Sample records for fr27au10r medicare program
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2012-04-18
..., 413, and 495 [CMS-0044-CN] RIN 0938-AQ84 Medicare and Medicaid Programs; Electronic Health Record... proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage... (77 FR 13698), the proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record...
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2011-09-26
... [CMS-1351-CN] RIN 0938-AQ29 Medicare Program; Prospective Payment System and Consolidated Billing for... rule entitled ``Medicare Program; Prospective Payment System and Consolidated Billing for Skilled... Payment System (PPS) final rule (76 FR 48486, 48540) inadvertently included several technical errors in...
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2012-07-27
...] Medicare Program; Application by the American Association of Diabetes Educators (AADE) for Continued... Register (77 FR 11130) entitled, ``Application by the American Association of Diabetes Educators (AADE) for... Notice. SUMMARY: This final notice announces the approval of an application from the American Association...
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2011-06-14
..., 413, and 476 [CMS-1518-CN] RIN 0938-AQ24 Medicare Program; Proposed Changes to the Hospital Inpatient...-9644 of May 5, 2011 (76 FR 25788), there were a number of technical and typographical errors that are...) endorsement number for the CMS quality measure, Percent of Residents With Pressure Ulcers That Are New or...
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2011-04-15
...] Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions Program... interested parties of an opportunity to apply to participate in the Medicare Community-based Care Transitions.... 111-148, enacted on March 23, 2010) (Affordable Care Act) authorized the Medicare Community-based Care...
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2013-02-08
... Parts 402 and 403 [CMS-5060-F] RIN 0938-AR33 Medicare, Medicaid, Children's Health Insurance Programs...'s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers... Vol. 78 Friday, No. 27 February 8, 2013 Part II Department of Health and Human Services Centers...
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75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting
2010-11-03
...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... conference will also provide an overview of the Community-based Care Transitions Program (CCTP) and provide...
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2012-05-18
...] Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education Demonstration... participate in the Medicare Graduate Nurse Education (GNE) Demonstration. DATES: Proposals will be considered...--(A) 1 or more applicable schools of nursing; and (B) 2 or more applicable non- hospital community...
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76 FR 19527 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations
2011-04-07
...). Under these provisions, providers of services and suppliers can continue to receive traditional Medicare... Plans and Integration of Community Resources 11. ACO Marketing Guidelines 12. Program Integrity... the Institute of Medicine report: Safety, effectiveness, patient-centeredness, timeliness, efficiency...
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76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations
2011-11-02
... Furnished by Non-Physician Practitioners in the Assignment Process c. Assignment of Beneficiaries to ACOs... Insurance Program CMP Civil Monetary Penalties CMS Centers for Medicare & Medicaid Services CNM Certified... the current payment system by rewarding providers for delivering high quality, efficient clinical care...
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2011-08-08
... Medicare and Medicaid Services Medicare and Medicaid Programs; Quarterly Listing of Program Issuances... Centers for Medicare & Medicaid Services [CMS-9066-NC] Medicare and Medicaid Programs; Quarterly Listing... Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with comment period. SUMMARY: This quarterly notice...
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2013-03-07
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 412... philosophy and principles identified in Executive Order 12866 and 13563, the RFA, and section 1102(b) of the.... Approved: March 1, 2013. Kathleen Sebelius, Secretary, Department of Health and Human Services. [FR Doc...
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2013-07-22
... and 423 [CMS-4173-CN] RIN 0938-AR69 Medicare Program; Medical Loss Ratio Requirements for the Medicare... number of technical, typographical, and cross-referencing errors that are identified and corrected in the... Minimum Medical Loss Ratio, we made a typographical error in a section number. On page 31311, in Sec. 423...
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78 FR 75304 - Medicare Program; Medicare Secondary Payer and Certain Civil Money Penalties
2013-12-11
... [CMS-6061-ANPRM] RIN 0938-AR88 Medicare Program; Medicare Secondary Payer and Certain Civil Money... practices for which civil money penalties (CMPs) may or may not be imposed for failure to comply with...-3951. I. Background A. Imposition of Civil Money Penalties (CMPs) In 1981, the Congress added section...
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2012-03-22
...] Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education Demonstration... Education (GNE) Demonstration. The primary goal of the GNE Demonstration is to increase the number of... schools of nursing; and (B) 2 or more applicable non-hospital community-based care settings. The written...
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76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative
2011-10-03
...] Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare & Medicaid Services... organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to... the Comprehensive Primary Care initiative or the application process. SUPPLEMENTARY INFORMATION: I...
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75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program
2010-07-28
... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...), eligible hospitals and critical access hospitals (CAHs) participating in Medicare and Medicaid programs...) technology. This final rule specifies--the initial criteria EPs, eligible hospitals, and CAHs must meet in...
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76 FR 26805 - Medicare Program; Hospice Wage Index for Fiscal Year 2012
2011-05-09
..., and hospices in low-wage index areas are unfairly advantaged. The commenter felt that our not wage... Medicare & Medicaid Services 42 CFR Part 418 Medicare Program; Hospice Wage Index for Fiscal Year 2012... [CMS-1355-P] RIN 0938-AQ31 Medicare Program; Hospice Wage Index for Fiscal Year 2012 AGENCY: Centers...
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75 FR 1843 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program
2010-01-13
... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...) and eligible hospitals participating in Medicare and Medicaid programs that adopt and meaningfully use... an EP and eligible hospital must meet in order to qualify for the incentive payment; calculation of...
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2012-02-21
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9069-N] Medicare and Medicaid Programs; Quarterly Listing of Program Issuances--October Through December 2011 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This quarterly...
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42 CFR 460.168 - Reinstatement in other Medicare and Medicaid programs.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Reinstatement in other Medicare and Medicaid programs. 460.168 Section 460.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Reinstatement in other Medicare and Medicaid programs. To facilitate a participant's reinstatement in other...
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2012-04-27
... osteopathy, dentistry, and podiatry, as required in order to become certified by the appropriate specialty...'' (January 23, 2004, 69 FR 3434). A final rule titled ``Medicare, Medicaid, and Children's Health Insurance...
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Can health promotion programs save Medicare money?
Directory of Open Access Journals (Sweden)
Ron Z Goetzel
2007-04-01
Full Text Available Ron Z Goetzel1, David Shechter2, Ronald J Ozminkowski1, David C Stapleton3, Pauline J Lapin4, J Michael McGinnis5, Catherine R Gordon6, Lester Breslow71Institute for Health and Productivity Studies, Cornell University, Washington, DC; 2Health and Productivity Research, Thomson Medstat, Santa Barbara, CA; 3Cornell Institute for Policy Research, Cornell University, Washington, DC; 4Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, MD; 5National Academy of Sciences, Institute of Medicine, The National Academies, Washington, DC; 6Office of the Director, Centers for Disease Control and Prevention, Washington, DC; 7UCLA School of Public Health, Dept. of Health Services, Los Angeles, CA, USAAbstract: The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program.Keywords: health promotion, return on investment, Medicare, financial
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2013-12-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...
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76 FR 68011 - Medicare Program; Advanced Payment Model
2011-11-02
...This notice announces the testing of the Advance Payment Model for certain accountable care organizations participating in the Medicare Shared Savings Program scheduled to begin in 2012, and provides information about the model and application process.
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76 FR 39006 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program; Correction
2011-07-05
... and 480 [CMS-3239-CN] RIN 0938-AQ55 Medicare Program; Hospital Inpatient Value-Based Purchasing... Value-Based Purchasing Program.'' DATES: Effective Date: These corrections are effective on July 1, 2011... for the hospital value-based purchasing program. Therefore, in section III. 6. and 7. of this notice...
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2013-03-18
... policy to address the issues raised by the Administrative Law Judge and Medicare Appeals Council... issued by the ALJs and the Medicare Appeals Council do not establish Medicare payment policy, we are... Council decisions previously described, this Ruling establishes a policy that revises the current policy...
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2013-07-31
...] Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Temporary Moratoria on... combat fraud, waste, and abuse in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment...
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2012-04-20
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1442-N... regulatory philosophy and principles identified in Executive Order 12866 and 13563, the RFA, and section 1102.... Kathleen Sebelius, Secretary, Department of Health and Human Services. [FR Doc. 2012-9598 Filed 4-19-12; 8...
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2010-06-08
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare...
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Traditions matrimoniales dans la région de Rabat-Salé-Zemmour-Zaer au Maroc
Hami, H.; Soulaymani, A.; Mokhtari, A.
2011-01-01
La pratique des mariages consanguins est très répandue au Moyen-Orient, en Afrique du Nord et dans le Sud-Ouest Asiatique où 20 à plus de 50 % de mariages sont consanguins. L’analyse d’un échantillon de 270 femmes mariées, pris au hasard dans le service de Maternité de l’Hôpital Souissi à Rabat (2004-2005), a fait l’objet d’une étude prospective visant à déterminer la fréquence des mariages consanguins dans la région de Rabat-Salé-Zemmour-Zaer au Maroc. Les résultats obtenus montrent que 20...
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2013-07-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3280-FN] Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality's (CIHQ's) Hospital Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS. ACTION: Final...
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2010-02-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1566-CN... 22, 2010 (75 FR 3743), there were a number of technical errors that are identified and corrected in... telephone at the number listed in the FOR FURTHER INFORMATION CONTACT section of this notice by the date...
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78 FR 8535 - Medicare Program: Comprehensive End-Stage Renal Disease Care Model Announcement
2013-02-06
... develop and test innovative health care payment and service delivery models that show promise of reducing... test innovative payment and service delivery models that reduce spending under Medicare, Medicaid or...] Medicare Program: Comprehensive End-Stage Renal Disease Care Model Announcement AGENCY: Centers for...
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2010-02-03
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1341-NC] Medicare and Medicaid Programs; Announcement of Applications From Hospitals Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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2013-01-03
... (PQRS), the Children's Health Insurance Program (CHIP), and the Pioneer Accountable Care Organization... No. 93.773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical...
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2011-12-20
... comment period. SUMMARY: This notice with comment period announces a waiver request from Pioneer Community... which the hospital is located: Pioneer Community Hospital (Medicare provider number 25-1302), of... No. 93.773, Medicare--Hospital Insurance; Program No. 93.774, Medicare-- Supplementary Medical...
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2013-09-20
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3287-PN] Medicare and Medicaid Programs; Application from the Compliance Team for Initial CMS-Approval of its Rural Health Clinic Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS. ACTION...
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76 FR 627 - Medicare Program; End-Stage Renal Disease Quality Incentive Program
2011-01-05
... important components of the Medicare ESRD payment system. In the proposed rule, we described the evolution...) of the Social Security Act (the Act), as the next step in the evolution of the ESRD quality program...-mix (for example, nursing home patients, patients with complex conditions) that may make meeting the...
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2010-01-22
... the Social Security Act (the Act), requiring the Secretary to provide informational materials to..., National Hispanic Council on Aging; Stephen L. Fera, Vice President, Social Mission Programs, Independence.... Medicare Outreach and Education Strategies. Public Comment. Listening Session with CMS Leadership. Next...
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2017-11-15
This major final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies such as changes to the Medicare Shared Savings Program, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. In addition, this final rule includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model.
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2013-07-09
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 431 [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...
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2016-11-15
This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.
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76 FR 41260 - Supplemental Funding for the Senior Medicare Patrol (SMP) Program
2011-07-13
... additional funding to double the size of the SMP program. The SMP program expansion has resulted in... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Supplemental Funding for the Senior Medicare Patrol (SMP) Program ACTION: Notice of intent to provide supplemental funding to the...
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2010-09-24
... are imposed by section 1804 of the Social Security Act (the Act), requiring the Secretary to provide... President, Social Mission Programs, Independence Blue Cross; Richard C. Frank, M.D., Director, Cancer... Committee Work Summary. Medicare Outreach and Education Strategies. Public Comment. Listening Session with...
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2013-01-02
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1456-NC] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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2012-08-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1452-NC] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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2013-03-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1457-NC] Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with...
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2011-06-03
..., ``Inpatient Psychiatric Facilities Prospective Payment System--Update for Rate Year Beginning July 1, 2011 (RY... [CMS-1346-CN] RIN 0938-AQ23 Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System--Update for Rate Year Beginning July 1, 2011 (RY 2012); Correction AGENCY: Centers for Medicare...
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2012-10-17
... [CMS-1588-F2] RIN 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates..., 2012 Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for...
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2010-12-08
... [CMS-1510-CN] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification... effective as if they had been included in the Medicare Program; Home Health Prospective Payment System Rate...
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Can health promotion programs save Medicare money?
Goetzel, Ron Z; Shechter, David; Ozminkowski, Ronald J; Stapleton, David C; Lapin, Pauline J; McGinnis, J Michael; Gordon, Catherine R; Breslow, Lester
2007-01-01
The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program. PMID:18044084
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2010-12-27
... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in... Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home...
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2010-11-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare and Medicaid Services [CMS-2332-PN] Medicare Program; Application by the American Association for Accreditation of Ambulatory Surgery... Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) for recognition as a national...
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Medicare program; Medicare depreciation, useful life guidelines--HCFA. Final rule.
1983-08-18
These final rules amend Medicare regulations to clarify which useful life guidelines may be used by providers of health care services to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize the Departmental useful life guidelines or, if none have been published by the Department, either the American Hospital Association (AHA) useful life guidelines of 1973 of IRS guidelines. We are eliminating the reference to IRS guidelines because these are now outdated for Medicare purposes since they have been rendered obsolete either by the IRS or by statutory change. We are also deleting the specific reference to the 1973 AHA guidelines since these guidelines are updated by the AHA periodically. In addition, we are clarifying that certain tax legislation on accelerated depreciation, passed by Congress, does not apply to the Medicare program.
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2012-05-16
... Provisions to Promote Program Efficiency, Transparency, and Burden Reduction; Final Rule #0;#0;Federal..., Transparency, and Burden Reduction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final... on providers of care. CMS has also identified non-regulatory changes to increase transparency and to...
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2010-05-28
... specified list of new Clinical Procedural Terminology (CPT) codes for clinical laboratory tests in calendar... are codified at 42 CFR part 414, subpart G. A newly created Current Procedural Terminology (CPT) code..., Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program...
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Results of the Medicare Health Support disease-management pilot program.
McCall, Nancy; Cromwell, Jerry
2011-11-03
In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.
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Evaluation of Medicare Health Support chronic disease pilot program.
Cromwell, Jerry; McCall, Nancy; Burton, Joe
2008-01-01
The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.
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2013-08-28
... the requirements at Sec. 482.41(c)(4), AOA/HFAP revised its standards to include the National Fire... Insurance Program; and No. 93.774, Medicare--Supplementary Medical Insurance Program) Dated: July 19, 2013...
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2010-12-15
...] Medicare Program; Re-Chartering of the Advisory Panel on Ambulatory Payment Classification (APC) Groups... announces the re-chartering of the Advisory Panel on Ambulatory Payment Classification (APC) Groups (the... (APC) groups and their associated weights established under the Medicare hospital Outpatient...
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2010-08-27
...] Medicare Program; Listening Session Regarding the Implementation of Section 10332 of the Patient Protection... of the Patient Protection and Affordable Care Act (the Affordable Care Act), which amended section 1874 of the Social Security Act: Availability of Medicare Data for Performance Measurement. The purpose...
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Medicare Beneficiary Knowledge of the Part D Program
U.S. Department of Health & Human Services — Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment According to findings appearing in Medicare Beneficiary Knowledge...
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2011-12-19
... Parts 402 and 403 [CMS-5060-P] RIN 0938-AR33 Medicare, Medicaid, Children's Health Insurance Programs...'s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers... State plan under title XIX (Medicaid) or XXI of the Act (the Children's Health Insurance Program, or...
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Sivakumar, Haran; Hanoch, Yaniv; Barnes, Andrew J; Federman, Alex D
2016-01-01
Poor Medicare knowledge is associated with worse health outcomes, especially in low-income patients. We examined the association of health literacy and cognition with actual and perceived Medicare knowledge in a sample of inner-city older adults. We conducted a cross-sectional analysis of data on 336 adults ages 65 years and older with Medicare coverage recruited from senior centers and low-income housing facilities in Manhattan, New York. Actual Medicare knowledge was determined by a summary score of 9 true/false questions about the Medicare program and perceived Medicare knowledge with a single item. Validated measures were used to assess health literacy and general cognition. Among respondents, 63.1% had high actual Medicare knowledge, and 36.0% believed that they knew what they needed to know about Medicare. Actual and perceived Medicare knowledge were poorly correlated (r = -.01, p > .05). In multivariable models, low health literacy was significantly associated with actual Medicare knowledge (β = -8.30, SE = 2.71, p information about the Medicare program and diminish their ability to make fully informed choices.
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76 FR 66309 - Pilot Program for Parallel Review of Medical Products; Correction
2011-10-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare and Medicaid Services [CMS-3180-N2] Food and Drug Administration [Docket No. FDA-2010-N-0308] Pilot Program for Parallel Review of Medical... 11, 2011 (76 FR 62808). The document announced a pilot program for sponsors of innovative device...
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2011-02-18
... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The... the Medicare prospective payment system for HHAs. This correcting amendment corrects a technical error...
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2012-09-10
..., Medicaid, and CHIP Programs: Research and Analysis on Impact of CMS Programs on the Indian Health Care System AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice of Single Source Award. SUMMARY: This notice supports expansion of research on the impact of CMS programs on the Indian health...
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Medicare program; clarification of Medicare's accrual basis of accounting policy--HCFA. Final rule.
1995-06-27
This final rule revises the Medicare regulations to clarify the concept of "accrual basis of accounting" to indicate that expenses must be incurred by a provider of health care services before Medicare will pay its share of those expenses. This rule does not signify a change in policy but, rather, incorporates into the regulations Medicare's longstanding policy regarding the circumstances under which we recognize, for the purposes of program payment, a provider's claim for costs for which it has not actually expended funds during the current cost reporting period.
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2011-06-14
... stakeholders to develop initiatives to test innovative payment and service delivery models to reduce program...] Medicare Program; Pioneer Accountable Care Organization Model; Extension of the Submission Deadlines for... of the Pioneer Accountable Care Organization Model letters of intent to June 30, 2011 and the...
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2011-08-12
...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... (CMS). This two-day training session is the second Accelerated Development Learning Session (ADLS.... Through Accelerated Development Learning Sessions (ADLS), the Innovation Center will test whether...
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2011-03-03
...] Medicare, Medicaid, and Children's Health Insurance Programs; Renewal, Expansion, and Renaming of the...'s Health Insurance Program (CHIP) about options for selecting health care coverage under these and... needs are for experts in health disparities, State Health Insurance Assistance Programs (SHIPs), health...
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2011-10-28
...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... Services (CMS). This two-day training session is the third and final Accelerated Development Learning... the quality of care for beneficiaries. Through Accelerated Development Learning Sessions (ADLS), the...
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2011-05-20
... Affordable Care Act, to test innovative payment and service delivery models that reduce spending under.... This Model will test the effectiveness of a combination of the following: Payment arrangements that...] Medicare Program; Pioneer Accountable Care Organization Model: Request for Applications AGENCY: Centers for...
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2012-02-24
...] Medicare Program; Application by the American Association of Diabetes Educators (AADE) for Continued... American Association of Diabetes Educators' (AADE) request for the Secretary's approval of its... Association of Diabetes Educators for continued recognition as a national accreditation program for...
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78 FR 21610 - Expansion Funds for the Support of the Senior Medicare Patrol (SMP) Program
2013-04-11
... Grants. Announcement Type: Health Care Fraud Prevention Program Expansion Capacity. Funding Opportunity... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Community Living Expansion Funds for the Support of the Senior Medicare Patrol (SMP) Program ACTION: Notice of intent to provide expansion...
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Ternary Au/ZnO/rGO nanocomposites electrodes for high performance electrochemical storage devices
Chaudhary, Manchal; Doong, Ruey-an; Kumar, Nagesh; Tseng, Tseung Yuen
2017-10-01
The combination of metal and metal oxide nanoparticles with reduced graphene oxides (rGO) is an active electrode material for electrochemical storage devices. Herein, we have, for the first time, reported the fabrication of ternary Au/ZnO/rGO nanocomposites by using a rapid and environmentally friendly microwave-assisted hydrothermal method for high performance supercapacitor applications. The ZnO/rGO provides excellent electrical conductivity and good macro/mesopore structures, which can facilitate the rapid electrons and ions transport. The Au nanoparticles with particle sizes of 7-12 nm are homogeneously distributed onto the ZnO/rGO surface to enhance the electrochemical performance by retaining the capacitance at high current density. The Au/ZnO/rGO nanocomposites, prepared with the optimized rGO amount of 100 mg exhibit a high specific capacitance of 875 and 424 F g-1 at current densities of 1 and 20 A g-1, respectively, in 2 M KOH. In addition, the energy and power densities of ternary Au/ZnO/rGO can be up to 17.6-36.5 Wh kg-1 and 0.27-5.42 kW kg-1, respectively. Results obtained in this study clearly demonstrate the excellence of ternary Au/ZnO/rGO nanocomposites as the active electrode materials for electrochemical pseudocapacitor performance and can open an avenue to fabricate metal/metal oxide/rGO nanocomposites for electrochemical storage devices with both high energy and power densities.
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75 FR 46948 - Medicare Program; Listening Session Regarding Confidential Feedback Reports and the...
2010-08-04
...] Medicare Program; Listening Session Regarding Confidential Feedback Reports and the Implementation of a... Services (CMS), HHS. ACTION: Notice of meeting. SUMMARY: This notice announces a listening session being... modifier to the fee- for-service physician fee schedule. The purpose of the listening session is to solicit...
