubMed

Schwalm, Nathan D; Townsend, Guy E; Groisman, Eduardo A

2016-10-11

The utilization of simple sugars is widespread across all domains of life. In contrast, the breakdown of complex carbohydrates is restricted to a subset of organisms. A regulatory paradigm for integration of complex polysaccharide breakdown with simple sugar utilization was established in the mammalian gut symbiont Bacteroides thetaiotaomicron, whereby sensing of monomeric fructose regulates catabolism of both fructose and polymeric fructans. We now report that a different regulatory paradigm governs utilization of monomeric arabinose and the arabinose polymer arabinan. We establish that (i) arabinan utilization genes are controlled by a transcriptional activator that responds to arabinan and by a transcriptional repressor that responds to arabinose, (ii) arabinose utilization genes are regulated directly by the arabinose-responding repressor but indirectly by the arabinan-responding activator, and (iii) activation of both arabinan and arabinose utilization genes requires a pleiotropic transcriptional regulator necessary for survival in the mammalian gut. Genomic analysis predicts that this paradigm is broadly applicable to the breakdown of other polysaccharides in both B. thetaiotaomicron and other gut Bacteroides spp. The uncovered mechanism enables regulation of polysaccharide utilization genes in response to both the polysaccharide and its breakdown products. Breakdown of complex polysaccharides derived from "dietary fiber" is achieved by the mammalian gut microbiota. This breakdown creates a critical nutrient source for both the microbiota and its mammalian host. Because the availability of individual polysaccharides fluctuates with variations in the host diet, members of the microbiota strictly control expression of polysaccharide utilization genes. Our findings define a regulatory architecture that controls the breakdown of a polysaccharide by a gut bacterium in response to three distinct signals. This architecture integrates perception of a complex polysaccharide and its monomeric constituent as well as feedback of central metabolism. Moreover, it is broadly applicable to several prominent members of the mammalian gut microbiota. The identified regulatory strategy may contribute to the abundance of gut Bacteroides, despite fluctuations in the host diet. Copyright © 2016 Schwalm et al.

[The effect of cervical headgear and lower utility arch on the control of vertical dimension in tooth and jaw].

PubMed

Zhang, Li; Luo, Ying; Wang, Ren-fei

2010-08-01

To evaluate the effect of cervical headgear and lower utility arch in growing skeletal Class II division 1 patients. The patients were divided into 3 groups, the first group was treated with cervical headgear alone (n=20), the second group was treated with cervical headgear and lower utility arch (n=20), and the third group was a control group without treatment (n=20). Cephalometric radiographs were taken and analyzed with SPSS15.0 software package. Student's t test was used to determine if there was significant difference among the 3 groups. Anterior facial height and ramus height displayed significantly increase in the treatment groups than those in the control group; the lower utility arch produced intrusion and lingual tipping of the mandibular incisors and distal tipping without extrusion of the mandibular molars; compared with the control group, maxillary molar total extrusion produced by cervical headgear treatment was not more than 1mm at average. The treatment groups show significant reduction in maxillary protrusion; significant increase in the anterior descent of the PP and ramus height, as a result, mandibular plane orientation is relatively unchanged. The treatment groups have maxillary molar extrusion less than 1mm, which can be considered clinically not significant. The lower utility arch produces mandibular incisor intrusion and lingual tipping, the mandibular molars tip distally without extrusion, the lower utility arch does not influence the mandibular rotation.

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Subsequent continued stay review dates. 456.234 Section 456.234 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.211 - Recipient information required for UR.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Recipient information required for UR. 456.211 Section 456.211 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.232 - Evaluation criteria for continued stay.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Evaluation criteria for continued stay. 456.232 Section 456.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... each continued stay of a recipient in the mental hospital, the committee, subgroup or designee reviews... committee, subgroup or designee finds that a recipient's continued stay in the mental hospital is needed...

42 CFR 456.233 - Initial continued stay review date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... must provide that— (a) When a recipient is admitted to the mental hospital under admission review... will be reviewed; (b) If an individual applies for Medicaid while in the mental hospital, the committee...

42 CFR 476.160 - General quality of care review procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false General quality of care review procedures. 476.160... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

ASSESSMENT OF CONTROL TECHNOLOGIES FOR REDUCING EMISSIONS OF SO2 AND NOX FROM EXISTING COAL-FIRED UTILITY BOILERS

EPA Science Inventory

The report reviews information and estimated costs on 15 emissioncontrol technology categories applicable to existing coal-fired electric utility boilers. he categories include passive controls such as least emission dispatching, conventional processes, and emerging technologies ...

42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

Code of Federal Regulations, 2010 CFR

2010-10-01

... practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

42 CFR 476.86 - Correlation of Title XI functions with Title XVIII functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... functions. 476.86 Section 476.86 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

CONTROL OF MERCURY EMISSIONS FROM COAL-FIRED ELECTRIC UTILITY BOILERS: INTERIM REPORT

EPA Science Inventory

The report provides additional information on mercury (Hg) emissions control following the release of "Study of Hazardous Air Pollutant Emissions from Electric Utility Steam Generating Units--Final Report to Congress" in February 1998. Chapters 1-3 describe EPA's December 2000 de...

Concurrent planning and execution for a walking robot

NASA Astrophysics Data System (ADS)

Simmons, Reid

1990-07-01

The Planetary Rover project is developing the Ambler, a novel legged robot, and an autonomous software system for walking the Ambler over rough terrain. As part of the project, we have developed a system that integrates perception, planning, and real-time control to navigate a single leg of the robot through complex obstacle courses. The system is integrated using the Task Control Architecture (TCA), a general-purpose set of utilities for building and controlling distributed mobile robot systems. The walking system, as originally implemented, utilized a sequential sense-plan-act control cycle. This report describes efforts to improve the performance of the system by concurrently planning and executing steps. Concurrency was achieved by modifying the existing sequential system to utilize TCA features such as resource management, monitors, temporal constraints, and hierarchical task trees. Performance was increased in excess of 30 percent with only a relatively modest effort to convert and test the system. The results lend support to the utility of using TCA to develop complex mobile robot systems.

Energy Saving Performance Analysis of An Inverter-based Regenerative Power Re-utilization Device for Urban Rail Transit

NASA Astrophysics Data System (ADS)

Li, Jin; Qiu, Zhiling; Hu, Leilei

2018-04-01

The inverter-based regenerative braking power utilization devices can re-utilize the regenerative energy, thus reduce the energy consumption of urban rail transit. In this paper the power absorption principle of the inverter-based device is introduced, then the key influencing factors of energy saving performance are analyzed based on the absorption model. The field operation data verified that the control DC voltage plays an important role and lower control DC voltage yields more energy saving. Also, the one year energy saving performance data of an inverter-based re-utilization device located in NanJing S8 line is provided, and more than 1.2 million kWh energy is recovered in the one year operation.

42 CFR 456.520 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.520 Definitions...

42 CFR 456.500 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals § 456.500 Purpose. For hospitals and mental hospitals, this subpart— (a...

Socio-economic and locational determinants of accessibility and utilization of primary health-care.

PubMed

Field, K S; Briggs, D J

2001-09-01

Differences in levels of utilization vary and are a function of socio-economic and geographical factors. This paper presents the results of a questionnaire study involving twelve GP practices in Northamptonshire, UK, of factors which affect access and utilization in asthmatics and diabetics; these groups were selected to control for differences in utilization behaviour, as a result of different aetiologies. The questionnaire sought data on: residential location of patients, utilization characteristics of primary health-care, personal circumstances and mobility and hindrances to access and utilization. Key themes were identified relating to age, gender, social class, employment, ethnicity and proximity to the GP surgery. The young, elderly and females report higher rates of utilization, as do nonmanual workers and those who are unemployed. However, accessibility and utilization vary greatly in response to mobility and locational characteristics; these variations tend to be masked by data on overall rates of usage. Optimal scaling techniques were used to investigate the interactions between the factors affecting accessibility and utilization, and to characterize patients in terms of their levels of utilization. Results confirmed that current service provision afforded a differential level of service to patients, which does not directly reflect their level of need.

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.

Internet SCADA Utilizing API's as Data Source

NASA Astrophysics Data System (ADS)

Robles, Rosslin John; Kim, Haeng-Kon; Kim, Tai-Hoon

An Application programming interface or API is an interface implemented by a software program that enables it to interact with other software. Many companies provide free API services which can be utilized in Control Systems. SCADA is an example of a control system and it is a system that collects data from various sensors at a factory, plant or in other remote locations and then sends this data to a central computer which then manages and controls the data. In this paper, we designed a scheme for Weather Condition in Internet SCADA Environment utilizing data from external API services. The scheme was designed to double check the weather information in SCADA.

Utilization of High-Temperature Slags From Metallurgy Based on Crystallization Behaviors

NASA Astrophysics Data System (ADS)

Sun, Yongqi; Zhang, Zuotai

2018-05-01

Here, following the principle of modifying crystallization behaviors, including avoidance and optimization, we review recent research on the utilization of hot slags. Because of the high-temperature property (1450-1650°C), the utilization of hot slags are much different from that of other wastes. We approach this issue from two main directions, namely, material recycling and heat utilization. From the respect of material recycling, the utilization of slags mainly follows total utilization and partial utilization, whereas the heat recovery from slags follows two main paths, namely, physical granulation and chemical reaction. The effective disposal of hot slags greatly depends on clarifying the crystallization behaviors, and thus, we discuss some optical techniques and their applicable scientific insights. For the purpose of crystallization avoidance, characterizing the glass-forming ability of slags is of great significance, whereas for crystallization modification, the selection of chemical additives and control of crystallization conditions comprise the central routes.

Working on the Work Framework for Engagement: Impacting Students' Perceived Learning, Attitudes toward School, and Achievement

ERIC Educational Resources Information Center

Forehand, Michael Joshua

2014-01-01

A quasi-experimental, pre-test post-test nonequivalent control group study was utilized to determine the difference in students' perceived learning, attitudes toward school, and achievement when participating in classes utilizing engagement design qualities as compared to students in classes not utilizing engagement design qualities. To inform the…

75 FR 45494 - Implementation of Section 224 of the Act; a National Broadband Plan for Our Future

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... attachers make informed decisions and should facilitate the attachment process. If a utility denies an... forward, and whether utilities' decisions regarding the use of boxing and bracketing should also be made... nondiscriminatory access to any pole, duct, conduit, or right-of-way owned or controlled by a utility. However, the...

42 CFR 456.23 - Post-payment review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Post-payment review process. 456.23 Section 456.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: All Medicaid Services § 456...

42 CFR 456.22 - Sample basis evaluation of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 456.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: All Medicaid Services § 456... available services and facilities the Medicaid agency must have procedures for the on-going evaluation, on a...

24 CFR 945.103 - General policies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... will not be housed in a designated project, PHAs shall utilize housing resources that they own, control... utilize, to the extent practicable, any housing facilities that they own or control in which supportive... housing, group homes, and congregate housing. (3) Exemption of mixed population projects. A PHA with a...

24 CFR 945.103 - General policies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... will not be housed in a designated project, PHAs shall utilize housing resources that they own, control... utilize, to the extent practicable, any housing facilities that they own or control in which supportive... housing, group homes, and congregate housing. (3) Exemption of mixed population projects. A PHA with a...

24 CFR 945.103 - General policies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... will not be housed in a designated project, PHAs shall utilize housing resources that they own, control... utilize, to the extent practicable, any housing facilities that they own or control in which supportive... housing, group homes, and congregate housing. (3) Exemption of mixed population projects. A PHA with a...

24 CFR 945.103 - General policies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... will not be housed in a designated project, PHAs shall utilize housing resources that they own, control... utilize, to the extent practicable, any housing facilities that they own or control in which supportive... housing, group homes, and congregate housing. (3) Exemption of mixed population projects. A PHA with a...

24 CFR 945.103 - General policies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... will not be housed in a designated project, PHAs shall utilize housing resources that they own, control... utilize, to the extent practicable, any housing facilities that they own or control in which supportive... housing, group homes, and congregate housing. (3) Exemption of mixed population projects. A PHA with a...

42 CFR 456.350 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Scope. 456.350 Section 456.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.350 Scope. This subpart prescribes requirements for...

42 CFR 456.350 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Scope. 456.350 Section 456.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.350 Scope. This subpart prescribes requirements for...

42 CFR 456.350 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Scope. 456.350 Section 456.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.350 Scope. This subpart prescribes requirements for...

42 CFR 456.350 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Scope. 456.350 Section 456.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.350 Scope. This subpart prescribes requirements for...

42 CFR 456.350 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Scope. 456.350 Section 456.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.350 Scope. This subpart prescribes requirements for...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before...) Activities; (v) Therapies; (vi) Social services; (vii) Diet; and (viii) Special procedures designed to meet...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before...) Activities; (v) Therapies; (vi) Social services; (vii) Diet; and (viii) Special procedures designed to meet...

42 CFR 456.243 - Content of medical care evaluation studies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Content of medical care evaluation studies. 456.243 Section 456.243 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

Final Technical Report: Commercial Advanced Lighting Control (ALC) Demonstration and Deployment

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

Arnold, Gabe

This three-year demonstration and deployment project sought to address market barriers to accelerating the adoption of Advanced Lighting Controls (ALCs), an underutilized technology with low market penetration. ALCs are defined as networked, addressable lighting control systems that utilize software or intelligent controllers to combine multiple energy-saving lighting control strategies in a single space (e.g., smart-time scheduling, daylight harvesting, task tuning, occupancy control, personal control, variable load-shedding, and plug-load control). The networked intelligent aspect of these systems allows applicable lighting control strategies to be combined in a single space, layered over one another, maximizing overall energy-savings. The project included five realmore » building demonstrations of ALCs across the Northeast US region. The demonstrations provided valuable data and experience to support deployment tasks that are necessary to overcome market barriers. These deployment tasks included development of training resources for building designers, installers, and trades, as well as development of new energy efficiency rebates for the technology from Efficiency Forward’s utility partners. Educating designers, installers, and trades on ALCs is a critical task for reducing the cost of the technology that is currently inflated due to perceived complexity and unfamiliarity with how to design and install the systems. Further, utility and non-utility energy efficiency programs continue to relegate the technology to custom or ill-suited prescriptive program designs that do not effectively deploy the technology at scale. This project developed new, scalable rebate approaches for the technology. Efficiency Forward utilized their DesignLights Consortium® (DLC) brand and network of 81 DLC member utilities to develop and deploy the results of the project. The outputs of the project have included five published case studies, a six-hour ALC technology training curriculum that has already been deployed in five US states, and new rebates offered for the technology that have been deployed by a dozen utilities across the US. Widespread adoption of ALC technology in commercial buildings would provide tremendous benefits. The current market penetration of ALC systems is estimated at <0.1% in commercial buildings. If ALC systems were installed in all commercial buildings, approximately 1,051 TBtu of energy could be saved. This would translate into customer cost savings of approximately $10.7 billion annually.« less

The estimated reduction in the odds of loss-of-control type crashes for sport utility vehicles equipped with electronic stability control.

PubMed

Green, Paul E; Woodrooffe, John

2006-01-01

Using data from the NASS General Estimates System (GES), the method of induced exposure was used to assess the effects of electronic stability control (ESC) on loss-of-control type crashes for sport utility vehicles. Sport utility vehicles were classified into crash types generally associated with loss of control and crash types most likely not associated with loss of control. Vehicles were then compared as to whether ESC technology was present or absent in the vehicles. A generalized additive model was fit to assess the effects of ESC, driver age, and driver gender on the odds of loss of control. In addition, the effects of ESC on roads that were not dry were compared to effects on roads that were dry. Overall, the estimated percentage reduction in the odds of a loss-of-control crash for sport utility vehicles equipped with ESC was 70.3%. Both genders and all age groups showed reduced odds of loss-of-control crashes, but there was no significant difference between males and females. With respect to driver age, the maximum percentage reduction of 73.6% occurred at age 27. The positive effects of ESC on roads that were not dry were significantly greater than on roads that were dry.

42 CFR 456.505 - Applicability of waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.505 Applicability of...

42 CFR 456.521 - Conditions for granting variance requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.525 - Request for renewal of variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.525 - Request for renewal of variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care... evaluation studies in the mental hospital; (2) Documents for each study— (i) Its results; and (ii) How the...

42 CFR 456.171 - Medicaid agency review of need for admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.171 Section 456.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...; (2) In an ICF that cares primarily for mental patients, at least one individual knowledgeable in the...

42 CFR 456.181 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Reports of evaluations and plans of care. 456.181 Section 456.181 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.160 - Certification and recertification of need for inpatient care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Certification of Need for Care § 456.160 Certification and recertification of... recipient that inpatient services in a mental hospital are or were needed. (2) The certification must be...

42 CFR 456.438 - Time limits for notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for notification of adverse decision... AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Review of Need for Continued Stay § 456.438 Time limits for notification...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs... and a reasonable amount of time to respond to a request for information about a claim, and if the...

42 CFR 456.438 - Time limits for notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for notification of adverse decision... AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Review of Need for Continued Stay § 456.438 Time limits for notification...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

42 CFR 456.80 - Individual written plan of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Individual written plan of care. 456.80 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Plan of Care § 456.80 Individual written plan of care. (a) Before admission to a hospital or before authorization for...

Hurricane exposure and county fetal death rates, utilization of a county environmental quality index for confounding control.

EPA Science Inventory

The effects of natural disasters on public health are a rising concern, with increasing severity of disaster events. Many disaster studies utilize county-level analysis, however most do not control for county level environmental factors. Hurricane exposure during pregnancy could ...

PRELIMINARY PERFORMANCE AND COST ESTIMATES OF MERCURY EMISSION CONTROL OPTIONS FOR ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper discusses preliminary performance and cost estimates of mercury emission control options for electric utility boilers. Under the Clean Air Act Amendments of 1990, EPA had to determine whether mercury emissions from coal-fired power plants should be regulated. To a...

Relative utility of arrhenotokous and Wolbachia-associated thelytokous Odontosema anastrephae figitid fruit fly parasitoids for mass rearing and biological control

USDA-ARS?s Scientific Manuscript database

Thelytokous parasitoid strains are theoretically advantageous when utilized for biological control, as the absence of males should reduce production costs and potentially increase field efficacy. The maternally inherited intracellular bacterium, Wolbachia pipientis, is capable of inducing reproducti...

42 CFR 456.651 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Definitions. 456.651 Section 456.651 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Penalty for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Progra...

42 CFR 456.351 - Definition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Definition. 456.351 Section 456.351 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.351 Definition. As used in this subpart: Intermediat...

42 CFR 456.651 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Definitions. 456.651 Section 456.651 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Penalty for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Progra...

42 CFR 456.351 - Definition.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Definition. 456.351 Section 456.351 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities § 456.351 Definition. As used in this subpart: Intermediat...

42 CFR 456.651 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Definitions. 456.651 Section 456.651 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Penalty for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Progra...

42 CFR 456.651 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Definitions. 456.651 Section 456.651 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Penalty for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Progra...

42 CFR 456.651 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Definitions. 456.651 Section 456.651 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Penalty for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Progra...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before... designed to meet the objectives of the plan of care; (5) Plans for continuing care, including review and...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before... designed to meet the objectives of the plan of care; (5) Plans for continuing care, including review and...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before... designed to meet the objectives of the plan of care; (5) Plans for continuing care, including review and...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2014 CFR

2014-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

42 CFR 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.

Code of Federal Regulations, 2014 CFR

2014-10-01

...; disqualification from UR committee membership. 456.206 Section 456.206 Public Health CENTERS FOR MEDICARE... UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Administrative Requirements § 456.206... the diagnosis and treatment of mental diseases, and assisted by other professional personnel. (c) The...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2012 CFR

2012-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

42 CFR 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; disqualification from UR committee membership. 456.206 Section 456.206 Public Health CENTERS FOR MEDICARE... UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Administrative Requirements § 456.206... the diagnosis and treatment of mental diseases, and assisted by other professional personnel. (c) The...

42 CFR 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.

Code of Federal Regulations, 2012 CFR

2012-10-01

...; disqualification from UR committee membership. 456.206 Section 456.206 Public Health CENTERS FOR MEDICARE... UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Administrative Requirements § 456.206... the diagnosis and treatment of mental diseases, and assisted by other professional personnel. (c) The...

42 CFR 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.

Code of Federal Regulations, 2013 CFR

2013-10-01

...; disqualification from UR committee membership. 456.206 Section 456.206 Public Health CENTERS FOR MEDICARE... UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Administrative Requirements § 456.206... the diagnosis and treatment of mental diseases, and assisted by other professional personnel. (c) The...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2013 CFR

2013-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

TEST DESIGN FOR ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) OF ADD-ON NOX CONTROL UTILIZING OZONE INJECTION

EPA Science Inventory

The paper discusses the test design for environmental technology verification (ETV) of add-0n nitrogen oxides (NOx) control utilizing ozone injection. (NOTE: ETV is an EPA-established program to enhance domestic and international market acceptance of new or improved commercially...

77 FR 34003 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... performance of the functions of the agency, including whether the information will have practical utility; (b..., Office of Information and Regulatory Affairs, Office of Management and Budget (OMB), [email protected] Utilities Service Title: Advance of Loan Funds and Budgetary Control and Related Burdens. OMB Control Number...

42 CFR 476.93 - Opportunity to discuss proposed initial denial determination and changes as a result of a DRG...

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.93 Opportunity to discuss proposed...

42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality... information on charges) that are pertinent to health care services furnished to Medicare beneficiaries and are...

42 CFR 476.96 - Review period and reopening of initial denial determinations and changes as a result of DRG...

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.96 Review period and reopening of...

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.85 Conclusive effect of QIO initial...

Cost-utility analysis of an adjunctive recombinant activated factor VIIa for on-demand treatment of bleeding episodes in dengue haemorrhagic fever.

PubMed

Naing, Cho; Poovorawan, Yong; Mak, Joon Wah; Aung, Kyan; Kamolratankul, Pirom

2015-06-01

The present study aimed to assess the cost-utility analysis of using an adjunctive recombinant activated factor VIIa (rFVIIa) in children for controlling life-threatening bleeding in dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS). We constructed a decision-tree model, comparing a standard care and the use of an additional adjuvant rFVIIa for controlling life-threatening bleeding in children with DHF/DSS. Cost and utility benefit were estimated from the societal perspective. The outcome measure was cost per quality-adjusted life years (QALYs). Overall, treatment with adjuvant rFVIIa gained QALYs, but the total cost was higher. The incremental cost-utility ratio for the introduction of adjuvant rFVIIa was $4241.27 per additional QALY. Sensitivity analyses showed the utility value assigned for calculation of QALY was the most sensitive parameter. We concluded that despite high cost, there is a role for rFVIIa in the treatment of life-threatening bleeding in patients with DHF/DSS.

Dedicated operating room for emergency surgery generates more utilization, less overtime, and less cancellations.

PubMed

van Veen-Berkx, Elizabeth; Elkhuizen, Sylvia G; Kuijper, Bart; Kazemier, Geert

2016-01-01

Two approaches prevail for reserving operating room (OR) capacity for emergency surgery: (1) dedicated emergency ORs and (2) evenly allocating capacity to all elective ORs, thereby creating a virtual emergency team. Previous studies contradict which approach leads to the best performance in OR utilization. Quasi-experimental controlled time-series design with empirical data from 3 university medical centers. Four different time periods were compared with analysis of variance with contrasts. Performance was measured based on 467,522 surgical cases. After closing the dedicated emergency OR, utilization slightly increased; overtime also increased. This was in contrast to earlier simulated results. The 2 control centers, maintaining a dedicated emergency OR, showed a higher increase in utilization and a decrease in overtime, along with a smaller ratio of case cancellations because of emergency surgery. This study shows that in daily practice a dedicated emergency OR is the preferred approach in performance terms regarding utilization, overtime, and case cancellations. Copyright © 2016 Elsevier Inc. All rights reserved.

Differences in carbon source utilization of Salmonella Oranienburg and Saintpaul isolated from river water.

PubMed

Medrano-Félix, Andrés; Estrada-Acosta, Mitzi; Peraza-Garay, Felipe; Castro-Del Campo, Nohelia; Martínez-Urtaza, Jaime; Chaidez, Cristóbal

2017-08-01

Long-term exposure to river water by non-indigenous micro-organisms such as Salmonella may affect metabolic adaptation to carbon sources. This study was conducted to determine differences in carbon source utilization of Salmonella Oranienburg and Salmonella Saintpaul (isolated from tropical river water) as well as the control strain Salmonella Typhimurium exposed to laboratory, river water, and host cells (Hep-2 cell line) growth conditions. Results showed that Salmonella Oranienburg and Salmonella Saintpaul showed better ability for carbon source utilization under the three growth conditions evaluated; however, S. Oranienburg showed the fastest and highest utilization on different carbon sources, including D-Glucosaminic acid, N-acetyl-D-Glucosamine, Glucose-1-phosphate, and D-Galactonic acid, while Salmonella Saintpaul and S. Typhimurium showed a limited utilization of carbon sources. In conclusion, this study suggests that environmental Salmonella strains show better survival and preconditioning abilities to external environments than the control strain based on their plasticity on diverse carbon sources use.

42 CFR 456.508 - Withdrawal of waiver.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and..., 1978, as amended at 61 FR 38399, July 24, 1996] UR Plan: Remote Facility Variances from Time...

Thermal Control of the Scientific Instrument Package in the Large Space Telescope

NASA Technical Reports Server (NTRS)

Hawks, K. H.

1972-01-01

The general thermal control system philosophy was to utilize passive control where feasible and to utilize active methods only where required for more accurate thermal control of the SIP components with narrow temperature tolerances. A thermal model of the SIP and a concept for cooling the SIP cameras are presented. The model and cooling concept have established a rationale for determining a Phase A baseline for SIP thermal control.

Wind and turbine characteristics needed for integration of wind turbine arrays into a utility system

NASA Technical Reports Server (NTRS)

Park, G. L.

1982-01-01

Wind data and wind turbine generator (WTG) performance characteristics are often available in a form inconvenient for use by utility planners and engineers. The steps used by utility planners are summarized and the type of wind and WTG data needed for integration of WTG arrays suggested. These included long term yearly velocity averages for preliminary site feasibility, hourly velocities on a 'wind season' basis for more detailed economic analysis and for reliability studies, worst-case velocity profiles for gusts, and various minute-to-hourly velocity profiles for estimating the effect of longer-term wind fluctuations on utility operations. wind turbine data needed includes electrical properties of the generator, startup and shutdown characteristics, protection characteristics, pitch control response and control strategy, and electro-mechanical model for stability analysis.

The Utility of Case-Control Methods for Health Policy and Planning Analysis: An Illustration from Kinshasa, Zaire.

ERIC Educational Resources Information Center

Mock, Nancy B.; And Others

1993-01-01

The use of case-control methodology as an applied policy/planning research tool in assessing the potential effectiveness of behavioral interventions is studied in connection with diarrhea control in Zaire. Results with 107 matched pairs of children demonstrate the importance of hygiene-related knowledge and the utility of the research approach.…

Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

PubMed

Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

2013-08-23

Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management. A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed. Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management. VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are providing only malaria control services. This underlines the importance of scaling-up VMWs' capacity by adding child health services of good quality, which will result in improving child health status in remote Cambodia.

Disaster and subsequent healthcare utilization: a longitudinal study among victims, their family members, and control subjects.

PubMed

Dorn, Tina; Yzermans, C Joris; Kerssens, Jan J; Spreeuwenberg, Peter M M; van der Zee, Jouke

2006-06-01

The impact of disasters on primary healthcare utilization is largely unknown. Moreover, it is often overlooked how disaster affects those closest to the primary victims, their family members. The objective of this study was to examine the long-term effects of a catastrophic fire on primary healthcare utilization. We conducted a prospective, population-based cohort study covering 1 year pre- and 3 years postfire. Utilization data were extracted from primary care records. Subjects consisted of 286 disaster victims, 802 family members of disaster victims, 3722 community control subjects, and 10,230 patients from a national reference population. As outcome measures, we studied 1) the annual number of contacts in primary care and 2) the annual number of contacts for problems related to mental health. Determinants are injury characteristics of victims and bereavement. All analyses control for age, gender, and insurance status. Being an uninjured victim who witnessed the disaster increases the number of contacts by a factor of 1.55 during the first year postfire (95% confidence interval [CI], 1.35-1.78). Uninjured victims contact the family practitioner more often for mental health-related problems than adolescent community control subjects (incidence rate ratio [IRR], 4.54; 95% CI, 1.69-12.20). In adult family members, the loss of a child predicts overall utilization (IRR, 1.88; 95% CI, 1.35-2.63) and utilization for mental health (IRR, 8.69; 95% CI, 2.10-35.92) during the first year postfire. Attention should be paid to the primary care needs of bereaved individuals and those who have witnessed the disaster.

Valuation of pemphigus vulgaris and pemphigus foliaceus health states: a convenience sample experiment.

PubMed

Rencz, F; Brodszky, V; Stalmeier, P F M; Tamási, B; Kárpáti, S; Péntek, M; Baji, P; Mitev, A Z; Gulácsi, L

2016-09-01

Health-related quality of life (HRQoL) in pemphigus has been widely investigated; nevertheless, utility values for economic evaluations are still lacking. To estimate health utilities for hypothetical pemphigus vulgaris (PV) and pemphigus foliaceus (PF) health states in a general population sample. Three health states (uncontrolled PV, uncontrolled PF and controlled pemphigus) were developed based on a systematic literature review of HRQoL studies in pemphigus. Utilities were obtained from a convenience sample of 108 adults using a visual analogue scale (VAS) and 10-year time trade-off (TTO). Lead-time TTO was applied for health states regarded as worse than dead with a lead time to disease time ratio of 1 : 1. The mean VAS utility scores for PV, PF and controlled pemphigus were 0·25 ± 0·15, 0·37 ± 0·17 and 0·63 ± 0·16, respectively. Corresponding TTO utilities were as follows: 0·34 ± 0·38, 0·51 ± 0·32 and 0·75 ± 0·31. Overall, 14% and 6% judged PV and PF as being worse than dead. For both VAS and TTO values, significant differences were observed between all health states (P < 0·001). VAS utilities were rated significantly lower compared with TTO in each health state (P < 0·001). This is the first study that reports health utility values for PV and PF. Successful treatment of pemphigus might result in significant utility gain (0·24-0·41). These empirical findings with respect to three health states in pemphigus may serve as anchor points for further utility studies and cost-effectiveness analyses. © 2016 British Association of Dermatologists.

