Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance.

PubMed

Sommers, Benjamin D; Blendon, Robert J; Orav, E John; Epstein, Arnold M

2016-10-01

Under the Affordable Care Act (ACA), more than 30 states have expanded Medicaid, with some states choosing to expand private insurance instead (the "private option"). In addition, while coverage gains from the ACA's Medicaid expansion are well documented, impacts on utilization and health are unclear. To assess changes in access to care, utilization, and self-reported health among low-income adults in 3 states taking alternative approaches to the ACA. Differences-in-differences analysis of survey data from November 2013 through December 2015 of US citizens ages 19 to 64 years with incomes below 138% of the federal poverty level in Kentucky, Arkansas, and Texas (n = 8676). Data analysis was conducted between January and May 2016. Medicaid expansion in Kentucky and use of Medicaid funds to purchase private insurance for low-income adults in Arkansas (private option), compared with no expansion in Texas. Self-reported access to primary care, specialty care, and medications; affordability of care; outpatient, inpatient, and emergency utilization; receiving glucose and cholesterol testing, annual check-up, and care for chronic conditions; quality of care, depression score, and overall health. Among the 3 states included in the study, Arkansas (n=2890), Kentucky (n=2898, and Texas (n=2888), there were no differences in sex, income, or marital status. Respondents from Texas were younger, more urban, and disproportionately Latino compared with those in Arkansas and Kentucky. Significant changes in coverage and access were more apparent in 2015 than in 2014. By 2015, expansion was associated with a 22.7 percentage-point reduction in the uninsured rate compared with nonexpansion (P < .001). Expansion was associated with significantly increased access to primary care (12.1 percentage points; P < .001), fewer skipped medications due to cost (-11.6 percentage points; P < .001), reduced out-of-pocket spending (-29.5%; P = .02), reduced likelihood of emergency department visits (-6.0 percentage points, P = .04), and increased outpatient visits (0.69 visits per year; P = .04). Screening for diabetes (6.3 percentage points; P = .05), glucose testing among patients with diabetes (10.7 percentage points; P = .03), and regular care for chronic conditions (12.0 percentage points; P = .008) all increased significantly after expansion. Quality of care ratings improved significantly (-7.1 percentage points with "fair/poor quality of care"; P = .03), as did the share of adults reporting excellent health (4.8 percentage points; P = .04). Comparisons of Arkansas vs Kentucky showed increased private coverage in the former (21.7 percentage points; P < .001), increased Medicaid in the latter (21.3 percentage points; P  < .001), and higher diabetic glucose testing rates in Kentucky (11.6 percentage points; P = .04), but no other statistically significant differences. In the second year of expansion, Kentucky's Medicaid program and Arkansas's private option were associated with significant increases in outpatient utilization, preventive care, and improved health care quality; reductions in emergency department use; and improved self-reported health. Aside from the type of coverage obtained, outcomes were similar for nearly all other outcomes between the 2 states using alternative approaches to expansion.

Liquid-assisted grinding and ion pairing regulates percentage conversion and diastereoselectivity of the Wittig reaction under mechanochemical conditions.

PubMed

Denlinger, Kendra Leahy; Ortiz-Trankina, Lianna; Carr, Preston; Benson, Kingsley; Waddell, Daniel C; Mack, James

2018-01-01

Mechanochemistry is maturing as a discipline and continuing to grow, so it is important to continue understanding the rules governing the system. In a mechanochemical reaction, the reactants are added into a vessel along with one or more grinding balls and the vessel is shaken at high speeds to facilitate a chemical reaction. The dielectric constant of the solvent used in liquid-assisted grinding (LAG) and properly chosen counter-ion pairing increases the percentage conversion of stilbenes in a mechanochemical Wittig reaction. Utilizing stepwise addition/evaporation of ethanol in liquid-assisted grinding also allows for the tuning of the diastereoselectivity in the Wittig reaction.

PROJECT TALENT, IDENTIFICATION, DEVELOPMENT, AND UTILIZATION OF HUMAN TALENTS--SELECTED PUPIL AND SCHOOL CHARACTERISTICS IN RELATION TO PERCENTAGE OF NEGROES IN SCHOOL ENROLLMENT. FINAL REPORT.

ERIC Educational Resources Information Center

BURKET, GEORGE R.; FLANAGAN, JOHN C.

CONSISTING MAINLY OF TABLES, THIS REPORT PRESENTS THE FINDINGS OF A STATISTICAL STUDY WHICH EXAMINED THE DIFFERENCES AND SIMILARITIES AMONG 733 PROJECT TALENT SENIOR HIGH SCHOOLS WITH VARYING PROPORTIONS OF NEGRO ENROLLMENT. THE FACTORS STUDIED IN THESE SCHOOLS WERE EDUCATIONAL OUTCOMES, SCHOOL PRACTICES, STUDENT BODY CHARACTERISTICS, AND SCHOOL…

2, 4, 5 -T amine not recommended for frill-treating hardwood culls in West Virginia

Treesearch

Harry W. Yawney

1962-01-01

Cull trees and undesirable species may occupy a high percentage of forest growing space. In a managed forest, these unwanted individuals must be cut or killed so that sound vigorous growing stock of good species can utilize the space. The methods most frequently used to eliminate medium to large-size trees from timber stands are either girdling or application of...

Women's autonomy and maternal healthcare service utilization in Ethiopia.

PubMed

Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Chuang, Ying-Chih

2017-11-13

Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women's autonomy. We assessed whether women's autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women's decision-making power and permissive gender norms associated with wife beating. We used Spearman's correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women's autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Our study shows that women's autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution.

Effect of rumen-undegradable protein supplementation and fresh forage composition on nitrogen utilization of dairy ewes.

PubMed

Mikolayunas, C; Thomas, D L; Armentano, L E; Berger, Y M

2011-01-01

Previous trials with dairy ewes fed stored feeds indicate a positive effect of rumen-undegradable protein (RUP) supplementation on milk yield. However, dairy sheep production in the United States is primarily based on grazing mixed grass-legume pastures, which contain a high proportion of rumen-degradable protein. Two trials were conducted to evaluate the effects of high-RUP protein supplementation and fresh forage composition on milk yield and N utilization of lactating dairy ewes fed in confinement or on pasture. In a cut-and-carry trial, 16 multiparous dairy ewes in mid-lactation were randomly assigned to 8 pens of 2 ewes each. Pens were randomly assigned 1 of 2 protein supplementation treatments, receiving either 0.0 or 0.3 kg of a high-RUP protein supplement (Soy Pass, LignoTech USA Inc., Rothschild, WI) per day. Within supplementation treatment, pens were randomly assigned to 1 of 4 forage treatments, which were applied in a 4×4 Latin square design for 10-d periods. Forage treatments included the following percentages of orchardgrass:alfalfa dry matter: 25:75, 50:50, 75:25, and 100:0. No interactions were observed between supplement and forage treatments. Supplementation with a high-RUP source tended to increase milk yield by 9%. Milk yield, milk protein yield, milk urea N, and urinary urea N excretion increased linearly with increased percentage of alfalfa. Milk N efficiency was greatest on the 100% orchardgrass diet. In a grazing trial, 12 multiparous dairy ewes in mid lactation were randomly assigned to 3 groups of 4 ewes each. Within group, 2 ewes were randomly assigned to receive either 0.0 or 0.3 kg of a high-RUP protein supplement (SoyPlus, West Central Cooperative, Ralston, IA) per day. Grazing treatments were arranged in a 3×3 Latin square design and applied to groups for 10-d periods. Ewes grazed paddocks that contained the following percentages of surface area of pure stands of orchardgrass:alfalfa: 50:50, 75:25, and 100:0. No interactions were found between supplement and forage treatments. Milk yield, milk protein yield, and milk urea N increased linearly with increased percentage of alfalfa in the paddock. In conclusion, supplementing with high-RUP protein tended to increase milk yield and increasing the proportion of alfalfa in the diet increased dry matter intake, milk yield, and protein yield of lactating dairy ewes fed or grazing fresh forage. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Poverty, wealth, and health care utilization: a geographic assessment.

PubMed

Cooper, Richard A; Cooper, Matthew A; McGinley, Emily L; Fan, Xiaolin; Rosenthal, J Thomas

2012-10-01

Geographic variation has been of interest to both health planners and social epidemiologists. However, while the major focus of interest of planners has been on variation in health care spending, social epidemiologists have focused on health; and while social epidemiologists have observed strong associations between poor health and poverty, planners have concluded that income is not an important determinant of variation in spending. These different conclusions stem, at least in part, from differences in approach. Health planners have generally studied variation among large regions, such as states, counties, or hospital referral regions (HRRs), while epidemiologists have tended to study local areas, such as ZIP codes and census tracts. To better understand the basis for geographic variation in hospital utilization, we drew upon both approaches. Counties and HRRs were disaggregated into their constituent ZIP codes and census tracts and examined the interrelationships between income, disability, and hospital utilization that were examined at both the regional and local levels, using statistical and geomapping tools. Our studies centered on the Milwaukee and Los Angeles HRRs, where per capita health care utilization has been greater than elsewhere in their states. We compared Milwaukee to other HRRs in Wisconsin and Los Angeles to the other populous counties of California and to a region in California of comparable size and diversity, stretching from San Francisco to Sacramento (termed "San-Framento"). When studied at the ZIP code level, we found steep, curvilinear relationships between lower income and both increased hospital utilization and increasing percentages of individuals reporting disabilities. These associations were also evident on geomaps. They were strongest among populations of working-age adults but weaker among seniors, for whom income proved to be a poor proxy for poverty and whose residential locations deviated from the major underlying income patterns. Among working-age adults, virtually all of the excess utilization in Milwaukee was attributable to very high utilization in Milwaukee's segregated "poverty corridor." Similarly, the greater rate of hospital use in Los Angeles than in San-Framento could be explained by proportionately more low-income ZIP codes in Los Angeles and fewer in San-Framento. Indeed, when only high-income ZIP codes were assessed, there was little variation in hospital utilization among California's 18 most populous counties. We estimated that had utilization within each region been at the rate of its high-income ZIP codes, overall utilization would have been 35 % less among working-age adults and 20 % less among seniors. These studies reveal the importance of disaggregating large geographic units into their constituent ZIP codes in order to understand variation in health care utilization among them. They demonstrate the strong association between low ZIP code income and both higher percentages of disability and greater hospital utilization. And they suggest that, given the large contribution of the poorest neighborhoods to aggregate utilization, it will be difficult to curb the growth of health care spending without addressing the underlying social determinants of health.

In situ hydrogen utilization for high fraction acetate production in mixed culture hollow-fiber membrane biofilm reactor.

PubMed

Zhang, Fang; Ding, Jing; Shen, Nan; Zhang, Yan; Ding, Zhaowei; Dai, Kun; Zeng, Raymond J

2013-12-01

Syngas fermentation is a promising route for resource recovery. Acetate is an important industrial chemical product and also an attractive precursor for liquid biofuels production. This study demonstrated high fraction acetate production from syngas (H₂ and CO₂) in a hollow-fiber membrane biofilm reactor, in which the hydrogen utilizing efficiency reached 100% during the operational period. The maximum concentration of acetate in batch mode was 12.5 g/L, while the acetate concentration in continuous mode with a hydraulic retention time of 9 days was 3.6 ± 0.1 g/L. Since butyrate concentration was rather low and below 0.1 g/L, the acetate fraction was higher than 99% in both batch and continuous modes. Microbial community analysis showed that the biofilm was dominated by Clostridium spp., such as Clostridium ljungdahlii and Clostridium drakei, the percentage of which was 70.5%. This study demonstrates a potential technology for the in situ utilization of syngas and valuable chemical production.

Theoretical and Numerical Approaches for Determining the Reflection and Transmission Coefficients of OPEFB-PCL Composites at X-Band Frequencies

PubMed Central

Ahmad, Ahmad F.; Abbas, Zulkifly; Obaiys, Suzan J.; Ibrahim, Norazowa; Hashim, Mansor; Khaleel, Haider

2015-01-01

Bio-composites of oil palm empty fruit bunch (OPEFB) fibres and polycaprolactones (PCL) with a thickness of 1 mm were prepared and characterized. The composites produced from these materials are low in density, inexpensive, environmentally friendly, and possess good dielectric characteristics. The magnitudes of the reflection and transmission coefficients of OPEFB fibre-reinforced PCL composites with different percentages of filler were measured using a rectangular waveguide in conjunction with a microwave vector network analyzer (VNA) in the X-band frequency range. In contrast to the effective medium theory, which states that polymer-based composites with a high dielectric constant can be obtained by doping a filler with a high dielectric constant into a host material with a low dielectric constant, this paper demonstrates that the use of a low filler percentage (12.2%OPEFB) and a high matrix percentage (87.8%PCL) provides excellent results for the dielectric constant and loss factor, whereas 63.8% filler material with 36.2% host material results in lower values for both the dielectric constant and loss factor. The open-ended probe technique (OEC), connected with the Agilent vector network analyzer (VNA), is used to determine the dielectric properties of the materials under investigation. The comparative approach indicates that the mean relative error of FEM is smaller than that of NRW in terms of the corresponding S21 magnitude. The present calculation of the matrix/filler percentages endorses the exact amounts of substrate utilized in various physics applications. PMID:26474301

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

ERIC Educational Resources Information Center

Hirasuna, Donald P.; Stinson, Thomas F.

2007-01-01

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

High utilization of inpatient detoxification: predictors among US veterans.

PubMed

Chang, Grace; Raffi, Edwin; Tang, Michael; Fernando, Gerard I; Zucker, Jarred; Schein, Abigail Z

2016-05-01

Readmissions are among the most problematic and expensive problems in the treatment of substance use disorders. To evaluate the characteristics associated with four or more inpatient medically managed detoxification admissions in FY 2012, when all had post-discharge appointments within 7 days. A retrospective case control study. A total of 38 (6.0%) of 623 unique veterans had four or more detoxification admissions (high utilizers). A random sample of 42 was selected from the remaining 585 people (comparison group). In all, 264 detoxification and 70 hospital admissions for other reasons were reviewed. The high utilizers had more alcohol use disorder (AUD, 82% versus 59%, p = 0.03) of significantly longer duration (mean 28.9 years [SD = 17] vs. 19.6 [SD = 13.4], p = 0.01). AUD increased the odds of being a high utilizer three-fold [OR = 3.0, 95% CI 1.1, 8.4], and every additional year of AUD, increased the number of admissions 1.3%, p = 0.0006. The high utilizers did not differ from the comparison group with regards to either number of hospitalizations for other reasons (mean 1.2 [SD = 1.9] vs. 0.57 [SD = 0.8], p = 0.06) or rate of 7 day post discharge appointments kept (46.9% vs. 49.3%, p = 0.82). High utilizers were a small percentage of patients (6.0%) who accounted for a disproportionate number (23%) of 977 detoxification admissions. They had greater disease severity as manifest by more years of AUD. They were not more likely to have hospitalizations for other reasons or less likely to keep post discharge appointments. These patients may warrant different services tailored to prevent hospital readmissions for detoxification.

Increasing the percentage of renewable energy in the Southwestern United States

USDA-ARS?s Scientific Manuscript database

Combining the output of wind farms with that of Concentrating Solar Power (CSP) plants (including a heat storage system) resulted in a substantial percentage (40%) of the total utility electrical generation in the Southwestern United States being met by renewable energy. Using wind and solar resourc...

B lymphocyte selection and age-related changes in VH gene usage in mutant Alicia rabbits.

PubMed

Zhu, X; Boonthum, A; Zhai, S K; Knight, K L

1999-09-15

Young Alicia rabbits use VHa-negative genes, VHx and VHy, in most VDJ genes, and their serum Ig is VHa negative. However, as Alicia rabbits age, VHa2 allotype Ig is produced at high levels. We investigated which VH gene segments are used in the VDJ genes of a2 Ig-secreting hybridomas and of a2 Ig+ B cells from adult Alicia rabbits. We found that 21 of the 25 VDJ genes used the a2-encoding genes, VH4 or VH7; the other four VDJ genes used four unknown VH gene segments. Because VH4 and VH7 are rarely found in VDJ genes of normal or young Alicia rabbits, we investigated the timing of rearrangement of these genes in Alicia rabbits. During fetal development, VH4 was used in 60-80% of nonproductively rearranged VDJ genes, and VHx and VHy together were used in 10-26%. These data indicate that during B lymphopoiesis VH4 is preferentially rearranged. However, the percentage of productive VHx- and VHy-utilizing VDJ genes increased from 38% at day 21 of gestation to 89% at birth (gestation day 31), whereas the percentage of VH4-utilizing VDJ genes remained at 15%. These data suggest that during fetal development, either VH4-utilizing B-lineage cells are selectively eliminated, or B cells with VHx- and VHy-utilizing VDJ genes are selectively expanded, or both. The accumulation of peripheral VH4-utilizing a2 B cells with age indicates that these B cells might be selectively expanded in the periphery. We discuss the possible selection mechanisms that regulate VH gene segment usage in rabbit B cells during lymphopoiesis and in the periphery.

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

PubMed

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

2012-08-16

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

The impact of oil price on Malaysian sector indices

NASA Astrophysics Data System (ADS)

Ismail, Mohd Tahir; Luan, Yeap Pei; Ee, Ong Joo

2015-12-01

In this paper, vector error correction model (VECM) has been utilized to model the dynamic relationships between world crude oil price and the sector indices of Malaysia. The sector indices have been collected are covering the period Jan 1998 to Dec 2013. Surprisingly, our investigations show that oil price changes do not Granger-cause any of the sectors in all of Malaysia. However, sector indices of Food Producer and Utilities are found to be the cause of the changes in world crude oil prices. Furthermore, from the results of variance decomposition, very high percentage of shocks is explained by world crude oil price itself over the 12 months and small impact from other sector indices.

Optimizing the dermal accumulation of a tazarotene microemulsion using skin deposition modeling.

PubMed

Nasr, Maha; Abdel-Hamid, Sameh

2016-01-01

It is well known that microemulsions are mainly utilized for their transdermal rather than their dermal drug delivery potential due to their low viscosity, and the presence of penetration enhancing surfactants and co-surfactants. Applying quality by design (QbD) principles, a tazarotene microemulsion formulation for local skin delivery was optimized by creating a control space. Critical formulation factors (CFF) were oil, surfactant/co-surfactant (SAA/CoS), and water percentages. Critical quality attributes (CQA) were globular size, microemulsion viscosity, tazarotene skin deposition, permeation, and local accumulation efficiency index. Increasing oil percentage increased globular size, while the opposite occurred regarding SAA/CoS, (p = 0.001). Microemulsion viscosity was reduced by increasing oil and water percentages (p < 0.05), due to the inherent high viscosity of the utilized SAA/CoS. Drug deposition in the skin was reduced by increasing SAA/CoS due to the increased hydrophilicity and viscosity of the system, but increased by increasing water due to hydration effect (p = 0.009). Models with very good fit were generated, predicting the effect of CFF on globular size, microemulsion viscosity, and drug deposition. A combination of 40% oil and 45% SAA/CoS showed the maximum drug deposition of 75.1%. Clinical skin irritation study showed that the aforementioned formula was safe for topical use. This article suggests that applying QbD tools such as experimental design is an efficient tool for drug product design.

78 FR 33757 - Rural Determination and Financing Percentage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

... supplies electricity to an electric utility serving an area that is less than 100 percent rural. By... percentage of the asset(s) can be financed, by amending 7 CFR part 1710. The properties of electricity are... territory is to be supplied with electricity by a RUS-financed project, the Agency proposes that the...

It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.

PubMed

Quick, Brian; Harrison, Tyler R; King, Andy J; Bosch, Dave

2013-01-01

The present project applied successful strategies employed in previous driver facility campaigns occurring during the inception of a registry to examine whether these approaches are effective in growing a mature registry, a registry where the majority of individuals have had the opportunity to register as an organ donor. Driver facilities (N = 40) in Illinois with high (n = 20) and low (n = 20) organ donation registration percentages were selected and served as either intervention or control sites for the campaign. Among facilities with historically high and low registration percentages, support for the campaign was found with the intervention facilities experiencing higher organ donation registration rates compared with control facilities. In addition, the results provide partial support for the effectiveness of employing a multi-message, phased driver facility intervention in states with a mature registry. The practical implications of utilizing driver facility campaigns in states with an established first-person consent registry also are discussed. © 2013 John Wiley & Sons A/S.

Adding concentrated solar power plants to wind farms to achieve a good utility electrical load match

USDA-ARS?s Scientific Manuscript database

Texas has the greatest installed wind turbine capacity of any state in the United States, the percentage of wind capacity approaches 10% of the utilities capacity (in 2010 the total wind generated capacity in Texas was 8%). It is becomimg increasingly difficult for the utility to balance the elec...

The impact of the global budget system on dynamics of dental manpower and utilization of dental services.

PubMed

Huang, Laura Yueh-Guey; Huang, Boyen

2016-01-01

This study aimed to investigate dentists' supply and practice patterns following the implementation of the global budget system in Taiwan. Data of reimbursement claims, municipal socioeconomic status and dental manpower were collected from the National Health Insurance administration, the Ministry of Internal Affair, and the Ministry of Health and Welfare, respectively. A multivariate linear regression method was used for data analysis. A municipality that reported a higher percentage of tertiary educated population (t = 3.718, P < 0.001), a higher per capita income (t = 6.172, P < 0.001), a higher population density (t = 6.172, P < 0.001), or a lower percentage of elderly population (t = -2.506, P = 0.014) was more likely to have a higher number of dentists per 100,000 population. A municipality that reported a higher Herfindahl-Hirschman Index (HHI) value (t = 2.880, P = 0.005) was more likely to show a higher move-out rate among dentists. The rate was lower after the implementation of the global budget system (t = -2.436, P = 0.018). A municipality that had a higher percentage of elderly population (t = 3.628, P < 0.001), a lower percentage of young population (t = -2.138, P = 0.035), or a higher rate of population growth (t = 4.412, P < 0.001) was more likely to display a higher move-in rate among dentists. The percentage of amalgam restorations in total claims reduced from 19.82% to 17.94%, while the percentage of tooth-colored material restorations increased from 25.46% to 28.79%. This study has demonstrated a stabilizing effect of the global budget system on dynamics of dental manpower in Taiwan. A relationship between HHI and dentists' move-out rate has been found. The relationship between municipal socioeconomic status and the density of dentists has also been confirmed. In addition, reduced utilization of amalgam restorations was accompanied by increased utilization of tooth-colored material restorations. Further investigations are indicated.

Utility of the Spelling Sensitivity Score to Analyze Spellings of Children with Specific Language Impairment

PubMed Central

Werfel, Krystal L.; Krimm, Hannah

2015-01-01

The purpose of this study was to examine the utility of the Spelling Sensitivity Score (SSS) beyond percentage correct scoring in analysing the spellings of children with specific language impairment (SLI). Participants were 31 children with SLI and 28 children with typical language in grades 2 through 4. Spellings of individual words were scored using two methods: (a) percentage correct and (b) SSS. Children with SLI scored lower than children with typical language when spelling was analysed with percentage correct scoring and with SSS scoring. Additionally, SSS scoring highlighted group differences in the nature of spelling errors. Children with SLI were more likely than children with typical language to omit elements and to represent elements with an illegal grapheme in words, whereas children with typical language were more likely than children with SLI to represent all elements with correct letters. PMID:26413194

Utility of a near real-time emergency department syndromic surveillance system to track injuries in New York City.

PubMed

Seil, Kacie; Marcum, Jennifer; Lall, Ramona; Stayton, Catherine

2015-12-01

The New York City emergency department (ED) syndromic surveillance (SS) system provides near real-time data on the majority of ED visits. The utility of ED SS for injury surveillance has not been thoroughly evaluated. We created injury syndromes based on ED chief complaint information and evaluated their utility compared to administrative billing data. Six injury syndromes were developed: traffic-related injuries to pedal cyclists, pedestrians, and motor vehicle occupants; fall-related injuries; firearm-related injuries; and assault-related stabbings. Daily injury counts were compared for ED SS and the administrative billing data for years 2008-2010. We examined characteristics of injury trends and patterns between the two systems, calculating descriptive statistics for temporal patterns and Pearson correlation coefficients (r) for temporal trends. We also calculated proportions of demographic and geospatial patterns for both systems. Although daily volume of the injuries varied between the two systems, the temporal patterns were similar (all r values for daily volume exceeded 0.65). Comparisons of injuries by time of day, day of week, and quarter of year demonstrated high agreement between the two systems-the majority had an absolute percentage point difference of 2.0 or less. Distributions of injury by sex and age group also aligned well. Distribution of injury by neighborhood of residence showed mixed results-some neighborhood comparisons showed a high level of agreement between systems, while others were less successful. As evidenced by the strong positive correlation coefficients and the small absolute percentage point differences in our comparisons, we conclude that ED SS captures temporal trends and patterns of injury-related ED visits effectively. The system could be used to identify changes in injury patterns, allowing for situational awareness during emergencies, timely response, and public messaging.

Utilization of preventive services by pregnant women in Jerusalem--a cross sectional study.

PubMed

Ellencweig, A Y; Ritter, M; Peleg-Olavsky, E; Tamir, D

1990-09-01

A study was made of health service utilization patterns during pregnancy of 279 young mothers, a representative sample of the Jewish population in Jerusalem. Only 47% reported that they used the municipal family health centers (FHCs) for prenatal care. Some 82% reported that they had resorted to more than one source of care during pregnancy. Sources other than the FHC were: regular Sick Fund doctor service (33%); private practitioners (25%); hospital-based services (25%). Among the FHC users, there was an unexpectedly high percentage of women of Asian-African origin and of those living in remote neighborhoods. Under-utilization was frequent among wealthy women, those with higher education and members of the Orthodox religious sector. While there was general satisfaction with the service, lower gratification was associated with higher utilization. This phenomenon may intimate that there may be a process of negative selection among women who use the service, when other alternatives are not readily available.

Supplementation of methionine and selection of highly digestible rumen undegradable protein to improve nitrogen efficiency for milk production.

PubMed

Noftsger, S; St-Pierre, N R

2003-03-01

Metabolizable protein (MP) supply and amino acid balance were manipulated through selection of highly digestible rumen-undegradable protein (RUP) sources and methionine (Met) supplementation. Effects on production efficiency and N utilization of lactating dairy cows were determined. Thirty-two multiparous (647 kg) and 28 primiparous (550 kg) Holstein cows were assigned during the fourth week of lactation to one of four dietary treatments. Treatments were 1) 18.3% crude protein (CP) with low estimated intestinal digestibility of RUP (HiCP-LoDRUP), 2) 18.3% CP with high digestibility RUP (HiCP-HiDRUP), 3) 16.9% CP with high digestibility RUP (LoCP-HiDRUP), and 4) 17.0% CP with high digestibility RUP and supplemental Met (LoCP-HiDRUP + Met). Diets were balanced to have equal concentrations of net energy for lactation (NE(L)), acid detergent fiber (ADF), neutral detergent fiber (NDF), and ash. Milk yields (40.8, 46.2, 42.9, 46.6 kg/d), protein percentages (2.95, 2.98, 2.99, 3.09%), and fat percentages (3.42, 3.64, 3.66, 3.73%) are reported here for HiCP-LoDRUP, HiCP-HiDRUP, LoCP-HiDRUP, and LoCP-HiDRUP + Met, respectively. Milk urea N and BUN decreased when feeding a lower CP diet. Efficiency of use of N for milk protein production was higher when feeding higher digestibility RUP, especially with the LoCP-HiDRUP + Met diet. A digestibility study followed the production trial, with six cows per treatment group continuing on the same treatment for an additional week. The experimental periods were 5 d long, with 1 d of adjustment and 4 d of total collection of urine and feces. Dry matter intake, milk production, milk protein production, and N digestibility were not significantly different among treatments during the collection trial, whereas N intake and N absorbed increased with the higher CP diets. The quantity of N in feces did not change with diet, but quantity of N in urine decreased in the low CP diets. Milk N as a percentage of intake N and milk N as a percentage of N absorbed showed a trend toward increasing as CP concentration in the diet decreased. The supplementation of Met did not improve the efficiency of N utilization during the digestibility study, in contrast to what was estimated during the production trial. Supplementing the highly digestible RUP source with rumen available and rumen escape sources of Met resulted in maximal milk and protein production and maximum N efficiency by cows during the production trial, indicating that postruminal digestibility of RUP and amino acid balance can be more important than total RUP supplementation.

The Application of Remote Sensing Techniques to Urban Data Acquisition

NASA Technical Reports Server (NTRS)

Horton, F. E.

1971-01-01

The application of remote sensing techniques useful in acquiring data concerning housing quality is discussed. Conclusions reached from the investigation were: (1) Use of individuals with a higher degree of training in photointerpretation should significantly increase the percentage of successful classifications. (2) Small area classification of urban housing quality can definitely be accomplished via high resolution aerial photography. Such surveys, at the levels of accuracy demonstrated, can be of major utility in quick look surveys. (3) Survey costs should be significantly reduced.

Diagnostic utility of abdominal ultrasonography in dogs with chronic vomiting.

PubMed

Leib, M S; Larson, M M; Panciera, D L; Troy, G C; Monroe, W E; Rossmeisl, J H; Forrester, S D; Herring, E S

2010-01-01

Chronic vomiting is a common problem in dogs that has many causes. Ultrasonographic descriptions of many gastrointestinal (GI) diseases have been published. However, diagnostic utility of ultrasonography in dogs with chronic vomiting has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. Eighty-nine pet dogs with chronic vomiting. Medical records were reviewed and the contribution of abdominal ultrasound to the clinical diagnosis was subjectively scored. In 68.5% of dogs, the reviewers thought that the same diagnosis would have been reached without performing ultrasonography. In 22.5% of dogs, the ultrasound examination was considered to be vital or beneficial to the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with increasing age, a greater number of vomiting episodes per week, presence of weight loss, a greater percentage of lost body weight, and a final diagnosis of GI lymphoma or gastric adenocarcinoma. However, multivariate analysis only identified increasing age and a final diagnosis of gastric adenocarcinoma or GI lymphoma to be associated with increased diagnostic utility. In 12.4% of dogs, additional benefits of ultrasonography to case management, excluding the contribution to the vomiting problem, were identified. The diagnostic utility of abdominal ultrasonography was high in 27% of dogs. The presence of factors that are associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic vomiting.

Molecular diversity and population structure of the forage grass Hemarthria compressa (Poaceae) in south China based on SRAP markers.

PubMed

Huang, L-K; Zhang, X-Q; Xie, W-G; Zhang, J; Cheng, L; Yan, H D

2012-08-16

Hemarthria compressa is one of the most important and widely utilized forage crops in south China, owing to its high forage yield and capability of adaptation to hot and humid conditions. We examined the population structure and genetic variation within and among 12 populations of H. compressa in south China using sequence-related amplified polymorphism (SRAP) markers. High genetic diversity was found in these samples [percentage polymorphic bands (PPB) = 82.21%, Shannon's diversity index (I) = 0.352]. However, there was relatively low level of genetic diversity at the population level (PPB = 29.17%, I = 0.155). A high degree of genetic differentiation among populations was detected based on other measures and molecular markers (Nei's genetic diversity analysis: G(ST) = 54.19%; AMOVA analysis: F(ST) = 53.35%). The SRAP markers were found to be more efficient than ISSR markers for evaluating population diversity. Based on these findings, we propose changes in sampling strategies for appraising and utilizing the genetic resources of this species.

Effects of supplementation and stage of lactation on performance of grazing dairy ewes.

PubMed

Mikolayunas, C M; Thomas, D L; Albrecht, K A; Combs, D K; Berger, Y M; Eckerman, S R

2008-04-01

The majority of dairy sheep in the world are fed pasture and supplemental grain during lactation; however, no trials have reported the effects of supplementation of dairy ewes grazing improved pastures in North America. In trial 1, 56 three-year-old grazing dairy ewes in early [21 +/- 10 d in milk (DIM)] or late (136 +/- 9 DIM) lactation were fed 0 or 0.82 kg of dry matter/d per ewe of supplement (16.5% crude protein mixture of corn and a soybean meal-based high-protein pellet) in a 2 x 2 factorial arrangement of treatments. There were no significant interactions between stage of lactation and supplementation treatments. Average test-day milk production was higher in early-lactation ewes than in late-lactation ewes (1.74 vs. 1.21 kg/d, respectively). Although test-day milk protein percentage was higher in late-lactation ewes than in early-lactation ewes (5.02 vs. 4.86%, respectively), there was no difference in milk fat percentage between stages of lactation. Supplemented ewes had higher milk production (1.59 vs. 1.36 kg/d, respectively), lower milk fat percentage (5.75 vs. 6.00%, respectively), and lower milk protein percentage (4.84 vs. 5.04%, respectively) than unsupplemented ewes. Milk urea N levels were similar between the 2 stages of lactation and between the 2 supplementation treatments and were above recommended levels for dairy sheep, indicating an excess intake or inefficient utilization of protein for both supplementation treatments. In trial 2, 96 two-, three-, and four-year-old grazing dairy ewes in midlactation (112 +/- 21 DIM) were randomly assigned to 4 treatments of 0, 0.41, 0.82, or 1.24 kg of dry matter/d per ewe of whole corn. Average test-day milk production increased linearly and milk fat percentage decreased quadratically with increasing amounts of corn supplementation. Milk protein yield increased linearly, and milk urea N levels decreased quadratically with increasing amounts of corn supplementation, suggesting an improvement in the utilization of pasture protein with increasing dietary energy intake.

Associations between socio-demographic characteristics and chemical concentrations contributing to cumulative exposures in the United States.

PubMed

Huang, Hongtai; Tornero-Velez, Rogelio; Barzyk, Timothy M

2017-11-01

Association rule mining (ARM) has been widely used to identify associations between various entities in many fields. Although some studies have utilized it to analyze the relationship between chemicals and human health effects, fewer have used this technique to identify and quantify associations between environmental and social stressors. Socio-demographic variables were generated based on U.S. Census tract-level income, race/ethnicity population percentage, education level, and age information from the 2010-2014, 5-Year Summary files in the American Community Survey (ACS) database, and chemical variables were generated by utilizing the 2011 National-Scale Air Toxics Assessment (NATA) census tract-level air pollutant exposure concentration data. Six mobile- and industrial-source pollutants were chosen for analysis, including acetaldehyde, benzene, cyanide, particulate matter components of diesel engine emissions (namely, diesel PM), toluene, and 1,3-butadiene. ARM was then applied to quantify and visualize the associations between the chemical and socio-demographic variables. Census tracts with a high percentage of racial/ethnic minorities and populations with low income tended to have higher estimated chemical exposure concentrations (fourth quartile), especially for diesel PM, 1,3-butadiene, and toluene. In contrast, census tracts with an average population age of 40-50 years, a low percentage of racial/ethnic minorities, and moderate-income levels were more likely to have lower estimated chemical exposure concentrations (first quartile). Unsupervised data mining methods can be used to evaluate potential associations between environmental inequalities and social disparities, while providing support in public health decision-making contexts.

10 CFR 490.307 - Option for Electric Utilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Option for Electric Utilities. 490.307 Section 490.307 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel... motor vehicles, the following percentages of new light duty motor vehicles acquired shall be alternative...

10 CFR 490.307 - Option for Electric Utilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Option for Electric Utilities. 490.307 Section 490.307 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel... motor vehicles, the following percentages of new light duty motor vehicles acquired shall be alternative...

Physician Service Attribution Methods for Examining Provision of Low-Value Care

PubMed Central

Chang, Eva; Buist, Diana SM; Handley, Matthew; Pardee, Roy; Gundersen, Gabrielle; Reid, Robert J.

2016-01-01

Objectives: There has been significant research on provider attribution for quality and cost. Low-value care is an area of heightened focus, with little of the focus being on measurement; a key methodological decision is how to attribute delivered services and procedures. We illustrate the difference in relative and absolute physician- and panel-attributed services and procedures using overuse in cervical cancer screening. Study Design: A retrospective, cross-sectional study in an integrated health care system. Methods: We used 2013 physician-level data from Group Health Cooperative to calculate two utilization attributions: (1) panel attribution with the procedure assigned to the physician’s predetermined panel, regardless of who performed the procedure; and (2) physician attribution with the procedure assigned to the performing physician. We calculated the percentage of low-value cervical cancer screening tests and ranked physicians within the clinic using the two utilization attribution methods. Results: The percentage of low-value cervical cancer screening varied substantially between physician and panel attributions. Across the whole delivery system, median panel- and physician-attributed percentages were 15 percent and 10 percent, respectively. Among sampled clinics, panel-attributed percentages ranged between 10 percent and 17 percent, and physician-attributed percentages ranged between 9 percent and 13 percent. Within a clinic, median panel-attributed screening percentage was 17 percent (range 0 percent–27 percent) and physician-attributed percentage was 11 percent (range 0 percent–24 percent); physician rank varied by attribution method. Conclusions: The attribution method is an important methodological decision when developing low-value care measures since measures may ultimately have an impact on national benchmarking and quality scores. Cross-organizational dialogue and transparency in low-value care measurement will become increasingly important for all stakeholders. PMID:28203612

Physician Service Attribution Methods for Examining Provision of Low-Value Care.

PubMed

Chang, Eva; Buist, Diana Sm; Handley, Matthew; Pardee, Roy; Gundersen, Gabrielle; Reid, Robert J

2016-01-01

There has been significant research on provider attribution for quality and cost. Low-value care is an area of heightened focus, with little of the focus being on measurement; a key methodological decision is how to attribute delivered services and procedures. We illustrate the difference in relative and absolute physician- and panel-attributed services and procedures using overuse in cervical cancer screening. A retrospective, cross-sectional study in an integrated health care system. We used 2013 physician-level data from Group Health Cooperative to calculate two utilization attributions: (1) panel attribution with the procedure assigned to the physician's predetermined panel, regardless of who performed the procedure; and (2) physician attribution with the procedure assigned to the performing physician. We calculated the percentage of low-value cervical cancer screening tests and ranked physicians within the clinic using the two utilization attribution methods. The percentage of low-value cervical cancer screening varied substantially between physician and panel attributions. Across the whole delivery system, median panel- and physician-attributed percentages were 15 percent and 10 percent, respectively. Among sampled clinics, panel-attributed percentages ranged between 10 percent and 17 percent, and physician-attributed percentages ranged between 9 percent and 13 percent. Within a clinic, median panel-attributed screening percentage was 17 percent (range 0 percent-27 percent) and physician-attributed percentage was 11 percent (range 0 percent-24 percent); physician rank varied by attribution method. The attribution method is an important methodological decision when developing low-value care measures since measures may ultimately have an impact on national benchmarking and quality scores. Cross-organizational dialogue and transparency in low-value care measurement will become increasingly important for all stakeholders.

Study Neutronic of Small Pb-Bi Cooled Non-Refuelling Nuclear Power Plant Reactor (SPINNOR) with Hexagonal Geometry Calculation

NASA Astrophysics Data System (ADS)

Nur Krisna, Dwita; Su'ud, Zaki

2017-01-01

Nuclear reactor technology is growing rapidly, especially in developing Nuclear Power Plant (NPP). The utilization of nuclear energy in power generation systems has been progressing phase of the first generation to the fourth generation. This final project paper discusses the analysis neutronic one-cooled fast reactor type Pb-Bi, which is capable of operating up to 20 years without refueling. This reactor uses Thorium Uranium Nitride as fuel and operating on power range 100-500MWtNPPs. The method of calculation used a computer simulation program utilizing the SRAC. SPINNOR reactor is designed with the geometry of hexagonal shaped terrace that radially divided into three regions, namely the outermost regions with highest percentage of fuel, the middle regions with medium percentage of fuel, and most in the area with the lowest percentage. SPINNOR fast reactor operated for 20 years with variations in the percentage of Uranium-233 by 7%, 7.75%, and 8.5%. The neutronic calculation and analysis show that the design can be optimized in a fast reactor for thermal power output SPINNOR 300MWt with a fuel fraction 60% and variations of Uranium-233 enrichment of 7%-8.5%.

Lipid content and fatty acid profile during lake whitefish embryonic development at different incubation temperatures.

PubMed

Mueller, Casey A; Doyle, Liam; Eme, John; Manzon, Richard G; Somers, Christopher M; Boreham, Douglas R; Wilson, Joanna Y

2017-01-01

Lipids serve as energy sources, structural components, and signaling molecules during fish embryonic development, and utilization of lipids may vary with temperature. Embryonic energy utilization under different temperatures is an important area of research in light of the changing global climate. Therefore, we examined percent lipid content and fatty acid profiles of lake whitefish (Coregonus clupeaformis) throughout embryonic development at three incubation temperatures. We sampled fertilized eggs and embryos at gastrulation, eyed and fin flutter stages following chronic incubation at temperatures of 1.8, 4.9 and 8.0°C. Hatchlings were also sampled following incubation at temperatures of 3.3, 4.9 and 8.0°C. Fertilized eggs had an initial high percentage of dry mass composed of lipid (percent lipid content; ~29%) consisting of ~20% saturated fatty acids (SFA), ~32% monounsaturated fatty acids (MUFA), ~44% polyunsaturated fatty acids (PUFA), and 4% unidentified. The most abundant fatty acids were 16:0, 16:1, 18:1(n-9c), 20:4(n-6), 20:5(n-3) and 22:6(n-3). This lipid profile matches that of other cold-water fish species. Percent lipid content increased during embryonic development, suggesting protein or other yolk components were preferentially used for energy. Total percentage of MUFA decreased during development, which indicated MUFA were the primary lipid catabolized for energy during embryonic development. Total percentage of PUFA increased during development, driven largely by an increase in 22:6(n-3). Temperature did not influence percent lipid content or percent MUFA at any development stage, and had inconsistent effects on percent SFA and percent PUFA during development. Thus, lake whitefish embryos appear to be highly adapted to low temperatures, and do not alter lipids in response to temperature within their natural incubation conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

Chromosomal Fragmentation: A Possible Marker for the Selection of High Gymnemic Acid Yielding Accessions of Gymnema sylvestre R. Br.

PubMed

Verma, Ashutosh Kumar; Dhawan, Sunita Singh

2017-10-01

Gymnema sylvestre R. Br. a member of family Asclepiadaceae as mentioned in Indian Pharmacopoeia popular among the researchers because of stimulatory effect of its phytoconstituent on pancreatic cells and potential to treat Type I and II type of diabetes. Development of cost-effective marker system for the selection of high gymnemic acid yielding accessions of G. sylvestre . Presoaked seeds of Brassica campestris treated with different dilutions of gymnemagenin and 10% leaf extract of twenty different accessions of G. sylvestre . Root tips of germinated seeds were fixed, and chromosomal studies were made by root tip bioassay method. Exposure of seeds to treatment solutions promotes various types of chromosomal anomalies in root meristem, and surprisingly, direct correlation between the percentage of chromosomal fragmentation and the percentage of gymnemic acid shared by treatment solution were observed. Later finding may be explored for the development of a novel methodology or marker system for the selection of high active principle yielding accessions of G. sylvestre . An experiment was carried out using root tip bioassay method for the study of effect of different dilutions of standard gymnemic acid and 10% leaf extract of twenty different accessions of Gymnema sylvestre on root tip meristem of Brassica campestris . Various types of chromosomal anomalies were observed. Of which, percentage of chromosomal fragmentation was showed a direct (∞) relationship with the percentage of gymnemic acid shared by treatment solution. This interesting result after more and more exploration and revalidation could be utilized for the development of a novel methodology for the selection of high active principle yielding accessions of G. sylvestre . Abbreviations used: MI: Mitotic index; CP: Condensed prophase; CM: Clumped metaphase; MC: Metaphase cleft; FR: Fragmentation; AP: Anaphase with persistent nucleolous; LA: Laggard, BR: Bridge; BI: Bi-nucleated cell; DA: Disturbed anaphasic polarity.

Chromosomal Fragmentation: A Possible Marker for the Selection of High Gymnemic Acid Yielding Accessions of Gymnema sylvestre R. Br

PubMed Central

Verma, Ashutosh Kumar; Dhawan, Sunita Singh

2017-01-01

Background: Gymnema sylvestre R. Br. a member of family Asclepiadaceae as mentioned in Indian Pharmacopoeia popular among the researchers because of stimulatory effect of its phytoconstituent on pancreatic cells and potential to treat Type I and II type of diabetes. Objectives: Development of cost-effective marker system for the selection of high gymnemic acid yielding accessions of G. sylvestre. Materials and Methods: Presoaked seeds of Brassica campestris treated with different dilutions of gymnemagenin and 10% leaf extract of twenty different accessions of G. sylvestre. Root tips of germinated seeds were fixed, and chromosomal studies were made by root tip bioassay method. Results: Exposure of seeds to treatment solutions promotes various types of chromosomal anomalies in root meristem, and surprisingly, direct correlation between the percentage of chromosomal fragmentation and the percentage of gymnemic acid shared by treatment solution were observed. Conclusion: Later finding may be explored for the development of a novel methodology or marker system for the selection of high active principle yielding accessions of G. sylvestre. SUMMARY An experiment was carried out using root tip bioassay method for the study of effect of different dilutions of standard gymnemic acid and 10% leaf extract of twenty different accessions of Gymnema sylvestre on root tip meristem of Brassica campestris. Various types of chromosomal anomalies were observed. Of which, percentage of chromosomal fragmentation was showed a direct (∞) relationship with the percentage of gymnemic acid shared by treatment solution. This interesting result after more and more exploration and revalidation could be utilized for the development of a novel methodology for the selection of high active principle yielding accessions of G. sylvestre. Abbreviations used: MI: Mitotic index; CP: Condensed prophase; CM: Clumped metaphase; MC: Metaphase cleft; FR: Fragmentation; AP: Anaphase with persistent nucleolous; LA: Laggard, BR: Bridge; BI: Bi-nucleated cell; DA: Disturbed anaphasic polarity. PMID:29142402

Utility of Inferential Norming with Smaller Sample Sizes

ERIC Educational Resources Information Center

Zhu, Jianjun; Chen, Hsin-Yi

2011-01-01

We examined the utility of inferential norming using small samples drawn from the larger "Wechsler Intelligence Scales for Children-Fourth Edition" (WISC-IV) standardization data set. The quality of the norms was estimated with multiple indexes such as polynomial curve fit, percentage of cases receiving the same score, average absolute…

Validation of national land-cover characteristics data for regional water-quality assessment

USGS Publications Warehouse

Zelt, Ronald B.; Brown, Jesslyn F.; Kelley, M.S.

1995-01-01

Land-cover information is used routinely to support the interpretation of water-quality data. The Prototype 1990 Conterminous US Land Cover Characteristics Data Set, developed primarily from Advanced Very High Resolution Radiometer (AVHRR) data, was made available to the US Geological Survey's National Water-Quality Assessment (NAWQA) Program. The study described in this paper explored the utility of the 1990 national data set for developing quantitative estimates of the areal extent of principal land-cover types within large areal units. Land-cover data were collected in 1993 at 210 sites in the Central Nebraska Basins, one of the NAWQA study units. Median percentage-corn estimates for each sampling stratum wre used to produce areally weighted estimates of the percentage-corn cover for hydrologic units. Comparison of those areal estimates with an independent source of 1992 land-cover data showed good agreement. -Authors

Mental illness and principal physical diagnoses among Asian American and Pacific Islander users of emergency services.

PubMed

Chen, Huey Jen

2005-12-01

The stigma of mental illness is one of the factors that prevents Asian Americans/Pacific Islanders (APIs) from seeking formal mental health services. A somatic complaint is more acceptable in expressing psychiatric/emotional distress. Admission diagnoses in API emergency service users with secondary psychiatric diagnoses were identified from the 2001 National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). The sample consisted of 10,623 adult APIs. The study examined the differences in the six leading principal physical admission diagnoses between API emergency service users with psychiatric diagnoses and those without psychiatric diagnoses. Several of the study findings create concern (e.g., the higher percentage of APIs with psychiatric diagnosis who were discharged against medical advice, the high percentage admitted with medication intoxication). Further study is needed to provide guidance for clinical practice.

Utilization of alum sludge as chromium removal

NASA Astrophysics Data System (ADS)

Zahari, Nazirul Mubin; Sidek, Lariyah Mohd; Zulkifli, Muhammad Azmeer Asyraf; Hua, Chua Kok; Jalil, Nurulhidayah Abdul

2017-09-01

The amount of alum sludge produced at water treatment plant has become a problem where it is highly costly in order to dispose them. Various research was conducted to find the most suitable and economic alternative to recycle and reused of alum sludge. In this study, alum sludge was retrieved from Waterworks where it was dewatered, dried, grounded and sieved to obtain smallest particle sizes of alum sludge. The synthetic water was prepared at the laboratory in as it was used to imitate the properties of real water contaminated with chromium. This study was conducted to determine the percentage reduction of chromium concentration in synthetic water by using alum sludge as absorbent. The percentage reduction of chromium was observed under the effect of initial concentration of chromium and the height of alum sludge. The result indicates that chromium concentration reduction was the highest at the lowest initial concentration and at the highest height of alum sludge and vice versa.

The Impact of the 2008 Council of Emergency Residency Directors (CORD) Panel on Emergency Medicine Resident Diversity.

PubMed

Boatright, Dowin; Tunson, Java; Caruso, Emily; Angerhofer, Christy; Baker, Brooke; King, Renee; Bakes, Katherine; Oberfoell, Stephanie; Lowenstein, Steven; Druck, Jeffrey

2016-11-01

In 2008, the Council of Emergency Medicine Residency Directors (CORD) developed a set of recruitment strategies designed to increase the number of under-represented minorities (URMs) in Emergency Medicine (EM) residency. We conducted a survey of United States (US) EM residency program directors to: describe the racial and ethnic composition of residents; ascertain whether each program had instituted CORD recruitment strategies; and identify program characteristics associated with recruitment of a high proportion of URM residents. The survey was distributed to accredited, nonmilitary US EM residency programs during 2013. Programs were dichotomized into high URM and low URM by the percentage of URM residents. High- and low-URM programs were compared with respect to size, geography, percentage of URM faculty, importance assigned to common applicant selection criteria, and CORD recruitment strategies utilized. Odds ratios and 95% confidence limits were calculated. Of 154 residency programs, 72% responded. The median percentage of URM residents per program was 9%. Only 46% of EM programs engaged in at least two recruitment strategies. Factors associated with higher resident diversity (high-URM) included: diversity of EM faculty (high-URM) (odds ratio [OR] 5.3; 95% confidence interval [CI] 2.1-13.0); applicant's URM status considered important (OR 4.9; 95% CI 2.1-11.9); engaging in pipeline activities (OR 4.8; 95% CI 1.4-15.7); and extracurricular activities considered important (OR 2.6; 95% CI 1.2-6.0). Less than half of EM programs have instituted two or more recruitment strategies from the 2008 CORD diversity panel. EM faculty diversity, active pipeline programs, and attention paid to applicants' URM status and extracurricular activities were associated with higher resident diversity. Copyright © 2016 Elsevier Inc. All rights reserved.

[Did the patients with chronic obstructive pulmonary disease in Primary Care center Anton de Borja correctly utilize inhalers?].

PubMed

Represas-Carrera, Francisco Jesús

2015-01-01

To determine the percentage of patients with Pulmonary Obstructive Chronic Disease who doing of incorrect form the inhaler technique. Descriptive transversal study made in the Primary Care Center "Antón de Borja" of Rubi (in Barcelona) during the period between May and December 2013, where it was studied a representative sample of 200 patients. To assess the inhaler technique was performed a personal interview with the patient in which it was requested him to carry out a demonstration of how he was using his inhaler regularly evaluating his inhaler technique by means of the regulations established by Spanish Society of Pneumology and Thoracic Surgery. 43% of the patients carry out inhaler technique incorrectly. The percentage of inadequate use of inhalers of dry powder was 26%, of the pressurized cartridge 38% and the inhaler chamber 10%. 82% of patients ≥ 65 years who have prescribed a pressurized inhaler cartridge do not perform accompanied by an inhaler chamber. A high percentage of patients do not correctly carry out inhaler technique, pointing the rare use made of the inhaler chamber despite its proven efficacy and the high number of patients with pressurized inhaler cartridge. These results reflect the need for the implementation of an educational program in our Primary Care Center to teach patients to use inhaler devices. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

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

PubMed Central

2012-01-01

Background Cancer is a major cause of global morbidity and mortality. Since a high prevalence of functional impairments has been observed among cancer patients, rehabilitation has been proposed as a strategy to restore patients’ functional independence. The increasing number of cancer patients combined with a growing need for rehabilitation may result in increased utilization of rehabilitation services. This study aimed to investigate the utilization of rehabilitation services among hospitalized cancer patients in Taiwan between 2004 and 2008. Methods Annual admissions and total inpatient expenditures for admissions with a cancer diagnosis were calculated from the National Health Insurance Research Database (NHIRD). Rehabilitation services used by cancer and non-cancer patients, as well as the distributions of rehabilitation service type among the different hospital departments were also analyzed. Results The percentages of inpatient admissions with a cancer diagnosis increased from 14.01% to 17.1% between 2004 and 2008. During 2004, 5.25% of all inpatient admissions received rehabilitation services; this percentage increased to 5.62% by 2008. Among cancer admissions, 2.26% to 2.62% received rehabilitation services from 2004 to 2008. By comparison, 5.68% to 6.24% of non-cancer admissions received rehabilitation services during this period. Of the admissions who received rehabilitation services, only 6.44% and 7.96% had a cancer diagnosis in 2004 and 2008, respectively. Sixty-one percent of rehabilitation services were delivered in the departments of orthopedics (25.6%), neurology (14.4%), rehabilitation (11.9%), and neurosurgery (9.2%). Conclusions In Taiwan, the utilization of rehabilitation services during hospitalization increased from 2004 to 2008. Although this trend was noted for cancer and non-cancer admissions, the utilization of rehabilitation services was generally greater by non-cancer admissions. Despite the benefits of rehabilitation, the actual rehabilitation needs of cancer patients remain unmet. PMID:22898402

The impact of the global budget system on dynamics of dental manpower and utilization of dental services

PubMed Central

Huang, Laura Yueh-Guey; Huang, Boyen

2016-01-01

Background: This study aimed to investigate dentists’ supply and practice patterns following the implementation of the global budget system in Taiwan. Materials and Methods: Data of reimbursement claims, municipal socioeconomic status and dental manpower were collected from the National Health Insurance administration, the Ministry of Internal Affair, and the Ministry of Health and Welfare, respectively. A multivariate linear regression method was used for data analysis. Results: A municipality that reported a higher percentage of tertiary educated population (t = 3.718, P < 0.001), a higher per capita income (t = 6.172, P < 0.001), a higher population density (t = 6.172, P < 0.001), or a lower percentage of elderly population (t = −2.506, P = 0.014) was more likely to have a higher number of dentists per 100,000 population. A municipality that reported a higher Herfindahl-Hirschman Index (HHI) value (t = 2.880, P = 0.005) was more likely to show a higher move-out rate among dentists. The rate was lower after the implementation of the global budget system (t = −2.436, P = 0.018). A municipality that had a higher percentage of elderly population (t = 3.628, P < 0.001), a lower percentage of young population (t = −2.138, P = 0.035), or a higher rate of population growth (t = 4.412, P < 0.001) was more likely to display a higher move-in rate among dentists. The percentage of amalgam restorations in total claims reduced from 19.82% to 17.94%, while the percentage of tooth-colored material restorations increased from 25.46% to 28.79%. Conclusion: This study has demonstrated a stabilizing effect of the global budget system on dynamics of dental manpower in Taiwan. A relationship between HHI and dentists’ move-out rate has been found. The relationship between municipal socioeconomic status and the density of dentists has also been confirmed. In addition, reduced utilization of amalgam restorations was accompanied by increased utilization of tooth-colored material restorations. Further investigations are indicated. PMID:27076827

Effects of daily management changes on behavioral patterns of a solitary female African elephant (Loxodonta africana) in a zoo.

PubMed

Koyama, Nao; Ueno, Yoshikazu; Eguchi, Yusuke; Uetake, Katsuji; Tanaka, Toshio

2012-07-01

This study investigated the effects of changes in daily management on behavior of a solitary female elephant in a zoo. The activity budget and space utilization of the subject and the management changes were recorded for 1 year after the conspecific male died. The observation days could be categorized into five clusters (C1-C5) by the characteristic behavioral pattern of each day. C1 had the highest percentage of resting of all clusters, and was observed after the loss of the conspecific and the beginning of use of the indoor exhibition room at night. C2, which had the highest percentage of stereotypy of any cluster, was observed after the beginning of habituation to the indoor exhibition room. Also, when the time schedule of management was changed irregularly, the subject frequently exhibited stereotypic pacing (C2, C4). The subject tended to rest when exhibiting lameness in the left hind limb (C3). In C5, activity reached a high level when she could utilize a familiar place under a stable management schedule. These results indicate that management changes affected the mental stability of an elephant in the early stage of social isolation. © 2012 The Authors. Animal Science Journal © 2012 Japanese Society of Animal Science.

Study of application of ERTS-A imagery to fracture-related mine safety hazards in the coal mining industry

NASA Technical Reports Server (NTRS)

Wier, C. E.; Wobber, F. J.; Russell, O. R.; Martin, K. R. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Mined land reclamation analysis procedures developed within the Indiana portion of the Illinois Coal Basin were independently tested in Ohio utilizing 1:80,000 scale enlargements of ERTS-1 image 1029-15361-7 (dated August 21, 1972). An area in Belmont County was selected for analysis due to the extensive surface mining and the different degrees of reclamation occurring in this area. Contour mining in this area provided the opportunity to extend techniques developed for analysis of relatively flat mining areas in Indiana to areas of rolling topography in Ohio. The analysts had no previous experience in the area. Field investigations largely confirmed office analysis results although in a few areas estimates of vegetation percentages were found to be too high. In one area this error approximated 25%. These results suggest that systematic ERTS-1 analysis in combination with selective field sampling can provide reliable vegetation percentage estimates in excess of 25% accuracy with minimum equipment investment and training. The utility of ERTS-1 for practical and reasonably reliable update of mined lands information for groups with budget limitations is suggested. Many states can benefit from low cost updates using ERTS-1 imagery from public sources.

The impact of including passive benefits in cost-effectiveness analysis: the case of automated external defibrillators on commercial aircraft.

PubMed

Cram, Peter; Vijan, Sandeep; Wolbrink, Alex; Fendrick, A Mark

2003-01-01

Traditional cost-utility analysis assumes that all benefits from health-related interventions are captured by the quality-adjusted life-years (QALYs) gained by the few individuals whose outcome is improved by the intervention. However, it is possible that many individuals who do not directly benefit from an intervention receive utility, and therefore QALYs, because of the passive benefit (aka sense of security) provided by the existence of the intervention. The objective of this study was to evaluate the impact that varying quantities of passive benefit have on the cost-effectiveness of airline defibrillator programs. A decision analytic model with Markov processes was constructed to evaluate the cost-effectiveness of defibrillator deployment on domestic commercial passenger aircraft over 1 year. Airline passengers were assigned small incremental utility gains (.001-.01) during an estimated 3-hour flight to evaluate the impact of passive benefit on overall cost-effectiveness. In the base case analysis with no allowance for passive benefit, the cost-effectiveness of airline automated external defibrillator deployment was US dollars 34000 per QALY gained. If 1% of all passengers received utility gain of.01, the cost-effectiveness declined to US dollars 30000. Cost-effectiveness was enhanced when the quantity of passive benefit was raised or the percentage of individuals receiving passive benefit increased. Automated external defibrillator deployment on passenger aircraft is likely to be cost-effective. If a small percentage of airline passengers receive incremental utility gains from passive benefit of automated external defibrillator availability, the impact on overall cost-effectiveness may be substantial. Further research should attempt to clarify the magnitude and percentage of patients who receive passive benefit.

Utilization of Mental Health Services in School-Based Health Centers

ERIC Educational Resources Information Center

Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-01-01

Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

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...

Isolation and characterization of yeasts capable of efficient utilization of hemicellulosic hydrolyzate as the carbon source.

PubMed

Cassa-Barbosa, L A; Procópio, R E L; Matos, I T S R; Filho, S A

2015-09-28

Few yeasts have shown the potential to efficiently utilize hemicellulosic hydrolyzate as the carbon source. In this study, microorganisms isolated from the Manaus region in Amazonas, Brazil, were characterized based on their utilization of the pentoses, xylose, and arabinose. The yeasts that showed a potential to assimilate these sugars were selected for the better utilization of lignocellulosic biomass. Two hundred and thirty seven colonies of unicellular microorganisms grown on hemicellulosic hydrolyzate, xylose, arabinose, and yeast nitrogen base selective medium were analyzed. Of these, 231 colonies were subjected to sugar assimilation tests. One hundred and twenty five of these were shown to utilize hydrolyzed hemicellulose, xylose, or arabinose as the carbon source for growth. The colonies that showed the best growth (N = 57) were selected, and their internal transcribed spacer-5.8S rDNA was sequenced. The sequenced strains formed four distinct groups in the phylogenetic tree, and showed a high percentage of similarity with Meyerozyma caribbica, Meyerozyma guilliermondii, Trichosporon mycotoxinivorans, Trichosporon loubieri, Pichia kudriavzevii, Candida lignohabitans, and Candida ethanolica. The discovery of these xylose-fermenting yeasts could attract widespread interest, as these can be used in the cost-effective production of liquid fuel from lignocellulosic materials.

Bedside identification of patients at risk for PVC-induced cardiomyopathy: Is ECG useful?

PubMed

Garster, Noelle C; Henrikson, Charles A

2017-07-01

Premature ventricular complexes (PVCs) are an underrecognized cause of cardiomyopathy. Standard 12-lead electrocardiogram (ECG) has potential to direct attention toward at-risk patients. We performed a single-center, retrospective chart review of 1,240 patients who completed ECG and Holter monitoring at Oregon Health and Science University Hospital between January 1, 2011 and December 31, 2013 to investigate the relationship of PVC frequency on ECG with burden on Holter. Primary outcome measures included PVC quantity on ECG, mean PVC quantity on Holter, and percentage of total beats on Holter recorded as PVCs. High PVC burden was defined as ≥10% of total beats. Weighted mean percentages of total beats on Holter monitor recorded as PVCs were calculated for 0, 1, 2, and ≥3 PVCs on ECG and found to be 1.4% (n = 1,128), 3.5% (n = 32), 4.3% (n = 25), and 16.6% (n = 55), respectively, which represent statistically significant differences (P < 0.001). The positive predictive value of at least three PVCs on ECG for ≥10% PVC Holter burden was 58%. Negative predictive value for 0 PVCs on ECG was 98%. The sensitivity and specificity of ECG to identify high PVC burden on Holter was 72% and 93.6%, respectively, when utilizing a positive ECG result as one PVC or more, and 44% and 98.9%, respectively, with ≥3 PVCs on ECG. The positive likelihood ratio corresponding to ≥3 PVCs on ECG was 40. These findings demonstrate that the number of PVCs on ECG can be utilized for quick bedside estimation of high PVC burden. © 2017 Wiley Periodicals, Inc.

Physicians' prescribing responses to a restricted formulary: the impact of Medicaid preferred drug lists in Illinois and Louisiana.

PubMed

Virabhak, Suchin; Shinogle, Judith A

2005-01-01

To determine the extent to which the strictness of the criteria used to control utilization of drugs not on a Medicaid preferred drug list (PDL) changes physician prescribing habits for non-Medicaid patients. Quasi-experimental design based on different timing of states' enactment of PDLs for cardiovascular medications. A regression model was developed to analyze the effect that PDL implementation had on off-PDL product market share across 3 patient types (Medicaid, third-party insurance, and cash paying). The models included data from 2 states (Illinois and Louisiana) with different PDL prior-authorization criteria. The data allowed examination of different physician responses according to the proportion of Medicaid patients treated by the physician. The analysis also followed prescribing patterns longitudinally to determine whether the PDL-induced prescribing behaviors changed over time. There was a decrease of 9 percentage points (67.7%) and 6.2 percentage points (40.5%) in the Medicaid prescription share of restricted cardiovascular drugs post-PDL for Illinois and Louisiana, respectively. In the third-party insurance market, prescription shares of off-PDL drugs decreased 0.9 percentage points (6.8%) in Illinois and 1.3 percentage points (8.6%) in Louisiana. For physicians with a high percentage of prescriptions paid for by Medicaid, the share loss for off-PDL drugs was estimated to be more than 37% for the non-Medicaid portion of the practice. The effects of a Medicaid PDL on prescribing behavior extend beyond the Medicaid population. The health outcomes and economic consequences of these "spillover" effects are poorly understood and warrant further research.

Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004-2010.

PubMed

Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

2013-01-01

This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004-2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001). A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001), and participated in health exhibitions (6% to 35%, P < 0.001). Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001), and attended one-one counseling (15% to 21%, P < 0.01). Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001). Adoption of a business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources.

Evaluating the McDonald’s business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

PubMed Central

Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

2013-01-01

Background This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. Methods The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald’s business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). Results The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001). A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001), and participated in health exhibitions (6% to 35%, P < 0.001). Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001), and attended one-one counseling (15% to 21%, P < 0.01). Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001). Conclusion Adoption of a business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources. PMID:23439724

Egg characteristics and hatch performance of Athens Canadian Random Bred 1955 meat-type chickens and 2013 Cobb 500 broilers.

PubMed

Collins, K E; McLendon, B L; Wilson, J L

2014-09-01

Athens Canadian Random Bred (ACRB) chickens, a 1955 meat-type control strain, were incubated with the 2013 Cobb 500 broiler to determine differences in egg composition, conductance values, incubation duration, hatch performance, and yolk utilization. Unincubated ACRB eggs had greater percentage solids than Cobb 500 eggs. The ACRB eggs had a greater solid portion as yolk, whereas the Cobb 500 devoted more solid percentage to albumen. Percentage shell was not different between the strains, but ACRB eggs had 2.7% greater percentage moisture loss after 18 d of incubation than Cobb 500 eggs. Conductance, conductance constant, and conductance standardized to a 100 g egg weight basis were all higher for ACRB eggs than Cobb 500 eggs at 12 and 18 d of incubation. The Cobb 500 chicks hatched 6 h earlier than ACRB chicks. The Cobb 500 incubation duration was 498 h, and the ACRB incubation duration was 504 h. There was no difference between the strains for percentage infertile eggs, embryonic mortality, hatchability, or salable chicks. The ACRB chicks hatched with a smaller dried residual yolk sac as a percentage of chick weight compared with the Cobb 500. Both strains had an average relative yolk-free chick weight of 61% of average initial egg weight. Thus the Cobb 500 eggs had decreased gas exchange across the eggshell, which may have contributed to the earlier hatch and decreased yolk utilization. Modern Cobb 500 broiler embryonic metabolism appears to have either become more dependent on albumen rather than yolk or has become more efficient with yolk reserves during development. Broiler hatch performance does not appear to have changed over the past 58 yr. © 2014 Poultry Science Association Inc.

Factors affecting utilization of university health services in a tertiary institution in South-West Nigeria.

PubMed

Obiechina, G O; Ekenedo, G O

2013-01-01

Most university health services have extensive health infrastructures, for the provision of effective and efficient health services to the students. In this study, we have tried to determine student's perception of factors affecting their utilization. To determine students' perception of health care services provided in a tertiary institution and assess students' attitude towards utilization. Simple random sampling technique was used to select 540 respondents, comprising of 390 males and 150 females. A structured and self-administered questionnaire was the instrument used to collect data for the study, while data collected was analyzed using descriptive statistics of frequency count and percentage. High cost of drugs (72.0%), non availability of essential drugs (54.8%), time spent waiting for treatment (67.2%), inadequate referral services (81.7%), and satisfaction with services (60.6%) were considered by the respondents as factors affecting the utilization of university health services. Students-medical staff relationship and accessibility to health facility (77.6% and 74.3% respectively) were, however, not considered as factors that affect utilization of university health services. It is recommended that to improve utilization and cost of care, government should make necessary efforts to incorporate tertiary institution into National Health Insurance scheme so that students above the age of 18 years can benefit from free treatment.

Exploring the literature on relationships between gender roles, intimate partner violence, occupational status, and organizational benefits.

PubMed

Kwesiga, Eileen; Bell, Myrtle P; Pattie, Marshall; Moe, Angela M

2007-03-01

Studies of intimate partner violence (IPV) and work have been primarily conducted with women in low-wage low-status (LWLS) positions, as much of this research has focused on poverty, welfare, and homelessness. Although women in LWLS positions represent a large percentage of working women in the United States, it is also important to investigate experiences of women in high-wage high-status (HWHS) positions because a growing number of women are employed within such jobs. We propose gender role theory can be used to explain occurrences of IPV among women in HWHS positions and their utilization of organizational benefits. We suggest those in HWHS positions may be likely to have access to organizational benefits (e.g., medical, vacation, and flexible work schedules) and the ability to utilize the Family and Medical Leave Act. However, prevailing gender roles existing in organizations may render women in HWHS positions unlikely to use benefits or to take leave.

Utilization of counseling services at one medical school.

PubMed

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

2013-08-01

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

Strategic groups and performance in the nursing home industry: a reexamination.

PubMed

Marlin, D; Sun, M; Huonker, J W

1999-06-01

This study further examines the relationship between strategic group membership and performance in the nursing home industry. The results indicate seven strategic groups in the industry with significant between-group differences in operating margin, average profit per patient day, catheterization rate, health deficiencies, life and safety deficiencies, and efficiency in the provision of services. The authors did not, however, find significant between-group differences in pressure sore rate, the use of restraints, or in the percentage of patients with significant unplanned weight changes. The group with the highest private-pay utilization combined with high Medicare utilization generally performed the best along all indicators. Results also suggest that strategic group membership and rural/urban location have a greater impact on performance than do ownership, chain membership, or possession of a dedicated specialty care unit.

Validation and utility of the PhysioTel™ Digital M11 telemetry implant for cardiovascular data evaluation in cynomolgus monkeys and Beagle dogs.

PubMed

Cordes, Jason S; Heyen, Jonathan R; Volberg, Marlo L; Poy, Nancy; Kreuser, Steven; Shoieb, Ahmed M; Steidl-Nichols, Jill

2016-01-01

The cardiovascular liability of candidate compounds can be evaluated by a number of methods including implanted telemetry, jacketed telemetry and surface lead electrocardiogram (ECG). The utility of the new PhysioTel™ Digital M11 cardiovascular telemetry implant was evaluated in monkeys and dogs. Eight monkeys and dogs (4 males and 4 females per species) were implanted with the M11 device utilizing a femoral blood pressure catheter and periosteal ECG leads. The signal quality of the ECGs was determined as a percentage of software-matched waveforms and as a percentage of signal loss during the recording periods. To investigate sensitivity for detecting changes in QT/QTc and HR/BP, moxifloxacin and doxazosin were administered to monkeys and dogs implanted with the M11 device. Additionally, histopathological evaluation of the implant site was completed. For both monkey and dog, the percentage of recognizable waveforms was high (65% and 85%, respectively), while the average amount of signal loss was low (1% and 3%, respectively), indicating that the M11 implants delivered data of sufficient quality. In monkeys, moxifloxacin (90mg/kg) induced QT and QTc prolongation up to 22 and 12ms, respectively, while at 30mg/kg in dogs, the maximal increases in QT and QTc were 13 and 16ms, respectively. Doxazosin (1.5 and 1.0mg/kg) produced HR increases up to 35 and 29bpm with decreases in blood pressure up to -14 and -26mmHg in monkeys and dogs, respectively. The histopathological impact of the implant, catheter and biopotential leads was limited to expected minor local inflammatory changes as assessed at necropsy and with microscopic examination. Based upon the results of this study, the PhysioTel™ Digital M11 is a suitable technology for assessing cardiovascular parameters in monkeys and dogs, and because of the size and limited invasiveness of the implant, is well positioned for use on toxicology studies. Copyright © 2016 Elsevier Inc. All rights reserved.

Public status and prevalence of acupuncture in Japan.

PubMed

Ishizaki, Naoto; Yano, Tadashi; Kawakita, Kenji

2010-12-01

Acupuncture originated in China and is widespread throughout Asia. It is expected that a higher utilization of this remedy exists in these countries compared to Western countries. We conducted annual nationwide surveys from 2003 through 2006 on the utilization of acupuncture in Japan. Face-to-face interviews were conducted with 2000 individuals randomly chosen from the resident database. Annual utilization percentages, based on the number of respondents, from 2003 to 2006 were 6.5%, 4.8%, 6.4%, and 6.7%, respectively, while lifetime experiences determined in each surveys were estimated as 26.7, 19.4, 24.4 and 25.4, respectively. Respondents who had utilized acupuncture and/or moxibustion tended to be older than those who had no experience. Acupuncture was mainly used for musculoskeletal symptoms, and a detailed breakdown of the musculoskeletal symptoms identified in the 2005 survey showed 50.9% for low back pain, 35.9% for shoulder stiffness and 12.0% for knee pain. Reasons given for continuing therapy included the effective amelioration of symptoms, comfort of the procedure and low number of side-effects, while those who decided against continuing cited no improvement of symptoms, cost and lack of time for treatment. In conclusion, annual utilization of acupuncture and/or moxibustion was estimated at more than 6%, and the percentage of those with a lifetime experience was ∼25%, thus demonstrating the relatively higher utilization of the remedy in Japan over utilization in western countries. Application of the treatment for musculoskeletal problems and utilization by the older population were specific standouts of the use of acupuncture and/or moxibustion in Japan.