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2010-11-26
...] Medicare Program; Quality Improvement Organization (QIO) Contracts: Solicitation of Proposals From In-State... the Social Security Act (the Act) to provide at least 6 months' advance notice of the expiration dates of contracts with out- of-State Quality Improvement Organizations (QIOs) before renewing any of those...
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Further stable neutron star models from f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Astashenok, Artyom V. [I. Kant Baltic Federal University, Institute of Physics and Technology, Nevskogo st. 14, Kaliningrad, 236041 (Russian Federation); Capozziello, Salvatore [Dipartimento di Fisica, Università di Napoli ' ' Federico II' ' , Via Cinthia, 9, Napoli, I–80126 (Italy); Odintsov, Sergei D., E-mail: artyom.art@gmail.com, E-mail: capozziello@na.infn.it, E-mail: odintsov@ieec.uab.es [Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona (Spain)
2013-12-01
Neutron star models in perturbative f(R) gravity are considered with realistic equations of state. In particular, we consider the FPS, SLy and other equations of state and a case of piecewise equation of state for stars with quark cores. The mass-radius relations for f(R) = R+R(e{sup −R/R{sub 0}}−1) model and for R{sup 2} models with logarithmic and cubic corrections are obtained. In the case of R{sup 2} gravity with cubic corrections, we obtain that at high central densities (ρ > 10ρ{sub ns}, where ρ{sub ns} = 2.7 × 10{sup 14} g/cm{sup 3} is the nuclear saturation density), stable star configurations exist. The minimal radius of such stars is close to 9 km with maximal mass ∼ 1.9M{sub ⊙} (SLy equation). A similar situation takes place for AP4 and BSK20 EoS. Such an effect can give rise to more compact stars than in General Relativity. If observationally identified, such objects could constitute a formidable signature for modified gravity at astrophysical level. Another interesting result can be achieved in modified gravity with only a cubic correction. For some EoS, the upper limit of neutron star mass increases and therefore these EoS can describe realistic star configurations (although, in General Relativity, these EoS are excluded by observational constraints)
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Further stable neutron star models from f(R) gravity
International Nuclear Information System (INIS)
Astashenok, Artyom V.; Capozziello, Salvatore; Odintsov, Sergei D.
2013-01-01
Neutron star models in perturbative f(R) gravity are considered with realistic equations of state. In particular, we consider the FPS, SLy and other equations of state and a case of piecewise equation of state for stars with quark cores. The mass-radius relations for f(R) = R+R(e −R/R 0 −1) model and for R 2 models with logarithmic and cubic corrections are obtained. In the case of R 2 gravity with cubic corrections, we obtain that at high central densities (ρ > 10ρ ns , where ρ ns = 2.7 × 10 14 g/cm 3 is the nuclear saturation density), stable star configurations exist. The minimal radius of such stars is close to 9 km with maximal mass ∼ 1.9M ⊙ (SLy equation). A similar situation takes place for AP4 and BSK20 EoS. Such an effect can give rise to more compact stars than in General Relativity. If observationally identified, such objects could constitute a formidable signature for modified gravity at astrophysical level. Another interesting result can be achieved in modified gravity with only a cubic correction. For some EoS, the upper limit of neutron star mass increases and therefore these EoS can describe realistic star configurations (although, in General Relativity, these EoS are excluded by observational constraints)
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2010-11-29
...] Medicare Program; Listening Session on Development of Additional Imaging Efficiency Measures for Use in the...), HHS. ACTION: Notice of meeting. SUMMARY: This notice announces a listening session to receive comments... Quality Data Reporting Program (HOP QDRP), which is authorized under section 1833(t)(17) of the Social...
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76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes
2011-03-18
... Services 42 CFR Part 488 [CMS-2435-F] Medicare and Medicaid Programs; Civil Money Penalties for Nursing... incentives for quality improvement, and to remove uncertainty for nursing homes, we proposed to set the... Vol. 76 Friday, No. 53 March 18, 2011 Part III Department of Health and Human Services Centers for...
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2010-05-05
... including Directors and Board Members of corporations and non-profit organizations and charities. The..., ``Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, Changes to...
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2010-11-16
... 0938-AP89 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal... the July 22, 2010 Federal Register entitled, ``Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2011.'' DATES: Effective Date. This correction is effective for IRF...
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2012-04-12
... Outcome Survey HPMS Health Plan Management System ICD-9-CM Internal Classification of Disease, 9th..., Improvement, and Modernization Act of 2003 (Pub. L. 108-173) MS-DRG Medicare Severity Diagnosis Related Group...
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2013-09-27
...] Medicare Program; Approval of Accrediting Organization for Suppliers of Advanced Diagnostic Imaging... accredit suppliers seeking to furnish the technical component (TC) of advanced diagnostic imaging services... advanced diagnostic imaging (ADI) service and establish procedures to ensure that the criteria used by an...
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2012-01-04
... lines was not applied correctly. We have corrected our programming logic in the OPPS data process to... made to the programming logic described in the CY 2012 OPPS/ASC final (see 76 FR 74141). The correct...
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2011-09-26
...; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size... [CMS-1349-CN] RIN 0938-AQ28 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units...
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Identifying the Transgender Population in the Medicare Program
Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.
2016-01-01
Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539
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2010-08-27
... outpatient rehabilitation facility (CORF), a home health agency (HHA), or a hospice that has in effect an agreement to participate in Medicare, or a clinic, a rehabilitation agency, or a public health agency that... devices used for reduction of fractures and dislocation'' as one of the ``medical and other health...
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Pre-Medicare Eligible Individuals’ Decision-Making In Medicare Part D: An Interview Study
Directory of Open Access Journals (Sweden)
Tao Jin, B.S. Pharm, Ph.D. Candidate
2010-01-01
Full Text Available ObjectivesThe objective of this study was to elicit salient beliefs among pre-Medicare eligible individuals regarding (1 the outcomes associated with enrolling in the Medicare Part D program; (2 those referents who might influence participants’ decisions about enrolling in the Part D program; and (3 the perceived barriers and facilitators facing those considering enrolling in the Part D program.MethodsFocused interviews were used for collecting data. A sample of 10 persons between 62 and 64 years of age not otherwise enrolled in the Medicare program was recruited. Interviews were audio taped and field notes were taken concurrently. Audio recordings were reviewed to amend field notes until obtaining a thorough reflection of interviews. Field notes were analyzed to elicit a group of beliefs, which were coded into perceived outcomes, the relevant others who might influence Medicare Part D enrollment decisions and perceived facilitators and impediments. By extracting those most frequently mentioned beliefs, modal salient sets of behavioral beliefs, relevant referents, and control beliefs were identified.ResultsAnalyses showed that (1 most pre-Medicare eligible believed that Medicare Part D could “provide drug coverage”, “save money on medications”, and “provide financial and health security in later life”. However, “monthly premiums”, “the formulary with limited drug coverage” and “the complexity of Medicare Part D” were perceived as major disadvantages; (2 immediate family members are most likely to influence pre-Medicare eligible’s decisions about Medicare Part D enrollment; and (3 internet and mailing educational brochures are considered to be most useful resources for Medicare Part D enrollment. Major barriers to enrollment included the complexity and inadequacy of insurance plan information.ConclusionThere are multiple factors related to decision-making surrounding the Medicare Part D enrollment. These factors
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Pre-Medicare Eligible Individuals' Decision-Making In Medicare Part D: An Interview Study
Directory of Open Access Journals (Sweden)
Tao Jin
2010-01-01
Full Text Available Objectives: The objective of this study was to elicit salient beliefs among pre-Medicare eligible individuals regarding (1 the outcomes associated with enrolling in the Medicare Part D program; (2 those referents who might influence participants' decisions about enrolling in the Part D program; and (3 the perceived barriers and facilitators facing those considering enrolling in the Part D program. Methods: Focused interviews were used for collecting data. A sample of 10 persons between 62 and 64 years of age not otherwise enrolled in the Medicare program was recruited. Interviews were audio taped and field notes were taken concurrently. Audio recordings were reviewed to amend field notes until obtaining a thorough reflection of interviews. Field notes were analyzed to elicit a group of beliefs, which were coded into perceived outcomes, the relevant others who might influence Medicare Part D enrollment decisions and perceived facilitators and impediments. By extracting those most frequently mentioned beliefs, modal salient sets of behavioral beliefs, relevant referents, and control beliefs were identified. Results: Analyses showed that (1 most pre-Medicare eligible believed that Medicare Part D could "provide drug coverage", "save money on medications", and "provide financial and health security in later life". However, "monthly premiums", "the formulary with limited drug coverage" and "the complexity of Medicare Part D" were perceived as major disadvantages; (2 immediate family members are most likely to influence pre-Medicare eligible's decisions about Medicare Part D enrollment; and (3 internet and mailing educational brochures are considered to be most useful resources for Medicare Part D enrollment. Major barriers to enrollment included the complexity and inadequacy of insurance plan information. Conclusion: There are multiple factors related to decision-making surrounding the Medicare Part D enrollment. These factors include the advantages
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2011-10-28
...] Medicare and Medicaid Programs; The American Association for Accreditation of Ambulatory Surgery Facilities... receipt of a deeming application from the American Association for Accreditation of Ambulatory Surgery... of Ambulatory Surgery Facilities (AAAASF's) request for deeming authority for RHCs. This notice also...
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2012-06-26
...This notice announces a new opportunity for participation in the Advance Payment Model for certain accountable care organizations participating in the Medicare Shared Savings Program scheduled to begin in January 2013.
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2011-11-30
...This notice announces a new application deadline for participation in the Advance Payment Model for certain accountable care organizations participating in the Medicare Shared Savings Program scheduled to begin in 2012.
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2010-12-23
... [CMS-1350-ANPRM] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act... Emergency Medical Treatment and Labor Act (EMTALA). Specifically, this document serves as a request for... available to persons without Federal government identification, commenters are encouraged to leave their...
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2012-02-02
... [CMS-1350-NC] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA... the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients... available to persons without Federal government identification, commenters are encouraged to leave their...
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Effects of a Community-Based Fall Management Program on Medicare Cost Savings.
Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael
2015-12-01
Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.
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2012-03-23
... for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the... accrediting body's approved program would be deemed to have met the Medicare conditions. A national... the national accrediting body making the request, describing the nature of the request, and providing...
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2010-06-17
... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long- Term Care Hospital Prospective Payment System and Rate Year 2010 Rates... Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care...
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42 CFR 403.206 - General standards for Medicare supplemental policies.
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false General standards for Medicare supplemental policies. 403.206 Section 403.206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Medicare Supplemental Policies...
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The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans
Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P
2004-01-01
Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective
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A viable logarithmic f(R) model for inflation
Energy Technology Data Exchange (ETDEWEB)
Amin, M.; Khalil, S. [Center for Fundamental Physics, Zewail City of Science and Technology,6 October City, Giza (Egypt); Salah, M. [Center for Fundamental Physics, Zewail City of Science and Technology,6 October City, Giza (Egypt); Department of Mathematics, Faculty of Science, Cairo University,Giza (Egypt)
2016-08-18
Inflation in the framework of f(R) modified gravity is revisited. We study the conditions that f(R) should satisfy in order to lead to a viable inflationary model in the original form and in the Einstein frame. Based on these criteria we propose a new logarithmic model as a potential candidate for f(R) theories aiming to describe inflation consistent with observations from Planck satellite (2015). The model predicts scalar spectral index 0.9615
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2010-10-01
...; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY 2011 Rates; Provider... Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...
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2012-02-01
... Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal... the final rule entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates...
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2011-03-11
... Prospective Payment System and CY 2011 Payment Rates; Changes to the Ambulatory Surgical Center Payment System..., 2010, entitled ``Medicare Program: Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates; Ambulatory Surgical Center Payment System and CY 2011 Payment Rates; Payments to Hospitals for...
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2012-10-29
... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates...
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2013-03-13
... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals...
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2011-05-16
... partner with States, providers, beneficiaries and their caregivers, and other stakeholders to improve... conflicting Medicaid and Medicare requirements. This document represents the first step. We have compiled what.... We will then determine which issues to address and in what order and timeframe. All areas are...
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2011-10-24
... consequence of increasing health care costs to the Medicare program and limiting the choices of those patients... with information concerning the illness, injury or condition that brought the patient to the ASC, as.../grievances relating, but not limited to, mistreatment, neglect, verbal, mental, sexual, or physical abuse...
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2010-08-03
... Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System...-1414-CN2] RIN 0938-AP41 Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010...
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2011-11-04
... Prospective Payment System Rate Update for Calendar Year 2012; Final Rule #0;#0;Federal Register / Vol. 76, No... 0938-AQ30 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012... sets forth updates to the home health prospective payment system (HH PPS) rates, including: the...
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Affections cutaneo-muqueuses au cours de l'Infection a VIH /SIDA ...
African Journals Online (AJOL)
Les affections dermatologiques sont fréquentes au cours de l'infection par le virus de l'Immunodéficience Humaine (VIH). Nous avons réalisé une étude prospective de janvier à décembre 2003 au service de l'hôpital du jour de Hôpital Central de Yaoundé, afin de répertorier les affections cutanes et muqueuses associées ...
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2012-12-14
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 438, 441, and 447 [CMS-2370-CN] RIN 0938-AQ63 Medicaid Program; Payments for Services Furnished by Certain...-26507 of November 6, 2012 (77 FR 66670), there were a number of technical errors that are identified and...
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The Medicare Health Outcomes Survey program: Overview, context, and near-term prospects
Directory of Open Access Journals (Sweden)
Miller Nancy A
2004-07-01
Full Text Available Abstract In 1996, the Centers for Medicare & Medicaid Services (CMS initiated the development of the Medicare Health Outcomes Survey (HOS. It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1 a recognized need to monitor the performance of managed care plans, 2 technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3 the existence of a tested functional health status assessment tool (SF-36®1, which was valid for an elderly population, 4 CMS leadership, and 5 political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1 Supports the technical/scientific development of the HOS measure, 2 Certifies survey vendors, 3 Collects Health Plan Employer Data and Information Set(HEDIS®2 HOS data, 4 Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs, Medicare+Choice Organizations (M+COs, and other stakeholders, 5 Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6 Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7 Conducts analyses using HOS data to support CMS and HHS priorities. CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the
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2013-05-31
...] Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for Available... announces the closure of two teaching hospitals and the initiation of an application process where hospitals... modifying language at section 1886(d)(5)(B)(v) of the Act, to instruct the Secretary to establish a process...
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Future dynamics in f(R) theories
International Nuclear Information System (INIS)
Mueller, D.; Andrade, V.C. de; Maia, C.; Reboucas, M.J.; Teixeira, A.F.F.
2015-01-01
The f(R) gravity theories provide an alternative way to explain the current cosmic acceleration without invoking a dark energy matter component used in the cosmological modeling in the framework of general relativity. However, the freedom in the choice of the functional forms of f(R) gives rise to the problem of the degeneracy among these gravity theories on theoretical and (or) observational grounds. In this paper we examine the question as to whether the future dynamics can be used to break the degeneracy between f(R) gravity theories by investigating the dynamics of spatially homogeneous and isotropic dust flat models in two f(R) gravity theories, namely the well known f(R) = R+αR n gravity and another byAviles et al., whose motivation comes from the cosmographic approach to f(R) gravity. We perform a detailed numerical study of the dynamics of these theories taking into account the recent constraints on the cosmological parameters made by the Planck Collaboration. We demonstrate that besides being useful for discriminating between these two f(R) gravity theories, the future dynamics technique can also be used to determine the finite-time behavior as well as the fate of the Universe in the framework of these f(R) gravity theories. There also emerges from our analysis the result that one still can have a dust flat FLRWsolution with a big rip, if gravity is governed by f(R) = R+αR n . We also show that FLRW dust solutions with f'' < 0 do not necessarily lead to singularities. (orig.)
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10 CFR 850.27 - Hygiene facilities and practices.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Hygiene facilities and practices. 850.27 Section 850.27 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.27 Hygiene facilities and practices. (a) General. The responsible employer must assure that in...
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Baicker, Katherine; Shepard, Mark; Skinner, Jonathan
2013-05-01
The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the "one-size-fits-all" Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product. Our framework highlights the key trade-offs between Medicare spending and economic prosperity.
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2012-06-26
... forth in 42 CFR 414.402 will be used to determine what items will be included in the competitions. These..., regardless of the method of delivery. Non-Mail Order Item--Any item that a beneficiary or caregiver picks up... what Medicare pays for mail order supplies versus non-mail order supplies may encourage fraud and abuse...
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Lessons for the new CMS innovation center from the Medicare health support program.
Barr, Michael S; Foote, Sandra M; Krakauer, Randall; Mattingly, Patrick H
2010-07-01
The Patient Protection and Affordable Care Act establishes a new Center for Medicare and Medicaid Innovation in the Centers for Medicare and Medicaid Services (CMS). The center is intended to enhance the CMS's role in promoting much-needed improvements in payment and service delivery. Lessons from the Medicare Health Support Program, a chronic care pilot program that ran between 2005 and 2008, illustrate the value of drawing on experience in planning for the center and future pilot programs. The lessons include the importance of strong leadership; collaboration and flexibility to foster innovation; receptivity of beneficiaries to care management; and the need for timely data on patients' status. The lessons also highlight pitfalls to be avoided in planning future pilot programs, such as flawed strategies for selecting populations to target when testing payment and service delivery reforms.
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2014-12-05
This final rule implements various provider enrollment requirements. These include: Expanding the instances in which a felony conviction can serve as a basis for denial or revocation of a provider or supplier's enrollment; if certain criteria are met, enabling us to deny enrollment if the enrolling provider, supplier, or owner thereof had an ownership relationship with a previously enrolled provider or supplier that had a Medicare debt; enabling us to revoke Medicare billing privileges if we determine that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements; and limiting the ability of ambulance suppliers to "backbill" for services performed prior to enrollment.
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2010-07-01
... testimony, industry also stated that the changes that were present in NCPDP SCRIPT 10.6 created an environment where long-term care (LTC) facilities could carry out e-prescribing under Medicare Part D. They.... Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or...
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76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity
2011-06-13
... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...
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U.S. Department of Health & Human Services — Data set merges information about the Centers for Medicare and Medicaid Services, Medicare and Medicaid EHR Incentive Programs attestations with the Office of the...
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De l’utopie socialiste au réalisme chrétien
Directory of Open Access Journals (Sweden)
Isabelle Richet
2006-03-01
Full Text Available Le New Deal est le premier mouvement réformiste d’ampleur dans l’histoire des Etats‑Unis qui n’ait pas été inspiré, ni soutenu, par les forces du protestantisme. Si une majorité des protestants et de leur clergé se sont opposés au New Deal à partir de positions conservatrices, le théologien Reinhold Niebuhr en a développé au départ une virulente critique de gauche avant de finalement rallier le président démocrate à la fin des années trente. Nourrie par le rejet de l’idéalisme du Social Gospel, incapable à ses yeux de comprendre les rapports sociaux en terme de classe et de pouvoir, la critique de Niebuhr emprunte les outils d’analyse marxistes pour développer une approche réaliste, tant du point de vue des fins que des moyens de la lutte politique. Le New Deal lui apparaît avant tout comme un programme visant à sauver le capitalisme, alors que la société fondée sur la justice qu’il envisage passe par la socialisation des moyens de production qui ne pourra émerger qu’à travers des conflits sociaux au cours desquels les moyens de lutte même violents sont justifiés. Mais sous l’influence des évènements en Europe au lendemain de la victoire d’Hitler, Reinhold Niebuhr se tourne au milieu des années trente vers une réflexion théologique inspirée de l’orthodoxie de Karl Barth et de son frère Richard Niebuhr, qui l’amène à réintroduire le péché comme la limite absolue de toute l’expérience humaine, interdisant d’envisager la création d’une société de paix et de justice. Ce nouvel absolutisme théologique nourrit un relativisme politique, le réalisme chrétien consistant désormais à choisir la moins mauvaise des options en présence. De ce point de vue, le président démocrate qui appelle à la préparation militaire s’impose désormais comme le choix le plus réaliste face à la montée du fascisme en Europe.The New Deal was the first major reformist experiment in the
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1992-05-04
This final rule sets forth the procedures to be followed for collection of past-due amounts owed by individuals who breached contracts under certain scholarship and loan programs. The programs that would be affected are the National Health Service Corps Scholarship, the Physician Shortage Area Scholarship, and the Health Education Assistance Loan. These procedures would apply to those individuals who breached contracts under the scholarship and loan programs and who-- Accept Medicare assignment for services; Are employed by or affiliated with a provider, Health Maintenance Organization, or Competitive Medical Plan that receives Medicare payment for services; or Are members of a group practice that receives Medicare payment for services. This regulation implements section 1892 of the Social Security Act, as added by section 4052 of the Omnibus Budget Reconciliation Act of 1987.
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2012-11-21
... of the Actuary in the Centers for Medicare & Medicaid Services. The estimates underlying these determinations are prepared by actuaries meeting the qualification standards and following the actuarial... alternative analysis and financial projection purposes, and the Office of the Actuary has adopted this...
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2011-10-24
... Efficiency, Transparency, and Burden Reduction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS...-regulatory changes to increase transparency and to become a better business partner. As explained in the plan...
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2011-04-29
... 2012 IRF PPS Federal Prospective Payment Rates A. Proposed Market Basket Increase Factor, Productivity.... Proposed Productivity Adjustment 3. Proposed Calculation of the IRF PPS Market Basket Increase Factor for... Medicare Provider Analysis and Review MFP Multifactor Productivity MMSEA Medicare, Medicaid, and SCHIP...