Economic evaluations and their use in infection prevention and control: a narrative review.

PubMed

Rennert-May, Elissa; Conly, John; Leal, Jenine; Smith, Stephanie; Manns, Braden

2018-01-01

The objective of this review is to provide a comprehensive overview of the different types of economic evaluations that can be utilized by Infection Prevention and Control practitioners with a particular focus on the use of the quality adjusted life year, and its associated challenges. We also highlight existing economic evaluations published within Infection Prevention and Control, research gaps and future directions. Narrative Review. To date the majority of economic evaluations within Infection Prevention and Control are considered partial economic evaluations. Acknowledging the challenges, which include variable utilities within infection prevention and control, a lack of randomized controlled trials, and difficulty in modelling infectious diseases in general, future economic evaluation studies should strive to be consistent with published guidelines for economic evaluations. This includes the use of quality adjusted life years. Further research is required to estimate utility scores of relevance within Infection Prevention and Control.

Optimal control of LQG problem with an explicit trade-off between mean and variance

NASA Astrophysics Data System (ADS)

Qian, Fucai; Xie, Guo; Liu, Ding; Xie, Wenfang

2011-12-01

For discrete-time linear-quadratic Gaussian (LQG) control problems, a utility function on the expectation and the variance of the conventional performance index is considered. The utility function is viewed as an overall objective of the system and can perform the optimal trade-off between the mean and the variance of performance index. The nonlinear utility function is first converted into an auxiliary parameters optimisation problem about the expectation and the variance. Then an optimal closed-loop feedback controller for the nonseparable mean-variance minimisation problem is designed by nonlinear mathematical programming. Finally, simulation results are given to verify the algorithm's effectiveness obtained in this article.

The MIST /MIUS Integration and Subsystems Test/ laboratory - A testbed for the MIUS /Modular Integrated Utility System/ program

NASA Technical Reports Server (NTRS)

Beckham, W. S., Jr.; Keune, F. A.

1974-01-01

The MIUS (Modular Integrated Utility System) concept is to be an energy-conserving, economically feasible, integrated community utility system to provide five necessary services: electricity generation, space heating and air conditioning, solid waste processing, liquid waste processing, and residential water purification. The MIST (MIUS Integration and Subsystem Test) integrated system testbed constructed at the Johnson Space Center in Houston includes subsystems for power generation, heating, ventilation, and air conditioning (HVAC), wastewater management, solid waste management, and control and monitoring. The key design issues under study include thermal integration and distribution techniques, thermal storage, integration of subsystems controls and displays, incinerator performance, effluent characteristics, and odor control.

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.

Study of urban spatial utilization on socio-cultural and environment based on sustainability index (study in Denpasar city)

NASA Astrophysics Data System (ADS)

Wiryananda, N. G. A. K.; Hasibuan, H. S.; Madiasworo, T.

2018-03-01

The rapid development of tourism and population growth in Denpasar City stimulated the dynamic changes in the spatial utilization. This study aims to analyse the impact of spatial utilization on sociocultural and environment and formulate the sustainable spatial utilization that accommodate both social and environmental aspects. This research uses methods of spatial analysis and sustainability index. The results showed that during the period of 2011 to 2015 there was an increase of settlement and tourism land uses, meanwhile at the same period the paddy field decreased. The impact of spatial utilization on sociocultural leads to unsustainable, that showed by the decreasing of the sociocultural index from 1.038 in 2011 to 1.036 in 2015. The low of sociocultural index was stated by the increasing poverty, the obedience of traditional rules of purity radius of Temple and the height limit of the building. The impact of spatial utilization on environmental leads to unsustainable, with the environmental index of 1.065 in 2011 decreased to 1.056 in 2015. The decline of environmental index is due to reduced green open space and paddy field. The strategy formulation of sustainable spatial utilization is done by integrating traditional rules into spatial planning, plan the vertical building, strengthening implementation of traditional rules, implementation of perennial paddy field, and the establishment of traditional task control unit of spatial control.

Utility and direct costs: ankylosing spondylitis compared with rheumatoid arthritis.

PubMed

Verstappen, S M M; Jacobs, J W G; van der Heijde, D M; van der Linden, Sj; Verhoef, C M; Bijlsma, J W J; Boonen, A

2007-06-01

To compare utility and disease-specific direct costs between patients with ankylosing spondylitis (AS) and patients with rheumatoid arthritis (RA) in the Netherlands. Patients with AS and those with RA completed questions on disease characteristics, the EuroQol-5D (EQ-5D) to assess utility, and questionnaire resource utilisation. Resource utilisation was assessed prospectively in AS, but retrospectively in RA. True cost estimates (2003) were used to calculate the costs. Differences in disease characteristics between AS and RA were described, and determinants of EQ-5D utility and costs were explored by Cox proportional hazard regressions. 576 patients with RA and 132 with AS completed the questionnaires. EQ-5D utility (0.63 vs 0.7) was lower, and annual direct costs higher in RA (euro5167 vs euro2574). In multivariate Cox proportional hazard regressions, there was no difference in utility between the diagnostic groups, but patients with RA incurred higher direct costs after controlling for age, gender and disease duration. In patients with RA and patients with AS, who are under the care of a rheumatologist, utility is equally reduced, but healthcare costs are higher in RA after controlling for age, gender and disease duration. These data can be helpful to provide insights into the differences and similarities between the healthcare needs of both patient groups and to identify issues for further research and for policy in healthcare organisations.

Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis

PubMed Central

Higa, Janelle; Trentacosta, Christopher J.; Herschell, Amy D.; Kolko, David J.

2013-01-01

We review 85 empirical articles published since 2000 that measured the acquisition and/or utilization of parent management skills and/or child cognitive-behavioral skills in the context of an evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there are no standardized measures of skill acquisition or skill utilization that are used across treatments, (2) little is known about predictors, correlates, or outcomes associated with skill acquisition and utilization, and (3) few studies systematically examined techniques to enhance the acquisition and utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed an overall treatment–control ES =.31, p < .01 for skill acquisition and ES =.20, p = ns for skill utilization. We recommend that future research focus on the following three areas: (1) development of standardized measures of skill acquisition and utilization from a “common elements” perspective that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated with skill acquisition and utilization; and (3) development of innovative interventions to enhance the acquisition and utilization of cognitive-behavioral and parent management skills. PMID:23649324

Optimal Wonderful Life Utility Functions in Multi-Agent Systems

NASA Technical Reports Server (NTRS)

Wolpert, David H.; Tumer, Kagan; Swanson, Keith (Technical Monitor)

2000-01-01

The mathematics of Collective Intelligence (COINs) is concerned with the design of multi-agent systems so as to optimize an overall global utility function when those systems lack centralized communication and control. Typically in COINs each agent runs a distinct Reinforcement Learning (RL) algorithm, so that much of the design problem reduces to how best to initialize/update each agent's private utility function, as far as the ensuing value of the global utility is concerned. Traditional team game solutions to this problem assign to each agent the global utility as its private utility function. In previous work we used the COIN framework to derive the alternative Wonderful Life Utility (WLU), and experimentally established that having the agents use it induces global utility performance up to orders of magnitude superior to that induced by use of the team game utility. The WLU has a free parameter (the clamping parameter) which we simply set to zero in that previous work. Here we derive the optimal value of the clamping parameter, and demonstrate experimentally that using that optimal value can result in significantly improved performance over that of clamping to zero, over and above the improvement beyond traditional approaches.

Understanding Service Utilization Disparities and Depression in Latinos: The Role of Fatalismo.

PubMed

Anastasia, Elizabeth A; Bridges, Ana J

2015-12-01

Research demonstrates a disparity between need and utilization of mental health services for Latinos. Cultural variations in perceptions of mental illness may be partially responsible for this discrepancy. Past research with Latinos has shown links between fatalismo, a cultural value similar to external locus of control, and both depression and lower service utilization in medical care, while links to psychiatric care have not been investigated. The current study therefore aimed to explore the associations between fatalismo, depression, and past year mental health service utilization by Latinos. A community sample of 83 Latino adults were recruited during local cultural events. Participants completed self-report measures of depression, fatalism, and past year service utilization. Analyses using structural equation modeling showed fatalismo was directly negatively related to past year medical service utilization (β = -.35). In contrast, the link between fatalismo and past year mental health service utilization was mediated by self-reported depressive symptoms (indirect β = .19, p < .001). We conclude that while fatalismo is associated with depression in Latinos, other barriers likely serve as more salient deterrents of service utilization.

42 CFR 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.

Code of Federal Regulations, 2010 CFR

2010-10-01

... UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Administrative Requirements § 456.206... the diagnosis and treatment of mental diseases, and assisted by other professional personnel. (c) The UR committee must be constituted as— (1) A committee of the mental hospital staff; (2) A group...

42 CFR 456.126 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.126 Time limits for final... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for final decision and notification of...

42 CFR 456.137 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Continued Stay § 456.137 Time limits for final... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for final decision and notification of...

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.238 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Review of Need for Continued Stay § 456.238 Time limits for... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for final decision and notification of...

42 CFR 456.137 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Continued Stay § 456.137 Time limits for final... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for final decision and notification of...

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.126 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.126 Time limits for final... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for final decision and notification of...

42 CFR 476.94 - Notice of QIO initial denial determination and changes as a result of a DRG validation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality... validation; (2) For day outliers in hospitals, the date on which the stay or services in the facility will...

Network efficient power control for wireless communication systems.

PubMed

Campos-Delgado, Daniel U; Luna-Rivera, Jose Martin; Martinez-Sánchez, C J; Gutierrez, Carlos A; Tecpanecatl-Xihuitl, J L

2014-01-01

We introduce a two-loop power control that allows an efficient use of the overall power resources for commercial wireless networks based on cross-layer optimization. This approach maximizes the network's utility in the outer-loop as a function of the averaged signal to interference-plus-noise ratio (SINR) by considering adaptively the changes in the network characteristics. For this purpose, the concavity property of the utility function was verified with respect to the SINR, and an iterative search was proposed with guaranteed convergence. In addition, the outer-loop is in charge of selecting the detector that minimizes the overall power consumption (transmission and detection). Next the inner-loop implements a feedback power control in order to achieve the optimal SINR in the transmissions despite channel variations and roundtrip delays. In our proposal, the utility maximization process and detector selection and feedback power control are decoupled problems, and as a result, these strategies are implemented at two different time scales in the two-loop framework. Simulation results show that substantial utility gains may be achieved by improving the power management in the wireless network.

Enhanced cued recall has a high utility as a screening test in the diagnosis of Alzheimer's disease and mild cognitive impairment in Turkish people.

PubMed

Saka, Esen; Mihci, Ebru; Topcuoglu, M Akif; Balkan, Sevin

2006-10-01

Enhanced cued recall (ECR) is highly sensitive and specific in discrimination of demented from non-demented elderly persons. The nature of the test promises that it can be applicable to subjects in different cultures and education level. We studied the utility of the test in a Turkish population. Eighty consecutive cases with dementia or mild cognitive impairment (MCI) and 33 elderly controls were studied. The utility of ECR was high in discriminating dementia from controls (area under curve (AUC)) of the ROC curve: 0.907 (95% confidence interval (CI): 0.830-0.953 for total recall), Alzheimer's disease from controls (AUC: 0.990 (95%CI: 0.934-0.998 for total recall)) and moderate (AUC: 0.625 (95%CI: 0.545-0.812 for third free recall)) in discriminating MCI from controls. Education did not affect the utility of the test. We conclude that ECR is a valuable test in assessment of elderly Turkish patients with a complaint of memory impairment.

Network Efficient Power Control for Wireless Communication Systems

PubMed Central

Campos-Delgado, Daniel U.; Luna-Rivera, Jose Martin; Martinez-Sánchez, C. J.; Gutierrez, Carlos A.; Tecpanecatl-Xihuitl, J. L.

2014-01-01

We introduce a two-loop power control that allows an efficient use of the overall power resources for commercial wireless networks based on cross-layer optimization. This approach maximizes the network's utility in the outer-loop as a function of the averaged signal to interference-plus-noise ratio (SINR) by considering adaptively the changes in the network characteristics. For this purpose, the concavity property of the utility function was verified with respect to the SINR, and an iterative search was proposed with guaranteed convergence. In addition, the outer-loop is in charge of selecting the detector that minimizes the overall power consumption (transmission and detection). Next the inner-loop implements a feedback power control in order to achieve the optimal SINR in the transmissions despite channel variations and roundtrip delays. In our proposal, the utility maximization process and detector selection and feedback power control are decoupled problems, and as a result, these strategies are implemented at two different time scales in the two-loop framework. Simulation results show that substantial utility gains may be achieved by improving the power management in the wireless network. PMID:24683350

Method for determining how to operate and control wind turbine arrays in utility systems

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

Javid, S.H.; Hauth, R.L.; Younkins, T.D.

1984-01-01

A method for determining how utility wind turbine arrays should be controlled and operated on the load frequency control time-scale is presented. Initial considerations for setting wind turbine control requirements are followed by a description of open loop operation and of closed loop and feed forward wind turbine array control concepts. The impact of variations in array output on meeting minimum criteria are developed. The method for determining the required control functions is then presented and results are tabulated. (LEW)

42 CFR 456.507 - Review and granting of waiver requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.507 Review and...

42 CFR 456.524 - Notification of Administrator's action and duration of variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote...

High voltage DC switchgear development for multi-kW space power system: Aerospace technology development of three types of solid state power controllers for 200-1100VDC with current ratings of 25, 50, and 80 amperes with one type utilizing an electromechanical device

NASA Technical Reports Server (NTRS)

Billings, W. W.

1981-01-01

Three types of solid state power controllers (SSPC's) for high voltage, high power DC system applications were developed. The first type utilizes a SCR power switch. The second type employes an electromechanical power switch element with solid state commutation. The third type utilizes a transistor power switch. Significant accomplishments include high operating efficiencies, fault clearing, high/low temperature performance and vacuum operation.

Robust Coordination for Large Sets of Simple Rovers

NASA Technical Reports Server (NTRS)

Tumer, Kagan; Agogino, Adrian

2006-01-01

The ability to coordinate sets of rovers in an unknown environment is critical to the long-term success of many of NASA;s exploration missions. Such coordination policies must have the ability to adapt in unmodeled or partially modeled domains and must be robust against environmental noise and rover failures. In addition such coordination policies must accommodate a large number of rovers, without excessive and burdensome hand-tuning. In this paper we present a distributed coordination method that addresses these issues in the domain of controlling a set of simple rovers. The application of these methods allows reliable and efficient robotic exploration in dangerous, dynamic, and previously unexplored domains. Most control policies for space missions are directly programmed by engineers or created through the use of planning tools, and are appropriate for single rover missions or missions requiring the coordination of a small number of rovers. Such methods typically require significant amounts of domain knowledge, and are difficult to scale to large numbers of rovers. The method described in this article aims to address cases where a large number of rovers need to coordinate to solve a complex time dependent problem in a noisy environment. In this approach, each rover decomposes a global utility, representing the overall goal of the system, into rover-specific utilities that properly assign credit to the rover s actions. Each rover then has the responsibility to create a control policy that maximizes its own rover-specific utility. We show a method of creating rover-utilities that are "aligned" with the global utility, such that when the rovers maximize their own utility, they also maximize the global utility. In addition we show that our method creates rover-utilities that allow the rovers to create their control policies quickly and reliably. Our distributed learning method allows large sets rovers be used unmodeled domains, while providing robustness against rover failures and changing environments. In experimental simulations we show that our method scales well with large numbers of rovers in addition to being robust against noisy sensor inputs and noisy servo control. The results show that our method is able to scale to large numbers of rovers and achieves up to 400% performance improvement over standard machine learning methods.

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.

Design and evaluation of an optical fine-pointing control system for telescopes utilizing a digital star sensor

NASA Technical Reports Server (NTRS)

Ostroff, A. J.; Romanczyk, K. C.

1973-01-01

One of the most significant problems associated with the development of large orbiting astronomical telescopes is that of maintaining the very precise pointing accuracy required. A proposed solution to this problem utilizes dual-level pointing control. The primary control system maintains the telescope structure attitude stabilized within the field of view to the desired accuracy. In order to demonstrate the feasibility of optically stabilizing the star images to the desired accuracy a regulating system has been designed and evaluated. The control system utilizes a digital star sensor and an optical star image motion compensator, both of which have been developed for this application. These components have been analyzed mathematically, analytical models have been developed, and hardware has been built and tested.

Home health care and patterns of subsequent VA and medicare health care utilization for veterans.

PubMed

Van Houtven, Courtney Harold; Jeffreys, Amy S; Coffman, Cynthia J

2008-10-01

The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HHC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched controls. We also consider crossover between the VA and Medicare. This is a retrospective study using propensity score and stratified analysis to control for selection bias on observable characteristics. We examined the full cohort of 2002 VA HHC users (n = 24,169) and a 2:1 sample of age- and race-based nonusers (n = 53,356). Utilization measures included VA and Medicare outpatient, inpatient, nursing home, and hospice use, as well as VA home-based primary care, respite care, and adult day health care. VA HHC users had a higher absolute probability of outpatient use by around 3%, of inpatient use by 12%, and nursing home use by 6% than their propensity-score-matched controls. Veterans who used HHC services had a higher rate of VA service use in the subsequent year than controls did, even after we adjusted for differences in observed health status, eligibility advantages, and supplemental insurance status. High utilization for VA home health users spilled over into high Medicare utilization.

Analysis of medical screening and surveillance in 21 Occupational Safety and Health Administration standards: support for a generic medical surveillance standard.

PubMed

Silverstein, M

1994-09-01

Twenty-one Occupational Safety and Health Act (OSHA) standards were identified which contain medical service provisions intended to help in the identification and control of harmful health effects of workplace exposures. The utility and effectiveness of these provisions have not previously been evaluated. All 21 standards were reviewed and assigned numerical scores for each of 24 potential medical program elements. Several of these elements were combined to calculate Quality Control, Screening Utility, and Surveillance Utility scores for each standard. Total scores varied greatly, suggesting a lack of consistency and uniformity which was even more obvious when the actual regulatory language was examined. The mean Quality score was only 26% of potential points. Seventeen of 21 standards received less than half the total possible Quality score. When arrayed on a two by two matrix only two standards scored above 50% for both Screening and Surveillance Utility. It was concluded that the medical service provisions in OSHA standards are lacking in consistency and coherence. Two major shortcomings are the lack of quality control elements and the absence of surveillance features which would permit medical program results to be utilized for prevention activities including the identification and control of workplace hazards. A generic occupational medical surveillance standard could address these current weaknesses. Elements of such a generic standard are proposed.

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

Utilizing geogebra in financial mathematics problems: didactic experiment in vocational college

NASA Astrophysics Data System (ADS)

Ghozi, Saiful; Yuniarti, Suci

2017-12-01

GeoGebra application offers users to solve real problems in geometry, statistics, and algebra fields. This studydeterminesthe effect of utilizing Geogebra on students understanding skill in the field of financial mathematics. This didactic experiment study used pre-test-post-test control group design. Population of this study were vocational college students in Banking and Finance Program of Balikpapan State Polytechnic. Two classes in the first semester were chosen using cluster random sampling technique, one class as experiment group and one class as control group. Data were analysed used independent sample t-test. The result of data analysis showed that students understanding skill with learning by utilizing GeoGeobra is better than students understanding skill with conventional learning. This result supported that utilizing GeoGebra in learning can assist the students to enhance their ability and depth understanding on mathematics subject.

International Comparison of Water Resources Utilization Efficiency in the Silk Road Economic Belt

NASA Astrophysics Data System (ADS)

Yan, Long; Ma, Jing; Deng, Wei; Wang, Yong

2018-03-01

In order to get knowledge of the standard of water utilization of the Silk Road Economic Belt from international point of view, the paper analyzes the annual variation of water resources utilization in the Silk Road Economic Belt, and compares with other typical countries. The study shows that Water resources utilization efficiency has been greatly improved in recent 20 years and the water consumption per USD 10000 of GDP has been declined 87.97%. the improvement of industrial water consumption efficiency is the key driving factors for substantial decrease in water consumption.The comparison of water utilization and human development shows that the higher HDI the country is, the more efficient water utilization the country has. water consumption per USD 10000 of GDP in country with HDI>0.9 is 194m³, being 8.5% of that in country with HDI from 0.5 to 0.6. On the premise of maintaining the stable economic and social development of the Silk Road Economic Belt, the realization of the control target of total water consumption must depend on the strict control over the disorderly expansion of irrigated area, the change in the mode of economic growth, the implementation of the development strategy for new industrialization and urbanization, vigorous development of the processing industry with low water consumption as well as the high-tech and high value-added industry. Only in this way, the control target of total water consumption can be realized in the process of completing the industrialization task.

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

Plemons, R.E.; Hopwood, W.H. Jr.; Hamilton, J.H.

For a number of years the Oak Ridge Y-12 Plant Laboratory has been analyzing coal predominately for the utilities department of the Y-12 Plant. All laboratory procedures, except a Leco sulfur method which used the Leco Instruction Manual as a reference, were written based on the ASTM coal analyses. Sulfur is analyzed at the present time by two methods, gravimetric and Leco. The laboratory has two major endeavors for monitoring the quality of its coal analyses. (1) A control program by the Plant Statistical Quality Control Department. Quality Control submits one sample for every nine samples submitted by the utilitiesmore » departments and the laboratory analyzes a control sample along with the utilities samples. (2) An exchange program with the DOE Coal Analysis Laboratory in Bruceton, Pennsylvania. The Y-12 Laboratory submits to the DOE Coal Laboratory, on even numbered months, a sample that Y-12 has analyzed. The DOE Coal Laboratory submits, on odd numbered months, one of their analyzed samples to the Y-12 Plant Laboratory to be analyzed. The results of these control and exchange programs are monitored not only by laboratory personnel, but also by Statistical Quality Control personnel who provide statistical evaluations. After analysis and reporting of results, all utilities samples are retained by the laboratory until the coal contracts have been settled. The utilities departments have responsibility for the initiation and preparation of the coal samples. The samples normally received by the laboratory have been ground to 4-mesh, reduced to 0.5-gallon quantities, and sealed in air-tight containers. Sample identification numbers and a Request for Analysis are generated by the utilities departments.« less

Drug utilization and medication costs at the end of life.

PubMed

Pont, Lisa; Jansen, Kristian; Schaufel, Margrete Aase; Haugen, Dagny Faksvåg; Ruths, Sabine

2016-01-01

In the end stages of life, drug treatment goals shift to symptom control and quality of life and as such changes in drug utilization are expected. The aim of this paper is to review the extent to which costs are considered in drug utilization research at the end of life, with a particular focus on the outcome measures being used. This systematic review identified seven studies across varied settings studies reporting both drug utilization and medication cost outcome measures. The main factors identified that impacted medication use and cost were the time period considered and the provision of specialist palliative care services. Combining drug utilization and medication cost outcomes is critical for the allocation of healthcare resources and the development of a sound health policy.

The business case for payer support of a community-based health information exchange: a humana pilot evaluating its effectiveness in cost control for plan members seeking emergency department care.

PubMed

Tzeel, Albert; Lawnicki, Victor; Pemble, Kim R

2011-07-01

As emergency department utilization continues to increase, health plans must limit their cost exposure, which may be driven by duplicate testing and a lack of medical history at the point of care. Based on previous studies, health information exchanges (HIEs) can potentially provide health plans with the ability to address this need. To assess the effectiveness of a community-based HIE in controlling plan costs arising from emergency department care for a health plan's members. Albert Tzeel. The study design was observational, with an eligible population (N = 1482) of fully insured plan members who sought emergency department care on at least 2 occasions during the study period, from December 2008 through March 2010. Cost and utilization data, obtained from member claims, were matched to a list of persons utilizing the emergency department where HIE querying could have occurred. Eligible members underwent propensity score matching to create a test group (N = 326) in which the HIE database was queried in all emergency department visits, and a control group (N = 325) in which the HIE database was not queried in any emergency department visit. Post-propensity matching analysis showed that the test group achieved an average savings of $29 per emergency department visit compared with the control group. Decreased utilization of imaging procedures and diagnostic tests drove this cost-savings. When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decrease. Although many factors can play a role in this finding, it is likely that HIEs obviate unnecessary service utilization through provision of historical medical information regarding specific patients at the point of care.

Effects of supplemental nanoparticle trivalent chromium on the nutrient utilization, growth performance and serum traits of broilers.

PubMed

Lin, Y C; Huang, J T; Li, M Z; Cheng, C Y; Lien, T F

2015-02-01

The aim of this study was to investigate the effect of dietary supplementation of nanoparticle trivalent chromium on nutrient utilization, growth performance and serum traits of broilers. This study included two trials. In trial 1, 32 three-week-old broilers were divided into four groups: the control, chromium chloride (CrCl3), chromium picolinate (CrPic) and nanoparticle chromium picolinate (NanoCrPic). Chromium was added at a 1200 μg/kg level to evaluate the nutrient and chromium utilization. In trial 2, 160 one-day-old broilers were randomly divided into four groups as in trial 1, with four replicates. The results of trial 1 indicated that the chromium utilization is as follows: NanoCrPic > CrPic > CrCl3 and control groups, with significant differences between groups (p < 0.05). Crude fat utilization in CrCl3 group was lower than in that the control group (p < 0.05). The results of trial 2 indicated that feed intake of 4-5 weeks showed better result in the CrCl3 group than that in the CrPic group (p < 0.05). The results of serum traits indicated that the LDL-cholesterol in the NanoCrPic groups was lower than that in the CrPic group (p < 0.05). The NanoCrpic and CrPic groups showed significantly increased serum chromium concentration when compared with the control and CrCl3 groups; the triglyceride level in the CrCl3 group was lower than that in the CrPic group (p < 0.05). This study concluded that compared with CrPic, NanoCrpic supplementation could increase chromium utilization and lower the serum LDL-cholesterol of broilers. Journal of Animal Physiology and Animal Nutrition © 2014 Blackwell Verlag GmbH.

42 CFR 456.160 - Certification and recertification of need for inpatient care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization... made at the time of admission or, if an individual applies for assistance while in a mental hospital...

42 CFR 456.360 - Certification and recertification of need for inpatient care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization... recipient that ICF services are or were needed. (2) The certification must be made at the time of admission...

42 CFR 456.360 - Certification and recertification of need for inpatient care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization... recipient that ICF services are or were needed. (2) The certification must be made at the time of admission...

X-31 post-stall envelope expansion and tactical utility testing

NASA Technical Reports Server (NTRS)

Canter, Dave

1994-01-01

Technical and nontechnical lessons learned from the X-31 aircraft program are described in this viewgraph presentation. The tactical utility of high angle of attack flight and thrust vector control is discussed.

47 CFR 15.103 - Exempted devices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... exclusively as an electronic control or power system utilized by a public utility or in an industrial plant... circuit to convert the signal to the format required (e.g., an integrated circuit for analog to digital...

47 CFR 15.103 - Exempted devices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... exclusively as an electronic control or power system utilized by a public utility or in an industrial plant... circuit to convert the signal to the format required (e.g., an integrated circuit for analog to digital...

47 CFR 15.103 - Exempted devices.

Code of Federal Regulations, 2013 CFR

2013-10-01

... exclusively as an electronic control or power system utilized by a public utility or in an industrial plant... circuit to convert the signal to the format required (e.g., an integrated circuit for analog to digital...

47 CFR 15.103 - Exempted devices.

Code of Federal Regulations, 2014 CFR

2014-10-01

... exclusively as an electronic control or power system utilized by a public utility or in an industrial plant... circuit to convert the signal to the format required (e.g., an integrated circuit for analog to digital...

47 CFR 15.103 - Exempted devices.

Code of Federal Regulations, 2012 CFR

2012-10-01

... exclusively as an electronic control or power system utilized by a public utility or in an industrial plant... circuit to convert the signal to the format required (e.g., an integrated circuit for analog to digital...

Teach It, Don't Preach It: The Differential Effects of Directly-communicated and Self-generated Utility Value Information.

PubMed

Canning, Elizabeth A; Harackiewicz, Judith M

2015-03-01

Social-psychological interventions in education have used a variety of "self-persuasion" or "saying-is-believing" techniques to encourage students to articulate key intervention messages. These techniques are used in combination with more overt strategies, such as the direct communication of messages in order to promote attitude change. However, these different strategies have rarely been systematically compared, particularly in controlled laboratory settings. We focus on one intervention based in expectancy-value theory designed to promote perceptions of utility value in the classroom and test different intervention techniques to promote interest and performance. Across three laboratory studies, we used a mental math learning paradigm in which we varied whether students wrote about utility value for themselves or received different forms of directly-communicated information about the utility value of a novel mental math technique. In Study 1, we examined the difference between directly-communicated and self-generated utility-value information and found that directly-communicated utility-value information undermined performance and interest for individuals who lacked confidence, but that self-generated utility had positive effects. However, Study 2 suggests that these negative effects of directly-communicated utility value can be ameliorated when participants are also given the chance to generate their own examples of utility value, revealing a synergistic effect of directly-communicated and self-generated utility value. In Study 3, we found that individuals who lacked confidence benefited more when everyday examples of utility value were communicated, rather than career and school examples.