Utilization of Molecular, Phenotypic, and Geographical Diversity to Develop Compact Composite Core Collection in the Oilseed Crop, Safflower (Carthamus tinctorius L.) through Maximization Strategy

PubMed Central

Kumar, Shivendra; Ambreen, Heena; Variath, Murali T.; Rao, Atmakuri R.; Agarwal, Manu; Kumar, Amar; Goel, Shailendra; Jagannath, Arun

2016-01-01

Safflower (Carthamus tinctorius L.) is a dryland oilseed crop yielding high quality edible oil. Previous studies have described significant phenotypic variability in the crop and used geographical distribution and phenotypic trait values to develop core collections. However, the molecular diversity component was lacking in the earlier collections thereby limiting their utility in breeding programs. The present study evaluated the phenotypic variability for 12 agronomically important traits during two growing seasons (2011–12 and 2012–13) in a global reference collection of 531 safflower accessions, assessed earlier by our group for genetic diversity and population structure using AFLP markers. Significant phenotypic variation was observed for all the agronomic traits in the representative collection. Cluster analysis of phenotypic data grouped the accessions into five major clusters. Accessions from the Indian Subcontinent and America harbored maximal phenotypic variability with unique characters for a few traits. MANOVA analysis indicated significant interaction between genotypes and environment for both the seasons. Initially, six independent core collections (CC1–CC6) were developed using molecular marker and phenotypic data for two seasons through POWERCORE and MSTRAT. These collections captured the entire range of trait variability but failed to include complete genetic diversity represented in 19 clusters reported earlier through Bayesian analysis of population structure (BAPS). Therefore, we merged the three POWERCORE core collections (CC1–CC3) to generate a composite core collection, CartC1 and three MSTRAT core collections (CC4–CC6) to generate another composite core collection, CartC2. The mean difference percentage, variance difference percentage, variable rate of coefficient of variance percentage, coincidence rate of range percentage, Shannon's diversity index, and Nei's gene diversity for CartC1 were 11.2, 43.7, 132.4, 93.4, 0.47, and 0.306, respectively while the corresponding values for CartC2 were 9.3, 58.8, 124.6, 95.8, 0.46, and 0.301. Each composite core collection represented the complete range of phenotypic and genetic variability of the crop including 19 BAPS clusters. This is the first report describing development of core collections in safflower using molecular marker data with phenotypic values and geographical distribution. These core collections will facilitate identification of genetic determinants of trait variability and effective utilization of the prevalent diversity in crop improvement programs. PMID:27807441

The histopathologic reliability of tissue taken from cadavers within the gross anatomy laboratory.

PubMed

Rae, Guenevere; Newman, William P; McGoey, Robin; Donthamsetty, Supriya; Karpinski, Aryn C; Green, Jeffrey

2018-03-01

The purpose of this study was to examine the histopathologic reliability of embalmed cadaveric tissue taken from the gross anatomy laboratory. Tissue samples from hearts, livers, lungs, and kidneys were collected after the medical students' dissection course was completed. All of the cadavers were embalmed in a formalin-based fixative solution. The tissue was processed, embedded in paraffin, sectioned at six micrometers, and stained with H&E. The microscope slides were evaluated by a board certified pathologist to determine whether the cellular components of the tissues were preserved at a high enough quality to allow for histopathologic diagnosis. There was a statistically significant relationship between ratings and organ groups. Across all organs, there was a smaller proportion of "poor" ratings. The lung group had the highest percentage of "poor" ratings (23.1%). The heart group had the least "poor" ratings (0.0%). The largest percentage of "satisfactory" ratings were in the lung group (52.8%), and the heart group contained the highest percentage of "good" ratings (58.5%) The lung group had the lowest percentage of "good" ratings (24.2%). These results indicate that heart tissue is more reliable than lung, kidney, or liver tissue when utilizing tissue from the gross anatomy laboratory for research and/or educational purposes. This information advises educators and researchers about the quality and histopathologic reliability of tissue samples obtained from the gross anatomy laboratory. Anat Sci Educ 11: 207-214. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Utility of the Spelling Sensitivity Score to Analyze Spellings of Children with Specific Language Impairment

ERIC Educational Resources Information Center

Werfel, Krystal L.; Krimm, Hannah

2015-01-01

The purpose of this study was to examine the utility of the Spelling Sensitivity Score (SSS) beyond percentage correct scoring in analyzing the spellings of children with specific language impairment (SLI). Participants were 31 children with SLI and 28 children with typical language in grades 2-4. Spellings of individual words were scored using…

Modeling the hydrologic and economic efficacy of stormwater utility credit programs for US single family residences.

PubMed

Kertesz, Ruben; Green, Olivia Odom; Shuster, William D

2014-01-01

As regulatory pressure to reduce the environmental impact of urban stormwater intensifies, US municipalities increasingly seek a dedicated source of funding for stormwater programs, such as a stormwater utility. In rare instances, single family residences are eligible for utility discounts for installing green infrastructure. This study examined the hydrologic and economic efficacy of four such programs at the parcel scale: Cleveland (OH), Portland (OR), Fort Myers (FL), and Lynchburg (VA). Simulations were performed to model the reduction in stormwater runoff by implementing bioretention on a typical residential property according to extant administrative rules. The EPA National Stormwater Calculator was used to perform pre- vs post-retrofit comparisons and to demonstrate its ease of use for possible use by other cities in utility planning. Although surface slope, soil type and infiltration rate, impervious area, and bioretention parameters were different across cities, our results suggest that modeled runoff volume was most sensitive to percent of total impervious area that drained to the bioretention cell, with soil type the next most important factor. Findings also indicate a persistent gap between the percentage of annual runoff reduced and the percentage of fee reduced.

RBANS memory percentage retention: No evidence of incremental validity beyond RBANS scores for diagnostic classification of mild cognitive impairment and dementia and for prediction of daily function.

PubMed

Jodouin, Kara A; O'Connell, Megan E; Morgan, Debra G

2017-01-01

RBANS percentage retention scores may be useful for diagnosis, but their incremental validity is unclear. Percentage retention versus RBANS immediate and delayed memory subtests and delayed index scores were compared for diagnostic classification and for prediction of function. Data from 173 memory clinic patients with an interdisciplinary diagnosis (no cognitive impairment, amnestic mild cognitive impairment [aMCI], and dementia due to Alzheimer's disease [AD]) and complete RBANS data were analyzed. Across diagnostic contrasts, list percentage retention classification accuracy was similar to List Learning delayed recall, but below the Delayed Memory Index (DMI). Similarly, for classifying no cognitive impairment versus aMCI or dementia due to AD, story percentage retention was similar to Story Memory subtests and below the DMI. For classifying aMCI versus AD; however, Story Memory exceeded the DMI, but was similar to Story Memory subtest scores. Similarly, for prediction of function percentage retention measures did not predict variance beyond that predicted by the RBANS subtest or index scores. In sum, there is no evidence that calculation of percentage retention for RBANS adds clinical utility beyond those provided by the standard RBANS scores.

Trends of Do-Not-Resuscitate consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan between 2010 and 2014

PubMed Central

Chang, Hsiao-Ting; Lin, Ming-Hwai; Chen, Chun-Ku; Chou, Pesus; Chen, Tzeng-Ji; Hwang, Shinn-Jang

2016-01-01

Abstract Do-Not-Resuscitate (DNR) and hospice care are not only applied to cancer patients but also to patients with noncancer progressive illness. However, the trends of DNR consent and hospice utilization are not well explored for noncancer patients. This study aimed to explore the trends of DNR consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan. We analyzed the Death and Hospice Palliative Care Database from the Taipei Veterans General Hospital in Taiwan. The Death and Hospice Palliative Care Database contains information including patient sex, major diagnosis, admission date, date of death, age at death, department at discharge, status of DNR consent, and status of hospice care of patients who died in the Taipei Veterans General Hospital. Data on patients aged 20 years old or more who died of major terminal noncancer diseases, including brain diseases, amyotrophic lateral sclerosis, dementia, chronic obstructive pulmonary disease (COPD) and other lung diseases, heart failure, chronic liver diseases and cirrhosis, and renal failure between 2010 and 2014 were extracted for analysis. A total of 1416 patients aged 20 years or more died of major noncancer diseases in Taipei Veterans General Hospital during the study period. The most common diagnosis was brain diseases, amyotrophic lateral sclerosis, and dementias (n = 510, 36%) followed by chronic obstructive pulmonary disease and other lung diseases (n = 322, 22.7%). Among these noncancer decedents, 1045 (73.8%) had DNR consents, while 134 (9.5%) received hospice care. Patients diagnosed with renal failure had the highest percentage of DNR consent (80%), followed by chronic liver diseases and cirrhosis (77.7%). Patients diagnosed with chronic liver diseases and cirrhosis had the highest percentage of hospice utilization (17.4%), followed by renal failure (15.8%). The percentages of DNR consent and hospice utilization were significantly different across different disease diagnosis, hospitalization department, and year of death. There were increased trends of DNR consent in patients with major noncancer diagnoses, and increased hospice care utilization in patients diagnosed with lung diseases and renal failure from 2010 to 2014. However, the hospice care utilization could be improved. Further study to evaluate factors associated hospice care to improve the utilization is suggested. PMID:27861375

Trends of Do-Not-Resuscitate consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan between 2010 and 2014: A Hospital-based observational study.

PubMed

Chang, Hsiao-Ting; Lin, Ming-Hwai; Chen, Chun-Ku; Chou, Pesus; Chen, Tzeng-Ji; Hwang, Shinn-Jang

2016-11-01

Do-Not-Resuscitate (DNR) and hospice care are not only applied to cancer patients but also to patients with noncancer progressive illness. However, the trends of DNR consent and hospice utilization are not well explored for noncancer patients. This study aimed to explore the trends of DNR consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan. We analyzed the Death and Hospice Palliative Care Database from the Taipei Veterans General Hospital in Taiwan. The Death and Hospice Palliative Care Database contains information including patient sex, major diagnosis, admission date, date of death, age at death, department at discharge, status of DNR consent, and status of hospice care of patients who died in the Taipei Veterans General Hospital. Data on patients aged 20 years old or more who died of major terminal noncancer diseases, including brain diseases, amyotrophic lateral sclerosis, dementia, chronic obstructive pulmonary disease (COPD) and other lung diseases, heart failure, chronic liver diseases and cirrhosis, and renal failure between 2010 and 2014 were extracted for analysis. A total of 1416 patients aged 20 years or more died of major noncancer diseases in Taipei Veterans General Hospital during the study period. The most common diagnosis was brain diseases, amyotrophic lateral sclerosis, and dementias (n = 510, 36%) followed by chronic obstructive pulmonary disease and other lung diseases (n = 322, 22.7%). Among these noncancer decedents, 1045 (73.8%) had DNR consents, while 134 (9.5%) received hospice care. Patients diagnosed with renal failure had the highest percentage of DNR consent (80%), followed by chronic liver diseases and cirrhosis (77.7%). Patients diagnosed with chronic liver diseases and cirrhosis had the highest percentage of hospice utilization (17.4%), followed by renal failure (15.8%). The percentages of DNR consent and hospice utilization were significantly different across different disease diagnosis, hospitalization department, and year of death. There were increased trends of DNR consent in patients with major noncancer diagnoses, and increased hospice care utilization in patients diagnosed with lung diseases and renal failure from 2010 to 2014. However, the hospice care utilization could be improved. Further study to evaluate factors associated hospice care to improve the utilization is suggested.

A Review of Liposuction as a Cosmetic Surgical Procedure

PubMed Central

Sumrall, Arthur J.

1987-01-01

Liposuction (suction-assisted lipectomy) is today an accepted, closed surgical technique utilized by physicians practicing in a number of different specialties. It is a procedure that can be learned and used as an adjunct to a number of open procedures, including rhytidectomy and abdominoplasty. The two principal keys to successful liposuction procedures are: (1) good patient selection, and (2) realistic expectations. Good selection should be based on physiological skin age of the patient rather than chronological age. Many liposuction procedures can be performed under local anesthesia in an office surgical suite. A conservative approach is always appropriate, as overcorrection is difficult to treat. Areas that can be suctioned effectively include the face, chin, neck, anterior and posterior axilary areas, arms, breasts, abdomen, waist, hips, buttocks, thighs, knees, and ankles. Using the blunt cannula technique pioneered by Fischer and modified and popularized by Illouz and Fournier yields a high percentage of good results. A low percentage of possible complications and undesired sequelae have been documented. PMID:3323540

Algodystrophy (CRPS) in minor orthopedic surgery.

PubMed

Corradini, Costantino; Bosizio, Claudia; Moretti, Antimo

2015-01-01

Algodystrophy or Chronic Regional Pain Syndrome (CRPS) is a painful disorder that develops especially at upper or lower extremities of the limbs after a fracture. This syndrome is probably due to bone microvascular changes with subsequent sympathetic nervous system involvement. The pain that characterizes CRPS is spontaneous, disproportionate to the traumatic event and is associated with hyperalgesia, and a variety of autonomic and trophic disorders. This condition has a variable incidence up to 37% of the cases, increasing along with the severity of the fracture. CRPS has a higher chance of developing in women, in older individuals, in smokers, and in patients with reduced bone strength. Early diagnosis is associated with remission in 80-90% of cases. Since the typical onset of the disease is insidious over 2 weeks after surgery, a diagnostic and therapeutic delay may occur. These are the major causes of a high percentage of chronic and disabling complications leading to impaired functional outcomes. In the acute or subacute phase, infusion of bisphosphonates has proven to be the first-choice of treatment with a high percentage of remissions. Moreover, it has been suggested the utility of vitamin C in prevention of CRPS. Furthermore, in the chronic phase electroanalgesia seems to provide promising results.

Studies of plasma irregularities and convection in the polar ionosphere using HILAT, SABRE and EISCAT. Interim report, 1 Feb 88-31 Mar 89

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

Jones, T.B.; Lester, M.; Wilkinson, A.J.

A statistical study of the F-region main ionospheric trough has been undertaken with EISCAT common programme data to assess the possibility that the trough region is a perferential region for the generation of E-region irregularities. Three years of CP-3 data from EISCAT formed the basis of this study. Backscatter observed by the coherent radar, SABRE, was also utilized to study the occurrence of irregularities in the E-region. On 26 out of the 36 days when the trough was observed by EISCAT, SABRE observed coherent backscatter. Although this percentage seems high, there was no consistent relationship between the latitude of themore » trough minimum and the latitude of peak backscatter intensity. A case study involving a four day run of EISCAT in September 1986 indicates that the trough latitude can be affected by changes in the interplanetary magnetic field north-south components. On two days rapid decreases in the latitude of the trough were related to a southward turning of the IMF and the onset of backscatter. The high percentage of occurrence of backscatter is believed to be caused by enhanced convection.« less

The value of residential photovoltaic systems: A comprehensive assessment

NASA Technical Reports Server (NTRS)

Borden, C. S.

1983-01-01

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

[Isolation and in vitro metabolic characterization of a lactate-utilizing bacterium from goat rumen].

PubMed

Long, Liming; Mao, Shengyong; Su, Yong; Zhu, Weiyun

2008-12-01

A lactate-utilizing, propionate-producing bacterium, strain L9, was isolated from rumen of goat fed with high concentrate by utilizing modified Hungate technique and anaerobic culture technique. The effect of the strain L9 culture on the rumen fermentation was further studied. According to the characteristics of morphology, physiology, biochemistry tests and sequence comparison of 16S rRNA gene, strain L9 was identified as selenomonas ruminantium. The influence of strain L9 culture on in vitro rumen fermentation was studied using mixed rumen micro-organisms of goats as inoculums. The results of the metabolism experiment showed that it was capable of using lactate as the sole carbon source, and 90 mmol/L lactate in LH medium could be completely utilized after 24 h incubation. As compared with the control, strain L9 culture addition significantly increased the total volatile fatty acids (TVFA), the percentage of propionate and pH value, while reduced the ratio of acetate to propionate and lactate production (P < 0.05). The results suggested that strain L9 can reduce lactic acid production and enhance the TVFA and propionate production in in vitro fermentation, and thus could be beneficial for the fermentation of rumen microorganisms.

The value of residential photovoltaic systems: A comprehensive assessment

NASA Astrophysics Data System (ADS)

Borden, C. S.

1983-09-01

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

48 CFR 215.404-71-5 - Cost efficiency factor.

Code of Federal Regulations, 2010 CFR

2010-10-01

... productivity measures may provide the basis for assessing the effectiveness of the contractor's cost reduction... asset utilization or improved productivity. (c) When selecting the percentage to use for this special...

National trends in carotid artery revascularization surgery.

PubMed

Dumont, Travis M; Rughani, Anand I

2012-06-01

Several randomized trials have emerged with conflicting data on the overall safety of carotid artery stenting (CAS) in comparison with carotid endarterectomy (CEA). The authors hypothesize that changes in national trends correspond to publication of randomized trials, including an increase in utilization of CAS after publication of trials favorable to CAS (for example, Carotid and Vertebral Artery Transluminal Angioplasty Study [CAVATAS] and Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy [SAPPHIRE]) and decrease in utilization of CAS after publication of trials favorable to CEA (for example, Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis [EVA3-S] and Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy [SPACE]). The Nationwide Inpatient Sample was obtained for the years 1998-2008. Individual cases were isolated for principal diagnosis of unilateral or bilateral carotid artery stenosis or occlusion undergoing CEA or CAS. The percentage of CAS for all carotid revascularization procedures was calculated for each year. Perioperative inpatient morbidity, including stroke or death, were calculated and compared. The percentage of patients undergoing CAS increased yearly from the start of the observed period to the end, with the exception of a decrease in 2007. The peak utilization of CAS for carotid artery revascularization procedures was 15% of all cases in 2006. The stroke or death rate was consistent at 5% among all patients undergoing CEA for all years, while the incidence of stroke or death decreased among patients undergoing CAS from 9% in 1998 to 5% in 2008. The practice of CAS in the US is expanding, from less than 3% of all carotid artery revascularization procedures to 13% in 2008. The utilization of CAS was seen to correlate with publication of randomized trials. Utilization nearly doubled in 2005 after publication of the CAS-favorable SAPPHIRE in 2004, and decreased by 22% after publication of the CEA-favorable EVA-3S and SPACE in 2007. With the publication of Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), the authors predict a resultant increase in the rate of CAS for carotid artery disease in the upcoming years.

Fiber type dependent upregulation of human skeletal muscle UCP2 and UCP3 mRNA expression by high-fat diet.

PubMed

Schrauwen, P; Hoppeler, H; Billeter, R; Bakker, A H; Pendergast, D R

2001-04-01

To test the hypothesis that consumption of a high-fat diet leads to an increase in UCP mRNA expression in human skeletal muscle. In a group of endurance athletes, with a range in fiber type distribution, we hypothesized that the effect of the high-fat diet on UCP2 and UCP3 mRNA expression is more pronounced in muscle fibers which are known to have a high capacity to shift from carbohydrate to fat oxidation (type IIA fibers). Ten healthy trained athletes (five males, five females) consumed a low-fat diet (17+/-0.9 en% of fat) and high-fat diet (41.4+/-1.4 en% fat) for 4 weeks, separated by a 4 week wash-out period. Muscle biopsies were collected at the end of both dietary periods. Using RT-PCR, levels of UCP2 and UCP3 mRNA expression were measured and the percentage of type I, IIA and IIB fibers were determined using the myofibrillar ATPase method in all subjects. UCP3L mRNA expression tended to be higher on the high-fat diet, an effect which reached significance when only males were considered (P=0.037). Furthermore, diet-induced change in mRNA expression of UCP3T (r: 0.66, P=0.037), UCP3L (r: 0.61, P=0.06) and UCP2 (r: 0.70, P=0.025), but not UCP3S, correlated significantly with percentage dietary fat on the high-fat diet. Plasma FFA levels were not different during the two diets. Finally, the percentage of type IIA fibers was positively correlated with the diet-induced change in mRNA expression for UCP2 (r: 0.7, P=0.03), UCP3L (r: 0.73, P=0.016) and UCP3T (r: 0.68, P=0.03) but not with UCP3S (r: 0.06, NS). UCP2 and UCP3 mRNAs are upregulated by a high-fat diet. This upregulation is more pronounced in humans with high proportions of type IIA fibers, suggesting a role for UCPs in lipid utilization.

Cost-effectiveness of exercise and diet in overweight and obese adults with knee osteoarthritis.

PubMed

Sevick, Mary A; Miller, Gary D; Loeser, Richard F; Williamson, Jeff D; Messier, Stephen P

2009-06-01

The purpose of this study was to compare the cost-effectiveness of dietary and exercise interventions in overweight or obese elderly patients with knee osteoarthritis (OA) enrolled in the Arthritis, Diet, and Physical Activity Promotion Trial (ADAPT). ADAPT was a single-blinded, controlled trial of 316 adults with knee OA, randomized to one of four groups: Healthy Lifestyle Control group, Diet group, Exercise group, or Exercise and Diet group. A cost analysis was performed from a payer perspective, incorporating those costs and benefits that would be realized by a managed care organization interested in maintaining the health and satisfaction of its enrollees while reducing unnecessary utilization of health care services. The Diet intervention was most cost-effective for reducing weight, at $35 for each percentage point reduction in baseline body weight. The Exercise intervention was most cost-effective for improving mobility, costing $10 for each percentage point improvement in a 6-min walking distance and $9 for each percentage point improvement in the timed stair climbing task. The Exercise and Diet intervention was most cost-effective for improving self-reported function and symptoms of arthritis, costing $24 for each percentage point improvement in subjective function, $20 for each percentage point improvement in self-reported pain, and $56 for each percentage point improvement in self-reported stiffness. The Exercise and Diet intervention consistently yielded the greatest improvements in weight, physical performance, and symptoms of knee OA. However, it was also the most expensive and was the most cost-effective approach only for the subjective outcomes of knee OA (self-reported function, pain, and stiffness). Perceived function and symptoms of knee OA are likely to be stronger drivers of downstream health service utilization than weight, or objective performance measures and may be the most cost-effective in the long term.

Compensation for Distributed Solar. A Survey of Options to Preserve Stakeholder Value

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

Flores-Espino, Francisco

2015-09-01

Compensation mechanisms for electricity generation systems installed behind the meter are under scrutiny in several jurisdictions in the United States. Legislators in 29 states introduced bills to amend net metering provisions in 2014, and in 33 states in the 2015 legislative session as of August 20, 2015. Some utilities have also sought to increase the revenue they receive from net-metered customers through rate redesign. The circumstances that have triggered the recent push for change include a growing percentage of net-metered customers, potential effects of distributed generation on cost allocation, decreasing photovoltaic (PV) system costs, the challenges of integrating high levelsmore » of solar generation in the distribution network, and increasing pressure on utility business models. This report presents a survey of options to charge and compensate PV customers, as well as options that may preserve utility revenues in scenarios with increased DG. These options could be used as building blocks to create a distributed generation (DG) compensation policy that may preserve the value of the different stakeholders and balance their interests.« less

Why caution is recommended with post-hoc individual patient matching for estimation of treatment effect in parallel-group randomized controlled trials: the case of acute stroke trials.

PubMed

Jafari, Nahid; Hearne, John; Churilov, Leonid

2013-11-10

A post-hoc individual patient matching procedure was recently proposed within the context of parallel group randomized clinical trials (RCTs) as a method for estimating treatment effect. In this paper, we consider a post-hoc individual patient matching problem within a parallel group RCT as a multi-objective decision-making problem focussing on the trade-off between the quality of individual matches and the overall percentage of matching. Using acute stroke trials as a context, we utilize exact optimization and simulation techniques to investigate a complex relationship between the overall percentage of individual post-hoc matching, the size of the respective RCT, and the quality of matching on variables highly prognostic for a good functional outcome after stroke, as well as the dispersion in these variables. It is empirically confirmed that a high percentage of individual post-hoc matching can only be achieved when the differences in prognostic baseline variables between individually matched subjects within the same pair are sufficiently large and that the unmatched subjects are qualitatively different to the matched ones. It is concluded that the post-hoc individual matching as a technique for treatment effect estimation in parallel-group RCTs should be exercised with caution because of its propensity to introduce significant bias and reduce validity. If used with appropriate caution and thorough evaluation, this approach can complement other viable alternative approaches for estimating the treatment effect. Copyright © 2013 John Wiley & Sons, Ltd.

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.

Impact of home-based, patient-centered support for people with advanced illness in an open health system: A retrospective claims analysis of health expenditures, utilization, and quality of care at end of life.

PubMed

Sudat, Sylvia Ek; Franco, Anjali; Pressman, Alice R; Rosenfeld, Kenneth; Gornet, Elizabeth; Stewart, Walter

2018-02-01

Home-based care coordination and support programs for people with advanced illness work alongside usual care to promote personal care goals, which usually include a preference for home-based end-of-life care. More research is needed to confirm the efficacy of these programs, especially when disseminated on a large scale. Advanced Illness Management is one such program, implemented within a large open health system in northern California, USA. To evaluate the impact of Advanced Illness Management on end-of-life resource utilization, cost of care, and care quality, as indicators of program success in supporting patient care goals. A retrospective-matched observational study analyzing medical claims in the final 3 months of life. Medicare fee-for-service 2010-2014 decedents in northern California, USA. Final month total expenditures for Advanced Illness Management enrollees ( N = 1352) were reduced by US$4824 (US$3379, US$6268) and inpatient payments by US$6127 (US$4874, US$7682). Enrollees also experienced 150 fewer hospitalizations/1000 (101, 198) and 1361 fewer hospital days/1000 (998, 1725). The percentage of hospice enrollees increased by 17.9 percentage points (14.7, 21.0), hospital deaths decreased by 8.2 percentage points (5.5, 10.8), and intensive care unit deaths decreased by 7.1 percentage points (5.2, 8.9). End-of-life chemotherapy use and non-inpatient expenditures in months 2 and 3 prior to death did not differ significantly from the control group. Advanced Illness Management has a positive impact on inpatient utilization, cost of care, hospice enrollment, and site of death. This suggests that home-based support programs for people with advanced illness can be successful on a large scale in supporting personal end-of-life care choices.

Compositional Analysis of Fine Particulate Matter in Fairbanks, Alaska

NASA Astrophysics Data System (ADS)

Nattinger, K.; Simpson, W. R.; Huff, D.

2015-12-01

Fairbanks, AK experiences extreme pollution episodes that result in winter violations of the fine particulate matter (PM2.5) National Ambient Air Quality Standards. This poses a significant health risk for the inhabitants of the area. These high levels result from trapping of pollution in a very shallow boundary layer due to local meteorology, but the role of primary (direct emission) of particulate matter versus secondary production (in the atmosphere) of particulate matter is not understood. Analysis of the PM2.5 composition is being conducted to provide insight into sources, trends, and chemistry. Methods are developed to convert carbon data from IMPROVE (post-2009 analysis method) to NIOSH (pre-2009 method) utilizing blank subtraction, sampler bias adjustment, and inter-method correlations from co-located samples. By converting all carbon measurements to a consistent basis, long-term trends can be analyzed. The approach shows excellent mass closure between PM2.5 mass reconstructed from constituents and gravimetric-analyzed mass. This approach could be utilized in other US locations where the carbon analysis methods also changed. Results include organic and inorganic fractional mass percentages, analyzed over an eight-year period for two testing sites in Fairbanks and two in the nearby city of North Pole. We focus on the wintertime (Nov—Feb) period when most air quality violations occur and find that the particles consist primarily of organic carbon, with smaller percentages of sulfate, elemental carbon, ammonium, and nitrate. The Fairbanks area PM2.5 organic carbon / elemental carbon partitioning matches the source profile of wood smoke. North Pole and Fairbanks PM2.5 have significant compositional differences, with North Pole having a larger percentage of organic matter. Mass loadings in SO42-, NO3-, and total PM2.5 mass correlate with temperature. Multi-year temporal trends show little if any change with a strong effect from temperature. Insights from this study regarding primary versus possible secondary PM2.5 production processes can help in identifying effective PM2.5 control strategies.

Enhancing Feedback on Professionalism and Communication Skills in Anesthesia Residency Programs.

PubMed

Mitchell, John D; Ku, Cindy; Diachun, Carol Ann B; DiLorenzo, Amy; Lee, Daniel E; Karan, Suzanne; Wong, Vanessa; Schell, Randall M; Brzezinski, Marek; Jones, Stephanie B

2017-08-01

Despite its importance, training faculty to provide feedback to residents remains challenging. We hypothesized that, overall, at 4 institutions, a faculty development program on providing feedback on professionalism and communication skills would lead to (1) an improvement in the quantity, quality, and utility of feedback and (2) an increase in feedback containing negative/constructive feedback and pertaining to professionalism/communication. As secondary analyses, we explored these outcomes at the individual institutions. In this prospective cohort study (October 2013 to July 2014), we implemented a video-based educational program on feedback at 4 institutions. Feedback records from 3 months before to 3 months after the intervention were rated for quality (0-5), utility (0-5), and whether they had negative/constructive feedback and/or were related to professionalism/communication. Feedback records during the preintervention, intervention, and postintervention periods were compared using the Kruskal-Wallis and χ tests. Data are reported as median (interquartile range) or proportion/percentage. A total of 1926 feedback records were rated. The institutions overall did not have a significant difference in feedback quantity (preintervention: 855/3046 [28.1%]; postintervention: 896/3327 [26.9%]; odds ratio: 1.06; 95% confidence interval, 0.95-1.18; P = .31), feedback quality (preintervention: 2 [1-4]; intervention: 2 [1-4]; postintervention: 2 [1-4]; P = .90), feedback utility (preintervention: 1 [1-3]; intervention: 2 [1-3]; postintervention: 1 [1-2]; P = .61), or percentage of feedback records containing negative/constructive feedback (preintervention: 27%; intervention: 32%; postintervention: 25%; P = .12) or related to professionalism/communication (preintervention: 23%; intervention: 33%; postintervention: 24%; P = .03). Institution 1 had a significant difference in feedback quality (preintervention: 2 [1-3]; intervention: 3 [2-4]; postintervention: 3 [2-4]; P = .001) and utility (preintervention: 1 [1-3]; intervention: 2 [1-3]; postintervention: 2 [1-4]; P = .008). Institution 3 had a significant difference in the percentage of feedback records containing negative/constructive feedback (preintervention: 16%; intervention: 28%; postintervention: 17%; P = .02). Institution 2 had a significant difference in the percentage of feedback records related to professionalism/communication (preintervention: 26%; intervention: 57%; postintervention: 31%; P < .001). We detected no overall changes but did detect different changes at each institution despite the identical intervention. The intervention may be more effective with new faculty and/or smaller discussion sessions. Future steps include refining the rating system, exploring ways to sustain changes, and investigating other factors contributing to feedback quality and utility.

Value of Landsat in urban water resources planning

NASA Technical Reports Server (NTRS)

Jackson, T. J.; Ragan, R. M.

1977-01-01

The reported investigation had the objective to evaluate the utility of satellite multispectral remote sensing in urban water resources planning. The results are presented of a study which was conducted to determine the economic impact of Landsat data. The use of Landsat data to estimate hydrologic model parameters employed in urban water resources planning is discussed. A decision regarding an employment of the Landsat data has to consider the tradeoff between data accuracy and cost. Bayesian decision theory is used in this connection. It is concluded that computer-aided interpretation of Landsat data is a highly cost-effective method of estimating the percentage of impervious area.

Pozzolanic Activity Assessment of LUSI (LUmpur SIdoarjo) Mud in Semi High Volume Pozzolanic Mortar

PubMed Central

Hardjito, Djwantoro; Antoni; Wibowo, Gunadi M.; Christianto, Danny

2012-01-01

LUSI mud obtained from the mud volcano in Sidoarjo, Indonesia, is a viable aluminosilicate material to be utilized as pozzolanic material. LUSI is an abbreviation of the local name of the mud, i.e., Lumpur Sidoarjo, meaning Sidoarjo mud. This paper reports the results of an investigation to assess the pozzolanic activity of LUSI mud, especially in semi high volume pozzolanic mortar. In this case, the amount of mud incorporated is between 30% to 40% of total cementitious material, by mass. The content of SiO2 in the mud is about 30%, whilst the total content of SiO2, Fe2O3 and Al2O3 is more than 70%. Particle size and degree of partial cement replacement by treated LUSI mud affect the compressive strength, the strength activity index (SAI), the rate of pozzolanic activity development, and the workability of mortar incorporating LUSI mud. Manufacturing semi high volume LUSI mud mortar, up to at least 40% cement replacement, is a possibility, especially with a smaller particle size of LUSI mud, less than 63 μm. The use of a larger percentage of cement replacement by LUSI mud does not show any adverse effect on the water demand, as the flow of the fresh mortar increased with the increase of percentage of LUSI mud usage.

Michigan's Physician Group Incentive Program offers a regional model for incremental 'fee for value' payment reform.

PubMed

Share, David A; Mason, Margaret H

2012-09-01

Blue Cross Blue Shield of Michigan partnered with providers across the state to create an innovative, "fee for value" physician incentive program that would deliver high-quality, efficient care. The Physician Group Incentive Program rewards physician organizations-formal groups of physicians and practices that can accept incentive payments on behalf of their members-based on the number of quality and utilization measures they adopt, such as generic drug dispensing rates, and on their performance on these measures across their patient populations. Physicians also receive payments for implementing a range of patient-centered medical home capabilities, such as patient registries, and they receive higher fees for office visits for incorporating these capabilities into routine practice while also improving performance. Taken together, the incentive dollars, fee increases, and care management payments amount to a potential increase in reimbursement of 40 percent or more from Blue Cross Blue Shield of Michigan for practices designated as high-performing patient-centered medical homes. At the same time, we estimate that implementing the patient-centered medical home capabilities was associated with $155 million in lower medical costs in program year 2011 for Blue Cross Blue Shield of Michigan members. We intend to devote a higher percentage of reimbursement over time to communities of caregivers that offer high-value, system-based care, and a lower percentage of reimbursement to individual physicians on a service-specific basis.

Multimode and single-mode fibers for data center and high-performance computing applications

NASA Astrophysics Data System (ADS)

Bickham, Scott R.

2016-03-01

Data center (DC) and high performance computing (HPC) applications have traditionally used a combination of copper, multimode fiber and single-mode fiber interconnects with relative percentages that depend on factors such as the line rate, reach and connectivity costs. The balance between these transmission media has increasingly shifted towards optical fiber due to the reach constraints of copper at data rates of 10 Gb/s and higher. The percentage of single-mode fiber deployed in the DC has also grown slightly since 2014, coinciding with the emergence of mega DCs with extended distance needs beyond 100 m. This trend will likely continue in the next few years as DCs expand their capacity from 100G to 400G, increase the physical size of their facilities and begin to utilize silicon-photonics transceiver technology. However there is a still a need for the low-cost and high-density connectivity, and this is sustaining the deployment of multimode fiber for links <= 100 m. In this paper, we discuss options for single-mode and multimode fibers in DCs and HPCs and introduce a reduced diameter multimode fiber concept which provides intra-and inter-rack connectivity as well as compatibility with silicon-photonic transceivers operating at 1310 nm. We also discuss the trade-offs between single-mode fiber attributes such as bend-insensitivity, attenuation and mode field diameter and their roles in capacity and connectivity in data centers.

Inequalities in maternal health care utilization in Benin: a population based cross-sectional study.

PubMed

Yaya, Sanni; Uthman, Olalekan A; Amouzou, Agbessi; Ekholuenetale, Michael; Bishwajit, Ghose

2018-05-31

Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services and fertility control methods, is one of the most critical challenges for public health sector. There are significant disparities in maternal health care indicators across many geographical locations, maternal, economic, socio-demographic factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization level of maternal health care, and examined disparities in the determinants of major maternal health outcomes. This paper used data from two rounds of Benin Demographic and Health Survey (BDHS) to examine the utilization and disparities in factors of maternal health care indicators using logistic regression models. Participants were 17,794 and 16,599 women aged between15-49 years in 2006 and 2012 respectively. Women's characteristics were reported in percentage, mean and standard deviation. Mean (±SD) age of the participants was 29.0 (±9.0) in both surveys. The percentage of at least 4 ANC visits was approximately 61% without any change between the two rounds of surveys, facility based delivery was 93.5% in 2012, with 4.9% increase from 2006; postnatal care was currently 18.4% and contraceptive use was estimated below one-fifth. The results of multivariable logistic regression models showed disparities in maternal health care service utilization, including antenatal care, facility-based delivery, postnatal care and contraceptive use across selected maternal factors. The current BHDS showed age, region, religion were significantly associated with maternal health care services. Educated women, those from households of high wealth index and women currently working were more likely to utilize maternal health care services, compared to women with no formal education, from poorest households or not currently employed. Women who watch television (TV) were 1.31 (OR = 1.31; 95% CI = 1.13-1.52), 1.69 (OR = 1.69; 95% CI = 1.20-2.37) and 1.38 (OR = 1.38; 95% CI = 1.16-1.65) times as likely to utilize maternal health care services after adjusting for other covariates. The findings would guide stakeholders to address inequalities in maternal health care services. More so, health care programmes and policies should be strengthened to enhance accessibility as well as improve the utilization of maternal care services, especially for the disadvantaged, uneducated and those who live in hard-to-reach rural areas in Benin. The Benin government needs to create strategies that cover both the supply and demand side factors at attain the universal health coverage.

Hospice Enrollment, Local Hospice Utilization Patterns, and Rehospitalization in Medicare Patients

PubMed Central

Holden, Timothy R.; Smith, Maureen A.; Bartels, Christie M.; Campbell, Toby C.; Yu, Menggang

2015-01-01

Abstract Background: Rehospitalizations are prevalent and associated with decreased quality of life. Although hospice has been advocated to reduce rehospitalizations, it is not known how area-level hospice utilization patterns affect rehospitalization risk. Objectives: The study objective was to examine the association between hospice enrollment, local hospice utilization patterns, and 30-day rehospitalization in Medicare patients. Methods: With a retrospective cohort design, 1,997,506 hospitalizations were assessed between 2005 and 2009 from a 5% national sample of Medicare beneficiaries. Local hospice utilization was defined using tertiles representing the percentage of all deaths occurring in hospice within each Hospital Service Area (HSA). Cox proportional hazard models were used to assess the relationship between 30-day rehospitalization, hospice enrollment, and local hospice utilization, adjusting for patient sociodemographics, medical history, and hospital characteristics. Results: Rates of patients dying in hospice were 27% in the lowest hospice utilization tertile, 41% in the middle tertile, and 53% in the highest tertile. Patients enrolled in hospice had lower rates of 30-day rehospitalization than those not enrolled (2.2% versus 18.8%; adjusted hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.118–0.131). Patients residing in areas of low hospice utilization were at greater rehospitalization risk than those residing in areas of high utilization (19.1% versus 17.5%; HR, 1.05; 95% CI, 1.04–1.06), which persisted beyond that accounted for by individual hospice enrollment. Conclusions: Area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees. PMID:25879990

Function, structure, and stability of enzymes confined in agarose gels.

PubMed

Kunkel, Jeffrey; Asuri, Prashanth

2014-01-01

Research over the past few decades has attempted to answer how proteins behave in molecularly confined or crowded environments when compared to dilute buffer solutions. This information is vital to understanding in vivo protein behavior, as the average spacing between macromolecules in the cell cytosol is much smaller than the size of the macromolecules themselves. In our study, we attempt to address this question using three structurally and functionally different model enzymes encapsulated in agarose gels of different porosities. Our studies reveal that under standard buffer conditions, the initial reaction rates of the agarose-encapsulated enzymes are lower than that of the solution phase enzymes. However, the encapsulated enzymes retain a higher percentage of their activity in the presence of denaturants. Moreover, the concentration of agarose used for encapsulation had a significant effect on the enzyme functional stability; enzymes encapsulated in higher percentages of agarose were more stable than the enzymes encapsulated in lower percentages of agarose. Similar results were observed through structural measurements of enzyme denaturation using an 8-anilinonaphthalene-1-sulfonic acid fluorescence assay. Our work demonstrates the utility of hydrogels to study protein behavior in highly confined environments similar to those present in vivo; furthermore, the enhanced stability of gel-encapsulated enzymes may find use in the delivery of therapeutic proteins, as well as the design of novel strategies for biohybrid medical devices.

Algodystrophy (CRPS) in minor orthopedic surgery

PubMed Central

Corradini, Costantino; Bosizio, Claudia; Moretti, Antimo

2015-01-01

Summary Algodystrophy or Chronic Regional Pain Syndrome (CRPS) is a painful disorder that develops especially at upper or lower extremities of the limbs after a fracture. This syndrome is probably due to bone microvascular changes with subsequent sympathetic nervous system involvement. The pain that characterizes CRPS is spontaneous, disproportionate to the traumatic event and is associated with hyperalgesia, and a variety of autonomic and trophic disorders. This condition has a variable incidence up to 37% of the cases, increasing along with the severity of the fracture. CRPS has a higher chance of developing in women, in older individuals, in smokers, and in patients with reduced bone strength. Early diagnosis is associated with remission in 80–90% of cases. Since the typical onset of the disease is insidious over 2 weeks after surgery, a diagnostic and therapeutic delay may occur. These are the major causes of a high percentage of chronic and disabling complications leading to impaired functional outcomes. In the acute or subacute phase, infusion of bisphosphonates has proven to be the first-choice of treatment with a high percentage of remissions. Moreover, it has been suggested the utility of vitamin C in prevention of CRPS. Furthermore, in the chronic phase electroanalgesia seems to provide promising results. PMID:27134628

Experimental data on compressive strength and durability of sulfur concrete modified by styrene and bitumen.

PubMed

Dehestani, M; Teimortashlu, E; Molaei, M; Ghomian, M; Firoozi, S; Aghili, S

2017-08-01

In this data article experimental data on the compressive strength, and the durability of styrene and bitumen modified sulfur concrete against acidic water and ignition are presented. The percent of the sulfur cement and the gradation of the aggregates used are according to the ACI 548.2R-93 and ASTM 3515 respectively. For the styrene modified sulfur concrete different percentages of styrene are used. Also for the bitumen modified sulfur concrete, different percentages of bitumen and the emulsifying agent (triton X-100) are utilized. From each batch three 10×10×10 cm cubic samples were casted. One of the samples was used for the compressive strength on the second day of casting, and one on the twenty-eighth day. Then the two samples were put under the high pressure flame of the burning liquid gas for thirty seconds and their ignition resistances were observed. The third sample was put into the acidic water and after twenty eight days immersion in water was dried in the ambient temperature. After drying its compressive strength has been evaluated.

Effects of percentage of blockage and flameholder downstream counterbores on lean combustion limits of premixed, prevaporized propane-air mixture

NASA Technical Reports Server (NTRS)

Fernandez, M. A. B.

1983-01-01

Lean combustion limits were determined for a premixed prevaporized propane air mixture with flat plate flame stabilizers. Experiments were conducted in a constant area flame tube combustor utilizing flameholders of varying percentages of blockage and downstream counterbores. Combustor inlet air velocity at ambient conditions was varied from 4 to 9 meters per second. Flameholders with a center hole and four half holes surrounding it were tested with 63, 73, and 85 percent blockage and counterbore diameters of 112 and 125 percent of the thru hole diameter, in addition to the no counterbore configuration. Improved stability was obtained by using counterbore flameholders and higher percentages of blockage. Increases in mixture velocity caused the equivalence ratio at blowout to increase in all cases.

Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

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

Vance, Sean M.; Stenmark, Matthew H.; Blas, Kevin

2012-07-01

Purpose: To investigate the prognostic utility of the percentage of cancer volume (PCV) in needle biopsy specimens for prostate cancer patients treated with dose-escalated external beam radiotherapy. Methods and Materials: The outcomes were analyzed for 599 men treated for localized prostate cancer with external beam radiotherapy to a minimal planning target volume dose of 75 Gy (range, 75-79.2). We assessed the effect of PCV and the pretreatment and treatment-related factors on the freedom from biochemical failure, freedom from metastasis, cause-specific survival, and overall survival. Results: The median number of biopsy cores was 7 (interquartile range, 6-12), median PCV was 10%more » (interquartile range, 2.5-25%), and median follow-up was 62 months. The PCV correlated with the National Comprehensive Cancer Network risk group and individual risk features, including T stage, prostate-specific antigen level, Gleason score, and percentage of positive biopsy cores. On log-rank analysis, the PCV stratified by quartile was prognostic for all endpoints, including overall survival. In addition, the PCV was a stronger prognostic factor than the percentage of positive biopsy cores when the two metrics were analyzed together. On multivariate analysis, the PCV predicted a worse outcome for all endpoints, including freedom from biochemical failure, (hazard ratio, 1.9; p = .0035), freedom from metastasis (hazard ratio, 1.7, p = .09), cause-specific survival (hazard ratio, 3.9, p = .014), and overall survival (hazard ratio, 1.8, p = .02). Conclusions: For patients treated with dose-escalated external beam radiotherapy, the volume of cancer in the biopsy specimen adds prognostic value for clinically relevant endpoints, particularly in intermediate- and high-risk patients. Although the PCV determination is more arduous than the percentage of positive biopsy cores, it provides superior risk stratification.« less

One-Hertz Waves at Mars: MAVEN Observations

NASA Astrophysics Data System (ADS)

Ruhunusiri, Suranga; Halekas, J. S.; Espley, J. R.; Eparvier, F.; Brain, D.; Mazelle, C.; Harada, Y.; DiBraccio, G. A.; Thiemann, E. M. B.; Larson, D. E.; Mitchell, D. L.; Jakosky, B. M.; Sulaiman, A. H.

2018-05-01

We perform a survey of 1-Hz waves at Mars utilizing Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft observations for a Martian year. We find that the 1-Hz wave occurrence rate shows an apparent variation caused by masking of the waves by background turbulence during the times when the background turbulence levels are high. To correct for this turbulence masking, we select waves that occur in time intervals where the background turbulence levels are low. We find that the extreme ultraviolet flux does not affect the wave occurrence rate significantly, suggesting that the newly born pickup ions originating in the Mars's exosphere contribute minimally to the 1-Hz wave generation. We find that the wave occurrence rates are higher for low Mach numbers and low beta values than for high Mach numbers and high beta values. Further, we find that a high percentage of 1-Hz waves satisfy the group-standing condition, which suggests that a high percentage of the waves seen as monochromatic waves in the spacecraft frame can be broadband waves in the solar wind frame that have group velocities nearly equal and opposite to the solar wind velocity. We infer that the wave occurrence rate trends with the Mach number and proton beta are a consequence of how the Mach numbers and beta values influence the wave generation and damping or how those parameters affect the group-standing condition. Finally, we find that the 1-Hz waves are equally likely to be found in both the quasi-parallel and the quasi-perpendicular foreshock regions.

Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings

PubMed Central

Eustache, Eddy; Gerbasi, Margaret E.; Severe, Jennifer; Fils-Aimé, J. Reginald; Smith Fawzi, Mary C.; Raviola, Giuseppe J.; Darghouth, Sarah; Boyd, Kate; Thérosmé, Tatiana; Legha, Rupinder; Pierre, Ermaze L.; Affricot, Emmeline; Alcindor, Yoldie; Grelotti, David J.; Becker, Anne E.

2017-01-01

Background Task-sharing with teachers to promote youth mental health is a promising but underdeveloped strategy in improving care access in low-income countries. Aims To assess feasibility, acceptability, and utility of the teacher accompaniment phase of a school-based teacher accompagnateur pilot study (TAPS) in Haiti. Methods We assigned student participants, ages 18–22 (n=120) to a teacher participant (n=22) within four Haitian schools; we instructed participants to arrange meetings with their assigned counterparts to discuss mental health treatment, academic skills, and/or well-being. We measured student and teacher perceived feasibility, acceptability, and utility of meetings with self-report Likert-style questions. We examined overall program feasibility by the percentage of students with a documented meeting, acceptability by a composite measure of student satisfaction, and utility by the percentage with identified mental health need who discussed treatment with a teacher. Results Favorable ratings support feasibility, acceptability, and utility of teacher-accompagnateur meetings with students. The majority of students (54%) met with a teacher. Among students with an identified mental disorder, 43.2% discussed treatment during a meeting. Conclusions This accompaniment approach to mental health task-sharing with teachers provided a school-based opportunity for students with mental health need to discuss treatment and has potential relevance to other low-income settings. PMID:28367718

Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings.

PubMed

Eustache, Eddy; Gerbasi, Margaret E; Severe, Jennifer; Fils-Aimé, J Reginald; Smith Fawzi, Mary C; Raviola, Giuseppe J; Darghouth, Sarah; Boyd, Kate; Thérosmé, Tatiana; Legha, Rupinder; Pierre, Ermaze L; Affricot, Emmeline; Alcindor, Yoldie; Grelotti, David J; Becker, Anne E

2017-06-01

Task-sharing with teachers to promote youth mental health is a promising but underdeveloped strategy in improving care access in low-income countries. To assess feasibility, acceptability and utility of the teacher accompaniment phase of a school-based Teacher- Accompagnateur Pilot Study (TAPS) in Haiti. We assigned student participants, aged 18-22 years ( n = 120), to teacher participants ( n = 22) within four Haitian schools; we instructed participants to arrange meetings with their assigned counterparts to discuss mental health treatment, academic skills, and/or well-being. We measured student and teacher perceived feasibility, acceptability and utility of meetings with self-report Likert-style questions. We examined overall program feasibility by the percentage of students with a documented meeting, acceptability by a composite measure of student satisfaction and utility by the percentage with identified mental health need who discussed treatment with a teacher. Favorable ratings support feasibility, acceptability and utility of teacher- accompagnateur meetings with students. The majority of students (54%) met with a teacher. Among students with an identified mental disorder, 43.2% discussed treatment during a meeting. This accompaniment approach to mental health task-sharing with teachers provided a school-based opportunity for students with mental health need to discuss treatment and has potential relevance to other low-income settings.

Expanded Normal Weight Obesity and Insulin Resistance in US Adults of the National Health and Nutrition Examination Survey

PubMed Central

Martinez, Keilah E.; Bailey, Bruce W.

2017-01-01

This study aims to expand the evaluation of normal weight obesity (NWO) and its association with insulin resistance using an NHANES (1999–2006) sample of US adults. A cross-sectional study including 5983 men and women (50.8%) was conducted. Body fat percentage (BF%) was assessed using dual-energy X-ray absorptiometry. Expanded normal weight obesity (eNWO) categories, pairings of BMI and body fat percentage classifications, were created using standard cut-points for BMI and sex-specific median for BF%. Homeostatic model assessment-insulin resistance (HOMA-IR) levels were used to index insulin resistance. Mean ± SE values were BMI: 27.9 ± 0.2 (women) and 27.8 ± 0.1 (men); body fat percentage: 40.5 ± 0.2 (women) and 27.8 ± 0.2 (men); and HOMA-IR: 2.04 ± 0.05 (women) and 2.47 ± 0.09 (men). HOMA-IR differed systematically and in a dose-response fashion across all levels of the eNWO categories (F = 291.3, P < 0.0001). As BMI levels increased, HOMA-IR increased significantly, and within each BMI category, higher levels of body fat were associated with higher levels of HOMA-IR. Both high BMI and high BF% were strongly related to insulin resistance. Insulin resistance appears to increase incrementally according to BMI levels primarily and body fat levels secondarily. Including a precise measure of body fat with BMI adds little to the utility of BMI in the prediction of insulin resistance. PMID:28812029

Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

PubMed

Gudu, William; Addo, Bright

2017-05-31

Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great potential of improving uptake of skilled delivery services.

Continuity Clinic Model and Diabetic Outcomes in Internal Medicine Residencies: Findings of the Educational Innovations Project Ambulatory Collaborative

PubMed Central

Francis, Maureen D.; Julian, Katherine A.; Wininger, David A.; Drake, Sean; Bollman, KeriLyn; Nabors, Christopher; Pereira, Anne; Rosenblum, Michael; Zelenski, Amy B.; Sweet, David; Thomas, Kris; Varney, Andrew; Warm, Eric; Francis, Mark L.

2016-01-01

Background Efforts to improve diabetes care in residency programs are ongoing and in the midst of continuity clinic redesign at many institutions. While there appears to be a link between resident continuity and improvement in glycemic control for diabetic patients, it is uncertain whether clinic structure affects quality measures and patient outcomes. Methods This multi-institutional, cross-sectional study included 12 internal medicine programs. Three outcomes (glycemic control, blood pressure control, and achievement of target low-density lipoprotein [LDL]) and 2 process measures (A1C and LDL measurement) were reported for diabetic patients. Traditional, block, and combination clinic models were compared using analysis of covariance (ANCOVA). Analysis was adjusted for continuity, utilization, workload, and panel size. Results No significant differences were found in glycemic control across clinic models (P = .06). The percentage of diabetic patients with LDL < 100 mg/dL was 60% in block, compared to 54.9% and 55% in traditional and combination models (P = .006). The percentage of diabetic patients with blood pressure < 130/80 mmHg was 48.4% in block, compared to 36.7% and 36.9% in other models (P < .001). The percentage of diabetic patients with HbA1C measured was 92.1% in block compared to 75.2% and 82.1% in other models (P < .001). Also, the percentage of diabetic patients with LDL measured was significantly different across all groups, with 91.2% in traditional, 70.4% in combination, and 83.3% in block model programs (P < .001). Conclusions While high scores on diabetic quality measures are achievable in any clinic model, the block model design was associated with better performance. PMID:26913099

Methanogenic population dynamics during startup of a full-scale anaerobic sequencing batch reactor treating swine waste.

PubMed

Angenent, Largus T; Sung, Shihwu; Raskin, Lutgarde

2002-11-01

Changes in methanogenic population levels were followed during startup of a full-scale, farm-based anaerobic sequencing batch reactor (ASBR) and these changes were linked to operational and performance data. The ASBR was inoculated with anaerobic digester sludge from a municipal wastewater treatment facility. During an acclimation period of approximately 3 months, the ASBR content was diluted to maintain a total ammonia-N level of approximately 2000mg l(-1). After this acclimation period, the volatile solids loading rate was increased to its design value of 1.7g l(-1) day(-1) with a 15-day hydraulic retention time, which increased the total ammonia-N level in the ASBR to approximately 3,600 mg l(-1). The 16S ribosomal RNA (rRNA) levels of the acetate-utilizing methanogens of the genus Methanosarcina decreased from 3.8% to 1.2% (expressed as a percentage of the total 16S rRNA levels) during this period, while the 16S rRNA levels of Methanosaeta concilii remained low (below 2.2%). Methane production and reactor performance were not affected as the 16S rRNA levels of the hydrogen-utilizing methanogens of the order Methanomicrobiales increased from 2.3% to 7.0%. Hence, it is likely that during operation with high ammonia levels, the major route of methane production is through a syntrophic relationship between acetate-oxidizing bacteria and hydrogen-utilizing methanogens. Anaerobic digestion at total ammonia-N levels exceeding 3500mg l(-1) was sustainable apparently due to the acclimation of hydrogen-utilizing methanogens to high ammonia levels.

Determination of acaricide residues in saudi arabian honey and beeswax using solid phase extraction and gas chromatography.

PubMed

Kamel, Alaa; Al-Ghamdi, Ahmad

2006-01-01

Determination of acaricide residues of flumethrin, tau-fluvalinate, coumaphos, and amitraz in honey and beeswax was carried out using a rapid extraction method utilizing C-18 SPE cartridges and an analytical method utilizing GC with ECD, NPD, and MSD detectors for the four acaricides. Recovery percentages from the extraction method ranged from 90-102%, while the minimum detection levels ranged from 0.01-0.05 mg/kg for the acaricides. Nine of the 21 analyzed samples were found to be contaminated with the acaricides tau-fluvalinate and coumaphos. Neither flumethrin nor amitraz was detected in any of the honey or wax samples. Coumaphos was found only in honey samples in which two samples exceeded the tolerance levels set by EPA and EC regulations. It has not been detected in beeswax. Five honey samples and eight beeswax samples were found to be contaminated with tau-fluvalinate. One of the wax samples was contaminated with a relatively high residue of tau-fluvalinate and contained above 10 mg/kg.

Body fat percentage, body mass index and waist-to-hip ratio as predictors of mortality and cardiovascular disease.

PubMed

Myint, Phyo Kyaw; Kwok, Chun Shing; Luben, Robert N; Wareham, Nicholas J; Khaw, Kay-Tee

2014-10-01

To study the utility of body fat percentage in predicting health outcomes when other obesity indices are considered. We conducted a prospective cohort study to evaluate the independent utility of body fat percentage and other obesity indices in predicting mortality and cardiovascular disease (CVD). We prospectively followed 15 062 European Prospective Investigation into Cancer (EPIC)-Norfolk participants who attended a health examination during 1997–2000 for all-cause mortality and incidence of CVD up to end of December 2011 and end of March 2009, respectively. During the follow-up, 2420 died and 4665 had incident CVD. After exclusion of prior stroke, myocardial infarction and cancer and adjusting for potential confounders, body mass index (BMI) and waist-to- hip ratio (WHR), the HR of mortality for men were 0.86 (0.68 to 1.09), 0.81 (0.61 to 1.07) and 0.76 (0.55 to 1.05) and for women were 0.91 (0.70 to 1.17), 0.75 (0.55 to 1.02) and 0.87 (0.61 to 1.23) for second, third and fourth quartile compared with the first (bottom) quartile of body fat percentage. The respective HRs for incident CVD were 0.99 (0.83 to 1.19), 0.85 (0.69 to 1.04) and 0.81 (0.64 to 1.03) for men and 0.98 (0.82 to 1.17), 0.89 (0.73 to 1.10) and 1.02 (0.81 to 1.29) for women. In contrast, higher BMI and WHR were associated with an increased risk of both outcomes and WHR appeared to have the best predictive value among three indices. Once BMI and WHR are taken into account, fat percentage does not add to prediction of mortality or CVD in middle-aged and older-aged adults.

Utilization of nanotechnology to enhance percutaneous absorption of acyclovir in the treatment of herpes simplex viral infections

PubMed Central

Al-Subaie, Mutlaq M; Hosny, Khaled M; El-Say, Khalid Mohamed; Ahmed, Tarek A; Aljaeid, Bader M

2015-01-01

This study aimed to formulate an optimized acyclovir (ACV) nanoemulsion hydrogel in order to provide a solution for the slow, variable, and incomplete oral drug absorption in patient suffering from herpes simplex viral infection. Solubility of ACV in different oils, surfactants, and cosurfactants was explored utilizing a cubic model mixture design to obtain a nanoemulsion with minimum globule size. Preparation of an optimized ACV nanoemulsion hydrogel using a three-factor, three-level Box–Behnken statistical design was conducted. The molecular weight of chitosan (X1), percentage of chitosan (X2), and percentage of Eugenol as a skin permeation enhancer (X3) were selected to study their effects on hydrogel spreadability (Y1) and percent ACV permeated through rat skin after 2.5 hours (Y2). A pharmacokinetic study of the optimized ACV nanoemulsion hydrogel was conducted in rats. Mixtures of clove oil and castor oil (3:1 ratio), Tween 80 and Span 80 (3:1 ratio), and propylene glycol and Myo-6V (3:1 ratio) were selected as the oil, surfactant, and cosurfactant phases, respectively. Statistical analysis indicated that the molecular weight of chitosan has a significant antagonistic effect on spreadability, but has no significant effect on the percent ACV permeated. The percentage of chitosan also has a significant antagonistic effect on the spreadability and percent ACV permeated. On the other hand, the percentage of Eugenol has a significant synergistic effect on percent ACV permeated, with no effect on spreadability. The ex vivo study demonstrated that the optimized ACV nanoemulsion hydrogel showed a twofold and 1.5-fold higher permeation percentage than the control gel and marketed cream, respectively. The relative bioavailability of the optimized ACV nanoemulsion hydrogel improved to 535.2% and 244.6% with respect to the raw ACV hydrogel and marketed cream, respectively, confirming improvement of the relative bioavailability of ACV in the formulated nanoemulsion hydrogel. PMID:26109856

[Clinical application evaluation of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine].

PubMed

Liu, Meng-Yu; Yang, Wei; Wang, Li-Ying; Zhao, Xue-Yao; Wang, Yue-Xi; Liu, Yu-Qi; Han, Xue-Jie; Lv, Ai-Ping

2017-09-01

Clinical application evaluation research of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine intends to evaluate the quality level and clinical application of the guideline. A questionnaire and prospective case survey methods were used to evaluate the applicability evaluation based on the clinician questionnaire and the application evaluation based on clinical case observation. The applicability evaluation, familiarity and utilization rate of doctors' guidelines were 85.06%, 62.76%; Sort by technical grade, intermediate grade doctors have a higher familiarity rate and utilization rate, while the junior grade doctor's is lower; Guide quality level of applicability evaluation, other items' rational percentage are better than 96% except the items of health preserving and prevention and other treatment is relatively low; Items' applicable percentage of applicability evaluation are more than 91% except the item of guide simplicity. Comprehensive applicability evaluation, The percentage of the guideline applicable to clinical practice accounted for 94.94%. The consistency rate of syndrome differentiation and clinical application is more than 96% in addition to prescription medication, other treatments and health preserving and prevention of the guidelines apply consistency of application evaluation. The percentage of good treatment effect accounted for 92.96% of application effect evaluation. The safety percentage is 99.89% and economy is 97.45%. The research shows that of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine quality level is good and is basically applicable to pediatric clinical practice which can be used as a standardized recommendation of pediatric common diseases' treatment specification. A small part of the guidelines are not applicable and need to be further consummated. Health preserving and prevention and other treatment of the guideline need to be revised. Copyright© by the Chinese Pharmaceutical Association.

Too many rodent carcinogens: Mitogenesis increases mutagenesis

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

Ames, B.N.; Gold, L.S.

1990-08-31

A clarification of the mechanism of carcinogenesis is developing at a rapid rate. This new understanding undermines many assumptions of current regulatory policy toward rodent carcinogens and necessitates rethinking the utility and meaning of routine animal cancer tests. At a recent watershed meeting on carcinogenesis, much evidence was presented suggesting that mitogenesis plays a dominant role in carcinogenesis. Our own rethinking of mechanism was prompted by our findings that: spontaneous DNA damage caused by endogenous oxidants is remarkably frequent and in chronic testing at the maximum tolerated dose (MTD), more than half of all chemicals tested (both natural and synthetic)more » are carcinogens in rodents, and a high percentage of these carcinogens are not mutagens.« less

Improved blood utilization using real-time clinical decision support.

PubMed

Goodnough, Lawrence T; Shieh, Lisa; Hadhazy, Eric; Cheng, Nathalie; Khari, Paul; Maggio, Paul

2014-05-01

We analyzed blood utilization at Stanford Hospital and Clinics after implementing real-time clinical decision support (CDS) and best practice alerts (BPAs) into physician order entry (POE) for blood transfusions. A clinical effectiveness (CE) team developed consensus with a suggested transfusion threshold of a hemoglobin (Hb) level of 7 g/dL, or 8 g/dL for patients with acute coronary syndromes. The CDS was implemented in July 2010 and consisted of an interruptive BPA at POE, a link to relevant literature, and an "acknowledgment reason" for the blood order. The percentage of blood ordered for patients whose most recent Hb level exceeded 8 g/dL ranged at baseline from 57% to 66%; from the education intervention by the CE team August 2009 to July 2010, the percentage decreased to a range of 52% to 56% (p = 0.01); and after implementation of CDS and BPA, by end of December 2010 the percentage of patients transfused outside the guidelines decreased to 35% (p = 0.02) and has subsequently remained below 30%. For the most recent interval, only 27% (767 of 2890) of transfusions occurred in patients outside guidelines. Comparing 2009 to 2012, despite an increase in annual case mix index from 1.952 to 2.026, total red blood cell (RBC) transfusions decreased by 7186 units, or 24%. The estimated net savings for RBC units (at $225/unit) in purchase costs for 2012 compared to 2009 was $1,616,750. Real-time CDS has significantly improved blood utilization. This system of concurrent review can be used by health care institutions, quality departments, and transfusion services to reduce blood transfusions. © 2013 American Association of Blood Banks.

Scheduling for Parallel Supercomputing: A Historical Perspective of Achievable Utilization

NASA Technical Reports Server (NTRS)

Jones, James Patton; Nitzberg, Bill

1999-01-01

The NAS facility has operated parallel supercomputers for the past 11 years, including the Intel iPSC/860, Intel Paragon, Thinking Machines CM-5, IBM SP-2, and Cray Origin 2000. Across this wide variety of machine architectures, across a span of 10 years, across a large number of different users, and through thousands of minor configuration and policy changes, the utilization of these machines shows three general trends: (1) scheduling using a naive FIFO first-fit policy results in 40-60% utilization, (2) switching to the more sophisticated dynamic backfilling scheduling algorithm improves utilization by about 15 percentage points (yielding about 70% utilization), and (3) reducing the maximum allowable job size further increases utilization. Most surprising is the consistency of these trends. Over the lifetime of the NAS parallel systems, we made hundreds, perhaps thousands, of small changes to hardware, software, and policy, yet, utilization was affected little. In particular these results show that the goal of achieving near 100% utilization while supporting a real parallel supercomputing workload is unrealistic.

Aircraft Survivability. Fall 2011

DTIC Science & Technology

2011-01-01

test the Mi-24 Hind, UH - 60 , and AH-64 Longbow rotorcraft. Bill also sat on the source selection boards for the Utility Tactical Transport Aircraft...medical evacuation (MEDEVAC, UH -60As and Air Force HH- 60s ), RW Attack (Army AH-64s and Marine AH-1s), RW Observation (Army OH-58s), and RW Utility... UH - 60s and UH -1s). Only a very small percentage of the incidents involved fixed wing aircraft with most of those involving C-130 variants that

Variables affecting the financial viability of your practice: a case study.

PubMed

Binderman, J

2001-01-01

Utilizing the discussion of variables affecting practice financial viability, a case study is considered. The case study reveals the relative impact multiple variables have upon the bottom line, including: practice capacity, percentage of capitation, and fee-for-service in the practice, as well as patient visit rates and patient churning. This article presents basic financial information through a case study model, utilizing a series of worksheets that can be adapted to any practice situation to encourage improved financial viability.

Performance of coagulation tests in patients on therapeutic doses of rivaroxaban. A cross-sectional pharmacodynamic study based on peak and trough plasma levels.

PubMed

Francart, Suzanne J; Hawes, Emily M; Deal, Allison M; Adcock, Dorothy M; Gosselin, Robert; Jeanneret, Cheryl; Friedman, Kenneth D; Moll, Stephan

2014-06-01

Knowledge of anticoagulation status during rivaroxaban therapy is desirable in certain clinical situations. It was the study objective to determine coagulation tests most useful for assessing rivaroxaban's anticoagulant effect. Peak and trough blood samples from 29 patients taking rivaroxaban 20 mg daily were collected. Mass spectrometry and various coagulation assays were performed. "On-therapy range" was defined as the rivaroxaban concentrations determined by LC-MS/MS. A "misprediction percentage" was calculated based on how often results of each coagulation assay were in the normal reference range, while the rivaroxaban concentration was in the "on-therapy" range. The on-therapy range was 8.9-660 ng/ml. The misprediction percentages for prothrombin time (PT) and activated partial thromboplastin time (aPTT), using multiple reagents and coagulometers, ranged from 10%-52% and 31%-59%, respectively. PT, aPTT and activated clotting time (ACT) were insensitive to trough rivaroxaban: 59%, 62%, and 80% of samples had a normal result, respectively. Over 95% of PT and ACT values were elevated at peak. Four different rivaroxaban calibrated anti-Xa assays had R² values >0.98, demonstrating strong correlations with rivaroxaban drug levels. In conclusion, PT, aPTT and ACT are often normal in patients on therapeutic doses of rivaroxaban. However, PT and ACT may have clinical utility at higher drug plasma levels. Rivaroxaban calibrated anti-factor Xa assays can accurately identify low and high on-therapy rivaroxaban drug levels and, therefore, have superior utility in all clinical situations where assessment of anticoagulation status may be beneficial.

Advanced Power Conversion Efficiency in Inventive Plasma for Hybrid Toroidal Reactor

NASA Astrophysics Data System (ADS)

Hançerlioğullari, Aybaba; Cini, Mesut; Güdal, Murat

2013-08-01

Apex hybrid reactor has a good potential to utilize uranium and thorium fuels in the future. This toroidal reactor is a type of system that facilitates the occurrence of the nuclear fusion and fission events together. The most important feature of hybrid reactor is that the first wall surrounding the plasma is liquid. The advantages of utilizing a liquid wall are high power density capacity good power transformation productivity, the magnitude of the reactor's operational duration, low failure percentage, short maintenance time and the inclusion of the system's simple technology and material. The analysis has been made using the MCNP Monte Carlo code and ENDF/B-V-VI nuclear data. Around the fusion chamber, molten salts Flibe (LI2BeF4), lead-lithium (PbLi), Li-Sn, thin-lityum (Li20Sn80) have used as cooling materials. APEX reactor has modeled in the torus form by adding nuclear materials of low significance in the specified percentages between 0 and 12 % to the molten salts. In this study, the neutronic performance of the APEX fusion reactor using various molten salts has been investigated. The nuclear parameters of Apex reactor has been searched for Flibe (LI2BeF4) and Li-Sn, for blanket layers. In case of usage of the Flibe (LI2BeF4), PbLi, and thin-lityum (Li20Sn80) salt solutions at APEX toroidal reactors, fissile material production per source neutron, tritium production speed, total fission rate, energy reproduction factor has been calculated, the results obtained for both salt solutions are compared.

Foundational Report Series. Advanced Distribution management Systems for Grid Modernization (Importance of DMS for Distribution Grid Modernization)

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

Wang, Jianhui

2015-09-01

Grid modernization is transforming the operation and management of electric distribution systems from manual, paper-driven business processes to electronic, computer-assisted decisionmaking. At the center of this business transformation is the distribution management system (DMS), which provides a foundation from which optimal levels of performance can be achieved in an increasingly complex business and operating environment. Electric distribution utilities are facing many new challenges that are dramatically increasing the complexity of operating and managing the electric distribution system: growing customer expectations for service reliability and power quality, pressure to achieve better efficiency and utilization of existing distribution system assets, and reductionmore » of greenhouse gas emissions by accommodating high penetration levels of distributed generating resources powered by renewable energy sources (wind, solar, etc.). Recent “storm of the century” events in the northeastern United States and the lengthy power outages and customer hardships that followed have greatly elevated the need to make power delivery systems more resilient to major storm events and to provide a more effective electric utility response during such regional power grid emergencies. Despite these newly emerging challenges for electric distribution system operators, only a small percentage of electric utilities have actually implemented a DMS. This paper discusses reasons why a DMS is needed and why the DMS may emerge as a mission-critical system that will soon be considered essential as electric utilities roll out their grid modernization strategies.« less

Plankton crustaceans in bays with different trophic status in Llanquihue lake (41° S Chile).

PubMed

Escalante, P De Los Ríos; Soto, D; Santander-Massa, R; Acevedo, P

2017-01-01

The Llanquihue lake is included in the called Araucanian or Nord Patagonian lakes located between 38-41° S. These lakes are characterized by their oligo-mesotrophic status due to human intervention which takes to the increase in nutrients inputs from industries and towns. Effects on zooplankton assemblages are observed with marked increase of daphnids abundance. The aim of the present study is to analyze the trophic status and zooplankton relative abundance in different bays of Llanquihue lake. It was found direct associations between chlorophyll a with daphnids percentage, total dissolved nitrogen with reactive soluble phosphorus nitrogen/phosphorus molar radio with cyclopoids percentage, and an inverse relation between daphnids and calanoids percentages. The occurrence of three kinds of microcrustacean assemblages and environmental conditions was evidenced: the first one with high calanoids percentage, low species number and low chlorophyll and nutrients concentration, a second with moderate chlorophyll and nutrients concentration and moderate daphnids percentage; high species number and a third site with high chlorophyll and nutrients concentration, high daphnids percentage and high species number. Daphnids increase under mesotrophic status, agree with similar results observed for southern Argentinean and New Zealand lakes.

The effect of family policies and public health initiatives on breastfeeding initiation among 18 high-income countries: a qualitative comparative analysis research design.

PubMed

Lubold, Amanda Marie

2017-01-01

The objective of this study is to examine the effects of macro-level factors - welfare state policies and public health initiatives - on breastfeeding initiation among eighteen high-income countries. This study utilizes fuzzy-set Qualitative Comparative Analysis methods to examine the combinations of conditions leading to both high and low national breastfeeding initiation rates among eighteen high-income countries. The most common pathway leading to high breastfeeding initiation is the combination of conditions including a high percentage of women in parliament, a low national cesarean section rate, and either low family spending, high rates of maternity leave, or high rates of women working part-time. The most common pathway leading to low breastfeeding initiation includes the necessary condition of low national adherence to the Baby-Friendly Hospital Initiative. This research suggests that there is a connection between broad level welfare state polices, public health initiatives, and breastfeeding initiation. Compliance with the WHO/UNICEF initiatives depends on welfare regime policies and overall support for women in both productive and reproductive labor.

Culture-dependent and culture-independent characterization of microbial assemblages associated with high-temperature petroleum reservoirs.

PubMed

Orphan, V J; Taylor, L T; Hafenbradl, D; Delong, E F

2000-02-01

Recent investigations of oil reservoirs in a variety of locales have indicated that these habitats may harbor active thermophilic prokaryotic assemblages. In this study, we used both molecular and culture-based methods to characterize prokaryotic consortia associated with high-temperature, sulfur-rich oil reservoirs in California. Enrichment cultures designed for anaerobic thermophiles, both autotrophic and heterotrophic, were successful at temperatures ranging from 60 to 90 degrees C. Heterotrophic enrichments from all sites yielded sheathed rods (Thermotogales), pleomorphic rods resembling Thermoanaerobacter, and Thermococcus-like isolates. The predominant autotrophic microorganisms recovered from inorganic enrichments using H(2), acetate, and CO(2) as energy and carbon sources were methanogens, including isolates closely related to Methanobacterium, Methanococcus, and Methanoculleus species. Two 16S rRNA gene (rDNA) libraries were generated from total community DNA collected from production wellheads, using either archaeal or universal oligonucleotide primer sets. Sequence analysis of the universal library indicated that a large percentage of clones were highly similar to known bacterial and archaeal isolates recovered from similar habitats. Represented genera in rDNA clone libraries included Thermoanaerobacter, Thermococcus, Desulfothiovibrio, Aminobacterium, Acidaminococcus, Pseudomonas, Halomonas, Acinetobacter, Sphingomonas, Methylobacterium, and Desulfomicrobium. The archaeal library was dominated by methanogen-like rDNAs, with a lower percentage of clones belonging to the Thermococcales. Our results strongly support the hypothesis that sulfur-utilizing and methane-producing thermophilic microorganisms have a widespread distribution in oil reservoirs and the potential to actively participate in the biogeochemical transformation of carbon, hydrogen, and sulfur in situ.