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2010-09-24
... Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on... judicial review. DATES: Effective Date: This notice is effective on January 1, 2011. FOR FURTHER...
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2011-09-23
... Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on... $1,350 for judicial review. DATES: Effective Date: This notice is effective on January 1, 2012. FOR...
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2013-09-27
... Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on... ALJ hearings and $1,430 for judicial review. DATES: This notice is effective on January 1, 2014. FOR...
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2012-09-28
... Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process. The adjustment to the AIC threshold amounts will be effective for requests for ALJ hearings and judicial review filed on... $1,400 for judicial review. Effective Date: This notice is effective on January 1, 2013. FOR FURTHER...
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Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S
2013-05-01
This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.
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Chollet, D J
1999-05-01
Despite the enactment of significant changes to the Medicare program in 1997, Medicare's Hospital Insurance trust fund is projected to be exhausted just as the baby boom enters retirement. To address Medicare's financial difficulties, a number of reform proposals have been offered, including several to individualize Medicare financing and benefits. These proposals would attempt to increase Medicare revenues and reduce Medicare expenditures by having individuals bear risk--investment market risk before retirement and insurance market risk after retirement. Many fundamental aspects of these proposals have yet to be worked out, including how to guarantee a baseline level of saving for health insurance after retirement, how retirees might finance unanticipated health insurance price increases after retirement, the potential implications for Medicaid of inadequate individual saving, and whether the administrative cost of making the system fair and adequate ultimately would eliminate any rate-of-return advantages from allowing workers to invest their Medicare contributions in corporate stocks and bonds.
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Social Security Administration — The purpose of this exchange is to identify any Medicare beneficiary who may be eligible for Medicare cost sharing under the Medicaid program, notify these potential...
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2013-12-27
... Conditions for Coverage CHAP Community Health Accreditation Program CMHC Community Mental Health Center COI... Pathology Services (Sec. 485.727) N. Emergency Preparedness Regulations for Community Mental Health Centers... Preparedness for Community Mental Health Centers (CMHCs)--Training and Testing (Sec. 485.920(d)) R. Conditions...
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2008-06-27
This final rule implements a number of regulatory provisions that are applicable to all providers and suppliers, including durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. This final rule establishes appeals processes for all providers and suppliers whose enrollment, reenrollment or revalidation application for Medicare billing privileges is denied and whose Medicare billing privileges are revoked. It also establishes timeframes for deciding enrollment appeals by an Administrative Law Judge (ALJ) within the Department of Health and Human Services (DHHS) or the Departmental Appeals Board (DAB), or Board, within the DHHS; and processing timeframes for CMS' Medicare fee-for-service (FFS) contractors. In addition, this final rule allows Medicare FFS contractors to revoke Medicare billing privileges when a provider or supplier submits a claim or claims for services that could not have been furnished to a beneficiary. This final rule also specifies that a Medicare contractor may establish a Medicare enrollment bar for any provider or supplier whose billing privileges have been revoked. Lastly, the final rule requires that all providers and suppliers receive Medicare payments by electronic funds transfer (EFT) if the provider or supplier, is submitting an initial enrollment application to Medicare, changing their enrollment information, revalidating or re-enrolling in the Medicare program.
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f(R) gravity solutions for evolving wormholes
Energy Technology Data Exchange (ETDEWEB)
Bhattacharya, Subhra [Presidency University, Department of Mathematics, Kolkata (India); Chakraborty, Subenoy [Jadavpur University, Department of Mathematics, Kolkata (India)
2017-08-15
The scalar-tensor f(R) theory of gravity is considered in the framework of a simple inhomogeneous space-time model. In this research we use the reconstruction technique to look for possible evolving wormhole solutions within viable f(R) gravity formalism. These f(R) models are then constrained so that they are consistent with existing experimental data. Energy conditions related to the matter threading the wormhole are analyzed graphically and are in general found to obey the null energy conditions (NEC) in regions around the throat, while in the limit f(R) = R, NEC can be violated at large in regions around the throat. (orig.)
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2013-10-30
...)(A) of the Act specifies that the premium that these individuals will pay for CY 2014 will be equal... OASDI program or the Railroad Retirement Act and certain others do not have to pay premiums for Medicare...-6390. SUPPLEMENTARY INFORMATION: I. Background Section 1818 of the Social Security Act (the Act...
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2012-11-21
...)(A) of the Act specifies that the premium that these individuals will pay for CY 2013 will be equal... program or the Railroad Retirement Act and certain others do not have to pay premiums for Medicare Part A.... SUPPLEMENTARY INFORMATION: I. Background Section 1818 of the Social Security Act (the Act) provides for...
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2011-11-01
... program or the Railroad Retirement Act and certain others do not have to pay premiums for Medicare Part A... will pay for CY 2012 will be equal to the premium for uninsured aged enrollees reduced by 45 percent.... SUPPLEMENTARY INFORMATION: I. Background Section 1818 of the Social Security Act (the Act) provides for...
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42 CFR 403.322 - Termination of agreements for Medicare recognition of State systems.
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Termination of agreements for Medicare recognition of State systems. 403.322 Section 403.322 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Recognition of State...
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Corazzini, Kirsten
2003-01-01
Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390
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Mahavivola, Ernestho-Ghoud Indretsy; Olivah, Razanaparany Miarisoa Mireille; Mihary, Dodo; Hendriniaina, Rakotoharivelo; Lalao, Randriamboavonjy Rado; Henintsoa, Rakotonirainy Oliva; Fahafahantsoa, Rapelanoro Rabenja
2014-01-01
La douleur induite par les soins correspond à la douleur survenant lors des actes à visé diagnostique et/ou thérapeutique. A notre connaissance, nous n'avons pas encore des données disponibles pour les douleurs induites par les soins à l'Hôpital de Befelatanana. Nos objectifs étaient de décrire le profil épidémiologique de la douleur induite par les soins, d'identifier les principaux facteurs influençant sur l'intensité de la douleur et leurs retentissements chez les patients. Il s'agissait d'une étude rétrospective, transversale type un jour donné menée dans les douze services de Médecines au Centre Hospitalier Universitaire de Befelatanana en Novembre 2013. Cent deux patients ont été retenus dans l’étude et trois cent vingt trois actes douloureux étaient enregistrés. La fréquence de la douleur induite par les soins était de 69,86%. Le genre féminin prédominait dans 52% des cas (n = 53) avec un sex-ratio à 0,92. L’âge moyen était de 46 ans. Les ponctions vasculaires étaient l'acte prédominant dans 49,54% (n = 109) des cas. Les infirmiers réalisaient les soins dans 47,05% (n = 48) des cas. L'information verbale était la mesure préventive utilisée dans 57,84% des cas (n = 59). Le transport par marche à pied et au dos représentait 16,67% des cas (n = 17). Les patients naïfs des gestes étaient plus anxieux. Ces patients gardaient de mauvais souvenir dans 64,71% des cas (n = 66). La fréquence de douleur induite par les soins était trop élevée. Un effort important est nécessaire pour réduire la douleur induite par les soins PMID:25932071
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Exploring plane-symmetric solutions in f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Shamir, M. F., E-mail: farasat.shamir@nu.edu.pk [National University of Computer and Emerging Sciences, Department of Sciences and Humanities (Pakistan)
2016-02-15
The modified theories of gravity, especially the f(R) gravity, have attracted much attention in the last decade. This paper is devoted to exploring plane-symmetric solutions in the context of metric f(R) gravity. We extend the work on static plane-symmetric vacuum solutions in f(R) gravity already available in the literature [1, 2]. The modified field equations are solved using the assumptions of both constant and nonconstant scalar curvature. Some well-known solutions are recovered with power-law and logarithmic forms of f(R) models.
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2013-10-03
... calculated by the our Office of the Actuary, to determine both the aggregate amount of empirically justified... Office of the Actuary used the March 2013 update of the Medicare Hospital Cost Report Information System..., as these hospitals do not receive a Medicare DSH payment. The CMS Office of the Actuary's final...
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2011-06-06
.../Kyphoplasty 7. Closed Treatment of Distal Radial Fracture 8. Orthopaedic Surgery--Thigh/Knee 9. Treatment of Ankle Fracture 10. Orthopaedic Surgery/Podiatry 11. Application of Cast and Strapping 12. Cardiothoracic... Immunology MMA Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Pub. L. 108-173) MMSV...
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47 CFR 27.1203 - EBS programming requirements.
2010-10-01
... 47 Telecommunication 2 2010-10-01 2010-10-01 false EBS programming requirements. 27.1203 Section....1203 EBS programming requirements. (a) Except as provided in paragraphs (b), (c), and (d) of this section, BRS and EBS licensees are authorized to provide fixed or mobile service, except aeronautical...
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Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P
2014-06-01
To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. © Health Research and Educational Trust.
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Disentangling the f(R). Duality
International Nuclear Information System (INIS)
Broy, Benedict J.; Westphal, Alexander; Pedro, Francisco G.; Univ. Autonoma de Madrid
2014-11-01
Motivated by UV realisations of Starobinsky-like inflation models, we study generic exponential plateau-like potentials to understand whether an exact f(R)-formulation may still be obtained when the asymptotic shift-symmetry of the potential is broken for larger field values. Potentials which break the shift symmetry with rising exponentials at large field values only allow for corresponding f(R)-descriptions with a leading order term R n with 1 2 -term survives as part of a series expansion of the function f(R) and thus cannot maintain a plateau for all field values. We further find a lean and instructive way to obtain a function f(R) describing m 2 φ 2 -inflation which breaks the shift symmetry with a monomial, and corresponds to effectively logarithmic corrections to an R+R 2 model. These examples emphasise that higher order terms in f(R)-theory may not be neglected if they are present at all. Additionally, we relate the function f(R) corresponding to chaotic inflation to a more general Jordan frame set-up. In addition, we consider f(R)-duals of two given UV examples, both from supergravity and string theory. Finally, we outline the CMB phenomenology of these models which show effects of power suppression at low-l.
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Geodesic congruences in the Palatini f(R) theory
International Nuclear Information System (INIS)
Shojai, Fatimah; Shojai, Ali
2008-01-01
We shall investigate the properties of a congruence of geodesics in the framework of Palatini f(R) theories. We shall evaluate the modified geodesic deviation equation and the Raychaudhuri's equation and show that f(R) Palatini theories do not necessarily lead to attractive forces. Also, we shall study energy condition for f(R) Palatini gravity via a perturbative analysis of the Raychaudhuri's equation.
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Clustering of galaxies with f(R) gravity
Capozziello, Salvatore; Faizal, Mir; Hameeda, Mir; Pourhassan, Behnam; Salzano, Vincenzo; Upadhyay, Sudhaker
2018-02-01
Based on thermodynamics, we discuss the galactic clustering of expanding Universe by assuming the gravitational interaction through the modified Newton's potential given by f(R) gravity. We compute the corrected N-particle partition function analytically. The corrected partition function leads to more exact equations of state of the system. By assuming that the system follows quasi-equilibrium, we derive the exact distribution function that exhibits the f(R) correction. Moreover, we evaluate the critical temperature and discuss the stability of the system. We observe the effects of correction of f(R) gravity on the power-law behaviour of particle-particle correlation function also. In order to check the feasibility of an f(R) gravity approach to the clustering of galaxies, we compare our results with an observational galaxy cluster catalogue.
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Nonlinear evolution of f(R) cosmologies. I. Methodology
International Nuclear Information System (INIS)
Oyaizu, Hiroaki
2008-01-01
We introduce the method and the implementation of a cosmological simulation of a class of metric-variation f(R) models that accelerate the cosmological expansion without a cosmological constant and evade solar-system bounds of small-field deviations to general relativity. Such simulations are shown to reduce to solving a nonlinear Poisson equation for the scalar degree of freedom introduced by the f(R) modifications. We detail the method to efficiently solve the nonlinear Poisson equation by using a Newton-Gauss-Seidel relaxation scheme coupled with the multigrid method to accelerate the convergence. The simulations are shown to satisfy tests comparing the simulated outcome to analytical solutions for simple situations, and the dynamics of the simulations are tested with orbital and Zeldovich collapse tests. Finally, we present several static and dynamical simulations using realistic cosmological parameters to highlight the differences between standard physics and f(R) physics. In general, we find that the f(R) modifications result in stronger gravitational attraction that enhances the dark matter power spectrum by ∼20% for large but observationally allowed f(R) modifications. A more detailed study of the nonlinear f(R) effects on the power spectrum are presented in a companion paper.
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Solar System constraints to general f(R) gravity
International Nuclear Information System (INIS)
Chiba, Takeshi; Smith, Tristan L.; Erickcek, Adrienne L.
2007-01-01
It has been proposed that cosmic acceleration or inflation can be driven by replacing the Einstein-Hilbert action of general relativity with a function f(R) of the Ricci scalar R. Such f(R) gravity theories have been shown to be equivalent to scalar-tensor theories of gravity that are incompatible with Solar System tests of general relativity, as long as the scalar field propagates over Solar System scales. Specifically, the parameterized post-Newtonian (PPN) parameter in the equivalent scalar-tensor theory is γ=1/2, which is far outside the range allowed by observations. In response to a flurry of papers that questioned the equivalence of f(R) theory to scalar-tensor theories, it was recently shown explicitly, without resorting to the scalar-tensor equivalence, that the vacuum field equations for 1/R gravity around a spherically symmetric mass also yield γ=1/2. Here we generalize this analysis to f(R) gravity and enumerate the conditions that, when satisfied by the function f(R), lead to the prediction that γ=1/2
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2011-11-04
... Stuart Caplan, (410) 786-8564 Emission Tomography Registry RN, MAS. Sites. XII Medicare-Approved JoAnna... Stuart Caplan, (410) 786-8564 Emission Tomography for RN, MAS. Dementia Trials. All Other Information...
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Hazarika, Moushumi; Sonowal, Shashanka; Saikia, Indranirekha; Boruah, Purna K.; Das, Manash R.; Tamuly, Chandan
2017-09-01
Au-Ag-In-rGO nanocomposite was synthesized using fruit extract of Zanthoxylum rhetsa which is an eco-friendly, simple and green method. It was characterized by UV-visible, FT-IR, XRD, XPS, EDX, TEM technique. The antioxidant capacity of the nanocomposite was evaluated in presence of AgNO3, HAuCl4 and InCl3 solution respectively at 25 °C. The results showed significant antioxidant activity in presence of 1 × 10-5 mM AgNO3 solution. The antibacterial activity of Au-Ag-In-rGO nanoparticles was carried out against the gram -ve bacteria Pseudomonas aeruginosa, Escherichia coli and gram +ve bacteria Staphylococcus aureus and Bacillus cereus. The bacterial growth kinetics was studied. The bacterial strain E. coli and S. aureus showed complete inhibition at concentration 100 µg ml-1. The activity is more effective in case of Au-Ag-In-rGO compared to GO.
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f(R) gravity and chameleon theories
International Nuclear Information System (INIS)
Brax, Philippe; Bruck, Carsten van de; Davis, Anne-Christine; Shaw, Douglas J.
2008-01-01
We analyze f(R) modifications of Einstein's gravity as dark energy models in the light of their connection with chameleon theories. Formulated as scalar-tensor theories, the f(R) theories imply the existence of a strong coupling of the scalar field to matter. This would violate all experimental gravitational tests on deviations from Newton's law. Fortunately, the existence of a matter dependent mass and a thin-shell effect allows one to alleviate these constraints. The thin-shell condition also implies strong restrictions on the cosmological dynamics of the f(R) theories. As a consequence, we find that the equation of state of dark energy is constrained to be extremely close to -1 in the recent past. We also examine the potential effects of f(R) theories in the context of the Eoet-wash experiments. We show that the requirement of a thin shell for the test bodies is not enough to guarantee a null result on deviations from Newton's law. As long as dark energy accounts for a sizeable fraction of the total energy density of the Universe, the constraints that we deduce also forbid any measurable deviation of the dark energy equation of state from -1. All in all, we find that both cosmological and laboratory tests imply that f(R) models are almost coincident with a ΛCDM model at the background level.
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76 FR 54599 - Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs
2011-09-01
...), prescription drug benefit program (Part D) and section 1876 cost plans including conforming changes to the MA... accounts (MSA) plans, cost-sharing for dual-eligible enrollees in the MA program and prescription drug pricing, coverage, and payment processes in the Part D program, and requirements governing the marketing...
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Stellar equilibrium configurations of white dwarfs in the f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Carvalho, G.A.; Moraes, P.H.R.S.; Marinho, R.M.; Malheiro, M. [Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Jose dos Campos, SP (Brazil); Lobato, R.V. [Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Jose dos Campos, SP (Brazil); Sapienza Universita di Roma, Dipartimento di Fisica, Rome (Italy); ICRANet, Pescara (Italy); Arbanil, Jose D.V. [Universidad Privada del Norte, Departamento de Ciencias, Lima (Peru); Otoniel, E. [Universidade Federal do Cariri, Instituto de Formacao de Professores, Brejo Santo, CE (Brazil)
2017-12-15
In this work we investigate the equilibrium configurations of white dwarfs in a modified gravity theory, namely, f(R, T) gravity, for which R and T stand for the Ricci scalar and trace of the energy-momentum tensor, respectively. Considering the functional form f(R, T) = R+2λT, with λ being a constant, we obtain the hydrostatic equilibrium equation for the theory. Some physical properties of white dwarfs, such as: mass, radius, pressure and energy density, as well as their dependence on the parameter λ are derived. More massive and larger white dwarfs are found for negative values of λ when it decreases. The equilibrium configurations predict a maximum mass limit for white dwarfs slightly above the Chandrasekhar limit, with larger radii and lower central densities when compared to standard gravity outcomes. The most important effect of f(R, T) theory for massive white dwarfs is the increase of the radius in comparison with GR and also f(R) results. By comparing our results with some observational data of massive white dwarfs we also find a lower limit for λ, namely, λ > -3 x 10{sup -4}. (orig.)
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Dynamics of anisotropic power-law f(R) cosmology
International Nuclear Information System (INIS)
Shamir, M. F.
2016-01-01
Modified theories of gravity have attracted much attention of the researchers in the recent years. In particular, the f(R) theory has been investigated extensively due to important f(R) gravity models in cosmological contexts. This paper is devoted to exploring an anisotropic universe in metric f(R) gravity. A locally rotationally symmetric Bianchi type I cosmological model is considered for this purpose. Exact solutions of modified field equations are obtained for a well-known f(R) gravity model. The energy conditions are also discussed for the model under consideration. The viability of the model is investigated via graphical analysis using the present-day values of cosmological parameters. The model satisfies null energy, weak energy, and dominant energy conditions for a particular range of the anisotropy parameter while the strong energy condition is violated, which shows that the anisotropic universe in f(R) gravity supports the crucial issue of accelerated expansion of the universe.
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Dynamics of anisotropic power-law f(R) cosmology
Energy Technology Data Exchange (ETDEWEB)
Shamir, M. F., E-mail: farasat.shamir@nu.edu.pk [National University of Computer and Emerging Sciences, Lahore Campus, Department of Sciences and Humanities (Pakistan)
2016-12-15
Modified theories of gravity have attracted much attention of the researchers in the recent years. In particular, the f(R) theory has been investigated extensively due to important f(R) gravity models in cosmological contexts. This paper is devoted to exploring an anisotropic universe in metric f(R) gravity. A locally rotationally symmetric Bianchi type I cosmological model is considered for this purpose. Exact solutions of modified field equations are obtained for a well-known f(R) gravity model. The energy conditions are also discussed for the model under consideration. The viability of the model is investigated via graphical analysis using the present-day values of cosmological parameters. The model satisfies null energy, weak energy, and dominant energy conditions for a particular range of the anisotropy parameter while the strong energy condition is violated, which shows that the anisotropic universe in f(R) gravity supports the crucial issue of accelerated expansion of the universe.
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76 FR 60050 - Medicaid Program: Money Follows the Person Rebalancing Demonstration Program
2011-09-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Medicaid Program: Money Follows the Person Rebalancing Demonstration Program AGENCY: Centers for Medicare & Medicaid... Medicaid beneficiaries with disabling and chronic conditions from institutions into the community. The...
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Medicare Non-Utilization Project (MNUP)
Social Security Administration — A program integrity initiative using a data exchange between SSA and the Centers for Medicare and Medicaid Services (CMS).CMS will identify Medicare Part B enrollees...
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Financial Performance of Rural Medicare ACOs.
Nattinger, Matthew C; Mueller, Keith; Ullrich, Fred; Zhu, Xi
2018-12-01
The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan. Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician-based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance. Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted. © 2016 National Rural Health Association.
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Cosmology of f(R) gravity in the metric variational approach
Li, Baojiu; Barrow, John D.
2007-04-01
We consider the cosmologies that arise in a subclass of f(R) gravity with f(R)=R+μ2n+2/(-R)n and n∈(-1,0) in the metric (as opposed to the Palatini) variational approach to deriving the gravitational field equations. The calculations of the isotropic and homogeneous cosmological models are undertaken in the Jordan frame and at both the background and the perturbation levels. For the former, we also discuss the connection to the Einstein frame in which the extra degree of freedom in the theory is associated with a scalar field sharing some of the properties of a “chameleon” field. For the latter, we derive the cosmological perturbation equations in general theories of f(R) gravity in covariant form and implement them numerically to calculate the cosmic microwave background (CMB) temperature and matter power spectra of the cosmological model. The CMB power is shown to reduce at low l’s, and the matter power spectrum is almost scale independent at small scales, thus having a similar shape to that in standard general relativity. These are in stark contrast with what was found in the Palatini f(R) gravity, where the CMB power is largely amplified at low l’s and the matter spectrum is strongly scale dependent at small scales. These features make the present model more adaptable than that arising from the Palatini f(R) field equations, and none of the data on background evolution, CMB power spectrum, or matter power spectrum currently rule it out.