Using Confirmatory Factor Analysis to Understand Executive Control in Preschool Children: Sources of Variation in Emergent Mathematic Achievement

ERIC Educational Resources Information Center

Bull, Rebecca; Espy, Kimberly Andrews; Wiebe, Sandra A.; Sheffield, Tiffany D.; Nelson, Jennifer Mize

2011-01-01

Latent variable modeling methods have demonstrated utility for understanding the structure of executive control (EC) across development. These methods are utilized to better characterize the relation between EC and mathematics achievement in the preschool period, and to understand contributing sources of individual variation. Using the sample and…

Systematic Field Study of NO(x) Emission Control Methods for Utility Boilers.

ERIC Educational Resources Information Center

Bartok, William; And Others

A utility boiler field test program was conducted. The objectives were to determine new or improved NO (x) emission factors by fossil fuel type and boiler design, and to assess the scope of applicability of combustion modification techniques for controlling NO (x) emissions from such installations. A statistically designed test program was…

42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Review of the quality of care of risk-basis health... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control...

Implementing Remote Image Capture/Control in a Wireless Sensor Network Utilizing the IEEE 802.15.4 Standard

DTIC Science & Technology

2009-09-01

with the flexibility provided by a wireless sensor network , could provide such enhancements. The objective of this research was to explore the...feasibility of remote management and control of a low-power/low-cost wireless sensor network by implementing a point-to-point wireless network utilizing IEEE

Environmental security control of resource utilization of shale gas' drilling cuttings containing heavy metals.

PubMed

Wang, Chao-Qiang; Lin, Xiao-Yan; Zhang, Chun; Mei, Xu-Dong

2017-09-01

The overall objective of this research project was to investigate the heavy metals environmental security control of resource utilization of shale gas' drilling cuttings. To achieve this objective, we got through theoretical calculation and testing, ultimately and preliminarily determine the content of heavy metals pollutants, and compared with related standards at domestically and abroad. The results indicated that using the second Fike's law, the theoretical model of the release amount of heavy metal can be made, and the groundwater environmental risk as main point compared with soil. This study can play a role of standard guidance on environmental security control of drilling cuttings resource utilization by the exploration and development of shale gas in our country.

Making medical decisions in dependence of genetic background: estimation of the utility of DNA testing in clinical, pharmaco-epidemiological or genetic studies.

PubMed

Nguyen, Thuy Trang; Schäfer, Helmut; Timmesfeld, Nina

2013-05-01

An index measuring the utility of testing a DNA marker before deciding between two alternative treatments is proposed which can be estimated from pharmaco-epidemiological case-control or cohort studies. In the case-control design, external estimates of the prevalence of the disease and of the frequency of the genetic risk variant are required for estimating the utility index. Formulas for point and interval estimates are derived. Empirical coverage probabilities of the confidence intervals were estimated under different scenarios of disease prevalence, prevalence of drug use, and population frequency of the genetic variant. To illustrate our method, we re-analyse pharmaco-epidemiological case-control data on oral contraceptive intake and venous thrombosis in carriers and non-carriers of the factor V Leiden mutation. We also re-analyse cross-sectional data from the Framingham study on a gene-diet interaction between an APOA2 polymorphism and high saturated fat intake on obesity. We conclude that the utility index may be helpful to evaluate and appraise the potential clinical and public health relevance of gene-environment interaction effects detected in genomic and candidate gene association studies and may be a valuable decision support for designing prospective studies on the clinical utility. © 2013 Wiley Periodicals, Inc.

Protecting water and wastewater infrastructure from cyber attacks

NASA Astrophysics Data System (ADS)

Panguluri, Srinivas; Phillips, William; Cusimano, John

2011-12-01

Multiple organizations over the years have collected and analyzed data on cyber attacks and they all agree on one conclusion: cyber attacks are real and can cause significant damages. This paper presents some recent statistics on cyber attacks and resulting damages. Water and wastewater utilities must adopt countermeasures to prevent or minimize the damage in case of such attacks. Many unique challenges are faced by the water and wastewater industry while selecting and implementing security countermeasures; the key challenges are: 1) the increasing interconnection of their business and control system networks, 2) large variation of proprietary industrial control equipment utilized, 3) multitude of cross-sector cyber-security standards, and 4) the differences in the equipment vendor's approaches to meet these security standards. The utilities can meet these challenges by voluntarily selecting and adopting security standards, conducting a gap analysis, performing vulnerability/risk analysis, and undertaking countermeasures that best meets their security and organizational requirements. Utilities should optimally utilize their limited resources to prepare and implement necessary programs that are designed to increase cyber-security over the years. Implementing cyber security does not necessarily have to be expensive, substantial improvements can be accomplished through policy, procedure, training and awareness. Utilities can also get creative and allocate more funding through annual budgets and reduce dependence upon capital improvement programs to achieve improvements in cyber-security.

Optimal Energy Management for a Smart Grid using Resource-Aware Utility Maximization

NASA Astrophysics Data System (ADS)

Abegaz, Brook W.; Mahajan, Satish M.; Negeri, Ebisa O.

2016-06-01

Heterogeneous energy prosumers are aggregated to form a smart grid based energy community managed by a central controller which could maximize their collective energy resource utilization. Using the central controller and distributed energy management systems, various mechanisms that harness the power profile of the energy community are developed for optimal, multi-objective energy management. The proposed mechanisms include resource-aware, multi-variable energy utility maximization objectives, namely: (1) maximizing the net green energy utilization, (2) maximizing the prosumers' level of comfortable, high quality power usage, and (3) maximizing the economic dispatch of energy storage units that minimize the net energy cost of the energy community. Moreover, an optimal energy management solution that combines the three objectives has been implemented by developing novel techniques of optimally flexible (un)certainty projection and appliance based pricing decomposition in an IBM ILOG CPLEX studio. A real-world, per-minute data from an energy community consisting of forty prosumers in Amsterdam, Netherlands is used. Results show that each of the proposed mechanisms yields significant increases in the aggregate energy resource utilization and welfare of prosumers as compared to traditional peak-power reduction methods. Furthermore, the multi-objective, resource-aware utility maximization approach leads to an optimal energy equilibrium and provides a sustainable energy management solution as verified by the Lagrangian method. The proposed resource-aware mechanisms could directly benefit emerging energy communities in the world to attain their energy resource utilization targets.

A new approach to global control of redundant manipulators

NASA Technical Reports Server (NTRS)

Seraji, Homayoun

1989-01-01

A new and simple approach to configuration control of redundant manipulators is presented. In this approach, the redundancy is utilized to control the manipulator configuration directly in task space, where the task will be performed. A number of kinematic functions are defined to reflect the desirable configuration that will be achieved for a given end-effector position. The user-defined kinematic functions and the end-effector Cartesian coordinates are combined to form a set of task-related configuration variables as generalized coordinates for the manipulator. An adaptive scheme is then utilized to globally control the configuration variables so as to achieve tracking of some desired reference trajectories. This accomplishes the basic task of desired end-effector motion, while utilizing the redundancy to achieve any additional task through the desired time variation of the kinematic functions. The control law is simple and computationally very fast, and does not require the complex manipulator dynamic model.

Tempest in a teapot: utility advertising

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

Ciscel, D.H.

Utility sales programs represent a form of organizational slack. It is an expense that can be traded off in times of administrative stress, providing a satisfactory payment to the consumer while maintaining the integrity of the present institutional arrangement. Because it is a trade-off commodity, regulatory control of utility advertising will remain a ''tempest in a teapot.'' Marketing programs are an integral part of the selling process in the modern corporation, and severe restrictions on advertising must be temporary in nature. Court cases have pointed out that utility companies need to inform the consumer about the use of the productmore » and to promote demand for the product. These actions will be considered legally reasonable no matter what the final disposition of current environmental regulations and energy restrictions. In fact, as acceptable social solutions develop for environmental and energy supply problems, the pressure on utility advertising can be expected to fall proportionately. However, the utility still represents the largest industrial concern in most locales. The utility advertising program makes the company even more visible. When there is public dissatisfaction with the more complex parts of the utility delivery system, the raucous voice of outrage will emerge from this tempestuous teapot.« less

Neutron probes for the Construction and Resource Utilization eXplorer (CRUX)

NASA Technical Reports Server (NTRS)

Elphic, R. C.; Hahn, S.; Lawrence, D. J.; Feldman, W. C.; Johnson, J. B.; Haldemann, A. F. C.

2006-01-01

The Construction and Resource Utilization eXplorer (CRUX) project is developing a flexible integrated suite of instruments with data fusion software and an executive controller for in situ regolith resource assessment and characterization.

Utility accommodation policy of the Iowa State Highway Commission.

DOT National Transportation Integrated Search

1970-05-01

This policy covers initial placement, adjustment, relocation and : replacement of utility facilities in, on, above or below all highway : rightof way over:Wnicn tneiowa.~state :Hig'hwaycommission exercises : control of access. It embodies the bas...

Semi-automatic system for ultrasonic measurement of texture

DOEpatents

Thompson, R. Bruce; Wormley, Samuel J.

1991-09-17

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

Semi-automatic system for ultrasonic measurement of texture

DOEpatents

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

1991-09-17

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

California Publicly-Owned Utilities (POUs) – LBNL ‘Beyond Widgets’ Project. Task: ambient lighting and occupancy-based plug load control. System Program Manual

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

Robinson, Alastair; Mathew, Paul A.; Regnier, Cynthia

This program manual contains detailed technical information for implementing an incentive program for task-ambient lighting and occupancy-based plug load control. This manual was developed by Lawrence Berkeley National Laboratory, in collaboration with the California Publicly-Owned Utilities (CA POUs) as a partner in the ‘Beyond Widgets’ program funded by the U.S. Department of Energy Building Technologies Office. The primary audience for this manual is the program staff of the various CA POUs. It may also be used by other utility incentive programs to help develop similar programs. It is anticipated that the content of this manual be utilized by the CAmore » POU staff for developing related documents such as the Technical Resource Manual and other filings pertaining to the rollout of an energy systems-based rebate incentive program.« less

Lean Six Sigma in Health Care: Improving Utilization and Reducing Waste.

PubMed

Almorsy, Lamia; Khalifa, Mohamed

2016-01-01

Healthcare costs have been increasing worldwide mainly due to over utilization of resources. The savings potentially achievable from systematic, comprehensive, and cooperative reduction in waste are far higher than from more direct and blunter cuts in care and coverage. At King Faisal Specialist Hospital and Research Center inappropriate and over utilization of the glucose test strips used for whole blood glucose determination using glucometers was observed. The hospital implemented a project to improve its utilization. Using the Six Sigma DMAIC approach (Define, Measure, Analyze, Improve and Control), an efficient practice was put in place including updating the related internal policies and procedures and the proper implementation of an effective users' training and competency check off program. That resulted in decreasing the unnecessary Quality Control (QC) runs from 13% to 4%, decreasing the failed QC runs from 14% to 7%, lowering the QC to patient testing ratio from 24/76 to 19/81.

Effect of Psychotherapy on Health Care Utilization in Children With Inflammatory Bowel Disease and Depression.

PubMed

Keerthy, Divya; Youk, Ada; Srinath, Arvind I; Malas, Nasuh; Bujoreanu, Simona; Bousvaros, Athos; Keljo, David; DeMaso, David R; Szigethy, Eva M

2016-12-01

Pediatric patients with inflammatory bowel disease (IBD) are at an increased risk of developing depression compared with community controls. Depression often negatively influences illness behaviors such as resource utilization. We sought to investigate the effects of treating depression on utilization of medical resources in depressed pediatric patients with IBD by comparing rates of health care utilization 1 year before and after psychotherapy. Two hundred seventeen subjects ages 9 to 17 years with IBD and depression received 3 months of psychotherapy for depression as part of a multicenter randomized controlled trial. Of these 217 subjects, 70 had utilization data available 1 year prior and 1 year after receiving 3 months of psychotherapy. Primary outcomes included frequency of hospitalizations, inpatient hospital days, outpatient gastrointestinal visits, and number of emergency room visits, radiological examinations, and endoscopies. Within subject analyses were completed comparing health care utilization 12 months before psychotherapy compared with the 12 months after the conclusion of psychotherapy. Fifty-one and 19 patients had CD and UC, respectively. A total of 55.7% of patients had major depression and 44.3% had minor depression. Overall, all study measures of health care utilization were significantly reduced after psychotherapy (P < 0.01)-including gastrointestinal-related (mean values) hospitalization frequency, inpatient days, outpatient visit, emergency room visits, radiological examinations, and endoscopies. Psychotherapy for comorbid depression in pediatric patients with IBD is associated with decreased GI-related health care utilization. The present study highlights the importance of screening for depression in a pediatric population with IBD, and that psychotherapy may be a reasonable adjunctive treatment for pediatric patients with IBD and comorbid depression.

Quality of life after TIA and stroke: ten-year results of the Oxford Vascular Study.

PubMed

Luengo-Fernandez, Ramon; Gray, Alastair M; Bull, Linda; Welch, Sarah; Cuthbertson, Fiona; Rothwell, Peter M

2013-10-29

To evaluate the 5-year impact of stroke and TIA on utility and quality-adjusted survival. TIA and stroke patients from a UK population-based study (Oxford Vascular Study) were recruited from 2002 to 2007, and followed up until 2012. Quality of life was assessed over 5 years using the EQ-5D (EuroQol-5 Dimensions), with responses converted into utilities ranging from -0.59 (worse than death) to 1 (perfect health), using UK population valuations. Utilities for stroke and TIA patients were compared with those in matched controls obtained from the 2006 Health Survey for England. Five-year quality-adjusted life years were estimated by combining utility and survival information. Four hundred forty TIA and 748 stroke patients were ascertained and included. Utility remained constant at approximately 0.78 over the 5 years after TIA. Utility improved from 0.64 one month after stroke to 0.70 at 6 months (p = 0.006), remaining at approximately 0.70 thereafter. Matched controls had considerably higher utility levels than stroke/TIA patients (0.85, p < 0.001). Event severity and recurrent stroke were significant predictors of decreased long-term utility. Five-year quality-adjusted life expectancy was 3.32 (95% confidence interval: 3.22-3.48) quality-adjusted life years after TIA and 2.21 (2.15-2.37) after stroke, varying considerably by severity (minor: 2.94; moderate: 1.65; and severe: 0.70). Quality-adjusted survival is low over the 5 years after stroke and TIA, with severity and recurrent stroke being major predictors. There remains considerable scope for improvements in acute treatment and secondary prevention to improve the quality of life after TIA and stroke.

A retrospective case-control analysis of the outpatient expenditures for western medicine and dental treatment modalities in CKD patients in Taiwan.

PubMed

Huang, Ren-Yeong; Lin, Yuh-Feng; Kao, Sen-Yeong; Shieh, Yi-Shing; Chen, Jin-Shuen

2014-01-01

To determine if expenditures for dentistry (DENT) correlate with severity of chronic kidney disease (CKD). A total of 10,457 subjects were enrolled from January 2008 to December 2010, divided into three groups: healthy control (HC) group (n = 1,438), high risk (HR) group (n = 3,392), and CKD group (n = 5,627). Five stages were further categorized for the CKD group. OPD utilization and expenditures for western medicine (WM), DENT, and TCM (traditional Chinese medicine) were analyzed retrospectively (2000-2008) using Taiwan's National Health Insurance Research Database. Three major areas were analyzed among groups CKD, HR and HC in this study: 1) demographic data and medical history; 2) utilization (visits/person/year) and expenditures (9-year cumulative expenditure, expenditure/person/year) for OPD services in WM, DENT, and TCM; and 3) utilization and expenditures for dental OPD services, particularly in dental filling, root canal and periodontal therapy. OPD utilization and expenditures of WM increased significantly for the CKD group compared with the HR and HC groups, and increased steadily along with the severity of CKD stages. However, overall DENT and TCM utilization and expenditures did not increase for the CKD group. In comparison among different CKD stages, the average expenditures and utilization for DENT including restorative filling and periodontal therapy, but not root canal therapy, showed significant decreases according to severity of CKD stage, indicating less DENT OPD utilization with progression of CKD. Patients with advanced CKD used DENT OPD service less frequently. However, the connection between CKD and DENT service utilization requires further study.

Modeling of Depth Cue Integration in Manual Control Tasks

NASA Technical Reports Server (NTRS)

Sweet, Barbara T.; Kaiser, Mary K.; Davis, Wendy

2003-01-01

Psychophysical research has demonstrated that human observers utilize a variety of visual cues to form a perception of three-dimensional depth. However, most of these studies have utilized a passive judgement paradigm, and failed to consider depth-cue integration as a dynamic and task-specific process. In the current study, we developed and experimentally validated a model of manual control of depth that examines how two potential cues (stereo disparity and relative size) are utilized in both first- and second-order active depth control tasks. We found that stereo disparity plays the dominate role for determining depth position, while relative size dominates perception of depth velocity. Stereo disparity also plays a reduced role when made less salient (i.e., when viewing distance is increased). Manual control models predict that position information is sufficient for first-order control tasks, while velocity information is required to perform a second-order control task. Thus, the rules for depth-cue integration in active control tasks are dependent on both task demands and cue quality.

Extending health maintenance organization insurance to the uninsured. A controlled measure of health care utilization.

PubMed

Bograd, H; Ritzwoller, D P; Calonge, N; Shields, K; Hanrahan, M

1997-04-02

To investigate the utilization of health care services of previously uninsured low-income patients after becoming insured by a health maintenance organization (HMO). Retrospective study of utilization in a previously uninsured study group compared with an age- and sex-matched randomly selected control group of commercial HMO enrollees. Group model HMO. A study group of 346 previously uninsured low-income patients and 382 controls. utpatient visits for primary and specialty care, outpatient pharmacy, laboratory, and radiology use, and inpatient admissions and hospital days over a 2-year period. Self-reported health status measures were obtained to control for differences in health status. There were no differences between the study and control groups in hospital admissions, hospital days, and measures of outpatient laboratory, pharmacy, and radiology use. The odds of having an outpatient visit per patient per month was 30% higher for the study group. Approximately half the increase in the odds ratio for outpatient visits was related to the worse self-perceived health status of the study group. While both groups utilized more services in the early phase of their enrollment, the intensity of this start-up effect was similar for both groups. Compared with a commercial group of the same age and sex, the patterns of utilization were similar and the financial costs of care were only moderately more for a previously uninsured group provided with comprehensive HMO insurance. With the growth of managed care, these data should be beneficial in the development of health care programs for the growing number of uninsured Americans.

Highly Effective Birth Control Use Before and After Women's Incarceration

PubMed Central

Chen, Hsiang-Feng; Cropsey, Karen L.; Clarke, Jennifer G.; Kelly, Patricia J.

2015-01-01

Abstract Background: We examined factors associated with women's use of highly effective birth control before and after incarceration, since women with ongoing criminal justice involvement bear a disproportionate burden of sexual and reproductive health problems, including high rates of unintended pregnancy and inconsistent contraceptive use. Methods: Using a longitudinal study design, we conducted surveys with 102 women in an urban midwestern jail and then followed up with 66 of them 6 months after incarceration. We used stepwise logistic regression to assess individual, interpersonal, resource-based, organizational, and environmental factors associated with utilizing highly effective birth control. Results: Forty-two percent of women reported utilizing highly effective birth control (e.g., sterilization or other highly effective reversible methods) prior to incarceration, and 54% reported using these methods after release from jail (p<0.001). Ninety percent of women reported not wanting to get pregnant. Consistent use of birth control (p=0.001) and alcohol problems (p=0.027) were associated with utilization of highly effective birth control prior to incarceration. Previous pregnancies (p=0.012) were the only factor associated with utilization of highly effective birth control after release from jail. Conclusions: Clinicians and public health practitioners can use findings from this study to develop clinical and intervention efforts aimed at improving unintended-pregnancy prevention among incarcerated women both during their confinement and during the tumultuous period after their release from jail. PMID:25555175

Highly Effective Birth Control Use Before and After Women's Incarceration.

PubMed

Ramaswamy, Megha; Chen, Hsiang-Feng; Cropsey, Karen L; Clarke, Jennifer G; Kelly, Patricia J

2015-06-01

We examined factors associated with women's use of highly effective birth control before and after incarceration, since women with ongoing criminal justice involvement bear a disproportionate burden of sexual and reproductive health problems, including high rates of unintended pregnancy and inconsistent contraceptive use. Using a longitudinal study design, we conducted surveys with 102 women in an urban midwestern jail and then followed up with 66 of them 6 months after incarceration. We used stepwise logistic regression to assess individual, interpersonal, resource-based, organizational, and environmental factors associated with utilizing highly effective birth control. Forty-two percent of women reported utilizing highly effective birth control (e.g., sterilization or other highly effective reversible methods) prior to incarceration, and 54% reported using these methods after release from jail (p<0.001). Ninety percent of women reported not wanting to get pregnant. Consistent use of birth control (p=0.001) and alcohol problems (p=0.027) were associated with utilization of highly effective birth control prior to incarceration. Previous pregnancies (p=0.012) were the only factor associated with utilization of highly effective birth control after release from jail. Clinicians and public health practitioners can use findings from this study to develop clinical and intervention efforts aimed at improving unintended-pregnancy prevention among incarcerated women both during their confinement and during the tumultuous period after their release from jail.

Rainwater utilization and storm pollution control based on urban runoff characterization.

PubMed

Zhang, Mulan; Chen, Hao; Wang, Jizhen; Pan, Gang

2010-01-01

The characteristics of urban runoffs and their impact on rainwater utilization and storm pollution control were investigated in three different functional areas of Zhengzhou City, China. The results showed that in the same rain event the pollutant loads (chemical oxygen demand (COD) and total suspended solids (TSS)) in the sampling areas were in the order of industrial area > commercial area > residential area, and within the same area the COD and TSS concentrations of road runoffs were higher than those of roof runoffs. The first flush effects in roof and road runoffs were observed, hence the initial rainwater should be treated separately to reduce rainwater utilization cost and control storm pollution. The initial roof rainfall of 2 mm in residential area, 5 mm in commercial area and 10 mm in industrial area, and the initial road rainfall of 4 mm in residential area and all the road rainfall in commercial and industrial areas should be collected and treated accordingly before direct discharge or utilization. Based on the strong correlation between COD and TSS (R2, 0.87-0.95) and the low biodegradation capacity (biochemical oxygen demand BOD5/COD < 0.3), a sedimentation process and an effective filtration system composed of soil and slag were designed to treat the initial rainwater, which could remove over 90% of the pollutant loads. The above results may help to develop better rainwater utilization and pollution control strategies for cities with water shortages.

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

Soldier-Machine Interface for the Army Future Combat System: Literature Review, Requirements, and Emerging Design Principles

DTIC Science & Technology

2003-04-01

Development vs . Iterative Design ............................ II-7 3. Getting to Know the User: Designing for Usability, Utility, and Pleasure...III-1 2. Terrain Focus .................................................................................... III-1 3. Display vs . Control...heterogeneous, and it diverged into broad philosophical issues, such as “design as engineering” vs . “design as art” and the utility of controlled

40 CFR 1051.107 - What are the exhaust emission standards for all-terrain vehicles (ATVs) and offroad utility...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false What are the exhaust emission standards for all-terrain vehicles (ATVs) and offroad utility vehicles? 1051.107 Section 1051.107 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM RECREATIONAL ENGINES AND VEHICLES...

40 CFR 1051.107 - What are the exhaust emission standards for all-terrain vehicles (ATVs) and offroad utility...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false What are the exhaust emission standards for all-terrain vehicles (ATVs) and offroad utility vehicles? 1051.107 Section 1051.107 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM RECREATIONAL ENGINES AND VEHICLES...

40 CFR 1051.107 - What are the exhaust emission standards for all-terrain vehicles (ATVs) and offroad utility...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false What are the exhaust emission standards for all-terrain vehicles (ATVs) and offroad utility vehicles? 1051.107 Section 1051.107 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM RECREATIONAL ENGINES AND VEHICLES...

Controls on stand transpiration and soil water utilization along a tree density gradient in a Neotropical savanna

Treesearch

Sandra J. Bucci; Fabian G. Scholz; Guillermo Goldstein; William A. Hoffmann; Frederick C. Meinzer; Augusto C. Franco; Thomas Giambelluca; Fernando Miralles-Wilhelm

2008-01-01

Environmental controls of stand-level tree transpiration (E) and seasonal patterns of soil water utilization were studied in five central Brazilian savanna (Cerrado) sites differing in tree density. Tree density of Cerrado vegetation in the study area consistently changes along topographic gradients from ~1,000 trees ha-1 in open savannas (campo...

Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999-2008.

PubMed

Kahende, Jennifer; Malarcher, Ann; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

2017-01-01

To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. We used the linked National Health Interview Survey (survey years 1995, 1997-2005) and the Medicaid Analytic eXtract files (1999-2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation.

A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.

PubMed

Klatt, Maryanna D; Sieck, Cynthia; Gascon, Gregg; Malarkey, William; Huerta, Timothy

2016-08-01

To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group. We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n=84) and the diet/exercise intervention (n=86) to a retrospectively matched control group (n=258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study. Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention. Significantly fewer primary care visits (p<.001) for both intervention groups as compared to controls, with a non-significant trend towards lower overall HC utilization (4,300.00 actual dollar differences) and hospital admissions for the intervention groups after five years. Pharmacy costs and number of prescriptions were significantly higher for the two intervention groups compared to controls over the five years (p<0.05), yet still resulted in less HC utilization costs, potentially indicating greater self-management of care. This study provides valuable information as to the cost savings and value of providing workplace lifestyle interventions that focus on awareness of one's body and health. Health economic studies validate the scale of personal and organization health cost savings that such programs can generate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does the Primary Care Behavioral Health Model Reduce Emergency Department Visits?

PubMed

Serrano, Neftali; Prince, Ronald; Fondow, Meghan; Kushner, Kenneth

2018-04-16

To examine the impact of integrating behavioral health services using the primary care behavioral health (PCBH) model on emergency department (ED) utilization. Utilization data from three Dane County, Wisconsin hospitals and four primary care clinics from 2003 to 2011. We used a retrospective, quasi-experimental, controlled, pre-post study design. Starting in 2007, two clinics began integrating behavioral health into their primary care practices with a third starting in 2010. A fourth, nonimplementing, community clinic served as control. Change in emergency department and primary care utilization (number of visits) for patients diagnosed with mood and anxiety disorders was the outcomes of interest. Retrospective data were obtained from electronic patient records from the three main area hospitals along with primary care data from participating clinics. Following the introduction of the PCBH model, one clinic experienced a statistically significant (p < .01, 95 percent CI 6.3-16.3 percent), 11.3 percent decrease in the ratio of ED visits to primary care encounters, relative to a control site, but two other intervention clinics did not. The PCBH model may be associated with a reduction in ED utilization, but better-controlled studies are needed to confirm this result. © Health Research and Educational Trust.

Regenerated cellulose capsules for controlled drug delivery: Part III. Developing a fabrication method and evaluating extemporaneous utility for controlled-release.

PubMed

Bhatt, Bhavik; Kumar, Vijay

2016-08-25

In this article, we describe a method to utilize cellulose dissolved in dimethyl sulfoxide and paraformaldehyde solvent system to fabricate two-piece regenerated cellulose hard shell capsules for their potential use as an oral controlled drug delivery a priori vehicle. A systematic evaluation of solution rheology as well as resulting capsule mechanical, visual and thermal analysis was performed to develop a suitable method to repeatedly fabricate RC hard shell capsule halves. Because of the viscoelastic nature of the cellulose solution, a combination of dip-coating and casting method, herein referred to as dip-casting method, was developed. The dip-casting method was formalized by utilizing two-stage 2(2) full factorial design approach in order to determine a suitable approach to fabricate capsules with minimal variability. Thermal annealing is responsible for imparting shape rigidity of the capsules. Proof-of-concept analysis for the utility of these capsules in controlled drug delivery was performed by evaluating the release of KCl from them as well as from commercially available USP equivalent formulations. Release of KCl from cellulose capsules was comparable to extended release capsule formulation. Copyright © 2016 Elsevier B.V. All rights reserved.

DSM and electric utility competitiveness: An Illinois perspective

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

Jackson, P.W.

1994-12-31

A predominant theme in the current electric utility industry literature is that competitive forces have emerged and may become more prominent. The wholesale bulk power market is alreadly competitive, as non-utility energy service providers already have had a significant impact on that market; this trend was accelerated by the Energy Policy Act of 1992. Although competition at the retail level is much less pervasive, electric utility customers increasingly have greater choice in selecting energy services. These choices may include, depending on the customer, the ability to self-generate, switch fuels, move to a new location, or rely more heavily on demand-sidemore » management as a means of controlling electric energy use. This paper explores the subject of how demand-side management (DSM) programs, which are often developed by a utility to satisfy resource requirements as a part of its least-cost planning process, can affect the utility`s ability to compete in the energy services marketplace. In this context, the term `DSM` is used in this paper to refer to those demand-side services and programs which provide resources to the utility`s system. Depending on one`s perspective, DSM programs (so defined) can be viewed either as an enhancement to the competitive position of a utility by enabling it to provide its customers with a broader menu of energy services, simultaneously satisfying the objectives of the utility as well as those of the customers, or as a detractor to a utility`s ability to compete. In the latter case, the concern is with respect to the potential for adverse rate impacts on customers who are not participants in DSM programs. The paper consists of an identification of the pros and cons of DSM as a competitive strategy, the tradeoff which can occur between the cost impacts and rate impacts of DSM, and an examination of alternative strategies for maximizing the utilization of DSM both as a resource and as a competitive strategy.« less

Horizontal inequity in public health care service utilization for non-communicable diseases in urban Vietnam

PubMed Central

Kien, Vu Duy; Van Minh, Hoang; Giang, Kim Bao; Weinehall, Lars; Ng, Nawi

2014-01-01

Background A health system that provides equitable health care is a principal goal in many countries. Measuring horizontal inequity (HI) in health care utilization is important to develop appropriate and equitable public policies, especially policies related to non-communicable diseases (NCDs). Design A cross-sectional survey of 1,211 randomly selected households in slum and non-slum areas was carried out in four urban districts of Hanoi city in 2013. This study utilized data from 3,736 individuals aged 15 years and older. Respondents were asked about health care use during the previous 12 months; information included sex, age, and self-reported NCDs. We assessed the extent of inequity in utilization of public health care services. Concentration indexes for health care utilization and health care needs were constructed via probit regression of individual utilization of public health care services, controlling for age, sex, and NCDs. In addition, concentration indexes were decomposed to identify factors contributing to inequalities in health care utilization. Results The proportion of healthcare utilization in the slum and non-slum areas was 21.4 and 26.9%, respectively. HI in health care utilization in favor of the rich was observed in the slum areas, whereas horizontal equity was achieved among the non-slum areas. In the slum areas, we identified some key factors that affect the utilization of public health care services. Conclusion Our results suggest that to achieve horizontal equity in utilization of public health care services, policy should target preventive interventions for NCDs, focusing more on the poor in slum areas. PMID:25095780

Teach It, Don’t Preach It: The Differential Effects of Directly-communicated and Self-generated Utility Value Information

PubMed Central

Canning, Elizabeth A.; Harackiewicz, Judith M.