The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

PubMed

Zamani-Hank, Yasamean

2016-08-01

The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278).

Correlation of two bioadhesion assays: the everted sac technique and the CAHN microbalance.

PubMed

Santos, C A; Jacob, J S; Hertzog, B A; Freedman, B D; Press, D L; Harnpicharnchai, P; Mathiowitz, E

1999-08-27

This contribution correlates two in vitro methods utilized to determine bioadhesion. One method, the everted intestinal sac technique, is a passive test for bioadhesion involving several polymer microspheres and a section of everted intestinal tissue. The other method, the CAHN microbalance, employs a CAHN dynamic contact angle analyzer with modified software to record the tensile forces measured as a single polymer microsphere is pulled from intestinal tissue. This study demonstrates that CAHN and everted sac experiments yield similar results when used to quantify the bioadhesive nature of polymer microsphere systems. A polymer showing high adhesion in one method also demonstrates high bioadhesion in the other method; polymers that exhibit high fracture strength and tensile work measurements with the CAHN microbalance also yield high binding percentages with the everted sac method. The polymers tested and reported here are poly(caprolactone) and different copolymer ratios of poly(fumaric-co-sebacic anhydride). The results of this correlation demonstrate that each method alone is a valuable indicator of bioadhesion.

Comparison of methodologies in determining bone marrow fat percentage under different environmental conditions.

PubMed

Murden, David; Hunnam, Jaimie; De Groef, Bert; Rawlin, Grant; McCowan, Christina

2017-01-01

The use of bone marrow fat percentage has been recommended in assessing body condition at the time of death in wild and domestic ruminants, but few studies have looked at the effects of time and exposure on animal bone marrow. We investigated the utility of bone marrow fat extraction as a tool for establishing antemortem body condition in postmortem specimens from sheep and cattle, particularly after exposure to high heat, and compared different techniques of fat extraction for this purpose. Femora were collected from healthy and "skinny" sheep and cattle. The bones were either frozen or subjected to 40°C heat; heated bones were either wrapped in plastic to minimize desiccation or were left unwrapped. Marrow fat percentage was determined at different time intervals by oven-drying, or by solvent extraction using hexane in manual equipment or a Soxhlet apparatus. Extraction was performed, where possible, on both wet and dried tissue. Multiple samples were tested from each bone. Bone marrow fat analysis using a manual, hexane-based extraction technique was found to be a moderately sensitive method of assessing antemortem body condition of cattle up to 6 d after death. Multiple replicates should be analyzed where possible. Samples from "skinny" sheep showed a different response to heat from those of "healthy" sheep; "skinny" samples were so reduced in quantity by day 6 (the first sampling day) that no individual testing could be performed. Further work is required to understand the response of sheep marrow.

Platelet indices and netrophil to lymphocyte ratio in adults with acute appendicitis.

PubMed

Kostakis, I D; Machairas, N; Damaskos, C; Doula, C; Tsaparas, P; Charalampoudis, P; Spartalis, E; Sotiropoulos, G C; Kouraklis, G

2016-03-01

A study was performed in adults with acute appendicitis and matched controls to assess the utility of the platelet indices and neutrophil to lymphocyte ratio, as a diagnostic adjunct. Data were retrospectively collected from a complete blood count test of 155 adult patients (72 men and 83 women) with histologically proven acute appendicitis upon admission, and of 50 healthy adults (20 men and 30 women). The parameters for white blood cells and platelets were compared between the two groups, and for each gender separately. A higher white blood cell count, neutrophil count, neutrophil percentage, neutrophil to lymphocyte ratio and lower lymphocyte percentage was reported in patients with acute appendicitis than that in the healthy controls, with high areas under the curve (AUC), sensitivities, specifi cities, positive predictive values (PPVs) and moderate negative predictive values (NPVs). The lymphocyte count was lower in patients than it was in the healthy controls. The platletcrit was lower in the female patients than that in the female controls, whereas a difference was not detected in the male participants. Differences were not detected with regard to platelet count, mean platelet volume and platelet distribution width for both genders. The neutrophil to lymphocyte ratio increases and lymphocyte percentage decreases in acute appendicitis, and can be used as an additional diagnostic marker. Plateletcrit, and therefore total platelet mass, is reduced in women with acute appendicitis, indicating the involvement of platelets in its pathophysiology. However, it is neither a reliable predictor or excluder of the disease.

How does the Structure of Spherical Dark Matter Halos Affect the Types of Orbits in Disk Galaxies?

NASA Astrophysics Data System (ADS)

Zotos, Euaggelos E.

The main objective of this work is to determine the character of orbits of stars moving in the meridional (R,z) plane of an axially symmetric time-independent disk galaxy model with a central massive nucleus and an additional spherical dark matter halo component. In particular, we try to reveal the influence of the scale length of the dark matter halo on the different families of orbits of stars, by monitoring how the percentage of chaotic orbits, as well as the percentages of orbits of the main regular resonant families evolve when this parameter varies. The smaller alignment index (SALI) was computed by numerically integrating the equations of motion as well as the variational equations to extensive samples of orbits in order to distinguish safely bet ween ordered and chaotic motion. In addition, a method based on the concept of spectral dynamics that utilizes the Fourier transform of the time series of each coordinate is used to identify the various families of regular orbits and also to recognize the secondary resonances that bifurcate from them. Our numerical computations reveal that when the dark matter halo is highly concentrated, that is when the scale length has low values the vast majority of star orbits move in regular orbits, while on the oth er hand in less concentrated dark matter halos the percentage of chaos increases significantly. We also compared our results with early related work.

Effects of school reformon education and labor market performance: Evidence from Chile’s universal voucher system

PubMed Central

Bravo, David; Mukhopadhyay, Sankar; Todd, Petra E.

2011-01-01

This paper studies the effects of school reform in Chile, which adopted a nationwide school voucher program along with school decentralization reforms in 1981. Since then, Chile has had a relatively unregulated, competitive market in primary and secondary education. It therefore provides a unique setting in which to study how these reforms affected school attainment and labor market outcomes. This paper develops and estimates a dynamic model of school attendance and work decisions using panel data from the 2002 and 2004 waves of the Encuesta de Protección Social survey. Some individuals in the sample completed their schooling before the voucher reforms were introduced, while others had the option of using the vouchers over part or all of their schooling careers. The impacts of the voucher reform are identified from differences in the schooling and work choices made and earnings returns received by similar aged individuals who were differentially exposed to the voucher system. Simulations based on the estimated model show that the voucher reform significantly increased the demand for private subsidized schools and decreased the demand for both public and nonsubsidized private schools. It increased high school (grades 9–12) graduation rates by 3.6 percentage points and the percentage completing at least two years of college by 2.6 percentage points. Individuals from poor and non-poor backgrounds on average experienced similar schooling attainment gains. The reform also increased lifetime utility and modestly reduced earnings inequality. PMID:22059095

Influence of an information literacy course on students' information search behavior.

PubMed

Weinert, Daniel J; Palmer, Erin M

2007-01-01

The purpose of this study was to determine the influence of an information literacy course on students' information gathering behavior. Two student groups, consisting of 69 (Group One) and 177 (Group Two) students, were compared in their performance on a literature review assignment. Group one did not have an information literacy course, while group two was the first class to receive a newly introduced course in information literacy. Assignment references served as the dependent variables and included the following categories: total number of references, number and percentage of peer reviewed journal references, number and percentage of non-peer reviewed journal references, number and percentage of website references, number and percentage of authority opinion references, and number and percentage of textbook references. Referenced websites were further divided into the following: .com, .org, .edu, .gov. for both total number and percent utilization.Independent T-tests were performed between the information literacy course status and each of the dependent variables. Descriptive data (prior education, cumulative GPA, average age of student groups) was similar for both groups. Independent T-test analysis revealed a strong association (p < .05) between increasing both the number and percentage of peer reviewed references and having the information literacy course. The introduction of an information literacy course did influence the information gathering behavior of students. Students showed an increased reliance on peer-reviewed references.

Implications of the 2013 ACC/AHA cholesterol guidelines on contemporary clinical practice for patients with atherosclerotic coronary and peripheral arterial disease.

PubMed

Gunasekaran, Prasad; Jeevanantham, Vinodh; Sharma, Suresh; Thapa, Rashmi; Gupta, Kamal

Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n=9563), peripheral arterial disease (PAD) (n=596) and CAD+PAD (n=975) by applying both guidelines. The percentage of patients who achieved guideline-specific targets using 2013 ACC/AHA (use of moderate/high intensity statins) or ATPIII guidelines (LDL-C<100mg/dl) was compared between all groups. Using both guidelines, the PAD only group demonstrated lower utilization and lower statin doses than the CAD or CAD+PAD groups. When applying the ACC/AHA guidelines, more patients in the CAD only group (age ≤75 years) were considered at goal as compared to the ATPIII guidelines (92.2% vs. 75%), primarily driven by the group placed on moderate/high intensity statins but had an LDL-C level >100mg/dl. Application of the ACC/AHA guidelines results in a higher percentage of patients considered to be 'at goal' when compared to the ATP III guidelines without changes in clinical practice. This is due to patients ≤75 years old on adequate statin doses but still have LDL-C levels >100mg/dl, thereby raising concerns that physicians may not pursue alternate LDL reduction strategies since they are now considered at goal despite LDL-C >100mg/dl. Lipid management of PAD patients remains sub-optimal as compared to CAD and CAD+PAD. Copyright © 2017. Published by Elsevier B.V.

Field Control and Performance of Asphalt Mixtures Containing Greater than 25 Percent Reclaimed Asphalt Pavement : Draft Final Report

DOT National Transportation Integrated Search

2018-02-02

The Alabama Department of Transportation (ALDOT) and other highway agencies are interested in utilization of higher percentages of reclaimed asphalt pavement (RAP) in asphalt mixtures. There are a number of research studies at both state and national...

47 CFR 1.1404 - Complaint.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., maintenance, and administrative. These charges may be expressed as a percentage of the net pole investment... state court that determines the treatment of accumulated deferred taxes if it is at issue in the... deferred taxes. (x) The rate of return authorized for the utility for intrastate service. With its pleading...

Student Leadership at the University

ERIC Educational Resources Information Center

Hilliard, Ann T.

2010-01-01

The focus of this article is about the utilization of student leadership at the University. Based on research, student leadership opportunities at the university have been frequently at a low percentage (Zimmerman, Burkhart, 2002). The researcher identifies practical ways to involve students in various leadership activities. Emphases are placed on…

Investigation of Warm Mix Asphalt (WMA) Technologies and Increased Percentages of Reclaimed Asphalt Pavement (RAP) in Asphalt Mixtures

DOT National Transportation Integrated Search

2011-04-01

The implementation of warm-mix asphalt (WMA) is becoming more widespread with a growing number of contractors utilizing various WMA technologies. Early research suggests WMA may be more susceptible to moisture damage than traditional hot-mix asphalt ...

The Affordable Care Act, Insurance Coverage, and Health Care Utilization of Previously Incarcerated Young Men: 2008-2015.

PubMed

Winkelman, Tyler N A; Choi, HwaJung; Davis, Matthew M

2017-05-01

To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act's (ACA's) Medicaid expansion and Marketplace plans in 2014. We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration. Uninsurance declined significantly among previously incarcerated men after ACA implementation (-5.9 percentage points; 95% confidence interval [CI] = -11.5, -0.4), primarily because of an increase in private insurance (6.8 percentage points; 95% CI = 0.1, 13.3). Previously incarcerated men accounted for a large proportion of the remaining uninsured (38.6%) in 2014 to 2015. Following ACA implementation, previously incarcerated men continued to be significantly less likely to report a regular source of primary care and more likely to report emergency department use than were never-incarcerated peers. Health insurance coverage improved among previously incarcerated men following ACA implementation. However, these men account for a substantial proportion of the remaining uninsured. Previously incarcerated men continue to lack primary care and frequently utilize acute care services.

Social Capital Enhanced Disaster Preparedness and Health Consultations after the 2011 Great East Japan Earthquake and Nuclear Power Station Accident

PubMed Central

Hasegawa, Makoto; Murakami, Michio; Suzuki, Satoshi; Ohto, Hitoshi

2018-01-01

After the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Station accident in 2011, there was a strong demand to promote disaster preparedness approaches and health checkups for the prevention of lifestyle diseases. This study examined the yearly change in the percentage of those who prepared for disasters and who utilized health checkups in Fukushima Prefecture, and identified the factors governing disaster preparedness and utilization of health checkups. We used the public opinion survey from 2011 to 2015 (n = 677–779 each year) on prefectural policies that is conducted every year by the Fukushima Prefecture government Public Consultation Unit. We found that the percentage of those who prepare for disasters decreased, while that for health checkups did not significantly change. With regard to disaster preparedness, experiences of disaster enhance disaster preparedness, while bonds with other local people help to maintain preparedness. For health checkups, familiarity with the welfare service was the most important factor governing such consultations. The findings suggest that social capital should be promoted in order to improve disaster preparedness. The findings also suggest that residents’ accessibility to medical and welfare services is also important in promoting the utilization of health checkups. PMID:29538320

Effect of racial and ethnic composition of neighborhoods in San Francisco on rates of mental health-related 911 calls.

PubMed

Kessell, Eric R; Alvidrez, Jennifer; McConnell, William A; Shumway, Martha

2009-10-01

This study investigated the association between the racial and ethnic residential composition of San Francisco neighborhoods and the rate of mental health-related 911 calls. A total of 1,341,608 emergency calls (28,197 calls related to mental health) to San Francisco's 911 system were made from January 2001 through June 2003. Police sector data in the call records were overlaid onto U.S. census tracts to estimate sector demographic and socioeconomic characteristics. Negative binomial regression was used to estimate the association between the percentage of black, Asian, Latino, and white residents and rates of mental health-related calls. A one-point increase in a sector's percentage of black residents was associated with a lower rate of mental health-related calls (incidence rate ratio=.99, p<.05). A sector's percentage of Asian and Latino residents had no significant effect. The observed relationship between the percentage of black residents and mental health-related calls is not consistent with known emergency mental health service utilization patterns.

Percentage body fat and prevalence of obesity in a UK offshore population.

PubMed

Light, I M; Gibson, M

1986-07-01

1. Body-weight, body height and skinfold measurements were taken in 419 adult males working in the UK offshore oil industry. Percentage body fat was estimated from skinfold thicknesses and the Quetelet index (weight:height) determined. 2. The prevalence of overweightness, assessed from the Quetelet index, in the age groups 20-29, 30-39 and 40-49 years was 31.6, 50.0 and 66.2% respectively. The Office of Population Census and Surveys (1981) showed that for age-matched groups, the incidence of overweightness in an onshore population was 26, 40 and 50% respectively. 3. The percentage body fat for each respective age group was greater than that reported for an age-matched onshore population. 4. The Quetelet index was significantly related to body fat (r 0.765, P less than 0.0001) and poorly correlated with height, thus this weight:height relation may be utilized in the assessment of overweightness in offshore personnel. 5. In conclusion it appears that the offshore population had a higher percentage body fat than their onshore peers and that the prevalence of overweightness was also greater.

Glut-1 expression in small cervical biopsies is prognostic in cervical cancers treated with chemoradiation.

PubMed

Kanjanapan, Yada; Deb, Siddhartha; Young, Richard J; Bressel, Mathias; Mileshkin, Linda; Rischin, Danny; Hofman, Michael S; Narayan, Kailash; Siva, Shankar

2017-02-01

Chemoradiation (CRT) is standard therapy for locally advanced cervical cancer (LACC). However, there is a lack of biomarkers to identify patients at high relapse-risk. We examine metabolic (glucose transporter-1 [Glut-1]), hypoxic (hypoxia inducible factor [HIF-1α]; carbonic anhydrase [CA-9]) and proliferative (Ki-67) markers for prognostic utility in LACC. 60 LACC patients treated with CRT had pre-treatment biopsies. Immunohistochemistry was performed for Glut-1, HIF-1a and CA-9, to generate a histoscore from intensity and percentage staining; and Ki-67 scored by percentage of positive cells. For each biomarker, treatment response and survival was compared between low and high-staining groups by logrank testing and multivariate analyses. High Glut-1 expression was associated with inferior progression-free survival (PFS), (hazard ratio [HR] 2.8, p  = 0.049) and overall survival (OS), (HR 5.0, p  = 0.011) on multifactor analysis adjusting for stage, node positivity, tumour volume and uterine corpus invasion. High Glut-1 correlated with increased risk of distant failure (HR 14.6, p  = 0.001) but not local failure. Low Glut-1 was associated with higher complete metabolic response rate on post-therapy positron emission tomography scan (odds ratio 3.4, p  = 0.048). Ki-67 was significantly associated with PFS only (HR 1.19 per 10 units increase, p  = 0.033). Biomarkers for hypoxia were not associated with outcome. High Glut-1 in LACC is associated with poor outcome post CRT. If prospectively validated, Glut-1 may help select patients for more intensive treatment regimens.

Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data.

PubMed

Cram, Peter; Landon, Bruce E; Matelski, John; Ling, Vicki; Stukel, Therese A; Paterson, J Michael; Gandhi, Rajiv; Hawker, Gillian A; Ravi, Bheeshma

2018-04-01

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common and effective surgical procedures. This study sought to compare utilization and short-term outcomes of primary TKA and THA in adjacent regions of Canada and the United States. The study was designed as a retrospective cohort study of patients who underwent primary TKA or THA, comparing administrative data from New York and Ontario in 2012-2013. Demographic features of the TKA and THA patients, per capita utilization rates, and short-term outcomes were compared between the jurisdictions. A higher percentage of New York hospitals performed TKA compared to Ontario hospitals (75.7% versus 42.1%; P < 0.001), and the mean annual procedural volume for TKAs was lower in New York hospitals (mean 179 versus 327 in Ontario hospitals; P < 0.001). After direct standardization, utilization was significantly lower in New York compared to Ontario, both for TKA (16.1 TKAs versus 21.4 TKAs per 10,000 population per year; P < 0.001) and for THA (10.5 THAs versus 11.5 THAs per 10,000 population per year; P < 0.001). For those who underwent TKA, the length of stay in Ontario hospitals was significantly longer (mean 3.7 days versus 3.4 days in New York hospitals; P < 0.001). A smaller percentage of New York patients were discharged directly home (46.2% versus 90.9% of Ontario patients; P < 0.001), but 30-day and 90-day readmission rates were higher in New York compared to Ontario (30-day rates, 4.6% versus 3.9% [P < 0.001]; 90-day rates, 8.4% versus 6.7% [P < 0.001]). For the THA cohorts, the results with regard to length of stay, discharge disposition, and readmission rates were similar to those for TKA. Ontario has higher utilization of total joint arthroplasty than New York but has a smaller percentage of hospitals performing these procedures. Patients are more likely to be discharged home and less likely to be readmitted in Ontario. Our results suggest areas where each jurisdiction could improve. © 2017, American College of Rheumatology.

Reusing recycled aggregates in structural concrete

NASA Astrophysics Data System (ADS)

Kou, Shicong

The utilization of recycled aggregates in concrete can minimize environmental impact and reduce the consumption of natural resources in concrete applications. The aim of this thesis is to provide a scientific basis for the possible use of recycled aggregates in structure concrete by conducting a comprehensive programme of laboratory study to gain a better understanding of the mechanical, microstructure and durability properties of concrete produced with recycled aggregates. The study also explored possible techniques to of improve the properties of recycled aggregate concrete that is produced with high percentages (≧ 50%) of recycled aggregates. These techniques included: (a) using lower water-to-cement ratios in the concrete mix design; (b) using fly ash as a cement replacement or as an additional mineral admixture in the concrete mixes, and (c) precasting recycled aggregate concrete with steam curing regimes. The characteristics of the recycled aggregates produced both from laboratory and a commercially operated pilot construction and demolition (C&D) waste recycling plant were first studied. A mix proportioning procedure was then established to produce six series of concrete mixtures using different percentages of recycled coarse aggregates with and without the use of fly ash. The water-to-cement (binder) ratios of 0.55, 0.50, 0.45 and 0.40 were used. The fresh properties (including slump and bleeding) of recycled aggregate concrete (RAC) were then quantified. The effects of fly ash on the fresh and hardened properties of RAC were then studied and compared with those RAC prepared with no fly ash addition. Furthermore, the effects of steam curing on the hardened properties of RAC were investigated. For micro-structural properties, the interfacial transition zones of the aggregates and the mortar/cement paste were analyzed by SEM and EDX-mapping. Moreover, a detailed set of results on the fracture properties for RAC were obtained. Based on the experimental results, a number of recommendations were made on how to optimize the use of recycled aggregates for structural concrete production. The results demonstrate that one of the practical ways to utilize a higher percentage of recycled aggregates in concrete is "precasting" with the use of fly ash and an initial steam curing stage immediately after casting.

Percentage Problems in Bridging Courses

ERIC Educational Resources Information Center

Kachapova, Farida; Kachapov, Ilias

2012-01-01

Research on teaching high school mathematics shows that the topic of percentages often causes learning difficulties. This article describes a method of teaching percentages that the authors used in university bridging courses. In this method, the information from a word problem about percentages is presented in a two-way table. Such a table gives…

COMPARATIVE DIVERSITY OF FECAL BACTERIA IN AGRICULTURALLY SIGNIFICANT ANIMALS TO IDENTIFY ALTERNATIVE TARGETS FOR MICROBIAL SOURCE TRACKING

EPA Science Inventory

Animals of agricultural significance contribute a large percentage of fecal pollution to waterways via runoff contamination. The premise of microbial source tracking is to utilize fecal bacteria to identify target populations which are directly correlated to specific animal feces...

Citation analysis of the 100 most common articles regarding distal radius fractures.

PubMed

Jones, Richard; Hughes, Travis; Lawson, Kevin; DeSilva, Gregory

2017-01-01

Bibliometric studies are increasingly being utilized as a tool for gauging the impact of different literature within a given field. The purpose of this study was to identify the most cited articles related to the management of distal radius fractures to better understand how the evidence of this topic has been shaped and changed over time. We utilized the ISI web of science database to conduct a search for the term "distal radius fracture" under the "orthopaedics" research area heading, and sorted the results by number of times cited. The 100 most cited articles published in orthopedic journals were then analyzed for number of citations, source journal, year of publication, number of authors, study type, level of evidence, and clinical outcomes utilized. The 100 most cited articles identified were published between 1951 and 2009. Total number of citations ranged between 525 and 67, and came from ten different orthopedic journals. The largest number of articles came from J Hand Surg Am and J Bone Joint Surg Am, each with 32. Consistent with previous analyses of orthopedic literature, the articles were primarily clinical, and of these, 53/76 were case series. The vast majority were evidence level IV. Only a small percentage of articles utilized patient reported outcome measures. These data show that despite distal radius fractures being a common fracture encountered by physicians, very few of the articles were high quality studies, and only a low proportion of the studies include patient reported outcome measures. Surgeons should take this lack of high-level evidence into consideration when referencing classic papers in this field. Analysis of the 100 most cited distal radius fracture articles allows for delineation of which articles are most common in the field and if a higher level of evidence correlates positively with citation quantity.

Characterization of Siarang Dairi local corn, Regency of Dairi, North Sumatera Province

NASA Astrophysics Data System (ADS)

Nasution, L. Z.; Buri, N.

2018-05-01

Corn is one of the carbohydrate-producing plants in addition to rice and wheat which contains nutrients that can be used for humans and animals. Local plants have an important role for genetic resources and can create new varieties. So it needs to be preserved and utilized. The purpose of this research is to characterize the local maize of Siarang Dairi. This research uses qualitative method is descriptive analysis. The data collected include the quantitative and qualitative character of agronomic and morphological characters using 5 plant samples. The results showed that the local Siarang Dairi maize had a root falling percentage of 0% and the stem fall percentage of 3.07%. The high of the plant ranged from 236 - 277 cm. The length of the cob were from 16 - 19 cm with an almost homogen diameter of 4 – 4.5 cm. The uppermost form of cylindrical and cylindrical conical. Grain lengths range from 6 - 8 mm, with grain widths ranging from 5 - 9 mm, and grain thicknesses ranging from 3 - 5 mm. The top grain surface shape is jagged, round, and flat. Specific color grains are unique and varied from brown, orange and red color.

Academic Facility Utilization and Survival Outcomes in Adult Head and Neck Sarcomas: An NCDB Analysis.

PubMed

Cannon, Richard B; Carpenter, Patrick S; Boothe, Dustin; Buchmann, Luke O; Hunt, Jason P; Lloyd, Shane; Hitchcock, Ying J; Houlton, Jeffrey J; Weis, John R; Shepherd, Hailey M; Monroe, Marcus M

2018-04-01

Objectives To investigate clinicopathologic and treatment factors associated with survival in adult head and neck sarcomas in the National Cancer Database (NCDB). To analyze whether treatment settings and therapies received influence survival outcomes and to compare trends in utilization via an aggregated national data set. Study Design Prospectively gathered data. Setting NCDB. Subjects and Methods The study comprised a total of 6944 adult patients treated for a head and neck sarcoma from January 2004 to December 2013. Overall survival (OS) was the primary outcome. Results Increased age and tumor size, nodal involvement, and poorly differentiated histology had significantly reduced OS ( P < .001). Angiosarcoma, malignant nerve sheath tumor, malignant fibrous histiocytoma, osteosarcoma, and rhabdomyosarcoma histologic subtypes had significantly reduced OS, while liposarcoma, chondrosarcoma, and chordoma had improved OS ( P < .001). Utilization of surgical therapy was associated with improved OS, while positive surgical margins were associated with treatment at a community-based cancer program and had reduced OS ( P < .001). On multivariate analysis, treatment with radiation and/or chemotherapy was not significantly associated with OS; however, primary treatment with definitive chemoradiotherapy had significantly reduced OS. Patients treated at academic/research cancer programs (n = 3874) had significantly improved 5- and 10-year OS (65% and 54%, respectively) when compared with patients treated at community-based cancer programs (n = 3027; 49% and 29%; P < .001). The percentage utilization of these programs (56% vs 44%) did not change over the study period. Conclusion For adult head and neck sarcomas, treatment at an academic/research cancer program was associated with improved survival; however, despite increasing medical specialization, the percentage utilization of these programs for this rare tumor remains constant.

Solar Heating And Cooling Of Buildings (SHACOB): Requirements definition and impact analysis-2. Volume 1: Energy-conserving design for residential structures

NASA Astrophysics Data System (ADS)

Cretcher, C. K.

1980-11-01

The impact of stringent energy conserving building standards on electric utility service areas and their customers was analyzed. The demands on the seven broadly representative electric utilities were aggregated to represent the total new construction electric heating demands in the years 1990 and 2000 to be compared to the aggregate obtained similarly for a nominal, less stringent standard, viz., ASHRAE 90-75. Results presented include the percentage of energy savings achieved in both heating and cooling seasons and typical demand profile changes. A utility economic impact analysis was performed for the cases investigated to determine changes in operating costs and potential capacity sales. A third cost component considered is the incremental cost of superinsulation (over ASHRAE 90-75) to the customer. The aggregate net cost to the utility/customer entity is utilized as a measure of overall economic benefit.

Coupling solid-phase microextraction and high-performance liquid chromatography for direct and sensitive determination of halogenated fungicides in wine.

PubMed

Millán, S; Sampedro, M C; Unceta, N; Goicolea, M A; Rodríguez, E; Barrio, R J

2003-05-02

A solid-phase microextraction (SPME) method coupled to high-performance liquid chromatography with diode array detection (HPLC-DAD) for the analysis of six organochlorine fungicides (nuarimol, triadimenol, triadimefon, folpet, vinclozolin and penconazole) in wine was developed. For this purpose, polydimethylsiloxane-divinylbenzene-coated fibers were utilized and all factors affecting throughput, precision, and accuracy of the SPME method were investigated and optimized. These factors include: matrix influence, extraction and desorption time, percentage of ethanol, pH, salt effect and desorption mode. The performed analytical procedure showed detectability ranging from 4 to 27 microg l(-1) and precision from 2.4 to 14.2% (as intra-day relative standard deviation, RSD) and 4.7-25.7% (as inter-day RSD) depending on the fungicide. The results demonstrate the suitability of the SPME-HPLC-DAD method to analyze these organochlorine fungicides in red wine.

Vegetational analysis with Skylab-3 imagery. [Perquimans County, North Carolina

NASA Technical Reports Server (NTRS)

Welby, C. W. (Principal Investigator); Holman, R. E.

1975-01-01

The author has identified the following significant results. Color infrared photography from Skylab 3 appeared to be superior to ERTS imagery in a vegetational study of northeastern North Carolina. An accuracy of 87% was achieved in delimiting species composition and zonation patterns of three coastal, vegetation classes. A vegetation map of Perquimans County, North Carolina, seemed to have a high degree of correlation with information provided by high altitude U-2 photography. Random verification sites revealed an overall interpretation accuracy above 84%. Comparison of maps drawn utilizing Skylab photography with North Carolina Dept. of Agriculture estimates of crop acreage revealed some marked discrepancies. The chief difference lies in the nonagricultural category in which there is a 30% discrepancy. This fact raised some questions as to the definition of nonagricultural land uses and methods used by the State Dept. of Agriculture to determine actual percentages of crops grown.

Optimization of furfural production from D-xylose with formic acid as catalyst in a reactive extraction system.

PubMed

Yang, Wandian; Li, Pingli; Bo, Dechen; Chang, Heying; Wang, Xiaowei; Zhu, Tao

2013-04-01

Furfural is one of the most promising platform chemicals derived from biomass. In this study, response surface methodology (RSM) was utilized to determine four important parameters including reaction temperature (170-210°C), formic acid concentration (5-25 g/L), o-nitrotoluene volume percentage (20-80 vt.%), and residence time (40-200 min). The maximum furfural yield of 74% and selectivity of 86% were achieved at 190°C for 20 g/L formic acid concentration and 75 vt.% o-nitrotoluene by 75 min. The high boiling solvent, o-nitrotoluene, was recommended as extraction solvent in a reactive extraction system to obtain high furfural yield and reduce furfural-solvent separation costs. Although the addition of halides to the xylose solutions enhanced the furfural yield and selectivity, the concentration of halides was not an important factor on the furfural yield and selectivity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Utilization of computer technology by science teachers in public high schools and the impact of standardized testing

NASA Astrophysics Data System (ADS)

Priest, Richard Harding

A significant percentage of high school science teachers are not using computers to teach their students or prepare them for standardized testing. A survey of high school science teachers was conducted to determine how they are having students use computers in the classroom, why science teachers are not using computers in the classroom, which variables were relevant to their not using computers, and what are the effects of standardized testing on the use of technology in the high school science classroom. A self-administered questionnaire was developed to measure these aspects of computer integration and demographic information. A follow-up telephone interview survey of a portion of the original sample was conducted in order to clarify questions, correct misunderstandings, and to draw out more holistic descriptions from the subjects. The primary method used to analyze the quantitative data was frequency distributions. Multiple regression analysis was used to investigate the relationships between the barriers and facilitators and the dimensions of instructional use, frequency, and importance of the use of computers. All high school science teachers in a large urban/suburban school district were sent surveys. A response rate of 58% resulted from two mailings of the survey. It was found that contributing factors to why science teachers do not use computers were not enough up-to-date computers in their classrooms and other educational commitments and duties do not leave them enough time to prepare lessons that include technology. While a high percentage of science teachers thought their school and district administrations were supportive of technology, they also believed more inservice technology training and follow-up activities to support that training are needed and more software needs to be created. The majority of the science teachers do not use the computer to help students prepare for standardized tests because they believe they can prepare students more efficiently without a computer. Nearly half of the teachers, however, gave lack of time to prepare instructional materials and lack of a means to project a computer image to the whole class as reasons they do not use computers. A significant percentage thought science standardized testing was having a negative effect on computer use.

Lignocellulosic Biomass to Ethanol Process Design and Economics Utilizing Co-Current Dilute Acid Prehydrolysis and Enzymatic Hydrolysis Current and Futuristic Scenarios

DTIC Science & Technology

1999-07-01

handled as a dry solid. This approach was recommended by vendors and is typical of dewatering equipment used in the utility flue gas desulfurization ...in a large continuous stirred- tank reactor (CSTR). 21 H. Majdeski, personal experience in the flue gas desulfurization industry, 1998. 22 Letter to B...defined as the percentage of the feed heat that is converted to steam heat, is 62% (see Figure 15). Flue gas from the dryer cyclone enters a baghouse to

Trends and causes of severity, size, and number of fires in northwestern California, USA.

PubMed

Miller, J D; Skinner, C N; Safford, H D; Knapp, E E; Ramirez, C M

2012-01-01

Research in the last several years has indicated that fire size and frequency are on the rise in western U.S. forests. Although fire size and frequency are important, they do not necessarily scale with ecosystem effects of fire, as different ecosystems have different ecological and evolutionary relationships with fire. Our study assessed trends and patterns in fire size and frequency from 1910 to 2008 (all fires > 40 ha), and the percentage of high-severity in fires from 1987 to 2008 (all fires > 400 ha) on the four national forests of northwestern California. During 1910-2008, mean and maximum fire size and total annual area burned increased, but we found no temporal trend in the percentage of high-severity fire during 1987-2008. The time series of severity data was strongly influenced by four years with region-wide lightning events that burned huge areas at primarily low-moderate severity. Regional fire rotation reached a high of 974 years in 1984 and fell to 95 years by 2008. The percentage of high-severity fire in conifer-dominated forests was generally higher in areas dominated by smaller-diameter trees than in areas with larger-diameter trees. For Douglas-fir forests, the percentage of high-severity fire did not differ significantly between areas that re-burned and areas that only burned once (10% vs. 9%) when re-burned within 30 years. Percentage of high-severity fire decreased to 5% when intervals between first and second fires were > 30 years. In contrast, in both mixed-conifer and fir/high-elevation conifer forests, the percentage of high-severity fire was less when re-burned within 30 years compared to first-time burned (12% vs. 16% for mixed conifer; 11% vs. 19% for fir/high-elevation conifer). Additionally, the percentage of high-severity fire did not differ whether the re-burn interval was less than or greater than 30 years. Years with larger fires and greatest area burned were produced by region-wide lightning events, and characterized by less winter and spring precipitation than years dominated by smaller human-ignited fires. Overall percentage of high-severity fire was generally less in years characterized by these region-wide lightning events. Our results suggest that, under certain conditions, wildfires could be more extensively used to achieve ecological and management objectives in northwestern California.

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

PubMed

Fekadu, Melaku; Regassa, Nigatu

2014-12-01

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

Pupils with special educational needs in basic education schools and teachers' sickness absences--a register-linkage study.

PubMed

Ervasti, Jenni; Kivimäki, Mika; Kawachi, Ichiro; Subramanian, S V; Pentti, Jaana; Ahola, Kirsi; Oksanen, Tuula; Pohjonen, Tiina; Vahtera, Jussi; Virtanen, Marianna

2012-05-01

We examined whether having a high percentage of pupils with special educational needs (SEN) in basic education schools increases the risk of sickness absence among teachers and whether this risk is dependent on the pupil-teacher ratio (PTR), an indicator of teacher resources at school. We obtained register data on 8089 teachers working in 404 schools in 10 municipalities in Finland during the school year 2004-2005. We used multilevel multinomial regression models to examine the risk of teachers' short- and long-term sickness absence in relation to the percentage of SEN pupils and the PTR at school. We tested the equality of trends in groups with high and low PTR using PTR × SEN interaction term. After adjustment for teacher and school characteristics, the risk for long-term absences was higher among teachers at schools with a high percentage of SEN pupils than among teachers at schools with a low percentage of SEN pupils [odds ratio (OR) 1.5, 95% confidence interval (95% CI) 1.2-1.8). This was also the case for short-term absences (OR 1.4, 95% CI 1.2-1.7). In analyses stratified by the PTR levels, the association between the percentage of SEN pupils and long-term absences was 15% higher among teachers with a high PTR than among those with a low PTR (P for interaction=0.10). Teachers' sickness absenteeism seems to increase with a higher percentage of SEN pupils, especially when the PTR is high. Teacher resources at schools that have a high percentage of SEN pupils should be well maintained to ensure the health of teachers.

Strategic considerations for support of humans in space and Moon/Mars exploration missions. Life sciences research and technology programs, volume 2

NASA Technical Reports Server (NTRS)

1992-01-01

Summary charts of the following topics are presented: the Percentage of Critical Questions in Constrained and Robust Programs; the Executive Committee and AMAC Disposition of Critical Questions for Constrained and Robust Programs; and the Requirements for Ground-based Research and Flight Platforms for Constrained and Robust Programs. Data Tables are also presented and cover the following: critical questions from all Life Sciences Division Discipline Science Plans; critical questions listed by category and criticality; all critical questions which require ground-based research; critical questions that would utilize spacelabs listed by category and criticality; critical questions that would utilize Space Station Freedom (SSF) listed by category and criticality; critical questions that would utilize the SSF Centrifuge; facility listed by category and criticality; critical questions that would utilize a Moon base listed by category and criticality; critical questions that would utilize robotic missions listed by category and criticality; critical questions that would utilize free flyers listed by category and criticality; and critical questions by deliverables.

Microorganism Utilization for Synthetic Milk Production

NASA Technical Reports Server (NTRS)

Morford, Megan A.; Khodadad, Christina Louise; Spencer, LaShelle E.; Richards, Jeffrey T.; Strayer, Richard F.; Caro, Janicce; Hummerick, Mary; Birmele, Michele N.; Wheeler, Raymond M.

2014-01-01

A desired architecture for long duration spaceflight, such as aboard the International Space Station (ISS) or for future missions to Mars, is to provide a supply of fresh food crops for the astronauts. However, some crops can create a high proportion of inedible plant waste. The main goal of this project was to produce the components of milk (sugar, lipid, protein) from inedible plant waste by utilizing microorganisms (fungi, yeast, bacteria). Of particular interest was utilizing the valuable polysaccharide, cellulose, found in plant waste, to naturally fuel- through microorganism cellular metabolism- the creation of sugar (glucose), lipid (milk fat), and protein (casein) to produce a synthetic edible food product. Environmental conditions such as pH, temperature, carbon source, aeration, and choice microorganisms were optimized in the laboratory and the desired end-products, sugars and lipids, were analyzed. Trichoderma reesei, a known cellulolytic fungus, was utilized to drive the production of glucose, with the intent that the produced glucose would serve as the carbon source for milk fat production and be a substitute for the milk sugar lactose. Lipid production would be carried out by Rhodosporidium toruloides, yeast known to accumulate those lipids that are typically found in milk fat. Results showed that glucose and total lipid content were below what was expected during this phase of experimentation. In addition, individual analysis of six fatty acids revealed that the percentage of each fatty acid was lower than naturally produced bovine milk. Overall, this research indicates that microorganisms could be utilized to breakdown inedible solid waste to produce useable products.

Firm- and drug-specific patterns of generic drug payments by US medicaid programs: 1991-2008.

PubMed

Kelton, Christina M L; Chang, Lenisa V; Guo, Jeff J; Yu, Yan; Berry, Edmund A; Bian, Boyang; Heaton, Pamela C

2014-04-01

The entry of generic drugs into markets previously monopolized by patented, branded drugs often represents large potential savings for healthcare payers in the USA. Our objectives were to describe and explain the trends in drug reimbursement by public Medicaid programmes post-generic entry for as many drug markets and for as long a time period as possible. The data were the Medicaid State Drug Utilization Data maintained by the Centers for Medicare and Medicaid Services. Quarterly utilization and expenditure data from 1991 to 2008 were extracted for 83 drugs, produced by 229 firms, that experienced initial generic entry between 1992 and 2004. A relative 'price' for a specific drug, firm and quarter was constructed as Medicaid reimbursement per unit (e.g. tablet, capsule or vial) divided by average reimbursement per unit for the branded drug the year before entry. Fixed-effects models controlling for time-, firm- and drug-specific differences were estimated to explain reimbursement. Twelve quarters after generic entry, 18 % of drugs had average per-unit reimbursement less than 50 % of the original branded-drug reimbursement. For each additional firm manufacturing the drug, reimbursement per unit, relative to the pre-generic-entry branded-drug reimbursement, was estimated to fall by 17 (p < 0.01) and 3 (p < 0.01) percentage points for generic and branded-drug companies, respectively. Each additional quarter post-generic entry brought a 2 (p < 0.01) percentage point drop in relative reimbursement. State Medicaid programmes generally have been able to obtain relief from high drug prices following patent expirations for many branded-drug medications by adjusting reimbursement following the expanded competition in the pharmaceutical market.

Limited Diagnostic Utility of Plasma Adrenocorticotropic Hormone for Differentiation between Adrenal Cushing Syndrome and Cushing Disease.

PubMed

Hong, A Ram; Kim, Jung Hee; Hong, Eun Shil; Kim, I Kyeong; Park, Kyeong Seon; Ahn, Chang Ho; Kim, Sang Wan; Shin, Chan Soo; Kim, Seong Yeon

2015-09-01

Measurement of the plasma adrenocorticotropic hormone (ACTH) level has been recommended as the first diagnostic test for differentiating between ACTH-independent Cushing syndrome (CS) and ACTH-dependent CS. When plasma ACTH values are inconclusive, a differential diagnosis of CS can be made based upon measurement of the serum dehydroepiandrosterone sulfate (DHEA-S) level and results of the high-dose dexamethasone suppression test (HDST). The aim of this study was to assess the utility of plasma ACTH to differentiate adrenal CS from Cushing' disease (CD) and compare it with that of the HDST results and serum DHEA-S level. We performed a retrospective, multicenter study from January 2000 to May 2012 involving 92 patients with endogenous CS. The levels of plasma ACTH, serum cortisol, 24-hour urine free cortisol (UFC) after the HDST, and serum DHEA-S were measured. Fifty-seven patients had adrenal CS and 35 patients had CD. The area under the curve of plasma ACTH, serum DHEA-S, percentage suppression of serum cortisol, and UFC after HDST were 0.954, 0.841, 0.950, and 0.997, respectively (all P<0.001). The cut-off values for plasma ACTH, percentage suppression of serum cortisol, and UFC after HDST were 5.3 pmol/L, 33.3%, and 61.6%, respectively. The sensitivity and specificity of plasma ACTH measurement were 84.2% and 94.3%, those of serum cortisol were 95.8% and 90.6%, and those of UFC after the HDST were 97.9% and 96.7%, respectively. Significant overlap in plasma ACTH levels was seen between patients with adrenal CS and those with CD. The HDST may be useful in differentiating between these forms of the disease, especially when the plasma ACTH level alone is not conclusive.

Rosiglitazone Improves Stallion Sperm Motility, ATP Content, and Mitochondrial Function.

PubMed

Swegen, Aleona; Lambourne, Sarah Renay; Aitken, R John; Gibb, Zamira

2016-11-01

Media used for equine sperm storage often contain relatively high concentrations of glucose, even though stallion spermatozoa preferentially utilize oxidative phosphorylation (OXPHOS) over glycolysis to generate ATP and support motility. Rosiglitazone is an antidiabetic compound that enhances metabolic flexibility and glucose utilization in various cell types, but its effects on sperm metabolism are unknown. This study investigated the effects of rosiglitazone on stallion sperm function in vitro, along with the possible role of AMP-activated protein kinase (AMPK) in mediating these effects. Spermatozoa were incubated with or without rosiglitazone, GW9662 (an antagonist of peroxisome proliferator-activating receptor-gamma), and compound C (CC; an AMPK inhibitor). Sperm motility, viability, reactive oxygen species production, mitochondrial membrane potential (mMP), ATP content, and glucose uptake capacity were measured. Samples incubated with rosiglitazone displayed significantly higher motility, percentage of cells with normal mMP, ATP content, and glucose uptake capacity, while sperm viability was unaffected. The percentage of spermatozoa positive for mitochondrial ROS was also significantly lower in rosiglitazone-treated samples. AMPK localized to the sperm midpiece, and its phosphorylation, was increased in rosiglitazone-treated spermatozoa. CC decreased sperm AMPK phosphorylation and reduced sperm motility, and successfully inhibited the effects of rosiglitazone. Inclusion of rosiglitazone in a room temperature sperm storage medium maintained sperm motility above 60% for 6 days, attaining significantly higher motility than sperm stored in control media. The ability of rosiglitazone to substantially alleviate the time-dependent deterioration of stallion spermatozoa by diverting metabolism away from OXPHOS and toward glycolysis has novel implications for the long-term, functional preservation of these cells. © 2016 by the Society for the Study of Reproduction, Inc.

Assessing the performance of LOINC® and RadLex for coverage of CT scans across three sites in a health information exchange.

PubMed

Beitia, Anton Oscar; Kuperman, Gilad; Delman, Bradley N; Shapiro, Jason S

2013-01-01

We evaluated the performance of LOINC® and RadLex standard terminologies for covering CT test names from three sites in a health information exchange (HIE) with the eventual goal of building an HIE-based clinical decision support system to alert providers of prior duplicate CTs. Given the goal, the most important parameter to assess was coverage for high frequency exams that were most likely to be repeated. We showed that both LOINC® and RadLex provided sufficient coverage for our use case through calculations of (a) high coverage of 90% and 94%, respectively for the subset of CTs accounting for 99% of exams performed and (b) high concept token coverage (total percentage of exams performed that map to terminologies) of 92% and 95%, respectively. With trends toward greater interoperability, this work may provide a framework for those wishing to map radiology site codes to a standard nomenclature for purposes of tracking resource utilization.

Spatial Variability of Grapevine Bud Burst Percentage and Its Association with Soil Properties at Field Scale

PubMed Central

Li, Tao; Hao, Xinmei; Kang, Shaozhong

2016-01-01

There is a growing interest in precision viticulture with the development of global positioning system and geographical information system technologies. Limited information is available on spatial variation of bud behavior and its possible association with soil properties. The objective of this study was to investigate spatial variability of bud burst percentage and its association with soil properties based on 2-year experiments at a vineyard of arid northwest China. Geostatistical approach was used to describe the spatial variation in bud burst percentage within the vineyard. Partial least square regressions (PLSRs) of bud burst percentage with soil properties were used to evaluate the contribution of soil properties to overall spatial variability in bud burst percentage for the high, medium and low bud burst percentage groups. Within the vineyard, the coefficient of variation (CV) of bud burst percentage was 20% and 15% for 2012 and 2013 respectively. Bud burst percentage within the vineyard showed moderate spatial variability, and the overall spatial pattern of bud burst percentage was similar between the two years. Soil properties alone explained 31% and 37% of the total spatial variation respectively for the low group of 2012 and 2013, and 16% and 24% for the high group of 2012 and 2013 respectively. For the low group, the fraction of variations explained by soil properties was found similar between the two years, while there was substantial difference for the high group. The findings are expected to lay a good foundation for developing remedy measures in the areas with low bud burst percentage, thus in turn improving the overall grape yield and quality. PMID:27798692

Mental health, concurrent disorders, and health care utilization in homeless women.

PubMed

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

2012-09-01

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

Factors associated with maternal healthcare services utilization in nine high focus states in India: a multilevel analysis based on 14 385 communities in 292 districts.

PubMed

Singh, Prashant Kumar; Kumar, Chandan; Rai, Rajesh Kumar; Singh, Lucky

2014-08-01

Studies have often ignored examining the role of community- and district-level factors in the utilization of maternity healthcare services, particularly in Indian contexts. The Social Determinants of Health framework emphasizes the role of governance and government policies, the measures for which are rarely incorporated in single-level individual analysis. This study examines factors associated with maternal healthcare utilization in nine high focus states in India, which shares more than half of the total maternal deaths in the country; accounting for individual-, household-, community- and district-level characteristics. The required data are extracted from the third round of the nationally representative District Level Household and Facility Survey conducted during 2007-08. Multilevel analyses were applied to three maternity outcomes, namely, four or more antenatal care visits, skilled birth attendance and post-natal care after birth. Results show that along with individual-/household-level factors, community and district-level factors influence the pattern of utilization of maternal healthcare services significantly. At the community level, the odds of maternal healthcare utilization were lower in rural areas and in communities with a high concentration of poor and illiterate women. Moreover, the average population coverage of primary health centres (PHCs), availability of labour room in PHC and percentage of registered pregnancies were significant factors at the district level that influenced the use of maternity care services. The study also found a strong association between the extent of previous use of maternal healthcare and its effect on subsequent usage patterns. This study highlights the role of strengthening public health infrastructure at district level in the study area, and promoting awareness about available healthcare services and subsidized schemes in the community. To reach out to rural and underprivileged communities and to apply a participatory approach from the programme officials are issues to delve into. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Translation and psychometric evaluation of Persian versions of Burn Specific Pain Anxiety Scale and Impact of Event Scale.

PubMed

Ghezeljeh, Tahereh Najafi; Ardebili, Fatimah Mohades; Rafii, Forough; Hagani, Hamid

2013-09-01

Burn as a traumatic life incident manifests severe pain and psychological problems. Specific instruments are needed to evaluate burn patients' psychological issues related to the injury. The aim of this study was to translate and evaluate the reliability and validity of the Persian versions of Impact of Burn Specific Pain Anxiety scale (BSPAS) and Impact of Event Scale (IES). In this cross-sectional study, convenience sampling method was utilized to select 55 Iranian hospitalized burn patients. Combined translation was utilized for translating scales. Alpha cronbach, item-total correlation, convergent and discriminative validity were evaluated. The Cronbach's α for both BSPAS- and IES-Persian version was 0.96. Item-total correlation coefficients ranged from 0.70 to 0.90. Convergent construct validity was confirmed by indicating high correlation between the scales designed to measure the same concepts. The mean score of BSPAS- and IES-Persian version was lower for individuals with a lower TBSA burn percentage which assessed discriminative construct validity of scales. BSPAS- and IES-Persian version showed high internal consistency and good validity for the assessment of burn psychological outcome in hospitalized burn patients. Future studies are needed to determine repeatability, factor structure, sensitivity and specificity of the scales. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

The Impact of Private Insurance Coverage on Prescription Drug Use in Ontario, Canada.

PubMed

Kratzer, Jillian; Cheng, Lucy; Allin, Sara; Law, Michael R

2015-05-01

Canadians obtain prescription drug coverage through a patchwork of public insurance, private benefit plans and out-of-pocket payments. Prior evidence suggests that insurance coverage, in general, leads to higher utilization rates of essential medicines; it is unclear whether individuals with private insurance have better access to medicines. Using data from the 2008 Canadian Community Health Survey, we identified cohorts from Ontario who reported having been diagnosed by a physician with asthma, high blood pressure or diabetes. Using propensity score stratification techniques, we compared drug utilization of individuals holding private insurance with that of individuals holding either public insurance (for those aged over 65 years) or no insurance (aged under 65 years). In five out of six comparisons, individuals with private insurance were more likely to take prescribed drugs than those without. Raw differences in the percentage of patients taking medicines ranged from 0.1 to 8.1%. Ontarians with chronic conditions holding private drug insurance are more likely to use prescription drugs than those who do not. Whether these inequities result in health outcome differences remains unknown. Copyright © 2015 Longwoods Publishing.

The Impact of Private Insurance Coverage on Prescription Drug Use in Ontario, Canada

PubMed Central

Kratzer, Jillian; Cheng, Lucy; Allin, Sara

2015-01-01

Canadians obtain prescription drug coverage through a patchwork of public insurance, private benefit plans and out-of-pocket payments. Prior evidence suggests that insurance coverage, in general, leads to higher utilization rates of essential medicines; it is unclear whether individuals with private insurance have better access to medicines. Using data from the 2008 Canadian Community Health Survey, we identified cohorts from Ontario who reported having been diagnosed by a physician with asthma, high blood pressure or diabetes. Using propensity score stratification techniques, we compared drug utilization of individuals holding private insurance with that of individuals holding either public insurance (for those aged over 65 years) or no insurance (aged under 65 years). In five out of six comparisons, individuals with private insurance were more likely to take prescribed drugs than those without. Raw differences in the percentage of patients taking medicines ranged from 0.1 to 8.1%. Ontarians with chronic conditions holding private drug insurance are more likely to use prescription drugs than those who do not. Whether these inequities result in health outcome differences remains unknown. PMID:26142359

The Persistence of Wives' Income Advantage

ERIC Educational Resources Information Center

Winslow-Bowe, Sarah

2006-01-01

Recent reports using cross-sectional data indicate an increase in the percentage of wives who outearn their husbands, yet we know little about the persistence of wives' income advantage. The present analyses utilize the 1990-1994 waves of the National Longitudinal Survey of Youth 1979 (N = 3,481) to examine wives' long-term earnings advantage.…

Reducing Unnecessary Accumulation of Incomplete Grades: A Quality Improvement Project

ERIC Educational Resources Information Center

Domocmat, Maria Carmela L.

2015-01-01

It has been noted that there is an increasing percentage of students accumulating incomplete (INC) grades. This paper aims to identify the factors that contribute to the accumulation of incomplete grades of students and, utilizing the best practices of various universities worldwide, it intends to recommend solutions in limiting the number of…

The Use of Multiple Regression and Trend Analysis to Understand Enrollment Fluctuations. AIR Forum 1979 Paper.

ERIC Educational Resources Information Center

Campbell, S. Duke; Greenberg, Barry

The development of a predictive equation capable of explaining a significant percentage of enrollment variability at Florida International University is described. A model utilizing trend analysis and a multiple regression approach to enrollment forecasting was adapted to investigate enrollment dynamics at the university. Four independent…

25 CFR 542.11 - What are the minimum internal control standards for pari-mutuel wagering?

Code of Federal Regulations, 2013 CFR

2013-04-01

... percentage of the handle. (b) Computer applications. For any computer applications utilized, alternate.... In case of computer failure between the pari-mutuel book and the hub, no tickets shall be manually... writer/cashier shall sign on and the computer shall document gaming operation name (or identification...

25 CFR 542.11 - What are the minimum internal control standards for pari-mutuel wagering?

Code of Federal Regulations, 2012 CFR

2012-04-01

... percentage of the handle. (b) Computer applications. For any computer applications utilized, alternate.... In case of computer failure between the pari-mutuel book and the hub, no tickets shall be manually... writer/cashier shall sign on and the computer shall document gaming operation name (or identification...

25 CFR 542.11 - What are the minimum internal control standards for pari-mutuel wagering?

Code of Federal Regulations, 2014 CFR

2014-04-01

... percentage of the handle. (b) Computer applications. For any computer applications utilized, alternate.... In case of computer failure between the pari-mutuel book and the hub, no tickets shall be manually... writer/cashier shall sign on and the computer shall document gaming operation name (or identification...

Projecting the visual carrying capacity of recreation areas

Treesearch

Thomas J. Nieman; Jane L. Futrell

1979-01-01

The aesthetic experience of people utilizing the recreational resources of the national parks and forests of the United States is of primary importance since a large percentage of perception is visual. Undesirable intrusions into this sphere of perception substantially reduce the level of enjoyment or satisfaction derived from the recreation experience. Perceived...

The effect of building façade on natural lighting (Case study: Building of phinisi tower UNM)

NASA Astrophysics Data System (ADS)

Jamala, Nurul

2017-04-01

Utilization of natural lighting is one factor to lower the energy consumption of a building. Model building facade effect on natural light sources that can be absorbed into the building. UNM Phinisi Tower Building is a metaphor for the display of boats phinisi using Hiperbolic paraboloid facade which is futuristic sophistication of the application of science and technology, so that this object that is the focus of research on the effects on the building facade natural lighting. A quantitative research methods using Autodesk Echotech program to determine the value of the building into the natural lighting illuminance, either by using the facade and do not. The aim of research is to determine the percentage utilization of natural light into the building using a building facade. The study concluded the decline percentage in the value of the illuminance after the building using the building facade is 49% -74% and a mean value of 60.3%, so it can be concluded that the building facade effects on the natural lighting.

Preference-based comparative effectiveness and cost–effectiveness: a review and relevance of value-based medicine for vitreoretinal interventions.

PubMed

Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander

2012-05-01

This analysis discusses the comparative effectiveness and cost-effectiveness of vitreoretinal interventions, measured in quality-adjusted life years (QALYs) and percentage patient value (PPV gain, or improvement in quality of life and/or length of life). The material is relevant since the Patient Protection and Affordable Care Act enacted by Congress with the support of the President has emphasized the critical importance of patient-based preferences. The majority of preference-based, comparative effectiveness and cost-effectiveness vitreoretinal interventions assessed in the US healthcare literature are Value-Based Medicine analyses, thus comparable. These interventions confer a mean patient (human) value gain (improvement in quality of life) of 8.3% [SD 6.3%, 95% confidence interval (CI) + 2.6%]. The average cost-utility of these vitreoretinal interventions is US$23 026/QALY (SD US$24 508, 95% CI + US$8770). Most vitreoretinal interventions are very cost effective using a conventional US standard of US$50 000/QALY as the upper anchor for a very cost-effective intervention, and the World Health Organization of approximately US$142 200/QALY as the upper anchor for a cost-effective intervention. Most vitreoretinal interventions confer considerable patient value and are very cost effective. Further standardization across healthcare is needed in the preference-based, comparative and cost-utility (cost-effectiveness) arena. The metrics of PPV (percentage patient value) gain and US$/PPV (dollars expended per percentage patient value gain) or financial value gain may be more user-friendly than the QALY.

Overweight status, self-perception, and suicidal behaviors among adolescents.

PubMed

Dave, Dhaval; Rashad, Inas

2009-05-01

Suicide is the third leading cause of death among adolescents in the USA. The suicide rate for individuals 15-19 years of age, while having declined since the early 1990s, has recently shown signs of an increasing trend. The prevalence of being overweight has also steadily risen among adolescents, and has tripled since 1960. This study utilizes data from the Youth Risk Behavioral Surveillance System (1999-2007) to explore the relationship between the perception of being overweight and suicidal behaviors. Studies have shown a high degree of correlation between overweight status, depressive disorders, and suicidal behaviors. This study analyzes these indicators in conjunction with individuals' perception of their weight. The empirical methodology is based on simultaneous-equations models and stratified samples to gauge whether the link between overweight indicators and suicide is causal or whether it is driven by other factors. Results indicate that body dissatisfaction, as measured by the perception of being overweight, has a strong impact on all suicidal behaviors for girls. It raises the risk of suicide ideation by 6.1 percentage points, suicide attempt by 3.6 percentage points, and a serious suicide attempt by 0.5 percentage points. Results are generally insignificant for males. Conditional on overweight perception, actual weight does not generally have an independent effect on suicidal behaviors. Policies aimed at reducing the prevalence of overweight among adolescents may further reduce suicidal behaviors by limiting overweight perception, especially among girls. However, the independent role of perception also highlights the importance of educating youths and fostering healthy attitudes regarding body image.

Analysis of small-bowel capsule endoscopy reading by using Quickview mode: training assistants for reading may produce a high diagnostic yield and save time for physicians.

PubMed

Shiotani, Akiko; Honda, Keisuke; Kawakami, Makiko; Kimura, Yoshiki; Yamanaka, Yoshiyuki; Fujita, Minoru; Matsumoto, Hiroshi; Tarumi, Ken-ichi; Manabe, Noriaki; Haruma, Ken

2012-01-01

The aim was to investigate the clinical utility of RAPID Access 6.5 Quickview software and to evaluate whether preview of the capsule endoscopy video by a trained nurse could detect significant lesions accurately compared with endoscopists. As reading capsule endoscopy is time consuming, one possible cost-effective strategy could be the use of trained nonphysicians or newly available software to preread and identify potentially important capsule images. The 100 capsule images of a variety of significant lesions from 87 patients were investigated. The minimum percentages for settings of sensitivity that could pick up the selected images and the detection rate for significant lesions by a well-trained nurse, two endoscopists with limited experience in reading, and one well-trained physician were examined. The frequency of the selected lesions picked up by Quickview mode using percentages for sensitivity settings of 5%, 15%, 25%, and 35% were 61%, 74%, 93%, and 98%, respectively. The percentages for sensitivity significantly correlated (r=0.78, P<0.001) with the reading time. The detection rate by the nurse or the well-trained physician was significantly higher than that by the physician with limited capsule experience (87% and 84.1% vs. 62.7%; P<0.01). The clinical use of Quickview at 25% did not significantly improve the detection rate. Quickview mode can reduce reading time but has an unacceptably miss rate for potentially important lesions. Use of a trained nonphysician assistant can reduce physician's time and improve diagnostic yield.

Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

PubMed

de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

2015-03-01

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

Efficient water disinfection using hybrid polyaniline/graphene/carbon nanotube nanocomposites.

PubMed

Hussein, Mahmoud A; El-Shishtawy, Reda M; Alamry, Khalid A; Asiri, Abdullah M; Mohamed, Saleh A

2018-04-25

Pathogens, such as Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), contaminate water resources and are the main causes of diseases, not just waterborne diseases. The present study aims to fabricate hybrid materials composed of polyaniline (PANI), graphene nanosheets (GNs), and carbon nanotubes (CNTs) and utilize the materials for water disinfection. Thus, a new class of hybrid nanocomposites (PANI/GN/CNTs a-e ) was fabricated under ultrasonic conditions following a well-known in situ oxidative polymerization technique in an aqueous acidic solution. A homogeneous mixture of GNs and CNTs (40/60 weight %) prepared at 2, 5, 10, 20 and 30% fixed ratios of GNs/CNTs was utilized in the fabrication of the nanocomposites. The structure of this new hybrid class of materials was confirmed by various characterization techniques that were utilized to corroborate their assembly. Column removal studies with bacteria indicated that the removal percentages of S. aureus and E. coli were 99.5 and 99.2%, respectively, using PANI/GN/CNTs e . The bacterial count is an indication of bacterial removal after and before adsorption. Additionally, the data indicated clear synergic effects among the nanocomposites. Reuse studies revealed that the same percentage of adsorption was obtained for four cycles, which shows the PANI/GN/CNTs e nanocomposites can be reused and recycled for a number of cycles with almost the same bacterial adsorption capability.

Dimensions of the local health care environment and use of care by uninsured children in rural and urban areas.

PubMed

Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, José J

2006-03-01

Despite concerted policy efforts, a sizeable percentage of children lack health insurance coverage. This article examines the impact of the health care safety net and health care market structure on the use of health care by uninsured children. We used the Medical Expenditure Panel Survey linked with data from multiple sources to analyze health care utilization among uninsured children. We ran analyses separately for children who lived in rural and urban areas and assessed the effects on utilization of the availability of safety net providers, safety net funding, supply of primary care physicians, health maintenance organization penetration, and the percentage of people who are uninsured, controlling for other factors that influence use. Fewer than half of uninsured children had office-based visits to health care providers during the year, 8% of rural and 10% of urban children visited the emergency department at least once, and just over half of children had medical expenditures or charges during the year. Among uninsured children in rural areas, living closer to a safety net provider and living in an area with a higher supply of primary care physicians were positively associated with higher use and medical expenditures. In urban areas, the supply of primary care physicians and the level of safety net funding were positively associated with uninsured children's medical expenditures, whereas the percentage of the population that was uninsured was negatively associated with use of the emergency department. Uninsured children had low levels of utilization over a range of different health care provider types and settings. The availability of safety net providers in the local area and the safety net's capacity to serve the uninsured influence access to care among children. Possible measures for ensuring access to health care among uninsured children include increasing the density of safety net providers in rural areas, enhancing funding for the safety net, and policies to increase primary care physician supply.

Taking the hassle out of wellness: Do peers and health matter?

PubMed

Danagoulian, Shooshan

2018-03-01

Despite substantial financial incentives provided by the Affordable Care Act and employers, employee enrollment in wellness programs is low. This paper studies enrollment in a wellness program offered along an employer-provided health insurance plan. Two factors are considered in the choice of health plan with wellness: the effect of peer choices and family health on plan choice. Using exclusively obtained data of health insurance plan choice and utilization, this paper compares similar plans and focuses on a subsample of new employees. Result show that peers affect own choice of health insurance: a 10 percentage point rise in the share of colleagues enrolled in Aetna Wellness increases the probability of own enrollment in the plan by up to 3.9 percentage points. This result suggests that lack of experience with a wellness program are key to employee reluctance to enroll. Health effect on probability of enrollment in Aetna Wellness ranges from a 3 percentage point decline to a 3 percentage point rise depending on the measure, suggesting that while wellness programs appeal to low- to medium-intensity users of medical services, they do not appeal to individuals with more severe medical conditions which might benefit most from better coordinated medical care.

Behavior of Tumor Necrosis Factor-α and Tumor Necrosis Factor Receptor 1/Tumor Necrosis Factor Receptor 2 System in Mononuclear Cells Recovered From Peritoneal Fluid of Women With Endometriosis at Different Stages

PubMed Central

Salmeri, Francesca M.; Sofo, Vincenza; Triolo, Onofrio; Sturlese, Emanuele; Retto, Giovanni; Pizzo, Alfonsa; D'Ascola, Angela; Campo, Salvatore

2015-01-01

During endometriosis, a breakdown occurs in endometrial and peritoneal homeostasis caused by cytokine-induced cell proliferation and dysregulation of apoptosis. We studied tumor necrosis factor (TNF)-α, TNF receptor (TNFR) 1, and TNFR2 gene expression at both messenger RNA (mRNA) and protein levels in peritoneal fluid (PF) mononuclear cells (PFMCs), the percentages of these cells bearing the same markers, and soluble TNF-α (sTNF-α) values in PF of 80 women with endometriosis. We found that TNFR1 mRNA and protein levels, the percentages of TNFR1-bearing PFMCs, and sTNF-α values decreased from minimal to severe stages of the disease. Instead, TNF-α and TNFR2 mRNA and protein levels, the percentages of membrane TNF-α (mTNF-α)- and TNFR2-bearing PFMCs increased as the disease worsened. These data allow us to hypothesize that, in early stages, the high percentages of TNFR1-bearing PFMCs and the high levels of sTNF-α could address signal toward complex I pathway, favoring the inflammatory response. With the worsening of the disease, the low percentages of TNFR1-bearing PFMCs are probably due to decreased TNFR1 mRNA transcription and protein translation rate. In early stages (minimal and mild), the percentages of both TNFR2- and mTNF-α–bearing PFMCs are so low, due to decreased mRNA transcription and protein translation rate, that subsequent cellular events may depend minimally by this interaction. The high levels of sTNF-α may be rerouted to bind TNFR1. In contrast, in the moderate and severe stages, the high percentages of TNFR2-bearing PFMCs may be saturated by high percentages of mTNF-α–bearing PFMCs, triggering death process. So, in endometriosis, each component of the TNF-α/TNFRs system may trigger opposite cellular fate. PMID:24844917

Modeling and Predicting the Electrical Conductivity of Composite Cathode for Solid Oxide Fuel Cell by Using Support Vector Regression

NASA Astrophysics Data System (ADS)

Tang, J. L.; Cai, C. Z.; Xiao, T. T.; Huang, S. J.

2012-07-01

The electrical conductivity of solid oxide fuel cell (SOFC) cathode is one of the most important indices affecting the efficiency of SOFC. In order to improve the performance of fuel cell system, it is advantageous to have accurate model with which one can predict the electrical conductivity. In this paper, a model utilizing support vector regression (SVR) approach combined with particle swarm optimization (PSO) algorithm for its parameter optimization was established to modeling and predicting the electrical conductivity of Ba0.5Sr0.5Co0.8Fe0.2 O3-δ-xSm0.5Sr0.5CoO3-δ (BSCF-xSSC) composite cathode under two influence factors, including operating temperature (T) and SSC content (x) in BSCF-xSSC composite cathode. The leave-one-out cross validation (LOOCV) test result by SVR strongly supports that the generalization ability of SVR model is high enough. The absolute percentage error (APE) of 27 samples does not exceed 0.05%. The mean absolute percentage error (MAPE) of all 30 samples is only 0.09% and the correlation coefficient (R2) as high as 0.999. This investigation suggests that the hybrid PSO-SVR approach may be not only a promising and practical methodology to simulate the properties of fuel cell system, but also a powerful tool to be used for optimal designing or controlling the operating process of a SOFC system.

Using administrative claims to identify children with chronic conditions in a statewide immunization registry.

PubMed

Dombkowski, Kevin J; Costello, Lauren; Dong, Shiming; Clark, Sarah J

2014-05-01

To demonstrate the feasibility and utility of using administrative claims data from commercial health plans to establish a high-risk indicator in a statewide immunization registry for enrollees with chronic conditions. Retrospective cohort analysis. Administrative data were used to identify children with 1 or more chronic conditions enrolled in 2 commercial health plans during the 2008-2009 and 2009-2010 influenza seasons and matched with a statewide immunization registry. The proportion of cases that successfully matched and historical health services utilization, including influenza vaccinations and missed opportunities, were assessed. A total of 93% of children with chronic conditions identified through administrative claims were successfully matched with the statewide registry. Less than one-third of children received the seasonal influenza vaccine in either the 2008-2009 (29%) or 2009-2010 (32%) seasons; 30% of children received the H1N1 vaccination in 2009-2010. Most children in the 2008-2009 (63%) and 2009-2010 (63%) seasons had at least 1 missed opportunity for seasonal influenza vaccination. Younger children had the highest percentage of missed opportunities while adolescents had the lowest rate of missed opportunities for vaccination. Conclusions It is feasible to identify children with chronic conditions using administrative data and to link them with a statewide immunization registry. Low influenza vaccination rates and high occurrences of missed opportunities among children with chronic conditions suggest the utility of integrating administrative claims data with statewide registries to support various outreach mechanisms, including physician-focused and parent-targeted reminder/recall, based on target age to improve vaccination rates.

Use of the Dual-Antiplatelet Therapy Score to Guide Treatment Duration After Percutaneous Coronary Intervention.

PubMed

Piccolo, Raffaele; Gargiulo, Giuseppe; Franzone, Anna; Santucci, Andrea; Ariotti, Sara; Baldo, Andrea; Tumscitz, Carlo; Moschovitis, Aris; Windecker, Stephan; Valgimigli, Marco

2017-07-04

The dual-antiplatelet therapy (DAPT) score was developed to identify patients more likely to derive harm (score <2) or benefit (score ≥2) from prolonged DAPT after percutaneous coronary intervention (PCI). To evaluate the safety and efficacy of DAPT duration according to DAPT score. Retrospective assessment of DAPT score-guided treatment duration in a randomized clinical trial. (ClinicalTrials.gov: NCT00611286). PCI patients. 1970 patients undergoing PCI. DAPT (aspirin and clopidogrel) for 24 versus 6 months. Primary efficacy outcomes were death, myocardial infarction, or cerebrovascular accident. The primary safety outcome was type 3 or 5 bleeding according to the Bleeding Academic Research Consortium definition. Outcomes were assessed between 6 and 24 months. 884 patients (44.9%) had a DAPT score of at least 2, and 1086 (55.1%) had a score less than 2. The reduction in the primary efficacy outcome with 24- versus 6-month DAPT was greater in patients with high scores (risk difference [RD] for score ≥2, -2.05 percentage points [95% CI, -5.04 to 0.95 percentage points]; RD for score <2, 2.91 percentage points [CI, -0.43 to 6.25 percentage points]; P = 0.030). However, the difference by score for the primary efficacy outcome varied by stent type; prolonged DAPT with high scores was effective only in patients receiving paclitaxel-eluting stents (RD, -7.55 percentage points [CI, -12.85 to -2.25 percentage points]). The increase in the primary safety outcome with 24- versus 6-month DAPT was greater in patients with low scores (RD for score ≥2, 0.20 percentage point [CI, -1.20 to 1.60 percentage points]; RD for score <2, 2.58 percentage points [CI, 0.71 to 4.46 percentage points]; P = 0.046). Retrospective calculation of the DAPT score. Prolonged DAPT resulted in harm in patients with low DAPT scores undergoing PCI but reduced risk for ischemic events in patients with high scores receiving paclitaxel-eluting stents. Whether prolonged DAPT benefits patients with high scores treated with contemporary drug-eluting stents requires further study. None.

Predictive model for disinfection by-product in Alexandria drinking water, northern west of Egypt.

PubMed

Abdullah, Ali M; Hussona, Salah El-dien

2013-10-01

Chlorine has been utilized in the early stages of water treatment processes as disinfectant. Disinfection for drinking water reduces the risk of pathogenic infection but may pose a chemical threat to human health due to disinfection residues and their by-products (DBP) when the organic and inorganic precursors are present in water. In the last two decades, many modeling attempts have been made to predict the occurrence of DBP in drinking water. Models have been developed based on data generated in laboratory-scale and field-scale investigations. The objective of this paper is to develop a predictive model for DBP formation in the Alexandria governorate located at the northern west of Egypt based on field-scale investigations as well as laboratory-controlled experimentations. The present study showed that the correlation coefficient between trihalomethanes (THM) predicted and THM measured was R (2)=0.88 and the minimum deviation percentage between THM predicted and THM measured was 0.8 %, the maximum deviation percentage was 89.3 %, and the average deviation was 17.8 %, while the correlation coefficient between dichloroacetic acid (DCAA) predicted and DCAA measured was R (2)=0.98 and the minimum deviation percentage between DCAA predicted and DCAA measured was 1.3 %, the maximum deviation percentage was 47.2 %, and the average deviation was 16.6 %. In addition, the correlation coefficient between trichloroacetic acid (TCAA) predicted and TCAA measured was R (2)=0.98 and the minimum deviation percentage between TCAA predicted and TCAA measured was 4.9 %, the maximum deviation percentage was 43.0 %, and the average deviation was 16.0 %.