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Hallam, K; Gardner, J
1999-11-08
Most Americans know Medicare as the health insurance program that covers the elderly. But to providers it's much more that. The program pays for medical education, finances capital projects and subsidizes care for the indigent. Should Medicare continue making those add-on payments? Is that the program's mission? The debate is intensifying.
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Measuring Coding Intensity in the Medicare Advantage Program
U.S. Department of Health & Human Services — In 2004, Medicare implemented a risk-adjustment system that pays Medicare Advantage (MA) plans based on diagnoses reported for their enrollees, giving the plans an...
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State Policies Influence Medicare Telemedicine Utilization.
Neufeld, Jonathan D; Doarn, Charles R; Aly, Reem
2016-01-01
Medicare policy regarding telemedicine reimbursement has changed little since 2000. Many individual states, however, have added telemedicine reimbursement for either Medicaid and/or commercial payers over the same period. Because telemedicine programs must serve patients from all or most payers, it is likely that these state-level policy changes have significant impacts on telemedicine program viability and utilization of services from all payers, not just those services and payers affected directly by state policy. This report explores the impact of two significant state-level policy changes-one expanding Medicaid telemedicine coverage and the other introducing telemedicine parity for commercial payers-on Medicare utilization in the affected states. Medicare claims data from 2011-2013 were examined for states in the Great Lakes region. All valid claims for live interactive telemedicine professional fees were extracted and linked to their states of origin. Allowed encounters and expenditures were calculated in total and on a per 1,000 members per year basis to standardize against changes in the Medicare population by state and year. Medicare telemedicine encounters and professional fee expenditures grew sharply following changes in state Medicaid and commercial payer policy in the examined states. Medicare utilization in Illinois grew by 173% in 2012 (over 2011) following Medicaid coverage expansion, and Medicare utilization in Michigan grew by 118% in 2013 (over 2012) following adoption of telemedicine parity for commercial payers. By contrast, annual Medicare telemedicine utilization growth in surrounding states (in which there were no significant policy changes during these years) varied somewhat but showed no discernible pattern. Although Medicare telemedicine policy has changed little since its inception, changes in state policies with regard to telemedicine reimbursement appear to have significant impacts on the practical viability of telemedicine programs
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Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas
Engbang, Jean Paul Ndamba; Essome, Henri; Koh, Valère Mve; Simo, Godefroy; Essam, Jean Daniel Sime; Mouelle, Albert Sone; Essame, Jean Louis Oyono
2015-01-01
Décrire les caractéristiques épidémiologiques et histo-pathologiques des tumeurs malignes du sein au Cameroun. Il s'agissait d'une étude rétrospective descriptive portant sur les tumeurs malignes du sein, colligées, dans les registres des différents laboratoires d'Anatomie Pathologique publiques et privés repartis dans cinq régions (centre, littoral, Ouest, Nord-ouest, Sud-ouest), pendant une période de 10 ans (2004-2013). Les paramètres étudiés étaient la fréquence, l’âge, le sexe, la localisation, le type et le grade histologique, et les récepteurs hormonaux. Un total de 3044 cas de cancers du sein a été recensé, soit une fréquence annuelle de 304,4 cas en moyenne. Le sexe féminin était le plus représenté avec 2971 cas (97,60%) et les hommes avec 73 cas (2,40%), soit un sexe ratio (H/F) de 0,02. L’âge moyen des patients était de 46±15,87 ans, avec des extrêmes de 13 et 95 ans. Selon la localisation, le sein gauche était atteint dans 1244 cas (52%) et le sein droit dans 1115 cas (47%). Au plan histologique, on retrouvait essentiellement des carcinomes avec 96,50% des cas, des sarcomes 1,39%, des lymphomes 1,07% et la maladie de Paget du mamelon, 1,03%. Les tumeurs épithéliales étaient infiltrantes dans 2049 cas (84,46%), avec une prédominance du carcinome canalaire infiltrant (1870 cas) et non infiltrantes dans 377 cas (15,54%). Le grade histo-pronostic de SBR avait révélé une prédominance du grade II dans 66% des cas. Les cancers du sein restent une pathologie fréquente au Cameroun et atteignent principalement la population féminine en âge de procréer. Ils sont caractérisés par la prédominance du carcinome canalaire infiltrant. PMID:26523182
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Les fondements de la mesure du temps comment les fréquences atomiques règlent le monde
Audoin, Claude
1998-01-01
La mesure du temps fondée sur des propriétés atomiques est née en 1955, avec le premier étalon de fréquence à jet de césium. Depuis, les horloges atomiques ne cessent de progresser et sont au coeur de nombreuses activités, telles que les comparaisons de temps, l'unification mondiale de l'heure ou la recherche en astronomie, géodésie, géophysique, télécommunications, etc. Cet ouvrage fournira des réponses détaillées au lecteur intéressé par la mesure du temps appliquée aux divers domaines cités.
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2011-03-14
...' FTE Resident Caps for Graduate Medical Education Payment Purposes AGENCY: Centers for Medicare... education affiliated groups for the purpose of determining possible full-time equivalent resident cap... caps for direct GME under Medicare for certain hospitals, and to authorize the ``redistribution'' of...
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Menz, Hylton B
2009-10-30
In 2004, as an extension of the Enhanced Primary Care (EPC) program, the Australian Government introduced a policy of providing Medicare rebates for allied health services provided to patients with chronic or complex health conditions. The objective of this study was to evaluate the utilisation of podiatry services provided under this scheme between 2004 and 2008. Data pertaining to the Medicare item 10962 for the calendar years 2004-2008 were extracted from the Australian Medicare Benefits Schedule (MBS) database and cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number of consultations provided and to assess for temporal trends over the five-year assessment period. The total cost to Medicare over this period was also determined. During the 2004-2008 period, a total of 1,338,044 EPC consultations were provided by podiatrists in Australia. Females exhibited higher utilisation than males (63 versus 37%), and those aged over 65 years accounted for 75% of consultations. There was a marked increase in the number of consultations provided from 2004 to 2008, and the total cost of providing EPC podiatry services during this period was $62.9 M. Podiatry services have been extensively utilised under the EPC program by primary care patients, particularly older women, and the number of services provided has increased dramatically between 2004 and 2008. Further research is required to determine whether the EPC program enhances clinical outcomes compared to standard practice.
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2010-03-26
... under Medicare. This notice also includes listings of all approval numbers from the Office of Management... stent facilities. Included in this notice is a list of the American College of Cardiology's National Cardiovascular Data registry sites, active CMS coverage-related guidance documents, and special one-time notices...
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Closed string tachyon driving f(R) cosmology
Wang, Peng; Wu, Houwen; Yang, Haitang
2018-05-01
To study quantum effects on the bulk tachyon dynamics, we replace R with f(R) in the low-energy effective action that couples gravity, the dilaton, and the bulk closed string tachyon of bosonic closed string theory and study properties of their classical solutions. The α' corrections of the graviton-dilaton-tachyon system are implemented in the f(R). We obtain the tachyon-induced rolling solutions and show that the string metric does not need to remain fixed in some cases. In the case with H( t=‑∞ ) = , only the R and R2 terms in f(R) play a role in obtaining the rolling solutions with nontrivial metric. The singular behavior of more classical solutions are investigated and found to be modified by quantum effects. In particular, there could exist some classical solutions, in which the tachyon field rolls down from a maximum of the tachyon potential while the dilaton expectation value is always bounded from above during the rolling process.
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f(R) gravity, torsion and non-metricity
International Nuclear Information System (INIS)
Sotiriou, Thomas P
2009-01-01
For both f(R) theories of gravity with an independent symmetric connection (no torsion), usually referred to as Palatini f(R) gravity theories, and for f(R) theories of gravity with torsion but no non-metricity, called U4 theories, it has been shown that the independent connection can actually be eliminated algebraically, as long as this connection does not couple to matter. Remarkably, the outcome in both cases is the same theory, which is dynamically equivalent with an ω 0 = -3/2 Brans-Dicke theory. It is shown here that even for the most general case of an independent connection with both non-metricity and torsion, one arrives at exactly the same theory as in the more restricted cases. This generalizes the previous results and explains why assuming that either the torsion or the non-metricity vanishing ultimately leads to the same theory. It also demonstrates that f(R) actions cannot support an independent connection which carries dynamical degrees of freedom, irrespective of how general this connection is, at least as long as there is no connection-matter coupling. (fast track communication)
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2011-07-18
...) 786-4533, and Jana Lindquist, (410) 786-4533, Partial hospitalization and community mental health... Laboratory Fee Schedule CMHC Community Mental Health Center CMS Centers for Medicare & Medicaid Services CPT... community mental health centers (CMHCs)) and hospital outpatient services that are furnished to inpatients...
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Standard cosmological evolution in the f(R) model to Kaluza-Klein cosmology
International Nuclear Information System (INIS)
Aghmohammadi, A; Abolhassani, M R; Saaidi, Kh; Vajdi, A
2009-01-01
In this paper, using f(R) theory of gravity we explicitly calculate cosmological evolution in the presence of a perfect fluid source in four- and five-dimensional space-time in which this cosmological evolution in self-creation is presented by Reddy et al (2009 Int. J. Theor. Phys. 48 10). An exact cosmological model is presented using a relation between Einstein's gravity field equation components due to a metric with the same component from f(R) theory of gravity. Some physics and kinematical properties of the model are also discussed.
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2011-11-25
... recommendations to the Medicare Trustees on how the Trustees might more accurately estimate health spending in the long run. The Panel's discussion is expected to be very technical in nature and will focus on the... making recommendations to the Medicare Trustees on how the Trustees might more accurately project health...
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2010-09-24
... Office of Management and Budget for collections of information in CMS regulations and a list of Medicare- approved carotid stent facilities. Included in this notice is a list of the American College of Cardiology... special one-time notices regarding national coverage provisions. Also included in this notice is a list of...
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Squitieri, Lee; Chung, Kevin C
2017-07-01
In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.
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2010-04-23
... within a reasonable distance of the facility; Assures that an adequate environment exists for operating... final rule on these operational issues, we will work with all interested stakeholders to develop the..., Health Records, Medicaid, Medicare, Nursing [[Page 21179
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Effective Dark Matter Halo Catalog in f(R) Gravity.
He, Jian-Hua; Hawken, Adam J; Li, Baojiu; Guzzo, Luigi
2015-08-14
We introduce the idea of an effective dark matter halo catalog in f(R) gravity, which is built using the effective density field. Using a suite of high resolution N-body simulations, we find that the dynamical properties of halos, such as the distribution of density, velocity dispersion, specific angular momentum and spin, in the effective catalog of f(R) gravity closely mimic those in the cold dark matter model with a cosmological constant (ΛCDM). Thus, when using effective halos, an f(R) model can be viewed as a ΛCDM model. This effective catalog therefore provides a convenient way for studying the baryonic physics, the galaxy halo occupation distribution and even semianalytical galaxy formation in f(R) cosmologies.
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Directory of Open Access Journals (Sweden)
Menz Hylton B
2009-10-01
Full Text Available Abstract Background In 2004, as an extension of the Enhanced Primary Care (EPC program, the Australian Government introduced a policy of providing Medicare rebates for allied health services provided to patients with chronic or complex health conditions. The objective of this study was to evaluate the utilisation of podiatry services provided under this scheme between 2004 and 2008. Methods Data pertaining to the Medicare item 10962 for the calendar years 2004-2008 were extracted from the Australian Medicare Benefits Schedule (MBS database and cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number of consultations provided and to assess for temporal trends over the five-year assessment period. The total cost to Medicare over this period was also determined. Results During the 2004-2008 period, a total of 1,338,044 EPC consultations were provided by podiatrists in Australia. Females exhibited higher utilisation than males (63 versus 37%, and those aged over 65 years accounted for 75% of consultations. There was a marked increase in the number of consultations provided from 2004 to 2008, and the total cost of providing EPC podiatry services during this period was $62.9 M. Conclusion Podiatry services have been extensively utilised under the EPC program by primary care patients, particularly older women, and the number of services provided has increased dramatically between 2004 and 2008. Further research is required to determine whether the EPC program enhances clinical outcomes compared to standard practice.
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Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D
2016-02-01
In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.
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Constraints on perturbative f(R) gravity via neutron stars
Energy Technology Data Exchange (ETDEWEB)
Arapoğlu, Savaş; Ekşi, K. Yavuz [İstanbul Technical University, Faculty of Science and Letters, Physics Engineering Department, Maslak 34469, İstanbul (Turkey); Deliduman, Cemsinan, E-mail: arapoglu@itu.edu.tr, E-mail: cemsinan@msgsu.edu.tr, E-mail: eksi@itu.edu.tr [Mimar Sinan Fine Arts University, Department of Physics, Beşiktaş 34349, İstanbul (Turkey)
2011-07-01
We study the structure of neutron stars in perturbative f(R) gravity models with realistic equations of state. We obtain mass-radius relations in a gravity model of the form f(R) = R+αR{sup 2}. We find that deviations from the results of general relativity, comparable to the variations due to using different equations of state (EoS'), are induced for |α| ∼ 10{sup 9} cm{sup 2}. Some of the soft EoS' that are excluded within the framework of general relativity can be reconciled with the 2 solar mass neutron star recently observed for certain values of α within this range. For some of the EoS' we find that a new solution branch, which allows highly massive neutron stars, exists for values of α greater than a few 10{sup 9} cm{sup 2}. We find constraints on α for a variety of EoS' using the recent observational constraints on the mass-radius relation. These are all 5 orders of magnitude smaller than the recent constraint obtained via Gravity Probe B for this gravity model. The associated length scale √(alpha)approx 10{sup 5} cm is only an order of magnitude smaller than the typical radius of a neutron star, the probe used in this test. This implies that real deviations from general relativity can be even smaller.
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Directory of Open Access Journals (Sweden)
Ruvoletto Samantha
2014-07-01
Dans cette étude nous cherchons d'évaluer de manière détaillée l’importance relative de la phonologie et des connaissances lexicales de 43 enfants français à l’entrée du CP et d'analyser les problématiques causées par les phénomènes consonantiques de liaison, d’élision et d’enchaînement dans cette phase d'acquisition. Les résultats d'une tâche de dénomination guidée montrent que les enfants de 6 ans et demi ont encore des problèmes avec le calcul des frontières des mots en français au début de l'école primaire. De plus dans nos données, la fréquence lexicale des mots tests ne résulte pas corrélée au nombre d'erreurs. Les fautes résiduelles dans la tâche sont donc consécutives à un problème phonologique et pas exclusivement lexical. Le rôle prioritaire de la phonologie à l'entrée de l'école primaire est en accord avec les conclusions de Sprenger-Charolles (1994 qui proposent que la première phase d’apprentissage de la lecture et de l'écriture repose essentiellement sur une analyse phonologique indépendante de la fréquence lexicale.
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Wormholes in R{sup 2}-gravity within the f(R, T) formalism
Energy Technology Data Exchange (ETDEWEB)
Sahoo, P.K.; Sahoo, Parbati [Birla Institute of Technology and Science-Pilani, Department of Mathematics, Hyderabad (India); Moraes, P.H.R.S. [ITA-Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Jose dos Campos, Sao Paulo (Brazil)
2018-01-15
We propose, as a novelty in the literature, the modeling of wormholes within a particular case of f(R, T) gravity, namely f(R, T) = R + αR{sup 2} + λT, with R and T being the Ricci scalar and trace of the energy-momentum tensor, respectively, while α and λ are constants. Although such a functional form application can be found in the literature, those concern compact astrophysical objects, such that no wormhole analysis has been done so far. The quadratic geometric and linear material corrections of this theory render the matter content of the wormhole remarkably able to obey the energy conditions. (orig.)
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75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes
2010-07-12
... law judge (ALJ) reverses the civil money penalty determination in whole or in part, the escrowed..., widespread harm, or resulting in a resident's death is not eligible for the civil money penalty reduction... Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed...
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Existence of relativistic stars in f(R) gravity
International Nuclear Information System (INIS)
Upadhye, Amol; Hu, Wayne
2009-01-01
We refute recent claims in the literature that stars with relativistically deep potentials cannot exist in f(R) gravity. Numerical examples of stable stars, including relativistic (GM * /r * ∼0.1), constant density stars, are studied. As a star is made larger, nonlinear 'chameleon' effects screen much of the star's mass, stabilizing gravity at the stellar center. Furthermore, we show that the onset of this chameleon screening is unrelated to strong gravity. At large central pressures P>ρ/3, f(R) gravity, like general relativity, does have a maximum gravitational potential, but at a slightly smaller value: GM * /r * | max =0.345<4/9 for constant density and one choice of parameters. This difference is associated with negative central curvature R under general relativity not being accessed in the f(R) model, but does not apply to any known astrophysical object.
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f(R) gravity: scalar perturbations in the late Universe
Czech Academy of Sciences Publication Activity Database
Eingorn, M.; Novák, Jan; Zhuk, A.
2014-01-01
Roč. 74, č. 8 (2014), s. 3005 ISSN 1434-6044 Institutional support: RVO:67985840 Keywords : nonlinear f(R) gravity * scalar cosmological perturbations * scalaron Subject RIV: BA - General Mathematics Impact factor: 5.084, year: 2014 http://link.springer.com/article/10.1140/epjc/s10052-014-3005-1
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Models of f(R) cosmic acceleration that evade solar system tests
International Nuclear Information System (INIS)
Hu, Wayne; Sawicki, Ignacy
2007-01-01
We study a class of metric-variation f(R) models that accelerates the expansion without a cosmological constant and satisfies both cosmological and solar-system tests in the small-field limit of the parameter space. Solar-system tests alone place only weak bounds on these models, since the additional scalar degree of freedom is locked to the high-curvature general-relativistic prediction across more than 25 orders of magnitude in density, out through the solar corona. This agreement requires that the galactic halo be of sufficient extent to maintain the galaxy at high curvature in the presence of the low-curvature cosmological background. If the galactic halo and local environment in f(R) models do not have substantially deeper potentials than expected in ΛCDM, then cosmological field amplitudes |f R | > or approx.10 -6 will cause the galactic interior to evolve to low curvature during the acceleration epoch. Viability of large-deviation models therefore rests on the structure and evolution of the galactic halo, requiring cosmological simulations of f(R) models, and not directly on solar-system tests. Even small deviations that conservatively satisfy both galactic and solar-system constraints can still be tested by future, percent-level measurements of the linear power spectrum, while they remain undetectable to cosmological-distance measures. Although we illustrate these effects in a specific class of models, the requirements on f(R) are phrased in a nearly model-independent manner
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2011-02-02
... Improvement Protection Act of 2000 (Pub. L. 106-544) CAH Critical access hospital CAP Competitive acquisition... corporations and non-profit organizations and charities. The ``Report to Congress on Steps Taken to Assure... primarily payable under Part A of Medicare, such as hospitals, home health agencies (including home health...
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f(R) gravity cosmology in scalar degree of freedom
International Nuclear Information System (INIS)
Goswami, Umananda Dev; Deka, Kabita
2014-01-01
The models of f(R) gravity belong to an important class of modified gravity models where the late time cosmic accelerated expansion is considered as the manifestation of the large scale modification of the force of gravity. f(R) gravity models can be expressed in terms of a scalar degree of freedom by explicit redefinition of model's variable. Here we report about the study of the features of cosmological parameters and hence the cosmological evolution using the scalar degree of freedom of the f(R) = ξR n gravity model in the Friedmann-Lemaître-Robertson-Walker (FLRW) background
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Innovations en apprentissage numérique pour les réfugiés syriens ...
International Development Research Centre (IDRC) Digital Library (Canada)
Les répercussions du conflit syrien et de la conséquente crise des réfugiés syriens sur les systèmes scolaires en Jordanie et au Liban sont très lourdes. Selon les estimations, quelque 714 000 enfants syriens déplacés ne fréquentent pas l'école et environ la moitié de ce nombre est en Jordanie et au Liban. Plus de 100 ...
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Constraint propagation equations of the 3+1 decomposition of f(R) gravity
International Nuclear Information System (INIS)
Paschalidis, Vasileios; Shapiro, Stuart L; Halataei, Seyyed M H; Sawicki, Ignacy
2011-01-01
Theories of gravity other than general relativity (GR) can explain the observed cosmic acceleration without a cosmological constant. One such class of theories of gravity is f(R). Metric f(R) theories have been proven to be equivalent to Brans-Dicke (BD) scalar-tensor gravity without a kinetic term (ω = 0). Using this equivalence and a 3+1 decomposition of the theory, it has been shown that metric f(R) gravity admits a well-posed initial value problem. However, it has not been proven that the 3+1 evolution equations of metric f(R) gravity preserve the (Hamiltonian and momentum) constraints. In this paper, we show that this is indeed the case. In addition, we show that the mathematical form of the constraint propagation equations in BD-equilavent f(R) gravity and in f(R) gravity in both the Jordan and Einstein frames is exactly the same as in the standard ADM 3+1 decomposition of GR. Finally, we point out that current numerical relativity codes can incorporate the 3+1 evolution equations of metric f(R) gravity by modifying the stress-energy tensor and adding an additional scalar field evolution equation. We hope that this work will serve as a starting point for relativists to develop fully dynamical codes for valid f(R) models.
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How Successful Is Medicare Advantage?