2015-01-01

Social-psychological interventions in education have used a variety of “self-persuasion” or “saying-is-believing” techniques to encourage students to articulate key intervention messages. These techniques are used in combination with more overt strategies, such as the direct communication of messages in order to promote attitude change. However, these different strategies have rarely been systematically compared, particularly in controlled laboratory settings. We focus on one intervention based in expectancy-value theory designed to promote perceptions of utility value in the classroom and test different intervention techniques to promote interest and performance. Across three laboratory studies, we used a mental math learning paradigm in which we varied whether students wrote about utility value for themselves or received different forms of directly-communicated information about the utility value of a novel mental math technique. In Study 1, we examined the difference between directly-communicated and self-generated utility-value information and found that directly-communicated utility-value information undermined performance and interest for individuals who lacked confidence, but that self-generated utility had positive effects. However, Study 2 suggests that these negative effects of directly-communicated utility value can be ameliorated when participants are also given the chance to generate their own examples of utility value, revealing a synergistic effect of directly-communicated and self-generated utility value. In Study 3, we found that individuals who lacked confidence benefited more when everyday examples of utility value were communicated, rather than career and school examples. PMID:26495326

Integrated Neural Flight and Propulsion Control System

NASA Technical Reports Server (NTRS)

Kaneshige, John; Gundy-Burlet, Karen; Norvig, Peter (Technical Monitor)

2001-01-01

This paper describes an integrated neural flight and propulsion control system. which uses a neural network based approach for applying alternate sources of control power in the presence of damage or failures. Under normal operating conditions, the system utilizes conventional flight control surfaces. Neural networks are used to provide consistent handling qualities across flight conditions and for different aircraft configurations. Under damage or failure conditions, the system may utilize unconventional flight control surface allocations, along with integrated propulsion control, when additional control power is necessary for achieving desired flight control performance. In this case, neural networks are used to adapt to changes in aircraft dynamics and control allocation schemes. Of significant importance here is the fact that this system can operate without emergency or backup flight control mode operations. An additional advantage is that this system can utilize, but does not require, fault detection and isolation information or explicit parameter identification. Piloted simulation studies were performed on a commercial transport aircraft simulator. Subjects included both NASA test pilots and commercial airline crews. Results demonstrate the potential for improving handing qualities and significantly increasing survivability rates under various simulated failure conditions.

Comparative evaluation of two asthma care quality measures among Medicaid beneficiaries.

PubMed

Samnaliev, Mihail; Baxter, Jeffrey D; Clark, Robin E

2009-05-01

The relative performance of asthma care quality measures has not been evaluated in Medicaid populations. Using complete claims and pharmaceutical data for 19,076 patients with persistent asthma (based on Health Effectiveness and Data Information Set criteria) in five Medicaid populations, we compared the following two measures of asthma care quality: filling prescriptions for controller asthma medications within 1 year and the ratio of controller medication to the total number of asthma medication prescriptions filled within 1 year. We calculated whether meeting each quality measure was associated with decreased odds of emergency department (ED) treatment episodes. We then compared the odds ratios, receiver operating characteristic (ROC) curves, and deviances between models, using each measure to predict ED utilization in Medicaid populations. Although meeting each measure was associated with lower odds of ED utilization, this decrease was larger if the controller asthma medication measure was met rather than the ratio measure. Additionally, models using the controller medication measure had greater areas under the ROC curve and smaller deviances than models using the ratio measure. Both administrative measures of asthma care quality were associated with lower odds of ED utilization. The controller medication measure of asthma care quality may be better than the ratio measure in relation to emergency asthma care utilization by Medicaid beneficiaries.

Maternal and child health and family planning service utilization in Guatemala: implications for service integration.

PubMed

Seiber, Eric E; Hotchkiss, David R; Rous, Jeffrey J; Berruti, Andrés A

2005-07-01

Does the utilization of modern maternal and child health (MCH) services influence subsequent contraceptive use? The answer to this question holds important implications for proposals which advocate MCH and family planning service integration. This study uses data from the 1995/6 Guatemalan Demographic Health Survey and its 1997 Providers Census to test the influence of MCH service utilization on individual contraceptive use decisions. We use a full-information maximum likelihood regression model to control for unobserved heterogeneity. This model produces estimates of the MCH effect, independent of individual women's underlying receptiveness to MCH and contraceptive messages. The results of the analysis indicate that the intensity of MCH service use is indeed positively associated with subsequent contraceptive use among Guatemalan women, even after controlling for observed and unobserved individual- , household- , and community-level factors. Importantly, this finding holds even after controlling for the unobserved factors that 'predispose' some women to use both types of services. Simulations reveal that, for these Guatemalan women, key determinants such as age and primary schooling work indirectly through MCH service use to increase contraceptive utilization.

A frequency and sensitivity tunable microresonator array for high-speed quantum processor readout

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

Whittaker, J. D., E-mail: jwhittaker@dwavesys.com; Swenson, L. J.; Volkmann, M. H.

Superconducting microresonators have been successfully utilized as detection elements for a wide variety of applications. With multiplexing factors exceeding 1000 detectors per transmission line, they are the most scalable low-temperature detector technology demonstrated to date. For high-throughput applications, fewer detectors can be coupled to a single wire but utilize a larger per-detector bandwidth. For all existing designs, fluctuations in fabrication tolerances result in a non-uniform shift in resonance frequency and sensitivity, which ultimately limits the efficiency of bandwidth utilization. Here, we present the design, implementation, and initial characterization of a superconducting microresonator readout integrating two tunable inductances per detector. Wemore » demonstrate that these tuning elements provide independent control of both the detector frequency and sensitivity, allowing us to maximize the transmission line bandwidth utilization. Finally, we discuss the integration of these detectors in a multilayer fabrication stack for high-speed readout of the D-Wave quantum processor, highlighting the use of control and routing circuitry composed of single-flux-quantum loops to minimize the number of control wires at the lowest temperature stage.« less

Building brand equity and customer loyalty

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

Pokorny, G.

Customer satisfaction and customer loyalty are two different concepts, not merely two different phrases measuring a single consumer attitude. Utilities having identical customer satisfaction ratings based on performance in areas like power reliability, pricing, and quality of service differ dramatically in their levels of customer loyalty. As competitive markets establish themselves, discrepancies in customer loyalty will have profound impacts on each utility`s prospects for market retention, profitability, and ultimately, shareholder value. Meeting pre-existing consumer needs, wants and preferences is the foundation of any utility strategy for building customer loyalty and market retention. Utilities meet their underlying customer expectations by performingmore » well in three discrete areas: product, customer service programs, and customer service transactions. Brand equity is an intervening variable standing between performance and the loyalty a utility desires. It is the totality of customer perceptions about the unique extra value the utility provides above and beyond its basic product, customer service programs and customer service transactions; it is the tangible, palpable reality of a branded utility that exists in the minds of consumers. By learning to manage their brand equity as well as they manage their brand performance, utilities gain control over all the major elements in the value-creation process that creates customer loyalty. By integrating brand performance and brand equity, electric utility companies can truly become in their customers` eyes a brand - a unique, very special, value-added energy services provider that can ask for and deserve a premium price in the marketplace.« less

Utility accommodation policy of the Iowa State Highway Commission.

DOT National Transportation Integrated Search

1973-02-01

This policy covers. initial placement, adjustment, relocation and : replacement of utility facilities in, on., above or below all highway : right of way over which the Iowa State Highway Corninission exe:tcii:les : cont.rol of access. It embodies the...

Obsolescence, Weeding, and the Utilization of Space.

ERIC Educational Resources Information Center

Lancaster, F. W.

1988-01-01

Suggests an objective approach to weeding library materials and discusses ways of measuring obsolescence and of controlling variables to provide a true picture of aging. Weeding is shown to improve space utilization and the quality of a collection. (5 references) (MES)

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

Policy for accommodating utilities on state highway rights-of-way, 1985.

DOT National Transportation Integrated Search

1985-04-01

This policy covers initial placement, adjustment, relocation and : replacement of utility facilities in, on, above or below all highway right of : way over which the Iowa Department of Transportation exercises control of : access. It embodies the bas...

10 CFR 436.30 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (3) Entering into negotiations with electric, water, and gas utilities to design cost-effective... regulations. The provisions of this subpart are controlling with regard to energy savings performance... manage electricity demand conducted by gas, water, or electric utilities and generally available to...

13. Site D57 & 58C, Layout and Utility Plan, U.S. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Site D-57 & 58-C, Layout and Utility Plan, U.S. Army Corps of Engineers, 1 March 1957. - Newport NIKE Missile Battery D-57/58, Integrated Fire Control Area, Newport Road, Carleton, Monroe County, MI

Micromachined electrostatic vertical actuator

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

Lee, Abraham P.; Sommargren, Gary E.; McConaghy, Charles F.

A micromachined vertical actuator utilizing a levitational force, such as in electrostatic comb drives, provides vertical actuation that is relatively linear in actuation for control, and can be readily combined with parallel plate capacitive position sensing for position control. The micromachined electrostatic vertical actuator provides accurate movement in the sub-micron to micron ranges which is desirable in the phase modulation instrument, such as optical phase shifting. For example, compact, inexpensive, and position controllable micromirrors utilizing an electrostatic vertical actuator can replace the large, expensive, and difficult-to-maintain piezoelectric actuators. A thirty pound piezoelectric actuator with corner cube reflectors, as utilized inmore » a phase shifting diffraction interferometer can be replaced with a micromirror and a lens. For any very precise and small amplitudes of motion` micromachined electrostatic actuation may be used because it is the most compact in size, with low power consumption and has more straightforward sensing and control options.« less

Micromachined electrostatic vertical actuator

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

Lee, A.P.; Sommargren, G.E.; McConaghy, C.F.

A micromachined vertical actuator utilizing a levitational force, such as in electrostatic comb drives, provides vertical actuation that is relatively linear in actuation for control, and can be readily combined with parallel plate capacitive position sensing for position control. The micromachined electrostatic vertical actuator provides accurate movement in the sub-micron to micron ranges which is desirable in the phase modulation instrument, such as optical phase shifting. For example, compact, inexpensive, and position controllable micromirrors utilizing an electrostatic vertical actuator can replace the large, expensive, and difficult-to-maintain piezoelectric actuators. A thirty pound piezoelectric actuator with corner cube reflectors, as utilized inmore » a phase shifting diffraction interferometer can be replaced with a micromirror and a lens. For any very precise and small amplitudes of motion, micromachined electrostatic actuation may be used because it is the most compact in size, with low power consumption and has more straightforward sensing and control options.« less

Utility fog: A universal physical substance

NASA Technical Reports Server (NTRS)

Hall, J. Storrs

1993-01-01

Active, polymorphic material ('Utility Fog') can be designed as a conglomeration of 100-micron robotic cells ('foglets'). Such robots could be built with the techniques of molecular nanotechnology. Controllers with processing capabilities of 1000 MIPS per cubic micron, and electric motors with power densities of one milliwatt per cubic micron are assumed. Utility Fog should be capable of simulating most everyday materials, dynamically changing its form and properties, and forms a substrate for an integrated virtual reality and telerobotics.

Short-term glucagon stimulation test of C-peptide effect on glucose utilization in patients with type 1 diabetes mellitus.

PubMed

Mojto, Viliam; Rausova, Zuzana; Chrenova, Jana; Dedik, Ladislav

2015-12-01

This work aimed to evaluate the use of a four-point glucagon stimulation test of C-peptide effect on glucose utilization in type 1 diabetic patients using a new mathematical model. A group of 32 type 1 diabetic patients and a group of 10 healthy control subjects underwent a four-point glucagon stimulation test with blood sampling at 0, 6, 15 and 30 min after 1 mg glucagon bolus intravenous administration. Pharmacokinetic and pharmacokinetic/pharmacodynamic models of C-peptide effect on glucose utilization versus area under curve (AUC) were used. A two-sample t test and ANOVA with Bonferroni correction were used to test the significance of differences between parameters. A significant difference between control and patient groups regarding the coefficient of whole-body glucose utilization and AUC C-peptide/AUC glucose ratio (p ≪ 0.001 and p = 0.002, respectively) was observed. The high correlation (r = 0.97) between modeled coefficient of whole-body glucose utilization and numerically calculated AUC C-peptide/AUC glucose ratio related to entire cohort indicated the stability of used method. The short-term four-point glucagon stimulation test allows the numerically calculated AUC C-peptide/AUC glucose ratio and/or the coefficient of whole-body glucose utilization calculated from model to be used to diagnostically identify type 1 diabetic patients.

Cost-utility of ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Spain.

PubMed

Hidalgo-Vega, Alvaro; Ramos-Goñi, Juan Manuel; Villoro, Renata

2014-12-01

Ranolazine is an antianginal agent that was approved in the EU in 2008 as an add-on therapy for symptomatic chronic angina pectoris treatment in patients who are inadequately controlled by, or are intolerant to, first-line antianginal therapies. These patients' quality of life is significantly affected by more frequent angina events, which increase the risk of revascularization. To assess the cost-utility of ranolazine versus placebo as an add-on therapy for the symptomatic treatment of patients with chronic angina pectoris in Spain. A decision tree model with 1-year time horizon was designed. Transition probabilities and utility values for different angina frequencies were obtained from the literature. Costs were obtained from Spanish official DRGs for patients with chronic angina pectoris. We calculated the incremental cost-utility ratio of using ranolazine compared with a placebo. Sensitivity analyses, by means of Monte Carlo simulations, were performed. Acceptability curves and expected value of perfect information were calculated. The incremental cost-utility ratio was €8,455 per quality-adjusted life-year (QALY) per patient in Spain. Sensitivity analyses showed that if the decision makers' willingness to pay is €15,000 per QALY, the treatment with ranolazine will be cost effective at a 95 % level of confidence. The incremental cost-utility ratio is particularly sensitive to changes in utility values of those non-hospitalized patients with mild or moderate angina frequency. Ranolazine is a highly efficient add-on therapy for the symptomatic treatment of chronic angina pectoris in patients who are inadequately controlled by, or intolerant to, first-line antianginal therapies in Spain.

Sacramento Municipal Utility District PV and Smart Grid Pilot at Anatolia

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

Rawson, Mark; Sanchez, Eddie Paul

2013-12-30

Under DE-FOA-0000085 High Penetration Solar Deployment, the U. S. Department of Energy funded agreements with SMUD and Navigant Consulting, SunPower, GridPoint, the National Renewable Energy Laboratory, and the California Energy Commission for this pilot demonstration project. Funding was $5,962,409.00. Cost share of $500,000 was also provided by the California Energy Commission. The project has strategic implications for SMUD, other utilities and the PV and energy-storage industries in business and resource planning, technology deployment and asset management. These implications include: -At this point, no dominant business models have emerged and the industry is open for new ideas. -Demonstrated two business modelsmore » for using distributed PV and energy storage, and brainstormed several dozen more, each with different pros and cons for SMUD, its customers and the industry. -Energy storage can be used to manage high penetrations of PV and mitigate potential issues such as reverse power flow, voltage control violations, power quality issues, increased wear and tear on utility equipment, and system wide power supply issues. - Smart meters are another tool utilities can use to manage high penetrations of PV. The necessary equipment and protocols exist, and the next step is to determine how to integrate the functionality with utility programs and what level of utility control is required. - Time-of-use rates for the residential customers who hosted energy storage systems did not cause a significant change in energy usage patterns. However, the rates we used were not optimized for PV and energy storage. Opportunities exist for utilities to develop new structures.« less

Enhanced subarctic Pacific stratification and nutrient utilization during glacials over the last 1.2 Myr

NASA Astrophysics Data System (ADS)

Knudson, Karla P.; Ravelo, Ana Christina

2015-11-01

The relationship between climate, biological productivity, and nutrient flux is of considerable interest in the subarctic Pacific, which represents an important high-nitrate, low-chlorophyll region. While previous studies suggest that changes in iron supply and/or physical ocean stratification could hypothetically explain orbital-scale fluctuations in subarctic Pacific nutrient utilization and productivity, previous records of nutrient utilization are too short to evaluate these relationships over many glacial-interglacial cycles. We present new, high-resolution records of sedimentary δ15N, which offer the first opportunity to evaluate systematic, orbital-scale variations in subarctic Pacific nitrate utilization from 1.2 Ma. Nitrate utilization was enhanced during all glacials, varied with orbital-scale periodicity since the mid-Pleistocene transition, was strongly correlated with enhanced aeolian dust and low atmospheric CO2, but was not correlated with productivity. These results suggest that glacial stratification, rather than iron fertilization, systematically exerted an important regional control on nutrient utilization and air-sea carbon flux.

Solar Heating And Cooling Of Buildings (SHACOB): Requirements definition and impact analysis-2. Volume 3: Customer load management systems

NASA Astrophysics Data System (ADS)

Cretcher, C. K.; Rountredd, R. C.

1980-11-01

Customer Load Management Systems, using off-peak storage and control at the residences, are analyzed to determine their potential for capacity and energy savings by the electric utility. Areas broadly representative of utilities in the regions around Washington, DC and Albuquerque, NM were of interest. Near optimum tank volumes were determined for both service areas, and charging duration/off-time were identified as having the greatest influence on tank performance. The impacts on utility operations and corresponding utility/customer economics were determined in terms of delta demands used to estimate the utilities' generating capacity differences between the conventional load management, (CLM) direct solar with load management (DSLM), and electric resistive systems. Energy differences are also determined. These capacity and energy deltas are translated into changes in utility costs due to penetration of the CLM or DSLM systems into electric resistive markets in the snapshot years of 1990 and 2000.

Distributed photovoltaic systems - Addressing the utility interface issues

NASA Astrophysics Data System (ADS)

Firstman, S. I.; Vachtsevanos, G. J.

This paper reviews work conducted in the United States on the impact of dispersed photovoltaic sources upon utility operations. The photovoltaic (PV) arrays are roof-mounted on residential houses and connected, via appropriate power conditioning equipment, to the utility grid. The presence of such small (4-6 Kw) dispersed generators on the distribution network raises questions of a technical, economic and institutional nature. After a brief identification of utility interface issues, the paper addresses such technical concerns as protection of equipment and personnel safety, power quality and utility operational stability. A combination of experimental and analytical approaches has been adopted to arrive at solutions to these problems. Problem areas, under various PV system penetration scenarios, are identified and conceptual designs of protection and control equipment and operating policies are developed so that system reliability is maintained while minimizing capital costs. It is hoped that the resolution of balance-of-system and grid interface questions will ascertain the economic viability of photovoltaic systems and assist in their widespread utilization in the future.

NORDA’s Pattern Analysis Laboratory: Current Contributions to Naval Mapping, Charting, and Geodesy

DTIC Science & Technology

1989-04-01

magnetic observatories (McLeod, 1988). Using system integrates a suite of sensors and control devices the PAL’s VAX 11/780, spherical harmonic models to...DJAO:[FPS]*.OLB 5. Miscellaneous Utilities CALENDAR (NORDA events) 780 $ CALENDAR (menu-driven) DIALER modem controller 780 $ R AUTO DIAL:DIALER DTC...Utilities CALENDAR (NORDA events) 780 CALENDAR (menu-driven) DIALER modem controller 780 $ R AUTO DIAL:DIALER DTC Desk Top Calendar 780 $ DTC (menu-driven

A Randomized Control Study Comparing Outcomes in Student Nurses Who Utilize Video during Simulation Debriefing as Compared to Those Who Utilize Traditional Debriefing

ERIC Educational Resources Information Center

Dusaj, Tresa Kaur

2014-01-01

Clinical placement sites for nursing students have become limited around the country. An alternative teaching strategy must be employed to allow for students to gain valuable knowledge and skills. High fidelity human patient simulation is one such strategy that allows students to safely practice nursing interventions in a controlled environment…

The effect of Erynia radicans on food consumption, utilization and fecundity by the spruce budworm, Choristoneura fumiferana.

Treesearch

Abdul K. A. Mohamed; Lucius Lewis; Denise Lewis

1985-01-01

In food consumption and utilization studies, observations were confined to a period of 5 days after which mortality of Erynia radicans larvae began to occur. Mortality due to the fungus was 76 and 83% in male and female larvae, respectively. In control larvae the pupation rate was over 95%. Control larvae of both sexes consumed significantly (P = 0....

Results of the Software Process Improvement Efforts of the Early Adopters in NAVAIR 4.0

DTIC Science & Technology

2007-12-01

and customer satisfaction. AIRSpeed utilizes a structured, problem solving methodology called DMAIC (Define, Measure, Analyze, Improve, Control...widely used in business. DMAIC leads project teams through the logical steps from problem definition to problem resolution. Each phase has a specific set...costs and improving productivity and customer satisfaction. AIRSpeed utilizes the DMAIC (Define, Measure, Analyze, Improve, Control) structured problem

Utility franchises reconsidered

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

Weidner, B.

It is easier to obtain a public utility franchise than one for a fast food store because companies like Burger King value the profit share and control available with a franchise arrangement. The investor-owned utilities (IOUs) in Chicago and elsewhere gets little financial or regulatory benefit, although they do have an alternative because the franchise can be taken over by the city with a one-year notice. As IOUs evolved, the annual franchise fee has been incorporated into the rate in a move that taxes ratepayers and maximizes profits. Cities that found franchising unsatisfactory are looking for ways to terminate themore » franchise and finance a takeover, but limited-term and indeterminate franchises may offer a better mechanism when public needs and utility aims diverge. A directory lists franchised utilities by state and comments on their legal status. (DCK)« less

A study of a space communication system for the control and monitoring of the electric distribution system. Volume 2: Supporting data and analyses

NASA Technical Reports Server (NTRS)

Vaisnys, A.

1980-01-01

It is technically feasible to design a satellite communication system to serve the United States electric utility industry's needs relative to load management, real-time operations management, remote meter reading and to determine the costs of various elements of the system. The functions associated with distribution automation and control and communication system requirements are defined. Factors related to formulating viable communication concepts, the relationship of various design factors to utility operating practices, and the results of the cost analysis are discussed The system concept and several ways in which the concept could be integrated into the utility industry are described.

Effect of Mangiferin and Mahanimbine on Glucose Utilization in 3T3-L1 cells.

PubMed

Kumar, B Dinesh; Krishnakumar, K; Jaganathan, Saravana Kumar; Mandal, Mahitosh

2013-01-01

Stem barks of Mangifera indica contain a rich content of mangiferin (xanthone glucoside), whereas Murraya koenigii leaves contain rich sources of mahanimbine (carbazole alkaloid) and used traditionally for the treatment of diabetes. To investigate the effects of mangiferin (xanthone glucoside) and mahanimbine (carbazole alkaloid) on glucose utilization in 3T3-L1 cells. Mangiferin was isolated from stem barks of Mangifera indica and mahanimbine was isolated from Murraya koenigii leaves. These isolated compounds were subjected to MTT assay and glucose utilization test with 3T3-L1 cells. Treatment of the 3T3-L1 cells with mangiferin and mahanimbine increased the glucose utilization in a dose-dependent manner. At a concentration of 1 mM, mangniferin showed 2-fold increase in glucose utilization compared with untreated control. In case of mahanimbine, the observed effect at 1 mM was almost equivalent to positive control (insulin at 1 μM). Moreover, MTT assay showed that both of these compounds were less toxic at a concentration of 1 mM (nearly 75% cells are viable). The present results indicated that these natural products (mangiferin and mahanimbine) exhibited potential ethnomedical uses in management of diabetes.

Role of catabolite regulatory mechanisms in control of carbohydrate utilization by the rumen anaerobic fungus Neocallimastix frontalis.

PubMed Central

Mountfort, D O; Asher, R A

1983-01-01

Neocallimastix frontalis PN-1 utilized the soluble sugars D-glucose, D-cellobiose, D-fructose, maltose, sucrose, and D-xylose for growth. L-Arabinose, D-galactose, D-mannose, and D-xylitol did not support growth of the fungus. Paired substrate test systems were used to determine whether any two sugars were utilized simultaneously or sequentially. Of the paired monosaccharides tested, glucose was found to be preferentially utilized compared with fructose and xylose. The disaccharides cellobiose and sucrose were preferentially utilized compared with fructose and glucose, respectively, an cellobiose was also the preferred substrate compared with xylose. Xylose was the preferred substrate compared with maltose. In further incubations, the fungus was grown on the substrate utilized last in the two-substrate tests. After moderate growth was attained, the preferred substrate was added to the culture medium. Inhibition of nonpreferred substrate utilization by the addition of the preferred substrate was taken as evidence of catabolite regulation. For the various combinations of substrates tested, fructose and xylose utilization was found to be inhibited in the presence of glucose, indicating that catabolite regulation was involved. No clear-cut inhibition was observed with any of the other substrate combinations tested. The significance of these findings in relation to rumen microbial interactions and competitions is discussed. PMID:6660873

42 CFR 456.520 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.520 Definitions... granted by the Administrator to the Medicaid agency for a specific remote facility to use time periods...

Utilization of Light Detection and Ranging for Quality Control and Quality Assurance of Pavement Grades

DOT National Transportation Integrated Search

2018-02-01

Light Detection and Ranging (Lidar) technology is a useful tool that can assist transportation agencies during the design, construction, and maintenance phases of transportation projects. To demonstrate the utility of Lidar, this report discusses how...

Uncovering Longitudinal Health Care Behaviors for Millions of Medicaid Enrollees: A Multistate Comparison of Pediatric Asthma Utilization.

PubMed

Hilton, Ross; Zheng, Yuchen; Fitzpatrick, Anne; Serban, Nicoleta

2018-01-01

This study introduces a framework for analyzing and visualizing health care utilization for millions of children, with a focus on pediatric asthma, one of the major chronic respiratory conditions. The data source is the 2005 to 2012 Medicaid Analytic Extract claims for 10 Southeast states. The study population consists of Medicaid-enrolled children with persistent asthma. We translate multiyear, individual-level medical claims into sequences of discrete utilization events, which are modeled using Markov renewal processes and model-based clustering. Network analysis is used to visualize utilization profiles. The method is general, allowing the study of other chronic conditions. The study population consists of 1.5 million children with persistent asthma. All states have profiles with high probability of asthma controller medication, as large as 60.6% to 90.2% of the state study population. The probability of consecutive asthma controller prescriptions ranges between 0.75 and 0.95. All states have utilization profiles with uncontrolled asthma with 4.5% to 22.9% of the state study population. The probability for controller medication is larger than for short-term medication after a physician visit but not after an emergency department (ED) visit or hospitalization. Transitions from ED or hospitalization generally have a lower probability into physician office (between 0.11 and 0.38) than into ED or hospitalization (between 0.20 and 0.59). In most profiles, children who take asthma controller medication do so regularly. Follow-up physician office visits after an ED encounter or hospitalization are observed at a low rate across all states. Finally, all states have a proportion of children who have uncontrolled asthma, meaning they do not take controller medication while they have severe outcomes.

Population-based home care services in breast cancer: utilization and costs

PubMed Central

Mittmann, N.; Isogai, P.K.; Saskin, R.; Liu, N.; Porter, J.M.; Cheung, M.C.; Leighl, N.B.; Hoch, J.S.; Trudeau, M.E.; Evans, W.K.; Dainty, K.N.; Earle, C.C.

2012-01-01

Objective To determine utilization and costs of home care services (hcs) for individuals with a diagnosis of breast cancer (bc). Methods Incident cases of invasive bc in women were extracted from the Ontario Cancer Registry (2005–2009) and linked with other Ontario health care administrative databases. Control patients were selected from the population of women never diagnosed with any type of cancer. The types and proportions of hcs used were determined and stratified by disease stage. Attributable home care utilization and costs for bc patients were determined. Factors associated with hcs costs were assessed using regression analysis. Results Among the 39,656 bc and 198,280 control patients identified (median age: 61.6 years for both), 75.4% of bc patients used hcs (62.1% stage i; 85.7% stage ii; 94.6% stage iii; 79.1% stage iv) compared with 14.6% of control patients. The number of hcs used per patient–year were significantly higher for the bc patients than for the control patients (14.97 vs. 6.13, p < 0.01), resulting in higher costs per patient–year ($1,210 vs. $325; $885 attributable cost to bc, p < 0.01). The number of hcs utilized and the associated costs increased as the bc stage increased. In contrast, hcs costs decreased as income increased and as previous health care exposure decreased. Interpretation Patients with bc used twice as many hcs, resulting in costs that were almost 4 times those observed in a matched control group. Less than an additional $1000 per bc patient per year were spent on hcs utilization in the study population. PMID:23300362

Cross-bridge blocker BTS permits direct measurement of SR Ca2+ pump ATP utilization in toadfish swimbladder muscle fibers.