Direct solar heating for Space Station application

NASA Technical Reports Server (NTRS)

Simon, W. E.

1985-01-01

Early investigations have shown that a large percentage of the power generated on the Space Station will be needed in the form of high-temperature thermal energy. The most efficient method of satisfying this requirement is through direct utilization of available solar energy. A system concept for the direct use of solar energy on the Space Station, including its benefits to customers, technologists, and designers of the station, is described. After a brief discussion of energy requirements and some possible applications, results of selective tradeoff studies are discussed, showing area reduction benefits and some possible configurations for the practical use of direct solar heating. Following this is a description of system elements and required technologies. Finally, an assessment of available contributive technologies is presented, and a Space Shuttle Orbiter flight experiment is proposed.

SURVIVAL OF THE RED BLOOD CELLS OF BLOOD TREATED WITH GENTIAN VIOLET. ITS IMPORTANCE IN THE PROPHYLAXIS OF CHAGAS DISEASE TRANSMITTED DURING TRANSFUSION (in Spanish)

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

Maspes, V.; Pieroni, R.R.; Mellone, O.

1959-01-01

The utility of adding gentian violet to blood to be transfused for prophylaxis of Chanas disease is discussed. It is quite useful in regions where a high percentage of blood donore are infected, The survivial of the erythrocytes in blood treated with sufficient gentian violet to kill Trypanosoma Cruzi (1: 4,000) is studied. The study was made at 4 deg C with chromium as the labeling substance, Mean cell life values found varied from 66 to 91 days. It was concluded that other properties of erythrcytes are not significantly changed, Therefore, the wide use of gentian violet in the prophylaxismore » of Chagas disease is recommended. (auth)« less

The input ambiguity hypothesis and case blindness: an account of cross-linguistic and intra-linguistic differences in case errors.

PubMed

Pelham, Sabra D

2011-03-01

English-acquiring children frequently make pronoun case errors, while German-acquiring children rarely do. Nonetheless, German-acquiring children frequently make article case errors. It is proposed that when child-directed speech contains a high percentage of case-ambiguous forms, case errors are common in child language; when percentages are low, case errors are rare. Input to English and German children was analyzed for percentage of case-ambiguous personal pronouns on adult tiers of corpora from 24 English-acquiring and 24 German-acquiring children. Also analyzed for German was the percentage of case-ambiguous articles. Case-ambiguous pronouns averaged 63·3% in English, compared with 7·6% in German. The percentage of case-ambiguous articles in German was 77·0%. These percentages align with the children's errors reported in the literature. It appears children may be sensitive to levels of ambiguity such that low ambiguity may aid error-free acquisition, while high ambiguity may blind children to case distinctions, resulting in errors.

The impact of missing trauma data on predicting massive transfusion

PubMed Central

Trickey, Amber W.; Fox, Erin E.; del Junco, Deborah J.; Ning, Jing; Holcomb, John B.; Brasel, Karen J.; Cohen, Mitchell J.; Schreiber, Martin A.; Bulger, Eileen M.; Phelan, Herb A.; Alarcon, Louis H.; Myers, John G.; Muskat, Peter; Cotton, Bryan A.; Wade, Charles E.; Rahbar, Mohammad H.

2013-01-01

INTRODUCTION Missing data are inherent in clinical research and may be especially problematic for trauma studies. This study describes a sensitivity analysis to evaluate the impact of missing data on clinical risk prediction algorithms. Three blood transfusion prediction models were evaluated utilizing an observational trauma dataset with valid missing data. METHODS The PRospective Observational Multi-center Major Trauma Transfusion (PROMMTT) study included patients requiring ≥ 1 unit of red blood cells (RBC) at 10 participating U.S. Level I trauma centers from July 2009 – October 2010. Physiologic, laboratory, and treatment data were collected prospectively up to 24h after hospital admission. Subjects who received ≥ 10 RBC units within 24h of admission were classified as massive transfusion (MT) patients. Correct classification percentages for three MT prediction models were evaluated using complete case analysis and multiple imputation. A sensitivity analysis for missing data was conducted to determine the upper and lower bounds for correct classification percentages. RESULTS PROMMTT enrolled 1,245 subjects. MT was received by 297 patients (24%). Missing percentage ranged from 2.2% (heart rate) to 45% (respiratory rate). Proportions of complete cases utilized in the MT prediction models ranged from 41% to 88%. All models demonstrated similar correct classification percentages using complete case analysis and multiple imputation. In the sensitivity analysis, correct classification upper-lower bound ranges per model were 4%, 10%, and 12%. Predictive accuracy for all models using PROMMTT data was lower than reported in the original datasets. CONCLUSIONS Evaluating the accuracy clinical prediction models with missing data can be misleading, especially with many predictor variables and moderate levels of missingness per variable. The proposed sensitivity analysis describes the influence of missing data on risk prediction algorithms. Reporting upper/lower bounds for percent correct classification may be more informative than multiple imputation, which provided similar results to complete case analysis in this study. PMID:23778514

The Association of Health Insurance with institutional delivery and access to skilled birth attendants: evidence from the Kenya Demographic and health survey 2008-09.

PubMed

Were, Lawrence P O; Were, Edwin; Wamai, Richard; Hogan, Joseph; Galarraga, Omar

2017-07-03

Healthcare financing through health insurance is gaining traction as developing countries strive to achieve universal health coverage and address the limited access to critical health services for specific populations including pregnant women and their children. However, these reforms are taking place despite limited evaluation of impact of health insurance on maternal health in developing countries including Kenya. In this study we evaluate the association of health insurance with access and utilization of obstetric delivery health services for pregnant women in Kenya. Nationally representative data from the Kenya Demographic and Health Survey 2008-09 was used in this study. 4082 pregnant women with outcomes of interest - Institutional delivery (Yes/No - delivery at hospital, dispensary, maternity home, and clinic) and access to skilled birth attendants (help by a nurse, doctor, or trained midwife at delivery) were selected from 8444 women ages 15-49 years. Linear and logistic regression, and propensity score adjustment are used to estimate the causal association of enrollment in insurance on obstetric health outcomes. Mothers with insurance are 23 percentage points (p < 0.01) more likely to deliver at an institution and 20 percentages points (p < 0.01) more likely have access to skilled birth attendants compared to those not insured. In addition mothers of lower socio-economic status benefit more from enrollment in insurance compared to mothers of higher socio-economic status. For both institutional delivery and access to skilled birth attendants, the average difference of the association of insurance enrollment compared to not enrolling for those of low SES is 23 percentage points (p < 0.01), and 6 percentage points (p < 0.01) for those of higher SES. Enrolling in health insurance is associated with increased access and utilization of obstetric delivery health services for pregnant women. Notably, those of lower socio-economic status seem to benefit the most from enrollment in insurance.

Health Care Access and Utilization Among Adults Aged 18-64, by Poverty Level: United States, 2013-2015.

PubMed

Martinez, Michael E; Ward, Brian W

2016-10-01

Data from the National Health Interview Survey, 2013-2015 •From 2013 through 2015, the percentage of adults aged 18-64 who were uninsured at the time of interview decreased for poor (40.0% to 26.2%), near-poor (37.8% to 23.9%), and not-poor (11.7% to 7.7%) adults. •The percentage of adults aged 18-64 who had a usual place to go for medical care increased for poor (66.9% to 73.6%) and near-poor (71.1% to 75.9%) adults. •The percentage of adults aged 18-64 who had seen or talked to a health professional in the past 12 months increased for poor (73.2% to 75.8%) and near-poor (71.9% to 75.9%) adults. •The percentage of adults aged 18-64 who did not obtain needed medical care due to cost at some time during the past 12 months decreased for poor (16.8% to 12.4%), near-poor (14.6% to 11.0%), and not-poor (4.9% to 3.8%) adults. In 2014, U.S. adults could purchase a private health insurance plan through the Health Insurance Marketplace or state-based exchanges established as part of the Affordable Care Act (ACA). Additionally, under ACA some states opted to expand Medicaid coverage to low-income adults. Individuals living in or near poverty may have benefited disproportionately from these changes given their lower rates of health insurance coverage (1). Data from the 2013-2015 National Health Interview Survey (NHIS) are used to describe recent changes in health insurance coverage and selected measures of health care access and utilization for adults aged 18-64 by family poverty level. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Implications of Current and Proposed Funding Plans for Oklahoma Common Schools. Research Report P-748.

ERIC Educational Resources Information Center

Lowrance, Danny; Tweeten, Luther

Utilizing data from the 1973-1974 school year, the study analyzed and compared the educational funding system presently used by Oklahoma with other school funding plans on the basis of economic efficiency and social equity. Funding plans used for comparison included Flat Grants, Minimum Foundation, Percentage Equalizing, Guaranteed Tax Base, Full…

Elementary School Principals' Learning-Centered Leadership and Educational Outcomes: Implications for Principals' Professional Development

ERIC Educational Resources Information Center

Reardon, R. Martin

2011-01-01

This article arises from research in one school district (utilizing the Vanderbilt Assessment of Leadership in Education, VAL-ED) into the relationships among the perceptions of elementary school leaders of their learning-centered leadership, and student achievement on state-mandated tests of reading in Virginia. Beyond the percentage of students…

Preliminary evidence of oxidation in standard oven drying of cotton: attenuated total reflectance/ Fourier transform spectroscopy, colorimetry, and particulate matter formation

USDA-ARS?s Scientific Manuscript database

Moisture is paramount to cotton fiber properties dictating harvesting, ginning, storage and spinning as well as others. Currently, oven drying in air is often utilized to generate the percentage of moisture in cotton fibers. Karl Fischer Titration another method for cotton moisture, has been compa...

Variation in leader length of bitterbrush

Treesearch

Richard L. Hubbard; David. Dunaway

1958-01-01

The estimation of herbage production and· utilization in browse plants has been a problem for many years. Most range technicians have simply estimated the average length of twigs or leaders. then expressed use by deer and livestock as a percentage thereof based on the estimated average length left after grazing. Riordan used this method on mountain mahogany (

Stem Sinuosity of Loblolly Pine Seedlings as Influenced by Taproot Shape

Treesearch

Michael S. Murphy; Timothy B. Harrington

2004-01-01

Sinuous stem growth in loblolly pine (Pinus taeda L.) results in diminished potential for the utilization of wood products since these stems are difficult to mill and contain a higher percentage of compression wood. In this study, 90 full-sibling loblolly pine seedlings (30 seedlings from each of 3 families) were planted with 5 taproot configurations...

The Consequences of Ignoring Item Parameter Drift in Longitudinal Item Response Models

ERIC Educational Resources Information Center

Lee, Wooyeol; Cho, Sun-Joo

2017-01-01

Utilizing a longitudinal item response model, this study investigated the effect of item parameter drift (IPD) on item parameters and person scores via a Monte Carlo study. Item parameter recovery was investigated for various IPD patterns in terms of bias and root mean-square error (RMSE), and percentage of time the 95% confidence interval covered…

Trends in the Artist Occupations: 1970-1980.

ERIC Educational Resources Information Center

Ellis, Diane C.

Data from both the 1970 and the 1980 Census are used to determine changes and trends in artist occupations and in the numbers of artists. The effects of changes in methods utilized to count artists in the 1980 Census are outlined, and estimated rates of growth by artist occupations are provided. The percentage of women artists, the ethnic…

Direct Behavior Rating Instrumentation: Evaluating the Impact of Scale Formats

ERIC Educational Resources Information Center

Miller, Faith G.; Riley-Tillman, T. Chris; Chafouleas, Sandra M.; Schardt, Alyssa A.

2017-01-01

The purpose of this study was to investigate the impact of two different Direct Behavior Rating--Single Item Scale (DBR-SIS) formats on rating accuracy. A total of 119 undergraduate students participated in one of two study conditions, each utilizing a different DBR-SIS scale format: one that included percentage of time anchors on the DBR-SIS…

Extraction and Analysis of Impervious Surfaces Based on a Spectral Un-Mixing Method Using Pearl River Delta of China Landsat TM/ETM+ Imagery from 1998 to 2008

PubMed Central

Deng, Yingbin; Fan, Fenglei; Chen, Renrong

2012-01-01

Impervious surface area (ISA) is considered as an indicator of environment change and is regarded as an important input parameter for hydrological cycle simulation, water management and area pollution assessment. The Pearl River Delta (PRD), the 3rd most important economic district of China, is chosen in this paper to extract the ISA information based on Landsat images of 1998, 2003 and 2008 by using a linear spectral un-mixing method and to monitor impervious surface change by analyzing the multi-temporal Landsat-derived fractional impervious surface. Results of this study were as follows: (1) the area of ISA in the PRD increased 79.09% from 1998 to 2003 and 26.88% from 2003 to 2008 separately; (2) the spatial distribution of ISA was described according to the 1998/2003 percentage respectively. Most of middle and high percentage ISA was located in northwestern and southeastern of the whole delta, and middle percentage ISA was mainly located in the city interior, high percentage ISA was mainly located in the suburban around the city accordingly; (3) the expanding direction and trend of high percentage ISA was discussed in order to understand the change of urban in this delta; High percentage ISA moved from inner city to edge of urban area during 1998–2003 and moved to the suburban area that far from the urban area mixed with jumpily and gradually during 2003–2008. According to the discussion of high percentage ISA spatial expanded direction, it could be found out that high percentage ISA moved outward from the centre line of Pearl River of the whole delta while a high ISA percentage in both shores of the Pearl River Estuary moved toward the Pearl River; (4) combining the change of ISA with social conditions, the driving relationship was analyzed in detail. It was evident that ISA percentage change had a deep relationship with the economic development of this region in the past ten years. Contemporaneous major sport events (16th Asia Games of Guangzhou, 26th Summer Universidad of Shenzhen) and the government policies also promoted the development of the ISA. Meanwhile, topographical features like the National Nature Reserve of China restricted and affected the expansion of the ISA. Above all, this paper attempted to extract ISA in a major region of the PRD; the temporal and spatial analyses to PRD ISA demonstrated the drastic changes in developed areas of China. These results were important and valuable for land use management, ecological protection and policy establishment. PMID:22438741

Extraction and analysis of impervious surfaces based on a spectral un-mixing method using Pearl River Delta of China Landsat TM/ETM+ imagery from 1998 to 2008.

PubMed

Deng, Yingbin; Fan, Fenglei; Chen, Renrong

2012-01-01

Impervious surface area (ISA) is considered as an indicator of environment change and is regarded as an important input parameter for hydrological cycle simulation, water management and area pollution assessment. The Pearl River Delta (PRD), the 3rd most important economic district of China, is chosen in this paper to extract the ISA information based on Landsat images of 1998, 2003 and 2008 by using a linear spectral un-mixing method and to monitor impervious surface change by analyzing the multi-temporal Landsat-derived fractional impervious surface. Results of this study were as follows: (1) the area of ISA in the PRD increased 79.09% from 1998 to 2003 and 26.88% from 2003 to 2008 separately; (2) the spatial distribution of ISA was described according to the 1998/2003 percentage respectively. Most of middle and high percentage ISA was located in northwestern and southeastern of the whole delta, and middle percentage ISA was mainly located in the city interior, high percentage ISA was mainly located in the suburban around the city accordingly; (3) the expanding direction and trend of high percentage ISA was discussed in order to understand the change of urban in this delta; High percentage ISA moved from inner city to edge of urban area during 1998-2003 and moved to the suburban area that far from the urban area mixed with jumpily and gradually during 2003-2008. According to the discussion of high percentage ISA spatial expanded direction, it could be found out that high percentage ISA moved outward from the centre line of Pearl River of the whole delta while a high ISA percentage in both shores of the Pearl River Estuary moved toward the Pearl River; (4) combining the change of ISA with social conditions, the driving relationship was analyzed in detail. It was evident that ISA percentage change had a deep relationship with the economic development of this region in the past ten years. Contemporaneous major sport events (16th Asia Games of Guangzhou, 26th Summer Universidad of Shenzhen) and the government policies also promoted the development of the ISA. Meanwhile, topographical features like the National Nature Reserve of China restricted and affected the expansion of the ISA. Above all, this paper attempted to extract ISA in a major region of the PRD; the temporal and spatial analyses to PRD ISA demonstrated the drastic changes in developed areas of China. These results were important and valuable for land use management, ecological protection and policy establishment.

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

Gender Differences in Enrollment in High Prestige Academic College Majors.

ERIC Educational Resources Information Center

Nelson, Eileen S.; Dixon, Cynthia

1997-01-01

A study examined the percentages of freshmen and seniors enrolled in high-prestige majors at James Madison University (Virginia), using a prestige ranking for 30 majors based on student body ratings. Contrary to expectation, there was not a higher percentage of male than female seniors enrolled in high-prestige majors. (Author/MSE)

Activity-induced regulation of myosin isoform distribution - Comparison of two contractile activity programs

NASA Technical Reports Server (NTRS)

Diffee, Gary M.; Caiozzo, Vince J.; Mccue, Samuel A.; Herrick, Robert E.; Baldwin, Kenneth M.

1993-01-01

This study examined the role of specific types of contractile activity in regulating myosin heavy chain (MHC) isoform expression in rodent soleus. A combination of hindlimb suspension (SN) and two programmed contractile training activity paradigms, either isometric contractile activity (ST-IM) or high-load slowly shortening isovelocity activity, were utilized. Both training paradigms increased muscle mass compared with SN alone. However, only ST-IM resulted in a partial prevention of the suspension-induced decrease in type I MHC. With the use of a fluorescently labeled antibody to type IIa MHC, the distribution of MHCs among fibers was examined immunohistochemically. In SN, the percentage of cells staining positive for type IIa MHC was increased but the staining intensity of the positively staining cells was unchanged compared with control cells. In the ST-IM soleus, the percentage of positively staining fibers was unchanged but the intensity of the positively staining cells was decreased compared with SN values. These results suggest that 1) isometric contractile activity is more effective than isovelocity activity in preventing suspension-induced shifts in soleus MHC distribution and 2) changes associated with both suspension and training occur in only a small number of fibers, with the majority of fibers apparently unresponsive to these interventions.

Quantitative chest computed tomography as a means of predicting exercise performance in severe emphysema.

PubMed

Crausman, R S; Ferguson, G; Irvin, C G; Make, B; Newell, J D

1995-06-01

We assessed the value of quantitative high-resolution computed tomography (CT) as a diagnostic and prognostic tool in smoking-related emphysema. We performed an inception cohort study of 14 patients referred with emphysema. The diagnosis of emphysema was based on a compatible history, physical examination, chest radiograph, CT scan of the lung, and pulmonary physiologic evaluation. As a group, those who underwent exercise testing were hyperinflated (percentage predicted total lung capacity +/- standard error of the mean = 133 +/- 9%), and there was evidence of air trapping (percentage predicted respiratory volume = 318 +/- 31%) and airflow limitation (forced expiratory volume in 1 sec [FEV1] = 40 +/- 7%). The exercise performance of the group was severely limited (maximum achievable workload = 43 +/- 6%) and was characterized by prominent ventilatory, gas exchange, and pulmonary vascular abnormalities. The quantitative CT index was markedly elevated in all patients (76 +/- 9; n = 14; normal < 4). There were correlations between this quantitative CT index and measures of airflow limitation (FEV1 r2 = .34, p = 09; FEV1/forced vital capacity r2 = .46, p = .04) and between maximum workload achieved (r2 = .93, p = .0001) and maximum oxygen utilization (r2 = .83, p = .0007). Quantitative chest CT assessment of disease severity is correlated with the degree of airflow limitation and exercise impairment in pulmonary emphysema.

Utilization of star-shaped polymer architecture in the creation of high-density polymer brush coatings for the prevention of platelet and bacteria adhesion

PubMed Central

Totani, Masayasu; Terada, Kayo; Terashima, Takaya; Kim, Ill Yong; Ohtsuki, Chikara; Xi, Chuanwu; Tanihara, Masao

2014-01-01

We demonstrate utilization of star-shaped polymers as high-density polymer brush coatings and their effectiveness to inhibit the adhesion of platelets and bacteria. Star polymers consisting of poly(2-hydroxyethyl methacrylate) (PHEMA) and/or poly(methyl methacrylate) (PMMA), were synthesized using living radical polymerization with a ruthenium catalyst. The polymer coatings were prepared by simple drop casting of the polymer solution onto poly(ethylene terephthalate) (PET) surfaces and then dried. Among the star polymers prepared in this study, the PHEMA star polymer (star-PHEMA) and the PHEMA/PMMA (mol. ratio of 71/29) heteroarm star polymer (star-H71M29) coatings showed the highest percentage of inhibition against platelet adhesion (78–88% relative to noncoated PET surface) and Escherichia coli (94–97%). These coatings also showed anti-adhesion activity against platelets after incubation in Dulbecco's phosphate buffered saline or surfactant solution for 7 days. In addition, the PMMA component of the star polymers increased the scratch resistance of the coating. These results indicate that the star-polymer architecture provides high polymer chain density on PET surfaces to prevent adhesion of platelets and bacteria, as well as coating stability and physical durability to prevent exposure of bare PET surfaces. The star polymers provide a simple and effective approach to preparing anti-adhesion polymer coatings on biomedical materials against the adhesion of platelets and bacteria. PMID:25485105

Combined effect of CVR and penetration of DG in the voltage profile and losses of lowvoltage secondary distribution networks

NASA Astrophysics Data System (ADS)

Bokhari, Abdullah

Demarcations between traditional distribution power systems and distributed generation (DG) architectures are increasingly evolving as higher DG penetration is introduced in the system. The concerns in existing electric power systems (EPSs) to accommodate less restrictive interconnection policies while maintaining reliability and performance of power delivery have been the major challenge for DG growth. In this dissertation, the work is aimed to study power quality, energy saving and losses in a low voltage distributed network under various DG penetration cases. Simulation platform suite that includes electric power system, distributed generation and ZIP load models is implemented to determine the impact of DGs on power system steady state performance and the voltage profile of the customers/loads in the network under the voltage reduction events. The investigation designed to test the DG impact on power system starting with one type of DG, then moves on multiple DG types distributed in a random case and realistic/balanced case. The functionality of the proposed DG interconnection is designed to meet the basic requirements imposed by the various interconnection standards, most notably IEEE 1547, public service commission, and local utility regulation. It is found that implementation of DGs on the low voltage secondary network would improve customer's voltage profile, system losses and significantly provide energy savings and economics for utilities. In a network populated with DGs, utility would have a uniform voltage profile at the customers end as the voltage profile becomes more concentrated around targeted voltage level. The study further reinforced the concept that the behavior of DG in distributed network would improve voltage regulation as certain percentage reduction on utility side would ensure uniform percentage reduction seen by all customers and reduce number of voltage violations.

The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

PubMed

Shane, Dan M; Wehby, George L

2017-09-01

Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

Utility of Immature Granulocyte Percentage in Pediatric Appendicitis

PubMed Central

Mathews, Eleanor K.; Griffin, Russell L.; Mortellaro, Vincent; Beierle, Elizabeth A.; Harmon, Carroll M.; Chen, Mike K.; Russell, Robert T.

2014-01-01

Background Acute appendicitis is the most common cause of abdominal surgery in children. Adjuncts are utilized to help clinicians predict acute or perforated appendicitis, which may affect treatment decisions. Automated hematologic analyzers can perform more accurate automated differentials including immature granulocyte percentages (IG%). Elevated IG% has demonstrated improved accuracy for predicting sepsis in the neonatal population than traditional immature to total neutrophil count (I/T) ratios. We intended to assess the additional discriminatory ability of IG% to traditionally assessed parameters in the differentiation between acute and perforated appendicitis. Materials and Methods We identified all patients with appendicitis from July 2012 to June 2013 by ICD-9 code. Charts were reviewed for relevant demographic, clinical, and outcome data, which were compared between acute and perforated appendicitis groups using Fischer’s exact and t-test for categorical and continuous variables, respectively. We utilized an adjusted logistic regression model utilizing clinical lab values to predict the odds of perforated appendicitis. Results 251 patients were included in the analysis. Those with perforated appendicitis had a higher white blood cell (WBC) count (p=0.0063), C-reactive protein (CRP) (p<0.0001), and IG% (p=0.0299). In the adjusted model, only elevated CRP (OR 3.46, 95% CI 1.40-8.54) and presence of left shift (OR 2.66, 95% CI 1.09-6.46) were significant predictors of perforated appendicitis. The c-statistic of the final model was 0.70, suggesting fair discriminatory ability in predicting perforated appendicitis. Conclusions IG% did not provide any additional benefit to elevated CRP and presence of left shift in the differentiation between acute and perforated appendicitis. PMID:24793450

Changes in Medical Services and Drug Utilization and Associated Costs After Narcolepsy Diagnosis in the United States

PubMed Central

Villa, Kathleen F.; Reaven, Nancy L.; Funk, Susan E.; McGaughey, Karen; Black, Jed

2018-01-01

Background Healthcare utilization and the cost implications associated with undiagnosed and/or misdiagnosed narcolepsy have not been evaluated, and there is scant literature characterizing the newly diagnosed population with narcolepsy with respect to treatment patterns and resource utilization. Objective To analyze the changes in medication use, healthcare utilization, and the associated costs after a new diagnosis of narcolepsy. Methods In this retrospective cohort study, we used data from the Truven Health Analytics MarketScan Research Databases, between January 2006 and March 2013, to identify patients who had a probable new diagnosis of narcolepsy—defined as a de novo medical claim for a multiple sleep latency test—which was preceded by ≥6 months of continuous insurance and was followed by a de novo diagnosis of narcolepsy. The utilization and cost of medical services and the percentage of patients filling prescriptions for narcolepsy-related medications were evaluated in 3 consecutive 1-year periods from the date of a positive multiple sleep latency test result (ie, index date), and each year's findings were compared with the annualized results from the 6-month preindex period. Results A total of 3757 patients who met the definition of a new diagnosis of narcolepsy were identified. The total medical service utilization decreased each year from a preindex average of 28.2 visits per patient per year (PPPY) to 26.9 visits (P <.05), 23.1 visits (P <.0001), and 22.5 visits (P <.0001) PPPY in years 1, 2, and 3 postdiagnosis, respectively. In each outpatient service category, the medical services utilization decreased from preindex to year 3 postdiagnosis, including hospital outpatient and physician visits (P <.0001), and other outpatient and emergency department visits (P <.05). The percentage of patients receiving narcolepsy-related medications increased from 54.0% preindex to 77.4%, 70.0%, and 66.9% for years 1, 2, and 3 postindex (all P <.0001 vs preindex). The total medical service cost PPPY was $12,159 preindex and decreased to $10,708, $8543, and $9136 in years 1, 2, and 3 postindex (all P <.0001 vs preindex). Conclusions In this study, the confirmation of a diagnosis of narcolepsy was associated with decreasing utilization and associated costs of medical services in the first 3 years after diagnosis. The total costs encompassing medical services and pharmacy costs were relatively stable during this period.

Combining ability analysis for within-boll yield components in upland cotton (Gossypium hirsutum L.).

PubMed

Imran, M; Shakeel, A; Azhar, F M; Farooq, J; Saleem, M F; Saeed, A; Nazeer, W; Riaz, M; Naeem, M; Javaid, A

2012-08-24

Cotton is an important cash crop worldwide, accounting for a large percentage of world agricultural exports; however, yield per acre is still poor in many countries, including Pakistan. Diallel mating system was used to identify parents for improving within-boll yield and fiber quality parameters. Combining ability analysis was employed to obtain suitable parents for this purpose. The parental genotypes CP-15/2, NIAB Krishma, CIM-482, MS-39, and S-12 were crossed in complete diallel mating under green house conditions during 2009. The F₀ seed of 20 hybrids and five parents were planted in the field in randomized complete block design with three replications during 2010. There were highly significant differences among all F₁ hybrids and their parents. Specific combining ability (SCA) variance was greater than general combining ability (GCA) variance for bolls per plant (9.987), seeds per boll (0.635), seed density (5.672), lint per seed (4.174), boll size (3.69), seed cotton yield (0.315), and lint percentage (0.470), showing predominance of non-additive genes; while seed volume (3.84) was controlled by additive gene action based on maximum GCA variance. Cultivar MS-39 was found to be the best general combiner for seed volume (0.102), seeds per boll (0.448), and lint per seed (0.038) and its utilization produced valuable hybrids, including MS-39 x NIAB Krishma and MS-39 x S-12. The parental line CIM-482 had high GCA effects for boll size (0.33) and seeds per boll (0.90). It also showed good SCA with S-12 and NIAB Krishma for bolls per plant, with CP- 15/2 for boll size, and with MS-39 for seeds per boll. The hybrids, namely, CP-15/2 x NIAB Krishma, NIAB Krishma x S-12, NIAB Krishma x CIM-482, MS-39 x NIAB Krishma, MS-39 x CP-15/2, and S-12 x MS-39 showed promising results. Correlation analysis revealed that seed cotton yield showed significant positive correlation with bolls per plant, boll size and seeds per boll while it showed negative correlation with lint percentage and lint per seed. Seed volume showed significant negative correlation with seed density. Seeds per boll were positively correlated with boll size and negatively correlated with bolls per plant lint percentage and lint per seed. Similarly, lint per seed exhibited positive correlation with lint percentage and boll size showed significantly negative correlation with bolls per plant. Presence of non-additive genetic effects in traits like bolls per plant, seeds per boll, lint per seed, seed cotton yield, and lint percentage is indicative of later generation selection or heterosis breeding may be adopted. For boll size, seed volume and seed density early generation selection may be followed because of the presence of additive gene action. The parental material used in this study and cross combinations obtained from these parents may be exploited in future breeding endeavors.

Impact of increasing adherence to disease-modifying therapies on healthcare resource utilization and direct medical and indirect work loss costs for patients with multiple sclerosis.

PubMed

Yermakov, Sander; Davis, Matthew; Calnan, Michaela; Fay, Monica; Cox-Buckley, Brieana; Sarda, Sujata; Duh, Mei Sheng; Iyer, Ravi

2015-01-01

To estimate the effect of adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) on healthcare resource utilization (HRU) and costs, and model the impact of a 10 percentage point increase in adherence on these outcomes. Employed patients, 18-64 years old, with ≥2 MS diagnoses and ≥1 DMT claim during January 1, 2002 to September 30, 2012 were identified from a large commercially-insured US claims database. Adherence was measured as proportion of days covered (PDC) during follow-up. Multivariate regression analyses were conducted to estimate the effect of adherence on HRU related to urgent care (i.e., inpatient or emergency room visit), days of work loss, direct medical cost, and indirect work loss costs. Model coefficients were used to evaluate the impact of a 10 percentage point increase in adherence on the outcomes. A total of 1510 patients were included (mean age = 43.4 years, 64% female). Patients with higher adherence had lower HRU, fewer days of work loss, and lower direct and indirect costs. A 10 percentage point increase in adherence significantly decreased the likelihood of an inpatient or emergency room visit by 9-19%, days of work loss by 3-8%, and direct and indirect costs by 3-5%, depending on the follow-up period (all p < 0.01). Increasing DMT adherence was found to significantly decrease urgent-care HRU, days of work loss, and direct and indirect costs among patients with MS.

Color constancy using bright-neutral pixels

NASA Astrophysics Data System (ADS)

Wang, Yanfang; Luo, Yupin

2014-03-01

An effective illuminant-estimation approach for color constancy is proposed. Bright and near-neutral pixels are selected to jointly represent the illuminant color and utilized for illuminant estimation. To assess the representing capability of pixels, bright-neutral strength (BNS) is proposed by combining pixel chroma and brightness. Accordingly, a certain percentage of pixels with the largest BNS is selected to be the representative set. For every input image, a proper percentage value is determined via an iterative strategy by seeking the optimal color-corrected image. To compare various color-corrected images of an input image, image color-cast degree (ICCD) is devised using means and standard deviations of RGB channels. Experimental evaluation on standard real-world datasets validates the effectiveness of the proposed approach.

GENETIC DIVERSITY AND POPULATION STRUCTURE ANALYSIS OF ACCESSIONS IN THE U.S. PEANUT MINI-CORE COLLECTION

USDA-ARS?s Scientific Manuscript database

Peanut seeds contain not only a high percentage of oil (49%) with high oleate but also a high percentage of protein (25%) and nutritious phytochemicals (such as flavonoids and resveratrol). Therefore, peanut is one of the most important oilseed and nutritional crops in the world. The U.S. Peanut ger...

Dental patient preferences and choice in clinical decision-making.

PubMed

Fukai, Kakuhiro; Yoshino, Koichi; Ohyama, Atsushi; Takaesu, Yoshinori

2012-01-01

In economics, the concept of utility refers to the strength of customer preference. In health care assessment, the visual analogue scale (VAS), the standard gamble, and the time trade-off are used to measure health state utilities. These utility measurements play a key role in promoting shared decision-making in dental care. Individual preference, however, is complex and dynamic. The purpose of this study was to investigate the relationship between patient preference and educational intervention in the field of dental health. The data were collected by distributing questionnaires to employees of two companies in Japan. Participants were aged 18-65 years and consisted of 111 males and 93 females (204 in total). One company (Group A) had a dental program of annual check-ups and health education in the workplace, while the other company (Group B) had no such program. Statistical analyses were performed with the t-test and Chi-square test. The questionnaire items were designed to determine: (1) oral health-related quality of life, (2) dental health state utilities (using VAS), and (3) time trade-off for regular dental check-ups. The percentage of respondents in both groups who were satisfied with chewing function, appearance of teeth, and social function ranged from 23.1 to 42.4%. There were no significant differences between groups A and B in the VAS of decayed, filled, and missing teeth. The VAS of gum bleeding was 42.8 in Group A and 51.3 in Group B (p<0.05). The percentage of persons having a regular dental check-up every three months was 34.1 and 31.3% in Groups A and B respectively. These results suggest that low preference results from lack of opportunity or utilization of dental care in the worksite. Ascertaining the factors involved in patient preference may have significant potential benefits in shared decision-making.

[Utility of congenital hypothyroidism screening in neonates for monitoring iodine deficit disorders in the Canary Islands (Spain)].

PubMed

Doménech Martínez, E; Barroso Guerrero, F

2003-04-01

Newborns in European cities where iodine intake is low have been demonstrated to present high frequencies of transitory hypothyroidism. Because the neonatal period is critical for cerebral development, this is a cause for concern. Published studies (WHO/UNICEF/ICCIDD) indicate that neonates with a thyroid-stimulating hormone (TSH) concentration of more than 5 mU/ml revealed by screening for congenital hypothyroidism present mild iodine deficiency. To analyze the utility of TSH values as an indicator of the prevalence of iodine deficiency in the general population. We prospectively evaluated 19 809 neonates, corresponding to all the neonates screened from May 2001 to April 2002 in the Canary Islands.TSH determination in whole blood dried on filter paper was performed using immunofluorescence (Delphia) in the Center for the Detection of Metabolic Disorders in the Canary Islands. The percentage of neonates in each island with TSH values of > 5 mU/l was calculated. Samples of cord blood were not used. A total of 19 809 infants were analyzed. Of these 1800 had values of TSH > 5 mU/L, representing 9.08 % of neonates. The mean age at blood extraction was 4.31 6 3.78 days (range: 0.5-40). The percentage of neonates with values of THS > 5 mU/L in each island was 13.1 % in Gran Canaria, 5.1 % in Lanzarote, 7.3 % in Fuerteventura, 6.0 % in Tenerife, 6.2 % in La Palma, 6.6 % in Gomera and 10.1 % in Hierro. In 77.5 % of neonates in Gran Canaria blood was extracted for screening within the first 72 hours of life and 15.2 % of these neonates had TSH concentrations of > 5 mU/L. In 22.5 % of neonates blood was extracted on the third day of life or later and 7.9 % of these neonates had TSH values of > 5 mU/L. In the Canary Islands, the percentage of neonates with iodine deficiency, according to elevated TSH levels detected screening for congenital hyperthyroidism, was small. The validity of TSH level as an indicator of the prevalence of iodine deficiency in the general population is influenced by the days of life at which the blood sample is taken.

Access to Oral Osteoporosis Drugs among Female Medicare Part D Beneficiaries

PubMed Central

Lin, Chia-Wei; Karaca-Mandic, Pinar; McCullough, Jeffrey S.; Weaver, Lesley

2014-01-01

Background For women living with osteoporosis, high out-of-pocket drug costs may prevent drug therapy initiation. We investigate the association between oral osteoporosis out-of-pocket medication costs and female Medicare beneficiaries’ initiation of osteoporosis drug therapy. Methods We used 2007 and 2008 administrative claims and enrollment data for a 5% random sample of Medicare beneficiaries. Our study sample included age-qualified, female beneficiaries who had no prior history of osteoporosis but were diagnosed with osteoporosis in 2007 or 2008. Additionally, we only included beneficiaries continuously enrolled in standalone prescription drug plans. We excluded beneficiaries who had a chronic condition that was contraindicated with osteoporosis drug utilization. Our final sample included 25,069 beneficiaries. Logistic regression analysis was used to examine the association between the out-of-pocket costs and initiation of oral osteoporosis drug therapy during the year of diagnosis. Findings Twenty-six percent of female Medicare beneficiaries newly diagnosed with osteoporosis initiated oral osteoporosis drug therapy. Beneficiaries’ out-of-pocket costs were not associated with the initiation of drug therapy for osteoporosis. However, there were statistically significant racial disparities in beneficiaries’ initiation of drug therapy. African Americans were 3 percentage points less likely to initiate drug therapy than whites. In contrast, Asian/Pacific Islander and Hispanic beneficiaries were 8 and 18 percentage points respectively more likely to initiate drug therapy than whites. Additionally, institutionalized beneficiaries were 11 percentage points less likely to initiate drug therapy than other beneficiaries. Conclusions Access barriers for drug therapy initiation may be driven by factors other than patients’ out-of-pocket costs. These results suggest that improved osteoporosis treatment requires a more comprehensive approach that goes beyond payment policies. PMID:24837398

Transfer and detection of freshly isolated or cultured chicken (Gallus gallus) and exotic species' embryonic gonadal germ stem cells in host embryos.

PubMed

Imus, Nastassja; Roe, Mandi; Charter, Suellen; Durrant, Barbara; Jensen, Thomas

2014-06-01

The management of captive avian breeding programs increasingly utilizes various artificial reproductive technologies, including in ovo sexing of embryos to adjust population sex ratios. Currently, however, no attention has been given to the loss of genetic diversity following sex-selective incubation, even with respect to individuals from critically endangered species. This project evaluated the possibility of using xenotransfer of embryonic gonadal germline stem cells (GGCs) for future reintroduction of their germplasm into the gene pool. We examined and compared the host gonad colonization of freshly isolated and 3 day (3d) cultured donor GGCs from chicken and 13 species of exotic embryos. Following 3d-culture of GGCs, there was a significant increase in the percentage of stem cell marker (SSEA-1, -3, -4) positive cells. However, the percentage of positive host gonads with chicken donor-derived cells decreased from 68% (fresh) to 22% (3d), while the percentage of exotic species donor-cells positive host gonads decreased from 61% (fresh) to 49% (3d-cultured). Donor GGCs from both chicken and exotic species were localized within the caudal endoderm, including the region encompassing the gonadal ridge by 16 hours post-injection. Furthermore, donor-derived cells isolated from stage 36 host embryos were antigenic for anti SSEA-1, VASA/DDX4 and EMA-1 antibodies, presumably indicating maintenance of stem cell identity. This study demonstrates that GGCs from multiple species can migrate to the gonadal region and maintain presumed stemness following xenotransfer into a chicken host embryo, suggesting that germline stem cell migration is highly conserved in birds.

Antibacterial substances from marine algae isolated from Jeddah coast of Red sea, Saudi Arabia

PubMed Central

Al-Saif, Sarah Saleh Abdu-llah; Abdel-Raouf, Nevein; El-Wazanani, Hend A.; Aref, Ibrahim A.

2013-01-01

Marine algae are known to produce a wide variety of bioactive secondary metabolites and several compounds have been derived from them for prospective development of novel drugs by the pharmaceutical industries. However algae of the Red sea have not been adequately explored for their potential as a source of bioactive substances. In this context Ulva reticulata, Caulerpa occidentalis, Cladophora socialis, Dictyota ciliolata, and Gracilaria dendroides isolated from Red sea coastal waters of Jeddah, Saudi Arabia, were evaluated for their potential for bioactivity. Extracts of the algae selected for the study were prepared using ethanol, chloroform, petroleum ether and water, and assayed for antibacterial activity against Escherichia coli ATCC 25322, Pseudomonas aeruginosa ATCC 27853, Stapylococcus aureus ATCC 29213, and Enterococcus faecalis ATCC 29212. It was found that chloroform was most effective followed by ethanol, petroleum ether and water for the preparation of algal extract with significant antibacterial activities, respectively. Results also indicated that the extracts of red alga G. dendroides were more efficient against the tested bacterial strains followed by green alga U. reticulata, and brown algae D. ciliolata. Chemical analyses showed that G. dendroides recorded the highest percentages of the total fats and total proteins, followed by U. reticulata, and D. ciliolate. Among the bioflavonoids determined Rutin, Quercetin and Kaempherol were present in high percentages in G. dendroides, U. reticulata, and D. ciliolate. Estimation of saturated and unsaturated fatty acids revealed that palmitic acid was present in highest percentage in all the algal species analyzed. Amino acid analyses indicated the presence of free amino acids in moderate contents in all the species of algae. The results indicated scope for utilizing these algae as a source of antibacterial substances. PMID:24596500

The Influence of Socioeconomic, Parental, and District Factors on the 2013 MCAS Grade 4 Language Arts and Mathematics Scores

ERIC Educational Resources Information Center

Caldwell, Dale G.

2017-01-01

This correlational, explanatory study utilized multiple linear and hierarchical regression to examine the predictive power of socioeconomic, parental and district factors on the total percentage of students who scored Proficient or Advanced Proficient on the 2013 MCAS Grade 4 language arts and mathematics test. The population for this study…

Use of Theory-Driven Research in Counseling: Investigating Three Counseling Psychology Journals from 1990 to 1999

ERIC Educational Resources Information Center

Karr, Carolyn A.; Larson, Lisa M.

2005-01-01

Three major journals in counseling psychology were sampled from 1990 to 1999 to assess the percentage of quantitative, empirical articles that were theory driven. Only 43% of the studies utilized a theory or model, and 57% predicted the relation between the variables, with few studies specifying the strength of the relation. Studies sampled in the…

40 CFR 72.91 - Phase I unit adjusted utilization.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sales is less than or equal to zero, then percentage change in dispatch system sales shall be treated as zero only for purposes of paragraph (a)(3)(iii) of this section. (D) If the result of the formula for “shift to sulfur-free generator” is less than or equal to zero, then “shift to sulfur-free generator” is...

40 CFR 72.91 - Phase I unit adjusted utilization.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sales is less than or equal to zero, then percentage change in dispatch system sales shall be treated as zero only for purposes of paragraph (a)(3)(iii) of this section. (D) If the result of the formula for “shift to sulfur-free generator” is less than or equal to zero, then “shift to sulfur-free generator” is...

40 CFR 72.91 - Phase I unit adjusted utilization.

Code of Federal Regulations, 2011 CFR

2011-07-01

... sales is less than or equal to zero, then percentage change in dispatch system sales shall be treated as zero only for purposes of paragraph (a)(3)(iii) of this section. (D) If the result of the formula for “shift to sulfur-free generator” is less than or equal to zero, then “shift to sulfur-free generator” is...

40 CFR 72.91 - Phase I unit adjusted utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... sales is less than or equal to zero, then percentage change in dispatch system sales shall be treated as zero only for purposes of paragraph (a)(3)(iii) of this section. (D) If the result of the formula for “shift to sulfur-free generator” is less than or equal to zero, then “shift to sulfur-free generator” is...

40 CFR 72.91 - Phase I unit adjusted utilization.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sales is less than or equal to zero, then percentage change in dispatch system sales shall be treated as zero only for purposes of paragraph (a)(3)(iii) of this section. (D) If the result of the formula for “shift to sulfur-free generator” is less than or equal to zero, then “shift to sulfur-free generator” is...

Human Capital and Economic Activity in Urban America. Staff Report No. 332

ERIC Educational Resources Information Center

Abel, Jaison R.; Gabe, Todd M.

2010-01-01

We examine the relationship between human capital and economic activity in U.S. metropolitan areas, extending the literature in two ways. First, we utilize new data on metropolitan area GDP to measure economic activity. Results show that a one-percentage-point increase in the proportion of residents with a college degree is associated with about a…

Utilization of a reminder mailing to improve blood glucose log reporting in an outpatient diabetes clinic.

PubMed

Moorman, John M; Frazee, Lawrence A; Dillon, Melanie L; Chomo, Diane L; Myers, Nancy A

2012-07-01

Self-monitored blood glucose (SMBG) offers a strategy used to achieve glycemic control in diabetic patients. However, if SMBG readings are unavailable to clinicians, this strategy will have a limited effect. This study assessed the impact of a reminder mailing on response rates to requests for SMBG logs. Patients were asked to mail completed SMBG logs to the clinic in 2 weeks. For the intervention, a reminder mailing was sent to each patient 1 week before SMBG logs were to be returned. Compliance rates pre and postinterventions were compared. The primary outcome was the percentage of all SMBG logs returned on time. Secondary outcomes included the percentage of SMBG logs returned, percentage fulfilled, percentage of clinic appointments kept, percentage of SMBG logs brought to follow-up appointments, and number of interventions made to antidiabetic therapy. Twenty SMBG requests were made in the preintervention cohort versus 19 in postintervention cohort. A trend toward more on time and fulfilled SMBG requests was observed post vs. preintervention. Overall return rates were similar between groups. A nonsignificant increase in clinic appointments kept and a nonsignificant decrease in interventions made were observed postintervention. Receipt of a reminder mail was not a significant predictor of patients bringing an SMBG log to follow-up appointments. In conclusion, the use of a reminder mail was not associated with an increase in the return rate of SMBG logs, although there were nonsignificant trends toward more on time and fulfilled SMBG logs received during the postintervention period.

Impact and utilization studies of a PACS display station in an ICU setting

NASA Astrophysics Data System (ADS)

Andriole, Katherine P.; Storto, Maria L.; Gamsu, Gordon; Huang, H. K.

1996-05-01

An assessment of changes in health-care professional behavior as a result of the introduction of a PACS (picture archiving and communication system) display station to an adult medical- surgical intensive care unit (ICU) is investigated via pre- and post-PACs evaluations. ICU display station utilization and the impact on clinical operations are also examined. Parameters measured both pre- and post-PACS ICU display station placement include the number of films per patient day, the number of clinician reviews of a patient's images per day and the percentage of images on which the unit interacts with a radiologist. The elapsed times from the time of exposure to the time of: review by the referring physician, radiologist-unit interaction and clinical action based on image information are also measured. The results of this investigation suggest that the introduction of a PaCS display station in the ICU may reduce the number of exams per patient day, decrease the elapsed time from the time of exposure to the time of review by the unit clinician, and improve the time to clinical action. Note, however, that it does not appear to change the percentage of total images on which the unit interacts with a radiologist.

Utilizing Clinical Pharmacy Specialists to Address Access to Care Barriers in the Veteran Population for the Management of Diabetes.

PubMed

Edwards, Krystal L; Hadley, Ryan L; Baby, Nidhu; Yeary, Julianne C; Chastain, Lisa M; Brown, Crystal D

2017-08-01

To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluated outcomes in patients with type 2 diabetes mellitus referred to CPSs at Fort Worth Outpatient Clinic (FWOPC) or the endocrinologist-managed specialty clinic at the Dallas VA Medical Center (DVAMC). The primary outcome was percentage of patients reaching hemoglobin A1c (HbA1c) goal of <8%. Secondary outcomes were percentage of patients reaching HbA1c <7%, time to reach HbA1c goals of <8% and <7%, and cost savings. There was no statistically significant difference in the number of patients reaching HbA1c goal <8% in the FWOPC (65.3%) compared to the DVAMC (55.8%). Secondary end points comparing FWOPC and DVAMC found no difference in patients reaching HbA1c <7% (20.8% vs 19.2%) and time to reach HbA1c goal of <8% (4.5 vs 6 months) and <7% (8.5 vs 7.5 months). Cost-saving analysis demonstrated a composite of US$350 292 could be saved by the VANTHCS facility if patients continued to be referred to CPS. CPSs can be utilized in diabetes management to provide similar health outcomes as the endocrinologist-managed clinic and to potentially allow for facility cost savings.

Temporal trends in early clinical outcomes and health care resource utilization for liver transplantation in the United States.

PubMed

Scarborough, John E; Pietrobon, Ricardo; Marroquin, Carlos E; Tuttle-Newhall, Janet E; Kuo, Paul C; Collins, Bradley H; Desai, Dev M; Pappas, Theodore N

2007-01-01

Procedures such as liver transplantation, which entail large costs while benefiting only a small percentage of the population, are being increasingly scrutinized by third-party payors. The purpose of our study was to conduct a longitudinal analysis of the early clinical outcomes and health care resource utilization for liver transplantation in the United States. The Nationwide Inpatient Sample database was used to conduct a longitudinal analysis of the clinical outcome and resource utilization data for liver transplantation procedures in adult recipients performed in the United States over three time periods (Period I: 1988-1993; Period II: 1994-1998: Period III: 1999-2003). Compared to Period I, adult liver transplant recipients were more likely to be male, older, and non-White in Period III. Recipients were more likely to have at least one major comorbidity preoperatively than in Period I. The in-hospital mortality rate after liver transplantation decreased significantly from Period I to Period III, but the major intraoperative and postoperative complication rates increased over the same time period. Mean length of hospital stay decreased over the 15-year period, but the percentage of patients with a non-routine discharge status increased. Our findings indicate that the rate of postoperative complications and non-routine discharges after liver transplantation is increasing. However, these negative changes in the cost-outcomes relationship for liver transplantation are balanced by improving postoperative survival rates and reductions in the length of hospital stay.

[EVALUATION OF THE PERCEPTION OF RISK IN THE NURSING STAFF IN CARE OF PATIENTS WITH SUSPECTED BIOLOGICAL HAZARD].

PubMed

Grau Giner, Ana; Fornieles Moreira, Margarita; Márquez Mora, Mónica; Moragas Bayés, Núria; Rodríguez Ruiz, Ma José; Gisbert Cases, Ángels

2016-05-01

Healthcare personnel is especially vulnerable to the risks derived from their job. The complexity that has the care of patients with Ebola justifies the study of the perception of risk of such professionals. To know the perception of risk in the nursing staff that takes care of patients suspected of suffering the Ebola virus. Transversal study carried out in the Hospital Clinic of Barcelona. 19 professionals of nursing staff that attended suspected Ebola patients were included in the study. The data was collected through a questionnaire of dimensional evaluation of the perceived risk along with sociodemographic variables and a subsequent statistics analysis. A percentage of 68% of the nursing staff refereed having a high level of knowledge of the risk associated with the factor of this study. A percentage of 42% determined that there was a very high possibility of being harmed. A percentage of 63% considered that the most harmful consequences would appear in short term, and finally a percentage of 48% considered that there was a very high risk of accident or illness associated to the factor of this study, whereas a percentage of 5% considered the risk to be very low. The answers obtained showed not only that nursing staff had a very high level of knowledge regarding the risk associated to the factor of this study, but also that the emotional fear was very high.

[Drug expenditure in primary care: associated variables and allocation of drug budgets according to health district].

PubMed

García-Sempere, A; Peiró, S

2001-01-01

Identify factors explaining variability in prescribing costs after reviewing ecological data related to costs and socio-demographic characteristics of the health care zones in the autonomous region of Valencia, and explore the usefulness of using the model to set prescribing budgets in basic healthcare zones. An ecological analysis of the value socio-demographic characteristics and use of healthcare services to explain prescribing costs in 1997. Development of a prediction model based on multiple linear regression in data for prescribing costs in 1997 and validation in data for 1998. Factors that correlated positively with prescribing costs were the percentage of inhabitants over the age of 80, the death rate, the percentage of inhabitants with only primary education or less, the percentage of inhabitants between the ages of 65 and 79 and the distance from the capital city. A multivariate model including the death rate, the percentage of inhabitants 80 years of age and older, the number of cars per 100 inhabitants and number of visits per inhabitant accounted for 44.5% of the variations in prescribing costs in 1997 and 32% in 1998. Socio-demographic factors and certain variables associated with health care utilization can be applied, within certain limitations, to set prescribing budgets in basic healthcare zones.

Measuring for enhancing high school students’ cooperative attitude and responsibilities in learning closed electrical circuits through STEM approach

NASA Astrophysics Data System (ADS)

Rusnayati, H.; Masripah, I.; Suwarma, I. R.

2018-05-01

This study conducted by the finding of the lack of students’ cooperative attitude that gained 35.29% and the students’ responsibility 29.41%. It also looks at the preliminary study that conducted by the observation group obtained the students’ cooperative attitude (34%) and student’s responsibility (30%). The purpose of this study to determine students’ cooperative attitude and responsibility at the time of learning a closed electrical circuit through STEM approach. This research method is the descriptive study with the pre-experimental design and the paradigm of one shot case study. The population of this study is the tenth-grade high school students with a sample size of 40 students that consist of 24 female and 16 male. The data collection techniques that utilized is the attitude rubric and the attitude measurement format. The result of this study showed that the percentage of students’ cooperative attitude in the first and second meeting is 83% and 81% with very high criteria. Meanwhile, the attitude of responsibility answerable for the first and second meeting was 81% and 79% with very high and high criteria. This indicates that the STEM approach can improve students’ cooperative attitude and responsibility.

The initial metabolic conversion of levulinic acid in Cupriavidus necator.

PubMed

Jaremko, Matt; Yu, Jian

2011-09-20

Levulinic acid or 4-ketovaleric acid is a potential renewable substrate for production of polyhydroxyalkanoates. In this work, the initial reactions of LA metabolism by Cupriavidus necator were examined in vitro. The organic acid was converted by membrane-bound crude enzymes obtained from the cells pre-grown on LA, while no LA activity was detected from cells pre-grown on acetic acid. Acetyl-CoA and propionyl-CoA were two major intermediates in the initial reactions of LA conversion. A mass balance on propionyl-CoA accounts for 84 mol% of LA added in vitro. It explains an interesting phenomenon that 3-hydroxbutyrate and 3-hydroxyvalerate are two major monomers of the biopolyester formed from LA, instead of 4-hydroxvalerate that has the similar chemical structure of LA as the precursor. A Monod model was used to describe the kinetics of LA utilization as a sole carbon source or a co-substrate of glucose and fructose. The μ(max) and K(m) of LA alone were 0.26 h⁻¹ and 0.01 g/L, respectively. The content and composition of PHA are also dependent on the culture conditions such as carbon to nitrogen ratio. The in vitro observation is supported by the high utilization rate of LA and the high molar percentage of 3HB and 3HV in the PHA derived from LA. Copyright © 2011 Elsevier B.V. All rights reserved.

Tannic acid degradation by Klebsiella strains isolated from goat feces

PubMed Central

Tahmourespour, Arezoo; Tabatabaee, Nooroldin; Khalkhali, Hossein; Amini, Imane

2016-01-01

Background and Objectives: Tannins are toxic polyphenols that either bind and precipitate or condense proteins. The high tannin content of some plants is the preliminary limitation of using them as a ruminant feed. So, the aim of this study was the isolation and characterization of tannic acid degrading bacterial strains from goat feces before and after feeding on Pistachio-Soft Hulls as tannin rich diet (TRD). Materials and Methods: Bacterial strains capable of utilizing tannic acid as sole carbon and energy source were isolated and characterized from goat feces before and after feeding on TRD. Tannase activity, maximum tolerable concentration and biodegradation potential were assessed. Results: Four tannase positive isolates were identified as Klebsiella pneumoniae. Isolated strains showed the maximum tolerable concentration of 64g/L of tannin. The tannic acid degradation percentage at a concentration of 15.0 g/L reached a maximum of 68% after 24 h incubation, and more than 98% after 72 h incubation. The pH of the medium also decreased along with tannic acid utilization. Conclusions: It is obvious that TRD induced adaptive responses. Thus, while the bacteria were able to degrade and detoxify the tannic acids, they had to adapt in the presence of high concentrations of tannic acid. So, these isolates have an amazing potential for application in bioremediation, waste water treatment, also reduction of tannins antinutritional effects in animal feeds. PMID:27092220

Temperature Treatment of Highly Porous Zirconium-Containing Metal-Organic Frameworks Extends Drug Delivery Release.

PubMed

Teplensky, Michelle H; Fantham, Marcus; Li, Peng; Wang, Timothy C; Mehta, Joshua P; Young, Laurence J; Moghadam, Peyman Z; Hupp, Joseph T; Farha, Omar K; Kaminski, Clemens F; Fairen-Jimenez, David

2017-06-07

Utilizing metal-organic frameworks (MOFs) as a biological carrier can lower the amount of the active pharmaceutical ingredient (API) required in cancer treatments to provide a more efficacious therapy. In this work, we have developed a temperature treatment process for delaying the release of a model drug compound from the pores of NU-1000 and NU-901, while taking care to utilize these MOFs' large pore volume and size to achieve exceptional model drug loading percentages over 35 wt %. Video-rate super-resolution microscopy reveals movement of MOF particles when located outside of the cell boundary, and their subsequent immobilization when taken up by the cell. Through the use of optical sectioning structured illumination microscopy (SIM), we have captured high-resolution 3D images showing MOF uptake by HeLa cells over a 24 h period. We found that addition of a model drug compound into the MOF and the subsequent temperature treatment process does not affect the rate of MOF uptake by the cell. Endocytosis analysis revealed that MOFs are internalized by active transport and that inhibiting the caveolae-mediated pathway significantly reduced cellular uptake of MOFs. Encapsulation of an anticancer therapeutic, alpha-cyano-4-hydroxycinnamic acid (α-CHC), and subsequent temperature treatment produced loadings of up to 81 wt % and demonstrated efficacy at killing cells beyond the burst release effect.

The role of mental health and addiction among high-cost patients: a population-based study.

PubMed

de Oliveira, Claire; Cheng, Joyce; Rehm, Jürgen; Kurdyak, Paul

2018-04-01

Previous work found that, among high-cost patients, those with a majority of mental health and addiction (MHA)-related costs (>50%) incur over 30% more costs than other high-cost patients. However, this work did not examine other high-cost patients in depth or whether they had any MHA-related costs. The objective of this analysis was to examine the role of MHA-related care among other high-cost patients. Using administrative healthcare data from Ontario, Canada, this study selected all patients in the 90th percentile of the cost distribution in 2012. It focused primarily on two groups based on the percentage of MHA-related costs relative to total costs: (1) high-cost patients with some MHA-related costs (0% > and <50%) and (2) high-cost patients with no MHA-related costs (0%). We examined socio-demographic and clinical characteristics, utilization and costs for both groups, and modeled patient-level costs using appropriate regression techniques. We also compared these groups with high-cost patients with a majority of MHA-related costs (>50%). High-cost patients with some MHA-related costs incurred over 40% more costs than those without ($27,883 vs $19,702). Patients with some MHA-related costs were older, lived in poorer neighborhoods, and had higher levels of comorbidity compared to those without. After controlling for relevant variables, having any type of MHA-related utilization increased costs by $2,698. Having a diagnosis of psychosis had a large impact on costs. This study did not examine children and adolescents. We were only able to account for 91% of all costs incurred by the public third-party payer; addiction-related costs from community-based agencies were not available. High-cost patients with MHA incur higher costs compared to those without. When considering interventions aimed at high-cost patients, policy-makers should consider their complex nature, specifically both their physical and MHA-related comorbidities.

Heritabilities and genetic correlations in the same traits across different strata of herds created according to continuous genomic, genetic, and phenotypic descriptors.

PubMed

Yin, Tong; König, Sven

2018-03-01

The most common approach in dairy cattle to prove genotype by environment interactions is a multiple-trait model application, and considering the same traits in different environments as different traits. We enhanced such concepts by defining continuous phenotypic, genetic, and genomic herd descriptors, and applying random regression sire models. Traits of interest were test-day traits for milk yield, fat percentage, protein percentage, and somatic cell score, considering 267,393 records from 32,707 first-lactation Holstein cows. Cows were born in the years 2010 to 2013, and kept in 52 large-scale herds from 2 federal states of north-east Germany. The average number of genotyped cows per herd (45,613 single nucleotide polymorphism markers per cow) was 133.5 (range: 45 to 415 genotyped cows). Genomic herd descriptors were (1) the level of linkage disequilibrium (r 2 ) within specific chromosome segments, and (2) the average allele frequency for single nucleotide polymorphisms in close distance to a functional mutation. Genetic herd descriptors were the (1) intra-herd inbreeding coefficient, and (2) the percentage of daughters from foreign sires. Phenotypic herd descriptors were (1) herd size, and (2) the herd mean for nonreturn rate. Most correlations among herd descriptors were close to 0, indicating independence of genomic, genetic, and phenotypic characteristics. Heritabilities for milk yield increased with increasing intra-herd linkage disequilibrium, inbreeding, and herd size. Genetic correlations in same traits between adjacent levels of herd descriptors were close to 1, but declined for descriptor levels in greater distance. Genetic correlation declines were more obvious for somatic cell score, compared with test-day traits with larger heritabilities (fat percentage and protein percentage). Also, for milk yield, alterations of herd descriptor levels had an obvious effect on heritabilities and genetic correlations. By trend, multiple trait model results (based on created discrete herd classes) confirmed the random regression estimates. Identified alterations of breeding values in dependency of herd descriptors suggest utilization of specific sires for specific herd structures, offering new possibilities to improve sire selection strategies. Regarding genomic selection designs and genetic gain transfer into commercial herds, cow herds for the utilization in cow training sets should reflect the genomic, genetic, and phenotypic pattern of the broad population. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Synchrotron-induced X-ray fluorescence from rat bone and lumber vertebra of different age groups

NASA Astrophysics Data System (ADS)

Rao, Donepudi V.; Swapna, Medasani; Cesareo, Roberto; Brunetti, Antonio; Akatsuka, Tako; Yuasa, Tetsuya; Takeda, Tohoru; Tromba, Giuliana; Gigante, Giovanni E.

2009-02-01

The fluorescence spectra from rat bones of different age groups (8, 56 and 78 weeks) and lumber vertebra were measured with 8, 10 and 12 keV synchrotron X-rays. We have utilized the new hard X-ray micro-spectroscopy beamline facility, X27A, available at NSLS with a primary beam spot size of the order of ˜10 μm. With this spatial resolution and high flux throughput, X-ray fluorescent intensities for Ca and other trace elements were measured using a liquid-nitrogen-cooled 13-element energy-dispersive high-purity germanium detector. Regarding the lumber vertebra, we acquired the fluorescence spectra from the left, right and middle portions and calcium accumulation was evaluated and compared with the other samples. We have identified the major trace elements of Ca, Ni, Fe and Zn and minor trace elements of Ti, Cr and Mn in the sample. The percentage of scattered radiation and trace element contributions from these samples were highlighted at different energies.

Update in mild traumatic brain injury.

PubMed

Freire-Aragón, María Dolores; Rodríguez-Rodríguez, Ana; Egea-Guerrero, Juan José

2017-08-10

There has been concern for many years regarding the identification of patients with mild traumatic brain injury (TBI) at high risk of developing an intracranial lesion (IL) that would require neurosurgical intervention. The small percentage of patients with these characteristics and the exceptional mortality associated with mild TBI with IL have led to the high use of resources such as computerised tomography (CT) being reconsidered. The various protocols developed for the management of mild TBI are based on the identification of risk factors for IL, which ultimately allows more selective indication or discarding both the CT application and the hospital stay for neurological monitoring. Finally, progress in the study of brain injury biomarkers with prognostic utility in different clinical categories of TBI has recently been incorporated by several clinical practice guidelines, which has allowed, together with clinical assessment, a more accurate prognostic approach for these patients to be established. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Reduced clot debris size using standing waves formed via high intensity focused ultrasound

NASA Astrophysics Data System (ADS)

Guo, Shifang; Du, Xuan; Wang, Xin; Lu, Shukuan; Shi, Aiwei; Xu, Shanshan; Bouakaz, Ayache; Wan, Mingxi

2017-09-01

The feasibility of utilizing high intensity focused ultrasound (HIFU) to induce thrombolysis has been demonstrated previously. However, clinical concerns still remain related to the clot debris produced via fragmentation of the original clot potentially being too large and hence occluding downstream vessels, causing hazardous emboli. This study investigates the use of standing wave fields formed via HIFU to disintegrate the thrombus while achieving a reduced clot debris size in vitro. The results showed that the average diameter of the clot debris calculated by volume percentage was smaller in the standing wave mode than in the travelling wave mode at identical ultrasound thrombolysis settings. Furthermore, the inertial cavitation dose was shown to be lower in the standing wave mode, while the estimated cavitation bubble size distribution was similar in both modes. These results show that a reduction of the clot debris size with standing waves may be attributed to the particle trapping of the acoustic potential well which contributed to particle fragmentation.

Money earlier or later? Simple heuristics explain intertemporal choices better than delay discounting does.

PubMed

Ericson, Keith M Marzilli; White, John Myles; Laibson, David; Cohen, Jonathan D

2015-06-01

Heuristic models have been proposed for many domains involving choice. We conducted an out-of-sample, cross-validated comparison of heuristic models of intertemporal choice (which can account for many of the known intertemporal choice anomalies) and discounting models. Heuristic models outperformed traditional utility-discounting models, including models of exponential and hyperbolic discounting. The best-performing models predicted choices by using a weighted average of absolute differences and relative percentage differences of the attributes of the goods in a choice set. We concluded that heuristic models explain time-money trade-off choices in experiments better than do utility-discounting models. © The Author(s) 2015.

Money Earlier or Later? Simple Heuristics Explain Intertemporal Choices Better than Delay Discounting1

PubMed Central

Marzilli Ericson, Keith M.; White, John Myles; Laibson, David; Cohen, Jonathan D.

2015-01-01

Heuristic models have been proposed for many domains of choice. We compare heuristic models of intertemporal choice, which can account for many of the known intertemporal choice anomalies, to discounting models. We conduct an out-of-sample, cross-validated comparison of intertemporal choice models. Heuristic models outperform traditional utility discounting models, including models of exponential and hyperbolic discounting. The best performing models predict choices by using a weighted average of absolute differences and relative (percentage) differences of the attributes of the goods in a choice set. We conclude that heuristic models explain time-money tradeoff choices in experiments better than utility discounting models. PMID:25911124

The Relationship of Welding Fume Exposure, Smoking, and Pulmonary Function in Welders.

PubMed

Roach, Laura L

2018-01-01

The purpose of this study was to explore the relationship between occupational exposure to welding fumes and pulmonary function in an effort to add supportive evidence and clarity to the current body of research. This study utilized a retrospective chart review of pulmonary function testing and pulmonary questionnaires already available in charts from preplacement physicals to the most recent test. When comparing smokers to nonsmokers, utilizing multiple regression and controlling for age and percentage of time using a respirator, years welding was statistically significant at p = .04. Data support that smoking has a synergistic effect when combined with welding fume exposure on pulmonary decline.

Economic inequality in eye care utilization and its determinants: a Blinder–Oaxaca decomposition

PubMed Central

Emamian, Mohammad Hassan; Zeraati, Hojjat; Majdzadeh, Reza; Shariati, Mohammad; Hashemi, Hassan; Fotouhi, Akbar

2014-01-01

Background: The current study aimed to determine eye care utilization, to assess the role of economic inequality in the utilization of eye care services, and to identify its determinants in Shahroud, North of Iran. Methods: Of the 6,311 invited people, 5,190 (82.24%) individuals aged 40 to 64 years old participated in the study. A history of a visit by an ophthalmologist or optometrist was considered as eye care utilization. The gap between low- and high-economic groups was decomposed into its determinants using the Oaxaca decomposition method. Results: Among the participants, 16.32% [95% Confidence Intervals (CI)= 15.31–17.33%] had never been examined by an ophthalmologist or optometrist, and 30.94% (95% CI= 29.69–32.20%) had not undergone an eye examination in the past 5 years. This negative history was significantly higher among female subjects [Odds Ratio (OR)= 1.79, 95% CI= 1.51–2.14], the low-economic group (OR= 2.33, 95% CI= 1.90–2.87), the visually impaired (OR= 1.41, 95% CI= 1.05–1.90), and the uninsured (OR= 1.93, 95% CI= 1.45–2.58). The negative history of eye examination decreased with increasing in age (OR= 0.94, 95% CI= 0.93–0.96) and education (OR= 0.94, 95% CI= 0.92–0.96). In this study, 24.72% (95% CI= 22.30–27.14) of the low-economic group and 9.94% (95% CI= 8.75–11.14) of the high-economic group had no history of eye examination. Decomposition of the gap between the two economic groups showed that education and gender were the most important determinants of inequality. Conclusion: A considerable percentage of adults, even those with visual impairment, do not receive appropriate eye care. There is a definite economic inequality in the community for which poverty per se could be the major cause. PMID:25396206

High-value utilization of egg shell to synthesize Silver and Gold-Silver core shell nanoparticles and their application for the degradation of hazardous dyes from aqueous phase-A green approach.

PubMed

Sinha, Tanur; Ahmaruzzaman, M

2015-09-01

The common household material, egg shell of Anas platyrhynchos is utilized for the synthesis of Silver and Gold-Silver core shell nanoparticles using greener, environment friendly and economic way. The egg shell extracts were acting as a stabilizing and reducing agents. This method avoids the use of external reducing and stabilizing agents, templates and solvents. The effects of various reaction parameters, such as reaction temperature, concentration in the formation of nanoparticles have also been investigated. The compositional abundance of gelatin may be envisaged for the effective reductive as well as stabilizing potency. The mechanisms for the formation of NPs have also been presented. The synthesized Ag NPs formed were predominantly spherical in nature with an average size of particles in the range of 6-26 nm. While, Au-Ag core shell nanoparticles formed were spherical and oval shaped, within a narrow size spectrum of 9-18 nm. Both the Ag NPs Au-and Ag core shell nanoparticles showed characteristic Bragg's reflection planes of fcc structure and surface plasmon resonance at 430 nm and 365 nm, respectively. The NPs were utilized for the removal of toxic and hazardous dyes, such as Rose Bengal, Methyl Violet 6 B and Methylene Blue from aqueous phase. Approximately 98.2%, 98.4% and 97% degradations of Rose Bengal, Methyl Violet 6 B, and Methylene Blue were observed with Ag NPs, while the percentage degradation of these dyes was 97.3%, 97.6% and 96% with Au-Ag NPs, respectively. Therefore, the present study has opened up an innovative way for synthesizing Ag NPs and Au-Ag bimetallic nanostructures of different morphologies and sizes involving the utilization of egg shell extract. The high efficiency of the NPs as photocatalysts has opened a promising application for the removal of hazardous dyes from the industrial effluents. Copyright © 2015 Elsevier Inc. All rights reserved.

The Escherichia coli argW-dsdCXA genetic island is highly variable, and E. coli K1 strains commonly possess two copies of dsdCXA.

PubMed

Moritz, Rebecca L; Welch, Rodney A

2006-11-01

The genome sequences of Escherichia coli pathotypes reveal extensive genetic variability in the argW-dsdCXA island. Interestingly, the archetype E. coli K1 neonatal meningitis strain, strain RS218, has two copies of the dsdCXA genes for d-serine utilization at the argW and leuX islands. Because the human brain contains d-serine, an epidemiological study emphasizing K1 isolates surveyed the dsdCXA copy number and function. Forty of 41 (97.5%) independent E. coli K1 isolates could utilize d-serine. Southern blot hybridization revealed physical variability within the argW-dsdC region, even among 22 E. coli O18:K1:H7 isolates. In addition, 30 of 41 K1 strains, including 21 of 22 O18:K1:H7 isolates, had two dsdCXA loci. Mutational analysis indicated that each of the dsdA genes is functional in a rifampin-resistant mutant of RS218, mutant E44. The high percentage of K1 strains that can use d-serine is in striking contrast to our previous observation that only 4 of 74 (5%) isolates in the diarrheagenic E. coli (DEC) collection have this activity. The genome sequence of diarrheagenic E. coli isolates indicates that the csrRAKB genes for sucrose utilization are often substituted for dsdC and a portion of dsdX present at the argW-dsdCXA island of extraintestinal isolates. Among DEC isolates there is a reciprocal pattern of sucrose fermentation versus d-serine utilization. The ability to use d-serine is a trait strongly selected for among E. coli K1 strains, which have the ability to infect a wide range of extraintestinal sites. Conversely, diarrheagenic E. coli pathotypes appear to have substituted sucrose for d-serine as a potential nutrient.

Creation of a simple natural language processing tool to support an imaging utilization quality dashboard.

PubMed

Swartz, Jordan; Koziatek, Christian; Theobald, Jason; Smith, Silas; Iturrate, Eduardo

2017-05-01

Testing for venous thromboembolism (VTE) is associated with cost and risk to patients (e.g. radiation). To assess the appropriateness of imaging utilization at the provider level, it is important to know that provider's diagnostic yield (percentage of tests positive for the diagnostic entity of interest). However, determining diagnostic yield typically requires either time-consuming, manual review of radiology reports or the use of complex and/or proprietary natural language processing software. The objectives of this study were twofold: 1) to develop and implement a simple, user-configurable, and open-source natural language processing tool to classify radiology reports with high accuracy and 2) to use the results of the tool to design a provider-specific VTE imaging dashboard, consisting of both utilization rate and diagnostic yield. Two physicians reviewed a training set of 400 lower extremity ultrasound (UTZ) and computed tomography pulmonary angiogram (CTPA) reports to understand the language used in VTE-positive and VTE-negative reports. The insights from this review informed the arguments to the five modifiable parameters of the NLP tool. A validation set of 2,000 studies was then independently classified by the reviewers and by the tool; the classifications were compared and the performance of the tool was calculated. The tool was highly accurate in classifying the presence and absence of VTE for both the UTZ (sensitivity 95.7%; 95% CI 91.5-99.8, specificity 100%; 95% CI 100-100) and CTPA reports (sensitivity 97.1%; 95% CI 94.3-99.9, specificity 98.6%; 95% CI 97.8-99.4). The diagnostic yield was then calculated at the individual provider level and the imaging dashboard was created. We have created a novel NLP tool designed for users without a background in computer programming, which has been used to classify venous thromboembolism reports with a high degree of accuracy. The tool is open-source and available for download at http://iturrate.com/simpleNLP. Results obtained using this tool can be applied to enhance quality by presenting information about utilization and yield to providers via an imaging dashboard. Copyright © 2017 Elsevier B.V. All rights reserved.