Newhouse, Joseph P; McGuire, Thomas G
2014-01-01
Context Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. Methods This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Findings Beneficiaries make “mistakes” in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of “zero-premium” plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Conclusions Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan
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2013-08-06
.... Accounting Statement 7. Conclusion B. Regulatory Flexibility Act Analysis C. Unfunded Mandates Reform Act...-eligible beneficiaries would receive their drugs through the Medicare Part D benefit, which would work... rate than higher-skilled occupations, using the [[Page 47943
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Robust approach to f(R) gravity
International Nuclear Information System (INIS)
Jaime, Luisa G.; Patino, Leonardo; Salgado, Marcelo
2011-01-01
We consider metric f(R) theories of gravity without mapping them to their scalar-tensor counterpart, but using the Ricci scalar itself as an ''extra'' degree of freedom. This approach avoids then the introduction of a scalar-field potential that might be ill defined (not single valued). In order to explicitly show the usefulness of this method, we focus on static and spherically symmetric spacetimes and deal with the recent controversy about the existence of extended relativistic objects in certain class of f(R) models.
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Effect of medicare payment on rural health care systems.
McBride, Timothy D; Mueller, Keith J
2002-01-01
Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.
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Possible antigravity regions in F(R) theory?
Energy Technology Data Exchange (ETDEWEB)
Bamba, Kazuharu, E-mail: bamba@kmi.nagoya-u.ac.jp [Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya 464-8602 (Japan); Nojiri, Shin' ichi, E-mail: nojiri@phys.nagoya-u.ac.jp [Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya 464-8602 (Japan); Department of Physics, Nagoya University, Nagoya 464-8602 (Japan); Odintsov, Sergei D., E-mail: odintsov@ieec.uab.es [Department of Physics, Nagoya University, Nagoya 464-8602 (Japan); Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona (Spain); Institut de Ciencies de l' Espai (CSIC-IEEC), Campus UAB, Facultat de Ciencies, Torre C5-Par-2a pl, E-08193 Bellaterra (Barcelona) (Spain); Tomsk State Pedagogical University, Kievskaya Avenue, 60, 634061, Tomsk (Russian Federation); Sáez-Gómez, Diego, E-mail: diego.saezgomez@uct.ac.za [Astrophysics, Cosmology and Gravity Centre (ACGC) and Department of Mathematics and Applied Mathematics, University of Cape Town, Rondebosch 7701, Cape Town (South Africa); Fisika Teorikoaren eta Zientziaren Historia Saila, Zientzia eta Teknologia Fakultatea, Euskal Herriko Unibertsitatea, 644 Posta Kutxatila, 48080 Bilbao (Spain)
2014-03-07
We construct an F(R) gravity theory corresponding to the Weyl invariant two scalar field theory. We investigate whether such F(R) gravity can have the antigravity regions where the Weyl curvature invariant does not diverge at the Big Bang and Big Crunch singularities. It is revealed that the divergence cannot be evaded completely but can be much milder than that in the original Weyl invariant two scalar field theory.
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Holographic dark energy and f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Aghamohammadi, A [Faculty of Science, Islamic Azad University of Sanandaj, Sanandaj (Iran, Islamic Republic of); Saaidi, Kh, E-mail: ksaaidi@uok.ac.ir, E-mail: agha35484@yahoo.com [Department of Physics, Faculty of Science, University of Kurdistan, Sanandaj (Iran, Islamic Republic of)
2011-02-15
We investigate the corresponding relation between f(R) gravity and holographic dark energy. We introduce a type of energy density from f(R) that has the same role as holographic dark energy. We obtain the differential equation that specifies the evolution of the introduced energy density parameter based on a varying gravitational constant. We discover the relation for the equation of state parameter for low redshifts that contains varying G correction.
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Possible antigravity regions in F(R) theory?
Bamba, Kazuharu; Nojiri, Shin'ichi; Odintsov, Sergei D.; Sáez-Gómez, Diego
2014-03-01
We construct an F(R) gravity theory corresponding to the Weyl invariant two scalar field theory. We investigate whether such F(R) gravity can have the antigravity regions where the Weyl curvature invariant does not diverge at the Big Bang and Big Crunch singularities. It is revealed that the divergence cannot be evaded completely but can be much milder than that in the original Weyl invariant two scalar field theory.
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Possible antigravity regions in F(R) theory?
International Nuclear Information System (INIS)
Bamba, Kazuharu; Nojiri, Shin'ichi; Odintsov, Sergei D.; Sáez-Gómez, Diego
2014-01-01
We construct an F(R) gravity theory corresponding to the Weyl invariant two scalar field theory. We investigate whether such F(R) gravity can have the antigravity regions where the Weyl curvature invariant does not diverge at the Big Bang and Big Crunch singularities. It is revealed that the divergence cannot be evaded completely but can be much milder than that in the original Weyl invariant two scalar field theory.
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Energy Technology Data Exchange (ETDEWEB)
Motohashi, Hayato [Universidad de Valencia-CSIC, Instituto de Fisica Corpuscular (IFIC), Valencia (Spain); Starobinsky, Alexei A. [L.D. Landau Institute for Theoretical Physics, RAS, Moscow (Russian Federation); National Research University Higher School of Economics, Moscow (Russian Federation)
2017-08-15
The previously introduced class of two-parametric phenomenological inflationary models in general relativity in which the slow-roll assumption is replaced by the more general, constant-roll condition is generalized to the case of f(R) gravity. A simple constant-roll condition is defined in the original Jordan frame, and exact expressions for a scalaron potential in the Einstein frame, for a function f(R) (in the parametric form) and for inflationary dynamics are obtained. The region of the model parameters permitted by the latest observational constraints on the scalar spectral index and the tensor-to-scalar ratio of primordial metric perturbations generated during inflation is determined. (orig.)
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IMS Learning Design : la flexibilité pédagogique au service des besoins de la e-formation
Burgos, Daniel; Arnaud, Michel; Neuhauser, Patrick; Koper, Rob
2005-01-01
Burgos, D., Arnaud, M., Neuhauser, P., Koper, R. IMS Learning Design : la flexibilité pédagogique au service des besoins de la e-formation. In La Revue de l'EPI. France: L'association Enseignement Public et Informatique [http://www.epi.asso.fr/revue/articsom.htm]. Available at
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42 CFR 423.800 - Administration of subsidy program.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Administration of subsidy program. 423.800 Section 423.800 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost...
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42 CFR 423.159 - Electronic prescription drug program.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...
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Medicare FFS Jurisdiction Error Rate Contribution Data
U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services CMS is dedicated to continually strengthening and improving the Medicare program, which provides vital services to...
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2012-01-11
...-0117; Airspace Docket No. 09-AGL-31] RIN 2120-AI92 Proposed Establishment of Restricted Areas R-5402, R-5403A, R- 5403B, R-5403C, R-5403D, R-5403E, R-5403F; Devils Lake, ND AGENCY: Federal Aviation... Restricted Areas R-5402, R-5403A, R-5403B, R- 5403C, R-5403D, R-5403E, R-5403F; Devils Lake, ND (76 FR 72869...
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Medicare and Medicaid fraud and abuse regulations.
Liang, F Z; Black, B L
1991-11-01
Specific business arrangements that are protected under legislation and regulations governing parties doing business with Medicare or Medicaid are discussed. Regulations implementing the Medicare and Medicaid Patient Protection Act of 1987 specify practices and activities that are not subject to criminal penalties under the antikickback provisions of the Social Security Act or to exclusion from Medicare or state health-care programs. As of July 29, 1991, all organized health-care settings that receive payments from either Medicare or state health-care programs must comply with these regulations. The final rule sets forth "safe harbors"--exceptions to prohibitions against (1) kickbacks, bribes, rebates, and other illegal activities involving remunerations for patient referrals and (2) inducements to purchase or lease goods paid for by Medicare or state health-care programs. The safe harbors comprise 11 broad categories--investment interests, space rental, equipment rental, personal services and management contracts, purchase of a medical practice, referral services, warranties, discounts, employees, group purchasing organizations, and waiver of deductibles and coinsurance. Implications for pharmacy are discussed. These regulations will affect the purchase of pharmaceuticals by institutional pharmacies. Each institution should review its current practices to determine whether they are within the safe harbors.
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Accouchement gémellaire en milieu africain: une analyse de 10 ans dans le district de Bamako au Mali
Théra, Tiounkani; Mounkoro, Niani; Traore, Soumana Omar; Hamidou, Albachar; Traore, Mamadou; Doumbia, Saleck; Tall, Saoudatou; Kouma, Aminata
2018-01-01
Introduction Le but de cette étude était de déterminer les facteurs influençant le pronostic de l'accouchement du deuxième jumeau. Méthodes L'étude était rétrospective et a porté sur tous les cas d'accouchements gémellaires enregistrés à la maternité du Centre de Santé de Référence de la commune V du District de Bamako du 1erJanvier 2007 au 31 Décembre 2016 soit sur une période de dix ans. Résultats Nous avons enregistré 34.899 accouchements dont 1374 accouchements gémellaires soit une fréquence de 2,54%; près de 15% étaient des primipares; 39,16% étaient référées; 69,10% et 15,5% autres sans aucun suivi prénatal. Les facteurs influençant négativement pronostic du deuxième jumeau étaient: un délai ≥ 15minutes entre les jumeaux, le recours tardif à la césarienne, la non qualification de l'accoucheur, la grossesse monochoréale, le faible poids de naissance. Par contre la parité, la réalisation de manœuvres obstétricales n'avaient aucune influence sur le pronostic du deuxième jumeau. Conclusion Le pronostic du deuxième jumeau est fortement influencé par un délai de naissance de plus de 15 minutes entre les jumeaux, les autres facteurs agissant comme des cofacteurs. PMID:29662606
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Statistical Uncertainty in the Medicare Shared Savings...
U.S. Department of Health & Human Services — According to analysis reported in Statistical Uncertainty in the Medicare Shared Savings Program published in Volume 2, Issue 4 of the Medicare and Medicaid Research...
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Bellinger, Adam S; Elliott, Sean P; Yang, Liu; Wei, John T; Saigal, Christopher S; Smith, Alexandria; Wilt, Timothy J; Strope, Seth A
2012-05-01
Benign prostatic hyperplasia creates significant expenses for the Medicare program. We determined expenditure trends for benign prostatic hyperplasia evaluative testing after urologist consultation and placed these trends in the context of overall Medicare expenditures. Using a 5% national sample of Medicare beneficiaries from 2000 to 2007 we developed a cohort of 40,253 with claims for new visits to urologists for diagnoses consistent with symptomatic benign prostatic hyperplasia. We assessed trends in initial inflation and geography adjusted expenditures within 12 months of diagnosis by evaluative test categories derived from the 2003 American Urological Association guideline on the management of benign prostatic hyperplasia. Using governmental reports on Medicare expenditure trends for benign prostatic hyperplasia we compared expenditures to overall and imaging specific Medicare expenditures. Comparisons were assessed by the Z-test and regression analysis for linear trends, as appropriate. Between 2000 and 2007 inflation adjusted total Medicare expenditures per patient for the initial evaluation of patients with benign prostatic hyperplasia seen by urologists increased from $255.44 to $343.98 (p inflation adjusted expenditures increased for benign prostatic hyperplasia related evaluations. This growth was slower than the overall growth in Medicare expenditures. The increase in BPH related imaging expenditures was restrained compared to that of the Medicare program as a whole. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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75 FR 46833 - 45th Anniversary of Medicare and Medicaid
2010-08-03
... Part III The President Proclamation 8544--45th Anniversary of Medicare and Medicaid #0; #0; #0..., 2010 45th Anniversary of Medicare and Medicaid By the President of the United States of America A Proclamation When President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965, millions...
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Disease management for chronically ill beneficiaries in traditional Medicare.
Bott, David M; Kapp, Mary C; Johnson, Lorraine B; Magno, Linda M
2009-01-01
We summarize the Centers for Medicare and Medicaid Services' (CMS's) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models.
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Liao, Lingwen; Zhuang, Shengli; Wang, Pu; Xu, Yanan; Yan, Nan; Dong, Hongwei; Wang, Chengming; Zhao, Yan; Xia, Nan; Li, Jin; Deng, Haiteng; Pei, Yong; Tian, Shi-Kai; Wu, Zhikun
2017-10-02
Although face-centered cubic (fcc), body-centered cubic (bcc), hexagonal close-packed (hcp), and other structured gold nanoclusters have been reported, it was unclear whether gold nanoclusters with mix-packed (fcc and non-fcc) kernels exist, and the correlation between kernel packing and the properties of gold nanoclusters is unknown. A Au 49 (2,4-DMBT) 27 nanocluster with a shell electron count of 22 has now been been synthesized and structurally resolved by single-crystal X-ray crystallography, which revealed that Au 49 (2,4-DMBT) 27 contains a unique Au 34 kernel consisting of one quasi-fcc-structured Au 21 and one non-fcc-structured Au 13 unit (where 2,4-DMBTH=2,4-dimethylbenzenethiol). Further experiments revealed that the kernel packing greatly influences the electrochemical gap (EG) and the fcc structure has a larger EG than the investigated non-fcc structure. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Stellar configurations in f(R) theories of gravity
International Nuclear Information System (INIS)
Henttunen, K.; Multamaeki, T.; Vilja, I.
2008-01-01
We study stellar configurations and the space-time around them in metric f(R) theories of gravity. In particular, we focus on the polytropic model of the Sun in two specific cases: the f(R)=R-μ 4 /R model and a model with a stabilizing higher order term f(R)=R-μ 4 /R+βR 3 /(3μ 4 ). We show how the stellar configuration in the f(R) theory can, by appropriate initial conditions, be selected to be equal to that described by the Lane-Emden equation and how a simple scaling relation exists between the solutions. We also derive the correct solution analytically near the center of the star in f(R) theory. Previous analytical and numerical results are confirmed, indicating that the space-time around the Sun is incompatible with solar system constraints in the f(R)=R-μ 4 /R model. Numerical work shows that stellar configurations, with a regular metric at the center, lead to γ PPN ≅1/2 outside the star for both models, i.e., the Schwarzschild-de Sitter space-time is not the correct vacuum solution for such configurations. This shows that even when one fine-tunes the initial conditions inside a star such that the mass of the effective scalar in the equivalent scalar-tensor theory is large, γ PPN is still 1/2 outside the star. Conversely, by selecting the Schwarzschild-de Sitter metric as the outside solution, or equivalently setting the mass of the effective scalar to be large outside the star, we find that the stellar configuration is unchanged but the metric is irregular at the center. The possibility of constructing a f(R) theory compatible with the solar system experiments and possible new constraints arising from the radius-mass relation of stellar objects is discussed
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77 FR 26827 - Medicaid Program; Community First Choice Option
2012-05-07
... Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option; Final Rule #0... [CMS-2337-F] RIN 0938-AQ35 Medicaid Program; Community First Choice Option AGENCY: Centers for Medicare... Affordable Care Act, which establishes a new State option to provide home and community-based attendant...
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Cosmological reconstruction of realistic modified F(R) gravities
International Nuclear Information System (INIS)
Nojiri, Shin'ichi; Odintsov, Sergei D.; Saez-Gomez, Diego
2009-01-01
The cosmological reconstruction scheme for modified F(R) gravity is developed in terms of e-folding (or, redshift). It is demonstrated how any FRW cosmology may emerge from specific F(R) theory. The specific examples of well-known cosmological evolution are reconstructed, including ΛCDM cosmology, deceleration with transition to phantom superacceleration era which may develop singularity or be transient. The application of this scheme to viable F(R) gravities unifying inflation with dark energy era is proposed. The additional reconstruction of such models leads to non-leading gravitational correction mainly relevant at the early/late universe and helping to pass the cosmological bounds (if necessary). It is also shown how cosmological reconstruction scheme may be generalized in the presence of scalar field.
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Xu, Peng; Burgess, James F; Cabral, Howard; Soria-Saucedo, Rene; Kazis, Lewis E
2015-03-03
The Centers for Medicare & Medicaid Services (CMS) publishes star ratings on Medicare Advantage (MA) contracts to measure plan quality of care with implications for reimbursement and bonuses. To investigate whether MA contract characteristics are associated with quality of care through the Medicare plan star ratings. Retrospective study of MA star ratings in 2010. Unadjusted and adjusted multivariable linear regression models assessed the relationship between 5-star rating summary scores and plan characteristics. CMS MA contracts nationally. 409 (71%) of a total of 575 MA contracts, covering 10.56 million Medicare beneficiaries (90% of the MA population) in the United States in 2010. The MA quality ratings summary score (stars range from 1 to 5) is a quality measure based on 36 indicators related to processes of care, health outcomes, access to care, and beneficiary satisfaction. Nonprofit, larger, and older MA contracts were more likely to receive higher star ratings. Star ratings ranged from 2 to 5. Nonprofit contracts received an average 0.55 (95% CI, 0.42 to 0.67) higher star ratings than for-profit contracts (P star ratings than for-profit contracts. When comparing health plans in the future, the CMS should give increasing attention to for-profit plans with lower quality ratings and consider developing programs to assist newer and smaller plans in improving their care for Medicare beneficiaries. None.
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Les réseaux d’investissement dans le thermalisme au XIXe siècle en France
Directory of Open Access Journals (Sweden)
Jérôme Penez
2004-03-01
Full Text Available Le XIXe siècle est le siècle de la « fièvre thermale » en France. Pour permettre cet extraordinaire développement, l’argent est nécessaire. La station thermale apparaît comme un eldorado où la fortune est à portée de la main. Cette fortune n’est pourtant pas si facile à obtenir, la gestion thermale est ingrate, et les centaines de villes d’eaux françaises ne peuvent pas toutes obtenir un succès comparable à celui de Vichy ou d’Aix-les-Bains. Le thermalisme français est diversité, diversité dans les réussites, diversité dans les types de gestion (de la gestion étatique à la gestion privée, diversité dans sa fréquentation, diversité dans ses périodes de développement, diversité dans les moyens de son financement. Etudier l’importance ou au contraire la rareté des réseaux d’investissement dans le thermalisme permet de lever une partie du voile de l’histoire encore bien mystérieuse des villes d’eaux françaises.
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2012-04-13
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP) Interagency Center for... (HTS) Assays for the Tox21 Initiative AGENCY: Division of the National Toxicology Program (DNTP...: April 5, 2012. John R. Bucher, Associate Director, National Toxicology Program. [FR Doc. 2012-8942 Filed...
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Use of Medicare's Diabetes Self-Management Training Benefit
Strawbridge, Larisa M.; Lloyd, Jennifer T.; Meadow, Ann; Riley, Gerald F.; Howell, Benjamin L.
2015-01-01
Medicare began reimbursing for outpatient diabetes self-management training (DSMT) in 2000; however, little is known about program utilization. Individuals diagnosed with diabetes in 2010 were identified from a 20% random selection of the Medicare fee-for-service population (N = 110,064). Medicare administrative and claims files were used to…
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Measuring coding intensity in the Medicare Advantage program.
Kronick, Richard; Welch, W Pete
2014-01-01
In 2004, Medicare implemented a system of paying Medicare Advantage (MA) plans that gave them greater incentive than fee-for-service (FFS) providers to report diagnoses. Risk scores for all Medicare beneficiaries 2004-2013 and Medicare Current Beneficiary Survey (MCBS) data, 2006-2011. Change in average risk score for all enrollees and for stayers (beneficiaries who were in either FFS or MA for two consecutive years). Prevalence rates by Hierarchical Condition Category (HCC). Each year the average MA risk score increased faster than the average FFS score. Using the risk adjustment model in place in 2004, the average MA score as a ratio of the average FFS score would have increased from 90% in 2004 to 109% in 2013. Using the model partially implemented in 2014, the ratio would have increased from 88% to 102%. The increase in relative MA scores appears to largely reflect changes in diagnostic coding, not real increases in the morbidity of MA enrollees. In survey-based data for 2006-2011, the MA-FFS ratio of risk scores remained roughly constant at 96%. Intensity of coding varies widely by contract, with some contracts coding very similarly to FFS and others coding much more intensely than the MA average. Underpinning this relative growth in scores is particularly rapid relative growth in a subset of HCCs. Medicare has taken significant steps to mitigate the effects of coding intensity in MA, including implementing a 3.4% coding intensity adjustment in 2010 and revising the risk adjustment model in 2013 and 2014. Given the continuous relative increase in the average MA risk score, further policy changes will likely be necessary.
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Hossegor (Landes, une station au cœur des réseaux de villégiature
Directory of Open Access Journals (Sweden)
Claude Laroche
2012-04-01
Full Text Available La station balnéaire d’Hossegor (Landes a connu son véritable lancement à partir de 1923, alors que le site avait été révélé quelques années auparavant, au tout début du siècle, par les séjours d’un groupe d’écrivains, parmi lesquels J.-H. Rosny jeune (1859-1948, Maxime Leroy (1873-1957 et Paul Margueritte (1860-1918. A partir de cet exemple landais, l’exposé tend à démontrer combien la création d’une station balnéaire, de sa découverte à sa promotion en passant par sa révélation au monde extérieur, doit au jeu des réseaux de tous ordres. Contemplatifs, les premiers occupants d’Hossegor n’auront pourtant de cesse de faire connaître le lieu en s’appuyant pour cela sur un puissant réseau de relations, notamment journalistiques. Actif, le promoteur de la station, Alfred Eluère (1893-1985, ne pourra assurer son succès qu’en utilisant le cercle relationnel très ouvert et très efficace que ses multiples activités – immobilières, mais aussi sportives et politiques – l’auront amené à constituer. Sa venue à Hossegor n’est d’ailleurs rien d’autre que le résultat de circonstances permises par le jeu de tout un tissu de relations au milieu duquel on trouve entre autres Maurice Martin (1861-1941, personnage haut en couleur, journaliste cultivant lui aussi au plus haut point le réseau des connaissances. Une fois la station lancée, la promotion immobilière saura jouer de tous les ressorts offerts par ces différents réseaux pour amener sur place la clientèle : de la propagande journalistique au réseau des agences immobilières en passant par le propre réseau relationnel d’Eluère. Parallèlement, le réseau des architectes sera lui aussi particulièrement actif, que ce soit pour s’attirer la commande ou pour propager la formule régionaliste. En conclusion, à côté de l’histoire officielle des stations balnéaires – une histoire au premier degré que les archives documentent
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2013-09-06
... millions) (2) change (3) Total $3,625 1% Eye and ocular adnexa 1,496 -3 Digestive system 743 8 Nervous... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 405...: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality...