PubMed

Young, Iain S; Harwood, Claire L; Rome, Lawrence C

2003-10-01

Because the major processes involved in muscle contraction require rapid utilization of ATP, measurement of ATP utilization can provide important insights into the mechanisms of contraction. It is necessary, however, to differentiate between the contribution made by cross-bridges and that of the sarcoplasmic reticulum (SR) Ca2+ pumps. Specific and potent SR Ca2+ pump blockers have been used in skinned fibers to permit direct measurement of cross-bridge ATP utilization. Up to now, there was no analogous cross-bridge blocker. Recently, N-benzyl-p-toluene sulfonamide (BTS) was found to suppress force generation at micromolar concentrations. We tested whether BTS could be used to block cross-bridge ATP utilization, thereby permitting direct measurement of SR Ca2+ pump ATP utilization in saponin-skinned fibers. At 25 microM, BTS virtually eliminates force and cross-bridge ATP utilization (both <4% of control value). By taking advantage of the toadfish swimbladder muscle's unique right shift in its force-Ca2+ concentration ([Ca2+]) relationship, we measured SR Ca2+ pump ATP utilization in the presence and absence of BTS. At 25 microM, BTS had no effect on SR pump ATP utilization. Hence, we used BTS to make some of the first direct measurements of ATP utilization of intact SR over a physiological range of [Ca2+]at 15 degrees C. Curve fits to SR Ca2+ pump ATP utilization vs. pCa indicate that they have much lower Hill coefficients (1.49) than that describing cross-bridge force generation vs. pCa (approximately 5). Furthermore, we found that BTS also effectively eliminates force generation in bundles of intact swimbladder muscle, suggesting that it will be an important tool for studying integrated SR function during normal motor behavior.

UNIX programmer`s environment and configuration control

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

Arnold, T.R.; Wyatt, P.W.

1993-12-31

A package of UNIX utilities has been developed which unities the advantages of the public domain utility ``imake`` and a configuration control system. The ``imake`` utility is portable It allows a user to make Makefiles on a wide variety of platforms without worrying about the machine-dependent idiosyncracies of the UNIX utility ``make.`` Makefiles are a labor-saving device for compiling and linking complicated programs, and ``imake`` is a labor-saving device for making Makefiles, as well as other useful software (like a program`s internal dependencies on included files). This ``Environment,`` which has been developed around ``imake,`` allows a programmer to manage amore » complicated project consisting of multiple executables which may each link with multiple user-created libraries. The configuration control aspect consists of a directory hierarchy (a baseline) which is mirrored in a developer`s workspace. The workspace includes a minimum of files copied from the baseline; it employs soft links into the baseline wherever possible. The utilities are a multi-tiered suite of Bourne shells to copy or check out sources, check them back in, import new sources (sources which are not in the baseline) and link them appropriately, create new low-level directories and link them, compare with the baseline, update Makefiles with minimal effort, and handle dependencies. The directory hierarchy utilizes a single source repository, which is mirrored in the baseline and in a workspace for a several platform architectures. The system was originally written to support C code on Sun-4`s and RS6000`s. It has now been extended to support FORTRAN as well as C on SGI and Cray YMP platforms as well as Sun-4`s and RS6000`s.« less

Wireless remote control clinical image workflow: utilizing a PDA for offsite distribution

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Documet, Luis; Documet, Jorge; Huang, H. K.; Muldoon, Jean

2004-04-01

Last year we presented in RSNA an application to perform wireless remote control of PACS image distribution utilizing a handheld device such as a Personal Digital Assistant (PDA). This paper describes the clinical experiences including workflow scenarios of implementing the PDA application to route exams from the clinical PACS archive server to various locations for offsite distribution of clinical PACS exams. By utilizing this remote control application, radiologists can manage image workflow distribution with a single wireless handheld device without impacting their clinical workflow on diagnostic PACS workstations. A PDA application was designed and developed to perform DICOM Query and C-Move requests by a physician from a clinical PACS Archive to a CD-burning device for automatic burning of PACS data for the distribution to offsite. In addition, it was also used for convenient routing of historical PACS exams to the local web server, local workstations, and teleradiology systems. The application was evaluated by radiologists as well as other clinical staff who need to distribute PACS exams to offsite referring physician"s offices and offsite radiologists. An application for image workflow management utilizing wireless technology was implemented in a clinical environment and evaluated. A PDA application was successfully utilized to perform DICOM Query and C-Move requests from the clinical PACS archive to various offsite exam distribution devices. Clinical staff can utilize the PDA to manage image workflow and PACS exam distribution conveniently for offsite consultations by referring physicians and radiologists. This solution allows the radiologist to expand their effectiveness in health care delivery both within the radiology department as well as offisite by improving their clinical workflow.

Electric vehicles look promising for use in utility fleets

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

Minner, D.

1984-06-01

The Electric Vehicle Development Corp. (EVDV) expects EV fleets to find a market for urban driving, especially among service fleets, once mass production begins. Electric utilities joined to form EVDC in order to keep abreast of research developments and the results of demonstrations taking place in several cities, where driver acceptance in utility demonstration programs is high. Major auto makers still need persuasion to develop a commercial prototype. Marketing will focus on controlled fleets having the management skills and the motivation to make the program work.

Space platform utilities distribution study

NASA Technical Reports Server (NTRS)

Lefever, A. E.

1980-01-01

Generic concepts for the installation of power data and thermal fluid distribution lines on large space platforms were discussed. Connections with central utility subsystem modules and pallet interfaces were also considered. Three system concept study platforms were used as basepoints for the detail development. The tradeoff of high voltage low voltage power distribution and the impact of fiber optics as a data distribution mechanism were analyzed. Thermal expansion and temperature control of utility lines and ducts were considered. Technology developments required for implementation of the generic distribution concepts were identified.

Utilization of artificial intelligence techniques for the Space Station power system

NASA Technical Reports Server (NTRS)

Evatt, Thomas C.; Gholdston, Edward W.

1988-01-01

Due to the complexity of the Space Station Electrical Power System (EPS) as currently envisioned, artificial intelligence/expert system techniques are being investigated to automate operations, maintenance, and diagnostic functions. A study was conducted to investigate this technology as it applies to failure detection, isolation, and reconfiguration (FDIR) and health monitoring of power system components and of the total system. Control system utilization of expert systems for load scheduling and shedding operations was also researched. A discussion of the utilization of artificial intelligence/expert systems for Initial Operating Capability (IOC) for the Space Station effort is presented along with future plans at Rocketdyne for the utilization of this technology for enhanced Space Station power capability.

Bimorphic polymeric photomechanical actuator

NASA Technical Reports Server (NTRS)

Sarkisov, Sergey S. (Inventor); Curley, Michael J. (Inventor); Adamovsky, Grigory (Inventor); Sarkisov, Jr., Sergey S. (Inventor); Fields, Aisha B. (Inventor)

2006-01-01

A bimorphic polymeric photomechanical actuator, in one embodiment using polyvinylidene fluoride (PVDF) as a photosensitive body, transmitting light over fiber optic cables, and controlling the shape and pulse duration of the light pulse to control movement of the actuator. Multiple light beams are utilized to generate different ranges of motion for the actuator from a single photomechanical body and alternative designs use multiple light beams and multiple photomechanical bodies to provide controlled movement. Actuator movement using one or more ranges of motion is utilized to control motion to position an actuating element in three dimensional space.

How NASA KSC Controls Interfaces with the use of Motion Skeletons and Product Structure

NASA Technical Reports Server (NTRS)

Jones, Corey

2013-01-01

This presentation will show how NASA KSC controls interfaces for Modular Product Architecture (MPA) using Locator Skeletons, Interface Skeletons, and Product Structure, to be combined together within a Motion Skeleton. The user will learn how to utilize skeleton models to communicate interface data, as successfully done at NASA KSC in their use of Motion Skeletons to control interfaces for multi-launch systems. There will be discussion of the methodology used to control design requirements through WTParts, and how to utilize product structure for non-CAD documents.

Maneuvering strategies using CMGs

NASA Technical Reports Server (NTRS)

Oh, H. S.; Vadali, S. R.

1988-01-01

This paper considers control strategies for maneuvering spacecraft using Single-Gimbal Control Momentum Gyros (CMGs). A pyramid configuration using four gyros is utilized. Preferred initial gimbal angles for maximum utilization of CMG momentum are obtained for some known torque commands. Feedback control laws are derived from the stability point of view by using the Liapunov's Second Theorem. The gyro rates are obtained by the pseudo-inverse technique. The effect of gimbal rate bounds on controllability are studied for an example maneuver. Singularity avoidance is based on limiting the gyro rates depending on a singularity index.

Collective Intelligence. Chapter 17

NASA Technical Reports Server (NTRS)

Wolpert, David H.

2003-01-01

Many systems of self-interested agents have an associated performance criterion that rates the dynamic behavior of the overall system. This chapter presents an introduction to the science of such systems. Formally, collectives are defined as any system having the following two characteristics: First, the system must contain one or more agents each of which we view as trying to maximize an associated private utility; second, the system must have an associated world utility function that rates the possible behaviors of that overall system. In practice, collectives are often very large, distributed, and support little, if any, centralized communication and control, although those characteristics are not part of their formal definition. A naturally occurring example of a collective is a human economy. One can identify the agents and their private utilities as the human individuals in the economy and the associated personal rewards they are each trying to maximize. One could then identify the world utility as the time average of the gross domestic product. ("World utility" per se is not a construction internal to a human economy, but rather something defined from the outside.) To achieve high world utility it is necessary to avoid having the agents work at cross-purposes lest phenomena like liquidity traps or the Tragedy of the Commons (TOC) occur, in which agents' individually pursuing their private utilities lowers world utility. The obvious way to avoid such phenomena is by modifying the agents utility functions to be "aligned" with the world utility. This can be done via punitive legislation. A real-world example of an attempt to do this was the creation of antitrust regulations designed to prevent monopolistic practices.

The Business Case for Payer Support of a Community-Based Health Information Exchange: A Humana Pilot Evaluating Its Effectiveness in Cost Control for Plan Members Seeking Emergency Department Care

PubMed Central

Tzeel, Albert; Lawnicki, Victor; Pemble, Kim R.

2011-01-01

Background As emergency department utilization continues to increase, health plans must limit their cost exposure, which may be driven by duplicate testing and a lack of medical history at the point of care. Based on previous studies, health information exchanges (HIEs) can potentially provide health plans with the ability to address this need. Objective To assess the effectiveness of a community-based HIE in controlling plan costs arising from emergency department care for a health plan's members. Albert Tzeel Methods The study design was observational, with an eligible population (N = 1482) of fully insured plan members who sought emergency department care on at least 2 occasions during the study period, from December 2008 through March 2010. Cost and utilization data, obtained from member claims, were matched to a list of persons utilizing the emergency department where HIE querying could have occurred. Eligible members underwent propensity score matching to create a test group (N = 326) in which the HIE database was queried in all emergency department visits, and a control group (N = 325) in which the HIE database was not queried in any emergency department visit. Results Post–propensity matching analysis showed that the test group achieved an average savings of $29 per emergency department visit compared with the control group. Decreased utilization of imaging procedures and diagnostic tests drove this cost-savings. Conclusions When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decrease. Although many factors can play a role in this finding, it is likely that HIEs obviate unnecessary service utilization through provision of historical medical information regarding specific patients at the point of care. PMID:25126351

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization

PubMed Central

Wu, F.; Fu, L.M.; Hser, Y.H.

2015-01-01

Background This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Methods Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Results Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Conclusions Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. PMID:24990956

42 CFR 456.522 - Content of request for variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time..., mental hospital, and ICF located within a 50-mile radius of the facility; (e) The distance and average...

42 CFR 456.508 - Withdrawal of waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.508 Withdrawal of waiver.... (b) If a waiver is withdrawn by the Administrator, each hospital or mental hospital covered by the...

42 CFR 456.522 - Content of request for variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time... travel time between the remote facility and each facility listed in paragraph (e) of this section; (f...

42 CFR 456.521 - Conditions for granting variance requests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time... is unable to meet the time requirements for which the variance is requested; and (2) A revised UR...

46 CFR Sec. 9 - Communications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Communications. Sec. 9 Section 9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION B-CONTROL AND UTILIZATION OF PORTS RESTRICTIONS UPON THE TRANSFER OR CHANGE IN USE OR IN TERMS GOVERNING UTILIZATION OF PORT FACILITIES Sec. 9 Communications. Communications...

46 CFR Sec. 9 - Communications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 8 2012-10-01 2012-10-01 false Communications. Sec. 9 Section 9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION B-CONTROL AND UTILIZATION OF PORTS RESTRICTIONS UPON THE TRANSFER OR CHANGE IN USE OR IN TERMS GOVERNING UTILIZATION OF PORT FACILITIES Sec. 9 Communications. Communications...

46 CFR Sec. 9 - Communications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false Communications. Sec. 9 Section 9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION B-CONTROL AND UTILIZATION OF PORTS RESTRICTIONS UPON THE TRANSFER OR CHANGE IN USE OR IN TERMS GOVERNING UTILIZATION OF PORT FACILITIES Sec. 9 Communications. Communications...

46 CFR Sec. 9 - Communications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false Communications. Sec. 9 Section 9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION B-CONTROL AND UTILIZATION OF PORTS RESTRICTIONS UPON THE TRANSFER OR CHANGE IN USE OR IN TERMS GOVERNING UTILIZATION OF PORT FACILITIES Sec. 9 Communications. Communications...

Vestibular-visual interactions in flight simulators

NASA Technical Reports Server (NTRS)

Clark, B.

1977-01-01

The following research work is reported: (1) vestibular-visual interactions; (2) flight management and crew system interactions; (3) peripheral cue utilization in simulation technology; (4) control of signs and symptoms of motion sickness; (5) auditory cue utilization in flight simulators, and (6) vestibular function: Animal experiments.

SOXAL{trademark} pilot plant demonstration at Niagara Mohawk`s Dunkirk Station

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

Strangway, P.K.

The Clean Air Act Amendments of 1990 made it necessary to accelerate the development of scrubber systems for use by some utilities burning sulfur-containing fuels, primarily coal. While many types of Flue Gas Desulfurization (FGD) systems operate based on lime and limestone scrubbing, these systems have drawbacks when considered for incorporation into long-term emissions control plans. Although the costs associated with disposal of large amounts of scrubber sludge may be manageable today, the trend is toward increased disposal costs. Many new SO{sub 2} control technologies are being pursued in the hope of developing an economical regenerable FGD system did recoversmore » the SO{sub 2} as a saleable commercial product, thus minimizing the formation of disposal waste. Some new technologies include the use of exotic chemical absorbents which are alien to the utility industry and utilities` waste treatment facilities. These systems present utilities with new environmental issues. The SOXAL{trademark} process has been developed so as to eliminate such issues.« less

Variation in inpatient hospital prices and outpatient service quantities drive geographic differences in private spending in Texas.

PubMed

Franzini, Luisa; White, Chapin; Taychakhoonavudh, Suthira; Parikh, Rohan; Zezza, Mark; Mikhail, Osama

2014-12-01

To measure the contribution of market-level prices, utilization, and health risk to medical spending variation among the Blue Cross Blue Shield of Texas (BCBSTX) privately insured population and the Texas Medicare population. Claims data for all BCBSTX members and publicly available CMS data for Texas in 2011. We used observational data and decomposed overall and service-specific spending into health status and health status adjusted utilization and input prices and input prices adjusted for the BCBSTX and Medicare populations. Variation in overall BCBSTX spending across HRRs appeared driven by price variation, whereas utilization variation factored more prominently in Medicare. The contribution of price to spending variation differed by service category. Price drove inpatient spending variation, while utilization drove outpatient and professional spending variation in BCBSTX. The context in which negotiations occur may help explain the patterns across services. The conventional wisdom that Medicare does a better job of controlling prices and private plans do a better job of controlling volume is an oversimplification. BCBSTX does a good job of controlling outpatient and professional prices, but not at controlling inpatient prices. Strategies to manage the variation in spending may need to differ substantially depending on the service and payer. © Health Research and Educational Trust.

Variation in Inpatient Hospital Prices and Outpatient Service Quantities Drive Geographic Differences in Private Spending in Texas

PubMed Central

Franzini, Luisa; White, Chapin; Taychakhoonavudh, Suthira; Parikh, Rohan; Zezza, Mark; Mikhail, Osama

2014-01-01

Objective To measure the contribution of market-level prices, utilization, and health risk to medical spending variation among the Blue Cross Blue Shield of Texas (BCBSTX) privately insured population and the Texas Medicare population. Data Sources Claims data for all BCBSTX members and publicly available CMS data for Texas in 2011. Study Design We used observational data and decomposed overall and service-specific spending into health status and health status adjusted utilization and input prices and input prices adjusted for the BCBSTX and Medicare populations. Principal Findings Variation in overall BCBSTX spending across HRRs appeared driven by price variation, whereas utilization variation factored more prominently in Medicare. The contribution of price to spending variation differed by service category. Price drove inpatient spending variation, while utilization drove outpatient and professional spending variation in BCBSTX. The context in which negotiations occur may help explain the patterns across services. Conclusions The conventional wisdom that Medicare does a better job of controlling prices and private plans do a better job of controlling volume is an oversimplification. BCBSTX does a good job of controlling outpatient and professional prices, but not at controlling inpatient prices. Strategies to manage the variation in spending may need to differ substantially depending on the service and payer. PMID:24919408

Succinic acid production from sucrose by Actinobacillus succinogenes NJ113.

PubMed

Jiang, Min; Dai, Wenyu; Xi, Yonglan; Wu, Mingke; Kong, Xiangping; Ma, Jiangfeng; Zhang, Min; Chen, Kequan; Wei, Ping

2014-02-01

In this study, sucrose, a reproducible disaccharide extracted from plants, was used as the carbon source for the production of succinic acid by Actinobacillus succinogenes NJ113. During serum bottle fermentation, the succinic acid concentration reached 57.1g/L with a yield of 71.5%. Further analysis of the sucrose utilization pathways revealed that sucrose was transported and utilized via a sucrose phosphotransferase system, sucrose-6-phosphate hydrolase, and a fructose PTS. Compared to glucose utilization in single pathway, more pathways of A. succinogenes NJ113 are dependent on sucrose utilization. By changing the control strategy in a fed-batch culture to alleviate sucrose inhibition, 60.5g/L of succinic acid was accumulated with a yield of 82.9%, and the productivity increased by 35.2%, reaching 2.16g/L/h. Thus utilization of sucrose has considerable potential economics and environmental meaning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Periphytic biofilms: A promising nutrient utilization regulator in wetlands.

PubMed

Wu, Yonghong; Liu, Junzhuo; Rene, Eldon R

2018-01-01

Low nutrient utilization efficiency in agricultural ecosystems is the main cause of nonpoint source (NPS) pollution. Therefore, novel approaches should be explored to improve nutrient utilization in these ecosystems. Periphytic biofilms composed of microalgae, bacteria and other microbial organisms are ubiquitous and form a 'third phase' in artificial wetlands such as paddy fields. Periphytic biofilms play critical roles in nutrient transformation between the overlying water and soil/sediment, however, their contributions to nutrient utilization improvement and NPS pollution control have been largely underestimated. This mini review summarizes the contributions of periphytic biofilms to nutrient transformation processes, including assimilating and storing bioavailable nitrogen and phosphorus, fixing nitrogen, and activating occluded phosphorus. Future research should focus on augmenting the nitrogen fixing, phosphate solubilizing and phosphatase producing microorganisms in periphytic biofilms to improve nutrient utilization and thereby reduce NPS pollution production in artificial and natural wetland ecosystems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Utilization of arterial blood gas measurements in a large tertiary care hospital.

PubMed

Melanson, Stacy E F; Szymanski, Trevor; Rogers, Selwyn O; Jarolim, Petr; Frendl, Gyorgy; Rawn, James D; Cooper, Zara; Ferrigno, Massimo

2007-04-01

We describe the patterns of utilization of arterial blood gas (ABG) tests in a large tertiary care hospital. To our knowledge, no hospital-wide analysis of ABG test utilization has been published. We analyzed 491 ABG tests performed during 24 two-hour intervals, representative of different staff shifts throughout the 7-day week. The clinician ordering each ABG test was asked to fill out a utilization survey. The most common reasons for requesting an ABG test were changes in ventilator settings (27.6%), respiratory events (26.4%), and routine (25.7%). Of the results, approximately 79% were expected, and a change in patient management (eg, a change in ventilator settings) occurred in 42% of cases. Many ABG tests were ordered as part of a clinical routine or to monitor parameters that can be assessed clinically or through less invasive testing. Implementation of practice guidelines may prove useful in controlling test utilization and in decreasing costs.

Predictive Utility of Personality Disorder in Depression: Comparison of Outcomes and Taxonomic Approach.

PubMed

Newton-Howes, Giles; Mulder, Roger; Ellis, Pete M; Boden, Joseph M; Joyce, Peter

2017-09-19

There is debate around the best model for diagnosing personality disorder, both in terms of its relationship to the empirical data and clinical utility. Four randomized controlled trials examining various treatments for depression were analyzed at an individual patient level. Three different approaches to the diagnosis of personality disorder were analyzed in these patients. A total of 578 depressed patients were included in the analysis. Personality disorder, however measured, was of little predictive utility in the short term but added significantly to predictive modelling of medium-term outcomes, accounting for more than twice as much of the variance in social functioning outcome as depression psychopathology. Personality disorder assessment is of predictive utility with longer timeframes and when considering social outcomes as opposed to symptom counts. This utility is sufficiently great that there appears to be value in assessing personality; however, no particular approach outperforms any other.

Implementing Group Medical Visits for Older Adults at Group Health Cooperative

PubMed Central

Levine, Martin D.; Ross, Tyler R.; Balderson, Benjamin H.K.; Phelan, Elizabeth A.

2010-01-01

In a pair of randomized controlled trials in Kaiser Colorado in the 1990s, Group Visits for older adults (monthly non disease-specific group medical appointments for a cohort of patients led by primary care teams) were proven to reduce costs, decrease hospitalizations, and improve patient and provider satisfaction. As part of a translational effort, this Group Visit intervention was replicated in a delivery system in Seattle, WA, and the log of total health care costs measured in the first year of the intervention. Utilization and patient and physician satisfaction were secondary outcomes. For the cost and utilization analysis, a retrospective case-control design compared 221 case patients 65 years of age and older with high outpatient utilization in the previous 18 months with 1,015 control patient selected randomly from clinics not participating in the intervention. Controls were matched to cases on the number of primary care visits in the prior 18 months. Total costs were not statistically different for intervention patients compared to controls ($8,845 vs. $10,288, p=0.11), nor were there statistically significant differences in utilization, including hospital admissions and outpatient visits. However, patient and provider satisfaction was high. This translational effort did not demonstrate the cost savings of the original efficacy trials. Possible explanations for these divergent results may have to do with differences in those who participated and differences between the two delivery systems. PMID:20002506

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

Kevin C. Galbreath; Donald L. Toman; Christopher J. Zygarlicke

Petroleum coke, a byproduct of the petroleum-refining process, is an attractive primary or supplemental fuel for power production primarily because of a progressive and predictable increase in the production volumes of petroleum coke (1, 2). Petroleum coke is most commonly blended with coal in proportions suitable to meet sulfur emission compliance. Petroleum coke is generally less reactive than coal; therefore, the cofiring of petroleum coke with coal typically improves ignition, flame stability, and carbon loss relative to the combustion of petroleum coke alone. Although petroleum coke is a desirable fuel for producing relatively inexpensive electrical power, concerns about the effectsmore » of petroleum coke blending on combustion and pollution control processes exist in the coal-fired utility industry (3). The Energy & Environmental Research Center (EERC) completed a 2-year technical assessment of petroleum coke as a supplemental fuel. A survey questionnaire was sent to seven electric utility companies that are currently cofiring coal and petroleum coke in an effort to solicit specific suggestions on research needs and fuel selections. An example of the letter and survey questionnaire is presented in Appendix A. Interest was expressed by most utilities in evaluating the effects of petroleum coke blending on grindability, combustion reactivity, fouling, slagging, and fly ash emissions control. Unexpectedly, concern over corrosion was not expressed by the utilities contacted. Although all seven utilities responded to the question, only two utilities, Northern States Power Company (NSP) and Ameren, sent fuels to the EERC for evaluation. Both utilities sent subbituminous coals from the Power River Basin and petroleum shot coke samples. Petroleum shot coke is produced unintentionally during operational upsets in the petroleum refining process. This report evaluates the effects of petroleum shot coke blending on grindability, fuel reactivity, fouling/slagging, and electrostatic precipitator (ESP) fly ash collection efficiency.« less

Discussion paper on wholesale ratemaking considerations for sulfur dioxide emissions allowance trading

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

Wessler, E.

1993-07-01

The acid rain provisions of the Clean Air Act Amendments of 1990 (CAAA) created an allowance trading program for SO{sub 2} emissions from electric utility power plants. Theoretically, the trading program will provide utilities the flexibility to control their SO{sub 2} emissions at minimum aggregate societal costs. The trading program is a significant change from command-and-control environmental policies. A continuing concern is whether the market-oriented trading program is compatible with the pervasive rate regulation of the electric utility industry. Economists accept traditional rate regulation policies tend to provide incentives for utilities to minimize risks, rather than costs. To the extentmore » that this is true, the allowance trading experiment is not likely to be successful. A number of commenters have described proposals for alternative regulatory policies to provide utilities with appropriate incentives for cost-minimization. These proposals focus on utility incentives at a {open_quotes}macro{close_quotes} level This paper has a {open_quotes}micro{close_quotes} level focus. It examines options for ratemaking that may also influence utility incentives for cost-minimization to provide a structured discussion of the different types of transactions that involve allowances. Emphasis is on the implications of allowance trading on ratemaking for wholesale power sales. Some of the same considerations that apply to wholesale ratemaking may also apply to retail ratemaking. Four generic types of allowance transactions are examined: Type 1: Unbundled Allowance Sales, Type 2: Wholesale Power Sales, Type 3: Pooling Arrangements, and Type 4: Holding Company Transactions. Each of these four generic allowance transactions is assessed along two 3 dimensions: jurisdictional issues and wholesale ratemaking considerations.« less

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

Stewart, John; Halbgewachs, Ron; Chavez, Adrian

The manner in which the control systems are being designed and operated in the energy sector is undergoing some of the most significant changes in history due to the evolution of technology and the increasing number of interconnections to other system. With these changes however come two significant challenges that the energy sector must face; 1) Cyber security is more important than ever before, and 2) Cyber security is more complicated than ever before. A key requirement in helping utilities and vendors alike in meeting these challenges is interoperability. While interoperability has been present in much of the discussions relatingmore » to technology utilized within the energy sector and especially the Smart Grid, it has been absent in the context of cyber security. The Lemnos project addresses these challenges by focusing on the interoperability of devices utilized within utility control systems which support critical cyber security functions. In theory, interoperability is possible with many of the cyber security solutions available to utilities today. The reality is that the effort required to achieve cyber security interoperability is often a barrier for utilities. For example, consider IPSec, a widely-used Internet Protocol to define Virtual Private Networks, or tunnels , to communicate securely through untrusted public and private networks. The IPSec protocol suite has a significant number of configuration options and encryption parameters to choose from, which must be agreed upon and adopted by both parties establishing the tunnel. The exercise in getting software or devices from different vendors to interoperate is labor intensive and requires a significant amount of security expertise by the end user. Scale this effort to a significant number of devices operating over a large geographical area and the challenge becomes so overwhelming that it often leads utilities to pursue solutions from a single vendor. These single vendor solutions may inadvertently lock utilities into proprietary and closed systems.« less

Flight Software Math Library

NASA Technical Reports Server (NTRS)

McComas, David

2013-01-01

The flight software (FSW) math library is a collection of reusable math components that provides typical math utilities required by spacecraft flight software. These utilities are intended to increase flight software quality reusability and maintainability by providing a set of consistent, well-documented, and tested math utilities. This library only has dependencies on ANSI C, so it is easily ported. Prior to this library, each mission typically created its own math utilities using ideas/code from previous missions. Part of the reason for this is that math libraries can be written with different strategies in areas like error handling, parameters orders, naming conventions, etc. Changing the utilities for each mission introduces risks and costs. The obvious risks and costs are that the utilities must be coded and revalidated. The hidden risks and costs arise in miscommunication between engineers. These utilities must be understood by both the flight software engineers and other subsystem engineers (primarily guidance navigation and control). The FSW math library is part of a larger goal to produce a library of reusable Guidance Navigation and Control (GN&C) FSW components. A GN&C FSW library cannot be created unless a standardized math basis is created. This library solves the standardization problem by defining a common feature set and establishing policies for the library s design. This allows the libraries to be maintained with the same strategy used in its initial development, which supports a library of reusable GN&C FSW components. The FSW math library is written for an embedded software environment in C. This places restrictions on the language features that can be used by the library. Another advantage of the FSW math library is that it can be used in the FSW as well as other environments like the GN&C analyst s simulators. This helps communication between the teams because they can use the same utilities with the same feature set and syntax.

Productivity, vitality and utility in a group of healthy professionally active individuals with nocturia.

PubMed

Kobelt, G; Borgström, F; Mattiasson, A

2003-02-01

To assess the effect of nocturia on productivity, vitality and utility in a selected group of professionally active individuals with nocturia, compared with matched controls, and investigate the effect of symptom severity, to test the hypothesis that lack of sleep caused by frequent sleep interruptions could reduce an individuals' daytime energy and activity levels. Subjects (203) were recruited in Sweden through advertisements, and their suitability for the study assessed in a structured interview. Controls (80) matched for age and gender were randomly selected from a market research panel and given the same interview. Both groups completed a productivity questionnaire, a generic quality-of-life questionnaire with a specific domain for vitality and a utility instrument. The study group with nocturia had a significantly lower level of vitality and utility, and greater impairment of work and activity, than the control group. Women were more affected than men. Symptom severity correlated with all three measures. In an otherwise healthy and professionally active group of individuals, waking at night to void significantly diminishes their overall well-being, vitality and productivity, leading to a significant level of indirect and intangible costs.

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

Precursor SSF utilization: The MODE experiments

NASA Technical Reports Server (NTRS)

Crawley, Edward F.