Detection of adulteration in diesel and petrol by kerosene using SPR based fiber optic technique

NASA Astrophysics Data System (ADS)

Verma, Rajneesh K.; Suwalka, Payal; Yadav, Jatin

2018-07-01

In this paper we focused on the experimental investigations for fabricating a surface plasmon resonance (SPR) based fiber optic sensor for the detection of the extent of adulteration in petrochemicals: petrol and diesel by kerosene. Primarily it is observed that the refractive index of the petrol and diesel changes if we mix kerosene in it. The variation in refractive index is linear in nature. Utilizing the phenomenon of surface plasmon resonance in Krestchmann configuration on optical fiber, the percentage of adulteration in petrol and diesel is detected. The detection level of adulteration is quantified systematically for both the petrol and diesel. The study carried out here explores the possibility of utilizing SPR technique for the detection of the level of adulteration in petrochemicals. The suitability of the optical fiber for remote sensing and its immunity towards electromagnetic interaction makes this probe very useful for such endeavor. High sensitivity, easy construction and its portability, makes this study important in the development of SPR based optical fiber sensors for petrochemical industries. Apart from this various aspects of environment polluting hazardous/toxic gases as an emission product of automobile fuels has also been discussed.

An empirical study of the effectiveness of electronic stability control system in reducing loss of vehicle control.

PubMed

Papelis, Yiannis E; Watson, Ginger S; Brown, Timothy L

2010-05-01

A significant percentage of fatal vehicle crashes involve loss of control (LOC). Electronic stability control (ESC) is an active safety system that detects impending LOC and activates counter-measures that help the driver maintain or re-gain control. To assess the effectiveness of ESC in preventing LOC, an empirical study was conducted on a high-fidelity driving simulator. The ESC systems for two vehicles were incorporated into the simulator's dynamics code which was calibrated to ensure engineering validation. The study utilized three scenarios designed to recreate typical LOC situations, and was designed to assess the effects of ESC presence, vehicle type, scenario, age and gender. A total of 120 research participants completed the study. Results showed a statistically significant reduction in LOC with ESC compared to without ESC (F=52.72, p<0.0001). The study findings of 5% LOC with ESC and 30% without ESC match several epidemiological studies that have analyzed ESC effectiveness on real-world crashes, providing strong support to the use of driving simulation for studying driver behavior. Study conclusions suggest that wide-spread utilization of ESC is likely to reduce traffic fatalities. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Extraction optimization of polysaccharides from Chinese rice wine from the Shaoxing region and evaluation of its immunity activities.

PubMed

Shen, Chi; Mao, Jian; Chen, Yongquan; Meng, Xiangyong; Ji, Zhongwei

2015-08-15

Chinese rice wine is well known for its unique flavor and high nutritional value. It is of interest to investigate the functional components of Chinese rice wine and their health benefits. Response surface design of three factors - pH, ethanol concentration and precipitation time - at three levels was utilized to optimize the extraction of Chinese rice wine polysaccharide (CRWP). The results indicated that the CRWP yield was 77.287% at the optimal levels for pH 8.4, ethanol concentration 88% and precipitation time 23 h. In addition, immune activity of CRWP was investigated by measuring body weight, spleen index and thymus index. Furthermore, immunity activity of CRWP was investigated by measuring lymphocyte proliferation, phagocytic index and phagocytic percentage of immunosuppressed mice. Compared with the control mice and model mice, it was found that CRWP has beneficial immune activities in vivo. These findings indicate that CRWP has immune activities in vivo by modulating the immune response, and implies full development and utilization of the nutritional value of Chinese rice wine. However, further work will be conducted in the future to elucidate the structure-bioactivity relationship for CRWP. © 2014 Society of Chemical Industry.

Health IT and inappropriate utilization of outpatient imaging: A cross-sectional study of U.S. hospitals.

PubMed

Appari, Ajit; Johnson, M Eric; Anthony, Denise L

2018-01-01

To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings. A retrospective cross-sectional analysis of 3332 nonfederal U.S. hospitals using data from: Hospital Compare (2011 outpatient imaging efficiency measures), HIMSS Analytics (2009 health IT), and Health Indicator Warehouse (market characteristics). Hospitals were categorized for their health IT infrastructure including EHR Stage-1 capability, and three advanced imaging functionalities/systems including integrated picture archiving and communication system, Web-based image distribution, and clinical decision support (CDS) with physician pathways. Three imaging efficiency measures suggesting inappropriate utilization during 2011 included: percentage of "combined" (with and without contrast) computed tomography (CT) studies out of all CT studies for abdomen and chest respectively, and percentage of magnetic resonance imaging (MRI) studies of lumbar spine without antecedent conservative therapy within 60days. For each measure, three separate regression models (GLM with gamma-log link function, and denominator of imaging measure as exposure) were estimated adjusting for hospital characteristics, market characteristics, and state fixed effects. Additionally, Heckman's Inverse Mills Ratio and propensity for Stage-1 EHR capability were used to account for selection bias. We find support for association of each of the four health IT capabilities with inappropriate utilization rates of one or more imaging modality. Stage-1 EHR capability is associated with lower inappropriate utilization rates for chest CT (incidence rate ratio IRR=0.72, p-value <0.01) and lumbar MRI (IRR=0.87, p-value <0.05). Integrated PACS is associated with lower inappropriate utilization rate of abdomen CT (IRR=0.84, p-value <0.05). Imaging distribution over Web capability is associated with lower inappropriate utilization rates for chest CT (IRR=0.66, p-value <0.05) and lumbar MRI (IRR=0.86, p-value <0.05). CDS with physician pathways is associated with lower inappropriate utilization rates for abdomen CT (IRR=0.87, p-value <0.01) and lumbar MRI (IRR=0.90, p-value <0.05). All other cases showed no association. The study offers mixed results. Taken together, the results suggest that the use of Stage-1 Meaningful Use capable EHR systems along with advanced imaging related functionalities could have a beneficial impact on reducing some of the inappropriate utilization of outpatient imaging. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Using Silica Fume and Polycarboxylate-Type Superplasticizer on Physical Properties of Cementitious Grout Mixtures for Semiflexible Pavement Surfacing

PubMed Central

Karim, Mohamed Rehan; Mahmud, Hilmi; Mashaan, Nuha S.; Katman, Herdayati; Husain, Nadiah Md

2014-01-01

Semi-flexible pavement surfacing is a composite pavement that utilizes the porous pavement structure of the flexible bituminous pavement, which is subsequently grouted with appropriate cementitious materials. This study aims to investigate the compressive strength, flexural strength, and workability performance of cementitious grout. The grout mixtures are designed to achieve high strength and maintain flow properties in order to allow the cement slurries to infiltrate easily through unfilled compacted skeletons. A paired-sample t-test was carried out to find out whether water/cement ratio, SP percentages, and use of silica fume influence the cementitious grout performance. The findings showed that the replacement of 5% silica fume with an adequate amount of superplasticizer and water/cement ratio was beneficial in improving the properties of the cementitious grout. PMID:24526911

Clinical scale rapid expansion of lymphocytes for adoptive cell transfer therapy in the WAVE® bioreactor

PubMed Central

2012-01-01

Background To simplify clinical scale lymphocyte expansions, we investigated the use of the WAVE®, a closed system bioreactor that utilizes active perfusion to generate high cell numbers in minimal volumes. Methods We have developed an optimized rapid expansion protocol for the WAVE bioreactor that produces clinically relevant numbers of cells for our adoptive cell transfer clinical protocols. Results TIL and genetically modified PBL were rapidly expanded to clinically relevant scales in both static bags and the WAVE bioreactor. Both bioreactors produced comparable numbers of cells; however the cultures generated in the WAVE bioreactor had a higher percentage of CD4+ cells and had a less activated phenotype. Conclusions The WAVE bioreactor simplifies the process of rapidly expanding tumor reactive lymphocytes under GMP conditions, and provides an alternate approach to cell generation for ACT protocols. PMID:22475724

Effects of using silica fume and polycarboxylate-type superplasticizer on physical properties of cementitious grout mixtures for semiflexible pavement surfacing.

PubMed

Koting, Suhana; Karim, Mohamed Rehan; Mahmud, Hilmi; Mashaan, Nuha S; Ibrahim, Mohd Rasdan; Katman, Herdayati; Husain, Nadiah Md

2014-01-01

Semi-flexible pavement surfacing is a composite pavement that utilizes the porous pavement structure of the flexible bituminous pavement, which is subsequently grouted with appropriate cementitious materials. This study aims to investigate the compressive strength, flexural strength, and workability performance of cementitious grout. The grout mixtures are designed to achieve high strength and maintain flow properties in order to allow the cement slurries to infiltrate easily through unfilled compacted skeletons. A paired-sample t-test was carried out to find out whether water/cement ratio, SP percentages, and use of silica fume influence the cementitious grout performance. The findings showed that the replacement of 5% silica fume with an adequate amount of superplasticizer and water/cement ratio was beneficial in improving the properties of the cementitious grout.

Cost Avoidance vs. Utility Bill Accounting - Explaining theDiscrepancy Between Guaranteed Savings in ESPC Projects and UtilityBills

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

Kumar, S.; Sartor, D.

2005-08-15

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

Disparities in staging prostate magnetic resonance imaging utilization for nonmetastatic prostate cancer patients undergoing definitive radiation therapy.

PubMed

Ajayi, Ayobami; Hwang, Wei-Ting; Vapiwala, Neha; Rosen, Mark; Chapman, Christina H; Both, Stefan; Shah, Meera; Wang, Xingmei; Agawu, Atu; Gabriel, Peter; Christodouleas, John; Tochner, Zelig; Deville, Curtiland

2016-01-01

There is growing evidence supporting incorporating multiparametric (mp) magnetic resonance imaging (MRI) scans into risk stratification, active surveillance, and treatment paradigms for prostate cancer. The purpose of our study was to determine whether demographic disparities exist in staging MRI utilization for prostate cancer patients. An institutional database of 705 nonmetastatic prostate cancer patients treated with radiation therapy from 2005 through 2013 was used to identify patients undergoing versus not undergoing pretreatment diagnostic prostate mpMRI. Uni- and multivariable logistic regression evaluated the relationship of clinical and demographic characteristics with MRI utilization. All demographic variables assessed, except the other race category, were significantly associated with MRI utilization (all P < .05), including age (odds ratio [OR], 0.92), black race (OR, 0.51), poverty (OR, 0.53), closer distance to radiation facility (OR, 1.79), and nonprivate primary insurance (OR, 0.57) on univariable analysis, while clinical stage T3 (OR, 3.37) was the only clinical characteristic. On multivariable analysis stratified by D'Amico risk group, age remained significant across all risk groups, whereas the black versus white racial (OR, 0.21; 95% confidence interval, 0.08-0.55) and nonprivate versus private insurance type (OR, 0.37; 95% confidence interval, 0.16-0.86) disparities persisted in the low-risk group. Clinical stage T3 remained associated in the high-risk group. For race specifically, the percentages of whites, blacks, and others undergoing MRI in the overall cohort and by risk group were, respectively: overall, 80% (343/427), 68% (156/231), and 85% (40/47); low risk, 86%, 56%, and 63%; intermediate risk, 79%, 72%, and 95%; and high risk, 72%, 72%, and 100%. In this urban, academic center cohort, older patients across all risk groups and black or nonprivate insurance patients in the low risk group were less likely to undergo staging prostate MRI scans. Further research should investigate these differences to ensure equitable utilization across all demographic groups considering the burden of prostate cancer disparities.

Pre-use anesthesia machine check; certified anesthesia technician based quality improvement audit.

PubMed

Al Suhaibani, Mazen; Al Malki, Assaf; Al Dosary, Saad; Al Barmawi, Hanan; Pogoku, Mahdhav

2014-01-01

Quality assurance of providing a work ready machine in multiple theatre operating rooms in a tertiary modern medical center in Riyadh. The aim of the following study is to keep high quality environment for workers and patients in surgical operating rooms. Technicians based audit by using key performance indicators to assure inspection, passing test of machine worthiness for use daily and in between cases and in case of unexpected failure to provide quick replacement by ready to use another anesthetic machine. The anesthetic machines in all operating rooms are daily and continuously inspected and passed as ready by technicians and verified by anesthesiologist consultant or assistant consultant. The daily records of each machines were collected then inspected for data analysis by quality improvement committee department for descriptive analysis and report the degree of staff compliance to daily inspection as "met" items. Replaced machine during use and overall compliance. Distractive statistic using Microsoft Excel 2003 tables and graphs of sums and percentages of item studied in this audit. Audit obtained highest compliance percentage and low rate of replacement of machine which indicate unexpected machine state of use and quick machine switch. The authors are able to conclude that following regular inspection and running self-check recommended by the manufacturers can contribute to abort any possibility of hazard of anesthesia machine failure during operation. Furthermore in case of unexpected reason to replace the anesthesia machine in quick maneuver contributes to high assured operative utilization of man machine inter-phase in modern surgical operating rooms.

Determination of the relative percentage distribution of THCA and Δ(9)-THC in herbal cannabis seized in Austria - Impact of different storage temperatures on stability.

PubMed

Taschwer, Magdalena; Schmid, Martin G

2015-09-01

Cannabis is globally by far the most widespread illicit drug of abuse. Especially since its legalization in some of the US, controversies about the legal status of cannabis for recreational and medical use have come up. Δ(9)-Tetrahydrocannabinol (Δ(9)-THC), which is the major active ingredient in cannabis products, is mainly responsible for the psychoactive effects. Its inactive biosynthetic precursor tetrahydrocannabinolic acid (THCA) is present in different quantities in fresh and undried cannabis plants. Under influence of drying, temperature and UV exposure it decomposes to Δ(9)-THC. In this study, a quantification of Δ(9)-THC and THCA was carried out to check the stability of cannabis samples. The determination of the degradation of THCA to Δ(9)-THC in 29 cannabis products seized in Austria was monitored by HPLC-UV. Mobile phase consisted of a 25mM triethylammoniumphosphate buffer (pH 3.0) and acetonitrile (36:64). A common LiChrospher(®) 100 RP-18 column was utilized as stationary phase. To check the influence of low as well as high temperature on the degradation process of the cannabinoid THCA to Δ(9)-THC, samples were stored in a freezer or in a drying cabinet for a specified time period. It was shown successfully that high storage temperatures led to a more rapid and complete decomposition of THCA to Δ(9)-THC while at low temperatures only slight or no changes of the percentage distribution were determined. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Hydrostatic weighing, skinfold thickness, body mass index relationships in high school girls].

PubMed

Tahara, Y; Yukawa, K; Tsunawake, N; Saeki, S; Nishiyama, K; Urata, H; Katsuno, K; Fukuyama, Y; Michimukou, R; Uekata, M

1995-12-01

A study was conducted to evaluate body composition by hydrostatic weighing, skinfold thickness, and body mass index (BMI) in 102 senior high school girls, aged 15 to 18 in Nagasaki City. Body density measured by the underwater weighing method, was used to determine the fat weight (Fat) and lean body mass (LBM. or fat free weight: FFW) utilizing the formulas by Brozek et al. The results were as follows; 1. Mean values of body density were 1.04428 in the first grade girls, 1.04182 in the second grade, and 1.04185 in the third grade. 2. Mean values of percentage body fat (%Fat) were 23.5% in the first grade, 24.5% in the second and 24.5% in the third. 3. Percentage body fat (%Fat), lean body mass (LBM) and LBM/Height were not significantly with different advance of grade from the first to the third. 4. The correlation coefficients between percent body fat and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses and the sum of seven skinfold thicknesses was 0.78, 0.79, and 0.80 respectively and were all statistically significant (p < 0.001). 5. The correlation coefficients between BMI and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses and the sum of seven skinfold thicknesses was 0.74, 0.74, and 0.74 respectively and were all statistically significant (p < 0.001). 6. Mean values of BMI, Rohrer index and waist-hip ratio (WHR) in all subjects (n = 102) were 20.3, 128.2 and 0.72 respectively.

In vivo anthelmintic efficacy of Aloe ferox, Agave sisalana, and Gunnera perpensa in village chickens naturally infected with Heterakis gallinarum.

PubMed

Mwale, Marizvikuru; Masika, Patrick Julius

2015-01-01

The study was conducted to determine the anthelmintic efficacy of Aloe ferox, Agave sisalana, and Gunnera perpensa against Heterakis gallinarum in village chickens. The chickens naturally infected with H. gallinarum were randomly divided into 14 groups of eight chickens and orally administered distilled water (negative control), mebendazole (positive control), and graded levels (50-, 100-, 200-, and 400-mg/kg doses) of the three plant extracts. At days 0, 7, and 14, the floatation technique was used to determine fecal egg counts and H. gallinarum worms from chicken ceca were counted at days 0 and 14. Egg count reduction percentage (ECR%) was high at day 7 for all the test materials except for A. sisalana (100 mg/kg) that had 33%. At day 14, ECR% was high for all the other test materials save for A. ferox (200 mg/kg), mebendazole, and distilled water which was 50, 32, and 50%, respectively. A. ferox (200 mg/kg), G. perpensa (200 and 400 mg/kg), and A. sisalana (50 and 100 mg/kg) had the highest (85, 78, 74, 86, and 73%, respectively) worm count reduction percentage. The plants had anthelmintic properties. Advocacy and utilization of these plants in improving the health of village chickens could lead to increased productivity, boosting profits for the poultry industry thereby enabling it to meet the supply of animal protein and enhance livelihoods. It is imperative to determine compounds in the crude extracts of these medicinal plants which are responsible for the anthelmintic activities and their mechanism of action.

U.S. Math Performance in Global Perspective: How Well Does Each State Do at Producing High-Achieving Students? PEPG Report No.: 10-19

ERIC Educational Resources Information Center

Hanushek, Eric A.; Peterson, Paul E.; Woessmann, Ludger

2010-01-01

To see how well U.S. schools do at producing high-achieving math students, the authors compare the percentage of U.S. public and private school students in the graduating Class of 2009 who were highly accomplished in mathematics in each of the 50 states and in 10 urban districts to percentages of high achievers in 56 other countries. Their…

Percentage tumor necrosis following chemotherapy in neuroblastoma correlates with MYCN status but not survival.

PubMed

Bomken, Simon; Davies, Beverley; Chong, Leeai; Cole, Michael; Wood, Katrina M; McDermott, Michael; Tweddle, Deborah A

2011-03-01

The percentage of chemotherapy-induced necrosis in primary tumors corresponds with outcome in several childhood malignancies, including high-risk metastatic diseases. In this retrospective pilot study, the authors assessed the importance of postchemotherapy necrosis in high-risk neuroblastoma with a histological and case notes review of surgically resected specimens. The authors reviewed all available histology of 31 high-risk neuroblastoma cases treated with COJEC (dose intensive etoposide and vincristine with either cyclophosphamide, cisplatin or carboplatin) or OPEC/OJEC (etoposide, vincristine and cyclophosphamide with alternating cisplatin [OPEC] or carboplatin [OJEC]) induction chemotherapy in 2 Children's Cancer & Leukaemia Group (CCLG) pediatric oncology centers. The percentage of postchemotherapy necrosis was assessed and compared with MYCN amplification status and overall survival. The median percentage of postchemotherapy tumor necrosis was 60%. MYCN status was available for 28 cases, of which 12 were amplified (43%). Survival in cases with ≥ 60% necrosis or ≥ 90% necrosis was not better than those with less necrosis, nor was percentage necrosis associated with survival using Cox regression. However, MYCN-amplified tumors showed a higher percentage of necrosis than non-MYCN-amplified tumors, 71.3% versus 37.2% (P = .006). This effect was not related to prechemotherapy necrosis and did not confer improved overall survival. Postchemotherapy tumor necrosis is higher in patients with MYCN amplification. In this study, postchemotherapy necrosis did not correlate with overall survival and should not lead to modification of postoperative treatment. However, these findings need to be confirmed in a larger prospective study of children with high-risk neuroblastoma.

Electric utility franchise guide

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

Not Available

Through franchise agreements, municipalities grant energy providers the use of public easements for the transmission of electricity and natural gas from power sources to consumers. Generally, access to the public rights-of-way is generated in exchange for the payment to the City of a percentage of the gross revenues of the utility. This Guide presents a Model Electric Utility Franchise Agreement, structured by the city of Houston, to address cost-saving and revenue-enhancing issues that should be considered by any municipality in both the day-to-day administration of existing franchises, and at the time of franchise renewal and renegotiation. In addition to themore » model agreement this Guide includes Explanatory Comments that provide the basis and rationale for certain sections of the agreement as well as a Summary of Major Elements of franchise agreements in over sixty US municipalities.« less

Effect of x-radiation to brain on cerebral glucose utilization in the rat.

PubMed

D'Aquino, S; Cicciarello, R; D'Avella, D; Mesiti, M; Albiero, F; Princi, P; Gagliardi, M E; Russi, E; D'Aquino, A

1990-01-01

We assessed, by means of the [14C]-2-deoxy-D-glucose autoradiography method, the effect of whole-brain x-radiation on local cerebral glucose utilization in the rat brain. Animals were exposed to conventional fractionation (200 +/- cGy/day given 5 days a week) to a total dose of 4000 cGy. Metabolic experiments were made 2 weeks after completion of the radiation exposure. In comparison with control and sham-irradiated animals, cerebral metabolic activity was diffusely decreased following irradiation. Statistically significant decreases in metabolic activity were observed in 13 of 27 brain regions studied. In general, brain areas with the highest basal metabolic rates showed the greatest percentage drop of glucose utilization. Post-irradiation metabolic alterations possibly provide an explanation for the syndrome of early delayed deterioration observed in humans after whole-brain radiotherapy.

Space Station Freedom biomedical monitoring and countermeasures: Biomedical facility hardware catalog

NASA Technical Reports Server (NTRS)

1990-01-01

This hardware catalog covers that hardware proposed under the Biomedical Monitoring and Countermeasures Development Program supported by the Johnson Space Center. The hardware items are listed separately by item, and are in alphabetical order. Each hardware item specification consists of four pages. The first page describes background information with an illustration, definition and a history/design status. The second page identifies the general specifications, performance, rack interface requirements, problems, issues, concerns, physical description, and functional description. The level of hardware design reliability is also identified under the maintainability and reliability category. The third page specifies the mechanical design guidelines and assumptions. Described are the material types and weights, modules, and construction methods. Also described is an estimation of percentage of construction which utilizes a particular method, and the percentage of required new mechanical design is documented. The fourth page analyzes the electronics, the scope of design effort, and the software requirements. Electronics are described by percentages of component types and new design. The design effort, as well as, the software requirements are identified and categorized.

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.

HIGH SCHOOL ENROLLMENTS IN LATIN, 1964-65.

ERIC Educational Resources Information Center

GOLDBERG, SAMUEL A.

A MODERN LANGUAGE ASSOCIATION (MLA) STATISTICAL SURVEY SHOWS THE NUMBER OF STUDENTS STUDYING FRENCH, SPANISH, GERMAN, OR LATIN IN THE SECONDARY SCHOOLS DURING EACH SCHOOL YEAR FROM 1958-59 TO 1964-65, THE PERCENTAGE STUDYING EACH LANGUAGE IN RELATION TO THE TOTAL HIGH SCHOOL POPULATION, AND THE PERCENTAGE STUDYING LATIN IN RELATION TO THE TOTAL…

Comparison of menopause healthcare considerations between Japanese and Filipino women living in local communities.

PubMed

Matsuo, Hiroya; Yamanaka, Rie; Senba, Naomi; Beltran, Ruth; Ladines-Llave, Cecilia; Blanco-Capito, Loudes

2012-12-13

To investigate the involvement of psychological/social factors in the condition of climacteric disturbance in Japan and the Philippines, we examined the menopausal symptoms and psychological/social factors in menopausal women living in local communities and compared among both countries whether differences in culture, lifestyle, etc. affected the condition of climacteric disturbance. High percentages of Japanese women reported mental symptoms, while relatively high percentages of Filipino women also experienced motor neurological symptoms in addition to psychoneurological symptoms. Japanese and Filipino women were found to have different stressors: a high percentage of the Japanese women had problems involving human relationships, such as providing nursing care, while a high percentage of the Filipino women had household problems, including husband's health and financial problems. Stress severity was associated with SMI scores in both countries. A poorer marital relationship in Japan than in the Philippines and an association between marital relationship and SMI scores were found. The present study suggests the association of differences in psychological/social factors between Japanese and Filipino women with differences in menopausal symptoms.

Quality Characteristics of Appalachian Red Oak Lumber

Treesearch

Janice K Wiedenbeck; Charles J. Gatchell; Elizabeth S. Walker

1995-01-01

Red oak lumber defect information derived from a well-constructed board data bank was analyzed. The potential utility of No. 1 Common and No. 2A Common lumber is indicated by the finding that 23 percent of the No. 1 Common boards and 35 percent of the No. 2A Common boards in the data bank contain clear-face cutting percentages that meet the minimum requirement for the...

26 CFR 1.411(a)-5 - Service included in determination of nonforfeitable percentage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... service. A year of service which is not required to be taken into account by reason of a break in service... on the last day of the year is a break in service rule because employees can lose benefits by reason..., such year may not be excluded by reason of this subparagraph. In the case of a plan utilizing the...

Comparison of Body Mass Index (BMI) Categories Based on Asian and Universal Standards and Language Spoken at Home among Asian American University Students

ERIC Educational Resources Information Center

Ng, Tiffany; McMahan, Shari; Mouttapa, Michele; Tanjasiri, Sora Park; Beam, William

2009-01-01

Background: The World Health Organization released lower Body Mass Index (BMI) cutoff points for Asian individuals to account for increased body fat percentage (BF%) and risk of obesity-related conditions at a lower body mass index. Purpose: This preliminary study: (1) explores the impact of utilizing Asian BMI standards (compared to universal…

Opportunities for expanded and higher value utilization of No. 3A Common hardwood lumber

Treesearch

Brian P. Shepley; Jan Wiedenbeck; Robert L. Smith

2004-01-01

The percentage of low-grade material composing the annual hardwood lumber production in the United States is on the rise. As a result, finding markets for low-grade and low-value lumber has been identified as a top priority by researchers and industry associations. This research used the ROMI-RIP and ROMI-CROSS simulation programs to determine specific conditions that...

How fuel treatment types, locations, and amounts impact landscape-scale fire behavior and carbon dynamics

Treesearch

Christopher A. Dicus; Kevin J. Osborne

2015-01-01

When managing for fire across a large landscape, the types of fuel treatments, the locations of treatments, and the percentage of the landscape being treated should all interact to impact not only potential fire size, but also carbon dynamics across that landscape. To investigate these interactions, we utilized a forest growth model (FVS-FFE) and fire simulation...

76 FR 10471 - Tart Cherries Grown in the States of Michigan, et al.; Final Free and Restricted Percentages for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-25

... of the prior three years 170 (2) Plus desirable carryout 0 (3) Optimum supply calculated by the Board... Formula: (1) Average sales of the prior three years 170 (2) Plus desirable carryout 0 (3) Optimum supply... was frozen, 27 percent was canned, and 12 percent was utilized for juice and other products. Based on...

More Rhode Island Adults Have Dental Coverage After the Medicaid Expansion: Did More Adults Receive Dental Services? Did More Dentists Provide Services?

PubMed

Zwetchkenbaum, Samuel; Oh, Junhie

2017-10-02

Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].

Drug utilization and teratogenicity risk categories during pregnancy.

PubMed

Basgül, Alin; Akici, Ahmet; Uzuner, Arzu; Kalaça, Sibel; Kavak, Zehra N; Tural, Alper; Oktay, Sule

2007-01-01

A limited number of studies have investigated in detail the use of drugs during pregnancy. Researchers in the present study investigated the details of drug utilization in pregnant women during the month before pregnancy, at the time that they became aware of the pregnancy, and during the first trimester. Face-to-face interviews were conducted with 359 pregnant women who were admitted to the fetal medicine unit at a university hospital for diagnosis and follow-up. A questionnaire was used to document sociodemographic characteristics and details of drug use. Drugs were categorized according to the US Food and Drug Administration fetal risk classification. Mean maternal age was 29.9+/-5.1 y, and mean gestational age was 19.6+/-9.5 wk. Many of the pregnant women studied (46.6%) were university graduates, and most (61.9%) had a relatively high annual income. Mean gestational age when participants first learned of their pregnancy was 39.8+/-16.4 d. One hundred seventeen participants (32.6%) used drugs during the month before conception, 54 (15%) at the time when they learned of their pregnancy, 180 (50.1%) at the time of the interview, and 289 (80.5%) during the first trimester. The percentages of drugs in categories D and X used by these subjects were 14%, 13.5%, 2.9%, and 5.9%, respectively. Most of the drugs were hormones. The total rate of drug utilization was not high before and during the first trimester of pregnancy. A considerable number of women were using drugs from the D and X categories; however, these numbers decreased significantly when women learned of their pregnancies. Intake of folic acid, vitamins, and iron was very low during the preconception period and was not high enough during the first trimester; this suggests that particular attention should be paid to the use of beneficial "safe" drugs during the preconception and early pregnancy periods.

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

Chen, Aiying; Liu, Jiabin; Wang, Hongtao

Gradient materials often have attractive mechanical properties that outperform uniform microstructure counterparts. It remains a difficult task to investigate and compare the performance of various gradient microstructures due to the difficulty of fabrication, the wide range of length scales involved, and their respective volume percentage variations. We have investigated four types of gradient microstructures in 304 stainless steels that utilize submicrotwins, nanotwins, nanocrystalline-, ultrafine- and coarse-grains as building blocks. Tensile tests reveal that the gradient microstructure consisting of submicrotwins and nanotwins has a persistent and stable work hardening rate and yields an impressive combination of high strength and high ductility,more » leading to a toughness that is nearly 50% higher than that of the coarse-grained counterpart. Ex- and in-situ transmission electron microscopy indicates that nanoscale and submicroscale twins help to suppress and limit martensitic phase transformation via the confinement of martensite within the twin lamellar. Twinning and detwinning remain active during tensile deformation and contribute to the work hardening behavior. We discuss the advantageous properties of using submicrotwins as the main load carrier and nanotwins as the strengthening layers over those coarse and nanocrystalline grains. Furthermore, our work uncovers a new gradient design strategy to help metals and alloys achieve high strength and high ductility.« less

77 FR 75420 - Applications for New Awards; Indian Education-Demonstration Grants for Indian Children

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-20

... development as evidenced by a pre- and post-test each project year; (2) the percentage of three- and four-year... post-test each project year; (3) the percentage of three- and four-year-old American Indian and Alaska... development as evidenced by a pre- and post-test each project year; (4) the percentage of high school American...

Accumulation of genistein and daidzein, soybean isoflavones implicated in promoting human health, is significantly elevated by irrigation.

PubMed

Bennett, John O; Yu, Oliver; Heatherly, Larry G; Krishnan, Hari B

2004-12-15

To circumvent drought conditions persisting during seed fill in the mid-south U.S. soybean production region, researchers have developed the early soybean (Glycine max [L.] Merr.) production system (ESPS), which entails early planting of short-season varieties. Because soybean supplies a preponderance of the world's protein and oil and consumption of soy-based foods has been associated with multiple health benefits, the effects of this agronomic practice on seed quality traits such as protein, oil, and isoflavones should be investigated. Four cultivars of soybean, two from maturity group IV and two from maturity group V, were planted in April (ESPS) and May (traditional) in a two-year study at Stoneville, MS. Near-infrared analysis of soybean seed was utilized to determine the percentages of protein and oil. Dependent upon variety, the oil content of the early-planted crop was increased by 3-8%, whereas protein was not significantly changed. Visualization of protein extracts fractionated by sodium dodecyl sulfate-polyacrylamide electrophoresis and fluorescence two-dimensional difference gel electrophoresis revealed that early planting did not affect the relative accumulation of the major seed-storage proteins; thus, protein composition was equal to that of traditionally cultivated soybeans. Maturity group IV cultivars contained a higher percentage of oil and a lower percentage of protein than did the maturity group V cultivars, regardless of planting date. Gas chromatographic separation of fatty acids revealed that the percentages of saturated and unsaturated fatty acids were not significantly altered by planting date. Methanol extracts of seed harvested from different planting dates when analyzed by high-performance liquid chromatography showed striking differences in isoflavone content. Dependent upon the variety, total isoflavone content was increased as much as 1.3-fold in early-planted soybeans. Irrigation enhanced the isoflavone content of both early- and late-planted soybeans as much as 2.5-fold. Accumulation of individual isoflavones, daidzein and genistein, was also elevated by irrigation. Because this cultural practice improves the quality traits of seeds, ESPS provides an opportunity for enhancing the quality of soybean.

Social-ecological predictors of global invasions and extinctions

USGS Publications Warehouse

Lotz, Aaron; Allen, Craig R.

2013-01-01

Most assessments of resilience have been focused on local conditions. Studies focused on the relationship between humanity and environmental degradation are rare, and are rarely comprehensive. We investigated multiple social-ecological factors for 100 countries around the globe in relation to the percentage of invasions and extinctions within each country. These 100 countries contain approximately 87% of the world’s population, produce 43% of the world’s per capita gross domestic product (GDP), and take up 74% of the earth’s total land area. We used an information theoretic approach to determine which models were most supported by our data, utilizing an a priori set of plausible models that included a combination of 15 social-ecological variables, each social-ecological factor by itself, and selected social-ecological factors grouped into three broad classes. These variables were per capita GDP, export-import ratio, tourism, undernourishment, energy efficiency, agricultural intensity, rainfall, water stress, wilderness protection, total biodiversity, life expectancy, adult literacy, pesticide regulation, political stability, and female participation in government. Our results indicate that as total biodiversity and total land area increase, the percentage of endangered birds also increases. As the independent variables (agricultural intensity, rainfall, water stress, and total biodiversity) in the ecological class model increase, the percentage of endangered mammals in a country increases. The percentage of invasive birds and mammals in a country increases as per capita GDP increases. As life expectancy increases, the percentage of invasive and endangered birds and mammals increases. Although our analysis does not determine mechanisms, the patterns observed in this study provide insight into the dynamics of a complex, global, social-ecological system.

The aging of America: a comprehensive look at over 25,000 geriatric trauma admissions to United States hospitals.

PubMed

Maxwell, Cathy A; Miller, Richard S; Dietrich, Mary S; Mion, Lorraine C; Minnick, Ann

2015-06-01

A 2001 study on geriatric trauma by trauma center (TC) status was based on 1989 Medicare data. The purpose of this study was to compare 1989 findings with a 2009 sample, and to examine patient characteristics and outcomes by TC status. From 2009 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP NIS) data, we examined a geographically representative sample (n = 25,512) of injured older adults (>/= age 65) admitted to 127 TCs and non-TCs in 24 states. Data analysis included descriptive statistics for eight patient characteristics and four outcome variables (mortality, discharge disposition, length of stay, and total charges). χ(2) tests were conducted to examine differences between 1989 and 2009 for age groups, gender, and mortality. Higher percentages of patients were in older age groups in 2009, however mortality declined overall (4.8% vs 3.4%, P < .001). Consistent incremental patterns of differences were observed among TC levels for all patient characteristics and outcomes. Level I TCs admitted highest percentages of: lower age groups, males, nonwhite race, motor-vehicle related trauma, and intracranial injuries. Non-TCs admitted highest percentages of oldest age groups, comorbidities, falls, femur neck fractures, and patients requiring OR procedures. Although Level I TCs had higher lengths of stay and total charges, a higher percentage of patients were discharged home. Despite a growing number of patients in older age groups, inpatient mortality declined over two decades. Level I TCs are managing patients at highest risk for decompensation and mortality; a significant percentage of patients are going to non-TCs.

Modeling syngas-fired gas turbine engines with two dilutants

NASA Astrophysics Data System (ADS)

Hawk, Mitchell E.

2011-12-01

Prior gas turbine engine modeling work at the University of Wyoming studied cycle performance and turbine design with air and CO2-diluted GTE cycles fired with methane and syngas fuels. Two of the cycles examined were unconventional and innovative. The work presented herein reexamines prior results and expands the modeling by including the impacts of turbine cooling and CO2 sequestration on GTE cycle performance. The simple, conventional regeneration and two alternative regeneration cycle configurations were examined. In contrast to air dilution, CO2 -diluted cycle efficiencies increased by approximately 1.0 percentage point for the three regeneration configurations examined, while the efficiency of the CO2-diluted simple cycle decreased by approximately 5.0 percentage points. For CO2-diluted cycles with a closed-exhaust recycling path, an optimum CO2-recycle pressure was determined for each configuration that was significantly lower than atmospheric pressure. Un-cooled alternative regeneration configurations with CO2 recycling achieved efficiencies near 50%, which was approximately 3.0 percentage points higher than the conventional regeneration cycle and simple cycle configurations that utilized CO2 recycling. Accounting for cooling of the first two turbine stages resulted in a 2--3 percentage point reduction in un-cooled efficiency, with air dilution corresponding to the upper extreme. Additionally, when the work required to sequester CO2 was accounted for, cooled cycle efficiency decreased by 4--6 percentage points, and was more negatively impacted when syngas fuels were used. Finally, turbine design models showed that turbine blades are shorter with CO2 dilution, resulting in fewer design restrictions.

Supplementing healthy rats with a high-niacin dose has no effect on muscle fiber distribution and muscle metabolic phenotype.

PubMed

Scholz, Kristen; Kynast, Anna Marie; Couturier, Aline; Mooren, Frank-Christoph; Krüger, Karsten; Most, Erika; Eder, Klaus; Ringseis, Robert

2014-08-01

It was recently shown that niacin prevents the obesity-induced type I to type II fiber switching in skeletal muscle of obese rats and favors the development of a more oxidative metabolic phenotype and thereby increases whole body utilization of fatty acids. Whether niacin also causes type II to type I fiber switching in skeletal muscle of healthy rats has not been investigated yet. Thus, the present study aimed to investigate whether niacin supplementation influences fiber distribution and metabolic phenotype of different skeletal muscles with a distinct type I-to-type II fiber ratio in healthy rats. Twenty-four male, 10-week-old Sprague-Dawley rats were randomly assigned into two groups of 12 rats each and fed either a control diet with 30 mg supplemented niacin/kg diet (control group) or a high-niacin diet with 780 mg supplemented niacin/kg diet (high-niacin group). After 27 days of treatment, the percentage number of type I fibers in rectus femoris, gastrocnemius, and tibialis anterior muscles was 5-10% greater in the niacin group than in the control group, but did not differ between groups in soleus and vastus intermedius muscles. Transcript levels of genes encoding transcription factors regulating fiber switching, fiber-specific myosin heavy chain isoforms, and proteins involved in fatty acid utilization, oxidative phosphorylation, and angiogenesis did not differ between groups. The results show that niacin has only negligible effects on fiber distribution and its regulation as well as the metabolic phenotype of skeletal muscle in healthy rats.

Net-infiltration map of the Navajo Sandstone outcrop area in western Washington County, Utah

USGS Publications Warehouse

Heilweil, Victor M.; McKinney, Tim S.

2007-01-01

As populations grow in the arid southwestern United States and desert bedrock aquifers are increasingly targeted for future development, understanding and quantifying the spatial variability of net infiltration and recharge becomes critically important for inventorying groundwater resources and mapping contamination vulnerability. A Geographic Information System (GIS)-based model utilizing readily available soils, topographic, precipitation, and outcrop data has been developed for predicting net infiltration to exposed and soil-covered areas of the Navajo Sandstone outcrop of southwestern Utah. The Navajo Sandstone is an important regional bedrock aquifer. The GIS model determines the net-infiltration percentage of precipitation by using an empirical equation. This relation is derived from least squares linear regression between three surficial parameters (soil coarseness, topographic slope, and downgradient distance from outcrop) and the percentage of estimated net infiltration based on environmental tracer data from excavations and boreholes at Sand Hollow Reservoir in the southeastern part of the study area.Processed GIS raster layers are applied as parameters in the empirical equation for determining net infiltration for soil-covered areas as a percentage of precipitation. This net-infiltration percentage is multiplied by average annual Parameter-elevation Regressions on Independent Slopes Model (PRISM) precipitation data to obtain an infiltration rate for each model cell. Additionally, net infiltration on exposed outcrop areas is set to 10 percent of precipitation on the basis of borehole net-infiltration estimates. Soils and outcrop net-infiltration rates are merged to form a final map.Areas of low, medium, and high potential for ground-water recharge have been identified, and estimates of net infiltration range from 0.1 to 66 millimeters per year (mm/yr). Estimated net-infiltration rates of less than 10 mm/yr are considered low, rates of 10 to 50 mm/yr are considered medium, and rates of more than 50 mm/yr are considered high. A comparison of estimated net-infiltration rates (determined from tritium data) to predicted rates (determined from GIS methods) at 12 sites in Sand Hollow and at Anderson Junction indicates an average difference of about 50 percent. Two of the predicted values were lower, five were higher, and five were within the estimated range. While such uncertainty is relatively small compared with the three order-of-magnitude range in predicted net-infiltration rates, the net-infiltration map is best suited for evaluating relative spatial distribution rather than for precise quantification of recharge to the Navajo aquifer at specific locations. An important potential use for this map is land-use zoning for protecting high net-infiltration parts of the aquifer from potential surface contamination.

Gradient twinned 304 stainless steels for high strength and high ductility

DOE PAGES

Chen, Aiying; Liu, Jiabin; Wang, Hongtao; ...

2016-04-23

Gradient materials often have attractive mechanical properties that outperform uniform microstructure counterparts. It remains a difficult task to investigate and compare the performance of various gradient microstructures due to the difficulty of fabrication, the wide range of length scales involved, and their respective volume percentage variations. We have investigated four types of gradient microstructures in 304 stainless steels that utilize submicrotwins, nanotwins, nanocrystalline-, ultrafine- and coarse-grains as building blocks. Tensile tests reveal that the gradient microstructure consisting of submicrotwins and nanotwins has a persistent and stable work hardening rate and yields an impressive combination of high strength and high ductility,more » leading to a toughness that is nearly 50% higher than that of the coarse-grained counterpart. Ex- and in-situ transmission electron microscopy indicates that nanoscale and submicroscale twins help to suppress and limit martensitic phase transformation via the confinement of martensite within the twin lamellar. Twinning and detwinning remain active during tensile deformation and contribute to the work hardening behavior. We discuss the advantageous properties of using submicrotwins as the main load carrier and nanotwins as the strengthening layers over those coarse and nanocrystalline grains. Furthermore, our work uncovers a new gradient design strategy to help metals and alloys achieve high strength and high ductility.« less

Making STEM Fun: How to Organize a STEM Camp

ERIC Educational Resources Information Center

Davis, Kimberly E. Bryant; Hardin, Stacey E.

2013-01-01

The work from the University of Central Florida's STEM summer camp (sponsored by Workforce Central Florida) is shared. The camps targeted low-SES schools with a high percentage of students on free and reduced lunch as well as high percentages of students with. Students were given preassessments and postassessments to gauge their knowledge of and…

Non-destructive prediction of 'Hass' avocado dry matter via FT-NIR spectroscopy.

PubMed

Wedding, Brett B; White, Ronald D; Grauf, Steve; Wright, Carole; Tilse, Bonnie; Hofman, Peter; Gadek, Paul A

2011-01-30

The inability to consistently guarantee internal quality of horticulture produce is of major importance to the primary producer, marketers and ultimately the consumer. Currently, commercial avocado maturity estimation is based on the destructive assessment of percentage dry matter (%DM), and sometimes percentage oil, both of which are highly correlated with maturity. In this study the utility of Fourier transform (FT) near-infrared spectroscopy (NIRS) was investigated for the first time as a non-invasive technique for estimating %DM of whole intact 'Hass' avocado fruit. Partial least squares regression models were developed from the diffuse reflectance spectra to predict %DM, taking into account effects of intra-seasonal variation and orchard conditions. It was found that combining three harvests (early, mid and late) from a single farm in the major production district of central Queensland yielded a predictive model for %DM with a coefficient of determination for the validation set of 0.76 and a root mean square error of prediction of 1.53% for DM in the range 19.4-34.2%. The results of the study indicate the potential of FT-NIRS in diffuse reflectance mode to non-invasively predict %DM of whole 'Hass' avocado fruit. When the FT-NIRS system was assessed on whole avocados, the results compared favourably against data from other NIRS systems identified in the literature that have been used in research applications on avocados. 2010 Society of Chemical Industry.

Interaction of beaver and elk herbivory reduces standing crop of willow

USGS Publications Warehouse

Baker, B.W.; Mitchell, D.C.S.; Ducharme, H.C.; Stanley, T.R.; Peinetti, H.R.

2005-01-01

Populations of beaver and willow have not thrived in riparian environments that are heavily browsed by livestock or ungulates, such as elk. The interaction of beaver and elk herbivory may be an important mechanism underlying beaver and willow declines in this competitive environment. We conducted a field experiment that compared the standing crop of willow three years after simulated beaver cutting on paired plants with and without intense elk browsing (∼85% utilization rate). Simulated beaver cutting with intense elk browsing produced willow that was small (biomass and diameter) and short, with far fewer, but longer, shoots and a higher percentage of dead biomass. In contrast, simulated beaver cutting without elk browsing produced willow that was large, tall, and leafy, with many more, but shorter, shoots (highly branched) and a lower percentage of dead biomass. Total stem biomass after three years was 10 times greater on unbrowsed plants than on browsed plants. Unbrowsed plants recovered 84% of their pre-cut biomass after only two growing seasons, whereas browsed plants recovered only 6%. Thus, the interaction of beaver cutting and elk browsing strongly suppressed the standing crop of willow. We predict that a lack of willow suitable as winter food for beaver can cause beaver populations to decline, creating a feedback mechanism that reduces beaver and willow populations. Thus, intense herbivory by ungulates or livestock can disrupt beaver–willow mutualisms that naturally occur in less competitive environments.

NC-TEST: noncontact thermal emissions screening technique for drug and alcohol detection

NASA Astrophysics Data System (ADS)

Prokoski, Francine J.

1997-01-01

Drug abuse is highly correlated with criminal behavior. The typical drug-using criminal commits hundreds of crimes per year. The crime rate cannot be significantly reduced without a reduction in the percentage of the population abusing drugs and alcohol. Accurate and timely estimation of that percentage is important for policy decisions concerning crime control, public health measures, allocation of intervention resources for prevention and treatment, projections of criminal justice needs, and the evaluation of policy effectiveness. Such estimation is particularly difficult because self reporting is unreliable; and physical testing has to date required blood or urine analysis which is expensive and invasive, with the result that too few people are tested. MIKOS Ltd. has developed a non-contact, passive technique with the potential for automatic, real- time screening for drug and alcohol use. The system utilizes thermal radiation which is spontaneously and continuously emitted by the human body. Facial thermal patterns and changes in patterns are correlated with standardized effects of specific drugs and alcohol. A portable system incorporating the collection and analysis technique can be used episodically to collect data for estimating drug and alcohol use by general unknown populations such as crowds at airports, or it can be used for repetitive routine screening of specific known groups such as airline pilots, military personnel, school children, or persons on probation or parole.

[Prescribing and drug utilization at community health centers].

PubMed

Diawara, A; Sangho, H; Maiga, D; Kone, A B D; Maiga, M D; Simaga, S Y

2007-01-01

The rationalization of the prescription and the good use of the drugs generally constitute a major problem in the health facilities. The present survey led in November 2002 in Mali assessed the practices of prescription and the use of the drugs by the populations. The indicators of drugs use rational have been measured from 600 drawn prescriptions randomly select at the level of 20 community health center (CSCOM) retained at random in the regions of Ségou, Sikasso, Mopti and the District of Bamako. The means of drugs by order (2.8), the percentages of prescription with antibiotic (61.6%) and injectable drugs (35%) are raised in relation to the normative values of WHO (Wold Health Organization). The rate of conformity to the treatments standardized estimated on exploitation of consultations registers in the centers is estimated to 0.5% for the simple diarrhoea, 13.5% for the acute respiratory infections (ARI) without pneumonia and 60.5% for the pneumonia. On 293 patients in the households our survey permitted to estimate to 84.6% the observance of the treatment by the persons having bought the prescribed drugs totality. The percentage of antibiotics prescription and injectable drugs, and the big insufficiency in the non respect of the treatment standard constitutes some practices potentially to high risk justifying the necessity of an urgent training to the rational prescription.

Racial Identification, Racial Composition, and Substance Use Vulnerability Among African American Adolescents and Young Adults

PubMed Central

Stock, Michelle L.; Gerrard, Meg; Weng, Chih-Yuan; Gibbons, Frederick X.; Houlihan, Amy E.; Lorenz, Fred O.; Simons, Ronald L.

2013-01-01

Objective Two studies examined racial identity (RI) as a protective factor against substance-related cognitions and substance use among Black adolescents and young adults living in high versus low percentage Black social environments. Method Using structural equation modeling techniques, Study 1 examined longer term effects of RI on substance use cognitions and behaviors among 720 Black adolescents. Study 2 examined the impact of RI and percentage Black peer environment on alcohol use among 203 Black young adults. Results Study 1 revealed that RI was prospectively associated with lower levels of perceived friends’ use and lower favorability of the substance user prototype and, in turn, lower substance willingness and use, but only among Black adolescents in predominantly White neighborhoods. These adolescents also reported greater access to substances. In Study 2, low RI Black young adults who reported predominantly White peer environments reported the highest levels of alcohol use. Conclusions These findings highlight the importance of RI among Black youth and the impact of the social context on the health risk behaviors of adolescents and young adults. This research also demonstrates the utility of social psychological models, such as the prototype–willingness model, to examine mediating and moderating effects of individual differences and contextual factors on health risk cognitions and behavior. Theoretical and applied implications of the results are discussed. PMID:23088177

Aggregation of Adenovirus 2 in Source Water and Impacts on Disinfection by Chlorine

PubMed Central

Cromeans, Theresa L.; Metcalfe, Maureen G.; Humphrey, Charles D.; Hill, Vincent R.

2016-01-01

It is generally accepted that viral particles in source water are likely to be found as aggregates attached to other particles. For this reason, it is important to investigate the disinfection efficacy of chlorine on aggregated viruses. A method to produce adenovirus particle aggregation was developed for this study. Negative stain electron microscopy was used to measure aggregation before and after addition of virus particles to surface water at different pH and specific conductance levels. The impact of aggregation on the efficacy of chlorine disinfection was also examined. Disinfection experiments with human adenovirus 2 (HAdV2) in source water were conducted using 0.2 mg/L free chlorine at 5 °C. Aggregation of HAdV2 in source water (≥3 aggregated particles) remained higher at higher specific conductance and pH levels. However, aggregation was highly variable, with the percentage of particles present in aggregates ranging from 43 to 71 %. Upon addition into source water, the aggregation percentage dropped dramatically. On average, chlorination CT values (chlorine concentration in mg/L × time in min) for 3-log10 inactivation of aggregated HAdV2 were up to three times higher than those for dispersed HAdV2, indicating that aggregation reduced the disinfection rate. This information can be used by water utilities and regulators to guide decision making regarding disinfection of viruses in water. PMID:26910058

Aggregation of Adenovirus 2 in Source Water and Impacts on Disinfection by Chlorine.

PubMed

Kahler, Amy M; Cromeans, Theresa L; Metcalfe, Maureen G; Humphrey, Charles D; Hill, Vincent R

2016-06-01

It is generally accepted that viral particles in source water are likely to be found as aggregates attached to other particles. For this reason, it is important to investigate the disinfection efficacy of chlorine on aggregated viruses. A method to produce adenovirus particle aggregation was developed for this study. Negative stain electron microscopy was used to measure aggregation before and after addition of virus particles to surface water at different pH and specific conductance levels. The impact of aggregation on the efficacy of chlorine disinfection was also examined. Disinfection experiments with human adenovirus 2 (HAdV2) in source water were conducted using 0.2 mg/L free chlorine at 5 °C. Aggregation of HAdV2 in source water (≥3 aggregated particles) remained higher at higher specific conductance and pH levels. However, aggregation was highly variable, with the percentage of particles present in aggregates ranging from 43 to 71 %. Upon addition into source water, the aggregation percentage dropped dramatically. On average, chlorination CT values (chlorine concentration in mg/L × time in min) for 3-log10 inactivation of aggregated HAdV2 were up to three times higher than those for dispersed HAdV2, indicating that aggregation reduced the disinfection rate. This information can be used by water utilities and regulators to guide decision making regarding disinfection of viruses in water.

Depression's moderation of the effectiveness of intensive case management with substance-dependent women on temporary assistance for needy families: outpatient substance use disorder treatment utilization and outcomes.

PubMed

Kuerbis, Alexis N; Neighbors, Charles J; Morgenstern, Jon

2011-03-01

Intensive case management (ICM) is effective for facilitating entry into and retention in outpatient substance use disorder treatment (OSUDT) for low-income substance-dependent women; however, no studies have specifically examined the moderating impact of depressive symptoms on ICM. The purpose of this study was to investigate whether depressive symptoms moderated ICM's effect on OSUDT engagement, attendance, and outcomes for substance-dependent women on Temporary Assistance for Needy Families (TANF). It was hypothesized that highly depressed women would demonstrate worse outcomes on all indicators. Logistic regression and generalized estimating equations were used to determine depression's moderating impact on ICM in a secondary analysis of data from a randomized controlled trial comparing the effectiveness of ICM to usual care provided by local public assistance offices in Essex County, NJ. Substance-dependent women (N = 294) were recruited while being screened for TANF eligibility and were followed for 24 months. Findings revealed that high levels of depressive symptoms moderated the effectiveness of ICM in unexpected directions for two outcome variables. Subjects with high levels of depressive symptoms in ICM were (a) significantly more likely to engage in at least one treatment program than those in usual care and (b) associated with the fewest mean drinks per drinking day across the 24-month follow-up period. Independent effects for high levels of depressive symptoms and ICM were also found to positively influence engagement, attendance, and percentage days abstinent. ICM is effective for substance-dependent women with a broad spectrum of depressive symptoms in enhancing OSUDT utilization and outcomes.

Exploring the Relationship between Body Composition and Eating Behavior Using the Three Factor Eating Questionnaire (TFEQ) in Young New Zealand Women

PubMed Central

Kruger, Rozanne; De Bray, Jacqui G.; Beck, Kathryn L.; Conlon, Cathryn A.; Stonehouse, Welma

2016-01-01

Obesity is a leading cause of morbidity and mortality, yet is preventable. This study aimed to investigate associations between body mass index, body fat percentage and obesity-related eating behaviors. Women (n = 116; 18–44 years) were measured for height, weight and body fat using air displacement plethysmography (BodPod). Women completed the validated Three Factor Eating Questionnaire to assess their eating behaviors using Restraint, Disinhibition and Hunger eating factor categories and sub-categories. The eating behavior data were analyzed for associations with body mass index and body fat percentage, and comparisons across body mass index and body fat percentage categories (< vs. ≥25 kg/m2; < vs. ≥30%, respectively). Women had a mean (standard deviation) body mass index of 23.4 (3.5) kg/m2, and body fat percentage of 30.5 (7.6)%. Disinhibition was positively associated with both body mass index (p < 0.001) and body fat percentage (p < 0.001). Emotional Disinhibition was positively associated with body fat percentage (p < 0.028). Women with low Restraint and high Disinhibition had significantly higher body mass index and body fat percentage than women with high Restraint and low Disinhibition. Disinhibition seems likely to be an important contributor to obesity. Tailored intervention strategies focused on counteracting Disinhibition should be a key target area for managing weight/fat gain. PMID:27347997

Factors affecting stall use for different freestall bases.

PubMed

Wagner-Storch, A M; Palmer, R W; Kammel, D W

2003-06-01

The objective of this study was to compare stall use (stall occupancy and cow position) by barn side for factors affecting stall use. A closed circuit television system recorded stall use four times per day for a 9-mo period starting May 9, 2001. Six factors were analyzed: stall base, distance to water, stall location within stall base section, stall location within barn, inside barn temperature, and length of time cows were exposed to stall bases. Two barn sides with different stocking densities were analyzed: low (66%), with cows milked by robotic milker; and high (100%), with cows milked 2X in parlor. Six stall base types were tested: two mattresses, a waterbed, a rubber mat, concrete, and sand (high side only). The base types were grouped 3 to 7 stalls/section and randomly placed in each row. Cows spent more time in mattress-based stalls, but the highest percentage lying was in sand-based stalls. The following significant stall occupancy percentages were found: sand had the highest percentage of cows lying on the high stocking density side (69%), followed by mattress type 1 (65%) > mattress type 2 (57%) > waterbed (45%) > rubber mat (33%) > concrete (23%). Mattress type 1 had the highest percentage stalls occupied (88%), followed by mattress type 2 (84%) > sand (79%) > soft rubber mat (65%) > waterbed (62%) > concrete (39%). On the low stocking rate side, mattress type 1 had the highest percentage cows lying (45%) and occupied (59.6%), followed by mattress type 2 > waterbed > soft rubber mat > concrete. Cow lying and stalls occupied percentages were highest for stalls 1) not at the end of a section, and 2) on the outside row, and varied by base type for time cows exposed to stalls and inside barn temperature. Lying and occupied percentages were different for different mattress types. The percentage of stalls with cows standing was higher for mat and mattress-based stalls. Results show mattress type 1 and sand to be superior and rubber mats and concrete inferior stall bases.

The drivers to adopt renewable energy among residential users.

NASA Astrophysics Data System (ADS)

Rahman, Zahari Abdul; Elinda, Esa

2016-03-01

This study aims to examine the drivers to adopt renewable energy (RE) among residential users in Malaysia. Based on the theoretical framework of a consumer’s decision making process, an empirical study of the adoption of RE was conducted. A total of 501 residential users were used in this study. This study proved that perceived utility of new technology, perceived utility of new service, and perceived benefit of new technology are the drivers to adopt RE among residential users. These factors are knowing crucial to RE suppliers and producers because it will generates more demand from the residential users and the percentage of energy mix from RE sources can be increase.

Intakes of Energy and Discretionary Food in Mexico Are Associated with the Context of Eating: Mealtime, Activity, and Place.

PubMed

Batis, Carolina; Rodríguez-Ramírez, Sonia; Ariza, Ana Carolina; Rivera, Juan A

2016-09-01

The prevalence of obesity and the intake of discretionary foods [high saturated fat and/or added sugar (HSFAS) products and sugar-sweetened beverages (SSBs)] are high in Mexico. It is important to understand whether the intakes of HSFAS products and SSBs are associated with the context in which they are consumed. Our aim was to estimate the associations between total energy and discretionary food (HSFAS products and SSBs) intakes and the context of eating (mealtime, activity, and place). We used data from 10,087 participants aged ≥1 y from the Mexican National Health and Nutrition Survey 2012. Dietary intake was estimated through a 24-h dietary recall that included questions on mealtime, activity, and place in which each food item was consumed. The associations between energy and discretionary food intakes and the context of eating were estimated by using multiple linear regression stratified by age group and adjusted for sociodemographic variables. Compared with breakfast, the percentage of energy that HSFAS products contributed was 16-29 (range in all age groups) percentage points higher during midafternoon snacks and 16-23 percentage points lower at lunch and almuerzo (Mexican brunch); the percentage of energy from SSBs was 3.4-7.6 percentage points higher during midmorning snacks (P < 0.05). In many age groups and mealtimes, we found that compared with eating only while seated, the percentage of energy as HSFAS was 5.3-14 percentage points higher when watching television (P < 0.05). Compared with eating at home, the percentage of energy from HSFAS was 12-26 percentage points higher on the street and the percentage of energy from SSBs was 3.4-6.0 percentage points higher at school and 2.9-15 percentage points higher at work (P < 0.05). These results highlight the need to promote healthier food selection among the Mexican population when snacking and watching television and healthier food environments at work, school, and on the street. © 2016 American Society for Nutrition.

The mediating role of C-reactive protein and handgrip strength between obesity and walking limitation.

PubMed

Stenholm, Sari; Rantanen, Taina; Heliövaara, Markku; Koskinen, Seppo

2008-03-01

To study the association between different obesity indicators and walking limitation and to examine the role of C-reactive protein (CRP) and handgrip strength in that association. A cross-sectional, population-based study. The Health 2000 Survey with a representative sample of the Finnish population. Subjects aged 55 and older with complete data on body composition, CRP, handgrip strength, and walking limitation (N=2,208). Body composition, anthropometrics, CRP, medical conditions, handgrip strength, and maximal walking speed were measured in the health examination. Walking limitation was defined as maximal walking speed less than 1.2 m/s or difficulty walking half a kilometer. The two highest quartiles of body fat percentage and CRP and the two lowest quartiles of handgrip strength were all significantly associated with greater risk of walking limitation when chronic diseases and other covariates were taken into account. In addition, high CRP and low handgrip strength partially explained the association between high body fat percentage and walking limitation, but the risk of walking limitation remained significantly greater in persons in the two highest quartiles than in those in the lowest quartile of body fat percentage (odds ratio (OR)=1.75, 95% confidence interval (CI)=1.19-2.57 and OR=2.80, 95% CI 1.89-4.16). The prevalence of walking limitation was much higher in persons who simultaneously had high body fat percentage and low handgrip strength (61%) than in those with a combination of low body fat percentage and high handgrip strength (7%). Using body mass index and waist circumference as indicators of obesity yielded similar results as body fat percentage. Low-grade inflammation and muscle strength may partially mediate the association between obesity and walking limitation. Longitudinal studies and intervention trials are needed to verify this pathway.

Contrast-to-noise ratio in magnification mammography: a Monte Carlo study

NASA Astrophysics Data System (ADS)

Koutalonis, M.; Delis, H.; Spyrou, G.; Costaridou, L.; Tzanakos, G.; Panayiotakis, G.

2007-06-01

Magnification views are a common way to perform a secondary examination when suspicious abnormalities are found in a screening mammogram. The visibility of microcalcifications and breast lesions is restricted by the compromise between the image quality and the absorbed dose. In this study, image quality characteristics in magnification mammography were evaluated based on Monte Carlo techniques. A breast phantom was utilized, simulating a homogeneous mixture of adipose and glandular tissue in various percentages of glandularity, containing inhomogeneities of various sizes and compositions. The effect of the magnification degree, breast glandularity, tube voltage and anode/filter material combination on image quality characteristics was investigated in terms of a contrast-to-noise ratio (CNR). A performance index PIν was introduced in order to study the overall performance of various anode/filter combinations under different exposure parameters. Results demonstrate that CNR is improved with the degree of magnification and degraded as the breast glandularity is increased. Degree of magnification 1.3 offers the best overall performance for most of the anode/filter combinations utilized. Under magnification conditions, the role of dose is demoted against the image quality, as magnification views are secondary, diagnostic examinations and not screening procedures oriented to non-symptomatic women. For decreased image quality weighting, some anode/filter combinations different from Mo/0.030mmMo can be utilized as they offer a similar performance index. However, if the desired weighting for the image quality is high, the Mo/0.030mmMo combination has the best overall performance.

BMDO Technology and the Electric Utility Industry

DTIC Science & Technology

1997-01-01

use flue gas desulfurization systems, called scrubbers, to control the emissions of S02. In general, such systems allow combustion gases to pass...M) of flue gas desulfurization systems were about .0114 cents per kilowatt-hour. This small fraction of a penny translates to hundreds of millions...diluent gas , and opacity of units (the percentage of light that one can see through the flue gas ). According to requirements, CEM equipment must be

Targeted Iron Chelation Will Improve Recovery after Spinal Cord Injury

DTIC Science & Technology

2014-10-01

Pasta test and Cylinder test were utilized since they directly assess forepaw function. Briefly, the Pasta test looks at the ability of the animal to...manipulate a piece of uncooked elbow pasta and this test is able to detect Normal, Abnormal, and Transitional forepaw movement. The transitional...animals that received deferiprone exhibited a greater percentage of transitional movements while eating the piece of pasta (Figure 15B), indicating

Energy: Selected Facts and Numbers

DTIC Science & Technology

2008-08-08

air quality by reducing emissions led utilities to convert a number of coal-fired powerplants to burn oil, and many new plants were designed to burn...years were recently submitted, but no new plants are currently under construction or on order. Construction of major hydroelectric projects has also...5.1 and 5.13a-d. Percentages calculated by CRS. Industrial consumption of petroleum, which includes such large consumers as refineries and

Evaluation of the Utility of the "Revised Get Ready to Read!" For Spanish-Speaking English-Language Learners through Differential Item Functioning Analysis

ERIC Educational Resources Information Center

Farrington, Amber L.; Lonigan, Christopher J.; Phillips, Beth M.; Farver, JoAnn M.; McDowell, Kimberly D.

2015-01-01

Children who are Spanish-speaking English-language learners (ELLs) comprise a rapidly growing percentage of the population in U.S. schools. To determine which of these children have weaker emergent literacy skills and are in need of intervention, it is necessary to assess emergent literacy skills accurately and reliably. In this study, 1,318…

Evaluation of the composite burn index for assessing fire severity in Alaskan black spruce forests

Treesearch

Eric S. Kasischke; Merritt R. Turetsky; Roger D. Ottmar; Nancy H.F. French; Elizabeth E. Hoy; Evan S. Kane

2008-01-01

We evaluated the utility of the composite burn index (CBI) for estimating fire severity in Alaskan black spruce forests by comparing data from 81 plots located in 2004 and 2005 fire events. We collected data to estimate the CBI and quantify crown damage, percentage of trees standing after the fire, depth of the organic layer remaining after the fire, depth of burning...

Understanding the economic burden of heart failure in China: impact on disease management and resource utilization.

PubMed

Huang, Jun; Yin, Hongjun; Zhang, Milun; Ni, Qian; Xuan, Jianwei

2017-05-01

This study has two objectives: (1) to examine healthcare resource utilization in heart failure (HF) patients; and (2) to examine the treatment costs associated with HF in China. The data used in this study was from the 2014 national insurance database sponsored by the China Health Insurance Research Association (CHIRA), that covers national urban employees and residents. ICD-10 codes and keywords indicating heart failure diagnoses were used to identify patients with heart failure. Drug utilization, hospital visits, re-admission, and treatment costs in different service categories were examined. A total of 7,847 patients were included in this analysis, of which 1,157 patients had a 1-year complete follow-up period. In total, 48.16% of patients received the combination treatment of angiotensin-converting-enzyme inhibitor (ACEI)/angiotensin II receptor blockers (ARB) and beta-blockers (BB); and 22.87% of patients received the combination treatment of ACEI/ARB, beta-blockers and Mineralocorticoid receptor antagonists (MRAs). The annual treatment cost per patient with HF diagnosis was RMB 28,974, of which 66% was for inpatient care. The cost on HF medications accounted for 8.2% of annual cost. Treatment cost was much higher in provincial-level municipalities than that of prefecture-level and other cities. Hospitalization is a major driver of HF treatment cost. Compared to the requirements in international treatment guidelines, HF standard of care medication treatment was under-utilized among HF patients in China. The high re-admission rate among Chinese patients indicates that the management of HF needs to be improved. The percentage of GDP spent on treating HF patients was much lower than that in the developed countries.

Predictors of modern contraceptive methods use among married women of reproductive age groups in Western Ethiopia: a community based cross-sectional study.

PubMed

Tekelab, Tesfalidet; Melka, Alemu Sufa; Wirtu, Desalegn

2015-07-17

In Ethiopia, the prevalence of modern contraceptive use is very low (27 %) and the percentage of those with unmet needs for family planning is 25 %. The current study identified factors associated with the utilization of modern contraceptive methods among married women in Western Ethiopia. A community based, cross-sectional study was employed from April 10 to April 25, 2014, among married women of reproductive age in Nekemte Town. A multi-stage sampling procedure was used to select 1003 study participants. A pretested structured questionnaire was used to collect data, and data collectors who had completed high school were involved in the data collection process. A bivariate, multivariable logistic regression model was fit, and statistical significance was determined with a 95% confidence level. The overall utilization rate of modern contraceptives in this study was 71.9%. The most common form of modern contraceptives used was injectable (60.3%). Age (AOR = 2.00, 95 % CI = 1.35-2.98), women's educational level (AOR = 2.50, 95 % CI = 1.62-3.84), monthly income (AOR = 2.26, 95 % CI = 1.24-4.10), respondent's fertility (AOR = 2.60, 95 % CI = 1.48-4.56), fertility-related decision (AOR = 3.70, 95 % CI = 2.45-5.58), and having radio (AOR = 1.93, 95 % CI = 1.37-2.71) showed significant positive associations with the utilization of modern contraceptive methods. The findings showed that women's empowerment, fertility-related discussions among couples, and the availability of the media were important factors that influenced the use of modern contraceptives. Thus, policymakers and implementers should work on those factors to increase the utilization of modern contraceptive methods.

Physical and mechanical properties by utilizing empty fruit bunch into fired clay brick

NASA Astrophysics Data System (ADS)

Kadir, Aeslina Abdul; Sarani, Noor Amira; Mokhtar, Siti Zulaikha; Abdullah, Mohd Mustafa Al Bakri

2017-04-01

Palm oil plantation has become one of the country's success stories in agricultural development which also generates the highest number of waste among the agricultural waste. In this study, the investigation on the possibility to utilize the empty fruit bunch (EFB) waste into the fired clay brick was carried out. The main purpose of this study is to determine the physical and mechanical properties of bricks incorporated with different percentages of EFB. In this study, bricks with four different percentages of EFB (0 %, 1 %, 5 % and 10 %) were manufactured. Manufactured bricks were fired at 1050 °C with heating rate of 1 °C/min. Physical and mechanical properties including shrinkage, density, Initial Rate of Suction (IRS) and compressive strength were reported and discussed. Since shrinkage for each mixing is below than 8 %, then a good brick was manufactured. Bricks become more porous due to the organic content of EFB are burnt away and voids are formed in the specimen, giving it a lighter appearance and were produced lightweight brick which is suitable for non-loading purposes. As a conclusion, the incorporation of EFB into fired clay brick gives some advantages to the brick properties and also provides an alternative solution to disposed EFB waste.

HABITAT-SPECIFIC FORAGING AND SEX DETERMINE MERCURY CONCENTRATIONS IN SYMPATRIC BENTHIC AND LIMNETIC ECOTYPES OF THE THREESPINE STICKLEBACK

PubMed Central

Willacker, James J.; Von Hippel, Frank A.; Ackerly, Kerri L.; O’Hara, Todd M.

2013-01-01

Mercury (Hg) is a widespread environmental contaminant known for the neurotoxicity of its methylated forms, especially monomethylmercury, which bioaccumulates and biomagnifies in aquatic food webs. Mercury bioaccumulation and biomagnification rates are known to vary among species utilizing different food webs (benthic vs limnetic) within and between systems. The authors assessed whether carbon and nitrogen stable isotope values and total Hg (THg) concentrations differed between sympatric benthic and limnetic ecotypes and sexes of threespine stickleback fish (Gasterosteus aculeatus) from Benka Lake, Alaska, USA. The mean THg concentration in the limnetic ecotype was significantly higher (26 mg/kg dry wt, 16.1%) than that of the benthic ecotype. Trophic position and benthic carbon percentage utilized were both important determinants of THg concentration; however, the 2 variables were of approximately equal importance in females, whereas trophic position clearly explained more of the variance than benthic carbon percentage in males. Additionally, strong sex effects (45 mg/kg dry wt, 29.4%) were observed in both ecotypes, with female fish having lower THg concentrations than males. These results indicate that trophic ecology and sex are both important determinants of Hg contamination even within a single species and lake and likely play a role in governing Hg concentrations in higher trophic levels. PMID:23456641

Conceptual Core Analysis of Long Life PWR Utilizing Thorium-Uranium Fuel Cycle

NASA Astrophysics Data System (ADS)

Rouf; Su'ud, Zaki

2016-08-01

Conceptual core analysis of long life PWR utilizing thorium-uranium based fuel has conducted. The purpose of this study is to evaluate neutronic behavior of reactor core using combined thorium and enriched uranium fuel. Based on this fuel composition, reactor core have higher conversion ratio rather than conventional fuel which could give longer operation length. This simulation performed using SRAC Code System based on library SRACLIB-JDL32. The calculation carried out for (Th-U)O2 and (Th-U)C fuel with uranium composition 30 - 40% and gadolinium (Gd2O3) as burnable poison 0,0125%. The fuel composition adjusted to obtain burn up length 10 - 15 years under thermal power 600 - 1000 MWt. The key properties such as uranium enrichment, fuel volume fraction, percentage of uranium are evaluated. Core calculation on this study adopted R-Z geometry divided by 3 region, each region have different uranium enrichment. The result show multiplication factor every burn up step for 15 years operation length, power distribution behavior, power peaking factor, and conversion ratio. The optimum core design achieved when thermal power 600 MWt, percentage of uranium 35%, U-235 enrichment 11 - 13%, with 14 years operation length, axial and radial power peaking factor about 1.5 and 1.2 respectively.

Reducing Inpatient Hospital and Emergency Room Utilization Among Nursing Home Residents.