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Les séquelles de brûlures cervicales: aspects épidémiologique, clinique et thérapeutique au Maroc
Rafik, Amine; Chabak, Hakim; Diouri, Mounia; Bahechar, Naïma; Chlihi, Abdessamad
2015-01-01
Les séquelles de brûlures cervicales représentent une entité fréquente des séquelles de brûlure, elles affectent la fonction, l'esthétique et l’état psychologique des patients et peuvent être de traitement difficile. Il s'agit d'une étude rétrospective étalée sur 5 ans de Mars 2009 au Octobre2014, réalisée au centre national des brûlés et de chirurgie plastique au CHU Ibn Rochd Casablanca. Nous avons analysé les caractéristiques épidémiologiqueset cliniques ainsi que les indications et les résultats thérapeutiques chez 300 patients présentant des rétractions cervicales post-brûlure, suivis dans notre formation. Les jeunes femmes étaient le plus souvent touchées (56%). la brûlure thermique par flamme de butane dans le cadre d'accident domestique était l’étiologie la plus fréquente (91%).75% des patients ont été pris en charge dans un délai de 18 mois après avoir présenté une incapacité fonctionnelle. Les brides cervicales modérées et sévères sont les plus fréquentes et représentent respectivement 60% et 16% des cas. Le traitement chirurgical a fait appel aux greffes cutanées dans 67%des cas, aux plasties locales dans 24%des cas et aux lambeaux dans 24% des cas, les résultats sont jugés bons dans 75%des cas et moyens dans 18% des cas, tandis que les cas restants (7%) ont nécessité une reprise chirurgicale. Le traitement des brides cervicales doit être associé à un programme de rééducation adapté, afin d'assurer la pérennité des résultats fonctionnels et esthétiques. PMID:26301017
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Changes in Postacute Care in the Medicare Shared Savings Program.
McWilliams, J Michael; Gilstrap, Lauren G; Stevenson, David G; Chernew, Michael E; Huskamp, Haiden A; Grabowski, David C
2017-04-01
Postacute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit postacute care spending has implications for the importance and design of other payment models that include postacute care. To assess changes in postacute care spending and use of postacute care associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred. With the use of fee-for-service Medicare claims from a random 20% sample of beneficiaries with 25 544 650 patient-years, 8 395 426 hospital admissions, and 1 595 352 stays in skilled nursing facilities (SNFs) from January 1, 2009, to December 31, 2014, difference-in-difference comparisons of beneficiaries served by ACOs with beneficiaries served by local non-ACO health care professionals (control group) were performed before vs after entry into the MSSP. Differential changes were estimated separately for cohorts of ACOs entering the MSSP in 2012, 2013, and 2014. Patient attribution to an ACO in the MSSP. Postacute spending, discharge to a facility, length of SNF stays, readmissions, use of highly rated SNFs, and mortality, adjusted for patient characteristics. For the 2012 cohort of 114 ACOs, participation in the MSSP was associated with an overall reduction in postacute spending (differential change in 2014 for ACOs vs control group, -$106 per beneficiary [95% CI, -$176 to -$35], or -9.0% of the precontract unadjusted mean of $1172; P = .003) that was driven by differential reductions in acute inpatient care, discharges to facilities rather than home (-0.6 percentage points [95% CI, -1.1 to 0.0], or -2.7% of the unadjusted precontract mean of 22.6%; P = .03), and length of SNF stays (-0.60 days per stay [95% CI, -0.99 to -0.22], or -2.2% of the precontract unadjusted mean of 27.07 days; P = .002). Reductions in use of SNFs and length of stay were largely due to within-hospital or
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2010-04-01
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false General. 10.1 Section 10.1... TREASURY LIQUORS COMMERCIAL BRIBERY Scope of Regulations § 10.1 General. The regulations in this part, issued pursuant to section 105 of the Federal Alcohol Administration Act (27 U.S.C. 205), specify...
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Harewood, Gavin C; Alsaffar, Omar
2015-03-01
The Centers for Medicare and Medicaid Services recently published data on Medicare payments to physicians for 2012. We investigated regional variations in payments to gastroenterologists and evaluated whether payments correlated with the number of Medicare patients in each state. We found that the mean payment per gastroenterologist in each state ranged from $35,293 in Minnesota to $175,028 in Mississippi. Adjusted per-physician payments ranged from $11 per patient in Hawaii to $62 per patient in Washington, DC. There was no correlation between the mean per-physician payment and the mean number of Medicare patients per physician (r = 0.09), there also was no correlation between the mean per-physician payment and the overall mean per-capita health care costs for each state (r = -0.22). There was a 5.6-fold difference between the states with the lowest and highest adjusted Medicare payments to gastroenterologists. Therefore, the Centers for Medicare and Medicaid Services payments do not appear to be associated with the volume of Medicare beneficiaries or overall per-capita health care costs for each state. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
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Cosmology of Horava-Lifshitz f(R) gravity
International Nuclear Information System (INIS)
Chakrabarti, Sayan K.; Sen, Anjan A.
2011-08-01
We discuss the cosmology of recently proposed Horava-Lifshitz f(R) gravity. In particular, we derive the modified Hubble equation that reduces to the standard HL gravity case in appropriate limit. We show how the bounce solutions in this theory are modified due to nonlinear effect of f(R) gravity. In addition we find that the solutions exist when the Universe can make turn around for large scale-factor. Therefore, in principle, the Universe in this set-up can show cyclic behavior. (orig.)
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Cosmology of Horava-Lifshitz f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Chakrabarti, Sayan K. [Univ. Tecnica de Lisboa (Portugal). Inst. Superior Tecnico; Dutta, Koushik [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Sen, Anjan A. [Centre of Theoretical Physics, Jamia Millia Islamia, New Dehli (India)
2011-08-15
We discuss the cosmology of recently proposed Horava-Lifshitz f(R) gravity. In particular, we derive the modified Hubble equation that reduces to the standard HL gravity case in appropriate limit. We show how the bounce solutions in this theory are modified due to nonlinear effect of f(R) gravity. In addition we find that the solutions exist when the Universe can make turn around for large scale-factor. Therefore, in principle, the Universe in this set-up can show cyclic behavior. (orig.)
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Reforming funding for chronic illness: Medicare-CDM.
Swerissen, Hal; Taylor, Michael J
2008-02-01
Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.
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Galaxy-galaxy weak gravitational lensing in f(R) gravity
Li, Baojiu; Shirasaki, Masato
2018-03-01
We present an analysis of galaxy-galaxy weak gravitational lensing (GGL) in chameleon f(R) gravity - a leading candidate of non-standard gravity models. For the analysis, we have created mock galaxy catalogues based on dark matter haloes from two sets of numerical simulations, using a halo occupation distribution (HOD) prescription which allows a redshift dependence of galaxy number density. To make a fairer comparison between the f(R) and Λ cold dark matter (ΛCDM) models, their HOD parameters are tuned so that the galaxy two-point correlation functions in real space (and therefore the projected two-point correlation functions) match. While the f(R) model predicts an enhancement of the convergence power spectrum by up to ˜ 30 per cent compared to the standard ΛCDM model with the same parameters, the maximum enhancement of GGL is only half as large and less than 5 per cent on separations above ˜1-2 h-1 Mpc, because the latter is a cross-correlation of shear (or matter, which is more strongly affected by modified gravity) and galaxy (which is weakly affected given the good match between galaxy autocorrelations in the two models) fields. We also study the possibility of reconstructing the matter power spectrum by combination of GGL and galaxy clustering in f(R) gravity. We find that the galaxy-matter cross-correlation coefficient remains at unity down to ˜2-3 h-1 Mpc at relevant redshifts even in f(R) gravity, indicating joint analysis of GGL and galaxy clustering can be a powerful probe of matter density fluctuations in chameleon gravity. The scale dependence of the model differences in their predictions of GGL can potentially allows us to break the degeneracy between f(R) gravity and other cosmological parameters such as Ωm and σ8.
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2013-04-29
.... ACTION: Proposed rule. SUMMARY: This proposed rule would revise the Incentive Reward Program provisions... significant of these revisions include: changing the Incentive Reward Program potential reward amount for... related to the Incentive Reward Program. Frank Whelan, (410) 786-1302, for issues related to provider...
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Chung, Sukyung; Lesser, Lenard I; Lauderdale, Diane S; Johns, Nicole E; Palaniappan, Latha P; Luft, Harold S
2015-01-01
Under the Affordable Care Act (ACA), Medicare coverage expanded in 2011 to fully cover annual preventive care visits. We assessed the impact of coverage expansion, using 2007-13 data from primary care patients of Medicare-eligible age at the Palo Alto Medical Foundation (204,388 patient-years), which serves people in four counties near San Francisco, California. We compared trends in preventive visits and recommended preventive services among Medicare fee-for-service and Medicare health maintenance organization (HMO) patients as well as non-Medicare patients ages 65-75 who were covered by private fee-for-service and private HMO plans. Among Medicare fee-for-service patients, the annual use of preventive visits rose from 1.4 percent before the implementation of the ACA to 27.5 percent afterward. This increase was significantly larger than was seen for patients in the other insurance groups. Nevertheless, rates of annual preventive care visit use among Medicare fee-for-service patients remained 10-20 percentage points lower than was the case for people with private coverage (43-44 percent) or those in a Medicare HMO (53 percent). ACA policy changes led to increased preventive service use by Medicare fee-for-service beneficiaries, which suggests that Medicare coverage expansion is an effective way to increase seniors' use of preventive services. Project HOPE—The People-to-People Health Foundation, Inc.
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The Impact of Hospital-Acquired Conditions on Medicare..
U.S. Department of Health & Human Services — According to findings reported in The Impact of Hospital-Acquired Conditions on Medicare Program Payments, published in Volume 4, Issue 4 of the Medicare and...
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Prise en charge de l'hematurie au chu Sylvanus Olympio de Lome ...
African Journals Online (AJOL)
Une transfusion sanguine avait été réalisée dans 64,8% des cas et nous avions enregistré 4 cas de décès. Conclusion : Les hématuries sont relativement fréquentes au Togo et souvent de causes tumorales. Elles nécessitent une prise en charge précoce pour un meilleur pronostic. Mots clés : hématurie, épidémiologie, ...
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2011-04-07
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1357-N] RIN... document, demonstrates that this notice is consistent with the regulatory philosophy and principles.... Kathleen Sebelius, Secretary, Department of Health and Human Services. Addendum This addendum includes...
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Late-time cosmological approach in mimetic f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Baffou, E.H. [Institut de Mathematiques et de Sciences Physiques (IMSP), Porto-Novo (Benin); Houndjo, M.J.S. [Institut de Mathematiques et de Sciences Physiques (IMSP), Porto-Novo (Benin); Faculte des Sciences et Techniques de Natitingou, Natitingou (Benin); Hamani-Daouda, M. [Universite de Niamey, Departement de Physique, Niamey (Niger); Alvarenga, F.G. [Universidade Federal do Espirito Santo, Departamento de Engenharia e Ciencias Naturais, CEUNES, Sao Mateus, ES (Brazil)
2017-10-15
In this paper, we investigate the late-time cosmic acceleration in mimetic f(R, T) gravity with the Lagrange multiplier and potential in a Universe containing, besides radiation and dark energy, a self-interacting (collisional) matter. We obtain through the modified Friedmann equations the main equation that can describe the cosmological evolution. Then, with several models from Q(z) and the well-known particular model f(R, T), we perform an analysis of the late-time evolution. We examine the behavior of the Hubble parameter, the dark energy equation of state and the total effective equation of state and in each case we compare the resulting picture with the non-collisional matter (assumed as dust) and also with the collisional matter in mimetic f(R, T) gravity. The results obtained are in good agreement with the observational data and show that in the presence of the collisional matter the dark energy oscillations in mimetic f(R, T) gravity can be damped. (orig.)
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42 CFR 460.90 - PACE benefits under Medicare and Medicaid.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false PACE benefits under Medicare and Medicaid. 460.90 Section 460.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...
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Generation of spherically symmetric metrics in f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Amirabi, Z.; Halilsoy, M.; Mazharimousavi, S.H. [Eastern Mediterranean University, Department of Physics, Gazimagusa (Turkey)
2016-06-15
In D-dimensional spherically symmetric f(R) gravity there are three unknown functions to be determined from the fourth order differential equations. It is shown that the system remarkably may be integrated to relate two functions through the third one to provide a reduction to second order equations accompanied with a large class of potential solutions. The third function, which acts as the generator of the process, is F(R) = (df(R))/(dR). We recall that our generating function has been employed as a scalar field with an accompanying self-interacting potential previously, which is entirely different from our approach. Reduction of f(R) theory into a system of equations seems to be efficient enough to generate a solution corresponding to each generating function. As particular examples, besides the known ones, we obtain new black hole solutions in any dimension D. We further extend our analysis to cover non-zero energy-momentum tensors. Global monopole and Maxwell sources are given as examples. (orig.)
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PACE and the Medicare+Choice risk-adjusted payment model.
Temkin-Greener, H; Meiners, M R; Gruenberg, L
2001-01-01
This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.
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Rational approximations of f(R) cosmography through Pad'e polynomials
Capozziello, Salvatore; D'Agostino, Rocco; Luongo, Orlando
2018-05-01
We consider high-redshift f(R) cosmography adopting the technique of polynomial reconstruction. In lieu of considering Taylor treatments, which turn out to be non-predictive as soon as z>1, we take into account the Pad&apose rational approximations which consist in performing expansions converging at high redshift domains. Particularly, our strategy is to reconstruct f(z) functions first, assuming the Ricci scalar to be invertible with respect to the redshift z. Having the so-obtained f(z) functions, we invert them and we easily obtain the corresponding f(R) terms. We minimize error propagation, assuming no errors upon redshift data. The treatment we follow naturally leads to evaluating curvature pressure, density and equation of state, characterizing the universe evolution at redshift much higher than standard cosmographic approaches. We therefore match these outcomes with small redshift constraints got by framing the f(R) cosmology through Taylor series around 0zsimeq . This gives rise to a calibration procedure with small redshift that enables the definitions of polynomial approximations up to zsimeq 10. Last but not least, we show discrepancies with the standard cosmological model which go towards an extension of the ΛCDM paradigm, indicating an effective dark energy term evolving in time. We finally describe the evolution of our effective dark energy term by means of basic techniques of data mining.
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F(R Gravity’s Rainbow and Its Einstein Counterpart
Directory of Open Access Journals (Sweden)
S. H. Hendi
2016-01-01
Full Text Available Motivated by UV completion of general relativity with a modification of a geometry at high energy scale, it is expected to have an energy dependent geometry. In this paper, we introduce charged black hole solutions with power Maxwell invariant source in the context of gravity’s rainbow. In addition, we investigate two classes of F(R gravity’s rainbow solutions. At first, we study energy dependent F(R gravity without energy-momentum tensor, and then we obtain F(R gravity’s rainbow in the presence of conformally invariant Maxwell source. We study geometrical properties of the mentioned solutions and compare their results. We also give some related comments regarding thermodynamical behavior of the obtained solutions and discuss thermal stability of the solutions.
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Exploring the liminality: properties of haloes and subhaloes in borderline f(R) gravity
Shi, Difu; Li, Baojiu; Han, Jiaxin; Gao, Liang; Hellwing, Wojciech A.
2015-09-01
We investigate the properties of dark matter haloes and subhaloes in an f(R) gravity model with |fR0| = 10-6, using a very-high-resolution N-body simulation. The model is a borderline between being cosmologically interesting and yet still consistent with current data. We find that the halo mass function in this model has a maximum 20 per cent enhancement compared with the Λ-cold-dark-matter (ΛCDM) predictions between z = 1 and 0. Because of the chameleon mechanism which screens the deviation from standard gravity in dense environments, haloes more massive than 1013 h-1 M⊙ in this f(R) model have very similar properties to haloes of similar mass in ΛCDM, while less massive haloes, such as that of the Milky Way, can have steeper inner density profiles and higher velocity dispersions due to their weaker screening. The halo concentration is remarkably enhanced for low-mass haloes in this model due to a deepening of the total gravitational potential. Contrary to the naive expectation, the halo formation time zf is later for low-mass haloes in this model, a consequence of these haloes growing faster than their counterparts in ΛCDM at late times and the definition of zf. Subhaloes, especially those less massive than 1011 h-1 M⊙, are substantially more abundant in this f(R) model for host haloes less massive than 1013 h-1 M⊙. We discuss the implications of these results for the Milky Way satellite abundance problem. Although the overall halo and subhalo properties in this borderline f(R) model are close to their ΛCDM predictions, our results suggest that studies of the Local Group and astrophysical systems, aided by high-resolution simulations, can be valuable for further tests of it.
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Trends in laboratory test volumes for Medicare Part B reimbursements, 2000-2010.
Shahangian, Shahram; Alspach, Todd D; Astles, J Rex; Yesupriya, Ajay; Dettwyler, William K
2014-02-01
Changes in reimbursements for clinical laboratory testing may help us assess the effect of various variables, such as testing recommendations, market forces, changes in testing technology, and changes in clinical or laboratory practices, and provide information that can influence health care and public health policy decisions. To date, however, there has been no report, to our knowledge, of longitudinal trends in national laboratory test use. To evaluate Medicare Part B-reimbursed volumes of selected laboratory tests per 10,000 enrollees from 2000 through 2010. Laboratory test reimbursement volumes per 10,000 enrollees in Medicare Part B were obtained from the Centers for Medicare & Medicaid Services (Baltimore, Maryland). The ratio of the most recent (2010) reimbursed test volume per 10,000 Medicare enrollees, divided by the oldest data (usually 2000) during this decade, called the volume ratio, was used to measure trends in test reimbursement. Laboratory tests with a reimbursement claim frequency of at least 10 per 10,000 Medicare enrollees in 2010 were selected, provided there was more than a 50% change in test reimbursement volume during the 2000-2010 decade. We combined the reimbursed test volumes for the few tests that were listed under more than one code in the Current Procedural Terminology (American Medical Association, Chicago, Illinois). A 2-sided Poisson regression, adjusted for potential overdispersion, was used to determine P values for the trend; trends were considered significant at P reimbursement volumes were electrolytes, digoxin, carbamazepine, phenytoin, and lithium, with volume ratios ranging from 0.27 to 0.64 (P reimbursement volumes were meprobamate, opiates, methadone, phencyclidine, amphetamines, cocaine, and vitamin D, with volume ratios ranging from 83 to 1510 (P reimbursement volumes increased for most of the selected tests, other tests exhibited statistically significant downward trends in annual reimbursement volumes. The observed
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75 FR 69037 - Medicaid Program; Recovery Audit Contractors
2010-11-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 455 [CMS-6034-P] RIN 0938-AQ19 Medicaid Program; Recovery Audit Contractors AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This proposed rule would provide guidance to...
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6 CFR 27.235 - Alternative security program.
2010-01-01
... 6 Domestic Security 1 2010-01-01 2010-01-01 false Alternative security program. 27.235 Section 27.235 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.235 Alternative security program. (a) Covered...
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2010-10-22
.... Palliative care in an LTC facility involves addressing physical, intellectual, emotional, social, and... Disability, Aging and Long-Term Care Policy and the Urban Institute; ``Synthesis and Analysis of Medicare..., mental, social, or emotional status; clinical complications that suggested a need to alter the care plan...
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2010-09-27
... in which the hospital is located: War Memorial Hospital (Medicare provider number 51-1309), of..., Virginia Beach, VA 23453. The Hospital's Designated OPO is: Center for Organ Recovery and Education, RIDC...
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The holographic bound in the scalar-tensor and f(R) gravities
International Nuclear Information System (INIS)
Firouzjaee, J.T.
2013-01-01
The holographic bound has been extended to the different theory of gravities such as scalar-tensor gravity and f(R) gravity according to the Noether charge definition of the entropy for a black hole surface. We have introduced some popular examples of the flat FRW cosmology in order to investigate holographic bound in scalar-tensor and f(R) gravity. Using the holographic bound, we put an additional constraint on scalar-tensor gravity and the f(R) gravity parameters. We also discuss the transformation from Jordan frame to Einstein frame. (orig.)
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Vertical integration strategies: revenue effects in hospital and Medicare markets.
Cody, M
1996-01-01
The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.
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... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Sign Up / Change Plans ...
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De nouveaux mécanismes de résilience : rapport interactif au sujet ...
International Development Research Centre (IDRC) Digital Library (Canada)
13 nov. 2012 ... On y trouve de nombreux liens vers des ressources relatives au programme et aux projets, ainsi que des pistes pour explorer plus en profondeur les résultats des recherches scientifiques. Lire le rapport De nouveaux mécanismes de résilience (PDF, 2,98 Mo). Une version récente d'Adobe Reader est ...