1992-01-01

The MIT Space Engineering Research Center is the principal investigator for a series of experiments which utilize the Shuttle Middeck as an engineering dynamics laboratory. The first, which flew on STS-48 in Sep. 1991, was the Middeck O-gravity Dynamics Experiment (MODE). This experiment focused on the dynamics of a scaled deployable truss, similar to that of SSF, and contained liquids in tanks. MODE will be reflown in the fall of 1993. In mid-1994, the Middeck Active Control Experiment (MACE) will examine the issues associated with predicting and verifying the closed loop behavior of a controlled structure in zero gravity. The paper will present experiment background, planning, operational experience, results, and lessons learned from these experiments which are pertinent to SSF utilization.

Metal precursor induced shape controlled synthesis of gold nanostructures

NASA Astrophysics Data System (ADS)

Verma, Manoj; Kathy, Annu Dahiya; Kumar, P. Senthil

2018-05-01

Anisotropic gold nanoparticles have excellent properties which enables them to utilize in exciting applications in plasmonics as well as in nanophotonics, catalysis etc. In this report we have synthesized/tune shape of gold nanoparticles by utilizing in situ polymer halide interaction. Our quest for achieving shape control of gold nanoparticles succeeded even under ambient conditions by utilizing the mild but effective reducing power of versatile polymer, polyvinyl pyrrolidone(PVP) on different precursor more specifically on Hydrochloroauric acid and Potassiumbromoauric acid. The significant shape dependent optical plasmonic signature agrees in excellent manner with TEM observations as shown below. Moreover, as prepared gold nanocrystals having different morphology were studied with XRD measurements and a beautiful conclusion was drawn between crystallographic facets and shapes of gold nanoparticles.

42 CFR 456.524 - Notification of Administrator's action and duration of variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.524 Notification of Administrator's action and duration of...

Bibliographic Utilities and the Use of Microcomputers in Libraries: Current and Projected Practices.

ERIC Educational Resources Information Center

McAninch, Glen

1986-01-01

Bibliographic utilities are marketing specially designed hardware and software that permit libraries to patch together automated cataloging, acquisitions, serials control, reference, online public catalogs, circulation, interlibrary loan, and administrative functions. The increasing complexity of the technology is making it more difficult to…

75 FR 45087 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... provide financial assistance to eligible entities that are proposing to deploy broadband transmission... assumptions used; (c) ways to enhance the quality, utility and clarity of the information to be collected; (d... Utilities Service Title: Broadband Grant Program. OMB Control Number: 0572-0127. Summary of Collection...

Surface and borehole neutron probes for the Construction and Resource Utilization eXplorer (CRUX)

NASA Technical Reports Server (NTRS)

Elphic, Richard C.; Hahn, Sangkoo; Lawrence, David J.; Feldman, William C.; Johnson, Jerome B.; Haldemann, Albert F. C.

2006-01-01

The Construction and Resource Utilization eXplorer (CRUX) project aims to develop an integrated, flexible suite of instruments with data fusion software and an executive controller for the purpose of in situ resource assessment and characterization for future space exploration.

Utilization of sunn hemp for cover crops and weed control in temperate climates

USDA-ARS?s Scientific Manuscript database

The need to develop increasingly integrated pest management and sustainable food production systems has encouraged a greater interest to thoroughly evaluate effective utilization of cover crops in agricultural systems. Sunn hemp, a tropical legume that originated most likely from the Indo-Pakistani ...

48 CFR 41.101 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... service supplier to cover utility service needs of Federal agencies within the franchise territory of the..., transports, controls, and sells electrical and water supply service to customers. Franchise territory means a geographical area that a utility supplier has a right to serve based upon a franchise, a certificate of public...

48 CFR 41.101 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... service supplier to cover utility service needs of Federal agencies within the franchise territory of the..., transports, controls, and sells electrical and water supply service to customers. Franchise territory means a geographical area that a utility supplier has a right to serve based upon a franchise, a certificate of public...

48 CFR 41.101 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... service supplier to cover utility service needs of Federal agencies within the franchise territory of the..., transports, controls, and sells electrical and water supply service to customers. Franchise territory means a geographical area that a utility supplier has a right to serve based upon a franchise, a certificate of public...

48 CFR 41.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... service supplier to cover utility service needs of Federal agencies within the franchise territory of the..., transports, controls, and sells electrical and water supply service to customers. Franchise territory means a geographical area that a utility supplier has a right to serve based upon a franchise, a certificate of public...

48 CFR 41.101 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... service supplier to cover utility service needs of Federal agencies within the franchise territory of the..., transports, controls, and sells electrical and water supply service to customers. Franchise territory means a geographical area that a utility supplier has a right to serve based upon a franchise, a certificate of public...

IAPCS: A COMPUTER MODEL THAT EVALUATES POLLUTION CONTROL SYSTEMS FOR UTILITY BOILERS

EPA Science Inventory

The IAPCS model, developed by U.S. EPA`s Air and Energy Engineering Research Laboratory and made available to the public through the National Technical Information Service, can be used by utility companies, architectural and engineering companies, and regulatory agencies at all l...

Role of vegetation and edaphic factors in controlling diversity and use of different carbon sources in semi-arid ecosystems

NASA Astrophysics Data System (ADS)

Lohse, K. A.; McLain, J. E.; Harman, C. J.; Sivapalan, M.; Troch, P. A.

2010-12-01

Microbially-mediated soil carbon cycling is closely linked to soil moisture and temperature. Climate change is predicted to increase intra-annual precipitation variability (i.e. less frequent yet more intense precipitation events) and alter biogeochemical processes due to shifts in soil moisture dynamics and inputs of carbon. However, the responses of soil biology and chemistry to predicted climate change, and their concomitant feedbacks on ecosystem productivity and biogeochemical processes are poorly understood. We collected soils at three different elevations in the Santa Catalina Mountains, AZ and quantified carbon utilization during pre-monsoon precipitation conditions. Contrasting parent materials (schist and granite) were paired at each elevation. We expected climate to determine the overall activity of soil fungal and bacterial communities and diversity of soil C utilization, and differences in parent material to modify these responses through controls on soil physical properties. We used EcoPlateTM C utilization assays to determine the relative abundance of soil bacterial and fungal populations and rate and diversity of carbon utilization. Additional plates were incubated with inhibitors selective to fungal or bacterial activity to assess relative contribution of these microbial groups to overall C utilization. We analyzed soils for soil organic matter, total C and N, particle size analysis and soil moisture content via both gravimetric and volumetric methods to assess the influences of soil physical and chemical properties on the measured biological responses. Consistent with our expectations, overall microbial activity was highest at the uppermost conifer elevation sites compared to the middle and lower elevation sites. In contrast to our expectations, however, overall activity was lower at the mid elevation oak woodland sites compared to the low elevation desert sites. Also consistent with our expectations was the observation that overall activities were consistently higher in schist parent material compared to granite. Though differences between canopy and intercanopy carbon utilization were subtle, the diversity of carbon utilization differed, suggesting a potential role of root exudates in governing C utilization in these semiarid soils. Findings from this study suggest that soil physical properties due to parent material have primary impacts in constraining microbial growth and carbon utilization under changing climate conditions.

Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008

PubMed Central

Kahende, Jennifer; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

2017-01-01

Objective To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. Methods We used the linked National Health Interview Survey (survey years 1995, 1997–2005) and the Medicaid Analytic eXtract files (1999–2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18–64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. Results In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. Conclusions Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999–2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation. PMID:28207744

Outcomes among chronically ill adults in a medical home prototype.

PubMed

Liss, David T; Fishman, Paul A; Rutter, Carolyn M; Grembowski, David; Ross, Tyler R; Johnson, Eric A; Reid, Robert J

2013-10-01

To compare quality, utilization, and cost outcomes for patients with selected chronic illnesses at a patient-centered medical home (PCMH) prototype site with outcomes for patients with the same chronic illnesses at 19 nonintervention control sites. Nonequivalent pretest-posttest control group design. PCMH redesign results were investigated for patients with preexisting diabetes, hypertension, and/or coronary heart disease. Data from automated databases were collected for eligible enrollees in an integrated healthcare delivery system. Multivariable regression models tested for adjusted differences between PCMH patients and controls during the baseline and follow-up periods. Dependent measures under study included clinical processes and, outcomes, monthly healthcare utilization, and costs. Compared with controls over 2 years, patients at the PCMH prototype clinic had slightly better clinical outcome control in coronary heart disease (2.20 mg/dL lower mean low-density lipoprotein cholesterol; P <.001). PCMH patients changed their patterns of primary care utilization, as reflected by 86% more secure electronic message contacts (P <.001), 10% more telephone contacts (P = .003), and 6% fewer in-person primary care visits (P <.001). PCMH patients had 21% fewer ambulatory care-sensitive hospitalizations (P <.001) and 7% fewer total inpatient admissions (P = .002) than controls. During the 2-year redesign, we observed 17% lower inpatient costs (P <.001) and 7% lower total healthcare costs (P <.001) among patients at the PCMH prototype clinic. A clinic-level population-based PCMH redesign can decrease downstream utilization and reduce total healthcare costs in a subpopulation of patients with common chronic illnesses.

[Assessment of ecological environment benefits of reclaimed water reuse in Beijing].

PubMed

Fan, Yu-Peng; Chen, Wei-Ping

2014-10-01

With the rapid development of the social economy and the sustained growth of population, China is facing increasingly serious water problems, and reclaimed water utilization has become an effective measure to solve water shortage problem and to control further deterioration of the ecological environment. Reclaimed water utilization can not only save a lot of fresh water, but also reduce the environmental impact of wastewater discharge, and thus has great ecological environmental benefits, including resource, environmental and human health benefits and so on. This study used the opportunity cost method to construct an evaluation system for ecological environmental benefits of reclaimed water utilization, and Beijing was taken as an example to conduct an estimation of ecological environmental benefits of reclaimed water utilization. Research results indicated that the reclaimed water utilization in Beijing had considerable environmental benefits for ¥ 1.2 billion in 2010, in which replacement of fresh water accounted for the largest share. The benefits of environmental improvement and groundwater recharge were large, while the other benefits were small or negative. The ecological environment benefits of reclaimed water utilization in Beijing was about 1.8 times that of its direct economic benefits, showing that reclaimed water utilization was in accordance with sustainable development. Related methods and results will provide scientific basis to promote the development of reclaimed water utilization in our country.

Individual determinants of research utilization by nurses: a systematic review update.

PubMed

Squires, Janet E; Estabrooks, Carole A; Gustavsson, Petter; Wallin, Lars

2011-01-05

Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only characteristic assessed in a sufficient number of studies and with consistent findings for the kinds of research utilization was attitude towards research; this characteristic had a positive association with instrumental and overall research utilization. This review reinforced conclusions in the previous review with respect to positive relationships between general research utilization and: beliefs and attitudes, and current role. Furthermore, attending conferences/in-services, having a graduate degree in nursing, working in a specialty area, and job satisfaction were also identified as individual characteristics important to research utilization. While these findings hold promise as potential targets of future research utilization interventions, there were methodological problems inherent in many of the studies that necessitate their findings be replicated in further research using more robust study designs and multivariate assessment methods.

Individual determinants of research utilization by nurses: a systematic review update

PubMed Central

2011-01-01

Background Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. Objective To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. Methods As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. Results A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only characteristic assessed in a sufficient number of studies and with consistent findings for the kinds of research utilization was attitude towards research; this characteristic had a positive association with instrumental and overall research utilization. Conclusions This review reinforced conclusions in the previous review with respect to positive relationships between general research utilization and: beliefs and attitudes, and current role. Furthermore, attending conferences/in-services, having a graduate degree in nursing, working in a specialty area, and job satisfaction were also identified as individual characteristics important to research utilization. While these findings hold promise as potential targets of future research utilization interventions, there were methodological problems inherent in many of the studies that necessitate their findings be replicated in further research using more robust study designs and multivariate assessment methods. PMID:21208425

Control Structures for VSC-based FACTS Devices under Normal and Faulted AC-systems

NASA Astrophysics Data System (ADS)

Babaei, Saman

This thesis is concerned with improving the Flexible AC Transmission Systems (FACTS) devices performance under the normal and fault AC-system conditions by proposing new control structures and also converter topologies. The combination of the increasing electricity demand and restrictions in expanding the power system infrastructures has urged the utility owners to deploy the utility-scaled power electronics in the power system. Basically, FACTS is referred to the application of the power electronics in the power systems. Voltage Source Converter (VSC) is the preferred building block of the FACTS devices and many other utility-scale power electronics applications. Despite of advances in the semiconductor technology and ultra-fast microprocessor based controllers, there are still many issues to address and room to improve[25]. An attempt is made in this thesis to address these important issues of the VSC-based FACTS devices and provide solutions to improve them.

NRRI summary of New York Public Service Commission: Staff investigation of Orange and Rockland Utilities, Inc.

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

NONE

1995-12-31

In June 1995, the New York Public Service Commission (NYPSC) released a Staff investigation of Orange and Rockland Utilities, Inc. (O&R). The primary focus of the Staffs investigation was the Corporate Policy and External Affairs Department, a restricted disbursements account, the Internal Auditing Department, and O&R officer malfeasance. The Staffs` investigation uncovered widespread, alleged instances of lax internal controls, unethical and illegal actions, and lavish officer behavior. In addition, the Staff investigated O&R`s internal control and purchasing functions. The Staff proposed a series of recommendations to improve the Company`s internal control, purchasing, ethical, climate and addressed the issue of amore » New York ratepayer reimbursement. The Staffs findings and recommendations were presented in the form of a report, entitled Staff Investigation of Orange and Rockland Utilities, Inc. This article summarizes the Report.« less

A threat intelligence framework for access control security in the oil industry

NASA Astrophysics Data System (ADS)

Alaskandrani, Faisal T.

The research investigates the problem raised by the rapid development in the technology industry giving security concerns in facilities built by the energy industry containing diverse platforms. The difficulty of continuous updates to network security architecture and assessment gave rise to the need to use threat intelligence frameworks to better assess and address networks security issues. Focusing on access control security to the ICS and SCADA systems that is being utilized to carry out mission critical and life threatening operations. The research evaluates different threat intelligence frameworks that can be implemented in the industry seeking the most suitable and applicable one that address the issue and provide more security measures. The validity of the result is limited to the same environment that was researched as well as the technologies being utilized. The research concludes that it is possible to utilize a Threat Intelligence framework to prioritize security in Access Control Measures in the Oil Industry.

Thermal Control Utilizing an Thermal Control Utilizing an Two-Phase Loop with High Heat Flux Source

NASA Technical Reports Server (NTRS)

Jeong, Seong-Il; Didion, Jeffrey

2004-01-01

The electric field applied in dielectric fluids causes an imbalance in the dissociation-recombination reaction generated free space charges. The generated charges are redistributed by the applied electric field resulting in the heterocharge layers in the Vicinity of the electrodes. Proper design of the electrodes generates net axial flow motion pumping the fluid. The electrohydrodynamic (EHD) conduction pump is a new device that pumps dielectric fluids utilizing heterocharge layers formed by imposition of electrostatic fields. This paper evaluates the experimental performance of a two-phase breadboard thermal control loop consisting of an EHD conduction pump, condenser, pre-heater, high heat flux evaporator (HE), transport lines, and reservoir (accumulator). The generated pressure head and the maximum applicable heat flux are experimentally determined at various applied voltages and sink temperatures. Recovery from dryout condition by increasing the applied voltage to the pump is also demonstrated.

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study

PubMed Central

Kikui, Miki; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-01-01

Abstract There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t‐test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t‐test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population. PMID:29744141

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study.

PubMed

Kikui, Miki; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-12-01

There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t -test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t -test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β  = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population.

Silk-based delivery systems of bioactive molecules

PubMed Central

Numata, Keiji; Kaplan, David L

2010-01-01

Silks are biodegradable, biocompatible, self-assemblying proteins that can also be tailored via genetic engineering to contain specific chemical features, offering utility for drug and gene delivery. Silkworm silk has been used in biomedical sutures for decades and has recently achieved Food and Drug Administration approval for expanded biomaterials device utility. With the diversity and control of size, structure and chemistry, modified or recombinant silk proteins can be designed and utilized in various biomedical application, such as for the delivery of bioactive molecules. This review focuses on the biosynthesis and applications of silk-based multi-block copolymer systems and related silk protein drug delivery systems. The utility of these systems for the delivery of small molecule drugs, proteins and genes are reviewed. PMID:20298729

Method for improving the fuel efficiency of a gas turbine engine

NASA Technical Reports Server (NTRS)

Coffinberry, G. A. (Inventor)

1985-01-01

An energy recovery system is provided for an aircraft gas turbine engine of the type in which some of the pneumatic energy developed by the engine is made available to support systems such as an environmental control system. In one such energy recovery system, some of the pneumatic energy made available to but not utilized by the support system is utilized to heat the engine fuel immediately prior to the consumption of the fuel by the engine. Some of the recovered energy may also be utilized to heat the fuel in the fuel tanks. Provision is made for multiengine applications wherein energy recovered from one engine may be utilized by another one of the engines or systems associated therewith.

Apparatus for improving the fuel efficiency of a gas turbine engine

NASA Technical Reports Server (NTRS)

Coffinberry, G. A. (Inventor)

1983-01-01

An energy recovery system is provided for an aircraft gas turbine engine of the type in which some of the pneumatic energy developed by the engine is made available to support systems such as an environmental control system. In one such energy recovery system, some of the pneumatic energy made available to but not utilized by the support system is utilized to heat the engine fuel immediately prior to the consumption of the fuel by the engine. Some of the recovered energy may also be utilized to heat the fuel in the fuel tanks. Provision is made for multiengine applications wherein energy recovered from one engine may be utilized by another one of the engines or systems associated therewith.

Monitoring and control requirement definition study for Dispersed Storage and Generation (DSG). Volume 5, appendix D: Cost-benefit considerations for providing dispersed storage and generation for electric utilities

NASA Technical Reports Server (NTRS)

1980-01-01

Cost benefit considerations are extremely important in obtaining the acceptance of dispersed storage and generation (DSG) by the electric utilities. These considerations involved somewhat different economic analyses depending on whether the generation is utility, customer, or combined ownership. It is necessary to get acceptance of more easily understood methods for evaluating the economics of DSG because much of the benefits of DSG may accrue in the generation and transmission portions of the utility system while the costs tend to be centered in the distribution portion of that system. The influence of factors, such as reliability, capital costs, and other economic measures were also investigated.

EPRI Guide to Managing Nuclear Utility Protective Clothing Programs. PCEVAL User`s Manual, A computer code for evaluating the economics of nuclear plant protective clothing programs: Final report

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

Kelly, J.J.; Kelly, D.M.

1993-10-01

The Electric Power Research Institute (EPRI) commissioned a radioactive waste related project (RP2414-34) in 1989 to produce a guide for developing and managing nuclear plant protective clothing programs. Every nuclear facility must coordinate some type of protective clothing program for its radiation workers to ensure proper and safe protection for the wearer and to maintain control over the spread of contamination. Yet, every nuclear facility has developed its own unique program for managing such clothing. Accordingly, a need existed for a reference guide to assist with standardizing protective clothing programs and in controlling the potentially escalating economics of such programs.more » The initial Guide to Managing Nuclear Utility Protective Clothing Programs, NP-7309, was published in May 1991. Since that time, a number of utilities have reviewed and/or used the report to enhance their protective clothing programs. Some of these utilities requested that a computer program be developed to assist utilities in evaluating the economics of protective clothing programs consistent with the guidance in NP-7309. The PCEVAL computer code responds to that industry need. This report, the PCEVAL User`s Manual, provides detailed instruction on use of the software.« less

The fate of mercury in coal utilization byproducts

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

William Aljoe; Thomas Feeley; James Murphy

2005-05-01

The US Department of Energy National Energy Technology Laboratory's (DOE/NETL's) research has helped to further scientific understanding of the environmental characteristics of coal-utilization by-products (CUBs) in both disposal and beneficial utilization applications. The following general observations can be drawn from results of the research that has been carried out to date: There appears to be only minimal mercury release to the environment in typical disposal or utilization applications for CUBs generated using activated carbon injection (ACI) control technologies; There appears to be only minimal mercury release to the environment in typical disposal and utilization applications for CUBs generated using wetmore » FGD control technologies. The potential release of mercury from wet FGD gypsum during the manufacture of wallboard is still under evaluation; The amount of mercury leached from CUB samples tested by DOE/NETL is significantly lower than the federal drinking water standards and water quality criteria for the protection of aquatic life; in many cases, leachate concentrations were below the standard test method detection limits. DOE/NETL will continue to partner with industry and other key stakeholders in carrying out research to better understand the fate of mercury and other trace elements in the byproducts from coal combustion. 16 refs., 6 tabs.« less

Utilization of urea, ammonia, nitrite, and nitrate by crop plants in a Controlled Ecological Life Support System (CELSS)

NASA Technical Reports Server (NTRS)

Huffaker, R. C.; Rains, D. W.; Qualset, C. O.

1982-01-01

The utilization of nitrogen compounds by crop plants is studied. The selection of crop varieties for efficient production using urea, ammonia, nitrite, and nitrate, and the assimilation of mixed nitrogen sources by cereal leaves and roots are discussed.

78 FR 38976 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... Reserve's functions; including whether the information has practical utility; b. The accuracy of the... the methodology and assumptions used; c. Ways to enhance the quality, utility, and clarity of the... Report Report title: Report of Selected Money Market Rates. Agency form number: FR 2420. OMB control...

Carrier account utilization at the Goddard Space Flight Center

NASA Technical Reports Server (NTRS)

Mathis, W. E.; Langmead, J. T.

1972-01-01

The system in use at Goddard Space Flight Center for the utilization of the Common Use Service Carrier Account and the R&D Inventory Carrier Account technique for budgeting, accounting, financial control, and management reporting, both for the individual functional area and on a Center-wide basis, is documented.

41 CFR 109-38.5102 - Utilization controls and practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... hazards, particularly when mingled with other motor vehicle traffic; and (h) The use of electric vehicles..., TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38..., such as trip tickets or vehicle logs, or hours of use, as appropriate, showing sufficiently detailed...

41 CFR 109-38.5102 - Utilization controls and practices.

Code of Federal Regulations, 2012 CFR

2012-01-01

... hazards, particularly when mingled with other motor vehicle traffic; and (h) The use of electric vehicles..., TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38..., such as trip tickets or vehicle logs, or hours of use, as appropriate, showing sufficiently detailed...

41 CFR 109-38.5102 - Utilization controls and practices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... hazards, particularly when mingled with other motor vehicle traffic; and (h) The use of electric vehicles..., TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38..., such as trip tickets or vehicle logs, or hours of use, as appropriate, showing sufficiently detailed...

15 CFR Supplement No. 2 to Part 730 - Technical Advisory Committees

Code of Federal Regulations, 2010 CFR

2010-01-01

... utilization of production technology; licensing procedures that affect the level of export controls applicable... questions involving technical matters, worldwide availability and actual utilization of production and... of U.S. producers of such items; and (ii) The volume of annual production by such persons or firms of...

Clinical Utility of Cancellation on the WISC-IV

ERIC Educational Resources Information Center

Zhu, Jianjun; Chen, Hsinyi

2013-01-01

This study examined empirical evidence for clinical utility of the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV) cancellation subtest by comparing data from 597 clinical and 597 matched control children. The results of dependent t and sequential logistic regression analyses demonstrated that (a) children with intellectual…

Linear motor drive system for continuous-path closed-loop position control of an object

DOEpatents

Barkman, William E.

1980-01-01

A precision numerical controlled servo-positioning system is provided for continuous closed-loop position control of a machine slide or platform driven by a linear-induction motor. The system utilizes filtered velocity feedback to provide system stability required to operate with a system gain of 100 inches/minute/0.001 inch of following error. The filtered velocity feedback signal is derived from the position output signals of a laser interferometer utilized to monitor the movement of the slide. Air-bearing slides mounted to a stable support are utilized to minimize friction and small irregularities in the slideway which would tend to introduce positioning errors. A microprocessor is programmed to read command and feedback information and converts this information into the system following error signal. This error signal is summed with the negative filtered velocity feedback signal at the input of a servo amplifier whose output serves as the drive power signal to the linear motor position control coil.

Locus of control and utilization of social support among mothers of young children with physical disabilities.

PubMed

Rimmerman, A; Stanger, V

1992-01-01

Sixty mothers of young children with physical disabilities were studied with respect to the effect of the mothers' locus of control on the utilization of social support. The initial findings failed to support the thesis that mothers with an 'internally' focused locus of control would demonstrate greater utilization of their support system, both in terms of descriptive and functional measures. A secondary analysis showed that the mothers' age, the children's level of functioning, and the existence of additional members of the family with a disability served as intervening variables. Only among older mothers, who perceived their children's functioning as severe, was there significant association between the locus of control ('internal') and greater use of their social support system. 'Internal' mothers who had no additional extended family members with a disability reported higher levels of functional social support, as compared to 'external' mothers. Findings are interpreted with respect to social support theory and its implications to applied research.

Healthcare costs and resource utilization of asthma in Germany: a claims data analysis.

PubMed

Jacob, Christian; Bechtel, Benno; Engel, Susanne; Kardos, Peter; Linder, Roland; Braun, Sebastian; Greiner, Wolfgang

2016-03-01

Asthma is associated with a substantial economic burden on the German Statutory Health Insurance. To determine costs and resource utilization associated with asthma and to analyze the impact of disease severity on subgroups based on age and gender. A claims database analysis from the statutory health insurance perspective was conducted. Patients with an ICD-10-GM code of asthma were extracted from a 10% sample of a large German sickness fund. Five controls for each asthma patient matched by age and gender were randomly selected from the same database. Costs and resource utilization were calculated for each individual in the asthma and control group. Incremental asthma-related costs were calculated as the mean cost difference. Based on prescribed asthma medication, patients were classified as intermittent or persistent. In addition, age groups of ≤ 5, 6-18, and >18 years were analyzed separately and gender differences were investigated. Overall, 49,668 individuals were included in the asthma group. On average, total annual costs per patient were €753 higher (p = 0.000) compared to the control group (€2,168 vs. €1,415). Asthma patients had significantly higher (p = 0.000) outpatient (€217), inpatient (€176), and pharmacy costs (€259). Incremental asthma-related total costs were higher for patients with persistent asthma compared to patients with intermittent asthma (€1,091 vs. €408). Women aged >18 years with persistent asthma had the highest difference in costs compared to their controls (€1,207; p < 0.0001). Corresponding healthcare resource utilization was significantly higher in the asthma group (p = 0.000). The treatment of asthma is associated with an increased level of healthcare resource utilization and significantly higher healthcare costs. Asthma imposes a substantial economic burden on sickness funds.

Improvements in the efficiency of turboexpanders in cryogenic applications

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

Agahi, R.R.; Lin, M.C.; Ershaghi, B.

1996-12-31

Process designers have utilized turboexpanders in cryogenic processes because of their higher thermal efficiencies when compared with conventional refrigeration cycles. Process design and equipment performance have improved substantially through the utilization of modern technologies. Turboexpander manufacturers have also adopted Computational Fluid Dynamic Software, Computer Numerical Control Technology and Holography Techniques to further improve an already impressive turboexpander efficiency performance. In this paper, the authors explain the design process of the turboexpander utilizing modern technology. Two cases of turboexpanders processing helium (4.35{degrees}K) and hydrogen (56{degrees}K) will be presented.

High Penetration Photovoltaic Power Electronics and Energy Management Technology Research, Development and Demonstration: Cooperative Research and Development Final Report, CRADA Number CRD-13-517

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

Hudgins, Andrew P.

Advanced Energy Industries, Inc., will partner with DOE's National Renewable Energy Laboratory (NREL) to conduct research and development to demonstrate technologies that will increase the penetration of photovoltaic (PV) technologies for commercial and utility applications. Standard PV power control systems use simple control techniques that only provide real power to the grid. A focus of this partnership is to demonstrate how state of the art control and power electronic technologies can be combined to create a utility interactive control platform.

Tethered Vehicle Control and Tracking System

NASA Technical Reports Server (NTRS)

North, David D. (Inventor); Aull, Mark J. (Inventor)

2017-01-01

A kite system includes a kite and a ground station. The ground station includes a sensor that can be utilized to determine an angular position and velocity of the kite relative to the ground station. A controller utilizes a fuzzy logic control system to autonomously fly the kite. The system may include a ground station having powered winding units that generate power as the lines to the kite are unreeled. The control system may be configured to fly the kite in a crosswind trajectory to increase line tension for power generation. The sensors for determining the position of the kite are preferably ground-based.

An application of artificial intelligence theory to reconfigurable flight control

NASA Technical Reports Server (NTRS)

Handelman, David A.

1987-01-01

Artificial intelligence techniques were used along with statistical hpyothesis testing and modern control theory, to help the pilot cope with the issues of information, knowledge, and capability in the event of a failure. An intelligent flight control system is being developed which utilizes knowledge of cause and effect relationships between all aircraft components. It will screen the information available to the pilots, supplement his knowledge, and most importantly, utilize the remaining flight capability of the aircraft following a failure. The list of failure types the control system will accommodate includes sensor failures, actuator failures, and structural failures.

Fuzzy logic control for camera tracking system

NASA Technical Reports Server (NTRS)

Lea, Robert N.; Fritz, R. H.; Giarratano, J.; Jani, Yashvant

1992-01-01

A concept utilizing fuzzy theory has been developed for a camera tracking system to provide support for proximity operations and traffic management around the Space Station Freedom. Fuzzy sets and fuzzy logic based reasoning are used in a control system which utilizes images from a camera and generates required pan and tilt commands to track and maintain a moving target in the camera's field of view. This control system can be implemented on a fuzzy chip to provide an intelligent sensor for autonomous operations. Capabilities of the control system can be expanded to include approach, handover to other sensors, caution and warning messages.