PubMed

Haber, Susan G; Wensky, Suzanne G; McCall, Nancy T

2017-04-01

To examine the association among nursing home residents between strength of relationship with a primary care provider (PCP) and inpatient hospital and emergency room (ER) utilization. Medicare administrative data for beneficiaries residing in a nursing home between July 2007 and June 2009 were used in multivariate analyses controlling for beneficiary, nursing home, and market characteristics to assess the association between two measures-percentage of months with a PCP visit and whether the patient maintained the same usual source of care after nursing home admission-and hospital admissions and ER visits for all causes and for ambulatory care sensitive conditions (ACSCs). Both measures of strength of patient-provider relationships were associated with fewer inpatient admissions and ER visits, except regularity of PCP visits and ACSC ER visits. Policy makers should consider increasing the strength of nursing home resident and PCP relationships as one strategy for reducing inpatient and ER utilization.

HIV Among MSM and Heterosexual Women in the United States: An Ecologic Analysis.

PubMed

Raymond, H Fisher; Al-Tayyib, Alia; Neaigus, Alan; Reilly, Kathleen H; Braunstein, Sarah; Brady, Kathleen A; Sey, Ekow; Risser, Jan; Padget, Paige; Lalota, Marlene; Schacht, John-Mark; Forrest, David W; Macomber, Katie; Griffin, Vivian; Higgins, Emily; Robinson, William T; Zarwell, Meagan C; Opoku, Jenevieve; Magnus, Manya; Kuo, Irene; Burt, Richard; Thiede, Hanne; Glick, Sara; Flynn, Colin; German, Danielle

2017-07-01

Phylogenetic studies show links between heterosexual women and men who have sex with men (MSM) that are more numerous than from heterosexual men to women suggesting that HIV infections among heterosexual women may stem from MSM. Poor communities have been associated with high rates of HIV among heterosexual women. Our analysis investigates potential transmission of HIV between MSM and female heterosexuals. National HIV Behavioral Surveillance data describe transmission risk behaviors of MSM, and HIV case reporting data describe the percentages of cases that are attributed to transmission risk categories. We examined correlations between the percentages of men who were MSM who also have sex with women and female heterosexual cases. We also examined census data to characterize each city in terms of poverty level and race/ethnicity makeup. There was a high correlation (0.93) between the percentage of reported living HIV cases attributed to male heterosexual contact and female heterosexual contact and a moderate nonsignificant correlation (0.49) between the percentage of MSM who were men who have sex with men and women (MSMW) in National HIV Behavioral Surveillance and the percentage of reported cases that were attributed to female heterosexual contact suggesting some potential overlap. Cities with high levels of poverty and African American/Black residents had higher levels of MSMW and higher levels of heterosexual female cases. Addressing HIV in cities with high levels of MSMW may have the dual effect of improving the health of MSM populations that have a high burden of HIV and to improve the health of their larger communities.

Long-Term Effects of Highly Active Antiretroviral Therapy on CD4+ Cell Evolution among Children and Adolescents Infected with HIV: 5 Years and Counting

PubMed Central

Patel, Kunjal; Hernán, Miguel A.; Williams, Paige L.; Seeger, John D.; McIntosh, Kenneth; Van Dyke, Russell B.; Seage, George R.

2011-01-01

Background Lower percentages of CD4+ T lymphocytes are associated with adverse clinical outcomes among children and adolescents infected with human immunodeficiency virus (HIV). CD4+ lymphocyte percentage generally increases with receipt of highly active antiretroviral therapy (HAART), but long-term follow-up is required to assess whether these increases in CD4+ cell percentage are maintained and whether they lead to normal CD4+ cell percentages in children with severe immunosuppression. Methods The study population included 1236 children and adolescents perinatally infected with HIV who were enrolled in a US-based multicenter prospective cohort study (Pediatric AIDS Clinical Trials Group 219/219C) and who were not receiving HAART at study initiation. We estimated the effects of HAART, HAART with protease inhibitors, and HAART with nonnucleoside reverse-transcriptase inhibitors on CD4+ cell percentage, using marginal structural models to account for confounding by severity. Results Initiation of any type of HAART increased CD4+ cell percentage by 2.34% (95% confidence interval, 1.35%–3.33%) in the first year, relative to noninitiation of HAART. The substantial increases in CD4+ cell percentage observed after the first year of experience with these combination therapies were followed by relatively smaller increases that continued for 5 years after initiation. Although larger increases in CD4+ cell percentage were observed among children with a greater degree of immunosuppression at baseline, the mean CD4+ cell percentage after 5 years of HAART did not reach normal levels. Conclusions Our study supports the initiation of HAART in children before severe immunosuppression occurs for long-term maintenance of normal CD4+ cell percentages. This beneficial result must be weighed against the evidence of potential adverse events associated with the prolonged use of such therapy. PMID:18426371

Method and means for generating a synchronizing pulse from a repetitive wave of varying frequency

DOEpatents

DeVolpi, Alexander; Pecina, Ronald J.; Travis, Dale J.

1976-01-01

An event that occurs repetitively at continuously changing frequencies can be used to generate a triggering pulse which is used to synchronize or control. The triggering pulse is generated at a predetermined percentage of the period of the repetitive waveform without regard to frequency. Counts are accumulated in two counters, the first counting during the "on" fraction of the period, and the second counting during the "off" fraction. The counts accumulated during each cycle are compared. On equality the trigger pulse is generated. Count input rates to each counter are determined by the ratio of the on-off fractions of the event waveform and the desired phase relationship. This invention is of particular utility in providing a trigger or synchronizing pulse during the open period of the shutter of a high-speed framing camera during its acceleration as well as its period of substantially constant speed.

Evaluation of a habitat suitability index model

USGS Publications Warehouse

Farmer, A.H.; Cade, B.S.; Stauffer, D.F.

2002-01-01

We assisted with development of a model for maternity habitat of the Indiana bat (Myotis soda/is), for use in conducting assessments of projects potentially impacting this endangered species. We started with an existing model, modified that model in a workshop, and evaluated the revised model, using data previously collected by others. Our analyses showed that higher indices of habitat suitability were associated with sites where Indiana bats were present and, thus, the model may be useful for identifying suitable habitat. Utility of the model, however, was based on a single component-density of suitable roost trees. Percentage of landscape in forest did not allow differentiation between sites occupied and not occupied by Indiana bats. Moreover, in spite of a general opinion by participants in the workshop that bodies of water were highly productive feeding areas and that a diversity of feeding habitats was optimal, we found no evidence to support either hypothesis.

Comparative survey of outdoor, residential and workplace radon concentrations

PubMed Central

Barros, Nirmalla; Field, Dan W.; Steck, Daniel J.; Field, R. William

2015-01-01

This study investigated radon concentrations in above-ground (i.e. first floor) workplace in Missouri and compared them with above-ground radon concentrations in nearby homes and outdoor locations. This study also examined the potential utility of using home and outdoor radon concentrations to predict the radon concentration at a nearby workplace (e.g. county agencies and schools). Even though workplace radon concentrations were not statistically different from home radon concentrations, the radon concentration at a particular home, or outdoor location, was a poor predictor of the radon concentration at a nearby workplace. Overall, 9.6 and 9.9 % of homes and workplace, respectively, exhibited radon concentrations of ≥148 Bq m−3. Because of the percentage of workplace with elevated radon concentrations, the results suggest that additional surveys of workplace radon concentrations are needed, especially in areas of high radon potential, to assess the contribution of workplace radon exposure to an individual's overall radon exposure. PMID:24936021

A novel two-level dielectric barrier discharge reactor for methyl orange degradation.

PubMed

Tao, Xumei; Wang, Guowei; Huang, Liang; Ye, Qingguo; Xu, Dongyan

2016-12-15

A novel pilot two-level dielectric barrier discharge (DBD) reactor has been proposed and applied for degradation of continuous model wastewater. The two-level DBD reactor was skillfully realized with high space utilization efficiency and large contact area between plasma and wastewater. Various conditions such as applied voltage, initial concentration and initial pH value on methyl orange (MO) model wastewater degradation were investigated. The results showed that the appropriate applied voltage was 13.4 kV; low initial concentration and low initial pH value were conducive for MO degradation. The percentage removal of 4 L MO with concentration of 80 mg/L reached 94.1% after plasma treatment for 80min. Based on ultraviolet spectrum (UV), Infrared spectrum (IR), liquid chromatography-mass spectrometry (LC-MS) analysis of degradation intermediates and products, insights in the degradation pathway of MO were proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Age-specific productivity and nest site characteristics of Cooper's hawks (Accipiter cooperii)

USGS Publications Warehouse

Moore, K.R.; Henny, C.J.

1984-01-01

Nesting Cooper's Hawks (Accipiter cooperii) were studied in northeastern Oregon. Second-year (SY) males did not breed, but 22 percent of the breeding females were SY's. Mean clutch size (P = 0.012) and mean number of young fledged per pair that laid eggs (P < 0.10) were lower for SY females than for adult (after second year [ASY}) females; however, an equal percentage of the eggs (excluding a collected sample egg) yielded fledged young for each age class. Stepwise discriminant analysis suggested differences in structural characteristics of the nest site habitat for ASY and SY females, i.e., SY female nest sites were associated with younger successional stages than ASY female nest sites. Nests of both age groups were built in trees with high crown volume, but ASY females utilized mistletoe (Arceuthobium sp.) for nest structures more frequently (P < 0.01) than SY females.

High quality interlayer dielectric for 4H SiC DMOSFETs

NASA Astrophysics Data System (ADS)

Okayama, T.; Arthur, S. D.; Waldrab, P.; Rao, Mulpuri V.

2007-11-01

In this work useful weight percentages of boron and phosphorus in boro-phospho-silicate-glass (BPSG) interlayer dielectric (ILD) films to getter mobile ions effectively in 4H-SiC DMOSFET structures are developed, considering the limitations, such as the required low glass flow temperature, and the possible hygroscopic nature of the films and formation of crystalline BPO4 particles, which may occur for high B and P weight percentages. The B and P weight percentage viscous flow temperature contours and empirical inequalities representing the above-mentioned limitations are developed and discussed. Results of this work are useful for both silicon and compound semiconductor device technologies.

Polychlorinated biphenyl toxicity to Japanese quail as related to degree of chlorination

USGS Publications Warehouse

Hill, E.F.; Heath, R.G.; Spann, J.W.; Williams, J.D.

1974-01-01

To learn if the percentage of chlorine in a mixture of polychlorinated biphenyls (PCB's) alone determines toxicity, Japanese quail were fed diets containing Aroelor 1248, 1254, or 1260 at levels that added equal amounts of chlorine to the feed. The experiment comprised two consecutive 5-day periods; three sublethal concentrations of chlorine were evaluated during the first period and three lethal concentrations during the second period. Evaluations utilized comparisons of mortality, time to death, weight change, and food consumption. Sublethal concentrations produced no detectable effects. Lethal concentrations with equal Chlorine showed Aroelor 1248 to be less toxic at the highest chlorine concentrations, but at lower concentrations Aroelor 1254 was more toxic than Aroclor 1260. Although chlorine percentage of a PCB is positively correlated with its avian toxicity, PCB toxicity is apparently not simply a function of chlorination.

Characteristics and Composition of African Oil Bean Seed (Pentaclethra macrophylla Benth)

NASA Astrophysics Data System (ADS)

Ikhuoria, Esther U.; Aiwonegbe, Anthony E.; Okoli, Peace; Idu, Macdonald

The African oil bean (Pentaclethra macrophylla) seed was analyzed for its proximate composition. The seed oil was also analyzed for mineral content and physicochemical characteristics. Proximate analysis revealed that the percentage crude protein, crude fibre, moisture and carbohydrate were 9.31, 21.66, 39.05 and 38.95%, respectively. The percentage oil content was 47.90% while the ash content was 3.27%. Results of minerals analysis showed that calcium had the highest concentration of all the elements analyzed and were found to be of the order: Ca > Mg > Pb > Fe > Mn > P > Cu. The low iodine value of the seed oil showed that it can be classified as non-drying oil and thus not suitable for paint and polish production. However, the low acid and free fatty acid values suggest its utilization as edible oil.

Constraints on continental accretion from sedimentation

NASA Technical Reports Server (NTRS)

Abbott, Dallas

1988-01-01

Heat loss in the ancient Earth was discussed assuming that classical sea floor spreading was the only mechanism. This may be expressed as faster spreading or longer total ridge length. These have important implications as to the size and number of cratonic plates in the distant past, the degree to which they are flooded, the kinds of sediments and volcanics that would be expected, and the amount of recycling of continental material taking place. The higher proportion of marine sedimentary rocks and oceanic volcanics in the Archean, and the relative paucity of evaporites and continental volcanics may in part be due to smaller cratonic blocks. A model was developed of the percentage of continental flooding which utilizes round continents and a constant width of the zone of flooding. This model produces a reasonable good fit to the percentage of flooding on the present day continents.

Modeling and validating Bayesian accrual models on clinical data and simulations using adaptive priors.

PubMed

Jiang, Yu; Simon, Steve; Mayo, Matthew S; Gajewski, Byron J

2015-02-20

Slow recruitment in clinical trials leads to increased costs and resource utilization, which includes both the clinic staff and patient volunteers. Careful planning and monitoring of the accrual process can prevent the unnecessary loss of these resources. We propose two hierarchical extensions to the existing Bayesian constant accrual model: the accelerated prior and the hedging prior. The new proposed priors are able to adaptively utilize the researcher's previous experience and current accrual data to produce the estimation of trial completion time. The performance of these models, including prediction precision, coverage probability, and correct decision-making ability, is evaluated using actual studies from our cancer center and simulation. The results showed that a constant accrual model with strongly informative priors is very accurate when accrual is on target or slightly off, producing smaller mean squared error, high percentage of coverage, and a high number of correct decisions as to whether or not continue the trial, but it is strongly biased when off target. Flat or weakly informative priors provide protection against an off target prior but are less efficient when the accrual is on target. The accelerated prior performs similar to a strong prior. The hedging prior performs much like the weak priors when the accrual is extremely off target but closer to the strong priors when the accrual is on target or only slightly off target. We suggest improvements in these models and propose new models for future research. Copyright © 2014 John Wiley & Sons, Ltd.

Generating Chimeric Mice by Using Embryos from Nonsuperovulated BALB/c Mice Compared with Superovulated BALB/c and Albino C57BL/6 Mice.

PubMed

Esmail, Michael Y; Qi, Peimin; Connor, Aurora Burds; Fox, James G; García, Alexis

2016-01-01

The reliable generation of high-percentage chimeras from gene-targeted C57BL/6 embryonic stem cells has proven challenging, despite optimization of cell culture and microinjection techniques. To improve the efficiency of this procedure, we compared the generation of chimeras by using 3 different inbred, albino host, embryo-generating protocols: BALB/cAnNTac (BALB/c) donor mice superovulated at 4 wk of age, 12-wk-old BALB/c donor mice without superovulation, and C57BL/6NTac-Tyr(tm1Arte) (albino B6) mice superovulated at 4 wk of age. Key parameters measured included the average number of injectable embryos per donor, the percentage of live pups born from the total number of embryos transferred to recipients, and the number of chimeric pups with high embryonic-stem-cell contribution by coat color. Although albino B6 donors produced significantly more injectable embryos than did BALB/c donors, 12-wk-old BALB/c donor produced high-percentage (at least 70%) chimeras more than 2.5 times as often as did albino B6 mice and 20 times more efficiently than did 4-wk-old BALB/c donors. These findings clearly suggest that 12-wk-old BALB/c mice be used as blastocyst donors to reduce the number of mice used to generate each chimera, reduce the production of low-percentage chimeras, and maximize the generation of high-percentage chimeras from C57BL/6 embryonic stem cells.

High mobility high efficiency organic films based on pure organic materials

DOEpatents

Salzman, Rhonda F [Ann Arbor, MI; Forrest, Stephen R [Ann Arbor, MI

2009-01-27

A method of purifying small molecule organic material, performed as a series of operations beginning with a first sample of the organic small molecule material. The first step is to purify the organic small molecule material by thermal gradient sublimation. The second step is to test the purity of at least one sample from the purified organic small molecule material by spectroscopy. The third step is to repeat the first through third steps on the purified small molecule material if the spectroscopic testing reveals any peaks exceeding a threshold percentage of a magnitude of a characteristic peak of a target organic small molecule. The steps are performed at least twice. The threshold percentage is at most 10%. Preferably the threshold percentage is 5% and more preferably 2%. The threshold percentage may be selected based on the spectra of past samples that achieved target performance characteristics in finished devices.

Reducing the CP content in broiler feeds: impact on animal performance, meat quality and nitrogen utilization.

PubMed

Belloir, P; Méda, B; Lambert, W; Corrent, E; Juin, H; Lessire, M; Tesseraud, S

2017-11-01

Reducing the dietary CP content is an efficient way to limit nitrogen excretion in broilers but, as reported in the literature, it often reduces performance, probably because of an inadequate provision in amino acids (AA). The aim of this study was to investigate the effect of decreasing the CP content in the diet on animal performance, meat quality and nitrogen utilization in growing-finishing broilers using an optimized dietary AA profile based on the ideal protein concept. Two experiments (1 and 2) were performed using 1-day-old PM3 Ross male broilers (1520 and 912 for experiments 1 and 2, respectively) using the minimum AA:Lys ratios proposed by Mack et al. with modifications for Thr and Arg. The digestible Thr (dThr): dLys ratio was increased from 63% to 68% and the dArg:dLys ratio was decreased from 112% to 108%. In experiment 1, the reduction of dietary CP from 19% to 15% (five treatments) did not alter feed intake or BW, but the feed conversion ratio was increased for the 16% and 15% CP diets (+2.4% and +3.6%, respectively), while in experiment 2 (three treatments: 19%, 17.5% and 16% CP) there was no effect of dietary CP on performance. In both experiments, dietary CP content did not affect breast meat yield. However, abdominal fat content (expressed as a percentage of BW) was increased by the decrease in CP content (up to +0.5 and +0.2 percentage point, in experiments 1 and 2, respectively). In experiment 2, meat quality traits responded to dietary CP content with a higher ultimate pH and lower lightness and drip loss values for the low CP diets. Nitrogen retention efficiency increased when reducing CP content in both experiments (+3.5 points/CP percentage point). The main consequence of this higher efficiency was a decrease in nitrogen excretion (-2.5 g N/kg BW gain) and volatilization (expressed as a percentage of excretion: -5 points/CP percentage point). In conclusion, this study demonstrates that with an adapted AA profile, it is possible to reduce dietary CP content to at least 17% in growing-finishing male broilers, without altering animal performance and meat quality. Such a feeding strategy could therefore help improving the sustainability of broiler production as it is an efficient way to reduce environmental burden associated with nitrogen excretion.

A multi-stakeholder framework for urban runoff quality management: Application of social choice and bargaining techniques.

PubMed

Ghodsi, Seyed Hamed; Kerachian, Reza; Zahmatkesh, Zahra

2016-04-15

In this paper, an integrated framework is proposed for urban runoff management. To control and improve runoff quality and quantity, Low Impact Development (LID) practices are utilized. In order to determine the LIDs' areas and locations, the Non-dominated Sorting Genetic Algorithm-II (NSGA-II), which considers three objective functions of minimizing runoff volume, runoff pollution and implementation cost of LIDs, is utilized. In this framework, the Storm Water Management Model (SWMM) is used for stream flow simulation. The non-dominated solutions provided by the NSGA-II are considered as management scenarios. To select the most preferred scenario, interactions among the main stakeholders in the study area with conflicting utilities are incorporated by utilizing bargaining models including a non-cooperative game, Nash model and social choice procedures of Borda count and approval voting. Moreover, a new social choice procedure, named pairwise voting method, is proposed and applied. Based on each conflict resolution approach, a scenario is identified as the ideal solution providing the LIDs' areas, locations and implementation cost. The proposed framework is applied for urban water quality and quantity management in the northern part of Tehran metropolitan city, Iran. Results show that the proposed pairwise voting method tends to select a scenario with a higher percentage of reduction in TSS (Total Suspended Solid) load and runoff volume, in comparison with the Borda count and approval voting methods. Besides, the Nash method presents a management scenario with the highest cost for LIDs' implementation and the maximum values for percentage of runoff volume reduction and TSS removal. The results also signify that selection of an appropriate management scenario by stakeholders in the study area depends on the available financial resources and the relative importance of runoff quality improvement in comparison with reducing the runoff volume. Copyright © 2016 Elsevier B.V. All rights reserved.

Impact of the Medicare Short Stay Transfer Policy on Patients undergoing Major Orthopedic Surgery

PubMed Central

FitzGerald, John D; John Boscardin, W; Hahn, Bevra H; Ettner, Susan L

2007-01-01

Objective To examine the impact of the Short Stay Transfer Policy (SSTP) on practice patterns. Data Sources This study uses data from the Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) file, Home Health Standard Analytical File, 1999 Provider of Service file, and data from the 2000 United States Census. Study Design An interrupted time-series analysis was used to examine the length of stay (LOS) and probability of “early” discharge to post acute care (PAC). Data Collection Separate 100percent samples of all fee-for-service Medicare recipients undergoing either elective joint replacement (JR) surgery or surgical management of hip fracture (FX) between January 1, 1996 and December 31, 2000 were selected. Principal Findings Prior to implementation of the SSTP. LOS had been falling by 0.37 and 0.30 days per year for JR and FX patients respectively. After implementation of the SSTP, there was an immediate increase in LOS by 0.20 and 0.17 days, respectively. Thereafter, LOS remained flat. The proportion of patients discharged “early” to PAC had been rising by 4.4 and 2.6 percentage points per year for JR and FX patients respectively, to a peak of 28.8percent and 20.4percent early PAC utilization in September 1998. Immediately after implementation of the SSTP, there was a 4.3 and 3.0 percentage point drop in utilization of “early” PAC. Thereafter utilization of early PAC increased at a much slower rate (for JR) or remained flat (for FX). There was significant regional variation in the magnitude of response to the policy. Conclusion Implementation of the SSTP reduced the financial incentive to discharge patients early to PAC. This was accomplished primarily through longer LOS without meaningful change in PAC utilization. With the recent expansion of the SSTP to 29 DRGs (representing 34percent of all discharges), these findings have important implications regarding patient care. PMID:17355580

Different utilization of intensive care services (ICSs) for patients dying of hemorrhagic and ischemic stroke, a hospital-based survey.

PubMed

Wang, Vinchi; Hsieh, Chieh-Chao; Huang, Yen-Ling; Chen, Chia-Ping; Hsieh, Yi-Ting; Chao, Tzu-Hao

2018-02-01

The intensive care service (ICS) saves lives and rescues the neurological function of stroke patients. We wondered the different utilization of ICS for patients with ischemic and hemorrhagic stroke, especially those who died within 30 days after stroke.Sixty-seven patients died during 2011 to 2015 due to acute stroke (42 due to intracranial hemorrhage [ICH]; 25 due to cerebral infarct [CI]). The durations of hospital stay (hospital staying days [HSDs]) and ICS staying days (ISDs) and codes of the do-not-resuscitate (DNR) were surveyed among these medical records. Statistics included chi-square and descriptive analyses.In this study, CI patients had a longer HSD (mean 14.3 days), as compared with ICH patients (mean 8.3 days); however, the ICH patients had a higher percentage of early entry within the first 24 hours of admission into ICS than CI group (95.1% vs 60.0%, P = .003). A higher rate of CI patients died in holidays or weekends than those with ICH (44.0% vs 21.4%, P = .051). DNR, requested mainly from direct descendants (children or grandchildren), was coded in all 25 CI patients (100.0%) and 38 ICH patients (90.5%). More cases with early DNR coded within 24 hours after admission occurred in ICH group (47%, 12% in CI patients, P = .003). None of the stroke patient had living wills. Withhold of endotracheal intubation (ETI) occurred among CI patients, more than for ICH patients (76.0% vs 18.4%, P < .005).In conclusion, CI patients longer HSD, ISD, higher mortality within holidays or weekends, and higher ETI withhold; but less percentage of ICS utilization expressed by a lower ISD/HSD ratio. This ICS utilization is a key issue of medical quality for stroke care.

The Prevalence of HIV Risk Behaviors among Felony Drug Court Participants.

PubMed

Festinger, David S; Dugosh, Karen L; Metzger, David S; Marlowe, Douglas B

2012-01-01

A small percentage of participants in a large metropolitan felony Drug Court engaged in high-risk injection drug use, but a large percentage engaged in high-risk sexual behaviors. HIV risk behaviors were associated with being male, African-American, and younger. A large proportion of Drug Court participants resided in areas of the city with a high prevalence of persons living with HIV/AIDS, thus heightening the probability of exposure to the virus.

Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: In vitro study

PubMed Central

Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente

2015-01-01

Background The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Material and Methods Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Results Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. Conclusions The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation. PMID:26155350

Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: In vitro study.

PubMed

Faus-Llácer, Vicente; Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente

2015-04-01

The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation.

Effect of Free Maternal Health Care Program on Health-seeking Behaviour of Women during Pregnancy, Intra-partum and Postpartum Periods in Cross River State of Nigeria: A Mixed Method Study.

PubMed

Edu, Betta Chimaobim; Agan, Thomas U; Monjok, Emmanuel; Makowiecka, Krystyna

2017-06-15

Increasing the percentage of maternal health service utilization in health facilities, through cost-removal policy is important in reducing maternal deaths. The Cross River State Government of Nigeria introduced a cost-removal policy in 2009, under the umbrella of "PROJECT HOPE" where free maternal health services are provided. Since its inception, there has been no formal evaluation of its effectiveness. This study aims to evaluate the effect of the free maternal health care program on the health care-seeking behaviours of pregnant women in Cross River State, Nigeria. A mixed method approach (quantitative and qualitative methods) was used to describe the effect of free maternal health care intervention. The quantitative component uses data on maternal health service utilisation obtained from PROJECT HOPE and Nigeria Demographic Health Survey. The qualitative part uses Focus Group Discussions to examine women's perception of the program. Results suggest weak evidence of change in maternal health care service utilization, as 95% Confidence Intervals overlap even though point estimate suggest increase in utilization. Results of quantitative data show increase in the percentage of women accessing maternal health services. This increase is greater than the population growth rate of Cross River State which is 2.9%, from 2010 to 2013. This increase is likely to be a genuine increase in maternal health care utilisation. Qualitative results showed that women perceived that there have been increases in the number of women who utilize Antenatal care, delivery and Post Partum Care at health facilities, following the removal of direct cost of maternal health services. There is urban and rural differences as well as between communities closer to health facility and those further off. Perceived barriers to utilization are indirect cost of service utilization, poor information dissemination especially in rural areas, perceived poor quality of care at facilities including drug and consumables stock-outs, geographical barriers, inadequate health work force, and poor attitude of skilled health workers and lack of trust in the health system. Reasons for Maternal health care utilisation even under a cost-removal policy is multi-factorial. Therefore, in addition to fee-removal, the government must be committed to addressing other deterrents so as to significantly increase maternal health care service utilisation.

Burden of illness and health care resource utilization in adult psychiatric outpatients with attention-deficit/hyperactivity disorder in Europe.

PubMed

Karlsdotter, Kristina; Bushe, Chris; Hakkaart, L; Sobanski, Esther; Kan, C C; Lebrec, Jeremie; Kraemer, Susanne; Dieteren, Nicole A H M; Deberdt, Walter

2016-09-01

To assess the burden of illness and health care resource utilization of adult nonpsychotic psychiatric outpatients with attention-deficit/hyperactivity disorder (ADHD) in Europe. This was a multicountry, cross-sectional, observational study where unselected routine patients from clinical psychiatric outpatient settings were screened and assessed for ADHD. Patients were evaluated using the Clinical Global Impressions of Severity (CGI-S) scale, the Sheehan Disability Scale (SDS), and the EuroQol-5 Dimensions questionnaire. Data on comorbidities, functional impairment, and health care resource utilization were captured. The study enrolled 2284 patients, of whom 1986 completed the study. The prevalence of ADHD was 17.4%, of whom 46.0% had a previous ADHD diagnosis. Patients with ADHD had a high clinical burden with psychiatric comorbidities, especially depression (43.0%) and anxiety disorders (36.4%). Substance abuse (9.2% vs. 3.4%) and alcohol abuse (10.3% vs. 5.2%) were more common in the ADHD cohort vs. the non-ADHD cohort. Only 11.5% of the patients with ADHD had no other psychiatric disorder. Various measures indicated a significantly poorer level of functioning for patients with ADHD than without ADHD, as indicated by higher scores for CGI-S (3.8 vs. 3.3) and SDS (18.9 vs. 11.6) and higher percentages of debt (35.5% vs. 24.3%) and criminality (13.8% vs. 6.1%). Lastly, the health care resource utilization was considerable and similar between adult psychiatric outpatients diagnosed and not diagnosed with ADHD. Although care was taken when choosing the sites for this study, to make it representative of the general outpatient adult psychiatric population, caution should be advised in generalizing the findings of our study to the general ADHD or psychiatric outpatient population. This was an observational study, thus no inference on causality can be drawn. Having ADHD imposes a considerable health and social burden on patient and health care resource utilization comparable to other chronic psychiatric disorders.

Microorganism Utilization for Synthetic Milk

NASA Technical Reports Server (NTRS)

Morford, Megan A.; Khodadad, Christina L.; Caro, Janicce I.; Spencer, LaShelle E.; Richards, Jeffery T.; Strayer, Richard F.; Birmele, Michele N.; Wheeler, Raymond M.

2014-01-01

A desired architecture for long duration spaceflight, like aboard the International Space Station or for future missions to Mars, is to provide a supply of fresh food crops for the astronauts. However, some crops can create a high proportion of inedible plant waste. The main goal of the Synthetic Biology project, Cow in a Column, was to produce the components of milk (sugar, lipid, protein) from inedible plant waste by utilizing microorganisms (fungi, yeast, bacteria). Of particular interest was utilizing the valuable polysaccharide, cellulose, found in plant waste, to naturally fuel-through microorganism cellular metabolism- the creation of sugar (glucose), lipid (milk fat), and protein (casein) in order to produce a synthetic edible food product. Environmental conditions such as pH, temperature, carbon source, aeration, and choice microorganisms were optimized in the laboratory and the desired end-products, sugars and lipids, were analyzed. Trichoderma reesei, a known cellulolytic fungus, was utilized to drive the production of glucose, with the intent that the produced glucose would serve as the carbon source for milk fat production and be a substitute for the milk sugar lactose. Lipid production would be carried out by Rhodosporidium toruloides, yeast known to accumulate those lipids that are typically found in milk fat. Results showed that glucose and total lipid content were below what was expected during this phase of experimentation. In addition, individual analysis of six fatty acids revealed that the percentage of each fatty acid was lower than naturally produced bovine milk. Overall, this research indicates that microorganisms could be utilized to breakdown inedible solid waste to produce useable products. For future work, the production of the casein protein for milk would require the development of a genetically modified organism, which was beyond the scope of the original project. Additional trials would be needed to further refine the required environment/organisms for the production of desired sugar and lipid end-products.

The association of peripheral blood regulatory T-cell concentrations with epithelial ovarian cancer: A brief report

PubMed Central

Hampras, Shalaka; Goode, Ellen L.; Knutson, Keith; Ness, Roberta; Modugno, Francesmary; Wallace, Paul; Szender, J. Brian; Mayor, Paul; Hong, Chi-Chen; Joseph, Janine M.; Friel, Grace; Davis, Warren; Nesline, Mary; Eng, Kevin H.; Edwards, Robert P.; Kruszka, Bridget; Schmitt, Kristina; Odunsi, Kunle; Moysich, Kirsten B.

2016-01-01

Objective There is a mounting body of evidence demonstrating higher percentages of regulatory T (Treg) cells in the peripheral blood of cancer patients in comparison to healthy controls, but there is a paucity of epidemiological literature characterizing circulating Treg cells among epithelial ovarian cancer (EOC) patients. To investigate the role of peripheral Treg cells in ovarian neoplasms, we conducted a case-control study to characterize circulating concentrations of Treg cells among EOC patients, women with benign ovarian conditions, and healthy controls without a history of cancer. Materials and Methods Participants were identified for inclusion due to their participation in the Data Bank and BioRepository program at Roswell Park Cancer Institute in Buffalo, NY. Patients included 71 women with a primary diagnosis of EOC and 195 women with a diagnosis of benign ovarian conditions. Controls included 101 age- and race-matched women without a history of cancer. Non-fasting, pre-treatment peripheral blood levels of CD3+CD4+CD25+FOXP3+ Treg cells were measured using flow cytometric analyses and expressed as a percentage of total CD3+ cells and as a percentage of total CD3+CD4+ cells. Results Compared to healthy controls and women with benign ovarian conditions, EOC patients had significantly higher frequency of Treg cells (p<0.04). In multivariable logistic regression analyses utilizing Treg frequency expressed as a percentage of CD+3 cells, we observed a significant positive association between Treg cell percentage and EOC risk, with each one percent increase associated with a 37% increased risk of EOC (OR=1.37, 95% CI: 1.04-1.80). We observed a similar trend when Treg frequency was expressed as a percentage of CD3+CD+4 cells (OR=1.22, 95% CI: 0.99-1.49). Conclusions The current study provides support that peripheral Treg cell frequency is elevated in EOC patients in comparison to women with benign ovarian conditions and healthy controls. PMID:27759594

Why (not) go east? Comparison of findings from FDA Investigational New Drug study site inspections performed in Central and Eastern Europe with results from the USA, Western Europe, and other parts of the world.

PubMed

Caldron, Paul H; Gavrilova, Svetlana I; Kropf, Siegfried

2012-01-01

Since the mid-1990s, investigational sites in the countries of Central and Eastern Europe (CEE) have been increasingly utilized by pharmaceutical companies because of their high productivity in terms of patient enrolment into clinical trials. Based on the FDA's publicly accessible Clinical Investigator Inspection List, we present an analysis of findings and outcome classifications from FDA inspections during Investigational New Drug (IND) studies and compare the results for the CEE region to those from Western European countries and the USA. Data from all 5531 FDA clinical trials inspections that occurred between 1994 (when the FDA first performed inspections in CEE) and the end of 2010 were entered into the database for comparative analysis. Of these, 4865 routine data audit (DA) inspections were analyzed: 401 from clinical trials performed in Western Europe, 230 in CEE, 3858 in the USA, and 376 in other countries. The average number of deficiencies per inspection ranged between 0.99 for CEE and 1.97 in Western Europe. No deficiencies were noted during 16.6%, 39.0%, and 21.5% of the inspections in Western Europe, CEE and USA, respectively. The percentages of inspections after which no follow-up action was indicated were 36.9% for Western Europe, 55.7% for CEE, and 44.3% for US sites. CEE was also the region with the lowest percentage of inspections that required official or voluntary action. On the basis of FDA inspection data, the high productivity of CEE sites appears to be accompanied by regulatory compliance as well as by data quality standards that are not inferior to those in Western regions.

Why (not) go east? Comparison of findings from FDA Investigational New Drug study site inspections performed in Central and Eastern Europe with results from the USA, Western Europe, and other parts of the world

PubMed Central

Caldron, Paul H; Gavrilova, Svetlana I; Kropf, Siegfried

2012-01-01

Since the mid-1990s, investigational sites in the countries of Central and Eastern Europe (CEE) have been increasingly utilized by pharmaceutical companies because of their high productivity in terms of patient enrolment into clinical trials. Based on the FDA’s publicly accessible Clinical Investigator Inspection List, we present an analysis of findings and outcome classifications from FDA inspections during Investigational New Drug (IND) studies and compare the results for the CEE region to those from Western European countries and the USA. Data from all 5531 FDA clinical trials inspections that occurred between 1994 (when the FDA first performed inspections in CEE) and the end of 2010 were entered into the database for comparative analysis. Of these, 4865 routine data audit (DA) inspections were analyzed: 401 from clinical trials performed in Western Europe, 230 in CEE, 3858 in the USA, and 376 in other countries. The average number of deficiencies per inspection ranged between 0.99 for CEE and 1.97 in Western Europe. No deficiencies were noted during 16.6%, 39.0%, and 21.5% of the inspections in Western Europe, CEE and USA, respectively. The percentages of inspections after which no follow-up action was indicated were 36.9% for Western Europe, 55.7% for CEE, and 44.3% for US sites. CEE was also the region with the lowest percentage of inspections that required official or voluntary action. On the basis of FDA inspection data, the high productivity of CEE sites appears to be accompanied by regulatory compliance as well as by data quality standards that are not inferior to those in Western regions. PMID:22563236

Stress Testing of an Artificial Pancreas System With Pizza and Exercise Leads to Improvements in the System's Fuzzy Logic Controller.

PubMed

Mauseth, Richard; Lord, Sandra M; Hirsch, Irl B; Kircher, Robert C; Matheson, Don P; Greenbaum, Carla J

2015-09-14

Under controlled conditions, the Dose Safety artificial pancreas (AP) system controller, which utilizes "fuzzy logic" (FL) methodology to calculate and deliver appropriate insulin dosages based on changes in blood glucose, successfully managed glycemic excursions. The aim of this study was to show whether stressing the system with pizza (high carbohydrate/high fat) meals and exercise would reveal deficits in the performance of the Dose Safety FL controller (FLC) and lead to improvements in the dosing matrix. Ten subjects with type 1 diabetes (T1D) were enrolled and participated in 30 studies (17 meal, 13 exercise) using 2 versions of the FLC. After conducting 13 studies with the first version (FLC v2.0), interim results were evaluated and the FLC insulin-dosing matrix was modified to create a new controller version (FLC v2.1) that was validated through regression testing using v2.0 CGM datasets prior to its use in clinical studies. The subsequent 17 studies were performed using FLC v2.1. Use of FLC v2.1 vs FLC v2.0 in the pizza meal tests showed improvements in mean blood glucose (205 mg/dL vs 232 mg/dL, P = .04). FLC v2.1 versus FLC v2.0 in exercise tests showed improvements in mean blood glucose (146 mg/dL vs 201 mg/dL, P = .004), percentage time spent >180 mg/dL (19.3% vs 46.7%, P = .001), and percentage time spent 70-180 mg/dL (80.0% vs 53.3%, P = .002). Stress testing the AP system revealed deficits in the FLC performance, which led to adjustments to the dosing matrix followed by improved FLC performance when retested. © 2015 Diabetes Technology Society.

Effects of the Affordable Care Act's young adult insurance expansion on prescription drug insurance coverage, utilization, and expenditures.

PubMed

Look, Kevin A; Arora, Prachi

2016-01-01

The US Affordable Care Act (ACA) extended the age of eligibility for young adults to remain on their parents' health insurance plans in order to address the disproportionate number of uninsured young adults in the United States. Effective September 23, 2010, the ACA has required all private health insurance plans to cover dependents until the age of 26. However, it is unknown whether the ACA dependent coverage expansion had an impact on prescription drug insurance or the use of prescription drugs. To evaluate short-term changes in prescription health insurance coverage, prescription drug insurance coverage, prescription drug use, and prescription drug expenditures following implementation of the ACA young adult insurance expansion using national data from 2009 and 2011. Full-year health insurance coverage increased 4.9 percentage points during the study period, which was mainly due to increases in private health insurance among middle- and high-income young adults. In contrast, full-year prescription drug insurance coverage increased 5.5 percentage points and was primarily concentrated among high-income young adults. Although no significant short-term changes in overall prescription drug use were observed, a 30% decrease in out-of-pocket expenditures was seen among young adults. While the main goal of the ACA's young adult insurance expansion was to increase health insurance coverage among young adults, it also had the unintended positive effect of increasing coverage for prescription drug insurance. Additionally, young adults experienced substantial decreases in out-of-pocket spending for prescription drugs. It is important for evaluations of health care policies to assess both intended and unintended outcomes to better understand the implications for the broader health system. Copyright © 2015 Elsevier Inc. All rights reserved.

Endo-exuberance and abdominal aortic aneurysm management: have we gone too far?

PubMed

Sternbergh, W Charles

2003-11-01

new technology, such as endovascular abdominal aortic aneurysm repair (EVAR) may promote an 'irrational exuberance' for its application. nonsuprarenal AAA repairs performed at a single institution over a 7 year period were retrospectively studied. Method of repair, 30-day mortality and EVAR aortic neck anatomy were assessed. 431 AAA repairs were performed between January 1996 and June 2002, 238 (55%) open and 193 (45%) EVAR. The percentage of EVAR increased steadily from approximately 20% in 1996 and 1997 to a peak of 69.5% in 2000. However, in 2001-2002 the percentage of EVAR fell to approximately 40% of total repairs. In this time period our selection criteria for EVAR became more conservative, with treatment of fewer patients with short aortic necks (12.8 vs. 28.9% with neck length < or = 20 mm, p = 0.05; 3.8 vs. 10.8% with neck length < or = 15 mm, p = 0.1) or highly angulated necks (3.8 vs. 28.9% with neck angulation > or = 40 degrees, p = 0.04) in 2001-2002 versus 1999-2000, respectively. Institutional volume of AAA repairs doubled over the study period (p = 0.001). 30-day mortality over the study period for nonruptured EVAR and open AAA repair was 2.6 and 3.3%, respectively (p = NS). The complexity of open repairs increased significantly during the final 3 years of the review. the application of EVAR has fallen from a high of 69.5% of our AAA repairs in 2000 to approximately 40% in 2001-2002. More prudent patient selection in recent years regarding unfavorable aortic neck anatomy was felt to be a primary etiology of changes in overall EVAR utilization. The anticipated improvement in long-term results from EVAR await multi-year follow-up.

SU-F-T-635: Lung SBRT: Dosimetric and Treatment Time Comparison of Volumetric-Modulated Arc Therapy and Three-Dimensional Conformal Radiotherapy in Clinically Treated Cases

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

Han, J; Xu, Z; Baker, J

Purpose: To compare three-dimensional conformal radiotherapy (3D CRT) and volumetric-modulated arc therapy (VMAT) in lung stereotactic body radiation therapy (SBRT) Methods: A retrospective study of clinically treated lung SBRT cases treated between 2010 and 2015 at our hospital was performed. All treatment modalities were included in this evaluation (VMAT, 3D CRT, static IMRT, and dynamic conformal arc therapy). However, the majority of treatment modalities were either VMAT or 3D CRT. Treatment times of patients and dosimetric plan quality metrics were compared. Treatment times were calculated based on the time the therapist opened and closed the patient’s treatment plan. This treatmentmore » time closely approximates the utilization time of the treatment room. The dosimetric plan quality metrics evaluated include ICRU conformity index, the volume of 105% prescribed dose outside PTV, the ratio of volume of 50% prescribed dose to the volume of PTV, the percentage of maximum dose at 2 cm away from PTV to the prescribed dose, and the V20 (percentage of lung volume receiving 20 Gy or more). Results: Treatment time comparisons show that on average VMAT has shorter treatment times than 3D CRT. Dose conformity, defined by the ICRU conformity index, and high dose spillage, defined by the volume of 105% dose outside the PTV, is reduced when using VMAT compared to 3D CRT. V20 and intermediate dose spillage/fall-off metrics of VMAT and 3D are not significantly different. Conclusion: Clinically treated lung SBRT cases indicate VMAT is superior to 3D with regard to shorter treatment times, plan dose conformity, and plan high dose spillage.« less

FETC/EPRI Biomass Cofiring Cooperative Agreement. Quarterly technical report, September 26-December 31, 1996

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

Hughes, E. Tillman, D.

1997-12-01

Biomass utilization to reduce fossil C0{sub 2} emissions is being supported by sixteen (16) EPRI research projects, each contributing to the commercialization of systems to address greenhouse gas emissions. These projects include: (1) cofiring combustion testing at the Seward Generating Station of GPU Genco; (2) fuel preparation testing at the Greenidge Generating Station of NYSEG; (3) precommercial testing of cofiring at the Allen and Colbert Fossil Plants of TVA; (4) testing of switchgrass cofiring at the Blount St. Station of Madison Gas & Electric; (5) high percentage biomass cofiring with Southern Company; (6) urban wood waste cofiring at the supercriticalmore » cyclone boiler at Michigan City Generating Station of Northern Indiana Public Service Co. (NIPSCO); (7) evaluation of switchgrass cofiring with Nebraska Public Power District at Sandia National Laboratories in Livermore, CA; (8) waste plastics cofiring with Duke Power in a tangentially-fired pulverized coal (PC) boiler; (9) cofiring a mixture of plastics, fiber, and pulp industry wastes with South Carolina Electric and Gas; (10) urban wood waste cofiring evaluation and testing by the University of Pittsburgh in stoker boilers; (11) assessment of toxic emissions from cofiring of wood and coal; (12) development of fuel and power plant models for analysis and interpretation of cofiring results; (13) analysis of C0{sub 2} utilization in algal systems for wastewater treatment; (14) combustion testing and combustor development focusing on high percentage cofiring; (15) analysis of problems and potential solutions to the sale of flyash from coal- fired boilers practicing cofiring; and (16) analysis of C0{sub 2} capture and disposal systems. EPRI is supported in these efforts by numerous contractors including: Foster Wheeler Environmental Corporation, Battelle Columbus Laboratories, New York State Electric and Gas Co., Tennessee Valley Authority (TVA), NIPSCO, the University of Pittsburgh, John Benneman, and others. These projects address various aspects of cofiring for C0{sub 2} mitigation including testing of cofiring with various fuels, and in all types of boilers; development of analytical tools to support the cofiring assessment; addressing specific barriers to cofiring such as the sale of flyash; longer term technology development; and evaluating alternative methods for C0{sub 2} mitigation. Taken together, they address the critical concerns associated with this approach to biofuel utilization. As such, they support implementation of the most promising near-term approach to biomass usage for greenhouse gas mitigation. This report contains a brief description of each project. It then reports the progress made during the first quarter of the contract, focusing upon test results from the Allen Fossil Plant, where precommercial testing at a cyclone boiler was used to evaluate particle size and NO{sub x} emissions from cofiring.« less

Trends in High School Dropout and Completion Rates in the United States: 2014. NCES 2018-117

ERIC Educational Resources Information Center

McFarland, Joel; Cui, Jiashan; Stark, Patrick

2018-01-01

This report draws on an array of nationally representative surveys and administrative datasets to present statistics on high school dropout and completion rates. The report includes estimates of the percentage of students who drop out in a given 12-month period (event dropout rates), the percentage of young people in a specified age range who are…

Exploring medical student decisions regarding attending live lectures and using recorded lectures.

PubMed

Gupta, Anmol; Saks, Norma Susswein

2013-09-01

Student decisions about lecture attendance are based on anticipated effect on learning. Factors involved in decision-making, the use of recorded lectures and their effect on lecture attendance, all warrant investigation. This study was designed to identify factors in student decisions to attend live lectures, ways in which students use recorded lectures, and if their use affects live lecture attendance. A total of 213 first (M1) and second year (M2) medical students completed a survey about lecture attendance, and rated factors related to decisions to attend live lectures and to utilize recorded lectures. Responses were analyzed overall and by class year and gender. M1 attended a higher percentage of live lectures than M2, while both classes used the same percentage of recorded lectures. Females attended more live lectures, and used a smaller percentage of recorded lectures. The lecturer was a key in attendance decisions. Also considered were the subject and availability of other learning materials. Students use recorded lectures as replacement for live lectures and as supplement to them. Lectures, both live and recorded, are important for student learning. Decisions about lecture placement in the curriculum need to be based on course content and lecturer quality.

Effectiveness evaluation of several cattle anthelmintics via the fecal egg count reduction test.

PubMed

Yazwinski, T A; Tucker, C A; Hornsby, J A; Powell, J G; Reynolds, J L; Johnson, Z B; Lindsey, W; Silver, T K

2009-07-01

Utilizing groups of cograzed, naturally infected beef-type heifers, three fecal egg count reduction tests were conducted in the later months of 2007 at the University of Arkansas. Each test was 28 days in length consisting of individual animal fecal nematode egg counts and coprocultures. Both original and generic ivermectin injectable formulations were used in two of the tests at 0.2 mg/kg BW, with FECR percentages never exceeding 90% in either test. Oral fenbendazole was evaluated at 5 and 10 mg/kg BW, with FECR%'s exceeding 90% on all occasions, but with a precipitous drop when recently treated animals were treated at the lower dose. Evaluated in one test, injectable moxidectin given at 0.2 mg/kg BW resulted in egg count reductions of 96-92% (days 7 to 28). Also evaluated in one test, albendazole delivered orally at 10 mg/kg BW was 98% and 97% effective at 17 and 28 days post-treatment. For all tests, coprocultures conducted post-treatment contained only Cooperia spp. larvae (benzimidazole use), relatively unmodified percentages of Cooperia spp. and Haemonchus spp. larvae (ivermectin use), and primarily Cooperia spp. larvae with a small percentage of Haemonchus spp. larvae (moxidectin use).

A new three-locus model for rootstock-induced dwarfing in apple revealed by genetic mapping of root bark percentage

PubMed Central

Harrison, Nicola; Harrison, Richard J.; Barber-Perez, Nuria; Cascant-Lopez, Emma; Cobo-Medina, Magdalena; Lipska, Marzena; Conde-Ruíz, Rebeca; Brain, Philip; Gregory, Peter J.; Fernández-Fernández, Felicidad

2016-01-01

Rootstock-induced dwarfing of apple scions revolutionized global apple production during the twentieth century, leading to the development of modern intensive orchards. A high root bark percentage (the percentage of the whole root area constituted by root cortex) has previously been associated with rootstock-induced dwarfing in apple. In this study, the root bark percentage was measured in a full-sib family of ungrafted apple rootstocks and found to be under the control of three loci. Two quantitative trait loci (QTLs) for root bark percentage were found to co-localize to the same genomic regions on chromosome 5 and chromosome 11 previously identified as controlling dwarfing, Dw1 and Dw2, respectively. A third QTL was identified on chromosome 13 in a region that has not been previously associated with dwarfing. The development of closely linked sequence-tagged site markers improved the resolution of allelic classes, thereby allowing the detection of dominance and epistatic interactions between loci, with high root bark percentage only occurring in specific allelic combinations. In addition, we report a significant negative correlation between root bark percentage and stem diameter (an indicator of tree vigour), measured on a clonally propagated grafted subset of the mapping population. The demonstrated link between root bark percentage and rootstock-induced dwarfing of the scion leads us to propose a three-locus model that is able to explain levels of dwarfing from the dwarf ‘M.27’ to the semi-invigorating rootstock ‘M.116’. Moreover, we suggest that the QTL on chromosome 13 (Rb3) might be analogous to a third dwarfing QTL, Dw3, which has not previously been identified. PMID:26826217

Early life-history predator-prey reversal in two cyprinid fishes.

PubMed

Šmejkal, Marek; Baran, Roman; Blabolil, Petr; Vejřík, Lukáš; Prchalová, Marie; Bartoň, Daniel; Mrkvička, Tomáš; Kubečka, Jan

2017-07-31

Predator-prey relationships are often perceived simply as a situation in which a predator enhances its own fitness while reducing the fitness of its prey. However, this relationship may become reversed when the prey feeds on the juvenile predator stages. We investigated this phenomenon in a model asp (Leuciscus aspius; predator)-bleak (Alburnus alburnus; prey) relationship. The adhesive asp eggs are available for bleak predation after a spawning event for only tens of seconds before they adhere to the stones, where bleak do not forage. Gut content analysis demonstrated that eggs were utilized in high quantities, especially in the spawning peak of the asp reproductive season. Furthermore, using underwater video, we recorded the bleak feeding efficiency on naturally drifting asp eggs as the percentage of eggs eaten. Within the 40 cm egg trajectory captured by our cameras, total egg mortality was 21.2 ± 2.2% on average. The highest survival chances occurred among eggs drifting in aggregations, since the short drifting distance together with their aggregated distribution satiated bleak and part of the egg aggregation could attach to the spawning ground. This study emphasizes the potential efficiency of predator egg utilization by prey, which may have further consequences in predator-prey dynamics.

Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

PubMed

Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

2016-08-01

Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

Modeling Lithium Movement over Multiple Cycles in a Lithium-Metal Battery

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

Ferrese, A; Newman, J

This paper builds on the work by Ferrese et al. [J. Electrochem., 159, A1615 (2012)], where a model of a lithium-metal battery with a LiyCoO2 positive electrode was created in order to predict the movement of lithium in the negative electrode along the negative electrode/separator interface during cell cycling. In this paper, the model is expanded to study the movement of lithium along the lithium-metal anode over multiple cycles. From this model, it is found that when a low percentage of lithium at the negative electrode is utilized, the movement of lithium along the negative electrode/separator interface reaches a quasimore » steady state after multiple cycles. This steady state is affected by the slope of the open-circuit-potential function in the positive electrode, the rate of charge and discharge, the depth of discharge, and the length of the rest periods. However, when a high percent of the lithium at the negative electrode is utilized during cycling, the movement does not reach a steady state and pinching can occur, where the lithium nearest the negative tab becomes progressively thinner after cycling. This is another nonlinearity that leads to a progression of the movement of lithium over multiple cycles. (C) 2014 The Electrochemical Society.« less

Thermal burn and electrical injuries among electric utility workers, 1995-2004.

PubMed

Fordyce, Tiffani A; Kelsh, Michael; Lu, Elizabeth T; Sahl, Jack D; Yager, Janice W

2007-03-01

This study describes the occurrence of work-related injuries from thermal-, electrical- and chemical-burns among electric utility workers. We describe injury trends by occupation, body part injured, age, sex, and circumstances surrounding the injury. This analysis includes all thermal, electric, and chemical injuries included in the Electric Power Research Institute (EPRI) Occupational Health and Safety Database (OHSD). There were a total of 872 thermal burn and electric shock injuries representing 3.7% of all injuries, but accounting for nearly 13% of all medical claim costs, second only to the medical costs associated with sprain- and strain-related injuries (38% of all injuries). The majority of burns involved less than 1 day off of work. The head, hands, and other upper extremities were the body parts most frequently injured by burns or electric shocks. For this industry, electric-related burns accounted for the largest percentage of burn injuries, 399 injuries (45.8%), followed by thermal/heat burns, 345 injuries (39.6%), and chemical burns, 51 injuries (5.8%). These injuries also represented a disproportionate number of fatalities; of the 24 deaths recorded in the database, contact with electric current or with temperature extremes was the source of seven of the fatalities. High-risk occupations included welders, line workers, electricians, meter readers, mechanics, maintenance workers, and plant and equipment operators.

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

Nelson, Cassandra E.; Rogowski, Artur; Morland, Carl

Degradation of polysaccharides forms an essential arc in the carbon cycle, provides a percentage of our daily caloric intake, and is a major driver in the renewable chemical industry. Microorganisms proficient at degrading insoluble polysaccharides possess large numbers of carbohydrate active enzymes, many of which have been categorized as functionally redundant. Here we present data that suggests that carbohydrate active enzymes that have overlapping enzymatic activities can have unique, non-overlapping biological functions in the cell. Our comprehensive study to understand cellodextrin utilization in the soil saprophyte Cellvibrio japonicus found that only one of four predicted β-glucosidases is required in amore » physiological context. Gene deletion analysis indicated that only the cel3B gene product is essential for efficient cellodextrin utilization in C. japonicus and is constitutively expressed at high levels. Interestingly, expression of individual β-glucosidases in Escherichia coli K-12 enabled this non-cellulolytic bacterium to be fully capable of using cellobiose as a sole carbon source. Furthermore, enzyme kinetic studies indicated that the Cel3A enzyme is significantly more active than the Cel3B enzyme on the oligosaccharides but not disaccharides. Finally, our approach for parsing related carbohydrate active enzymes to determine actual physiological roles in the cell can be applied to other polysaccharide-degradation systems.« less

Glycine uptake by microvillous and basal plasma membrane vesicles from term human placentae.

PubMed

Dicke, J M; Verges, D; Kelley, L K; Smith, C H

1993-01-01

Like most amino acids, glycine is present in higher concentrations in the fetus than in the mother. Unlike most amino acids, animal studies suggest fetal concentrations of glycine are minimally in excess of those required for protein synthesis. Abnormal glycine utilization has also been demonstrated in small-for-gestational age human fetuses. The mechanism(s) of glycine uptake in the human placenta are unknown. In other mammalian cells glycine is a substrate for the A, ASC and Gly amino acid transport systems. In this study human placental glycine uptake was characterized using microvillous and basal plasma membrane vesicles each prepared from the same placenta. In both membranes glycine uptake was mediated predominantly by the sodium-dependent A system. Competitive inhibition studies suggest that in microvillous vesicles the small percentage of sodium-dependent glycine uptake not inhibited by methylaminoisobutyric acid (MeAIB) shares a transport system with glycine methyl ester and sarcosine, substrates of the Gly system in other tissues. In addition there are mediated sodium-independent and non-selective transport mechanisms in both plasma membranes. If fetal glycine availability is primarily contingent upon the common and highly regulated A system, glycine must compete with many other substrates potentially resulting in marginal fetal reserves, abnormal utilization and impaired growth.

Unlocking the genetic diversity of Creole wheats.

PubMed

Vikram, Prashant; Franco, Jorge; Burgueño-Ferreira, Juan; Li, Huihui; Sehgal, Deepmala; Saint Pierre, Carolina; Ortiz, Cynthia; Sneller, Clay; Tattaris, Maria; Guzman, Carlos; Sansaloni, Carolina Paola; Ellis, Mark; Fuentes-Davila, Guillermo; Reynolds, Matthew; Sonders, Kai; Singh, Pawan; Payne, Thomas; Wenzl, Peter; Sharma, Achla; Bains, Navtej Singh; Singh, Gyanendra Pratap; Crossa, José; Singh, Sukhwinder

2016-03-15

Climate change and slow yield gains pose a major threat to global wheat production. Underutilized genetic resources including landraces and wild relatives are key elements for developing high-yielding and climate-resilient wheat varieties. Landraces introduced into Mexico from Europe, also known as Creole wheats, are adapted to a wide range of climatic regimes and represent a unique genetic resource. Eight thousand four hundred and sixteen wheat landraces representing all dimensions of Mexico were characterized through genotyping-by-sequencing technology. Results revealed sub-groups adapted to specific environments of Mexico. Broadly, accessions from north and south of Mexico showed considerable genetic differentiation. However, a large percentage of landrace accessions were genetically very close, although belonged to different regions most likely due to the recent (nearly five centuries before) introduction of wheat in Mexico. Some of the groups adapted to extreme environments and accumulated high number of rare alleles. Core reference sets were assembled simultaneously using multiple variables, capturing 89% of the rare alleles present in the complete set. Genetic information about Mexican wheat landraces and core reference set can be effectively utilized in next generation wheat varietal improvement.

Production of sn-1,3-distearoyl-2-oleoyl-glycerol-rich fats from mango kernel fat by selective fractionation using 2-methylpentane based isohexane.

PubMed

Jin, Jun; Zheng, Liyou; Mwinyi Pembe, Warda; Zhang, Jinfang; Xie, Dan; Wang, Xiaosan; Huang, Jianhua; Jin, Qingzhe; Wang, Xingguo

2017-11-01

High-purity isohexane containing 88.12% 2-methylpentane, which has a higher polarity than industrial hexane, was selected to selectively fractionate mango kernel fat to produce 1,3-distearoyl-2-oleoyl-glycerol (SOS)-rich fat. The three-stage fractionation process was optimized by considering the stearin yield and its SOS content to obtain a third stearin (TS). This fat contained a high percentage of SOS (69.2%) with only 0.8% diacylglycerol. Mass spectra and sn-2 fatty acid analyses further revealed that the TS was mainly composed of symmetrical monounsaturated triacylglycerols. Compared with cocoa butter (CB), the unique composition of the TS improved its thermal properties (35.6% and 0% solid fat content at 35°C for the TS and CB, respectively). In particular, tempered binary fat blends, which were composed of 20-50% TS and 50-80% CB, showed acceptable compatibility at 20-28°C. The TS could be utilized by chocolate manufacturers to make products suitable for sale and consumption in tropical conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fiber optic video monitoring system for remote CT/MR scanners clinically accepted

NASA Astrophysics Data System (ADS)

Tecotzky, Raymond H.; Bazzill, Todd M.; Eldredge, Sandra L.; Tagawa, James; Sayre, James W.

1992-07-01

With the proliferation of CT travel to distant scanners to review images before their patients can be released. We designed a fiber-optic broadband video system to transmit images from seven scanner consoles to fourteen remote monitoring stations in real time. This system has been used clinically by radiologists for over one years. We designed and conducted a user survey to categorize the levels of system use by section (Chest, GI, GU, Bone, Neuro, Peds, etc.), to measure operational utilization and acceptance of the system into the clinical environment, to clarify the system''s importance as a clinical tool for saving radiologists travel-time to distant CT the system''s performance and limitations as a diagnostic tool. The study was administered directly to radiologists using a printed survey form. The results of the survey''s compiled data show a high percentage of system usage by a wide spectrum of radiologists. Clearly, this system has been accepted into the clinical environment as a highly valued diagnostic tool in terms of time savings and functional flexibility.

NursesforTomorrow: a proactive approach to nursing resource analysis.

PubMed

Bournes, Debra A; Plummer, Carolyn; Miller, Robert; Ferguson-Paré, Mary

2010-03-01

This paper describes the background, development, implementation and utilization of NursesforTomorrow (N4T), a practical and comprehensive nursing human resources analysis method to capture regional, institutional and patient care unit-specific actual and predicted nurse vacancies, nurse staff characteristics and nurse staffing changes. Reports generated from the process include forecasted shortfalls or surpluses of nurses, percentage of novice nurses, occupancy, sick time, overtime, agency use and other metrics. Readers will benefit from a description of the ways in which the data generated from the nursing resource analysis process are utilized at senior leadership, program and unit levels to support proactive hiring and resource allocation decisions and to predict unit-specific recruitment and retention patterns across multiple healthcare organizations and regions.

Radiolarian indicators of El Nino and anti-El Nino events in Holocene sediments of Santa Barbara basin

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

Weinheimer, A.L.

Radiolarian distributions and physical oceanographic data from the Santa Barbara basin indicate the following. Strong anti-El Nino periods can be characterized by (1) intermediate radiolarian density, (2) high percentage of transition-central radiolarian fauna, and (3) low percentage and number of warm-water radiolarian fauna. This distribution pattern is attributed to strong wind-driven upwelling and reduced northward transport by the California Countercurrent during anti-El Nino periods. Strong El Nino periods are typically (1) high in radiolarian density, and (2) low in percentage but high in number of warm-water fauna. This distribution is attributed to reduced wind-driven upwelling, enhanced northward countercurrent transport, andmore » geostrophic doming of the cold-water masses in the shear zone between the California Current and California Countercurrent.« less

Operating room waste: disposable supply utilization in neurosurgical procedures.

PubMed

Zygourakis, Corinna C; Yoon, Seungwon; Valencia, Victoria; Boscardin, Christy; Moriates, Christopher; Gonzales, Ralph; Lawton, Michael T

2017-02-01

OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

Allocation of systemic glucose output to cerebral utilization as a function of fetal canine growth.

PubMed

Huang, M M; Kliegman, R M; Trindade, C; Kall, D; Voelker, K

1988-05-01

To determine whether the neonatal canine brain consumes a major proportion of the systemic glucose production, we investigated the cerebral glucose requirement and hepatic glucose production in beagle pups. Sixteen pups received D-[6-3H]-glucose to determine systemic glucose production. Cerebral blood flow was measured by [N-methyl-14C]antipyrine, and the brain uptake index (BUI) of glucose was determined using 2-[14C]deoxy-D-glucose. Glucose production was 49.6 +/- 11.0 mumol.kg-1.min-1. Cerebral blood flow was 0.83 ml.g-1.min-1; cerebral uptake of glucose was 0.60 +/- 0.15 mumol.g-1.min-1. Of the total glucose production 36.6 +/- 7.9% was accounted for by the cerebral uptake of glucose. Brain-to-body weight and brain-to-liver weight ratios were the greatest in the smallest pups, suggesting brain sparing. The effect of growth status on cerebral substrate availability could not be correlated with cerebral uptake of glucose or oxygen or with systemic glucose production. However, the percentage of systemic glucose production allotted to the cerebral cortex increased with increasing body weight (r = 0.50, P less than 0.05). Cerebral glucose entry measured by BUI was demonstrated to be 0.108 +/- 0.014; BUI inversely correlated with canine birth weight (r = -0.832, P less than 0.001). We conclude that the percentage of glucose production utilized by the neonatal canine brain is not proportionately larger in the smaller pups despite a proportionately larger brain. Because the absolute cerebral glucose utilization may be static, we speculate that BUI (glucose entry) may be less of a rate-limiting factor for cerebral glucose entry in the smallest pups.

Work-related injuries in a state trauma registry: relationship between industry and drug screening.

PubMed

Bunn, Terry L; Slavova, Svetla; Bernard, Andrew C

2014-08-01

Work-related injuries exert a great financial and economic burden on the US population. The study objectives were to identify the industries and occupations associated with worker injuries and to determine the predictors for injured worker drug screening in trauma centers. Work-related injury cases were selected using three criteria (expected payer source of workers' compensation, industry-related e-codes, and work-related indicator) from the Kentucky Trauma Registry data set for years 2008 to 2012. Descriptive analyses and multiple logistic regression were performed on the work-related injury cases. The "other services" and construction industry sectors accounted for the highest number of work-related cases. Drugs were detected in 55% of all drug-screened work-related trauma cases. Higher percentages of injured workers tested positive for drugs in the natural resources and mining, transportation and public utilities, and construction industries. In comparison, higher percentages of injured workers in the other services as well as transportation and public utilities industries were drug screened. Treatment at Level I trauma centers and Glasgow Coma Scale (GCS) scores indicating a coma or severe brain injury were both significant independent predictors for being screened for drugs; industry was not a significant predictor for being drug screened. The injured worker was more likely to be drug screened if the worker had a greater than mild injury, regardless of whether the worker was an interfacility transfer. These findings indicate that there may be elevated drug use or abuse in natural resources and mining, transportation and public utilities, as well as construction industry workers; improved identification of the specific drug types in positive drug screen results of injured workers is needed to better target prevention efforts. Epidemiologic study, level III.

Cocoa Flavanol Supplementation Influences Skin Conditions of Photo-Aged Women: A 24-Week Double-Blind, Randomized, Controlled Trial.

PubMed

Yoon, Hyun-Sun; Kim, Jong Rhan; Park, Gyeong Yul; Kim, Jong-Eun; Lee, Dong Hun; Lee, Ki Won; Chung, Jin Ho

2016-01-01

The consumption of dietary antioxidants is considered to be a good strategy against photo-aging. However, the results of previous clinical trials that investigated the effects of oral consumption of high-flavanol cocoa products on skin photo-aging have been contradictory. The aim of this study was to investigate whether high-flavanol cocoa supplementation would improve the moderately photo-aged facial skin of female participants, by assessing skin wrinkles and elasticity. We performed a 24-wk, randomized, double-blind, placebo-controlled study to evaluate the effects of oral supplementation of cocoa flavanols on cutaneous photo-aging. All participants were moderately photo-aged Korean women with visible facial wrinkles (age range: 43-86 y). Participants were randomly assigned to receive a placebo beverage or cocoa beverage that contained 320 mg total cocoa flavanols/d. We measured wrinkles, skin elasticity, and hydration at baseline and at 12 and 24 wk. The primary endpoint was the mean percentage change in the average roughness value (Rz) at 24 wk. At 24 wk, the mean percentage change in Rz (primary endpoint) was significantly lower in the cocoa group than in the placebo group (-8.7 percentage points; 95% CI: -16.1, -1.3 percentage points; P = 0.023). The mean percentage changes in gross elasticity, as determined by a cutometer, also differed between the groups at 12 wk (9.1 percentage points; 95% CI: 1.5, 16.7 percentage points; P = 0.020) and 24 wk (8.6 percentage points; 95% CI: 1.0, 16.2 percentage points; P = 0.027). However, there were no significant differences in skin hydration and barrier integrity between the 2 groups. In moderately photo-aged women, regular cocoa flavanol consumption had positive effects on facial wrinkles and elasticity. Cocoa flavanol supplementation may contribute to the prevention of the progression of photo-aging. This trial was registered at clinicaltrials.gov as NCT02060097. © 2016 American Society for Nutrition.

The Use of an Intra-Articular Depth Guide in the Measurement of Partial Thickness Rotator Cuff Tears

PubMed Central

Carroll, Michael J.; More, Kristie D.; Sohmer, Stephen; Nelson, Atiba A.; Sciore, Paul; Boorman, Richard; Hollinshead, Robert; Lo, Ian K. Y.

2013-01-01

Purpose. The purpose of this study was to compare the accuracy of the conventional method for determining the percentage of partial thickness rotator cuff tears to a method using an intra-articular depth guide. The clinical utility of the intra-articular depth guide was also examined. Methods. Partial rotator cuff tears were created in cadaveric shoulders. Exposed footprint, total tendon thickness, and percentage of tendon thickness torn were determined using both techniques. The results from the conventional and intra-articular depth guide methods were correlated with the true anatomic measurements. Thirty-two patients were evaluated in the clinical study. Results. Estimates of total tendon thickness (r = 0.41, P = 0.31) or percentage of thickness tears (r = 0.67, P = 0.07) using the conventional method did not correlate well with true tendon thickness. Using the intra-articular depth guide, estimates of exposed footprint (r = 0.92, P = 0.001), total tendon thickness (r = 0.96, P = 0.0001), and percentage of tendon thickness torn (r = 0.88, P = 0.004) correlated with true anatomic measurements. Seven of 32 patients had their treatment plan altered based on the measurements made by the intra-articular depth guide. Conclusions. The intra-articular depth guide appeared to better correlate with true anatomic measurements. It may be useful during the evaluation and development of treatment plans for partial thickness articular surface rotator cuff tears. PMID:23533789

For All Kids: How Kentucky Is Closing the High School Graduation Gap for Low-Income Students

ERIC Educational Resources Information Center

Fox, Joanna Hornig; Ingram, Erin S.; Depaoli, Jennifer L.

2016-01-01

In the 2012-13 school year, Kentucky led the nation with an 85.4 percent high school graduation rate for low-income students and a one-percentage-point graduation gap between low-income and non-low-income students. In 2013-14 the state ranked fourth in the nation with a seven-percentage-point incomebased graduation rate gap. Even though Kentucky's…

Teacher Use of Brain-Based Research, Response to Intervention, and Teacher Efficacy in Elementary Schools with High and Low Individual Education Plan Growth for English Language Learners

ERIC Educational Resources Information Center

Fernandez, Nicole

2012-01-01

The purpose of this study was to explore the possible causes that might contribute to the disproportionate percentage of English language learners ELLs with special education individual education plans (IEPs). Elementary school classroom teachers from school districts that exhibited high growth in the percentage of ELLs with IEPs during 2007-2010…

Oregon's On-Time High School Graduation Rate Shows Strong Growth in 2014-15. Research Brief

ERIC Educational Resources Information Center

Oregon Department of Education, 2016

2016-01-01

Oregon continues to make gains in its on-time high school graduation rate. The rate increased to 74% for the 2014-15 school year--up from 72% the year before. The graduation rate for almost all student groups rose, led by Hispanic students (2.4 percentage points) and Black students (2.4 percentage points). The rate for economically disadvantaged…

Magnetic Cellulose Nanocrystal Based Anisotropic Polylactic Acid Nanocomposite Films: Influence on Electrical, Magnetic, Thermal, and Mechanical Properties.

PubMed

Dhar, Prodyut; Kumar, Amit; Katiyar, Vimal

2016-07-20

This paper reports a single-step co-precipitation method for the fabrication of magnetic cellulose nanocrystals (MGCNCs) with high iron oxide nanoparticle content (∼51 wt % loading) adsorbed onto cellulose nanocrystals (CNCs). X-ray diffraction (XRD), Fourier transform infrared (FTIR), and Raman spectroscopic studies confirmed that the hydroxyl groups on the surface of CNCs (derived from the bamboo pulp) acted as anchor points for the adsorption of Fe3O4 nanoparticles. The fabricated MGCNCs have a high magnetic moment, which is utilized to orient the magnetoresponsive nanofillers in parallel or perpendicular orientations inside the polylactic acid (PLA) matrix. Magnetic-field-assisted directional alignment of MGCNCs led to the incorporation of anisotropic mechanical, thermal, and electrical properties in the fabricated PLA-MGCNC nanocomposites. Thermomechanical studies showed significant improvement in the elastic modulus and glass-transition temperature for the magnetically oriented samples. Differential scanning calorimetry (DSC) and XRD studies confirmed that the alignment of MGCNCs led to the improvement in the percentage crystallinity and, with the absence of the cold-crystallization phenomenon, finds a potential application in polymer processing in the presence of magnetic field. The tensile strength and percentage elongation for the parallel-oriented samples improved by ∼70 and 240%, respectively, and for perpendicular-oriented samples, by ∼58 and 172%, respectively, in comparison to the unoriented samples. Furthermore, its anisotropically induced electrical and magnetic properties are desirable for fabricating self-biased electronics products. We also demonstrate that the fabricated anisotropic PLA-MGCNC nanocomposites could be laminated into films with the incorporation of directionally tunable mechanical properties. Therefore, the current study provides a novel noninvasive approach of orienting nontoxic bioderived CNCs in the presence of low magnetic fields, with potential applications in the manufacturing of three-dimensional composites with microstructural features comparable to biological materials for high-performance engineering applications.

Spatial vulnerability of fine particulate matter relative to the prevalence of diabetes in the United States.