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2015-08-17
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the
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Chafiki, N.; Fassi Fihri, J.; Boukind, E.H.
2007-01-01
Summary Il s'agit d'une étude épidémiologique des séquelles de brûlures à propos de 100 cas colligés au service de chirurgie réparatrice et de brûlés du centre hospitalier universitaire Ibn Rochd (Casablanca). Les adultes représentent 55% de la population étudiée, l'âge moyen global est de 20 ans. Le sexe féminin est le plus touché avec 61% des cas. Les brûlures survenues à domicile sont les plus fréquentes avec 80%. L'agent causal le plus incriminé est la petite bouteille de butane avec 44,4%. Plus de la moitié de la population brûlée (55%) sont accueillis initialement au niveau d'hôpitaux régionaux. Le délai de cicatrisation moyen de 7 mois et 11 jours et par conséquent les séquelles mineures (dyschromie dans 90% des cas et prurit dans 49% des cas) et majeures (rétractions dans 86% et l'hypertrophie dans 51%) sont fréquentes. La répartition globale des séquelles montre une prédominance du segment cervicocéphalique avec 89% des cas et des membres supérieurs dans 82% des cas. Les différents aspects anatomocliniques essentiels ont été décrits au niveau de chaque segment corporel. Nos résultats ont été comparés aux données de la littérature, ce qui nous amène à considérer qu'une large campagne de prévention couplée à une meilleure prise en charge initiale, précoce, bien conduite et multidisciplinaire permet non seulement de réduire le nombre de séquelles mais aussi de diminuer leur sévérité. PMID:21991060
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Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B
2015-06-01
To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.
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Veilleux, Jean Wright
2012-01-01
This Article argues that the current approach of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to enforcement of the Ethics in Patient Referrals Act (the "Stark Law") is unnecessarily punitive and discourages health-care providers from self-disclosing even very minor violations of the Stark Law. This Article suggests a number of specific changes to encourage provider self-disclosure and proposes that CMS create a demonstration project under the authority of the Patient Protection and Affordable Care Act to test the reforms. A demonstration project provides the perfect vehicle to prove that increased self-disclosure protocols for the Stark Law can decrease the government's costs of enforcement, improve program integrity, and encourage providers to deal responsibly with the inevitable minor lapses in compliance that arise in such an enormous government program as Medicare.
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76 FR 31338 - Agency Information Collection Activities: Proposed Collection; Comment Request
2011-05-31
... Medicare program and Medicare plans design and monitor patient-centered quality improvement initiatives... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier CMS-10147, CMS-10396 and CMS-R-246] Agency Information Collection Activities: Proposed Collection...
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Le developpement de Limacella glioderma (Fr.) R. Maire
Reijnders, A.F.M.
1979-01-01
A comparison of the development of Limacella guttata (Fr.) Konrad & Maublanc with that of L. glioderma (Fr.) R. Maire shows clearly that the latter is of a more primitive type. This conclusion is based on the following observations: a. Limacella guttata has a pileocarpic development: the first
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Semilla, April P; Chen, Fang; Dall, Timothy M
2015-07-01
Medicare Part D is a prescription drug program that provides seniors and disabled individuals enrolled in Medicare with outpatient drug coverage benefits. Part D has been shown to increase access to medicines and improve medication adherence; however, the effect of Part D on health outcomes has not yet been extensively studied. In this study, we used a published and validated Markov-based microsimulation model to quantify the relationships among medication use, disease incidence and severity, and mortality. Based on the simulation results, we estimate that since the implementation of Part D in 2006, nearly 200,000 Medicare beneficiaries have lived at least 1 year longer. Reductions in mortality have occurred because of fewer deaths associated with medication-sensitive conditions such as diabetes, congestive heart failure, stroke, and myocardial infarction. Improved access to medication through Medicare Part D helps patients improve blood pressure, cholesterol, and blood glucose levels, which in turn can prevent or delay the onset of disease and the incidence of adverse health events, thus reducing mortality.
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Le rôle des chefs traditionnels au Ghana : un modèle inspirant ...
International Development Research Centre (IDRC) Digital Library (Canada)
8 févr. 2011 ... Avec ses partenaires du Sud, avec aussi le soutien du Centre de recherches pour le développement international ( CRDI ), organisme canadien, Ray a étudié le rôle des chefs traditionnels au Ghana dans la lutte contre le VIH et le sida. Les collectivités politiques antérieures au colonialisme sont une ...
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Au-delà du plan. La topologie urbaine des livreurs
Directory of Open Access Journals (Sweden)
Céline Cholez
2011-03-01
Full Text Available Nombreuses sont les activités professionnelles au sein desquelles s’orchestrent des « défis » classant les professionnels en fonction de leur degré d’expertise. Parmi les livreurs, une joute fréquente consiste à soumettre à un collègue un nom et un numéro de rue au hasard pour qu’il indique le plus rapidement possible le plus court chemin pour y parvenir. Ces jeux professionnels révèlent un aspect essentiel de l’engagement dans l’activité de travail : l’ancrage dans un espace approprié comme territoire, le secteur de tournée. Les livreurs maîtrisent en effet leurs tâches grâce à leur connaissance des zones géographiques qu’ils sillonnent quotidiennement.
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2013-12-10
... MFP Multi-Factor Productivity MGMA Medical Group Management Association MIEA-TRHCA The Medicare... 69624), we revised the methodology for calculating direct PE RVUs from the top- down to the bottom-up... Based on RVUs To calculate the payment for each physicians' service, the components of the fee schedule...
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Kinda, Georges; Millogo, Georges Rosario Christian; Koueta, Fla; Dao, Lassina; Talbousouma, Sollimy; Cissé, Hassane; Djiguimdé, Aristide; Yé, Diarra; Sorgho, Claudine Lougue
2015-01-01
Notre travail avait pour objectif d’étudier les aspects épidémiologiques et écho-cardiographiques des cardiopathies congénitales au CHUP-CDG afin d'y faire l’état des lieux. Pour se faire, nous avons mené sur une période de 27 mois d'aout 2009 à mai 2010 et d'octobre 2011 à décembre 2011, une étude rétrospective des comptes rendus d’échocardiographies Doppler des patients admis dans le service d'imagerie médicale. Nous avons utilisé une sonde cardiaque de 5MHz sur appareil Aloka Prosound 4000 Plus. Durant la période d’étude, 380 examens écho-cardiographiques ont été réalisés et ont permis de mettre en évidence 109 cas de cardiopathies congénitales avec 138 entités nosologiques différentes. Les cardiopathies congénitales représentaient 0,98% des 11169 entrées. Les souffles étaient au premier rang des motifs de demande de l’échographie Doppler cardiaque (121 cas sur 380) soit 39,53%. Les CIV étaient au premier plan des cardiopathies congénitales (28,26%), suivies des CIA (23,19%), des sténoses pulmonaires (19,57%), des Tétralogie de Fallot (9,42%). Dans leur forme isolée, les CIA étaient les plus fréquentes avec 21,95% des cas, suivies des CIV avec 20,73%. Sur 138 cas de cardiopathies congénitales (chez 109 enfants), 53 cas ont été observés chez des enfants de sexe féminin et 56 cas chez des enfants de sexe masculin soit un sexe ration de 1,1. La tranche d’âge présentant une fréquence élevée de cardiopathie congénitale est celle de 1mois- 30 mois avec 55% des cas. Les cardiopathies congénitales de l'enfant sont une réalité en Afrique, leurs fréquences dans toutes les séries rapportées sont certainement sous estimées en raison de l'inaccessibilité de l’échocardiographie doppler. PMID:26090039
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77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010
2012-03-23
... Medicare and Medicaid Services 42 CFR Parts 431, 435 and 457 Medicaid Program; Eligibility Changes Under... for Medicare & Medicaid Services 42 CFR Parts 431, 435, and 457 [CMS-2349-F] RIN 0938-AQ62 Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010 AGENCY: Centers for Medicare & Medicaid...
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Université de Genève | Séminaire de physique corpusculaire | 27 November
2013-01-01
Dans le cadre de la procédure de nomination d'un-e professeur-e associé-e ou assistant-e au DPNC, le mercredi 27 novembre 2013 Auditoire 1S059 - Sciences III - Boulevard d’Yvoy 9h – 10h Colloque du Dr Tobias Golling "Life after Higgs" 10h – 11h Colloque Lucia Masetti "Searches for New Physics with top Quarks: a two-way approach" 11h – 12h Colloque du Dr Krisztian Peters "Higgs Physics at the Energy Frontier" Les résumés des différents colloques sont disponibles ici. Les membres du corps enseignant et les étudiants sont invités aux colloques et peuvent faire part de leurs commentaires au Doyen de la Faculté.
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78 FR 6272 - Rules Relating to Additional Medicare Tax; Correction
2013-01-30
... Rules Relating to Additional Medicare Tax; Correction AGENCY: Internal Revenue Service (IRS), Treasury... regulations are relating to Additional Hospital Insurance Tax on income above threshold amounts (``Additional Medicare Tax''), as added by the Affordable Care Act. Specifically, these proposed regulations provide...
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Anomalous decrease of resistance at 250 K in ultrathin Au-Nb film on single-crystal silicon
International Nuclear Information System (INIS)
Yamamoto, H.; Kawashima, T.; Tanaka, M.
1986-01-01
Ultrathin Au-Nb films as thin as 0.2 about 10 nm were deposited on clean surfaces of single-crystal silicon in order to investigate interfacial excitonic superconductivity. The samples were classified into two types, Nb-Au/Si and Au-Nb-Au/Si. In the latter case, the secondary Au film was deposited on the former sample cooled by liquid nitrogen. In the Nb-Au/ Si type of sample, a sheet resistance, R /SUB s/ at room temperature abruptly increased from 10 3 Ωsq -1 order to about 10 5 Ωsq -1 in several days a few months after the sample preparation. Then the sample showed an anomalous decrease of R /SUB s/ at about 250 K and an approximately null resistance at lower temperatures. This phenomenon was not so stable and was observed only for a few days. The Au-Nb-Au/Si type of sample showed low R /SUB s/ (10 2 about 10 3 Ωsq -1 ) at room temperature. A decrease and disappearance of R /SUB s/ were also observed at about 240 K in the sample with comparatively good reproducibility. These phenomena are discussed qualitatively, based on the excitonic superconductive model for an interface of metal/semiconductor by Allender, Bray, and Bardeen
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2017-08-14
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey
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2011-06-17
... Community Mental Health Centers; Proposed Rule #0;#0;Federal Register / Vol. 76 , No. 117 / Friday June 17... (CoPs) for Community Mental Health Centers AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... participation (CoPs) that community mental health centers (CMHCs) would have to meet in order to participate in...
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2013-07-19
... Index MFP Multi-Factor Productivity MIEA-TRHCA The Medicare Improvements and Extension Act, Division B... calculating direct PE RVUs from the top- down to the bottom-up methodology beginning in CY 2007. We adopted a... $20 million. 2. Calculation of Payments Based on RVUs To calculate the payment for each physicians...
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2010-12-27
... Director.) Specific conflict of interest rules that should apply to RACs for the Medicare Parts C and D... Remuneration (DIR). The DIR information reported by plans includes rebates paid by pharmaceutical manufacturers, as well as other remuneration received by the plan that has the effect of reducing their drug costs...
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Energy Technology Data Exchange (ETDEWEB)
Ma, Shuzhen; Cai, Qian; Lu, Kailing; Liao, Fan, E-mail: fliao@suda.edu.cn; Shao, Mingwang, E-mail: mwshao@suda.edu.cn [Institute of Functional Nano & Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices & Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University (China)
2016-01-15
The bi-functional Au/FeS (Au/Co{sub 3}O{sub 4}) composite was fabricated by in situ reducing Au nanoparticles onto the surface of FeS (Co{sub 3}O{sub 4}). The as-prepared FeS possessed a multi-structure composed of plenty of nanoplates, which were coated by Au nanoparticles with an average size of ∼47.5 nm. While the Co{sub 3}O{sub 4} showed a thin hexagonal sheet containing Au nanoparticles on its surface with an average size of ∼79.0 nm. Both the as-prepared Au/FeS and Au/Co{sub 3}O{sub 4} composites exhibited excellent SERS performance, capable of enhancing the Raman signals of R6G molecules with the enhancement factor up to 1.81 × 10{sup 6} and 7.60 × 10{sup 4}, respectively. Moreover, Au/FeS (Au/Co{sub 3}O{sub 4}) composite also has been verified to have intrinsic peroxidase-like activity, which could decompose H{sub 2}O{sub 2} into hydroxyl radicals and then degrade organic pollutants into small molecules. Therefore, SERS can be used to real-time and in situ monitoring the degradation process of R6G molecules, employing the Au/FeS (Au/Co{sub 3}O{sub 4}) composite both as SERS substrate and catalyst. Graphical abstract: SERS was used to real-time and in situ monitoring the degradation of R6G, employing the Au/FeS and Au/Co{sub 3}O{sub 4} composites both as SERS substrates and catalysts.
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Propagating Degrees of Freedom in f(R Gravity
Directory of Open Access Journals (Sweden)
Yun Soo Myung
2016-01-01
Full Text Available We have computed the number of polarization modes of gravitational waves propagating in the Minkowski background in f(R gravity. These are three of two from transverse-traceless tensor modes and one from a massive trace mode, which confirms the results found in the literature. There is no massless breathing mode and the massive trace mode corresponds to the Ricci scalar. A newly defined metric tensor in f(R gravity satisfies the transverse-traceless (TT condition as well as the TT wave equation.
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The coincidence problem in holographic f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Bisabr, Yousef, E-mail: y-bisabr@srttu.edu [Department of Physics, Shahid Rajaee Teacher Training University, Lavizan, Tehran 16788 (Iran, Islamic Republic of)
2011-09-15
It is well known that f(R) gravity models formulated in the Einstein conformal frame are equivalent to Einstein gravity together with a minimally coupled scalar field. In this case, the scalar field couples with the matter sector and the coupling term is given by the conformal factor. We apply the holographic principle to such interacting models. In a spatially flat universe, we show that the Einstein frame representation of f(R) models leads to a constant ratio of energy densities of dark matter to dark energy.
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Directory of Open Access Journals (Sweden)
Fang Chen
Full Text Available Type 2 diabetes and cardiovascular disease impose substantial clinical and economic burdens for seniors (age 65 and above and the Medicare program. Intensive Behavioral Counseling (IBC interventions like the National Diabetes Prevention Program (NDPP, have demonstrated effectiveness in reducing excess body weight and lowering or delaying morbidity onset. This paper estimated the potential health implications and medical savings of a digital version of IBC modeled after the NDPP.Participants in this digital IBC intervention, the Omada program, include 1,121 overweight or obese seniors with additional risk factors for diabetes or heart disease. Weight changes were objectively measured via participant use of a networked weight scale. Participants averaged 6.8% reduction in body weight within 26 weeks, and 89% of participants completed 9 or more of the 16 core phase lessons. We used a Markov-based microsimulation model to simulate the impact of weight loss on future health states and medical expenditures over 10 years. Cumulative per capita medical expenditure savings over 3, 5 and 10 years ranged from $1,720 to 1,770 (3 years, $3,840 to $4,240 (5 years and $11,550 to $14,200 (10 years. The range reflects assumptions of weight re-gain similar to that seen in the DPP clinical trial (lower bound or minimal weight re-gain aligned with age-adjusted national averages (upper bound. The estimated net economic benefit after IBC costs is $10,250 to $12,840 cumulative over 10 years. Simulation outcomes suggest reduced incidence of diabetes by 27-41% for participants with prediabetes, and stroke by approximately 15% over 5 years.A digital, remotely-delivered IBC program can help seniors at risk for diabetes and cardiovascular disease achieve significant weight loss, reduces risk for diabetes and cardiovascular disease, and achieve meaningful medical cost savings. These findings affirm recommendations for IBC coverage by the U.S. Preventive Services Task Force.
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L'Asie du Sud peut-elle éliminer les obstacles au travail rémunéré ...
International Development Research Centre (IDRC) Digital Library (Canada)
22 janv. 2018 ... Il est donc prioritaire d'élaborer et de mettre en place des politiques ... à la vie économique et qui reconnaissent et valorisent les soins non ... par semaine aux activités professionnelles et non professionnelles ... par le CRDI au Bangladesh a révélé qu'une combinaison de formation, ... Tous droits réservés.
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Plenary III–04: Responses to Drug Costs: Year Three of the Medicare Part D Program
Fung, Vicki; Reed, Mary; Hsu, John
2010-01-01
Background/Aims: Many Medicare Part D beneficiaries face substantial prescription drug cost-sharing. In the first year of the program, many beneficiaries reported substantial drug use changes in response to the coverage gap. In response, an increasing number of plans offer generic drug coverage during the gap. We compared responses to Part D costs among beneficiaries with generic-only gap coverage and full gap coverage in 2008, the third year of the Part D program.
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Directory of Open Access Journals (Sweden)
Moussa Diallo
2017-11-01
Full Text Available Background: The purpose of this study was to specify the epidemiological and clinical characteristics of pemphigus in the Department of Dermatology of the University Hospital of Dakar. Patients and Methodology: All medical records of patients seen for pemphigus in our department over a 11-year period were analyzed retrospectively. Results: We collected 105 cases of pemphigus, corresponding to a frequency of 10 cases/year and a hospital prevalence of 2.7%. Thus, pemphigus held the second rank of blistering autoimmune bullous diseases after bullous pemphigoid. The mean age of patients was 47.62 years and the age group [40-59 years] was predominantly affected (28 cases; 45 %. There were 41 femeles and 21 men (F/M ratio: 2. We did not find an endemic focus in our country. Clinical forms were dominated by pemphigus foliaceus (30 cases; 48.5 %, followed by pemphigus vulguaris (19 cases; 30.6 % and finally by pemphigus erythematosus (13 cases; 21%. In 16 cases (25 %, the pemphigus had begun after the consumption of a traditional medicinal plant (8 cases. An associated toxidermia was found in12 cases. Pruritus was present in 43 patients (69.35%. Discussion: In Senegal, pemphigus are common diseases, but without however an endemic focuc. They occur in young women, with a predominance of superficial forms, especially pemphigus foliaceus. The presence of pruritus and associated toxidermia to traditional medicinal plants are common. RÉSUMÉ Introduction: L’objectif de cette étude était de préciser les aspects épidémiologiques et cliniques des pemphigus au CHU de Dakar. Patients et Méthodes: Tous les dossiers des malades admis pour pemphigus ont été analysé de façon rétrospective sur une période de 11 ans. Résultats: Nous avons colligé 105 cas de pemphigus, correspondant à une fréquence de 10 cas/an et une prévalence hospitalière de 2,7 %. Les pemphigus occupaient le 2° rang des dermatoses bulleuses auto-immunes après la pemphigoide
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Distinguishing f(R) theories from general relativity by gravitational lensing effect
Energy Technology Data Exchange (ETDEWEB)
Liu, Hongguang [Beijing Normal University, Department of Physics, Beijing (China); Aix Marseille Universite et Universite de Toulon, Centre de Physique Theorique (UMR 7332), Marseille (France); Wang, Xin; Li, Haida; Ma, Yongge [Beijing Normal University, Department of Physics, Beijing (China)
2017-11-15
The post-Newtonian formulation of a general class of f(R) theories is set up in a third-order approximation. It turns out that the information of a specific form of f(R) gravity is encoded in the Yukawa potential, which is contained in the perturbative expansion of the metric components. Although the Yukawa potential is canceled in the second-order expression of the effective refraction index of light, detailed analysis shows that the difference of the lensing effect between the f(R) gravity and general relativity does appear at the third order when √(f''(0)/f{sup '}(0)) is larger than the distance d{sub 0} to the gravitational source. However, the difference between these two kinds of theories will disappear in the axially symmetric spacetime region. Therefore only in very rare case the f(R) theories are distinguishable from general relativity by gravitational lensing effect in a third-order post-Newtonian approximation. (orig.)
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Disease prevention policy under Medicare: a historical and political analysis.
Schauffler, H H
1993-01-01
I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.
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General proof of the entropy principle for self-gravitating fluid in f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Fang, Xiongjun [Department of Physics and Key Laboratory of Low Dimensional Quantum Structures andQuantum Control of Ministry of Education, Hunan Normal University,Changsha, Hunan 410081 (China); Guo, Minyong [Department of Physics, Beijing Normal University,Beijing 100875 (China); Jing, Jiliang [Department of Physics and Key Laboratory of Low Dimensional Quantum Structures andQuantum Control of Ministry of Education, Hunan Normal University,Changsha, Hunan 410081 (China)
2016-08-29
The discussions on the connection between gravity and thermodynamics attract much attention recently. We consider a static self-gravitating perfect fluid system in f(R) gravity, which is an important theory could explain the accelerated expansion of the universe. We first show that the Tolman-Oppenheimer-Volkoff equation of f(R) theories can be obtained by thermodynamical method in spherical symmetric spacetime. Then we prove that the maximum entropy principle is also valid for f(R) gravity in general static spacetimes beyond spherical symmetry. The result shows that if the constraint equation is satisfied and the temperature of fluid obeys Tolmans law, the extrema of total entropy implies other components of gravitational equations. Conversely, if f(R) gravitational equation hold, the total entropy of the fluid should be extremum. Our work suggests a general and solid connection between f(R) gravity and thermodynamics.