Tethered Vehicle Control and Tracking System

NASA Technical Reports Server (NTRS)

North, David D. (Inventor); Aull, Mark J. (Inventor)

2014-01-01

A kite system includes a kite and a ground station. The ground station includes a sensor that can be utilized to determine an angular position and velocity of the kite relative to the ground station. A controller utilizes a fuzzy logic control system to autonomously fly the kite. The system may include a ground station having powered winding units that generate power as the lines to the kite are unreeled. The control system may be configured to fly the kite in a crosswind trajectory to increase line tension for power generation. The sensors for determining the position of the kite are preferably ground-based.

Economic comparison of fabric filters and electrostatic precipitators for particulate control on coal-fired utility boilers

NASA Technical Reports Server (NTRS)

Cukor, P. M.; Chapman, R. A.

1978-01-01

The uncertainties and associated costs involved in selecting and designing a particulate control device to meet California's air emission regulations are considered. The basic operating principles of electrostatic precipitators and fabric filters are discussed, and design parameters are identified. The size and resulting cost of the control device as a function of design parameters is illustrated by a case study for an 800 MW coal-fired fired utility boiler burning a typical southwestern subbituminous coal. The cost of selecting an undersized particulate control device is compared with the cost of selecting an oversized device.

DISTRIBUTION AND UTILISATION OF IVERMECTIN (MECTIZAN): A CHEMOTHERAPEUTIC APPROACH TO THE CONTROL OF ONCHOCERCIASIS IN OLD OHAOZARA LGA, EBONYI STATE, EASTERN NIGERIA.

PubMed

Okpara, Elom Michael; Mnaemeka, Alo Moses; Iyioku, Ugah Uchenna; Udoh, Usanga Victor

2015-12-01

Onchocerciasis (river blindness) is a devastating, debilitating Stigmatising and incapacitating parasitic disease that is endemic in tropical and subtropical regions of the world, including Nigeria. Mass distribution of ivermectin (Mectizan) to the endemic parts of the world was initiated by the Onchocerciasis Control Programmes (OCPs). Absolute compliance to the regimen for up to 15 years has been reported to be effective in the control of the disease. The study was carried out in Ohaozara LGA, Onicha LGA and Ivo LGA. The three (3) LGAs made up the defunct Old Ohaozara LGA. A structured questionnaire was used to generate information on knowledge of Onchocerciasis and on the use of ivermectin by the inhabitants of the communities of the study areas. The distribution coverage of ivermectin in the study areas dating from 2010 to 2014 was ascertained with drug distribution charts obtained from Ebonyi State Health Management Board (ESHMB), Abakaliki (the point source of distribution in the state), and from the health centres in communities of old Ohaozara LGA (the service delivery points (SDPs) to inhabitants of the communities. Data was analysed using descriptive statistics. Utilization of the regimen was ascertained by determining the actual number of tablets of mectizan that was administered to the patients at the various health cenrtes (service delivery points (SDPs) in the communities. The percentage utilization of the regimen was determined by dividing the number of mectizan tablets administered to the patients at SDPs with the number of mectizan tablets supplied from state point source of distribution and multiplying by 100. A total of 347, 299 out of 1, 919135 tablets of mectizan supplied to the study areas from 2010 to 2014 were actually utilized, forming an overall percentage utilization of 18.10%. There was adequate supply but very poor utilization of the regimen. The poor utilization resulted from factors including locating of health centres very far from homes of some of the rural villagers, non-yearly compliance with regimen administration, poor health sensitization and education and lack of incentives orpoor incentives to the village-based health workers (VBHWs). Intensification of efforts to cover the lapses in the utilization of the regimen is advocated for a more effective control of the disease.

Design considerations to improve cognitive ergonomic issues of unmanned vehicle interfaces utilizing video game controllers.

PubMed

Oppold, P; Rupp, M; Mouloua, M; Hancock, P A; Martin, J

2012-01-01

Unmanned (UAVs, UCAVs, and UGVs) systems still have major human factors and ergonomic challenges related to the effective design of their control interface systems, crucial to their efficient operation, maintenance, and safety. Unmanned system interfaces with a human centered approach promote intuitive interfaces that are easier to learn, and reduce human errors and other cognitive ergonomic issues with interface design. Automation has shifted workload from physical to cognitive, thus control interfaces for unmanned systems need to reduce mental workload on the operators and facilitate the interaction between vehicle and operator. Two-handed video game controllers provide wide usability within the overall population, prior exposure for new operators, and a variety of interface complexity levels to match the complexity level of the task and reduce cognitive load. This paper categorizes and provides taxonomy for 121 haptic interfaces from the entertainment industry that can be utilized as control interfaces for unmanned systems. Five categories of controllers were based on the complexity of the buttons, control pads, joysticks, and switches on the controller. This allows the selection of the level of complexity needed for a specific task without creating an entirely new design or utilizing an overly complex design.

The Impact of Hospice Patient Disease Type and Length of Stay on Caregiver Utilization of Grief Counseling: A 10-Year Retrospective Study.

PubMed

Palmer, William W; Yuen, Francis K

2017-11-01

This investigation explored the relationship between hospice patient disease type, length of stay (LOS) in hospice, and caregiver utilization of grief counseling in bereavement. A 10-year retrospective study was conducted utilizing data from caregivers associated with hospice patients who died between 2004 and 2014. A threshold of inclusion for disease type (≥1.00% of hospice admissions) resulted in a sample size of 3704 patients, comprising 19 different disease types and 348 associated caregivers who received counseling. Replicating a previous study, brain cancer, lung cancer, and renal failure were among the top 4 disease types associated with higher-than-average utilization of bereavement services among caregivers, regardless of the patient's LOS. This finding may be related to factors such as the duration of the disease, the deterioration of the patient, the absence of symptom control, and secondary losses. LOS as a predictor of whether counseling will be utilized by hospice caregivers was unsupported by this study, as the percentage of caregivers receiving counseling closely paralleled the patient's LOS across 4 cohorts (1-30 days, 31-60 days, 61-90 days, and 91+ days). However, among the caregivers who utilized counseling, the LOS was a statistically significant predictor of the number of counseling sessions utilized. For caregivers who utilized only 1 counseling session, the associated patient median LOS was 21.5 days. For caregivers who utilized 5 or more counseling sessions, the associated patient median LOS dropped to 12 days, suggesting an inverted relationship between hospice patient LOS and the duration of counseling in bereavement.

Examining the Relationship Between Individual Characteristics, Community-Level Traits, Multidimensional Empowerment, and Maternal Health Care Utilization in the Islamic Republic of Pakistan.

PubMed

Hearld, Kristine R; Anderson, Jami L; Budhwani, Henna

2018-03-06

Introduction The Islamic Republic of Pakistan's maternal mortality ratio is particularly high, and the nation ranks 126 out of 149 countries on the Human Development Report-Gender Inequality Index. This is because Pakistani women have low levels of empowerment, make limited economic contributions, and underutilization of maternal health care. The aim of this study is to create a multidimensional index of women's empowerment and assess the association between this index and maternal health care utilization in Pakistan, controlling for individual characteristics and community-level traits. Methods Data from the 2012-2013 Pakistan Demographic and Health Surveys were employed to investigate the relationship between this index and the latent construct of maternal health care utilization. Results Using exploratory factor analysis, four indicators of maternal health care utilization were loaded onto a single latent factor. Multivariate analyses found support for the association between empowerment and health care utilization, despite adjustments for individual and area level factors. Positive associations between education, wealth, and maternal health care utilization were found. Conclusions Although we find support for the association of educational attainment with maternal health care utilization, the multidimensional women's empowerment index was independently a consistent associate of maternal health care utilization. This illustrates a complex mechanism with both-education and empowerment, being necessary for improved maternal health care utilization. Policy makers seeking to improve outcomes should expand their focus beyond simply improving rates of education to examining effects of cultural norms which constrain the independence of women in making decisions about their own health care.

Facilities Utilization Program Implementation Handbook

NASA Technical Reports Server (NTRS)

1987-01-01

This Facilities Utilization Program Implementation Handbook (FUPIH) prescribes procedures for the review and the reporting on the utilization of NASA facilities. The Directors of NASA Field Installations should designate an Installation Official responsible for coordinating the assignment of buildings space and implementing the facilities utilization reviews and annual report preparation. The individual designated shall be known as the 'Facilities Utilization Officer (FUO).' Functional responsibilities of the FUO are detailed in NASA Management Instruction (NMI) 7234.1. It is recognized that titles used in the implementation of the Facilities Utilization Program may vary between field installations. The Facilities Utilization Program (FUP) is designed to provide a uniform and orderly process for meeting or addressing the following objectives: the establishment of sound facilities requirements to meet NASA's programmatic and institutional needs; the optimum allocation of available facilities and related resources to meet these requirements; and the early identification and request for required additional facilities resources. The detailed review and reporting system enacted by NMI 7234.1 should encourage more comprehensive utilization planning for all NASA facilities and ensure, to the maximum extent practicable, that all such facilities are put to their highest and best use consistent with NASA programmatic and institutional priorities. A principal purpose of the FUP is the early identification of NASA facilities which may be or may become underutilized or excess to NASA needs and to provide a timely reference point from which corrective actions (i.e., consolidation, elimination of duplication, improved utilization of disposal) may be taken. Because the supply of this handbook is limited, distribution should be controlled at the field installation level.

Impact of depression on health utility value in cancer patients.

PubMed

Fujisawa, Daisuke; Inoguchi, Hironobu; Shimoda, Haruki; Yoshiuchi, Kazuhiro; Inoue, Shinichiro; Ogawa, Asao; Okuyama, Toru; Akechi, Tatsuo; Mimura, Masaru; Shimizu, Ken; Uchitomi, Yosuke

2016-05-01

The quality-adjusted life year, which is usually calculated from the health utility value, is now a standard measurement used in political decision-making in health. Although depression is the leading cause of decrement in health utility in general population, impact of comorbid depression among cancer patients has not been studied sufficiently. Therefore, this study aimed to measure the impact of depression on cancer patients' health utility score, according to the severity of depression. Impact of depression severity (measured by the Patient Health Questionnaire) on health utility score (measured by the EuroQoL-5 scale) was evaluated in a sample of 328 Japanese cancer patients, controlling for performance status, symptom burden, and demographic variables. The patients with depression had significantly lower health utility value than those without depression (mean decrement = 0.14). Decrements in health utility of 0.13, 0.18, and 0.19 were observed for mild, moderate, and moderately severe to severe level of depression, respectively. The difference was significant between groups. Depression severity was a significant predictor for health utility (standardized coefficient beta = -0.25), which was comparable with physical symptom burden and performance status. Participants' age, gender, cancer stage, and comorbid illness were not significant. The model explained 37.9% of the variance. Even mild level of depression caused clinically meaningful decrement in health utility value in cancer patients, which was comparable with decrements due to major physical complications of cancer. Influence of depression should be carefully investigated when interpreting the quality-adjusted life year among cancer patients. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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.

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

Seal, Brian; Huque, Aminul; Rogers, Lindsey

In 2011, EPRI began a four-year effort under the Department of Energy (DOE) SunShot Initiative Solar Energy Grid Integration Systems - Advanced Concepts (SEGIS-AC) to demonstrate smart grid ready inverters with utility communication. The objective of the project was to successfully implement and demonstrate effective utilization of inverters with grid support functionality to capture the full value of distributed photovoltaic (PV). The project leveraged ongoing investments and expanded PV inverter capabilities, to enable grid operators to better utilize these grid assets. Developing and implementing key elements of PV inverter grid support capabilities will increase the distribution system’s capacity for highermore » penetration levels of PV, while reducing the cost. The project team included EPRI, Yaskawa-Solectria Solar, Spirae, BPL Global, DTE Energy, National Grid, Pepco, EDD, NPPT and NREL. The project was divided into three phases: development, deployment, and demonstration. Within each phase, the key areas included: head-end communications for Distributed Energy Resources (DER) at the utility operations center; methods for coordinating DER with existing distribution equipment; back-end PV plant master controller; and inverters with smart-grid functionality. Four demonstration sites were chosen in three regions of the United States with different types of utility operating systems and implementations of utility-scale PV inverters. This report summarizes the project and findings from field demonstration at three utility sites.« less

Case studies in configuration control for redundant robots

NASA Technical Reports Server (NTRS)

Seraji, H.; Lee, T.; Colbaugh, R.; Glass, K.

1989-01-01

A simple approach to configuration control of redundant robots is presented. The redundancy is utilized to control the robot configuration directly in task space, where the task will be performed. A number of task-related kinematic functions are defined and combined with the end-effector coordinates to form a set of configuration variables. An adaptive control scheme is then utilized to ensure that the configuration variables track the desired reference trajectories as closely as possible. Simulation results are presented to illustrate the control scheme. The scheme has also been implemented for direct online control of a PUMA industrial robot, and experimental results are presented. The simulation and experimental results validate the configuration control scheme for performing various realistic tasks.

Analysis of a display and control system man-machine interface concept. Volume 1: Final technical report

NASA Technical Reports Server (NTRS)

Karl, D. R.

1972-01-01

An evaluation was made of the feasibility of utilizing a simplified man machine interface concept to manage and control a complex space system involving multiple redundant computers that control multiple redundant subsystems. The concept involves the use of a CRT for display and a simple keyboard for control, with a tree-type control logic for accessing and controlling mission, systems, and subsystem elements. The concept was evaluated in terms of the Phase B space shuttle orbiter, to utilize the wide scope of data management and subsystem control inherent in the central data management subsystem provided by the Phase B design philosophy. Results of these investigations are reported in four volumes.

Comparative Genomics Reveals the Regulatory Complexity of Bifidobacterial Arabinose and Arabino-Oligosaccharide Utilization.

PubMed

Arzamasov, Aleksandr A; van Sinderen, Douwe; Rodionov, Dmitry A

2018-01-01

Members of the genus Bifidobacterium are common inhabitants of the human gastrointestinal tract. Previously it was shown that arabino-oligosaccharides (AOS) might act as prebiotics and stimulate the bifidobacterial growth in the gut. However, despite the rapid accumulation of genomic data, the precise mechanisms by which these sugars are utilized and associated transcription control still remain unclear. In the current study, we used a comparative genomic approach to reconstruct arabinose and AOS utilization pathways in over 40 bacterial species belonging to the Bifidobacteriaceae family. The results indicate that the gene repertoire involved in the catabolism of these sugars is highly diverse, and even phylogenetically close species may differ in their utilization capabilities. Using bioinformatics analysis we identified potential DNA-binding motifs and reconstructed putative regulons for the arabinose and AOS utilization genes in the Bifidobacteriaceae genomes. Six LacI-family transcriptional factors (named AbfR, AauR, AauU1, AauU2, BauR1 and BauR2) and a TetR-family regulator (XsaR) presumably act as local repressors for AOS utilization genes encoding various α- or β-L-arabinofuranosidases and predicted AOS transporters. The ROK-family regulator AraU and the LacI-family regulator AraQ control adjacent operons encoding putative arabinose transporters and catabolic enzymes, respectively. However, the AraQ regulator is universally present in all Bifidobacterium species including those lacking the arabinose catabolic genes araBDA , suggesting its control of other genes. Comparative genomic analyses of prospective AraQ-binding sites allowed the reconstruction of AraQ regulons and a proposed binary repression/activation mechanism. The conserved core of reconstructed AraQ regulons in bifidobacteria includes araBDA , as well as genes from the central glycolytic and fermentation pathways ( pyk, eno, gap, tkt, tal, galM, ldh ). The current study expands the range of genes involved in bifidobacterial arabinose/AOS utilization and demonstrates considerable variations in associated metabolic pathways and regulons. Detailed comparative and phylogenetic analyses allowed us to hypothesize how the identified reconstructed regulons evolved in bifidobacteria. Our findings may help to improve carbohydrate catabolic phenotype prediction and metabolic modeling, while it may also facilitate rational development of novel prebiotics.

Health utilities in gynecological oncology and mastology in Germany.

PubMed

Hildebrandt, Thomas; Thiel, Falk C; Fasching, Peter A; Graf, Christiane; Bani, Mayada R; Loehberg, Christian R; Schrauder, Michael G; Jud, Sebastian M; Hack, Carolin C; Beckmann, Matthias W; Lux, Michael P

2014-02-01

Cost increases in the healthcare system are leading to a need to distribute financial resources in accordance with the value of each service performed. Health-economic decision-making models can support these decisions. Due to the previous unavailability of health utilities in Germany (scored states of health as a basis for calculating quality-adjusted life-years, QALYs) for women undergoing treatment, international data are often used for such models. However, these may widely deviate from the values for a woman actually living in Germany. It is, therefore, necessary to collect and analyze health utilities in Germany. In a questionnaire survey, health utilities were collected, along with data for a healthy control group, for 580 female patients receiving treatment in the fields of mastology and gynecological oncology using a German version of the EuroQol questionnaire (EQ-5D) and a visual analogue scale (VAS). Data were also collected for the patients' medical history, tumor disease, and treatment. Significant differences with regard to quality of life were measured in relation to the individual tumor entities and in comparison to the controls. Apart from the healthy control group, patients with breast or cervical carcinoma had the best quality of life. In patients with recurrent and metastatic disease, those with breast carcinoma experienced the greatest impairment of their quality of life. According to current treatment, the most important impairment of life quality occurred in patients under radiotherapy and after surgical treatment. There are significant differences from the health utilities recorded for other countries - for example, the state of health declines much more markedly in patients with metastatic disease among American women with breast carcinoma than among German women, in whom recurrent disease and a first diagnosis of metastasis were comparable. Overall, the VAS was able to distinguish more adequately than the EQ-5D questionnaire between the different situations and impairments resulting from diagnosis and therapy. Health utilities are now, for the first time, available for further health-economics analyses in the field of gynecological oncology and mastology for women living in Germany. Important differences in these utilities from those of other countries are evident.

Comparative Genomics Reveals the Regulatory Complexity of Bifidobacterial Arabinose and Arabino-Oligosaccharide Utilization

PubMed Central

Arzamasov, Aleksandr A.; van Sinderen, Douwe; Rodionov, Dmitry A.

2018-01-01

Members of the genus Bifidobacterium are common inhabitants of the human gastrointestinal tract. Previously it was shown that arabino-oligosaccharides (AOS) might act as prebiotics and stimulate the bifidobacterial growth in the gut. However, despite the rapid accumulation of genomic data, the precise mechanisms by which these sugars are utilized and associated transcription control still remain unclear. In the current study, we used a comparative genomic approach to reconstruct arabinose and AOS utilization pathways in over 40 bacterial species belonging to the Bifidobacteriaceae family. The results indicate that the gene repertoire involved in the catabolism of these sugars is highly diverse, and even phylogenetically close species may differ in their utilization capabilities. Using bioinformatics analysis we identified potential DNA-binding motifs and reconstructed putative regulons for the arabinose and AOS utilization genes in the Bifidobacteriaceae genomes. Six LacI-family transcriptional factors (named AbfR, AauR, AauU1, AauU2, BauR1 and BauR2) and a TetR-family regulator (XsaR) presumably act as local repressors for AOS utilization genes encoding various α- or β-L-arabinofuranosidases and predicted AOS transporters. The ROK-family regulator AraU and the LacI-family regulator AraQ control adjacent operons encoding putative arabinose transporters and catabolic enzymes, respectively. However, the AraQ regulator is universally present in all Bifidobacterium species including those lacking the arabinose catabolic genes araBDA, suggesting its control of other genes. Comparative genomic analyses of prospective AraQ-binding sites allowed the reconstruction of AraQ regulons and a proposed binary repression/activation mechanism. The conserved core of reconstructed AraQ regulons in bifidobacteria includes araBDA, as well as genes from the central glycolytic and fermentation pathways (pyk, eno, gap, tkt, tal, galM, ldh). The current study expands the range of genes involved in bifidobacterial arabinose/AOS utilization and demonstrates considerable variations in associated metabolic pathways and regulons. Detailed comparative and phylogenetic analyses allowed us to hypothesize how the identified reconstructed regulons evolved in bifidobacteria. Our findings may help to improve carbohydrate catabolic phenotype prediction and metabolic modeling, while it may also facilitate rational development of novel prebiotics. PMID:29740413

Concurrent image-based visual servoing with adaptive zooming for non-cooperative rendezvous maneuvers

NASA Astrophysics Data System (ADS)

Pomares, Jorge; Felicetti, Leonard; Pérez, Javier; Emami, M. Reza

2018-02-01

An image-based servo controller for the guidance of a spacecraft during non-cooperative rendezvous is presented in this paper. The controller directly utilizes the visual features from image frames of a target spacecraft for computing both attitude and orbital maneuvers concurrently. The utilization of adaptive optics, such as zooming cameras, is also addressed through developing an invariant-image servo controller. The controller allows for performing rendezvous maneuvers independently from the adjustments of the camera focal length, improving the performance and versatility of maneuvers. The stability of the proposed control scheme is proven analytically in the invariant space, and its viability is explored through numerical simulations.

Adaptive Control of a Utility-Scale Wind Turbine Operating in Region 3

NASA Technical Reports Server (NTRS)

Frost, Susan A.; Balas, Mark J.; Wright, Alan D.

2009-01-01

Adaptive control techniques are well suited to nonlinear applications, such as wind turbines, which are difficult to accurately model and which have effects from poorly known operating environments. The turbulent and unpredictable conditions in which wind turbines operate create many challenges for their operation. In this paper, we design an adaptive collective pitch controller for a high-fidelity simulation of a utility scale, variable-speed horizontal axis wind turbine. The objective of the adaptive pitch controller in Region 3 is to regulate generator speed and reject step disturbances. The control objective is accomplished by collectively pitching the turbine blades. We use an extension of the Direct Model Reference Adaptive Control (DMRAC) approach to track a reference point and to reject persistent disturbances. The turbine simulation models the Controls Advanced Research Turbine (CART) of the National Renewable Energy Laboratory in Golden, Colorado. The CART is a utility-scale wind turbine which has a well-developed and extensively verified simulator. The adaptive collective pitch controller for Region 3 was compared in simulations with a bas celliansesical Proportional Integrator (PI) collective pitch controller. In the simulations, the adaptive pitch controller showed improved speed regulation in Region 3 when compared with the baseline PI pitch controller and it demonstrated robustness to modeling errors.

Secure ICCP Final Report

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

Rice, Mark J.; Bonebrake, Christopher A.; Dayley, Greg K.

Inter-Control Center Communications Protocol (ICCP), defined by the IEC 60870-6 TASE.2 standard, was developed to enable data exchange over wide area networks between electric system entities, including utility control centers, Independent System Operators (ISOs), Regional Transmission Operators (RTOs) and Independent Power Producers (IPP) also known as Non-Utility Generators (NUG). ICCP is an unprotected protocol, and as a result is vulnerable to such actions as integrity violation, interception or alteration, spoofing, and eavesdropping. Because of these vulnerabilities with unprotected ICCP communication, security enhancements, referred to as Secure ICCP, have been added and are included in the ICCP products that utilities havemore » received since 2003 when the standard was defined. This has resulted in an ICCP product whose communication can be encrypted and authenticated to address these vulnerabilities.« less

Medicaid policy and the substitution of hospital outpatient care for physician care.

PubMed

Cohen, J W

1989-04-01

This article explores the effects of reimbursement and utilization control policies on utilization patterns and spending for physician and hospital outpatient services under state Medicaid programs. The empirical work shows a negative relationship between the level of Medicaid physician fees relative to Medicare and private fees, and the numbers of outpatient care recipients, suggesting that outpatient care substitutes for physician care in states with low fee levels. In addition, it shows a positive relationship between Medicaid physician fees and outpatient spending per recipient, suggesting that in low-fee states outpatient departments are providing some types of care that could be provided in a physician's office. Finally, the analysis demonstrates that reimbursement and utilization control policies have significant effects in the expected directions on aggregate Medicaid spending for physician and outpatient services.

Health utilities lost and risk factors associated with HPV-induced diseases in men and women: the HPV Italian collaborative study group.

PubMed

Marcellusi, Andrea; Capone, Alessandro; Favato, Giampiero; Mennini, Francesco Saverio; Baio, Gianluca; Haeussler, Katrin; Bononi, Marco

2015-01-01

A complete economic evaluation requires accurate data concerning the resources used, outcomes, and utilities (patient's preferences) to properly value the cost utility of human papillomavirus (HPV) vaccination strategies. This study was designed to measure the utility loss in health states affected by a broad range of HPV-induced pathologies in both sexes in Italy. As a secondary objective, risk factors influencing the viral transmission and development of HPV infections were also investigated. Patients with a diagnosis of several HPV-induced pathologies including atypical squamous cells of undetermined significance (ASC-US), cervical intraepithelial neoplasia (CIN), cervical and anal-colorectal cancer, head and neck squamous cell carcinoma (HNSCC) and anogenital warts (AWs) were evaluated. Utilities, quality of life, and risk factors were elicited using a standardized and computer-guided administration of time trade-off, European Quality of Life 5 Dimensions (EQ-5D), 3 levels, and risk factor questionnaires. Utilities were measured at 6 clinical research centers across Italy. A group of healthy subjects was used as a control. A mean number of 20 healthy subjects was used as a control for each pathology group. Overall, 600 respondents were eligible for analysis: 465 patients (mean [SD] age, 44.0 [16.3] years) and 135 controls (mean [SD] age, 44.0 [13.2] years). With the exception of anal and HNSCC cancer, no statistically significant differences were observed between case and control groups, in terms of either age or quality of life at the time of interview. The patients' perception of their health condition at baseline was equal to an EQ-5D score of 0.87 (0.22). The mean (SD) value of utilities associated with the HPV-induced pathologies corresponded to 0.83 (0.24), 0.78 (0.27), 0.83 (0.22), 0.81 (0.27), 0.58 (0.31), 0.51 (0.26), and 0.69 (0.30) for ASC-US, AWs, CIN 1 (mild), CIN 2-3 (moderate to severe), cervical cancer, anal cancer and HNSCC, respectively. Utility lost due to AWs was significantly higher in females compared with males (0.71 [0.29] vs 0.83 [0.25]; P = 0.018). Having >5 sexual partners increased the risk of acquiring HPV-induced infections as much as 2.52-fold (P = 0.004), whereas for smoking or the age at start of sexual activity younger than 18 years, the risk increased by ~1.62-fold (P = 0.034). High levels of education were associated with a statistically significant protective effect (P < 0.001). Risk factors and utilities elicited in this study can be used as part of future economic assessments of other HPV vaccination strategies, including an immunization program for preadolescents of both sexes in Italy. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Field Trial Results of a 14-channel GPR Integrated with a U.S. Program for 3-D Utility Mapping

NASA Astrophysics Data System (ADS)

Anspach, James H.

2013-04-01

Existing underground utilities continue to be a leading cause of highway construction delay claims in the United States. Although 80-90% of existing utilities can typically be discovered and mapped using a wide range of geophysical tools, there is a recognizable need to improve the process. Existing shortcomings to the utility mapping process include a lack of viable depth attributes, long field occupation times, low experience level of the field technicians, and separate survey / geophysics functions. The U.S. National Academies and its Transportation Research Board recently concluded a project on alleviating the existing utility mapping shortcomings through the development of enhanced GPR. An existing commercial 400MHz 14-channel towed array was enhanced with positioning and interpretation hardware and software over a 3-year US 2M program. Field trials for effectiveness were conducted in a city suburb commercialized environment where the relative permittivity values averaged 9.4. The effectiveness of enhanced GPR was compared to traditional utility mapping techniques (Single Channel GPR, FDEM, Acoustic, Sondes, Gradiometric Magnetometers) during the project. The project area utilities included natural gas, water, electric, telephone, cable, storm, sanitary, traffic control, and several unknown function lines. Depths for these utilities were mostly unknown. 81% of known (from records and field appurtenance visual observation) utilities were detected via traditional geophysical means. These traditional geophysical means also detected 14% additional and previously "unknown" utilities. The enhanced GPR detected approximately 40% of the known and unknown utilities, and found an additional 6% of utilities that were previously undetected. These additional utilities were subsequently determined to be small diameter abandoned water and gas systems in very poor and broken condition. Although it did well with metallic water and gas lines, communication and electric utilities were mostly undetectable. Through a ground-truthing program of test holes to expose utilities, the depth values derived from the enhanced GPR were fairly consistent and within 15 cm of actual depth. The incomplete underground picture determined by the enhanced GPR reinforces previous studies that show that the mapping of existing underground utilities is a multi-tool effort that takes highly trained and skilled field technicians and data interpreters. The addition of a new GPR tool is valuable in determining continuous depth profiles of imaged utilities. A second and significant benefit is the interpretation of other geotechnical data that benefit project designers. This might include showing geometry, location, intensity, and depths of either areas of anomalies, or of known structures, such as paving thickness, substrate thickness, voids, water table, soil lenses, boulders, bedrock, and so forth. The Florida Department of Transportation has decided to take advantage of this new technology and has entered into an experimental contract with Cardno TBE to incorporate several enhanced GPR arrays with traditional utility detection tools. The goal of this contract will be to provide a 3-D model of existing underground utilities for use in automated construction. The GPR 3-D data model will be melded with conventional subsurface utility engineering and mapping practices and will be required to follow the ASCE 38 standard for utility data reliability.

Supporting Building Portfolio Investment and Policy Decision Making through an Integrated Building Utility Data Platform

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

Aziz, Azizan; Lasternas, Bertrand; Alschuler, Elena

The American Recovery and Reinvestment Act stimulus funding of 2009 for smart grid projects resulted in the tripling of smart meters deployment. In 2012, the Green Button initiative provided utility customers with access to their real-time1 energy usage. The availability of finely granular data provides an enormous potential for energy data analytics and energy benchmarking. The sheer volume of time-series utility data from a large number of buildings also poses challenges in data collection, quality control, and database management for rigorous and meaningful analyses. In this paper, we will describe a building portfolio-level data analytics tool for operational optimization, businessmore » investment and policy assessment using 15-minute to monthly intervals utility data. The analytics tool is developed on top of the U.S. Department of Energy’s Standard Energy Efficiency Data (SEED) platform, an open source software application that manages energy performance data of large groups of buildings. To support the significantly large volume of granular interval data, we integrated a parallel time-series database to the existing relational database. The time-series database improves on the current utility data input, focusing on real-time data collection, storage, analytics and data quality control. The fully integrated data platform supports APIs for utility apps development by third party software developers. These apps will provide actionable intelligence for building owners and facilities managers. Unlike a commercial system, this platform is an open source platform funded by the U.S. Government, accessible to the public, researchers and other developers, to support initiatives in reducing building energy consumption.« less

42 CFR 456.501 - UR plans as a condition for FFP.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals § 456.501 UR plans as a condition for FFP. (a) Except... services furnished by a hospital or mental hospital unless the facility has in effect a UR plan that meets...