PubMed

Chien, Lung-Chang; Alamgir, Hasanat; Yu, Hwa-Lung

2015-03-01

Recent research supports a link between diabetes and fine particulate matter (≤ 2.5μg in diameter; PM2.5) in both laboratory and epidemiology studies. However, research investigating the potential relationship of the spatial vulnerability of diabetes to concomitant PM2.5 levels is still sparse, and the level of diabetes geographic disparities attributed to PM2.5 levels has yet to be evaluated. We conducted a Bayesian structured additive regression modeling approach to determine whether long-term exposure to PM2.5 is spatially associated with diabetes prevalence after adjusting for the socioeconomic status of county residents. This study utilizes the following data sources from 2004 to 2010: the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Environmental Protection Agency. We also conducted spatial comparisons with low, median-low, median-high, and high levels of PM2.5 concentrations. When PM2.5 concentrations increased 1 μg/m(3), the increase in the relative risk percentage for diabetes ranged from -5.47% (95% credible interval = -6.14, -4.77) to 2.34% (95% CI = 2.01, 2.70), where 1323 of 3109 counties (42.55%) displayed diabetes vulnerability with significantly positive relative risk percentages. These vulnerable counties are more likely located in the Southeast, Central, and South Regions of the U.S. A similar spatial vulnerability pattern for concentrations of low PM2.5 levels was also present in these same three regions. A clear cluster of vulnerable counties at median-high PM2.5 level was found in Michigan. This study identifies the spatial vulnerability of diabetes prevalence associated with PM2.5, and thereby provides the evidence needed to prompt and establish enhanced surveillance that can monitor diabetes vulnerability in areas with low PM2.5 pollution. Copyright © 2014 Elsevier B.V. All rights reserved.

Spatial vulnerability of fine particulate matter relative to the geographic disparities of adult's diabetes prevalence in the United States

NASA Astrophysics Data System (ADS)

Chien, Lung-Chang; Alamgir, Hassanat; Yu, Hwa-Lung

2015-04-01

Potentially larger regional effects of climate change have been revealed on the elevation of fine particulate matter (≤ 2.5 µg in diameter; PM2.5) in the U.S. In addition, recent research supports a link between diabetes and PM2.5 in both laboratory and epidemiology studies. However, research investigating the potential relationship of the spatial vulnerability of diabetes to concomitant PM2.5 levels is still sparse, and the level of diabetes geographic disparities attributed to PM2.5 levels has yet to be evaluated. We conducted a Bayesian structured additive regression modeling approach to determine whether long-term exposure to PM2.5 is spatially associated with diabetes prevalence after adjusting for the socioeconomic status of county residents. This study utilizes the following data sources from 2004-2010: the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Environmental Protection Agency. We also conducted spatial comparisons with low, median-low, median-high, and high levels of PM2.5 concentrations. When PM2.5 concentrations increased 1 µg/m3, the increase in the relative risk percentage for diabetes ranged from -5.47% (95% credible interval = -6.14, -4.77) to 2.34% (95% CI = 2.01, 2.70), where 1,323 of 3,109 counties (42.55%) displayed diabetes vulnerability with significantly positive relative risk percentages. These vulnerable counties are more likely located in the Southeast, Central, and South Regions of the U.S. A similar spatial vulnerability pattern for concentrations of low PM2.5 levels was also present in these same three regions. A clear cluster of vulnerable counties at median-high PM2.5 level was found in Michigan. This study identifies the spatial vulnerability of diabetes prevalence associated with PM2.5, and thereby provides the evidence needed to prompt and establish enhanced surveillance that can monitor diabetes vulnerability in areas with low PM2.5 pollution.

Thin-film CdTe detector for microdosimetric study of radiation dose enhancement at gold-tissue interface.

PubMed

Paudel, Nava Raj; Shvydka, Diana; Parsai, E Ishmael

2016-09-08

Presence of interfaces between high and low atomic number (Z) materials, often encountered in diagnostic imaging and radiation therapy, leads to radiation dose perturbation. It is characterized by a very narrow region of sharp dose enhancement at the interface. A rapid falloff of dose enhancement over a very short distance from the interface makes the experimental dosimetry nontrivial. We use an in-house-built inexpensive thin-film Cadmium Telluride (CdTe) photodetector to study this effect at the gold-tissue interface and verify our experimental results with Monte Carlo (MC) modeling. Three-micron thick thin-film CdTe photodetectors were fabricated in our lab. One-, ten- or one hundred-micron thick gold foils placed in a tissue-equivalent-phantom were irradiated with a clinical Ir-192 high-dose-rate (HDR) source and current measured with a CdTe detector in each case was compared with the current measured for all uniform tissue-equivalent phantom. Percentage signal enhancement (PSE) due to each gold foil was then compared against MC modeled percentage dose enhancement (PDE), obtained from the geometry mimicking the experimental setup. The experimental PSEs due to 1, 10, and 100 μm thick gold foils at the closest measured distance of 12.5μm from the interface were 42.6 ± 10.8 , 137.0 ± 11.9, and 203.0 ± 15.4, respectively. The corresponding MC modeled PDEs were 38.1 ± 1, 164 ± 1, and 249 ± 1, respectively. The experimental and MC modeled values showed a closer agreement at the larger distances from the interface. The dose enhancement in the vicinity of gold-tissue interface was successfully measured using an in-house-built, high-resolution CdTe-based photodetector and validated with MC simulations. A close agreement between experimental and the MC modeled results shows that CdTe detector can be utilized for mapping interface dose distribution encountered in the application of ionizing radiation. © 2016 The Authors.

Plasma impregnation of wood with fire retardants

NASA Astrophysics Data System (ADS)

Pabeliña, Karel G.; Lumban, Carmencita O.; Ramos, Henry J.

2012-02-01

The efficacy of chemical and plasma treatments with phosphate and boric compounds, and nitrogen as flame retardants on wood are compared in this study. The chemical treatment involved the conventional method of spraying the solution over the wood surface at atmospheric condition and chemical vapor deposition in a vacuum chamber. The plasma treatment utilized a dielectric barrier discharge ionizing and decomposing the flame retardants into innocuous simple compounds. Wood samples are immersed in either phosphoric acid, boric acid, hydrogen or nitrogen plasmas or a plasma admixture of two or three compounds at various concentrations and impregnated by the ionized chemical reactants. Chemical changes on the wood samples were analyzed by Fourier transform infrared spectroscopy (FTIR) while the thermal changes through thermo gravimetric analysis (TGA). Plasma-treated samples exhibit superior thermal stability and fire retardant properties in terms of highest onset temperature, temperature of maximum pyrolysis, highest residual char percentage and comparably low total percentage weight loss.

[Preservation of fungi and actinomycetes of medical importance in distilled water].

PubMed

Rodrigues, E G; Lírio, V S; Lacaz, C da S

1992-01-01

Several methods have been used for the preservation of fungi, all of them presenting advantages and disadvantages. The choice of the methods depends upon the laboratory availabilities, time of preservation, genetic stability of the cultures and other factors. In this work the results obtained through the utilization of Castellani's method (preservation in distilled water) for the maintenance of 174 strains belonging to the "Micoteca do Instituto de Medicina Tropical de São Paulo" are presented. These strains were analyzed after 6, 12, 18 and 24 months, with regard to the percentage of viability taking into consideration the rates of growth and contamination. The smallest percentage of viability occurred in the group of the actinomycetes (50 to 100%) and the largest one in the group of the yeasts (near 100%). According to other authors, the Castellani's method, besides being simple and economically feasible for small size laboratories, yields good results.

A demonstration of glass bonding using patterned nanocomposite thermites deposited from fluid

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

Rodriguez, Juan Carlos

2015-01-01

Ceramics and other nonmetals are widely used in industrial and research applications. Although these materials provide many advantages, they often pose unique challenges during bonding. This work aims to expand on current processes, which have much narrower applications, to nd a more universal method for nonmetal bonding. We utilize inks comprised of aluminum-based nanoenergetics, (a heat source) and tin (a bonding agent). Requirements for successful bonding are explored and four key criteria are established. Through statistical simulation and thermochemical equilibrium calculations, we conclude that the presence of a diluent in large percentages negatively impacts reaction kinetics. Conversely, we show smallmore » percentages of added tin enhance gas generation and drive faster reaction rates. The bulk bonding material, thermite plus tin, forms a continuous structure during reaction, adhering well to the substrate surface. In some cases, these bonds failed above 1200 kPa.« less

The Impact of Halloysite on the Thermo-Mechanical Properties of Polymer Composites.

PubMed

Gaaz, Tayser Sumer; Sulong, Abu Bakar; Kadhum, Abdul Amir H; Al-Amiery, Ahmed A; Nassir, Mohamed H; Jaaz, Ahed Hameed

2017-05-20

Nanotubular clay minerals, composed of aluminosilicate naturally structured in layers known as halloysite nanotubes (HNTs), have a significant reinforcing impact on polymer matrixes. HNTs have broad applications in biomedical applications, the medicine sector, implant alloys with corrosion protection and manipulated transportation of medicines. In polymer engineering, different research studies utilize HNTs that exhibit a beneficial enhancement in the properties of polymer-based nanocomposites. The dispersion of HNTs is improved as a result of pre-treating HNTs with acids. The HNTs' percentage additive up to 7% shows the highest improvement of tensile strength. The degradation of the polymer can be also significantly improved by doping a low percentage of HNTs. Both the mechanical and thermal properties of polymers were remarkably improved when mixed with HNTs. The effects of HNTs on the mechanical and thermal properties of polymers, such as ultimate strength, elastic modulus, impact strength and thermal stability, are emphasized in this study.

Knowledge of European orthodontic postgraduate students on biostatistics.

PubMed

Polychronopoulou, Argy; Eliades, Theodore; Taoufik, Konstantina; Papadopoulos, Moschos A; Athanasiou, Athanasios E

2011-08-01

The purpose of this study was to explore the level of knowledge in biostatistics of orthodontic postgraduate students. A four-section questionnaire, which included a knowledge test/quiz on biostatistics and epidemiology, was developed. This questionnaire was distributed to postgraduate programme directors of European universities to be delivered to students for completion under mock examination conditions (in-class session). The frequency distributions of demographic characteristics were examined, the percentages of participants who agreed or strongly agreed with each attitudinal statement were calculated, and the percentages of participants who felt fairly to highly confident for each statement were determined. Knowledge scores were calculated by the percentage of correct answers; missing values were counted as incorrect answers. The Student's t-test or one-way analysis of variance, where appropriate, was utilized to determine the participants' characteristics associated with mean knowledge scores. Data were further analysed with multiple linear regression modelling to determine the adjusted/unconfounded effect of possible knowledge score predictors. A two-tailed P-value of 0.05 was considered statistically significant with a 95 percent confidence interval (CI). One hundred and twenty seven from a total of 129 orthodontic students who replied completed the questionnaire. The mean correct answers of the participants were 43.8 percent with a 95 percent CI of 40.2-47.3 percent. This score was not influenced by gender, years elapsed from graduation, other advanced degree, or year of study; the sole parameter, which seemed to influence this score was attendance at a biostatistics/epidemiology course (51.9 versus 39.5 percent score of participants who had previously taken a course versus those who had not, P<0.001). A surprising finding was the inability of the responders to identify the appropriate use of the chi-square test (11.8 percent, 95 percent CI: 6.1-17.5 percent). The knowledge on biostatistics of orthodontic postgraduate students in Europe is only influenced by previous relevant education.

A novel concentration and viability detection method for Brettanomyces using the Cellometer image cytometry.

PubMed

Martyniak, Brian; Bolton, Jason; Kuksin, Dmitry; Shahin, Suzanne M; Chan, Leo Li-Ying

2017-01-01

Brettanomyces spp. can present unique cell morphologies comprised of excessive pseudohyphae and budding, leading to difficulties in enumerating cells. The current cell counting methods include manual counting of methylene blue-stained yeasts or measuring optical densities using a spectrophotometer. However, manual counting can be time-consuming and has high operator-dependent variations due to subjectivity. Optical density measurement can also introduce uncertainties where instead of individual cells counted, an average of a cell population is measured. In contrast, by utilizing the fluorescence capability of an image cytometer to detect acridine orange and propidium iodide viability dyes, individual cell nuclei can be counted directly in the pseudohyphae chains, which can improve the accuracy and efficiency of cell counting, as well as eliminating the subjectivity from manual counting. In this work, two experiments were performed to demonstrate the capability of Cellometer image cytometer to monitor Brettanomyces concentrations, viabilities, and budding/pseudohyphae percentages. First, a yeast propagation experiment was conducted to optimize software counting parameters for monitoring the growth of Brettanomyces clausenii, Brettanomyces bruxellensis, and Brettanomyces lambicus, which showed increasing cell concentrations, and varying pseudohyphae percentages. The pseudohyphae formed during propagation were counted either as multiple nuclei or a single multi-nuclei organism, where the results of counting the yeast as a single multi-nuclei organism were directly compared to manual counting. Second, a yeast fermentation experiment was conducted to demonstrate that the proposed image cytometric analysis method can monitor the growth pattern of B. lambicus and B. clausenii during beer fermentation. The results from both experiments displayed different growth patterns, viability, and budding/pseudohyphae percentages for each Brettanomyces species. The proposed Cellometer image cytometry method can improve efficiency and eliminate operator-dependent variations of cell counting compared with the traditional methods, which can potentially improve the quality of beverage products employing Brettanomyces yeasts.

Work-related symptoms and dose-response relationships for personal exposures and pulmonary function among woodworkers.

PubMed

Mandryk, J; Alwis, K U; Hocking, A D

1999-05-01

Four sawmills, a wood chipping mill, and five joineries in New South Wales, Australia, were studied for the effects of personal exposure to wood dust, endotoxins. (1-->3)-beta-D-glucans, Gram-negative bacteria, and fungi on lung function among woodworkers. Personal inhalable and respirable dust sampling was carried out. The lung function tests of workers were conducted before and after a workshift. The mean percentage cross-shift decrease in lung function was markedly high for woodworkers compared with the controls. Dose-response relationships among personal exposures and percentage cross-shift decrease in lung function and percentage predicted lung function were more pronounced among joinery workers compared with sawmill and chip mill workers. Woodworkers had markedly high prevalence of regular cough, phlegm, and chronic bronchitis compared with controls. Significant associations were found between percentage cross-shift decrease in FVC and regular phlegm and blocked nose among sawmill and chip mill workers. Both joinery workers and sawmill and chip mill workers showed significant relationships between percentage predicted lung function (FVC, FEV1, FEV1/FVC, FEF25-75%) and respiratory symptoms. Wood dust and biohazards associated with wood dust are potential health hazards and should be controlled.

Changes in healthcare use among individuals who move into public housing: a population-based investigation.

PubMed

Hinds, Aynslie M; Bechtel, Brian; Distasio, Jino; Roos, Leslie L; Lix, Lisa M

2018-06-05

Residence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use. We used linked population-based administrative data housed in the Population Research Data Repository at the Manitoba Centre for Health Policy. The cohort consisted of individuals who moved into public housing in 2009 and 2010. We counted the number of hospitalizations, general practitioner (GP) visits, specialist visits, emergency department visits, and prescriptions drugs dispensed in the twelve 30-day intervals (i.e., months) immediately preceding and following the public housing move-in date. Generalized linear models with generalized estimating equations tested for a period (pre/post-move-in) by month interaction. Odds ratios (ORs), incident rate ratios (IRRs), and means are reported along with 95% confidence intervals (95% CIs). The cohort included 1942 individuals; the majority were female (73.4%) who lived in low income areas and received government assistance (68.1%). On average, the cohort had more than four health conditions. Over the 24 30-day intervals, the percentage of the cohort that visited a GP, specialist, and an emergency department ranged between 37.0% and 43.0%, 10.0% and 14.0%, and 6.0% and 10.0%, respectively, while the percentage of the cohort hospitalized ranged from 1.0% to 5.0%. Generally, these percentages were highest in the few months before the move-in date and lowest in the few months after the move-in date. The period by month interaction was statistically significant for hospitalizations, GP visits, and prescription drug use. The average change in the odds, rate, or mean was smaller in the post-move-in period than in the pre-move-in period. Use of some healthcare services declined after people moved into public housing; however, the decrease was only observed in the first few months and utilization rebounded. Knowledge of healthcare trends before individuals move in are informative for ensuring the appropriate supports are available to new public housing residents. Further study is needed to determine if decreased healthcare utilization following a move is attributable to decreased access.

Investigation of antimicrobial use at a tertiary care hospital in Southern Punjab, Pakistan using WHO methodology.

PubMed

Atif, Muhammad; Azeem, Muhammad; Saqib, Anum; Scahill, Shane

2017-01-01

Globally, between 20 to 50% of antimicrobial consumption is inappropriate, causing significant impact on the quality of care, cost of therapy and incidence of adverse drug reactions. The purpose of this study was to investigate the prescribing patterns and utilization of antimicrobials in ten selected wards at Bahawal Victoria Hospital (BVH), Bahawalpur, Punjab, Pakistan. A descriptive cross-sectional study was designed using the World Health Organization (WHO) indicators for antimicrobial use. Standard data collection forms were used in ten wards and the Pharmacy Department at BVH. Antimicrobial utilization patterns in terms of frequency and percentage were also determined. Systematic random sampling techniques were used to collect data from 1,000 prescription records out of 21,115 prescriptions written for the six months January to June 2016. For the hospital indicators, a formulary list or essential medicines list (FL/EML) was available, but standard treatment guidelines (STGs) for infectious diseases was not. The average number of days that key antimicrobials were out of stock was 3.3 days per month. The expenditure on antimicrobials as a percentage of the total medicines costs was 12.2%. For the prescribing indicators, the percentage of hospitalizations with antimicrobial(s) prescribed was 82.3%, and the average number of antimicrobials per hospitalization was 1.4 (SD = 0.6). The average duration of antimicrobial treatment per hospitalization was 5.4 days (SD = 3.2). The average cost of antimicrobials prescribed per hospitalization was USD 5.4 (SD = 6.7). None of the patients who were prescribed antimicrobials, received AM according to the STGs (pneumonia and cesarean section cases). Among the patient-care and supplemental indicators, the average duration of hospital stay of patients who received antimicrobials was 6.4 (SD = 4.3) days. The drug sensitivity testing was almost non-existent, with only 0.24% prescription records having drug sensitivity tests. Ceftriaxone (39.6%), metronidazole (23.4%) and cefotaxime (23.1%) were the top most frequently prescribed antimicrobials. The results of the current study revealed less than optimal antimicrobial prescribing and utilization patterns of selected wards at BVH. Continuous education and training of physicians, and cost-effective policies could play an important role in promoting the rational use of antimicrobials in this setting.

Increased Regulatory T-Cell Percentage Contributes to Poor CD4(+) Lymphocytes Recovery: A 2-Year Prospective Study After Introduction of Antiretroviral Therapy.

PubMed

Saison, Julien; Maucort Boulch, Delphine; Chidiac, Christian; Demaret, Julie; Malcus, Christophe; Cotte, Laurent; Poitevin-Later, Francoise; Miailhes, Patrick; Venet, Fabienne; Trabaud, Mary Anne; Monneret, Guillaume; Ferry, Tristan

2015-04-01

Background.  The primary aim of this study was to determine the impact of regulatory T cells (Tregs) percentage on immune recovery in human immunodeficiency virus (HIV)-infected patients after antiretroviral therapy introduction. Methods.  A 2-year prospective study was conducted in HIV-1 chronically infected naive patients with CD4 count <500 cells/mm(3). Regulatory T cells were identified as CD4(+)CD25(high)CD127(low) cells among CD4(+) lymphocytes. Effect of Treg percentage at inclusion on CD4 evolution overtime was analyzed using a mixed-effect Poisson regression for count data. Results.  Fifty-eight patients were included (median CD4 = 293/mm(3), median Treg percentage = 6.1%). Percentage of Treg at baseline and CD4 nadir were independently related to the evolution of CD4 absolute value according to time: (1) at any given nadir CD4 count, 1% increase of initial Treg was associated with a 1.9% lower CD4 absolute value at month 24; (2) at any given Treg percentage at baseline, 10 cell/mm(3) increase of CD4 nadir was associated with a 2.4% increase of CD4 at month 24; and (3) both effects did not attenuate with time. The effect of Treg at baseline on CD4 evolution was as low as the CD4 nadir was high. Conclusions.  Regulatory T-cell percentage at baseline is a strong independent prognostic factor of immune recovery, particularly among patients with low CD4 nadir.

Observable characteristics associated with alcohol intoxication within licensed entertainment venues in Australia.

PubMed

Coomber, Kerri; Pennay, Amy; Droste, Nicolas; Mayshak, Richelle; Martino, Florentine; Bowe, Steven J; Miller, Peter G

2016-10-01

The aim of the current study was to assess correlates of intoxication in licensed venues in Australia. Covert observations of licensed venues and venue patron in night-time entertainment districts of five Australian cities were conducted. In total, 828 unique cross-sectional observations were completed across 62 bars, nightclubs, and large mainstream pubs. Venues were selected from the main entertainment district of smaller cities and the busiest entertainment districts of larger cities. Outcomes were the estimated percentage of patrons showing any signs of alcohol intoxication and the overall level of intoxication ('high' versus 'none to medium'). Seven predictors of patron intoxication were examined: hour of observation; estimated percentage of male patrons; estimated percentage of patrons <25 years old; venue crowding; presence of observable alcohol promotions; type of alcoholic beverage consumed by the majority of patrons; and, venue type. Time of night (coefficient=11.71, p<.001; OR=9.61, p<.001), percentage of patrons aged <25 (coefficient=0.14, p<.001; OR=1.01, p=.031), and venue crowding (coefficient=4.40, p<.001; OR=1.39, p=.009) had significant positive associations with both signs of intoxication and high levels of intoxication. Nightclubs had a lower percentage of signs of intoxication compared to pubs (coefficient=-10.73, p=.021). Increased percentage of male patrons was associated with increased odds of high-level intoxication (OR=1.05, p=.020). Time of night and proportion of younger patrons had a strong association with patron intoxication adding further support for the strong body of evidence that ceasing service of alcohol earlier in the evening will reduce intoxication levels. Copyright © 2016 Elsevier B.V. All rights reserved.

Investigations on Heat Treatment of a High-Speed Steel Roll

NASA Astrophysics Data System (ADS)

Fu, Hanguang; Qu, Yinhu; Xing, Jiandong; Zhi, Xiaohui; Jiang, Zhiqiang; Li, Mingwei; Zhang, Yi

2008-08-01

High-carbon high-speed steels (HSS) are very abrasion-resistant materials primarily due to their high hardness MC-type carbide and high hardness martensitic matrix. The effects of quenching and tempering treatment on the microstructure, mechanical properties, and abrasion resistance of centrifugal casting high-carbon HSS roll were studied. Different microstructures and mechanical properties were obtained after the quenching and tempering temperatures of HSS roll were changed. With air-cooling and sodium silicate solution cooling, when the austenitizing temperature reaches 1273 K, the metallic matrix all transforms into the martensite. Afterwards, the eutectic carbides dissolve into the metallic matrix and their continuous network distribution changes into the broken network. The second hardening temperature of high-carbon HSS roll is around 793 K. No significant changes in tensile strength and elongation percentage are observed unless the tempering temperature is beyond 753 K. The tensile strength increases obviously and the elongation percentage decreases slightly beyond 753 K. However, the tensile strength decreases and the elongation percentage increases when the tempering temperature exceeds 813 K. When the tempering temperature excels 773 K, the impact toughness has a slight decrease. Tempering at 793-813 K, high-carbon HSS roll presents excellent abrasion resistance.

Dog cloning with in vivo matured oocytes obtained using electric chemiluminescence immunoassay-predicted ovulation method.

PubMed

Lee, Seunghoon; Zhao, Minghui; No, Jingu; Nam, Yoonseok; Im, Gi-Sun; Hur, Tai-Young

2017-01-01

Radioactive immunoassay (RIA) is a traditional serum hormone assay method, but the application of the method in reproductive studies is limited by the associated radioactivity. The aim of present study was to evaluate the reliability of RIA and to compare its canine serum progesterone concentration determination accuracy to that of the electric chemiluminescence immunoassay (ECLI). In vivo matured oocytes were utilized for canine somatic cell nuclear transfer (SCNT), and serum progesterone levels were assessed to accurately determine ovulation and oocyte maturation. Canine serum progesterone concentrations during both proestrus and estrus were analyzed by RIA and ECLI to determine the ovulation day. Although both methods detected similar progesterone levels before ovulation, the mean progesterone concentration determined using ECLI was significantly higher than of RIA three days before ovulation. Following ovulation, oocytes were collected by surgery, and a lower percentage of mature oocytes were observed using ECLI (39%) as compared to RIA (67%) if 4-8ng/ml of progesterone were used for determination of ovulation. A high percentage of mature oocytes was observed using ECLI when 6-15 ng/mL of progesterone was used for ovulation determination. To determine whether ECLI could be used for canine cloning, six canines were selected as oocyte donors, and two puppies were obtained after SCNT and embryo transfer. In conclusion, compared to the traditional RIA method, the ECLI method is a safe and reliable method for canine cloning.

Statistics in the pharmacy literature.

PubMed

Lee, Charlene M; Soin, Herpreet K; Einarson, Thomas R

2004-09-01

Research in statistical methods is essential for maintenance of high quality of the published literature. To update previous reports of the types and frequencies of statistical terms and procedures in research studies of selected professional pharmacy journals. We obtained all research articles published in 2001 in 6 journals: American Journal of Health-System Pharmacy, The Annals of Pharmacotherapy, Canadian Journal of Hospital Pharmacy, Formulary, Hospital Pharmacy, and Journal of the American Pharmaceutical Association. Two independent reviewers identified and recorded descriptive and inferential statistical terms/procedures found in the methods, results, and discussion sections of each article. Results were determined by tallying the total number of times, as well as the percentage, that each statistical term or procedure appeared in the articles. One hundred forty-four articles were included. Ninety-eight percent employed descriptive statistics; of these, 28% used only descriptive statistics. The most common descriptive statistical terms were percentage (90%), mean (74%), standard deviation (58%), and range (46%). Sixty-nine percent of the articles used inferential statistics, the most frequent being chi(2) (33%), Student's t-test (26%), Pearson's correlation coefficient r (18%), ANOVA (14%), and logistic regression (11%). Statistical terms and procedures were found in nearly all of the research articles published in pharmacy journals. Thus, pharmacy education should aim to provide current and future pharmacists with an understanding of the common statistical terms and procedures identified to facilitate the appropriate appraisal and consequential utilization of the information available in research articles.

The metabolic pathway of metamifop degradation by consortium ME-1 and its bacterial community structure.

PubMed

Dong, Weiliang; Liu, Kuan; Wang, Fei; Xin, Fengxue; Zhang, Wenming; Zhang, Min; Wu, Hao; Ma, Jiangfeng; Jiang, Min

2017-06-01

Metamifop is universally used in agriculture as a post-emergence aryloxyphenoxy propionate herbicide (AOPP), however its microbial degradation mechanism remains unclear. Consortium ME-1 isolated from AOPP-contaminated soil can degrade metamifop completely after 6 days and utilize it as the carbon source for bacterial growth. Meanwhile, consortium ME-1 possessed the ability to degrade metamifop stably under a wide range of pH (6.0-10.0) or temperature (20-42 °C). HPLC-MS analysis shows that N-(2-fluorophenyl)-2-(4-hydroxyphenoxy)-N-methyl propionamide, 2-(4-hydroxyphenoxy)-propionic acid, 6-chloro-2-benzoxazolinone and N-methyl-2-fluoroaniline, were detected and identified as four intermediate metabolites. Based on the metabolites identified, a putative metabolic pathway of metamifop was proposed for the first time. In addition, the consortium ME-1 was also able to transform or degrade other AOPP such as fenoxaprop-p-ethyl, clodinafop-propargyl, quizalofop-p-ethyl and cyhalofop-butyl. Moreover, the community structure of ME-1 with lower microbial diversity compared with the initial soil sample was investigated by high throughput sequencing. β-Proteobacteria and Sphingobacteria were the largest class with sequence percentages of 46.6% and 27.55% at the class level. In addition, 50 genera were classified in consortium ME-1, of which Methylobacillus, Sphingobacterium, Bordetella and Flavobacterium were the dominant genera with sequence percentages of 25.79, 25.61, 14.68 and 9.55%, respectively.

Dog cloning with in vivo matured oocytes obtained using electric chemiluminescence immunoassay-predicted ovulation method

PubMed Central

No, Jingu; Nam, Yoonseok; Im, Gi-Sun; Hur, Tai-Young

2017-01-01

Radioactive immunoassay (RIA) is a traditional serum hormone assay method, but the application of the method in reproductive studies is limited by the associated radioactivity. The aim of present study was to evaluate the reliability of RIA and to compare its canine serum progesterone concentration determination accuracy to that of the electric chemiluminescence immunoassay (ECLI). In vivo matured oocytes were utilized for canine somatic cell nuclear transfer (SCNT), and serum progesterone levels were assessed to accurately determine ovulation and oocyte maturation. Canine serum progesterone concentrations during both proestrus and estrus were analyzed by RIA and ECLI to determine the ovulation day. Although both methods detected similar progesterone levels before ovulation, the mean progesterone concentration determined using ECLI was significantly higher than of RIA three days before ovulation. Following ovulation, oocytes were collected by surgery, and a lower percentage of mature oocytes were observed using ECLI (39%) as compared to RIA (67%) if 4-8ng/ml of progesterone were used for determination of ovulation. A high percentage of mature oocytes was observed using ECLI when 6–15 ng/mL of progesterone was used for ovulation determination. To determine whether ECLI could be used for canine cloning, six canines were selected as oocyte donors, and two puppies were obtained after SCNT and embryo transfer. In conclusion, compared to the traditional RIA method, the ECLI method is a safe and reliable method for canine cloning. PMID:28288197

Intimate partner violence and physical and mental health among women utilizing community health services in Gujarat, India.

PubMed

Kamimura, Akiko; Ganta, Vikas; Myers, Kyl; Thomas, Tomi

2014-10-16

Intimate partner violence (IPV) is a significant public health threat which causes injury and acute and chronic physical and mental health problems. In India, a high percentage of women experience IPV. The purposes of this study include 1) to describe the lifetime prevalence of IPV, and 2) to examine the association between IPV and physical and mental health well-being, among women utilizing community health services for the economically disadvantaged in India. Women utilizing community health services (N = 219) aged between 18 and 62 years completed a self-administered survey in Gujarat, India. Standardized instruments were used to measure perceived physical and mental health well-being. In addition, participants were asked about their lifetime experience with IPV, and socio-demographic questions. Analysis was restricted to the ever-married participants who completed the questions on IPV (N = 167). Participants with a lifetime history of IPV were more likely to have reported poorer physical and mental health compared to those without a lifetime history of IPV. More than half of the participants with an IPV history experienced multiple types of IPV (physical, sexual and/or emotional IPV). While being in the highest caste was a significant positive factor associated with better health, caste and other socio-demographic factors were not associated with IPV. Women in India face risk of IPV. Yet those experiencing IPV do not seek help or rely on informal help sources. Community health organizations may take a role in IPV prevention and intervention. Diversity of intervention options would be important to encourage more women with IPV experience to seek help.

A Prototype Overview for Allocating USAID Foreign Aid

DTIC Science & Technology

2012-03-22

treatment (WB) 9. Malaria - Percentage of children with fever receiving antimalarial drugs (WB) 10. Tuberculosis - Percentage tuberculosis...to maintain body weight and undertake light activity . The depth of hunger is low when it is less than 200 kilocalories per person per day, and high

Utilizing the Digital Fingerprint Methodology for Secure Key Generation

DTIC Science & Technology

2010-03-01

circuits. 2.2.2. Arbiter PUF 2.2.1 Arbiter PUF Description Figure 3 represents the arbiter PUF circuitry designed by Suh and Devadas [4]. The D latch...Reliability The results of Suh and Devadas ‟s experiments on the arbiter PUF circuit showed that when the arbiter circuit output was measured for the...and Devada pointed out that this low percentage was the result of not laying out their circuit symmetrically as it appears in the idealized

Mobile Information Collection Application: Water Equipment Tracker (MICA:WET) Tool

DTIC Science & Technology

2013-10-01

position unless so designated by other authorized documents. DESTROY THIS REPORT WHEN NO LONGER NEEDED. DO NOT RETURN IT TO THE ORIGINATOR. ERDC TR...for the report. Despite this utility, an ongoing programming “ bug ” causes photos to be- come associated with the wrong building, floor, and room after...other sleeping quarters, number of beds , demographic percentages. Some fields require the user to enter the data manually or to select from a menu

Criterion 6, indicator 33 : recovery or recycling of forest products as a percentage of total forest products consumption

Treesearch

Ken Skog; James Howard; Rebecca Westby

2011-01-01

This indicator shows the trend in recovering wood and paper for reuse in products in the United States. This reuse can hold down the need to harvest wood to meet U.S. consumption needs. The paper recycling rate (utilization rate in producing new paper) increased from 22% to 38% between 1970 and 1996, but then stabilized at 37% to 38% between 1996 and 2006. This rate...

Advanced Flight Simulator: Utilization in A-10 Conversion and Air-to-Surface Attack Training.

DTIC Science & Technology

1981-01-01

ASPT to the A-I0. Finally. the objectivity of the criteria ( parameters of aircraft control. bomb-drop circular error. and percentage of rounds through a...low angle strafe task. Table 4 presents a listing of these tasks and their related release parameters . 12 __ __ _ __ Tab/e .1. A/S Weapons I)eliven...Scoring. Two dependent variables, specific to the phase of student training, were used. In the conversion training phase. specific parameters for

Are honors received during surgery clerkships useful in the selection of incoming orthopaedic residents?

PubMed

Harris, Damion; Dyrstad, Brad; Eltrevoog, Holly; Milbrandt, Joseph C; Allan, D Gordon

2009-01-01

The purpose of this study was to review institutional statistics provided in dean's letters and determine the percentage of honors awarded by institution and clerkship specialty.Institutional and clerkship aggregate data were compiled from a review of dean's letters from 80 United States medical schools. The percentage of honors awarded during 3rd year clerkships during 2005 were collected for analysis. Across clerkship specialties, there were no statistically significant differences between the mean percentage of honors given by the medical schools examined with Internal Medicine (27.6%) the low and Psychiatry (33.5%) the high. However, inter-institutional variability observed within each clerkship was high, with surgery clerkship percentage of honors ranging from 2% to 75% of the students. This suggests some schools may be more lenient and other more stringent in awarding honors to their students. This inter-institutional variability makes it difficult to compare honors received by students from different medical schools and weakens the receipt of honors as a primary tool for evaluating potential incoming residents.

Effect of high hydrostatic pressure on seed germination, microbial quality, anatomy-morphology and physiological characteristics of garden cress (Lepidium sativum) seedlings

NASA Astrophysics Data System (ADS)

İşlek, Cemil; Murat Altuner, Ergin; Çeter, Talip; Alpas, Hami

2013-06-01

High hydrostatic pressure is a non-thermal food processing technology that is found to increase the percentage of germination, decrease the germination time and improve the microbial quality of seeds. In this study, pressures of 100-400 MPa for 10 min at 30°C are used to compare the percentage of germination, the microbial quality of seeds, chlorophyll a and b, and total phenolic compounds concentrations in seedlings, and the anatomy-morphology characteristics of garden cress. Enhanced reductions of total aerobic mesophilic bacteria, total and fecal coliforms, and yeast and mould populations in seeds were observed, especially at 300 MPa. In addition, the percentage of germination, chlorophyll content and phenolic compounds concentrations, fresh and dry weights, and hypocotyl lengths of the seedlings are higher than those of all samples, where the percentage of germination is equal to controls but higher than other samples, and radicula length is lower than controls but higher than others.

[Socioeconomic inequalities in oral health service utilization any time in their lives for Mexican schoolchildren from 6 to 12 years old].

PubMed

Jiménez-Gayosso, Sandra Isabel; Medina-Solís, Carlo Eduardo; Lara-Carrillo, Edith; Scougal-Vilchis, Rogelio José; de la Rosa-Santillana, Rubén; Márquez-Rodríguez, Sonia; Mendoza-Rodríguez, Martha; Navarrete-Hernández, José de Jesús

2015-01-01

To determine the prevalence and the existence of socioeconomic inequalities in dental health service utilization (DHSU) any time in the life of Mexican schoolchildren aged 6-12 years of Pachuca Hidalgo, Mexico. We performed a cross-sectional study in 1,404 school children 6-12 years of age from 14 public schools in the city of Pachuca, Hidalgo, Mexico. Questionnaires were distributed to determine socioeconomic position variables (SEP). The dependent variable was DHSU once in life (0 = No, 1 = Yes). The analysis was performed in Stata 9 using chi-square tests. The mean age was 8.97 ± 1.99 years, 50.1% were boys. The prevalence of DHSU any time in life was 71.4%. The DHSU percentage increased according increasing age (p < 0.05). Significant differences (p < 0.05) in percentages of USSB through SEP variables: health insurance, car ownership in the home, dwelling and household characteristics, a better level of SEP increased prevalence of DHSU. Although in the mother's schooling no differences were observed (p > 0.05), father's schooling was associated (p < 0.05) inversely to expectations. The findings of this study demonstrate that the prevalence of DHSU was not 100%; 28.6% of children have never had contact with a dentist. We identified certain indicator variables of SEP associated with DHSU, indicating the existence of inequalities in this oral health indicator.

The Iowa Disinfection Cleaning Project: Opportunities, Successes, and Challenges of a Structured Intervention Program in 56 Hospitals.

PubMed

Carling, Philip; Herwaldt, Loreen A

2017-08-01

OBJECTIVE A diverse group of hospitals in Iowa implemented a program to objectively evaluate and improve the thoroughness of disinfection cleaning of near-patient surfaces. Administrative benefits of, challenges of, and impediments to the program were also evaluated. METHODS We conducted a prospective, quasi-experimental pre-/postintervention trial to improve the thoroughness of terminal room disinfection cleaning. Infection preventionists utilized an objective cleaning performance monitoring system (DAZO) to evaluate the thoroughness of disinfection cleaning (TDC) expressed as a proportion of objects confirmed to have been cleaned (numerator) to objects to be cleaned per hospital policy (denominator)×100. Data analysis, educational interventions, and objective performance feedback were modeled on previously published studies using the same monitoring tool. Programmatic analysis utilized unstructured and structured information from participants irrespective of whether they participated in the process improvement aspects to the program. RESULTS Initially, the overall TDC was 61% in 56 hospitals. Hospitals completing 1 or 2 feedback cycles improved their TDC percentages significantly (P90% for at least 38 months. A survey of infection preventionists found that lack of time and staff turnover were the most common reasons for terminating the study early. CONCLUSION The study confirmed that hospitals using this program can improve their TDC percentages significantly. Hospitals must invest resources to improve cleaning and to sustain their gains. Infect Control Hosp Epidemiol 2017;38:960-965.

Utilization of Mental Health Services in School-Based Health Centers.

PubMed

Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

2017-08-01

We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

Authoritative school climate and high school dropout rates.

PubMed

Jia, Yuane; Konold, Timothy R; Cornell, Dewey

2016-06-01

This study tested the association between school-wide measures of an authoritative school climate and high school dropout rates in a statewide sample of 315 high schools. Regression models at the school level of analysis used teacher and student measures of disciplinary structure, student support, and academic expectations to predict overall high school dropout rates. Analyses controlled for school demographics of school enrollment size, percentage of low-income students, percentage of minority students, and urbanicity. Consistent with authoritative school climate theory, moderation analyses found that when students perceive their teachers as supportive, high academic expectations are associated with lower dropout rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Biocrusts role on nitrogen cycle and microbial communities from underlying soils in drylands

NASA Astrophysics Data System (ADS)

Anguita-Maeso, Manuel; Miralles*, Isabel; van Wesemael, Bas; Lázaro, Roberto; Ortega, Raúl; Garcia-Salcedo, José Antonio; Soriano**, Miguel

2017-04-01

Biocrusts are distributed in arid areas widely covering most of the soil surface and playing an essential role in the functioning of nitrogen cycle. The absence of biocrust coverage might affect the soil nitrogen content and the quantity and diversity of microbial communities in underlying biocrust soils. To analyse this mater, we have collected three underlying soils biocrusts samples dominated by the lichen Diploschistes diacapsis and Squamarina lentigera from Tabernas desert (southeast of Spain) at two extremes of its spatial distribution range: one with a high percentage of biocrust coverage and other with a huge degradation and low percentage of biocrust coverage in order to determine differences on the total nitrogen content and microbial communities from these underlying soils. DNA from these samples was isolated though a commercial kit and it was used as template for metagenomic analysis. We accomplished a sequencing of the amplicons V4-V5 of the 16S rRNA gene with Next-Generation Sequencing (NGS) Illumina MiSeq platform and a relative quantity of bacteria (rRNA 16S) and fungi (ITS1-5.8S) were conducted by quantitative qPCR. Total nitrogen was measured by the Kjeldahl method. Statistical analyses were based on ANOVAs, heatmap and Generalized Linear Models (GLM). The results showed 1.89E+09 bacteria per gram of soil in the high biocrust coverage position while 6.98E+08 microorganisms per gram of soil were found in the less favourable position according to the lower percentage of biocrust coverage. Similarly, 1.19E+12 was the amount of fungi per gram of soil located in the favourable position with higher biocrust coverage and 7.62E+11 was found in the unfavourable position. Furthermore, the soil under high percentage of biocrust coverage showed the greatest total nitrogen content (1.1 g kg-1) whereas the soil sampled under depressed percentage of biocrust coverage displayed the fewest quantity of total nitrogen content (0.9 g kg-1). Metagenomic and statistical analysis exhibited different bacteria communities according to underlying soils with unlike percentage of biocrust coverage. Opitutus and Adhaeribacter predominated in soil under high biocrust coverage percentage whereas Chelatococcus was found as prevalent bacteria community in soils under low biocrust coverage percentage. Our data illustrate that the percentage of biocrust coverage influence the total nitrogen content in underlying biocrust soils and also affects the amount and the variety of bacteria communities in these underlying soils. (*) Financial support by Marie Curie Intra-European Fellowship (FP7-577 PEOPLE-2013-IEF, Proposal n° 623393) and (**) by the Ministerio de Economía y Competitividad (MINECO) cofinanced with FEDER funds (project CGL2015-71709-R) is acknowledged.

Calculation of the C3A Percentage in High Sulfur Clinker

PubMed Central

Horkoss, Sayed; Lteif, Roger; Rizk, Toufic

2010-01-01

The aim of this paper is to clarify the influence of the clinker SO3 on the amount of C3A. The calculation of the cement phases percentages is based on the research work, Calculation of the Compounds in Portland Cement, published by Bogue in 1929 .The usage of high sulphur fuels, industrial wastes, and tires changes completely the working condition of Bogue because the assumed phase compositions may change. The results prove that increasing the amount of SO3 in the low alkali clinker decreases the percentages of C3A due to the high incorporation of alumina in the clinker phases mainly C2S and C3S. The correlation is linear till the clinker SO3 reaches the 2%. Over that the influence of the clinker SO3 became undetectable. A new calculation method for the determination of the C3A in the high sulphur and low alkali clinker was proposed. PMID:20689732

ABCs and AYP Results, Wake County Public School System (WCPSS): 2009-10. Measuring Up. E&R Report No. 10.20

ERIC Educational Resources Information Center

Haynie, Glenda

2011-01-01

In 2009-10, 92% of WCPSS schools met Expected or High Growth as measured by the North Carolina ABCs program, a 3.5 percentage point increase from 2008-09. Fifty-four percent of the schools made High Growth and 38% made Expected Growth. All subgroups saw their percentages of students meeting growth increase to above 55% in 2009-10; with the…

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.

Annoyance from transportation noise: relationships with exposure metrics DNL and DENL and their confidence intervals.

PubMed Central

Miedema, H M; Oudshoorn, C G

2001-01-01

We present a model of the distribution of noise annoyance with the mean varying as a function of the noise exposure. Day-night level (DNL) and day-evening-night level (DENL) were used as noise descriptors. Because the entire annoyance distribution has been modeled, any annoyance measure that summarizes this distribution can be calculated from the model. We fitted the model to data from noise annoyance studies for aircraft, road traffic, and railways separately. Polynomial approximations of relationships implied by the model for the combinations of the following exposure and annoyance measures are presented: DNL or DENL, and percentage "highly annoyed" (cutoff at 72 on a scale of 0-100), percentage "annoyed" (cutoff at 50 on a scale of 0-100), or percentage (at least) "a little annoyed" (cutoff at 28 on a scale of 0-100). These approximations are very good, and they are easier to use for practical calculations than the model itself, because the model involves a normal distribution. Our results are based on the same data set that was used earlier to establish relationships between DNL and percentage highly annoyed. In this paper we provide better estimates of the confidence intervals due to the improved model of the relationship between annoyance and noise exposure. Moreover, relationships using descriptors other than DNL and percentage highly annoyed, which are presented here, have not been established earlier on the basis of a large dataset. PMID:11335190

Evaluating health worker performance in Benin using the simulated client method with real children.

PubMed

Rowe, Alexander K; Onikpo, Faustin; Lama, Marcel; Deming, Michael S

2012-10-08

The simulated client (SC) method for evaluating health worker performance utilizes surveyors who pose as patients to make surreptitious observations during consultations. Compared to conspicuous observation (CO) by surveyors, which is commonly done in developing countries, SC data better reflect usual health worker practices. This information is important because CO can cause performance to be better than usual. Despite this advantage of SCs, the method's full potential has not been realized for evaluating performance for pediatric illnesses because real children have not been utilized as SCs. Previous SC studies used scenarios of ill children that were not actually brought to health workers. During a trial that evaluated a quality improvement intervention in Benin (the Integrated Management of Childhood Illness [IMCI] strategy), we conducted an SC survey with adult caretakers as surveyors and real children to evaluate the feasibility of this approach and used the results to assess the validity of CO. We conducted an SC survey and a CO survey (one right after the other) of health workers in the same 55 health facilities. A detailed description of the SC survey process was produced. Results of the two surveys were compared for 27 performance indicators using logistic regression modeling. SC and CO surveyors observed 54 and 185 consultations, respectively. No serious problems occurred during the SC survey. Performance levels measured by CO were moderately higher than those measured by SCs (median CO - SC difference = 16.4 percentage-points). Survey differences were sometimes much greater for IMCI-trained health workers (median difference = 29.7 percentage-points) than for workers without IMCI training (median difference = 3.1 percentage-points). SC surveys can be done safely with real children if appropriate precautions are taken. CO can introduce moderately large positive biases, and these biases might be greater for health workers exposed to quality improvement interventions. http://clinicaltrials.gov Identifier NCT00510679.

Effects of filtration through Sephadex columns improve overall quality parameters and "in vivo" fertility of subfertile refrigerated boar-semen.

PubMed

Ramió-Lluch, L; Balasch, S; Bonet, S; Briz, M; Pinart, E; Rodríguez-Gil, J E

2009-10-01

This study was performed to test the effects of filtration through several chromatographic resins on the semen quality parameters (percentages of viability, altered acrosomes and morphological abnormalities, motion characteristics and the response to the Osmotic Resistance Test) of boar ejaculates of poor quality. Our results indicate that filtration through a non-ionic Sephadex resin bed (Sephadex G-15), combined with a glasswool subjection bed, induced an overall improvement of semen quality parameters, especially seen in a significant (P<0.05) decrease in the percentages of morphological abnormalities and an increase of several motility parameters related to velocity and linearity. Similar results, although less intense, were observed when the filtration through G-15 resin was accompanied by an ionically neutral polypropylene disk bed instead of glasswool. On the other hand, filtration through two separate ion-exchange Sephadex resins, cationic C-50 and anionic A-50, have less beneficial, and even detrimental, effects on boar-semen quality. In all cases, filtration was accompanied by a significant (P<0.01) decrease in the final concentration of the samples. Ultrastructural and lectin studies showed that the interaction between sperm and chromatographic resins depends on the resin type utilized, and in the case of G-15 it seems that it works by trapping that sperm with not enough strength to overcome the physical resistance associated with chromatographic particles. When semen of poor quality was filtered through G-15 resin and then was utilized for "in vivo" fertility trials, a significant (P<0.05) increase in the percentage of fertility was observed, when compared with the same, but unfiltered, samples. In summary, our results strongly indicate that filtration through ionically inert, Sephadex chromatographic resins could be a very useful and practical method to improve both boar-semen quality and fertilizing ability, especially from mediocre and/or subfertile samples.

Maximal oxygen uptake, anaerobic threshold and running economy in women and men with similar performances level in marathons.

PubMed

Helgerud, J

1994-01-01

Sex differences in running economy (gross oxygen cost of running, CR), maximal oxygen uptake (VO2max), anaerobic threshold (Th(an)), percentage utilization of aerobic power (% VO2max), and Th(an) during running were investigated. There were six men and six women aged 20-30 years with a performance time of 2 h 40 min over the marathon distance. The VO2max, Th(an), and CR were measured during controlled running on a treadmill at 1 degree and 3 degrees gradient. From each subject's recorded time of running in the marathon, the average speed (vM) was calculated and maintained during the treadmill running for 11 min. The VO2max was inversely related to body mass (mb), there were no sex differences, and the mean values of the reduced exponent were 0.65 for women and 0.81 for men. These results indicate that for running the unit ml.kg-0.75.min-1 is convenient when comparing individuals with different mb. The VO2max was about 10% (23 ml.kg-0.75.min-1) higher in the men than in the women. The women had on the average 10-12 ml.kg-0.75.min-1 lower VO2 than the men when running at comparable velocities. Disregarding sex, the mean value of CR was 0.211 (SEM 0.005) ml.kg-1.m-1 (resting included), and was independent of treadmill speed. No sex differences in Th(an) expressed as % VO2max or percentage maximal heart rate were found, but Th(an) expressed as VO2 in ml.kg-0.75.min-1 was significantly higher in the men compared to the women. The percentage utilization of fcmax and concentration of blood lactate at vM was higher for the female runners.(ABSTRACT TRUNCATED AT 250 WORDS)

Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits.

PubMed

Martsolf, Grant; Fingar, Kathryn R; Coffey, Rosanna; Kandrack, Ryan; Charland, Tom; Eibner, Christine; Elixhauser, Anne; Steiner, Claudia; Mehrotra, Ateev

2017-04-01

We assess whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. We used data from the Healthcare Cost and Utilization Project State Emergency Department Databases for 2,053 EDs in 23 states from 2007 to 2012. We used Poisson regression models to examine the association between retail clinic penetration and the rate of ED visits for 11 low-acuity conditions. Retail clinic "penetration" was measured as the percentage of the ED catchment area that overlapped with the 10-minute drive radius of a retail clinic. Rate ratios were calculated for a 10-percentage-point increase in retail clinic penetration per quarter. During the course of a year, this represents the effect of an increase in retail clinic penetration rate from 0% to 40%, which was approximately the average penetration rate observed in 2012. Among all patients, retail clinic penetration was not associated with a reduced rate of low-acuity ED visits (rate ratio=0.999; 95% confidence interval=0.997 to 1.000). Among patients with private insurance, there was a slight decrease in low-acuity ED visits (rate ratio=0.997; 95% confidence interval=0.994 to 0.999). For the average ED in a given quarter, this would equal a 0.3% reduction (95% confidence interval 0.1% to 0.6%) in low-acuity ED visits among the privately insured if retail clinic penetration rate increased by 10 percentage points per quarter. With increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Ethnomedicinal uses of plants for the treatment of malaria in Soon Valley, Khushab, Pakistan.

PubMed

Shah, Amin; Rahim, Sarvat

2017-03-22

To best of our knowledge this is the first quantitative ethno-medicinal study with the aim of documenting the indigenous knowledge and practices of using plants for malarial therapy in Soon Valley, Khushab, Pakistan. In this Valley, malaria is among the major public health problems but, until now, the population still mostly relies on herbal medicine for treatment. Ethno-medicinal data were documented from 63 informants by using semi-structured questionnaires and interviewing the informants about their knowledge of plants regarding malaria and related symptoms. Documented data were evaluated using the quantitative ethno-botanical indices of frequency citation (FC), relative frequency of citation (RFC), percentage of respondents having knowledge (PRK) and Jaccard index (JI). A total of 70 plant species belonging to 62 genera and 34 families were recorded as anti-malarial in the study area. Solanaceae was found to be the most cited family with 7 species, followed by Fabaceae, Rutaceae and Lamiaceae with 5 species each. Ocimum americanum and Solanum incanum were the species with the highest relative frequency of citation (RFC =0.25 each) and percentage of respondents having knowledge (PRK =25.4% each), followed by Grewia tenax (RFC =0.23, PRK =23.8%), which indicates that these plants are the best species with anti-malarial properties. The most highly cited life form was found to be herbs (56%). The dominant plant part used in preparations were leaves (49%). The main mode of utilization was decoction (47%) followed by infusion (29%). In comparison, maximum similarity index is found in our study with JI (16.83) followed by (13.13). Similarity percentage of plants uses ranges from 0.81 to 16.83 while dissimilarity percentage varies from 0% to 17.65%. To the best of our knowledge seven plant species, viz. Withania coagulans, Fagonia cretica, Carthamus oxyacantha, Ehretia obtusifolia, Helianthus annuus, Olea ferruginea and Vitex trifolia, are reported from this region for the first time for the treatment of malaria. This first ethno-medicinal study highlights potential sources for the development of new antimalarial drugs from indigenous knowledge of medicinal plants found in the Soon Valley, Pakistan. Such investigations could be a subject for in vitro and in vivo anti-plasmodial screening to develop new plant-based antimalarial drugs and can also be evaluated for other biological activities and novel drug discoveries. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Protein requirements of bobwhite chicks for survival, growth and efficiency of feed utilization

USGS Publications Warehouse

Nestler, R.B.; Bailey, W.W.; McClure, H.E.

1942-01-01

During the summer and fall of 1939 four experiments were conducted at the Patuxent Research Refuge, Bowie, Maryland, to determine the protein requirements of bobwhite chicks. A total of 816 chicks were used to compare six levels of protein, namely, 22,24,26, 28, 30, and 32 per cent.....From the three standpoints of survival, rate of growth, and efficiency of feed utilization for the first ten weeks of life, the 28 per cent level of protein gave the best results. During the ninth and tenth weeks, the highest efficiency of feed utilization was obtained on the 22 per cent level. The results indicate that after the birds have reached about twothirds of their mature weight, the difference in efficiency between a diet containing 28 per cent of protein and one containing 22 per cent may be small enough to justify, in the interest of economy, the use of a diet containing the lower percentage of protein.

Audit of the Functioning of the Elective Neurosurgical Operation Theater in India: A Prospective Study and Review of Literature.

PubMed

Saikia, Amrit Kumar; Sriganesh, Kamath; Ranjan, Manish; Claire, Marie; Mittal, Mohit; Pandey, Paritosh

2015-08-01

Knowledge about the utilization of the operation theater (OT) is essential to improve its efficiency. This study evaluated the neurosurgical operation theater utilization in a neurosciences teaching hospital. Data collected included OT start time, delay in start, anesthesia induction time, surgical preparation time, anesthesia recovery time, operating time, time between cases, and theater closing time. Five hundred thirty-seven surgeries were performed during the study period. The percentage of time used for anesthesia induction, actual surgical procedure, recovery from anesthesia, and theater preparation between the two cases were 8%, 70%, 6% and 5%, respectively. Fourteen percent of scheduled cases were cancelled. On 220 occasions (70.51%), theater was over-run. Late start contributed to loss of 8370 minutes (140 hours) of theater time. This study identified the proportion of time spent on each activity in the neurosurgical OT. This knowledge is likely to facilitate better planning of neurosurgical theater schedule and result in optimal utilization. Copyright © 2015 Elsevier Inc. All rights reserved.

Radiation Shielding of Lunar Regolith/Polyethylene Composites and Lunar Regolith/Water Mixtures

NASA Technical Reports Server (NTRS)

Johnson, Quincy F.; Gersey, Brad; Wilkins, Richard; Zhou, Jianren

2011-01-01

Space radiation is a complex mixed field of ionizing radiation that can pose hazardous risks to sophisticated electronics and humans. Mission planning for lunar exploration and long duration habitat construction will face tremendous challenges of shielding against various types of space radiation in an attempt to minimize the detrimental effects it may have on materials, electronics, and humans. In late 2009, the Lunar Crater Observation and Sensing Satellite (LCROSS) discovered that water content in lunar regolith found in certain areas on the moon can be up to 5.6 +/-2.8 weight percent (wt%) [A. Colaprete, et. al., Science, Vol. 330, 463 (2010). ]. In this work, shielding studies were performed utilizing ultra high molecular weight polyethylene (UHMWPE) and aluminum, both being standard space shielding materials, simulated lunar regolith/ polyethylene composites, and simulated lunar regolith mixed with UHMWPE particles and water. Based on the LCROSS findings, radiation shielding experiments were conducted to test for shielding efficiency of regolith/UHMWPE/water mixtures with various percentages of water to compare relative shielding characteristics of these materials. One set of radiation studies were performed using the proton synchrotron at the Loma Linda Medical University where high energy protons similar to those found on the surface of the moon can be generated. A similar experimental protocol was also used at a high energy spalation neutron source at Los Alamos Neutron Science Center (LANSCE). These experiments studied the shielding efficiency against secondary neutrons, another major component of space radiation field. In both the proton and neutron studies, shielding efficiency was determined by utilizing a tissue equivalent proportional counter (TEPC) behind various thicknesses of shielding composite panels or mixture materials. Preliminary results from these studies indicated that adding 2 wt% water to regolith particles could increase shielding of the regolith materials by about 6%. The findings may be utilized to extend the possibilities of potential candidate materials for lunar habitat structures, will potentially impact the design criteria of future human bases on the moon, and provide some guidelines for future space mission planning with respect to radiation exposure and risks posed on astronauts.

Right back like we left something: examining the commodification of Blackness in social services to address racial disparities - the case of Hartford.

PubMed

Searcy, Yan

2018-05-14

Market-based approaches to addressing racial disparities have essentially re-commodified Blackness. Utilizing Hartford, which contains the largest percentage of Blacks per capita in Connecticut, this article examines market-based approaches to address racial disparities while discussing Blackness as an enduring commodity that is tied to private sector profit. The study argues that market based approaches incentivize punitive approaches to social problems associated with Blackness. The study concludes by suggesting that addressing disparities utilizing markets requires reimagining policy incentives to focus on prevention and treatment of social problems associated with Blackness. Failure to reimagine policy incentives serves to commodify Blackness whereby industries benefit from the continuity of disparities rather than the elimination of disparities.

"Life without nuclear power": A nuclear plant retirement formulation model and guide based on economics. San Onofre Nuclear Generating Station case: Economic impacts and reliability considerations leading to plant retirement

NASA Astrophysics Data System (ADS)

Wasko, Frank

Traditionally, electric utilities have been slow to change and very bureaucratic in nature. This culture, in and of itself, has now contributed to a high percentage of United States electric utilities operating uneconomical nuclear plants (Crooks, 2014). The economic picture behind owning and operating United States nuclear plants is less than favorable for many reasons including rising fuel, capital and operating costs (EUCG, 2012). This doctoral dissertation is specifically focused on life without nuclear power. The purpose of this dissertation is to create a model and guide that will provide electric utilities who currently operate or will operate uneconomical nuclear plants the opportunity to economically assess whether or not their nuclear plant should be retired. This economic assessment and stakeholder analysis will provide local government, academia and communities the opportunity to understand how Southern California Edison (SCE) embraced system upgrade import and "voltage support" opportunities to replace "base load" generation from San Onofre Nuclear Generating Station (SONGS) versus building new replacement generation facilities. This model and guide will help eliminate the need to build large replacement generation units as demonstrated in the SONGS case analysis. The application of The Nuclear Power Retirement Model and Guide will provide electric utilities with economic assessment parameters and an evaluation assessment progression needed to better evaluate when an uneconomical nuclear plant should be retired. It will provide electric utilities the opportunity to utilize sound policy, planning and development skill sets when making this difficult decision. There are currently 62 nuclear power plants (with 100 nuclear reactors) operating in the United States (EIA, 2014). From this group, 38 are at risk of early retirement based on the work of Cooper (2013). As demonstrated in my model, 35 of the 38 nuclear power plants qualify to move to the economic assessment review and then on to the stakeholder cost benefit analysis (if model qualifications are met) leading to a final plant retirement decision. This application via the model and guide, in turn, will lead electric utilities to explore system upgrade import opportunities and mitigation measures versus building new replacement generation facilities. United States nuclear reactors are licensed for 40 years with a 20 year extension available prior to the expiration date (EIA, 2013). Since late 2012, electric power companies have announced the early retirement of four uneconomical nuclear power plants while other studies have indicated that as many as 70 percent of United States nuclear power plants are potentially at risk for early retirement (Crooks, 2014 and Cooper, 2013). A high percentage of these aforementioned nuclear plants have operating licenses that will not expire until 2030 and beyond. Thus, for the most part, replacement power contingency planning has not been initiated for these plants or is still in preliminary stages. The recent nuclear plant retirements are the first since 1998 (EIA, 2013). Decisions to retire the plants involved concerns over maintenance and repair costs as well as declining profitability (EIA, 2013). In addition, the Energy Information Administration (2010-2012) released data that demonstrated that the worst 25 percent of United States nuclear plants are far more expensive to operate and generate electricity than new gas plants. It is equally important to understand and explain the economic and power replacement implications to both ratepayers and end-users. A SONGS case study analysis will review the economic, operational and political challenges that SCE faced leading to the retirement decision of SONGS. As preface to the case study, replacement steam generators (RSGs) were installed in Unit 2 in 2009 and in Unit 3 in 2010. In January 2012, while Unit 2 was down for routine maintenance, a small leak was discovered inside a steam generator in Unit 3. Because of the situation, both units remained shut down to evaluate the cause of the leakage and to make repairs. SCE submitted plans to the Nuclear Regulatory Commission (NRC) to re-start Unit 2 at reduced power. However, concerns over the length of the review process and the high costs associated with steam generator repairs led SCE to retire both reactors (SCE SONGS Fact Sheets, 2012-2013). Finally, collaborative resource power replacement planning is needed more than ever as nuclear facilities in the United States are now being retired for economic related reasons (Crooks, 2014). This collaborative power replacement process and implementation must encompass all relevant stakeholders including state grid operators, ratepayers, shareholders and the electric utility company.

Does the universal health insurance program affect urban-rural differences in health service utilization among the elderly? Evidence from a longitudinal study in taiwan.

PubMed

Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

2012-01-01

To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences model was employed and estimated by the random-effect probit method. The introduction of universal NHI in Taiwan heterogeneously affected outpatient and inpatient health service utilization among the elderly in urban and rural areas. The introduction of NHI reduced the disparity of outpatient (inpatient) utilization between the previously uninsured and insured older urban residents by 12.9 (22.0) percentage points. However, there was no significant reduction in the utilization disparity between the previously uninsured and insured elderly among rural residents. Our study on Taiwan's experience should provide a valuable lesson to countries that are in an initial stage of proposing a universal health insurance system. Although NHI is designed to ensure the equitable right to access health care, it may result in differential impacts on health service utilization among the elderly across areas. The rural elderly tend to confront more challenges in accessing health care associated with spatial distance, transportation, social isolation, poverty, and a lack of health care providers, especially medical specialists. © 2011 National Rural Health Association.

Decreasing unnecessary utilization in acute bronchiolitis care: results from the value in inpatient pediatrics network.

PubMed

Ralston, Shawn; Garber, Matthew; Narang, Steve; Shen, Mark; Pate, Brian; Pope, John; Lossius, Michele; Croland, Trina; Bennett, Jeff; Jewell, Jennifer; Krugman, Scott; Robbins, Elizabeth; Nazif, Joanne; Liewehr, Sheila; Miller, Ansley; Marks, Michelle; Pappas, Rita; Pardue, Jeanann; Quinonez, Ricardo; Fine, Bryan R; Ryan, Michael

2013-01-01

Acute viral bronchiolitis is the most common diagnosis resulting in hospital admission in pediatrics. Utilization of non-evidence-based therapies and testing remains common despite a large volume of evidence to guide quality improvement efforts. Our objective was to reduce utilization of unnecessary therapies in the inpatient care of bronchiolitis across a diverse network of clinical sites. We formed a voluntary quality improvement collaborative of pediatric hospitalists for the purpose of benchmarking the use of bronchodilators, steroids, chest radiography, chest physiotherapy, and viral testing in bronchiolitis using hospital administrative data. We shared resources within the network, including protocols, scores, order sets, and key bibliographies, and established group norms for decreasing utilization. Aggregate data on 11,568 hospitalizations for bronchiolitis from 17 centers was analyzed for this report. The network was organized in 2008. By 2010, we saw a 46% reduction in overall volume of bronchodilators used, a 3.4 dose per patient absolute decrease in utilization (95% confidence interval [CI] 1.4-5.8). Overall exposure to any dose of bronchodilator decreased by 12 percentage points as well (95% CI 5%-25%). There was also a statistically significant decline in chest physiotherapy usage, but not for steroids, chest radiography, or viral testing. Benchmarking within a voluntary pediatric hospitalist collaborative facilitated decreased utilization of bronchodilators and chest physiotherapy in bronchiolitis. Copyright © 2012 Society of Hospital Medicine.

Using search engine query data to track pharmaceutical utilization: a study of statins.

PubMed

Schuster, Nathaniel M; Rogers, Mary A M; McMahon, Laurence F

2010-08-01

To examine temporal and geographic associations between Google queries for health information and healthcare utilization benchmarks. Retrospective longitudinal study. Using Google Trends and Google Insights for Search data, the search terms Lipitor (atorvastatin calcium; Pfizer, Ann Arbor, MI) and simvastatin were evaluated for change over time and for association with Lipitor revenues. The relationship between query data and community-based resource use per Medicare beneficiary was assessed for 35 US metropolitan areas. Google queries for Lipitor significantly decreased from January 2004 through June 2009 and queries for simvastatin significantly increased (P <.001 for both), particularly after Lipitor came off patent (P <.001 for change in slope). The mean number of Google queries for Lipitor correlated (r = 0.98) with the percentage change in Lipitor global revenues from 2004 to 2008 (P <.001). Query preference for Lipitor over simvastatin was positively associated (r = 0.40) with a community's use of Medicare services. For every 1% increase in utilization of Medicare services in a community, there was a 0.2-unit increase in the ratio of Lipitor queries to simvastatin queries in that community (P = .02). Specific search engine queries for medical information correlate with pharmaceutical revenue and with overall healthcare utilization in a community. This suggests that search query data can track community-wide characteristics in healthcare utilization and have the potential for informing payers and policy makers regarding trends in utilization.

Primary Health Care Utilization by the Mexican Indigenous Population: The Role of the Seguro Popular in Socially Inequitable Contexts

PubMed Central

Leyva-Flores, Rene; Servan-Mori, Edson; Infante-Xibille, Cesar; Pelcastre-Villafuerte, Blanca Estela; Gonzalez, Tonatiuh

2014-01-01

Objective To analyze the relationship between primary health care utilization and extended health insurance coverage under the Seguro Popular (SP) among Mexican indigenous people. Methodology A cross-sectional analysis was conducted using data from the Mexican National Nutrition Survey 2012 (n = 194,758). Quasi-experimental matching methods and nonlinear regression probit models were used to estimate the influence of SP on primary health care utilization. Results 25% of the Mexican population reported having no health insurance coverage, while 59% of indigenous versus 35% of non-indigenous reported having SP coverage. Health problems were reported by 13.9% of indigenous vs. 10.5% of non-indigenous; of these, 52.8% and 57.7% respectively, received primary health care (p<0.05). Economic barriers were the most frequent reasons for not using primary health care services. The probability of utilizing primary health care services was 11.5 percentage points higher (p<0.01) for indigenous SP affiliates in comparison with non-indigenous, in similar socioeconomic conditions. Conclusion Socioeconomic conditions, not ethnicity per-se, determine whether people utilize primary health care services. Therefore, SP can be conceived as a public policy strategy which acts as a social buffer by enhancing health care utilization regardless of ethnicity. Further analysis is required to explore the potential gaps as a result of SP coverage among socially vulnerable groups. PMID:25099399

47 CFR 54.505 - Discounts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... consortium of only such entities shall be determined by indicators of poverty and high cost. (1) For schools and school districts, the level of poverty shall be based on the percentage of the student enrollment... consortia, the level of poverty shall be based on the percentage of the student enrollment that is eligible...

47 CFR 54.505 - Discounts.

Code of Federal Regulations, 2013 CFR

2013-10-01

... consortium of only such entities shall be determined by indicators of poverty and high cost. (1) For schools and school districts, the level of poverty shall be measured by the percentage of their student.... (2) For libraries and library consortia, the level of poverty shall be based on the percentage of the...

47 CFR 54.505 - Discounts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... consortium of only such entities shall be determined by indicators of poverty and high cost. (1) For schools and school districts, the level of poverty shall be measured by the percentage of their student.... (2) For libraries and library consortia, the level of poverty shall be based on the percentage of the...

Monte carlo simulation of innovative neutron and photon shielding material composing of high density concrete, waste rubber, lead and boron carbide

NASA Astrophysics Data System (ADS)

Aim-O, P.; Wongsawaeng, D.; Phruksarojanakun, P.; Tancharakorn, S.

2017-06-01

High-density concrete exhibits high strength and can perform an important role of gamma ray attenuation. In order to upgrade this material’s radiation-shielding performance, hydrogen-rich material can be incorporated. Waste rubber from vehicles has high hydrogen content which is the prominent characteristic to attenuate neutron. The objective of this work was to evaluate the radiation-shielding properties of this composite material against neutron and photon radiations. Monte Carlo transport simulation was conducted to simulate radiation through the composite material. Am-241/Be was utilized for neutron source and Co-60 for photon source. Parameters of the study included volume percentages of waste rubber, lead and boron carbide and thickness of the shielding material. These designs were also fabricated and the radiation shielding properties were experimentally evaluated. The best neutron and gamma ray shielding material was determined to be high-density concrete mixed with 5 vol% crumb rubber and 5 vol% lead powder. This shielding material increased the neutron attenuation by 64% and photon attenuation by 68% compared to ordinary concrete. Also, increasing the waste rubber content to greater than 5% resulted in a decrease in the radiation attenuation. This innovative composite radiation shielding material not only benefits nuclear science and engineering applications, but also helps solve the environmental issue of waste rubber.

Predictors of Dental Care Use: Findings from the National Longitudinal Study of Adolescent Health

PubMed Central

Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I.; Visotcky, Alexis (Dye); Szabo, Aniko

2013-01-01

Objective To examine longitudinal trends and associated factors in dental service utilization by adolescents progressing to early adulthood in the United States. Data Source The National Longitudinal Study of Adolescent Health from Waves I (1994-95), II (1996), III (2001-2002) and IV (2007-2008). Study Design This is a retrospective, observational study of adolescents' transition to early adulthood. We obtained descriptive statistics and performed logistic regression analyses to identify the effects of baseline and concurrent covariates on dental service utilization from adolescence to early adulthood over time. Principal Findings Dental service utilization within the prior 12 months peaked at age 16 (72%), gradually decreased until age 21 (57%), and thereafter remained flat. Whites and Asians had a 10-20 percentage points higher proportion of dental service utilization at most ages compared to Blacks and Hispanics. Dental service utilization at later follow-up visits was strongly associated with baseline utilization with OR= 10.7, 2.4 and 1.5 at the 1-year, 7-year and 13-year follow-ups respectively. These effects decreased when adjusted for current income, insurance and education. Compared to Whites, Blacks were consistently less likely to report any dental examination. Conclusion Dental service utilization was highest in adolescents. Gender, education, health insurance and income in young adulthood were significant predictors of reporting a dental examination. Blacks had lower odds of reporting a dental examination either as adolescents or as young adults. PMID:23850156

Phenols removal using ozonation-adsorption with granular activated carbon (GAC) in rotating packed bed reactor

NASA Astrophysics Data System (ADS)

Karamah, E. F.; Leonita, S.; Bismo, S.

2018-01-01

Synthetic wastewater containing phenols was treated using combination method of ozonation-adsorption with GAC (Granular Activated Carbon) in a packed bed rotating reactor. Ozone reacts quickly with phenol and activated carbon increases the oxidation process by producing hydroxyl radicals. Performance parameters evaluated are phenol removal percentage, the quantity of hydroxyl radical formed, changes in pH and ozone utilization, dissolved ozone concentration and ozone concentration in off gas. The performance of the combination method was compared with single ozonation and single adsorption. The influence of GAC dose and initial pH of phenols were evaluated in ozonation-adsorption method. The results show that ozonation-adsorption method generates more OH radicals than a single ozonation. Quantity of OH radical formation increases with increasing pH and quantity of the GAC. The combination method prove better performance in removing phenols. At the same operation condition, ozonation-adsorption method is capable of removing of 78.62% phenols as compared with single ozonation (53.15%) and single adsorption (36.67%). The increasing percentage of phenol removal in ozonation-adsorption method is proportional to the addition of GAC dose, solution pH, and packed bed rotator speed. Maximum percentage of phenol removal is obtained under alkaline conditions (pH 10) and 125 g of GAC

Self Reported Behavioral Health Habits and Other Health Issues Influencing Capabilities and Mission Readiness of Combat Search and Rescue Personnel

DTIC Science & Technology

2017-02-23

percentages for increased poor health habits, healthcare utilization, and medication usage were computed using the group n as the denominator instead of the n... survey to assess for general areas of health-related behaviors (i.e., sleep and exercise; alcohol, tobacco, and caffeine use; common reasons for seeking...medical care and mental health support services; and reasons for increased prescription and over-the-counter medication usage ) relevant to

[Experience with the clinical use of the PKS-25 and KTs-28 suturing devices].

PubMed

Kalinina, T V

1976-01-01

A study of the experience gained during many years of use in the surgical practice of a stitcher PKS-25 for establishing esophageal-intestinal anastomoses and of the KTs-28 apparatus for anastomosing the colon with superjacent segments of the large intestine proved their efficient performance. Their utilization makes it possible to reduce the percentage of lethal outcomes due to inadequacy of the anastomosis sutures following operations involving gastrectomy, resection of the cardia, esophagus and segments of the large intestine.