40 CFR 63.40 - Applicability of §§ 63.40 through 63.44.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air Act Sections...). (c) Exclusion for electric utility steam generating units. The requirements of this subpart do not apply to electric utility steam generating units unless and until such time as these units are added to...

The Language of Mathematics: Learning to Read Mathematics for Understanding and Success

ERIC Educational Resources Information Center

Im, Yang Ok

2013-01-01

The intention of this project was to explore the effect of utilizing basic reading skills to promote student growth in mathematical literacy among middle school students. Mathematics was approached as a linquistical language and teachers utilized decoding skills as the treatment. This study used a nonequivalent control group quasi-experimental…

Control of Listeria monocytogenes in Ham Deli Loaves using Organic Acids as Formulation Ingredients

USDA-ARS?s Scientific Manuscript database

Organic acids are popular preservatives and are utilized in the industry to inhibit the growth of Listeria monocytogenes (LM) in ready-to-eat (RTE) products. In this study, sodium lactate (SL), potassium lactate (PL) and sodium diacetate (SD) were utilized alone or in combination in the raw product...

Advanced Grid-Friendly Controls Demonstration for Utility-Scale

Science.gov Websites

PV power plant in CAISO's footprint. NREL, CAISO, and First Solar conducted demonstration tests that vendors, integrators, and utilities to develop and evaluate photovoltaic (PV) power plants with advanced grid-friendly capabilities. Graph of power over time that shows a PV plant varying output to follow an

Solar Newsletter | Solar Research | NREL

Science.gov Websites

, General Electric Optimize Voltage Control for Utility-Scale PV As utilities increasingly add solar power components that may be used to integrate distributed solar PV onto distribution systems. More than 335 data Innovation Award for Grid Reliability PV Demonstration First Solar, the California Independent System

76 FR 46267 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... assumptions used; (c) ways to enhance the quality, utility and clarity of the information to be collected; (d... Utility Service Title: 7 CFR Part 1780, Water and Waste Loan and Grant Program. OMB Control Number: 0572-0121. Summary of Collection: Section 306 of the Consolidated Farm and Rural Development Act (CONACT), 7...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

Utilizing PowerPoint Presentation to Promote Fall Prevention among Older Adults

ERIC Educational Resources Information Center

McCrary-Quarles, Audrey R.

2008-01-01

This study evaluated a PowerPoint home safety (PPHS) presentation in enhancing awareness, knowledge and behavior change among senior center attendees in southern Illinois. Twelve centers were utilized as data collection sites in a pretest-posttest control group design. Through stratified randomization, centers were placed into categories (high,…

Exercise and Diet in Obesity Treatment: An Integrative System Dynamics Perspective.

ERIC Educational Resources Information Center

Abdel-Hamid, Tarek K.

2003-01-01

Examined the utility of System Dynamics modeling as a vehicle for controlled experimentation to study and gain insight into the impacts of physical activity and diet on body weight and composition. Results underscored the significant interaction effects between physical activity, diet, and body composition and demonstrated the utility of…

USING RESPIROMETRY TO MEASURE HYDROGEN UTILIZATION IN SULFATE REDUCING BACTERIA IN THE PRESENCE OF COPPER AND ZINC

EPA Science Inventory

A respirometric method has been developed to measure hydrogen utilization by sulfate reducing bacteria (SRB). One application of this method has been to test inhibitory metals effects on the SRB culture used in a novel acid mine drainage treatment technology. As a control param...

40 CFR 60.4333 - What are my general requirements for complying with this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... consistent with good air pollution control practices for minimizing emissions at all times including during startup, shutdown, and malfunction. (b) When an affected unit with heat recovery utilizes a common steam... the other unit(s) utilizing the common heat recovery unit; or (2) Develop, demonstrate, and provide...

40 CFR 60.4333 - What are my general requirements for complying with this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... consistent with good air pollution control practices for minimizing emissions at all times including during startup, shutdown, and malfunction. (b) When an affected unit with heat recovery utilizes a common steam... the other unit(s) utilizing the common heat recovery unit; or (2) Develop, demonstrate, and provide...

Classroom Utilization. AIR 1986 Annual Forum Paper.

ERIC Educational Resources Information Center

Gracie, Larry W.

The use of an index to match classes and classroom space was assessed. The index initiates the use of several variables controlling utilization: number of hours that rooms are scheduled per week, average percentage of occupancy per room, and amount of area per station per room. Interviews with deans covered current classroom assignment…

13 CFR 307.16 - Effective utilization of Revolving Loan Funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the prescribed lending schedule, EDA may de-obligate the non-disbursed balance of the RLF Grant. EDA... control of the RLF Recipient; (ii) The financial need for the RLF still exists; (iii) The current and... loaned. (2) When the percentage of loaned RLF Capital falls below the applicable capital utilization...

40 CFR 63.40 - Applicability of §§ 63.40 through 63.44.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air Act Sections...). (c) Exclusion for electric utility steam generating units. The requirements of this subpart do not apply to electric utility steam generating units unless and until such time as these units are added to...

40 CFR 63.40 - Applicability of §§ 63.40 through 63.44.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air Act Sections...). (c) Exclusion for electric utility steam generating units. The requirements of this subpart do not apply to electric utility steam generating units unless and until such time as these units are added to...

40 CFR 63.40 - Applicability of §§ 63.40 through 63.44.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air Act Sections...). (c) Exclusion for electric utility steam generating units. The requirements of this subpart do not apply to electric utility steam generating units unless and until such time as these units are added to...

40 CFR 63.40 - Applicability of §§ 63.40 through 63.44.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air Act Sections...). (c) Exclusion for electric utility steam generating units. The requirements of this subpart do not apply to electric utility steam generating units unless and until such time as these units are added to...

47 CFR 1.1402 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Procedures § 1.1402 Definitions. (a) The term utility means any person that is a local exchange carrier or an electric, gas, water, steam, or other public utility, and who owns or controls poles, ducts, conduits, or... telecommunications services (as defined in 47 U.S.C. 226) or incumbent local exchange carriers (as defined in 47 U.S...

Enhancing fatty acid utilization ameliorates mitochondrial fragmentation and cardiac dysfunction via rebalancing optic atrophy 1 processing in the failing heart.

PubMed

Guo, Yongzheng; Wang, Zhen; Qin, Xinghua; Xu, Jie; Hou, Zuoxu; Yang, Hongyan; Mao, Xuechao; Xing, Wenjuan; Li, Xiaoliang; Zhang, Xing; Gao, Feng

2018-06-01

Heart failure (HF) is characterized by reduced fatty acid (FA) utilization associated with mitochondrial dysfunction. Recent evidence has shown that enhancing FA utilization may provide cardioprotection against HF. Our aim was to investigate the effects and the underlying mechanisms of cardiac FA utilization on cardiac function in response to pressure overload. Transverse aortic constriction (TAC) was used in C57 mice to establish pressure overload-induced HF. TAC mice fed on a high fat diet (HFD) exhibited increased cardiac FA utilization and improved cardiac function and survival compared with those on control diet. Such cardioprotection could also be provided by cardiac-specific overexpression of CD36. Notably, both HFD and CD36 overexpression attenuated mitochondrial fragmentation and improved mitochondrial function in the failing heart. Pressure overload decreased ATP-dependent metalloprotease (YME1L) expression and induced the proteolytic cleavage of the dynamin-like guanosine triphosphatase OPA1 as a result of suppressed FA utilization. Enhancing FA utilization upregulated YME1L expression and subsequently rebalanced OPA1 processing, resulting in restoration of mitochondrial morphology in the failing heart. In addition, cardiac-specific overexpression of YME1L exerted similar cardioprotective effects against HF to those provided by HFD or CD36 overexpression. These findings demonstrate that enhancing FA utilization ameliorates mitochondrial fragmentation and cardiac dysfunction via rebalancing OPA1 processing in pressure overload-induced HF, suggesting a unique metabolic intervention approach to improving cardiac functions in HF.

Reductions in Diagnostic Imaging With High Deductible Health Plans.

PubMed

Zheng, Sarah; Ren, Zhong Justin; Heineke, Janelle; Geissler, Kimberley H

2016-02-01

Diagnostic imaging utilization grew rapidly over the past 2 decades. It remains unclear whether patient cost-sharing is an effective policy lever to reduce imaging utilization and spending. Using 2010 commercial insurance claims data of >21 million individuals, we compared diagnostic imaging utilization and standardized payments between High Deductible Health Plan (HDHP) and non-HDHP enrollees. Negative binomial models were used to estimate associations between HDHP enrollment and utilization, and were repeated for standardized payments. A Hurdle model were used to estimate associations between HDHP enrollment and whether an enrollee had diagnostic imaging, and then the magnitude of associations for enrollees with imaging. Models with interaction terms were used to estimate associations between HDHP enrollment and imaging by risk score tercile. All models included controls for patient age, sex, geographic location, and health status. HDHP enrollment was associated with a 7.5% decrease in the number of imaging studies and a 10.2% decrease in standardized imaging payments. HDHP enrollees were 1.8% points less likely to use imaging; once an enrollee had at least 1 imaging study, differences in utilization and associated payments were small. Associations between HDHP and utilization were largest in the lowest (least sick) risk score tercile. Increased patient cost-sharing may contribute to reductions in diagnostic imaging utilization and spending. However, increased cost-sharing may not encourage patients to differentiate between high-value and low-value diagnostic imaging services; better patient awareness and education may be a crucial part of any reductions in diagnostic imaging utilization.

Measured effects of wind turbine generation at the Block Island Power Company

NASA Technical Reports Server (NTRS)

Wilreker, V. F.; Smith, R. F.; Stiller, P. H.; Scot, G. W.; Shaltens, R. K.

1984-01-01

Data measurements made on the NASA MOD-OA 200-kw wind-turbine generator (WTG) installed on a utility grid form the basis for an overall performance analysis. Fuel displacement/-savings, dynamic interactions, and WTG excitation (reactive-power) control effects are studied. Continuous recording of a large number of electrical and mechanical variables on FM magnetic tape permit evaluation and correlation of phenomena over a bandwidth of at least 20 Hz. Because the wind-power penetration reached peaks of 60 percent, the impact of wind fluctuation and wind-turbine/diesel-utility interaction is evaluated in a worst-case scenario. The speed-governor dynamics of the diesel units exhibited an underdamped response, and the utility operation procedures were not altered to optimize overall WTG/utility performance. Primary findings over the data collection period are: a calculated 6.7-percent reduction in fuel consumption while generating 11 percent of the total electrical energy; acceptable system voltage and frequency fluctuations with WTG connected; and applicability of WTG excitation schemes using voltage, power, or VARS as the controlled variable.

Fuzzy Model-based Pitch Stabilization and Wing Vibration Suppression of Flexible Wing Aircraft.

NASA Technical Reports Server (NTRS)

Ayoubi, Mohammad A.; Swei, Sean Shan-Min; Nguyen, Nhan T.

2014-01-01

This paper presents a fuzzy nonlinear controller to regulate the longitudinal dynamics of an aircraft and suppress the bending and torsional vibrations of its flexible wings. The fuzzy controller utilizes full-state feedback with input constraint. First, the Takagi-Sugeno fuzzy linear model is developed which approximates the coupled aeroelastic aircraft model. Then, based on the fuzzy linear model, a fuzzy controller is developed to utilize a full-state feedback and stabilize the system while it satisfies the control input constraint. Linear matrix inequality (LMI) techniques are employed to solve the fuzzy control problem. Finally, the performance of the proposed controller is demonstrated on the NASA Generic Transport Model (GTM).

Silk-based delivery systems of bioactive molecules.

PubMed

Numata, Keiji; Kaplan, David L

2010-12-30

Silks are biodegradable, biocompatible, self-assembling proteins that can also be tailored via genetic engineering to contain specific chemical features, offering utility for drug and gene delivery. Silkworm silk has been used in biomedical sutures for decades and has recently achieved Food and Drug Administration approval for expanded biomaterials device utility. With the diversity and control of size, structure and chemistry, modified or recombinant silk proteins can be designed and utilized in various biomedical application, such as for the delivery of bioactive molecules. This review focuses on the biosynthesis and applications of silk-based multi-block copolymer systems and related silk protein drug delivery systems. The utility of these systems for the delivery of small molecule drugs, proteins and genes is reviewed. Copyright © 2010 Elsevier B.V. All rights reserved.

Evidence for surprise minimization over value maximization in choice behavior

PubMed Central

Schwartenbeck, Philipp; FitzGerald, Thomas H. B.; Mathys, Christoph; Dolan, Ray; Kronbichler, Martin; Friston, Karl

2015-01-01

Classical economic models are predicated on the idea that the ultimate aim of choice is to maximize utility or reward. In contrast, an alternative perspective highlights the fact that adaptive behavior requires agents’ to model their environment and minimize surprise about the states they frequent. We propose that choice behavior can be more accurately accounted for by surprise minimization compared to reward or utility maximization alone. Minimizing surprise makes a prediction at variance with expected utility models; namely, that in addition to attaining valuable states, agents attempt to maximize the entropy over outcomes and thus ‘keep their options open’. We tested this prediction using a simple binary choice paradigm and show that human decision-making is better explained by surprise minimization compared to utility maximization. Furthermore, we replicated this entropy-seeking behavior in a control task with no explicit utilities. These findings highlight a limitation of purely economic motivations in explaining choice behavior and instead emphasize the importance of belief-based motivations. PMID:26564686

Seizure Action Plans Do Not Reduce Health Care Utilization in Pediatric Epilepsy Patients.

PubMed

Roundy, Lindsi M; Filloux, Francis M; Kerr, Lynne; Rimer, Alyssa; Bonkowsky, Joshua L

2016-03-01

Management of pediatric epilepsy requires complex coordination of care. We hypothesized that an improved seizure management care plan would reduce health care utilization and improve outcomes. The authors conducted a cohort study with historical controls of 120 epilepsy patients before and after implementation of a "Seizure Action Plan." The authors evaluated for differences in health care utilization including emergency department visits, hospitalizations, clinic visits, telephone calls, and the percentage of emergency department visits that resulted in hospitalization in patients who did or did not have a Seizure Action Plan. The authors found that there was no decrease in these measures of health care utilization, and in fact the number of follow-up clinic visits was increased in the group with Seizure Action Plans (4.2 vs 3.3, P = .006). However, the study was underpowered to detect smaller differences. This study suggests that pediatric epilepsy quality improvement measures may require alternative approaches to reduce health care utilization and improve outcomes. © The Author(s) 2015.

Seizure Action Plans Do Not Reduce Health Care Utilization in Pediatric Epilepsy Patients

PubMed Central

Roundy, Lindsi M.; Filloux, Francis M.; Kerr, Lynne; Rimer, Alyssa; Bonkowsky, Joshua L.

2015-01-01

Management of pediatric epilepsy requires complex coordination of care. We hypothesized that an improved seizure management care plan would reduce healthcare utilization and improve outcomes. We conducted a cohort study with historical controls of 120 epilepsy patients before and after implementation of a “Seizure Action Plan.” We evaluated for differences in healthcare utilization including emergency department visits, hospitalizations, clinic visits, telephone calls, and the percentage of emergency department visits that resulted in hospitalization in patients who did or did not have a Seizure Action Plan. We found that there was no decrease in these measures of healthcare utilization, and in fact the number of follow-up clinic visits was increased in the group with Seizure Action Plans (4.2 versus 3.3, p 0.006). However, the study was underpowered to detect smaller differences. Our study suggests that pediatric epilepsy quality improvement measures may require alternative approaches to reduce healthcare utilization and improve outcomes. PMID:26245799

Allowance trading activity and state regulatory rulings: Evidence from the US Acid Rain Program

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

Bailey, E.M.

1997-12-31

The US Acid Rain Program is one of the first, and by far the most extensive, applications of a market based approach to pollution control. From the beginning, there has been concern whether utilities would participate in allowance trading, and whether regulatory activity at the state level would further complicate utilities` decision to trade allowances. This paper finds that public utility commission regulation has encouraged allowance trading activity in states with regulatory rulings, but that allowance trading activity has not been limited to states issuing regulations. Until there is evidence suggesting that significant additional cost savings could have been obtainedmore » if additional allowance trading activity had occurred in states without regulations or that utilities in states with regulations are still not taking advantage of all cost saving trading opportunities, this analysis suggests that there is little reason to believe that allowance trading activity is impeded by public utility commission regulations.« less

Outcomes Among Chronically Ill Adults in a Medical Home Prototype

PubMed Central

Liss, David T.; Fishman, Paul A.; Rutter, Carolyn M.; Grembowski, David; Ross, Tyler R.; Johnson, Eric A.; Reid, Robert J.

2014-01-01

Objectives To compare quality, utilization, and cost outcomes for patients with selected chronic illnesses at a patient-centered medical home (PCMH) prototype site with outcomes for patients with the same chronic illnesses at 19 nonintervention control sites. Study Design Nonequivalent pretest-posttest control group design. Methods PCMH redesign results were investigated for patients with preexisting diabetes, hypertension, and/or coronary heart disease. Data from automated databases were collected for eligible enrollees in an integrated healthcare delivery system. Multivariable regression models tested for adjusted differences between PCMH patients and controls during the baseline and follow-up periods. Dependent measures under study included clinical processes and, outcomes, monthly healthcare utilization, and costs. Results Compared with controls over 2 years, patients at the PCMH prototype clinic had slightly better clinical outcome control in coronary heart disease (2.20 mg/dL lower mean low-density lipoprotein cholesterol; P <.001). PCMH patients changed their patterns of primary care utilization, as reflected by 86% more secure electronic message contacts (P <.001), 10% more telephone contacts (P = .003), and 6% fewer in-person primary care visits (P <.001). PCMH patients had 21% fewer ambulatory care–sensitive hospitalizations (P <.001) and 7% fewer total inpatient admissions (P = .002) than controls. During the 2-year redesign, we observed 17% lower inpatient costs (P <.001) and 7% lower total healthcare costs (P <.001) among patients at the PCMH prototype clinic. Conclusions A clinic-level population-based PCMH redesign can decrease downstream utilization and reduce total healthcare costs in a subpopulation of patients with common chronic illnesses. PMID:24304182

Advanced Grid-Friendly Controls Demonstration Project for Utility-Scale PV Power Plants

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

Gevorgian, Vahan; O'Neill, Barbara

A typical photovoltaic (PV) power plant consists of multiple power electronic inverters and can contribute to grid stability and reliability through sophisticated 'grid-friendly' controls. The availability and dissemination of actual test data showing the viability of advanced utility-scale PV controls among all industry stakeholders can leverage PV's value from being simply an energy resource to providing additional ancillary services that range from variability smoothing and frequency regulation to power quality. Strategically partnering with a selected utility and/or PV power plant operator is a key condition for a successful demonstration project. The U.S. Department of Energy's (DOE's) Solar Energy Technologies Officemore » selected the National Renewable Energy Laboratory (NREL) to be a principal investigator in a two-year project with goals to (1) identify a potential partner(s), (2) develop a detailed scope of work and test plan for a field project to demonstrate the gird-friendly capabilities of utility-scale PV power plants, (3) facilitate conducting actual demonstration tests, and (4) disseminate test results among industry stakeholders via a joint NREL/DOE publication and participation in relevant technical conferences. The project implementation took place in FY 2014 and FY 2015. In FY14, NREL established collaborations with AES and First Solar Electric, LLC, to conduct demonstration testing on their utility-scale PV power plants in Puerto Rico and Texas, respectively, and developed test plans for each partner. Both Puerto Rico Electric Power Authority and the Electric Reliability Council of Texas expressed interest in this project because of the importance of such advanced controls for the reliable operation of their power systems under high penetration levels of variable renewable generation. During FY15, testing was completed on both plants, and a large amount of test data was produced and analyzed that demonstrates the ability of PV power plants to provide various types of new grid-friendly controls.« less

Solar Energy Grid Integration Systems (SEGIS): adding functionality while maintaining reliability and economics

NASA Astrophysics Data System (ADS)

Bower, Ward

2011-09-01

An overview of the activities and progress made during the US DOE Solar Energy Grid Integration Systems (SEGIS) solicitation, while maintaining reliability and economics is provided. The SEGIS R&D opened pathways for interconnecting PV systems to intelligent utility grids and micro-grids of the future. In addition to new capabilities are "value added" features. The new hardware designs resulted in smaller, less material-intensive products that are being viewed by utilities as enabling dispatchable generation and not just unpredictable negative loads. The technical solutions enable "advanced integrated system" concepts and "smart grid" processes to move forward in a faster and focused manner. The advanced integrated inverters/controllers can now incorporate energy management functionality, intelligent electrical grid support features and a multiplicity of communication technologies. Portals for energy flow and two-way communications have been implemented. SEGIS hardware was developed for the utility grid of today, which was designed for one-way power flow, for intermediate grid scenarios, AND for the grid of tomorrow, which will seamlessly accommodate managed two-way power flows as required by large-scale deployment of solar and other distributed generation. The SEGIS hardware and control developed for today meets existing standards and codes AND provides for future connections to a "smart grid" mode that enables utility control and optimized performance.

Effect of diabetic case management intervention on health service utilization in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

2015-12-01

This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups. © 2014 Wiley Publishing Asia Pty Ltd.

EQ-5D-5L and SF-6D Utility Measures in Symptomatic benign Thyroid Nodules: Acceptability and Psychometric Evaluation.

PubMed

Wong, Carlos K H; Lang, Brian H H; Yu, Hill M S; Lam, Cindy L K

2017-08-01

The aim of this study was to examine the acceptability, validity, and reliability of the EuroQoL Five-Dimension Five-Level (EQ-5D-5L) and Short-Form Six-Dimension (SF-6D) health utility measures in patients with symptomatic benign thyroid nodules. Data from a randomized controlled trial (ClinicalTrials.gov identifier: NCT02398721) of 294 patients with symptomatic benign thyroid nodules were utilized for this psychometric evaluation of health-related quality of life (HR-QOL) measurement. Three HR-QOL questionnaires-the generic 12-item Short Form Health Survey (SF-12v2), EQ-5D-5L, and SF-6D-were interviewer-administered at baseline and 2 weeks afterwards. Responses to SF-6D were transformed to SF-6D utility scores using a Hong Kong population scoring algorithm derived by standard gamble, whereas responses to EQ-5D-5L were mapped onto EQ-5D-3L response via interim mapping algorithms and then converted to EQ-5D-5L utility scores using a Chinese-specific value set. Construct validity was determined by evaluating Spearman correlation between SF-12v2 scores and utility scores. Two-week test-retest reliability was assessed using intra-class correlation coefficient. No significant (>15%) floor and ceiling effects were observed for SF-6D utility scores. The SF-6D utility scores had a moderate Spearman rank correlation with the SF-12v2 domain score providing evidence for adequate construct validity. The SF-6D utility scores showed good test-retest reliability (0.794; range 0.696-0.860). Better reliability was observed in SF-6D utility scores than in EQ-5D-5L utility scores. While the EQ-5D-5L instrument was less reproducible, the SF-6D instrument appeared to be an applicable, valid, and reliable measure in assessing the HR-QOL of Chinese patients with symptomatic benign thyroid nodules. The impact of utility score selection on the effectiveness and cost effectiveness of clinical interventions targeted to these patients needs further exploration. NCT02398721, ClinicalTrials.gov.

Impact of Community Health Workers on Use of Healthcare Services in the United States: A Systematic Review.

PubMed

Jack, Helen E; Arabadjis, Sophia D; Sun, Lucy; Sullivan, Erin E; Phillips, Russell S

2017-03-01

As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015. We included US-based studies that evaluated a CHW intervention for patients with at least one chronic health condition and reported cost or healthcare utilization outcomes. We evaluated studies using tools specific to study design. Our search yielded 2,941 studies after removing duplicates. Thirty-four met inclusion and methodological criteria. Sixteen studies (47%) were randomized controlled trials (RCTs). RCTs typically had less positive outcomes than other study designs. Of the 16 RCTs, 12 reported utilization outcomes, of which 5 showed a significant reduction in one or more of ED visits, hospitalizations and/or urgent care visits. Significant reductions reported in ED visits ranged from 23%-51% and in hospitalizations ranged from 21%-50%, and the one significant reduction in urgent care visits was recorded at 60% (p < 0.05 for all). Our results suggest that CHW interventions have variable effects, but some may reduce costs and preventable utilization. These findings suggest that it is possible to achieve reductions in care utilization and cost savings by integrating CHWs into chronic care management. However, variations in cost and utilization outcomes suggest that CHWs alone do not make an intervention successful. The paucity of rigorous studies and heterogeneity of study designs limited conclusions about factors associated with reduced utilization.

Factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review.

PubMed

Benenson, Irina; Jadotte, Yuri; Echevarria, Mercedes

2017-03-01

Painful vaso-occlusive crisis is a hallmark of sickle cell disease (SCD) that commonly results in utilization of hospital services. Recurrent use of hospital services by SCD patients is associated with high healthcare costs and adverse clinical outcomes. Understanding the factors influencing the pattern of utilization is a first step in improving medical care of this patient population while reducing healthcare expenditures. The primary objective of this systematic review was to determine what modifiable and non-modifiable factors influence utilization of hospital services by adult SCD patients. Adult SCD patients of both sexes who utilized hospital services for acute or emergency care. Non-modifiable and modifiable factors influencing utilization of hospital services. Prospective and retrospective cohort studies, case-control and analytical cross-sectional studies. The primary outcome of interest was high utilization of hospital services by adult SCD patients based on non-modifiable and modifiable factors measured as an odds ratio (analytical outcome). The secondary outcome was the prevalence of non-modifiable and modifiable factors among SCD patients who utilized hospital services measured as an event rate (descriptive outcome). A comprehensive multi-step search was undertaken to find both published and unpublished studies. Only studies published in the English language were included. The search was not limited by year of publication. Retrieved papers were assessed for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Data were extracted using a researcher-developed tool. Included studies were combined in a statistical meta-analysis. The meta-analysis was based on a random effect model. For studies that did not allow statistical pooling, the findings have been presented in a narrative form. Fourteen studies were included in this review. The analysis demonstrated that male patients accounted for 40.8% (95% confidence interval [CI] 0.370-0.447) of all utilizing patients. Sickle cell disease patients who were publically insured accounted for 76.5% (95% CI 0.632-0.861) of all patients who had hospital encounters. Patients aged 25-35 years had the highest rate of utilization, and the rate of utilization declined in patients older than 50 years. High utilizing patients had more diagnoses of acute chest syndrome and sepsis than patients who were moderate or low utilizers. The majority of SCD patients who utilized hospital services were women, young people and publically insured individuals. Patients with particularly high level of utilization had more frequent diagnoses of acute chest syndrome and sepsis.

Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

PubMed

de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

2015-02-01

A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

FTOOLS: A FITS Data Processing and Analysis Software Package

NASA Astrophysics Data System (ADS)

Blackburn, J. Kent; Greene, Emily A.; Pence, William

1993-05-01

FTOOLS, a highly modular collection of utilities for processing and analyzing data in the FITS (Flexible Image Transport System) format, has been developed in support of the HEASARC (High Energy Astrophysics Research Archive Center) at NASA's Goddard Space Flight Center. Each utility performs a single simple task such as presentation of file contents, extraction of specific rows or columns, appending or merging tables, binning values in a column or selecting subsets of rows based on a boolean expression. Individual utilities can easily be chained together in scripts to achieve more complex operations such as the generation and displaying of spectra or light curves. The collection of utilities provides both generic processing and analysis utilities and utilities common to high energy astrophysics data sets. The FTOOLS software package is designed to be both compatible with IRAF and completely stand alone in a UNIX or VMS environment. The user interface is controlled by standard IRAF parameter files. The package is self documenting through the IRAF help facility and a stand alone help task. Software is written in ANSI C and FORTRAN to provide portability across most computer systems. The data format dependencies between hardware platforms are isolated through the FITSIO library package.

Toward an Understanding of Health Care Delay Among Minorities: Examining Health Care Behaviors Among Military Young-Adult Males

DTIC Science & Technology

2001-05-01

anxiety, and health locus of control ) and delay time . Mor, Masterson-Allen, Goldberg, Guadagnoli, and Wool (1990) also examined symptom recognition and...race/ethnicity and their relationship to health care utilization. Many times race and ethnicity are included as indicators of SES since they are...quality health care thereby removing access as one of the major barriers to utilization and controlling for SES. The purpose of this study was to

Hybrid spread spectrum radio system

DOEpatents

Smith, Stephen F.; Dress, William B.

2010-02-02

Systems and methods are described for hybrid spread spectrum radio systems. A method includes modulating a signal by utilizing a subset of bits from a pseudo-random code generator to control an amplification circuit that provides a gain to the signal. Another method includes: modulating a signal by utilizing a subset of bits from a pseudo-random code generator to control a fast hopping frequency synthesizer; and fast frequency hopping the signal with the fast hopping frequency synthesizer, wherein multiple frequency hops occur within a single data-bit time.

Managing computer-controlled operations

NASA Technical Reports Server (NTRS)

Plowden, J. B.

1985-01-01

A detailed discussion of Launch Processing System Ground Software Production is presented to establish the interrelationships of firing room resource utilization, configuration control, system build operations, and Shuttle data bank management. The production of a test configuration identifier is traced from requirement generation to program development. The challenge of the operational era is to implement fully automated utilities to interface with a resident system build requirements document to eliminate all manual intervention in the system build operations. Automatic update/processing of Shuttle data tapes will enhance operations during multi-flow processing.