Economic Values for Evaluation of Federal Aviation Administration Investment and Regulatory Programs

DTIC Science & Technology

1989-10-01

Classifications: Critical Spinal Cord Injury Resulting in Quadriplegia $ 2,210,000 Critical Head Injury Resulting in Total Disability $ 2,460,000...34 Table 8 Percentage Utility Loss Associated with Severe Injuries AIS 4 AIS 5 Quadriplegia Paraplegia Quadriplegia Paraplegia Spinal Cord 109% 46% 109... Quadriplegia : d Air Carrier Domestic Pass. 1,719,071 91,522 223,492 23,784 75.4% Int’l Pass. 1,719,071 237,261 225,049 23,915 4.8% Commuter 1,719,071

An adaptive technique for estimating the atmospheric density profile during the AE mission

NASA Technical Reports Server (NTRS)

Argentiero, P.

1973-01-01

A technique is presented for processing accelerometer data obtained during the AE missions in order to estimate the atmospheric density profile. A minimum variance, adaptive filter is utilized. The trajectory of the probe and probe parameters are in a consider mode where their estimates are unimproved but their associated uncertainties are permitted an impact on filter behavior. Simulations indicate that the technique is effective in estimating a density profile to within a few percentage points.

Utility of Sleep Stage Transitions in Assessing Sleep Continuity

PubMed Central

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

2010-01-01

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

[Effects of nitrogen application rate on potassium uptake and utilization of direct-seeded cotton after wheat harvest].

PubMed

Zhang, Guo Wei; Yang, Chang Qin; Liu, Rui Xian; Zhang, Lei; Ni, Wan Chao

2016-10-01

By using cotton cultivar CCRI-50 as material, field experiments were conducted in the summer seasons of 2013 and 2014 at the experimental station of Jiangsu Academy of Agricultural Sciences (Nanjing, China) to study the effects of different nitrogen application rates (0, 60, 120, 150, 180 and 240 kg N·hm -2 ) on the potassium uptake and utilization of the cotton plant that was direct-seeded after wheat harvest. Data suggested that the elevated nitrogen application rates increased the cotton potassium uptake of all growth stages, and the largest increment was observed at the peak flowering-boll opening stage. Nitrogen application also changed the uptake percentage of potassium uptake of each stage, i.e., the percentage of potassium uptake decreased in the stage from seedling to peak flowering, while increased in the stage from peak flowering to boll maturing. In addition, the elevated nitrogen applications reduced the decreasing rate of nitrogen concentration in upper fruiting branches, but promoted the decreasing rate in middle and low fruiting branches at later growth stages. As the nitrogen application rate increased, the marginal effect of potassium uptake (promoted amount of potassium uptake due to 1 kg increase of N application) increased first and then decreased, and the lint production efficiency of potassium descended steadily. In cotton plants that were direct-seeded after wheat harvest, potassium and biomass were mainly accumulated in the lower and middle fruiting branches. At the 150 and 180 kg N·hm -2 application levels, much more potassium was allocated to the reproductive organs and the characters and the eigenvalues of simulated curves of potassium concentration and total potassium accumulation were more optimized than those at the higher or the lower N application levels. At the high nitrogen application (more than 180 kg N·hm -2 ) level, the marginal effect of potassium uptake and lint production efficiency decreased, and at the lower nitrogen application (less than 150 kg N·hm -2 ) level, lint yield was lower due to the decrease of economic coefficient of biomass and potassium in the middle and low fruiting branches.

Analogue evaluation of the effects of opportunities to respond and ratios of known items within drill rehearsal of Esperanto words.

PubMed

Szadokierski, Isadora; Burns, Matthew K

2008-10-01

Drill procedures have been used to increase the retention of various types of information, but little is known about the causal mechanisms of these techniques. The current study compared the effect of two key features of drill procedures, a large number of opportunities to respond (OTR) and a drill ratio that maintains a high percentage of known to unknown items (90% known). Using a factorial design, 27 4th graders were taught the pronunciation and meaning of Esperanto words using four versions of incremental rehearsal that varied on two factors, percentage of known words (high - 90% vs. moderate - 50%) and the number of OTR (high vs. low). A within-subject ANOVA revealed a significant main effect for OTR and non-significant effects for drill ratio and the interaction between the two variables. Moreover, it was found that increasing OTR from low to high yielded a large effect size (d=2.46), but increasing the percentage of known material from moderate (50%) to high (90%) yielded a small effect (d=0.16). These results suggest that a high number of OTR may be a key feature of flashcard drill techniques in promoting learning and retention.

The effects of a high dosage of creatine and caffeine supplementation on the lean body mass composition of rats submitted to vertical jumping training.

PubMed

Franco, Frederico Sc; Costa, Neuza Mb; Ferreira, Susana A; Carneiro-Junior, Miguel A; Natali, Antônio J

2011-03-01

The influences of creatine and caffeine supplementation associated with power exercise on lean body mass (LBM) composition are not clear. The purpose of this research was to determine whether supplementation with high doses of creatine and caffeine, either solely or combined, affects the LBM composition of rats submitted to vertical jumping training. Male Wistar rats were randomly divided into 8 groups: Sedentary (S) or Exercised (E) [placebo (Pl), creatine (Cr), caffeine (Caf) or creatine plus caffeine (CrCaf)]. The supplemented groups received creatine [load: 0.430 g/kg of body weight (BW) for 7 days; and maintenance: 0.143 g/kg of BW for 35 days], caffeine (15 mg/kg of BW for 42 days) or creatine plus caffeine. The exercised groups underwent a vertical jump training regime (load: 20 - 50% of BW, 4 sets of 10 jumps interspersed with 1 min resting intervals), 5 days/wk, for 6 weeks. LBM composition was evaluated by portions of water, protein and fat in the rat carcass. Data were submitted to ANOVA followed by the Tukey post hoc test and Student's t test. Exercised animals presented a lower carcass weight (10.9%; P = 0.01), as compared to sedentary animals. However, no effect of supplementation was observed on carcass weight (P > 0.05). There were no significant differences among the groups (P > 0.05) for percentage of water in the carcass. The percentage of fat in the group SCr was higher than in the groups SCaf and ECr (P < 0.05). A higher percentage of protein was observed in the groups EPl and ECaf when compared to the groups SPl and SCaf (P < 0.001). The percentage of fat in the carcass decreased (P < 0.001), while those of water and protein increased (P < 0.05) in exercised animals, compared to sedentary animals. Caffeine groups presented reduced percentage of fat when compared to creatine supplemented groups (P < 0.05). High combined doses of creatine and caffeine does not affect the LBM composition of either sedentary or exercised rats, however, caffeine supplementation alone reduces the percentage of fat. Vertical jumping training increases the percentages of water and protein and reduces the fat percentage in rats.

Changing Patterns of Mental Health Care Use: The Role of Integrated Mental Health Services in Veteran Affairs Primary Care.

PubMed

Leung, Lucinda B; Yoon, Jean; Rubenstein, Lisa V; Post, Edward P; Metzger, Maureen E; Wells, Kenneth B; Sugar, Catherine A; Escarce, José J

2018-01-01

Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs. We performed a retrospective longitudinal cohort study of primary care patients with identified mental health needs in 29 Southern California VA clinics from October 1, 2008 to September 30, 2013, using electronic administrative data (n = 66,638). We calculated clinic PC-MHI engagement as the proportion of patients receiving PC-MHI services among all primary care clinic patients in each year. Capitalizing on variation in PC-MHI engagement across clinics, our multivariable regression models predicted annual patient use of 1) non-primary care based mental health specialty (MHS) visits, 2) total mental health visits (ie, the sum of MHS and PC-MHI visits), and 3) health care utilization and costs. We controlled for year- and clinic-fixed effects, other clinic interventions, and patient characteristics. Median clinic PC-MHI engagement increased by 8.2 percentage points over 5 years. At any given year, patients treated at a clinic with 1 percentage-point higher PC-MHI engagement was associated with 0.5% more total mental health visits (CI, 0.18% to 0.90%; P = .003) and 1.0% fewer MHS visits (CI, -1.6% to -0.3%; P = .002); this is a substitution rate, at the mean, of 1.5 PC-MHI visits for each MHS visit. There was no PC-MHI effect on other health care utilization and costs. As intended, greater clinic engagement in PC-MHI services seems to increase realized accessibility to mental health care for primary care patients, substituting PC-MHI for MHS visits, without increasing acute care use or total costs. Thus, PC-MHI services within primary care clinics may improve mental health care value at the patient population level. More research is needed to understand the relationship between clinic PC-MHI engagement and clinical quality of mental health care. © Copyright 2018 by the American Board of Family Medicine.

Use of myocardial perfusion imaging and estimation of associated radiation doses in Germany from 2005 to 2012.

PubMed

Lindner, O; Bengel, F M; Hacker, M; Schäfer, W; Burchert, W

2014-05-01

For several years the Working Group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine has been performing a regular survey to obtain information on technique, utilization and development of myocardial perfusion scintigraphy (MPS). Currently, data of six surveys from 2005 to 2012 are available. The aim of this paper is to deliver a general and comprehensive overview of all surveys documenting the course of patient doses over time and the development of the method. A one-page questionnaire with number of MPS patients, number of stress and rest MPS, referral structure and several technical issues was sent to all centres performing MPS in Germany and evaluated. With the data on protocol utilization, effective MPS patient doses were estimated. MPS per million population (pmp) varied between 2,380 and 2,770. In 2012, MPS pmp showed a slight increase for the first time. From 2005 to 2009 the angiography to MPS ratio increased from 3.4 to 4.4, and the revascularization to MPS ratio decreased from 0.66 to 0.53. In 2012, both indices demonstrated an opposite trend for the first time (4.1 and 0.55). A total of 108 centres participated in all surveys. They showed an increase in MPS patients of 4.0 % over the reporting period. In 2012, more than 50 % of the centres experienced no change or an increase in MPS numbers. The leading single competitor was MRI, followed by angiography and stress echocardiography. (201)Tl studies have decreased since 2005 from 20 to 5 %. (99m)Tc MPS studies showed a mild increase in 2-day protocols. In 2012, the average effective dose per patient was estimated at 7.4 mSv. Due to the decreasing use of (201)Tl, a mild decline over the observation period can be documented. Dynamic exercise stress was the most common stress test and adenosine the leading pharmacological stress agent, with a growing percentage. In 2012, the regadenoson percentage was 9 %. Gated single photon emission computed tomography (SPECT) noted an increasing acceptance with >70 % in 2012. The segmental scoring of perfusion studies had a low acceptance. Ambulatory care cardiologists represented the major referral group. Germany has a moderate to moderate-high MPS utilization rate. Nevertheless, coronary artery disease (CAD) diagnosis and disease management are dominated by angiography. The survey data reveal a positive trend in MPS and a decrease in average patient dose reflecting good practice with guideline adherence, the implementation of technical improvements and success in training.

The effect of water binder ratio and fly ash on the properties of foamed concrete

NASA Astrophysics Data System (ADS)

Saloma, Hanafiah, Urmila, Dea

2017-11-01

Foamed concrete is a lightweight concrete composed by cement, water, fine aggregate and evenly distributed foam. Foamed concrete is produced by adding foam to the mixture. The function of foam is to create air voids in the mixture, so the weight of the concrete becomes lighter. The foaming agent is diluted in water then given air pressure by foam generator to produce foam. This research utilizes coal combustion, which is fly ash as cementitious material with a percentage of 0%, 10%, 15%, and 20%. The purpose of the research is to examine the effect of water binder ratio 0.425, 0.450, 0.475, and 0.500 using fly ash on the properties of foamed concrete. Fresh concrete tests include slump flow and setting time test while hardened concrete tests include density and compressive strength. The maximum value of slump flow test result is 59.50 cm on FC-20-0.500 mixture with w/b = 0.500 and 20% of fly ash percentage. The results of the setting time tests indicate the fastest initial and final time are 335 and 720 minutes, respectively on FC-0-0.425 mixture with w/b = 0.425 without fly ash. The lowest density is 978.344 kg/m3 on FC-20-0.500 mixture with w/b = 0.500 and 20% of fly ash percentage. The maximum compressive strength value is 4.510 MPa at 28 days on FC-10-0.450 mixture with w/b = 0.450 and 10% of fly ash percentage.

The state of racial/ethnic diversity in North Carolina's health workforce.

PubMed

McGee, Victoria; Fraher, Erin

2012-01-01

Increasing the racial and ethnic diversity of the health care workforce is vital to achieving accessible, equitable health care. This study provides baseline data on the diversity of health care practitioners in North Carolina compared with the diversity of the state's population. We analyzed North Carolina health workforce diversity using licensure data from the respective state boards of selected professions from 1994-2009; the data are stored in the North Carolina Health Professions Data System. North Carolina's health care practitioners are less diverse than is the state's population as a whole; only 17% of the practitioners are nonwhite, compared with 33% of the state's population. Levels of diversity vary among the professions, which are diversifying slowly over time. Primary care physicians are diversifying more rapidly than are other types of practitioners; the percentage who are nonwhite increased by 14 percentage points between 1994 and 2009, a period during which 1,630 nonwhite practitioners were added to their ranks. The percentage of licensed practical nurses who are nonwhite increased by 7 percentage points over the same period with the addition of 1,542 nonwhite practitioners to their ranks. Nonwhite health professionals cluster regionally throughout the state, and 79% of them practice in metropolitan counties. This study reports on only a selected number of health professions and utilizes race/ethnicity data that were self-reported by practitioners. Tracking the diversity among North Carolina's health care practitioners provides baseline data that will facilitate future research on barriers to health workforce entry, allow assessment of diversity programs, and be useful in addressing racial and ethnic health disparities.

Influence of porcine spermadhesins on the susceptibility of boar spermatozoa to high dilution.

PubMed

Centurion, Fernando; Vazquez, Juan M; Calvete, Juan J; Roca, Jordi; Sanz, Libia; Parrilla, Inmaculada; Garcia, Eva M; Martinez, Emilio A

2003-08-01

The effect of heparin-binding and non-heparin-binding spermadhesins on the viability, motility, and mitochondrial activity of boar spermatozoa at the high dilution (300,000 sperm/ml) to which sperm are exposed during the process of sex sorting by flow cytometry was investigated. Incubation of spermatozoa with heparin-binding spermadhesins caused a time- and dose-dependent decrease in the percentage of functional spermatozoa. The percentage of viable spermatozoa incubated at 38 degrees C with heparin-binding spermadhesins diluted in PBS (1 mg/ml) dropped from 75% (0.5 h) to 4% (5 h), whereas the percentage of viable spermatozoa incubated in PBS without proteins (control) decreased from 85% (0.5 h) to 19% (5 h). Addition of non-heparin-binding PSP-I/PSP-II spermadhesin to the PBS resulted in a concentration-dependent increment of the percentage of viable cells (65% after 5-h incubation), with maximum effect at 1.5 mg/ml. The heparin-binding spermadhesins totally suppressed sperm motility and mitochondrial activity after 5 h of incubation. The same parameters of sperm incubated in the presence of 1.5 mg/ml of PSP-I/PSP-II were 50% and 58%, respectively, and the percentages of control sperm displaying motility and mitochondrial activity were 21% and 26%, respectively. Moreover, the viability, motility, and mitochondrial activity all decreased on incubation of spermatozoa with mixtures of PSP-I/PSP-II and heparin-binding spermadhesins as the concentration of the latter increased. We conclude that PSP-I/PSP-II and the heparin-binding spermadhesins exert antagonistic effects on the functionality of highly diluted boar spermatozoa. The finding that PSP-I/PSP-II contributes to maintaining sperm with high viability, motility, and mitochondrial activity for at least 5 h at physiological temperature points to its potential use as an additive for sperm preservation, specifically of highly diluted, flow-sorted spermatozoa for sex preselection.

Caloric restriction in lean and obese strains of laboratory rat: effects on body composition, metabolism, growth and overall health.

PubMed

Aydin, C; Jarema, K A; Phillips, P M; Gordon, C J

2015-11-01

What is the central question of this study? How do lean and obese rats respond physiologically to caloric restriction? What is the main finding and its importance? Obese rats show marked benefits compared with lean animals. Reduced body fat is associated with improved longevity with caloric restriction (CR) in rodents. Little is known regarding effects of CR in genetically lean versus obese strains. Long-Evans (LE) and Brown Norway (BN) rats make an ideal comparison for a CR study because the percentage body fat of young adult LE rats is double that of BN rats. Male LE and BN rats were either fed ad libitum (AL) or were calorically restricted to 80 or 90% of their AL weight. The percentages of fat, lean and fluid mass were measured non-invasively at 2- to 4-week intervals. Metabolic rate and respiratory quotient were measured after 3, 6, 9 and 12 months of CR. Overall health was scored monthly. The percentage of fat of the LE strain decreased with CR, whereas the percentage of fat of the BN strain remained above the AL group for several months. The percentage of lean mass increased above the AL for both strains subjected to CR. The percentage of fluid was unaffected by CR. The average metabolic rate over 22 h of the BN rats subjected to CR was reduced, whereas that of LE rats was increased slightly above the AL group. The respiratory quotient of BN rats was decreased with CR. Overall health of the CR LE group was significantly improved compared with that of the AL group, whereas health of the CR BN rats was impaired compared with the AL group. Overall, the lean BN and obese LE strains differ markedly in fat utilization and metabolic response to prolonged CR. There appears to be little benefit of CR in the lean strain. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Redirection of Metabolic Hydrogen by Inhibiting Methanogenesis in the Rumen Simulation Technique (RUSITEC)

PubMed Central

Guyader, Jessie; Ungerfeld, Emilio M.; Beauchemin, Karen A.

2017-01-01

A decrease in methanogenesis is expected to improve ruminant performance by allocating rumen metabolic hydrogen ([2H]) to more energy-rendering fermentation pathways for the animal. However, decreases in methane (CH4) emissions of up to 30% are not always linked with greater performance. Therefore, the aim of this study was to understand the fate of [2H] when CH4 production in the rumen is inhibited by known methanogenesis inhibitors (nitrate, NIT; 3-nitrooxypropanol, NOP; anthraquinone, AQ) in comparison with a control treatment (CON) with the Rumen Simulation Technique (RUSITEC). Measurements started after 1 week adaptation. Substrate disappearance was not modified by methanogenesis inhibitors. Nitrate mostly seemed to decrease [2H] availability by acting as an electron acceptor competing with methanogenesis. As a consequence, NIT decreased CH4 production (−75%), dissolved dihydrogen (H2) concentration (−30%) and the percentages of reduced volatile fatty acids (butyrate, isobutyrate, valerate, isovalerate, caproate and heptanoate) except propionate, but increased acetate molar percentage, ethanol concentration and the efficiency of microbial nitrogen synthesis (+14%) without affecting gaseous H2. Nitrooxypropanol decreased methanogenesis (−75%) while increasing both gaseous and dissolved H2 concentrations (+81% and +24%, respectively). Moreover, NOP decreased acetate and isovalerate molar percentages and increased butyrate, valerate, caproate and heptanoate molar percentages as well as n-propanol and ammonium concentrations. Methanogenesis inhibition with AQ (−26%) was associated with higher gaseous H2 production (+70%) but lower dissolved H2 concentration (−76%), evidencing a lack of relationship between the two H2 forms. Anthraquinone increased ammonium concentration, caproate and heptanoate molar percentages but decreased acetate and isobutyrate molar percentages, total microbial nitrogen production and efficiency of microbial protein synthesis (−16%). Overall, NOP and AQ increased the amount of reduced volatile fatty acids, but part of [2H] spared from methanogenesis was lost as gaseous H2. Finally, [2H] recovery was similar among CON, NOP and AQ but was largely lower than 100%. Consequently, further studies are required to discover other so far unidentified [2H] sinks for a better understanding of the metabolic pathways involved in [2H] production and utilization. PMID:28352256

Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality: A Cohort Study.

PubMed

Padwal, Raj; Leslie, William D; Lix, Lisa M; Majumdar, Sumit R

2016-04-19

Prior mortality studies have concluded that elevated body mass index (BMI) may improve survival. These studies were limited because they did not measure adiposity directly. To examine associations of BMI and body fat percentage (separately and together) with mortality. Observational study. Manitoba, Canada. Adults aged 40 years or older referred for bone mineral density (BMD) testing. Participants had dual-energy x-ray absorptiometry (DXA), entered a clinical BMD registry, and were followed using linked administrative databases. Adjusted, sex-stratified Cox models were constructed. Body mass index and DXA-derived body fat percentage were divided into quintiles, with quintile 1 as the lowest, quintile 5 as the highest, and quintile 3 as the reference. The final cohort included 49 476 women (mean age, 63.5 years; mean BMI, 27.0 kg/m2; mean body fat, 32.1%) and 4944 men (mean age, 65.5 years; mean BMI, 27.4 kg/m2; mean body fat, 29.5%). Death occurred in 4965 women over a median of 6.7 years and 984 men over a median of 4.5 years. In fully adjusted mortality models containing both BMI and body fat percentage, low BMI (hazard ratio [HR], 1.44 [95% CI, 1.30 to 1.59] for quintile 1 and 1.12 [CI, 1.02 to 1.23] for quintile 2) and high body fat percentage (HR, 1.19 [CI, 1.08 to 1.32] for quintile 5) were associated with higher mortality in women. In men, low BMI (HR, 1.45 [CI, 1.17 to 1.79] for quintile 1) and high body fat percentage (HR, 1.59 [CI, 1.28 to 1.96] for quintile 5) were associated with increased mortality. All participants were referred for BMD testing, which may limit generalizability. Serial measures of BMD and weight were not used. Some measures, such as physical activity and smoking, were unavailable. Low BMI and high body fat percentage are independently associated with increased mortality. These findings may help explain the counterintuitive relationship between BMI and mortality. None.

HIGH STRENGTH CONTROL RODS FOR NEUTRONIC REACTORS

DOEpatents

Lustman, B.; Losco, E.F.; Cohen, I.

1961-07-11

Nuclear reactor control rods comprised of highly compressed and sintered finely divided metal alloy panticles and fine metal oxide panticles substantially uniformly distributed theretbrough are described. The metal alloy consists essentially of silver, indium, cadmium, tin, and aluminum, the amount of each being present in centain percentages by weight. The oxide particles are metal oxides of the metal alloy composition, the amount of oxygen being present in certain percentages by weight and all the oxygen present being substantially in the form of metal oxide. This control rod is characterized by its high strength and resistance to creep at elevated temperatures.

The Prevalence of HIV Risk Behaviors among Felony Drug Court Participants

PubMed Central

Festinger, David S.; Dugosh, Karen L.; Metzger, David S.; Marlowe, Douglas B.

2013-01-01

[15] HIV Risk Behaviors in Drug Court A small percentage of participants in a large metropolitan felony Drug Court engaged in high-risk injection drug use, but a large percentage engaged in high-risk sexual behaviors. [16] HIV Risk Factors in Drug Court HIV risk behaviors were associated with being male, African–American, and younger. [17] Geographic Risk for HIV A large proportion of Drug Court participants resided in areas of the city with a high prevalence of persons living with HIV/AIDS, thus heightening the probability of exposure to the virus. PMID:25309974

[Social network, alcohol drinking habits and injuries caused by violence among women and men in the county of Akershus. Results from anonymous questionnaires among persons aged 40-42 years. 1990-91].

PubMed

Graff-Iversen, S; Gjervig, T; Lund-Larsen, P G; Hjemmen, A; Dalgard, O S; Holmsen, E

1992-11-20

All residents aged 40-42 in Akershus county were invited to screening for cardiovascular risk factors in 1990-91 as part of a prevention programme. Of the 13,607 attendants, 8,960 answered an anonymous questionnaire about social network, drinking habits, and injuries due to violence. Compared with data from the Central Bureau of Statistics, our material included a high percentage of persons with a higher education, a high percentage of married persons, and a low percentage of persons living alone. Results in respect of social network and drinking habits roughly agreed with those of other studies. Of the males, 15.7% had been injured at least once as a result of violence, most often assault and robbery. Of the females, the corresponding percentage was 18.1. Here the dominating forms of violence were maltreatment, threats and sexual assault. Females were more often exposed than males to repeated violence and more often suffered persisting problems as a result of maltreatment. Compared with other studies, we found a high prevalence of injuries from violence among females, suggesting underreporting of experiences of violence by females in studies based on personal interview or the hospitals' injury register.

Impaired activation of adenylyl cyclase in lung of the Basenji-greyhound model of airway hyperresponsiveness: decreased numbers of high affinity beta-adrenoceptors.

PubMed Central

Emala, C. W.; Aryana, A.; Hirshman, C. A.

1996-01-01

1. To evaluate mechanisms involved in the impaired beta-adrenoceptor stimulation of adenylyl cyclase in tissues from the Basenji-greyhound (BG) dog model of airway hyperresponsiveness, we compared agonist and antagonist binding affinity of beta-adrenoceptors, beta-adrenoceptor subtypes, percentage of beta-adrenoceptors sequestered, and coupling of the beta-adrenoceptor to Gs alpha in lung membranes from BG and control mongrel dogs. We found that lung membranes from the BG dog had higher total numbers of beta-adrenoceptors with a greater percentage of receptors of the beta 2 subtype as compared to mongrel lung membranes. 2. Agonist and antagonist binding affinity and the percentage of beta-adrenoceptors sequestered were not different in BG and mongrel dog lung membranes. However, the percentage of beta-adrenoceptors in the high affinity state for agonist was decreased in BG lung membranes suggesting an uncoupling of the receptor from Gs alpha. 3. Impaired coupling between the beta-adrenoceptor and G protein documented by the decreased numbers of beta-adrenoceptors in the high affinity state in BG lung membranes, is a plausible explanation for the reduced stimulation of adenylyl cyclase and the resultant reduction in airway smooth muscle relaxation in this model. PMID:8864536

Environmental supports for walking/biking and traffic safety: income and ethnicity disparities.

PubMed

Yu, Chia-Yuan

2014-10-01

The present study investigates the influence of income, ethnicity, and built environmental characteristics on the percentages of workers who walk/bike as well as on pedestrian/cyclist crash rates. Furthermore, income and ethnicity disparities are also explored. This study chose 162 census tracts in Austin as the unit of analysis. To explore income and ethnicity differences in built environments, this study examined the associations of the poverty rate, the percentage of white population, and the percentage of Hispanic population to each built environmental variable. Path models were applied to examine environmental supports of walking/biking and pedestrian/cyclist safety. Areas with high poverty rates had more biking trips and experienced more cyclist crashes, while areas with a high percentage of white population generated more walking trips and fewer pedestrian crashes. Sidewalk completeness and mixed land uses promoted walking to work but increased the crash risk for pedestrians as well. In terms of biking behaviors, road density and transit stop density both increased biking trips and cyclist crashes. Environmental designs that both encourage walking/biking trips and generate more safety threats should attract more attention from policy makers. Policies should also be more devoted to enhancing the mobility and health for areas with high poverty rates. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of Obesity and Chronic Inflammation on TRAIL-Based Immunotherapy for Advanced Breast Cancer

DTIC Science & Technology

2015-04-01

resistance. J Clin Invest, 112: 1821, 2003 3. Lee, I. S., Shin, G., Choue, R.: Shifts in diet from high fat to high carbohydrate improved levels of...phenotype and percentages via multiparameter flow cytometry – months 10-13 (Dr. Norian) B. Evaluate shifts in DC stimulatory vs . regulatory function...cohort of 13 NW and 13 DIO mice is shown in Fig. 1B. Compared to NW mice, DIO mice had increased percentages of visceral body fat and increased

Effect of Obesity and Chronic Inflammation on TRAIL-Based Immunotherapy for Advanced Breast Cancer

DTIC Science & Technology

2014-04-01

to high carbohydrate improved levels of adipokines and pro-inflammatory cytokines in mice fed a high- fat diet. Endocr J, 57: 39, 2009 4. Fenton, J...phenotype and percentages via multiparameter flow cytometry – months 10-13 (Dr. Norian) B. Evaluate shifts in DC stimulatory vs . regulatory...weights of one cohort of 13 NW and 13 DIO mice is shown in Fig. 1B. Compared to NW mice, DIO mice had increased percentages of visceral body fat and

Oral health care utilization by US rural residents, National Health Interview Survey 1999.

PubMed

Vargas, Clemencia M; Dye, Bruce A; Hayes, Kathy

2003-01-01

To compare the dental care utilization practices of rural and urban residents in the United States. Data on dental care utilization from the 1999 National Health Interview Survey for persons 2 years of age and older (n=42, 139) were analyzed by rural/urban status. Percentages and 95 percent confidence intervals were calculated to produce national estimates for having had a visit in the past year, the number of visits, reasons given for last dental visit and for not visiting a dentist, unmet dental needs, and private dental insurance. Rural residents were more likely to report that their last dental visit was because something was "bothering or hurting" (23.3% vs 17.6%) and that they had unmet dental needs (10.1% vs 7.5%). Urban residents were more likely to report having a dental visit in the past year (57.7% vs 66.5%) and having private dental insurance (32.7% vs 37.2%), compared to rural residents. There were no significant differences in most reasons given for not visiting the dentist between rural and urban respondents. Dental care utilization characteristics differ between rural and urban residents in the United States, with rural residents tending to underutilize dental care.

Pathologists' roles in clinical utilization management. A financing model for managed care.

PubMed

Zhao, J J; Liberman, A

2000-03-01

In ancillary or laboratory utilization management, the roles of pathologists have not been explored fully in managed care systems. Two possible reasons may account for this: pathologists' potential contributions have not been defined clearly, and effective measurement of and reasonable compensation for the pathologist's contribution remains vague. The responsibilities of pathologists in clinical practice may include clinical pathology and laboratory services (which have long been well-defined and are compensated according to a resource-based relative value system-based coding system), laboratory administration, clinical utilization management, and clinical research. Although laboratory administration services have been compensated with mechanisms such as percentage of total service revenue or fixed salary, the involvement of pathologists seems less today than in the past, owing to increased clinical workload and time constraints in an expanding managed care environment, especially in community hospital settings. The lack of financial incentives or appropriate compensation mechanisms for the services likely accounts for the current situation. Furthermore, the importance of pathologist-driven utilization management in laboratory services lacks recognition among hospital administrators, managed care executives, and pathologists themselves, despite its potential benefits for reducing cost and enhancing quality of care. We propose a financial compensation model for such services and summarize its advantages.

Utilization of Radiation Therapy in Norway After the Implementation of The National Cancer Plan—A National, Population-Based Study

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

Åsli, Linn M., E-mail: linn.merete.asli@kreftregisteret.no; Kvaløy, Stein O.; Jetne, Vidar

2014-11-01

Purpose: To estimate actual utilization rates of radiation therapy (RT) in Norway, describe time trends (1997-2010), and compare these estimates with corresponding optimal RT rates. Methods and Materials: Data from the population-based Cancer Registry of Norway was used to identify all patients diagnosed with cancer and/or treated by RT for cancer in 1997-2010. Radiation therapy utilization rates (RURs) were calculated as (1) the proportion of incident cancer cases who received RT at least once within 1 year of diagnosis (RUR{sub 1Y}); and (2) the proportion who received RT within 5 years of diagnosis (RUR{sub 5Y}). The number of RT treatment courses per incidentmore » cancer case (TCI) was also calculated for all cancer sites combined. The actual RURs were compared with corresponding Australian and Canadian epidemiologic- and evidence-based model estimates and criterion-based benchmark estimates of optimal RURs. The TCIs were compared with TCI estimates from the 1997 Norwegian/National Cancer Plan (NCP). Joinpoint regression was used to identify changes in trends and to estimate annual percentage change (APC) in actual RUR{sub 1Y} and actual TCI. Results: The actual RUR{sub 5Y} (all sites) increased significantly to 29% in 2005 but still differed markedly from the Australian epidemiologic- and evidence-based model estimate of 48%. With the exception of RUR{sub 5Y} for breast cancer and RUR{sub 1Y} for lung cancers, all actual RURs were markedly lower than optimal RUR estimates. The actual TCI increased significantly during the study period, reaching 42.5% in 2010, but was still lower than the 54% recommended in the NCP. The trend for RUR{sub 1Y} (all sites) and TCI changed significantly, with the annual percentage change being largest during the first part of the study period. Conclusions: Utilization rates of RT in Norway increased after the NCP was implemented and RT capacity was increased, but they still seem to be lower than optimal levels.« less

Impact of media and antifoam selection on monoclonal antibody production and quality using a high throughput micro‐bioreactor system

PubMed Central

Velugula‐Yellela, Sai Rashmika; Williams, Abasha; Trunfio, Nicholas; Hsu, Chih‐Jung; Chavez, Brittany; Yoon, Seongkyu

2017-01-01

Monoclonal antibody production in commercial scale cell culture bioprocessing requires a thorough understanding of the engineering process and components used throughout manufacturing. It is important to identify high impact components early on during the lifecycle of a biotechnology‐derived product. While cell culture media selection is of obvious importance to the health and productivity of mammalian bioreactor operations, other components such as antifoam selection can also play an important role in bioreactor cell culture. Silicone polymer‐based antifoams were known to have negative impacts on cell health, production, and downstream filtration and purification operations. High throughput screening in micro‐scale bioreactors provides an efficient strategy to identify initial operating parameters. Here, we utilized a micro‐scale parallel bioreactor system to study an IgG1 producing CHO cell line, to screen Dynamis, ProCHO5, PowerCHO2, EX‐Cell Advanced, and OptiCHO media, and 204, C, EX‐Cell, SE‐15, and Y‐30 antifoams and their impacts on IgG1 production, cell growth, aggregation, and process control. This study found ProCHO5, EX‐Cell Advanced, and PowerCHO2 media supported strong cellular growth profiles, with an IVCD of 25‐35 × 106 cells‐d/mL, while maintaining specific antibody production (Qp > 2 pg/cell‐d) for our model cell line and a monomer percentage above 94%. Antifoams C, EX‐Cell, and SE‐15 were capable of providing adequate control of foaming while antifoam 204 and Y‐30 noticeably stunted cellular growth. This work highlights the utility of high throughput micro bioreactors and the importance of identifying both positive and negative impacts of media and antifoam selection on a model IgG1 producing CHO cell line. © 2017 The Authors Biotechnology Progress published by Wiley Periodicals, Inc. on behalf of American Institute of Chemical Engineers Biotechnol. Prog., 34:262–270, 2018 PMID:29086492

Best practices in specialty pharmacy management.

PubMed

Patterson, Courtney J

2013-01-01

Specialty pharmacy is a growing area of research, utilization, and cost. Because of the unique nature of the diseases treated by specialty pharmaceuticals, such as cancer and rheumatoid arthritis, novel management approaches are needed. Advocate Physician Partners (APP) is an entity within the Advocate Health Care Health System in the Chicago and the central Illinois area. It coordinates the care management and managed care contracting between the Advocate Health Care System and more than 4,000 physicians on the medical staffs of Advocate hospitals. APP has experienced a per-member-per-month (PMPM) increase of less than  3% in oncology intravenous medications spend in 2012. This spend refers to the intravenous medications covered under the medical benefits for APP's health maintenance organization (HMO) population. The spend has consistently been less than national projections, and we believe this is tied to the adoption of several key best practices. Prior to instituting the best practices, the yearly percentage increases for oncology spending were 5.52% (2007 to 2008), 9.39% (2008 to 2009), and 5.29% (2009 to 2010). After instituting best practices during the first quarter of 2011, the increases in PMPM were 3.11% (2010 to 2011) and 2.11% (2011 to 2012), which were below previous years. To describe the best practices of specialty pharmacy management adopted by APP, specifically (a) establishing a content expert and governing bodies, (b) ensuring compliance with policies, and (c) providing educational resources. APP has several key result areas (KRAs). One KRA was compliance with appropriate utilization of intravenous oncology protocols for its HMO population. The protocols for each medication outline the appropriate indication and patient population. These protocols were developed and reviewed by the APP Pharmacy and Technology (PT) committee. The PT-approved indications reflect FDA indications and indications found in national guidelines. The APP KRA target for the utilization of protocols was 80%. The compliance for completing the protocols that correspond to these medications was calculated by tabulating the number of paid claims over the number of completed protocols, resulting in a compliance percentage. APP defined noncompliance as any utilization not outlined in the protocol. Another KRA was physician feedback. APP requires that physicians complete a certain number of continuing medical education (CME) programs provided by APP each year. Feedback from physicians, provided at the end of the CME, were tabulated and utilized for further programs. Additionally, APP strived to increase physician engagement by placing them in key roles that oversaw clinical and business aspects of the organization. In order to meet the KRAs, investigate inappropriate utilization, and become better involved in engaging oncology specialists, APP invested in an oncology clinical pharmacist position. The primary responsibility of the oncology clinical pharmacist was to be a specialty drug resource for the organization with a focus on provider education. The oncology clinical pharmacist was deemed the content expert who developed clinical protocols, educated providers, and encouraged compliance with organizational policies and procedures as it pertained to the KRAs. Since establishing the oncology clinical pharmacist position, APP has seen an increase in protocol compliance. Prior to the institution of this position, the protocol compliance was 62%. In less than 1 year after hiring the oncology clinical pharmacist, the compliance percentage spiked to over 80%. APP has several committees and boards that oversee the clinical and business aspects of the organization. By placing physicians in chairmanship positions of the committees, APP has seen the benefit of handling difficult patient decisions and increased compliance with policies. Lastly, extensive provider education has led to an improved physician satisfaction in the educational initiatives of APP. Greater than 80% of the physicians felt the CME content was relevant to their practices; the content would likely have a positive impact on their practices; and the clinical content was evidence based and accepted by the medical community. By hiring an oncology clinical pharmacist, engaging physicians by placing them in key roles, and providing more specialist-specific education, APP has improved its KRAs and compliance percentages. APP achieved success in containing expenditures for oncology intravenous medications by implementing key best practices combined with traditional management strategies.

Electrogram Morphology Recurrence Patterns during Atrial Fibrillation

PubMed Central

Ng, Jason; Gordon, David; Passman, Rod S.; Knight, Bradley P.; Arora, Rishi; Goldberger, Jeffrey J.

2014-01-01

Background Traditional mapping of atrial fibrillation (AF) is limited by changing electrogram morphologies and variable cycle lengths. Objective We tested the hypothesis that morphology recurrence plot analysis would identify sites of stable and repeatable electrogram morphology patterns. Methods AF electrograms recorded from left atrial (LA) and right atrial (RA) sites in 19 patients (10 male, 59±10 years old) prior to AF ablation were analyzed. Morphology recurrence plots for each electrogram recording were created by cross-correlation of each automatically detected activation with every other activation in the recording. A recurrence percentage, the percentage of the most common morphology, and the mean cycle length of activations with the most common morphology (CLR) were computed. Results The morphology recurrence plots commonly showed checkerboard patterns of alternating high and low cross correlation values indicating periodic recurrences in morphologies. The mean recurrence percentage for all sites and all patients was 38±25%. The highest recurrence percentage per patient averaged 83±17%. The highest recurrence percentage was located in the RA in 5 patients and in the LA in 14 patients. Patients with sites of shortest CLR in the LA and RA had ablation failure rates of 25% and 100%, respectively (HR=4.95; p=0.05). Conclusions A new technique to characterize electrogram morphology recurrence demonstrated that there is a distribution of sites with high and low repeatability of electrogram morphologies. Sites with rapid activation of highly repetitive morphology patterns may be critical to sustaining AF. Further testing of this approach to map and ablate AF sources is warranted. PMID:25101485

Activation thermodynamics of virus adsorption to solids.

PubMed Central

Preston, D R; Farrah, S R

1988-01-01

The kinetics of bacteriophage MS2, T2, and f2 adsorption to powdered nitrocellulose and disrupted Seitz S1 filters at pH 7 were determined as a function of temperature. Data from these studies were combined with data produced in a previous study on MS2 adsorption to clay by Stagg et al. (Appl. Environ. Microbiol. 33:385-391, 1977). These workers studied the adsorption of MS2 to bentonite clay as a function of temperature. Data from both this previous study and the current one were used to calculate the thermodynamic parameters of virus adsorption. The results show that adsorption of bacteriophages to the solids tested is a physical process (energy of activation, less than 40 kcal [168 J]/mol) rather than a chemical process (energy of activation, greater than 40 kcal/mol). The free energy of activation showed a high negative correlation (r = -0.904, r2 = 0.817) with the percentage of virus adsorption to the solids tested. The energy of activation was highly negatively correlated with the percentage of virus adsorption to nitrocellulose and clay (r = -0.913, r2 = 0.834) but poorly correlated with the percentage of virus adsorption to disrupted Seitz S1 filters (r = -0.348, r2 = 0.121). In general, under conditions in which the percentage of virus adsorption was low, the energy of activation, the free energy of activation, and the entropy of activation were high. Increasing the percentage of virus adsorbed by changing the adsorbing conditions or changing the adsorbing solid decreased the energy of activation, the free energy of activation, and the entropy of activation. PMID:3214152

Influence of mitochondrial membrane potential of spermatozoa on in vitro fertilisation outcome.

PubMed

Marchetti, P; Ballot, C; Jouy, N; Thomas, P; Marchetti, C

2012-04-01

To determine whether the outcome of in vitro fertilisation (IVF) is influenced by the percentage of spermatozoa with functional mitochondria, a total of 91 random couples undergoing IVF were included. Mitochondrial function was determined by flow cytometry and expressed as percentage of spermatozoa. Conventional sperm parameters were studied by light microscopy. Reproductive outcome parameters were fertilisation rate, embryo quality and clinical pregnancy. It was found that the fertilisation rate was correlated with the percentage of spermatozoa (r = 0.24, P = 0.01) as well as with the percentage of highly motile spermatozoa. However, we did not find any relationship between the percentage of spermatozoa and embryo quality. Nevertheless, no patient who exhibited less than 64% of spermatozoa achieved pregnancy. It is concluded that determination of Δψ(m) provides accurate information to guide physicians to identify male patients for whom IVF will be unlikely to result in pregnancy. Therefore, we suggest that the percentage of spermatozoa may contribute to identify the most appropriate treatment for an individual patient. © 2011 Blackwell Verlag GmbH.

Remediating High School Students' Misconceptions Concerning Diffusion and Osmosis through Concept Mapping and Conceptual Change Text.

ERIC Educational Resources Information Center

Tekkaya, Ceren

2003-01-01

Investigates the effectiveness of combining conceptual change text and concept mapping strategies on students' understanding of diffusion and osmosis. Results indicate that while the average percentage of students in the experimental group holding a scientifically correct view rose, the percentage of correct responses in the control group…

Investigation of a novel approach to scoring Giemsa-stained malaria-infected thin blood films.

PubMed

Proudfoot, Owen; Drew, Nathan; Scholzen, Anja; Xiang, Sue; Plebanski, Magdalena

2008-04-21

Daily assessment of the percentage of erythrocytes that are infected ('percent-parasitaemia') across a time-course is a necessary step in many experimental studies of malaria, but represents a time-consuming and unpopular task among researchers. The most common method is extensive microscopic examination of Giemsa-stained thin blood-films. This study explored a method for the assessment of percent-parasitaemia that does not require extended periods of microscopy and results in a descriptive and permanent record of parasitaemia data that is highly amenable to subsequent 'data-mining'. Digital photography was utilized in conjunction with a basic purpose-written computer programme to test the viability of the concept. Partial automation of the determination of percent parasitaemia was then explored, resulting in the successful customization of commercially available broad-spectrum image analysis software towards this aim. Lastly, automated discrimination between infected and uninfected RBCs based on analysis of digital parameters of individual cell images was explored in an effort to completely automate the calculation of an accurate percent-parasitaemia.

Food waste and food processing waste for biohydrogen production: a review.

PubMed

Yasin, Nazlina Haiza Mohd; Mumtaz, Tabassum; Hassan, Mohd Ali; Abd Rahman, Nor'Aini

2013-11-30

Food waste and food processing wastes which are abundant in nature and rich in carbon content can be attractive renewable substrates for sustainable biohydrogen production due to wide economic prospects in industries. Many studies utilizing common food wastes such as dining hall or restaurant waste and wastes generated from food processing industries have shown good percentages of hydrogen in gas composition, production yield and rate. The carbon composition in food waste also plays a crucial role in determining high biohydrogen yield. Physicochemical factors such as pre-treatment to seed culture, pH, temperature (mesophilic/thermophilic) and etc. are also important to ensure the dominance of hydrogen-producing bacteria in dark fermentation. This review demonstrates the potential of food waste and food processing waste for biohydrogen production and provides a brief overview of several physicochemical factors that affect biohydrogen production in dark fermentation. The economic viability of biohydrogen production from food waste is also discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Characterization of Low Firing Temperature Ceramic Glaze Using Phuket MSW and Soda Lime Cullet

NASA Astrophysics Data System (ADS)

Ketboonruang, P.; Jinawat, S.; Kashima, D. P.; Wasanapiarnpong, T.; Sujaridworakun, P.; Buggakuptav, W.; Traipol, N.; Jiemsirilers, S.

2011-10-01

The normal firing temperature of ceramic products is around 1200 °C. In order to reduce firing temperature, industrial wastes were utilized in ceramic glaze. Phuket municipal solid waste (MSW), soda lime cullet, and borax were used as raw materials for low firing temperature glazes. The glaze compositions were designed using a triaxial diagram. Stoneware ceramic body was glazed then fired at 1000 and 1150 °C for 15 minutes. Morphology and phase composition of glazes were analyzed by Scanning electron microscopy (SEM-EDS) and X-ray diffraction (XRD). Thermal expansion compatibility of Stoneware body and glazes were investigated using a dilatometer. Melting behaviour of selected glaze was analyzed by heating stage microscopy. Phuket MSW and Soda lime glass cullet can be used in high percentage as major raw materials for low firing temperature ceramic glaze that show good texture and vitrified at lower firing temperature without using any commercial ceramic frits. The firing temperature can be reduced up to 150 °C in this study.

Application of a Novel Liquid Nitrogen Control Technique for Heat Stress and Fire Prevention in Underground Mines.

PubMed

Shi, Bobo; Ma, Lingjun; Dong, Wei; Zhou, Fubao

2015-01-01

With the continually increasing mining depths, heat stress and spontaneous combustion hazards in high-temperature mines are becoming increasingly severe. Mining production risks from natural hazards and exposures to hot and humid environments can cause occupational diseases and other work-related injuries. Liquid nitrogen injection, an engineering control developed to reduce heat stress and spontaneous combustion hazards in mines, was successfully utilized for environmental cooling and combustion prevention in an underground mining site named "Y120205 Working Face" (Y120205 mine) of Yangchangwan colliery. Both localized humidities and temperatures within the Y120205 mine decreased significantly with liquid nitrogen injection. The maximum percentage drop in temperature and humidity of the Y120205 mine were 21.9% and 10.8%, respectively. The liquid nitrogen injection system has the advantages of economical price, process simplicity, energy savings and emission reduction. The optimized heat exchanger used in the liquid nitrogen injection process achieved superior air-cooling results, resulting in considerable economic benefits.

Thermal re-design of the Galileo spacecraft for a Venus-earth-earth-gravity assist (VEEGA) trajectory

NASA Technical Reports Server (NTRS)

Reeve, R.

1989-01-01

The cancellation of the Centaur upper stage program in the aftermath of the Challenger tragedy forced a redesign of the flight trajectory of the Galileo spacecraft to Jupiter, i.e., from a direct trajectory to the Venus-earth-earth-gravity-assist (VEEGA) trajectory on the lower energy two-stage inertial upper stage (IUS), with the result that the spacecraft would be exposed to more than twofold increase in peak solar irradiance. This paper describes the general system-level thermal redesign effort for the Galileo spacecraft, from the start of feasibility studies to its final implementation. Results indicate that the addition of sunshades and the generous utilization of second-surface aluminized Kapton surface material for reflecting high percentages of incident solar irradiation would 'harden' the spacecraft's existing thermal protection system adequately, provided that sun-pointing at the relatively higher solar irradiance levels could be maintained. The final miximum flight temperature predictions for the spacecraft's subsystem thermal designs are given.

Utilization of Corn Cob and TiO2 Photocatalyst Thin Films for Dyes Removal.

PubMed

Gan, Hui-Yee; Leow, Li-Eau; Ong, Siew-Teng

2017-01-01

The effectiveness of using TiO2 and corn cob films to remove Malachite Green oxalate (MG) and Acid Yellow 17 (AY 17) from binary dye solution was studied. The immobilization method in this study can avoid the filtration step which is not suited for practical applications. Batch studies were performed under different experimental conditions and the parameters studied involved initial pH of dye solution, initial dye concentration and contact time and reusability. The equilibrium data of MG and AY 17 conform to Freundlich and Langmuir isotherm model, respectively. The percentage removal of MG remained high after four sorption cycles, however for AY 17, a greater reduction was observed. The removal of both dyes were optimized and modeled via Plackett- Burman design (PB) and Response Surface Methodology (RSM). IR spectrum and surface conditions analyses were carried out using fourier-transform infrared spectrophotometer (FTIR), scanning electron microscope (SEM) and atomic force microscope (AFM), respectively.

Noninvasive in vivo glucose sensing using an iris based technique

NASA Astrophysics Data System (ADS)

Webb, Anthony J.; Cameron, Brent D.

2011-03-01

Physiological glucose monitoring is important aspect in the treatment of individuals afflicted with diabetes mellitus. Although invasive techniques for glucose monitoring are widely available, it would be very beneficial to make such measurements in a noninvasive manner. In this study, a New Zealand White (NZW) rabbit animal model was utilized to evaluate a developed iris-based imaging technique for the in vivo measurement of physiological glucose concentration. The animals were anesthetized with isoflurane and an insulin/dextrose protocol was used to control blood glucose concentration. To further help restrict eye movement, a developed ocular fixation device was used. During the experimental time frame, near infrared illuminated iris images were acquired along with corresponding discrete blood glucose measurements taken with a handheld glucometer. Calibration was performed using an image based Partial Least Squares (PLS) technique. Independent validation was also performed to assess model performance along with Clarke Error Grid Analysis (CEGA). Initial validation results were promising and show that a high percentage of the predicted glucose concentrations are within 20% of the reference values.

Effects of process parameters on peanut skins extract and CO2 diffusivity by supercritical fluid extraction

NASA Astrophysics Data System (ADS)

Putra, N. R.; Yian, L. N.; Nasir, H. M.; Idham, Z. Binti; Yunus, M. A. C.

2018-03-01

Peanut skins (Arachis hypogea) are an agricultural waste product which has received much attention because they contain high nutritional values and can be potentially utilized in difference industries. At present, only a few studies have been conducted to study the effects of parameters on the peanut skins oil extraction. Therefore, this study aimed to determine the best extraction condition in order to obtain the highest extract yield using supercritical carbon dioxide (SC-CO2) with co-solvent Ethanol as compared to Soxhlet extraction method. Diffusivity of carbon dioxide in supercritical fluid extraction was determined using Crank model. The mean particle size used in this study was 425 µm. The supercritical carbon dioxide was performed at temperature (40 – 70 °C), flow rate of co-solvent ethanol (0 - 7.5% Vethanol/Vtotal), and extraction pressure (10 – 30 MPa) were used in this studies. The results showed that the percentage of oil yields and effective diffusivity increase as the pressure, rate of co-solvent, and temperature increased.

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

Pandit, Bill; Jackson, Nicholas E.; Zheng, Tianyue

Rational design strategies for controlling the energetics of conjugated “donor–acceptor” copolymers are ubiquitous in the literature, as they allow for simple energy-level tuning strategies to be employed for photovoltaic and transistor applications. Utilizing the recently reported PTRn series of conjugated polymers closely related to the widely implemented material PTB7, we investigate the effect of local copolymer block energetics on the generation of transient excitonic and charge carrier species. It is clearly demonstrated that local copolymer block energetics play a much larger role than is apparent from simple energy-level tuning arguments, and drastically affect the ultrafast generation of free-charge carrier andmore » trap state populations. Specifically, we observe an almost complete reversal in the efficient generation of free-charge in PTB7 to the ultrafast creation of a high percentage of trapped pseudo charge-transfer states. The implications of this secondary effect of “donor–acceptor” energy level tuning are discussed, along with strategies for avoiding the generation of trap states in “donor–acceptor” copolymers.« less

Enhanced outage prediction modeling for strong extratropical storms and hurricanes in the Northeastern United States

NASA Astrophysics Data System (ADS)

Cerrai, D.; Anagnostou, E. N.; Wanik, D. W.; Bhuiyan, M. A. E.; Zhang, X.; Yang, J.; Astitha, M.; Frediani, M. E.; Schwartz, C. S.; Pardakhti, M.

2016-12-01

The overwhelming majority of human activities need reliable electric power. Severe weather events can cause power outages, resulting in substantial economic losses and a temporary worsening of living conditions. Accurate prediction of these events and the communication of forecasted impacts to the affected utilities is necessary for efficient emergency preparedness and mitigation. The University of Connecticut Outage Prediction Model (OPM) uses regression tree models, high-resolution weather reanalysis and real-time weather forecasts (WRF and NCAR ensemble), airport station data, vegetation and electric grid characteristics and historical outage data to forecast the number and spatial distribution of outages in the power distribution grid located within dense vegetation. Recent OPM improvements consist of improved storm classification and addition of new predictive weather-related variables and are demonstrated using a leave-one-storm-out cross-validation based on 130 severe extratropical storms and two hurricanes (Sandy and Irene) in the Northeast US. We show that it is possible to predict the number of trouble spots causing outages in the electric grid with a median absolute percentage error as low as 27% for some storm types, and at most around 40%, in a scale that varies between four orders of magnitude, from few outages to tens of thousands. This outage information can be communicated to the electric utility to manage allocation of crews and equipment and minimize the recovery time for an upcoming storm hazard.

Systems analysis in Cellvibrio japonicus resolves predicted redundancy of β-glucosidases and determines essential physiological functions: Functional analysis of C. japonicus β-glucosidases

DOE PAGES

Nelson, Cassandra E.; Rogowski, Artur; Morland, Carl; ...

2017-02-28

Degradation of polysaccharides forms an essential arc in the carbon cycle, provides a percentage of our daily caloric intake, and is a major driver in the renewable chemical industry. Microorganisms proficient at degrading insoluble polysaccharides possess large numbers of carbohydrate active enzymes, many of which have been categorized as functionally redundant. Here we present data that suggests that carbohydrate active enzymes that have overlapping enzymatic activities can have unique, non-overlapping biological functions in the cell. Our comprehensive study to understand cellodextrin utilization in the soil saprophyte Cellvibrio japonicus found that only one of four predicted β-glucosidases is required in amore » physiological context. Gene deletion analysis indicated that only the cel3B gene product is essential for efficient cellodextrin utilization in C. japonicus and is constitutively expressed at high levels. Interestingly, expression of individual β-glucosidases in Escherichia coli K-12 enabled this non-cellulolytic bacterium to be fully capable of using cellobiose as a sole carbon source. Furthermore, enzyme kinetic studies indicated that the Cel3A enzyme is significantly more active than the Cel3B enzyme on the oligosaccharides but not disaccharides. Finally, our approach for parsing related carbohydrate active enzymes to determine actual physiological roles in the cell can be applied to other polysaccharide-degradation systems.« less

Costing for long-term care: the development of Scottish health service resource utilization groups as a casemix instrument.

PubMed

Urquhart, J; Kennie, D C; Murdoch, P S; Smith, R G; Lennox, I

1999-03-01

to create a casemix measure with a limited number of categories which discriminate in terms of resource use and will assist in the development of a currency for contracting for the provision of health care. nursing staff completed a questionnaire providing clinical data and also gave estimates of relative patient resource use; ward-based costs were collected from appropriate unit managers. National Health Service continuing-care wards in 50 Scottish hospitals. 2783 long-stay patients aged 65 years and over. inter-rater reliability was assessed using 1402 patients; percentage agreement between raters for individual variables varied from 68% for feeding to 97% for clinically complex treatments. Nursing costs gave 62% agreement given categories of high, medium and low. The Scottish health service resource utilization groups (SHRUG) measure was developed using 606 cases, and 67% consistency was achieved for the five categories. The relative weights for the SHRUG categories ranged from 0.56 to 1.41. The five categories explain 35% of variance in costs. the five SHRUG casemix categories show good discrimination in terms of costs. The SHRUG measure compares favourably with diagnosis-related groups in the acute sector and with other casemix instruments for long-term care previously piloted in the UK. SHRUG is a useful measurement instrument in assessing the resource needs of elderly people in long-term care.

Analytical performance evaluation of a high-volume hematology laboratory utilizing sigma metrics as standard of excellence.

PubMed

Shaikh, M S; Moiz, B

2016-04-01

Around two-thirds of important clinical decisions about the management of patients are based on laboratory test results. Clinical laboratories are required to adopt quality control (QC) measures to ensure provision of accurate and precise results. Six sigma is a statistical tool, which provides opportunity to assess performance at the highest level of excellence. The purpose of this study was to assess performance of our hematological parameters on sigma scale in order to identify gaps and hence areas of improvement in patient care. Twelve analytes included in the study were hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), mean corpuscular volume (MCV), red cell distribution width (RDW), total leukocyte count (TLC) with percentages of neutrophils (Neutr%) and lymphocytes (Lymph %), platelet count (Plt), mean platelet volume (MPV), prothrombin time (PT), and fibrinogen (Fbg). Internal quality control data and external quality assurance survey results were utilized for the calculation of sigma metrics for each analyte. Acceptable sigma value of ≥3 was obtained for the majority of the analytes included in the analysis. MCV, Plt, and Fbg achieved value of <3 for level 1 (low abnormal) control. PT performed poorly on both level 1 and 2 controls with sigma value of <3. Despite acceptable conventional QC tools, application of sigma metrics can identify analytical deficits and hence prospects for the improvement in clinical laboratories. © 2016 John Wiley & Sons Ltd.

Hydrogen Storage in Diamond Powder Utilizing Plasma NaF Surface Treatment for Fuel Cell Applications

NASA Astrophysics Data System (ADS)

Leal, David A.; Velez, Angel; Prelas, Mark A.; Gosh, Tushar; Leal-Quiros, E.

2006-12-01

Hydrogen Fuel Cells offer the vital solution to the world's socio-political dependence on oil. Due to existing difficulty in safe and efficient hydrogen storage for fuel cells, storing the hydrogen in hydrocarbon compounds such as artificial diamond is a realistic solution. By treating the surface of the diamond powder with a Sodium Fluoride plasma exposure, the surface of the diamond is cleaned of unwanted molecules. Due to fluorine's electro negativity, the diamond powder is activated and ready for hydrogen absorption. These diamond powder pellets are then placed on a graphite platform that is heated by conduction in a high voltage circuit made of tungsten wire. Then, the injection of hydrogen gas into chamber allows the storage of the Hydrogen on the surface of the diamond powder. By neutron bombardment in the nuclear reactor, or Prompt Gamma Neutron Activation Analysis, the samples are examined for parts per million amounts of hydrogen in the sample. Sodium Fluoride surface treatment allows for higher mass percentage of stored hydrogen in a reliable, resistant structure, such as diamond for fuel cells and permanently alters the diamonds terminal bonds for re-use in the effective storage of hydrogen. The highest stored amount utilizing the NaF plasma surface treatment was 22229 parts per million of hydrogen in the diamond powder which amounts to 2.2229% mass increase.

Transcriptome-wide single nucleotide polymorphisms (SNPs) for abalone (Haliotis midae): validation and application using GoldenGate medium-throughput genotyping assays.

PubMed

Bester-Van Der Merwe, Aletta; Blaauw, Sonja; Du Plessis, Jana; Roodt-Wilding, Rouvay

2013-09-23

Haliotis midae is one of the most valuable commercial abalone species in the world, but is highly vulnerable, due to exploitation, habitat destruction and predation. In order to preserve wild and cultured stocks, genetic management and improvement of the species has become crucial. Fundamental to this is the availability and employment of molecular markers, such as microsatellites and single nucleotide (SNPs). Transcriptome sequences generated through sequencing-by-synthesis technology were utilized for the in vitro and in silico identification of 505 putative SNPs from a total of 316 selected contigs. A subset of 234 SNPs were further validated and characterized in wild and cultured abalone using two Illumina GoldenGate genotyping assays. Combined with VeraCode technology, this genotyping platform yielded a 65%-69% conversion rate (percentage polymorphic markers) with a global genotyping success rate of 76%-85% and provided a viable means for validating SNP markers in a non-model species. The utility of 31 of the validated SNPs in population structure analysis was confirmed, while a large number of SNPs (174) were shown to be informative and are, thus, good candidates for linkage map construction. The non-synonymous SNPs (50) located in coding regions of genes that showed similarities with known proteins will also be useful for genetic applications, such as the marker-assisted selection of genes of relevance to abalone aquaculture.

Production, purification and utilization of biogas as fuel for internal combustion engine

NASA Astrophysics Data System (ADS)

Hernandez, Noel M.; Villanueva, Eliseo P.

2018-03-01

This study attempts to modify a 4-cylinder gasoline engine to run with a purified compressed biogas as substitute for fossil fuels. Water scrubbing method was used as the easiest purification technique to remove CO2 and iron filing for H2S. The pressurized raw biogas was fed in a low cost made portable floating type gas holder with volume capacity of 0.74 m3. The purified biogas was compressed using a reciprocating compressor through a two stage series of enrichment and moisture removal process using activated alumina into the steel cylinder to improve the quality of the methane content. The enriched biogas was filled in the LPG tank for 20 minutes at 10 bars at an average of 73.67% CH4 with no traces of H2S as storage for engine utilization. The modification involved the installation and mounting of LPG conversion kit. A comparative analysis of the performance and combustion characteristics of the engine was evaluated separately with gasoline and purified compressed biogas using electro-dynamometer as variable loads. The findings show that power output deterioration in compressed biogas was mainly due to high percentage of CO2 and other gases impurities. It also shows that because of the calorific value of biogas, the thermal efficiency is lesser than that of gasoline. It implies that the overall engine performance can be improved by removing undesirable gases in the mixture.

Acetate concentrations and oxidation in salt marsh sediments

NASA Technical Reports Server (NTRS)

1992-01-01

Acetate concentrations and rates of acetate oxidation and sulfate reduction were measured in S. alterniflora sediments in New Hampshire and Massachusetts. Pore water extracted from cores by squeezing or centrifugation contained in greater than 0.1 mM acetate and, in some instances, greater than 1.0 mM. Pore water sampled nondestructively contained much less acetate, often less than 0.01 mM. Acetate was associated with roots, and concentrations varied with changes in plant physiology. Acetate turnover was very low whether whole core or slurry incubations were used. Radiotracers injected directly into soils yielded rates of sulfate reduction and acetate oxidation not significantly different from core incubation techniques. Regardless of incubation method, acetate oxidation did not account for a substantial percentage of sulfate reduction. These results differ markedly from data for unvegetated coastal sediments where acetate levels are low, oxidation rate constants are high, and acetate oxication rates greatly exceed rates of sulfate reduction. The discrepancy between rates of acetate oxidation and sulfate reduction in these marsh soils may be due either to the utilization of substrates other than acetate by sulfate reducers or artifacts associated with measurements of organic utilization by rhizosphere bacteria. Care must be taken when interpreting data from salt marsh sediments since the release of material from roots during coring may affect the concentrations of certain compounds as well as influencing results obtained when sediment incubations are employed.

Elevated acetate concentrations in the rhizosphere of Spartina alterniflora and potential influences on sulfate reduction

NASA Technical Reports Server (NTRS)

Hines, Mark E.; Tugel, Joyce B.; Giblin, A. E.; Banta, G. T.; Hobbie, J. E.

1992-01-01

Acetate is important in anaerobic metabolism of non-vegetated sediments but its role in salt marsh soils was not investigated thoroughly. Acetate concentrations, oxidation (C-14) and SO4(2-) reduction (S-35) were measured in S. alterniflora soils in NH and MA. Pore water from cores contained greater than 0.1 mM acetate and in some instances greater than 1.0 mM. Non-destructive samples contained less than 0.01 mM. Acetate was associated with roots and concentrations were highest during vegetative growth and varied with changes in plant physiology. Acetate turnover was very low whether whole core or slurry incubations were used. Radiotracers injected directly into soils yielded rates of SO4(2-) reduction and acetate oxidation not significantly different from core incubation techniques. Regardless of incubation method, acetate oxidation did not account for a significant percentage of SO4(2-) reduction. These results differ markedly from data for non-vegetated coastal sediments where acetate levels are low, oxidation rate constants are high and acetate oxidation rates greatly exceed rates of SO4(2-) reduction. The discrepancy between rates of acetate oxidation and SO4(2-) reduction in marsh soils may be due either to the utilization of substrates other than acetate by SO4(2-) reducers or artifacts associated with measurements of organic utilization by rhizosphere bacteria.

Low physical activity and energy dense Malaysian foods are associated with non-alcoholic fatty liver disease in centrally obese but not in non-centrally obese patients with diabetes mellitus.

PubMed

Chan, Wah-Kheong; Tan, Alexander Tong-Boon; Vethakkan, Shireene Ratna; Tah, Pei-Chien; Vijayananthan, Anushya; Goh, Khean-Lee

2015-01-01

To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD). Consecutive adult patients with type 2 diabetes mellitus seen in our hospital diabetes clinic were enrolled. The Global Physical Activity Questionnaire and a semi-quantitative food-frequency questionnaire were used to assess PA and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake and other causes of chronic liver disease. Data for 299 patients were analyzed (mean age 63.3±10.5 years old, 41.1% male). Prevalence of NAFLD was 49.2%. Patients with low PA were more likely to have NAFLD (OR=1.75, 95% CI=1.03-2.99, p=0.029). There was no significant difference in energy intake, intake of macronutrients and percentage energy intake from each macronutrient, high sugar food, high cholesterol food and high SFA food between patients with and without NAFLD. Among centrally obese patients, patients with low PA and in the highest quartile of percentage energy intake from fat (OR=4.03, 95% CI=1.12-15.0, p=0.015), high cholesterol food (OR=3.61, 95% CI=1.37-9.72, p=0.004) and high SFA food (OR=2.67, 95% CI=1.08-6.67, p=0.019) were most likely to have NAFLD. Among those who were not centrally obese, PA and percentage energy intake from fat, high cholesterol food and high SFA food was not associated with NAFLD. Low PA and high percentage energy intake from fat, high cholesterol food and high SFA food is associated with NAFLD in centrally obese but not in non-centrally obese patients with diabetes mellitus.

High incidence of defective high-shear platelet function among platelet donors.

PubMed

Harrison, Paul; Segal, Helen; Furtado, Charlene; Verjee, Salim; Sukhu, Kampta; Murphy, Michael F

2004-05-01

Because single-donor plateletpheresis concentrates now account for a large percentage of PLT concentrates, the PLT quality of individual donations is increasingly important. There has been little previous work on PLT function in blood donors. The aim of this study was to investigate the prevalence of defective PLT function among 100 healthy UK PLT donors on 3 consecutive donation days. Citrated blood samples were taken before plateletpheresis. High-shear PLT function testing was performed by a PLT function analyzer (PFA-100, Dade Behring), within both collagen-ADP (CADP) and collagen-epinephrine (CEPI) cartridges. Sixteen percent of PLT donors (mainly over the 3 donating days) had prolonged CEPI closure times (CTs) only, indicative of an aspirin-like pattern; 9 percent had a severe defect with prolonged CEPI CTs between 200 and 300 seconds, and 4 percent had maximal CEPI CTs of greater than 300 seconds. The majority of prolonged CEPI CTs appeared transient in nature. PLT dysfunction as detected by the PFA-100 is surprisingly common within a voluntary PLT donor population. The majority of CEPI defects appeared transient in nature and are indicative of surreptitious intake of cyclooxygenase inhibitors (e.g., aspirin). Identification of defective PLT function within donors would provide a simple means to eradicate defective PLTs from being clinically utilized.

Resource utilization and disability outcome assessment of combat casualties from Operation Iraqi Freedom and Operation Enduring Freedom.

PubMed

Masini, Brendan D; Waterman, Scott M; Wenke, Joseph C; Owens, Brett D; Hsu, Joseph R; Ficke, James R

2009-04-01

Injuries are common during combat operations. The high costs of extremity injuries both in resource utilization and disability are well known in the civilian sector. We hypothesized that, similarly, combat-related extremity injuries, when compared with other injures from the current conflicts in Iraq and Afghanistan, require the largest percentage of medical resources, account for the greatest number of disabled soldiers, and have greater costs of disability benefits. Descriptive epidemiologic study and cost analysis. The Department of Defense Medical Metrics (M2) database was queried for the hospital admissions and billing data of a previously published cohort of soldiers injured in Iraq and Afghanistan between October 2001 and January 2005 and identified from the Joint Theater Trauma Registry. The US Army Physical Disability Administration database was also queried for Physical Evaluation Board outcomes for these soldiers, allowing calculation of disability benefit cost. Primary body region injured was assigned using billing records that gave a primary diagnosis International Classification of Diseases Ninth Edition code, which was corroborated with Joint Theater Trauma Registry injury mechanisms and descriptions for accuracy. A total of 1333 soldiers had complete admission data and were included from 1566 battle injuries not returned to duty of 3102 total casualties. Extremity-injured patients had the longest average inpatient stay at 10.7 days, accounting for 65% of the $65.3-million total inpatient resource utilization, 64% of the 464 patients found "unfit for duty," and 64% of the $170-million total projected disability benefit costs. Extrapolation of data yields total disability costs for this conflict, approaching $2 billion. Combat-related extremity injuries require the greatest utilization of resources for inpatient treatment in the initial postinjury period, cause the greatest number of disabled soldiers, and have the greatest projected disability benefit costs. This study highlights the need for continued or increased funding and support for military orthopaedic surgeons and extremity trauma research efforts.

Expression Variants of the Lipogenic AGPAT6 Gene Affect Diverse Milk Composition Phenotypes in Bos taurus

PubMed Central

Littlejohn, Mathew D.; Tiplady, Kathryn; Lopdell, Thomas; Law, Tania A.; Scott, Andrew; Harland, Chad; Sherlock, Ric; Henty, Kristen; Obolonkin, Vlad; Lehnert, Klaus; MacGibbon, Alistair; Spelman, Richard J.; Davis, Stephen R.; Snell, Russell G.

2014-01-01

Milk is composed of a complex mixture of lipids, proteins, carbohydrates and various vitamins and minerals as a source of nutrition for young mammals. The composition of milk varies between individuals, with lipid composition in particular being highly heritable. Recent reports have highlighted a region of bovine chromosome 27 harbouring variants affecting milk fat percentage and fatty acid content. We aimed to further investigate this locus in two independent cattle populations, consisting of a Holstein-Friesian x Jersey crossbreed pedigree of 711 F2 cows, and a collection of 32,530 mixed ancestry Bos taurus cows. Bayesian genome-wide association mapping using markers imputed from the Illumina BovineHD chip revealed a large quantitative trait locus (QTL) for milk fat percentage on chromosome 27, present in both populations. We also investigated a range of other milk composition phenotypes, and report additional associations at this locus for fat yield, protein percentage and yield, lactose percentage and yield, milk volume, and the proportions of numerous milk fatty acids. We then used mammary RNA sequence data from 212 lactating cows to assess the transcript abundance of genes located in the milk fat percentage QTL interval. This analysis revealed a strong eQTL for AGPAT6, demonstrating that high milk fat percentage genotype is also additively associated with increased expression of the AGPAT6 gene. Finally, we used whole genome sequence data from six F1 sires to target a panel of novel AGPAT6 locus variants for genotyping in the F2 crossbreed population. Association analysis of 58 of these variants revealed highly significant association for polymorphisms mapping to the 5′UTR exons and intron 1 of AGPAT6. Taken together, these data suggest that variants affecting the expression of AGPAT6 are causally involved in differential milk fat synthesis, with pleiotropic consequences for a diverse range of other milk components. PMID:24465687

How Much are Built Environments Changing, and Where?: Patterns of Change by Neighborhood Sociodemographic Characteristics across Seven U.S. Metropolitan Areas

PubMed Central

Hirsch, Jana A.; Grengs, Joe; Schulz, Amy; Adar, Sara D.; Rodriguez, Daniel A.; Brines, Shannon J.; Diez Roux, Ana V.

2016-01-01

Investments in neighborhood built environments could increase physical activity and overall health. Disproportionate distribution of these changes in advantaged neighborhoods could inflate health disparities. Little information exists on where changes are occurring. This paper aims to 1) identify changes in the built environment in neighborhoods and 2) investigate associations between high levels of change and sociodemographic characteristics. Using Geographic Information Systems, neighborhood land-use, local destinations (for walking, social engagement, and physical activity), and sociodemographics were characterized in 2000 and 2010 for seven U.S. cities. Linear and change on change models estimated associations of built environment changes with baseline (2000) and change (2010–2000) in sociodemographics. Spatial patterns were assessed using Global Moran’s I to measure overall clustering of change and Local Moran’s I to identify statistically significant clusters of high increases surrounded by high increases (HH). Sociodemographic characteristics were compared between HH cluster and other tracts using Analysis of Variance (ANOVA). We observed small land-use changes but increases in the destination types. Greater increases in destinations were associated with higher percentage non-Hispanic whites, percentage households with no vehicle, and median household income. Associations were present for both baseline sociodemographics and changes over time. Greater increases in destinations were associated with lower baseline percentage over 65 but higher increases in percentage over 65 between 2000 and 2010. Global Moran’s indicated changes were spatially clustered. HH cluster tracts started with a higher percentage non-Hispanic whites and higher percentage of households without vehicles. Between 2000 and 2010, HH cluster tracts experienced increases in percent non-Hispanic white, greater increases in median household income, and larger decreases in percent of households without a vehicle. Changes in the built environment are occurring in neighborhoods across a diverse set of U.S. metropolitan areas, but are patterned such that they may lead to increased health disparities over time. PMID:27701020