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Najdi, Adil; Berraho, Mohamed; Bendahhou, Karima; Obtel, Majdouline; Zidouh, Ahmed; Errihani, Hassan; Nejjari, Chakib
2014-01-01
Introduction Le cancer au Maroc représente un problème majeur de santé publique, sa prise en charge doit être globale, active et complète pour tous les patients. L'objectif de ce travail était d'estimer la fréquence des perdus de vue « PDV » en oncologie au Maroc durant la première année de suivi et de déterminer les facteurs associés à ce problème. Méthodes Par une étude rétrospective portant sur 2854 dossiers de malades hospitalisés dans les trois principaux centres d'oncologie au Maroc depuis janvier 2003 jusqu’à juin 2007 et concernant les cinq principales localisations de cancer au Maroc, nous avons cherché la date des dernières nouvelles des patients ayant un recul de 18 mois minimum afin de déterminer le statut de ces malades après un an de suivi. Résultats La moyenne d’âge était de 52±14 ans, une proportion féminine de 63%, les sujets actifs constituaient 28%, les mariés 71%, les analphabètes 51%, 70% des patients habitaient en milieu urbain et seulement 11% des malades disposaient d'une couverture sociale. La localisation cancéreuse la plus fréquente était le poumon (23,8%) suivie du colon-rectum (23,5%) puis le col (21,9%), le sein (20,4%) et les lymphomes (10,4%). Le taux des «PDV» à un an de suivi était de 48%, ce statut était significativement lié au sexe, à l’âge, au NSE et au statut matrimonial. Sur le plan médical, le statut «PDV» était lié à la localisation du cancer, au stade de diagnostic et au type de traitement reçu. Conclusion Notre étude a mis en évidence la grande ampleur du problème des PDV en cancérologie au Maroc ainsi que ces déterminants. Ces résultats incitent tous les acteurs dans le domaine de la cancérologie à collaborer ensemble pour prendre les mesures qui s'imposent pour y pallier PMID:25400850
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Thermodynamic laws for generalized f(R) gravity with curvature-matter coupling
International Nuclear Information System (INIS)
Wu Yabo; Zhao Yueyue; Cai Ronggen; Lu Jianbo; Lu Junwang; Gao Xiaojing
2012-01-01
The first law and the generalized second law (GSL) of thermodynamics for the generalized f(R) gravity with curvature-matter coupling are studied in the spatially homogeneous, isotropic FRW universe. The research results show that the field equations of the generalized f(R) gravity with curvature-matter coupling can be cast to the form of the first law of thermodynamics with the so-called the entropy production terms dS ¯ and the GSL can be given by considering the FRW universe filled only with ordinary matter enclosed by the dynamical apparent horizon with the Hawking temperature. Furthermore, as a concrete example, by utilizing the GSL the constraints on the gravitational model with f 1 (R)=R+αR l and f 2 (R)=R m are also discussed. It is worth noting these results given by us are quite general and can degenerate to the ones in Einstein's general relativity and pure f(R) gravity with non-coupling and non-minimal coupling as special cases. Comparing with the case of Einstein's general relativity, the appearance of the entropy production term dS ¯ in the first law of thermodynamics demonstrates that the horizon thermodynamics is non-equilibrium one for generalized f(R) gravity with curvature-matter coupling, which is consistent with the arguments given in Akbar and Cai (2007) [13] and Eling et al. (2006) [18].
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Constraining f(R gravity in solar system, cosmology and binary pulsar systems
Directory of Open Access Journals (Sweden)
Tan Liu
2018-02-01
Full Text Available The f(R gravity can be cast into the form of a scalar–tensor theory, and scalar degree of freedom can be suppressed in high-density regions by the chameleon mechanism. In this article, for the general f(R gravity, using a scalar–tensor representation with the chameleon mechanism, we calculate the parametrized post-Newtonian parameters γ and β, the effective gravitational constant Geff, and the effective cosmological constant Λeff. In addition, for the general f(R gravity, we also calculate the rate of orbital period decay of the binary system due to gravitational radiation. Then we apply these results to specific f(R models (Hu–Sawicki model, Tsujikawa model and Starobinsky model and derive the constraints on the model parameters by combining the observations in solar system, cosmological scales and the binary systems.
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A no-hair theorem for black holes in f(R) gravity
Cañate, Pedro
2018-01-01
In this work we present a no-hair theorem which discards the existence of four-dimensional asymptotically flat, static and spherically symmetric or stationary axisymmetric, non-trivial black holes in the frame of f(R) gravity under metric formalism. Here we show that our no-hair theorem also can discard asymptotic de Sitter stationary and axisymmetric non-trivial black holes. The novelty is that this no-hair theorem is built without resorting to known mapping between f(R) gravity and scalar–tensor theory. Thus, an advantage will be that our no-hair theorem applies as well to metric f(R) models that cannot be mapped to scalar–tensor theory.
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Energy Technology Data Exchange (ETDEWEB)
Lee, Myeongsoon; Kim, Don, E-mail: donkim@pknu.ac.kr
2016-08-15
The Au nanoparticles attached carbon nanotubes (Au-CNTs), diameter ranged from 40 to 250 nm, were prepared and discussed their chemical and electrical properties. The shape and crystallinity of the carbon nanotubes (CNTs) phase depended main2ly on the diameter of CNTs (r{sub Au-CNT}). Highly crystalline, straight CNTs were observed when the r{sub Au-CNT} exceeded 80 nm, and less crystalline noodle-shaped CNTs were observed when the r{sub Au-CNT} was smaller than 80 nm. The crystallinity of the CNT phase was confirmed by analyzing the G and D bands in their Raman spectra and the electrical conductivities of the Au-CNTs. The electrical conductivity of the highly crystalline carbon phase of Au-CNTs (r{sub Au-CNT} = 250 nm) was ∼10{sup 4} S/cm. The back-gated field effect transistors (FETs) based on the Au-CNTs, which were assembled on a SiO{sub 2}/Si wafer using the dielectrophoresis technique, showed that the Au-CNTs would be a good functional electronic material for future electronic and sensing applications. The transconductance and hole mobility of the FETs, which were assembled with the highly crystalline Au-CNTs (r{sub Au-CNT} = 250 nm), reached to 3.6 × 10{sup −4} A/V and 3.1 × 10{sup 4} cm{sup 2}/V s, respectively. These values are in the middle of those of reported for single walled carbon nanotubes and graphene. However, we could not find any field effect in a CNTFET, which assembled without Au nanoparticles, through the same process. - Highlights: • The shape and crystallinity of the CNTs depended mainly on the diameter of CNTs. • The electrical conductivity of the highly crystalline Au-CNTs was ∼10{sup 4} S/cm. • The Au-CNT FET shows typical p-channel gate effect with the on/off ratio of ∼10{sup 4}. • The Au-CNT FET shows very high transconductance (g{sub m}) and carrier mobility (μ{sub h}).
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Medicare-Medicaid Enrollee Profiles (State and National)
U.S. Department of Health & Human Services — Today there are over 10 million Medicare-Medicaid enrollees in the United States.To provide a greater understanding of the Medicare-Medicaid enrollee population, the...
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2010-08-03
... hospitalization and community mental health center issues. James Poyer, (410) 786-2261, Reporting of quality data... Community mental health center CMS Centers for Medicare & Medicaid Services CoP Conditions of Participation... (which includes partial hospitalization services furnished by community mental health centers (CMHCs...
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2012-07-13
... national standardized 60- day episode rates, the national per-visit rates, the low-utilization payment... Care Hospital LUPA Low Utilization Payment Amount MEPS Medical Expenditures Panel Survey MMA Medicare... units of services, adjustments for geographic differences in wage levels, outlier payments, the...
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2012-06-11
... identify outlier cases for both inpatient operating and inpatient capital related payments, which is... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 412... Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality...
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1995-09-01
This rule clarifies and updates portions of the HCFA regulations that pertain to the following: The conditions that an HMO or CMP must meet to qualify for a Medicare contract (Subpart J). The contract requirements (Subpart L). The rules for enrollment, entitlement, and disenrollment of Medicare beneficiaries in a contracting HMO or CMP (Subpart K). How a Medicare contract is affected when there is change of ownership or leasing of facilities of a contracting HMO or CMP (Subpart M). These are technical and editorial changes that do not affect the substance of the regulations. They are intended to make it easier to find particular provisions, to provide overviews of the different program aspects, and to better ensure uniform understanding of the rules.
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Extension of loop quantum gravity to f(R) theories.
Zhang, Xiangdong; Ma, Yongge
2011-04-29
The four-dimensional metric f(R) theories of gravity are cast into connection-dynamical formalism with real su(2) connections as configuration variables. Through this formalism, the classical metric f(R) theories are quantized by extending the loop quantization scheme of general relativity. Our results imply that the nonperturbative quantization procedure of loop quantum gravity is valid not only for general relativity but also for a rather general class of four-dimensional metric theories of gravity.
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Market Size and Innovation: Effects of Medicare Part D on Pharmaceutical Research and Development.
Blume-Kohout, Margaret E; Sood, Neeraj
2013-01-01
Recent evidence suggests that Medicare Part D increased prescription drug use among seniors, and increased pharmaceutical firms' revenues from sales. Previous studies also indicate that increases in market size induce pharmaceutical innovation. This paper assesses the impact of the Medicare Part D legislation on pharmaceutical research and development (R&D), using time-series data on the number of drugs entering preclinical and clinical development by therapeutic class and phase. We find that the passage and implementation of Medicare Part D is associated with significant increases in pharmaceutical R&D for therapeutic classes with higher Medicare market share.
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Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.
Keohane, Laura M; Rahman, Momotazur; Mor, Vincent
2016-04-01
To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.
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Directory of Open Access Journals (Sweden)
Maria McInerney
2018-01-01
Full Text Available Introduction : Il a été prouvé qu’un régime alimentaire de piètre qualité augmente le risque de maladies chroniques courantes susceptibles de nuire à la qualité de vie et d'alourdir le fardeau qui pèse sur le système de santé. Les recommandations fondées sur des données probantes du Guide alimentaire canadien (GAC fournissent des conseils nutritionnels destinés à améliorer la qualité du régime alimentaire. L’Indice canadien de saine alimentation (ICSA, un outil de mesure de la qualité du régime alimentaire, permet d'évaluer la conformité au GAC. Le Questionnaire canadien de fréquence alimentaire II (QFA-C II [Canadian Diet History Questionnaire II, C-DHQ II], mis au point récemment, pourrait quant à lui servir à estimer l’ICSA au sein de la population canadienne si on pouvait ajouter à sa base de données sur les éléments nutritifs les équivalents des groupes alimentaires (correspondant aux portions du GAC. Nous décrivons dans cet article des méthodes destinées à enrichir cette base de données sur les éléments nutritifs du QFA-C II en vue d’estimer l’ICSA. Méthodologie : Nous avons créé des équivalents des groupes alimentaires à partir de données provenant de diverses bases de données sur les aliments et les éléments nutritifs, en particulier l’Enquête sur la santé dans les collectivités canadiennes, cycle 2.2 Nutrition de 2004. Nous avons ajouté ces variables à la base de données sur les éléments nutritifs du QFA-C II. Nous avons déterminé les scores de l’ICSA et avons effectué des analyses descriptives pour les participants qui ont répondu au QFA-C II dans le cadre d’une étude transversale canadienne. Résultats : Le score moyen de l’ICSA dans notre échantillon de 446 adultes de 20 à 83 ans était de 64,4 (écart-type : 10,8. Les femmes, les non-fumeurs et les personnes ayant un niveau de scolarité supérieur au secondaire ont obtenu de manière statistiquement
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Practice arrangement and medicare physician payment in otolaryngology.
Cracchiolo, Jennifer; Ridge, John A; Egleston, Brian; Lango, Miriam
2015-06-01
Medicare Part B physician payment indicates a cost to Medicare beneficiaries for a physician service and connotes physician clinical productivity. The objective of this study was to determine whether there was an association between practice arrangement and Medicare physician payment. Cross-sectional study. Medicare provider utilization and payment data. Otolaryngologists from 1 metropolitan area were included as part of a pilot study. A generalized linear model was used to determine the effect of practice-specific variables including patient volumes on physician payment. Of 67 otolaryngologists included, 23 (34%) provided services through an independent practice, while others were employed by 1 of 3 local academic centers. Median payment was $58,895 per physician for the year, although some physicians received substantially higher payments. Reimbursements to faculty at 1 academic department were higher than to those at other institutions or to independent practitioners. After adjustments were made for patient volumes, physician subspecialty, and gender, payments to each faculty at Hospital C were 2 times higher than to those at Hospital A (relative ratio [RR] 2.03; 95% CI, 1.27-3.27; P = .003); 2 times higher than to faculty at Hospital B (RR 2.04; 95% CI, 1.4-2.7; P = .0001); and 1.6 times higher than to independent practitioners (RR 1.6; 95% CI, 1.04-2.7; P = .03). Payments to physicians in the other groups were not significantly different. Differences in reimbursement corresponded to an emphasis on procedures over office visits but not Medicare case mix adjustments for patient discharges from associated institutions. Variation in the cost of academic otolaryngology care may be subject in part to institutional factors. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
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2010-01-01
... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Landing Gear § 27.735 Brakes. For rotorcraft... dry, smooth pavement. [Doc. No. 5074, 29 FR 15695, Nov. 24, 1964, as amended by Amdt. 27-21, 49 FR...
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Competitive pricing and the challenge of cost control in medicare.
Coulam, Robert F; Feldman, Roger D; Dowd, Bryan E
2011-08-01
The Medicare program faces a serious challenge: it must find ways to control costs but must do so through a system of congressional oversight that necessarily limits its choices. We look at one approach to prudent purchasing - competitive pricing - that Medicare has attempted many times and in various ways since the beginning of the program, and in all but one case unsuccessfully due to the politics of provider opposition working through Congress and the courts. We look at some related efforts to change Medicare pricing to explore when the program has been successful in making dramatic changes in how it pays for health care. A set of recommendations emerges for ways to respond to the impediments of law and politics that have obstructed change to more efficient payment methods. Except in unusual cases, competitive pricing threatens too many stakeholders in too many ways for key political actors to support it. But an unusual case may arise in the coming Medicare fiscal crisis, a crisis related in part to the prices Medicare pays. At that point, competitive pricing may look less like a problem and more like a solution coming at a time when the system badly needs one.
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2011-04-06
... Payment System Transition Budget-Neutrality Adjustment AGENCY: Centers for Medicare & Medicaid Services... in the CY 2011 ESRD Prospective Payment System (PPS) final rule for renal dialysis services provided...-Stage Renal Disease Prospective Payment System'', hereinafter, referred to as the CY 2011 ESRD PPS final...
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42 CFR 411.204 - Medicare benefits secondary to LGHP benefits.
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Medicare benefits secondary to LGHP benefits. 411... benefits secondary to LGHP benefits. (a) Medicare benefits are secondary to benefits payable by an LGHP for services furnished during any month in which the individual— (1) Is entitled to Medicare Part A benefits...
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Predictors of regional Medicare expenditures for otolaryngology physician services.
Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N
2017-06-01
To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society
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2015-11-13
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.
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Chen, Lena M; Epstein, Arnold M; Orav, E John; Filice, Clara E; Samson, Lok Wong; Joynt Maddox, Karen E
2017-08-01
Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. To compare performance in the PVBM Program by practice characteristics. Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, -0.55 [95% CI, -0.77 to -0.32]; high social risk only: z score, -0.86 [95% CI, -1.17 to -0.54]; and high medical and social risk: -0.78 [95% CI, -1.04 to -0.51]) (P risk only performed the best on the composite cost score (z score, -0.52 [95% CI, -0.71 to -0.33]), low risk had the next best cost score (z score, -0.18 [95% CI, -0.25 to -0.10]), then
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Constraint on reconstructed f(R) gravity models from gravitational waves
Lee, Seokcheon
2018-06-01
The gravitational wave (GW) detection of a binary neutron star inspiral made by the Advanced LIGO and Advanced Virgo paves the unprecedented way for multi-messenger observations. The propagation speed of this GW can be scrutinized by comparing the arrival times between GW and neutrinos or photons. It provides the constraint on the mass of the graviton. f(R) gravity theories have the habitual non-zero mass gravitons in addition to usual massless ones. Previously, we show that the model independent f(R) gravity theories can be constructed from the both background evolution and the matter growth with one undetermined parameter. We show that this parameter can be constrained from the graviton mass bound obtained from GW detection. Thus, the GW detection provides the invaluable constraint on the validity of f(R) gravity theories.
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Energy Technology Data Exchange (ETDEWEB)
Lu, Jianbo; Wu, Yabo; Wang, Yan; Yang, Weiqiang [Liaoning Normal University, Department of Physics, Dalian (China); Liu, Molin [Xinyang Normal University, Department of Physics, Xinyang (China)
2016-12-15
Tensions between several cosmic observations were found recently, such as the inconsistent values of H{sub 0} (or σ{sub 8}) were indicated by the different cosmic observations. Introducing the massive neutrinos in ΛCDM could potentially solve the tensions. Viable f(R) gravity producing ΛCDM background expansion with massive neutrinos is investigated in this paper. We fit the current observational data: Planck-2015 CMB, RSD, BAO, and SNIa to constrain the mass of neutrinos in viable f(R) theory. The constraint results at 95% confidence level are: Σm{sub ν} < 0.202 eV for the active-neutrino case, m{sub ν,sterile}{sup eff} < 0.757 eV with N{sub eff} < 3.22 for the sterile neutrino case. For the effects due to the mass of the neutrinos, the constraint results on model parameter at 95% confidence level become f{sub R0} x 10{sup -6} > -1.89 and f{sub R0} x 10{sup -6} > -2.02 for two cases, respectively. It is also shown that the fitting values of several parameters much depend on the neutrino properties, such as the cold dark matter density, the cosmological quantities at matter-radiation equality, the neutrino density and the fraction of baryonic mass in helium. Finally, the constraint result shows that the tension between direct and CMB measurements of H{sub 0} gets slightly weaker in the viable f(R) model than that in the base ΛCDM model. (orig.)
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2013-05-31
... health coverage options available. The Advisory Panel on Outreach and Education allows us to consider a... Education (APOE) and Request for Nominations AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... Education (APOE) has been renewed. It also requests nominations for individuals to serve on the APOE. DATES...
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Père au foyer : une nouvelle entrée au répertoire du masculin ?
Chatot, Myriam
2017-01-01
Cadre de la recherche : En dépit de la promotion dans les représentations d’un partage égalitaire des tâches domestiques et des responsabilités parentales entre conjoints, les femmes sont encore largement responsables de la prise en charge des enfants et des tâches ménagères ; l’entrée d’un homme dans la situation de « père au foyer » représente une inversion des rôles traditionnels.Objectifs : L’objectif de cet article est de comprendre comment se recomposent les rôles de genre traditionnels...
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Probing the f(R) formalism through gravitational wave polarizations
International Nuclear Information System (INIS)
Alves, M.E.S.; Miranda, O.D.; Araujo, J.C.N. de
2009-01-01
The direct observation of gravitational waves (GW) in the near future, and the corresponding determination of the number of independent polarizations, is a powerful tool to test general relativity and alternative theories of gravity. In the present work we use the Newman-Penrose formalism to characterize GWs in quadratic gravity and in a particular class of f(R) Lagrangians. We find that both quadratic gravity and the f(R) theory belong to the most general invariant class of GWs, i.e., they can present up to six independent polarizations of GWs. For a particular combination of the parameters, we find that quadratic gravity can present up to five polarizations states. On the other hand, if we use the Palatini approach for f(R) theories, GWs present only the usual two transverse-traceless polarizations such as in general relativity. Thus, we conclude that the observation of GWs can strongly constrain the suitable formalism for these theories.
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On Analytical Solutions of f(R) Modified Gravity Theories in FLRW Cosmologies
Domazet, Silvije; Radovanović, Voja; Simonović, Marko; Štefančić, Hrvoje
2013-02-01
A novel analytical method for f(R) modified theories without matter in Friedmann-Lemaitre-Robertson-Walker (FLRW) spacetimes is introduced. The equation of motion for the scale factor in terms of cosmic time is reduced to the equation for the evolution of the Ricci scalar R with the Hubble parameter H. The solution of equation of motion for actions of the form of power law in Ricci scalar R is presented with a detailed elaboration of the action quadratic in R. The reverse use of the introduced method is exemplified in finding functional forms f(R), which leads to specified scale factor functions. The analytical solutions are corroborated by numerical calculations with excellent agreement. Possible further applications to the phases of inflationary expansion and late-time acceleration as well as f(R) theories with radiation are outlined.
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Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen
2016-09-01
At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The
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f(R in Holographic and Agegraphic Dark Energy Models and the Generalized Uncertainty Principle
Directory of Open Access Journals (Sweden)
Barun Majumder
2013-01-01
Full Text Available We studied a unified approach with the holographic, new agegraphic, and f(R dark energy model to construct the form of f(R which in general is responsible for the curvature driven explanation of the very early inflation along with presently observed late time acceleration. We considered the generalized uncertainty principle in our approach which incorporated the corrections in the entropy-area relation and thereby modified the energy densities for the cosmological dark energy models considered. We found that holographic and new agegraphic f(R gravity models can behave like phantom or quintessence models in the spatially flat FRW universe. We also found a distinct term in the form of f(R which goes as R 3 / 2 due to the consideration of the GUP modified energy densities. Although the presence of this term in the action can be important in explaining the early inflationary scenario, Capozziello et al. recently showed that f(R ~ R 3 / 2 leads to an accelerated expansion, that is, a negative value for the deceleration parameter q which fits well with SNeIa and WMAP data.
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2010-11-24
...The final rule with comment period in this document revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2011. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011. In this document, we also are including two final rules that implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest. In the interim final rule with comment period that is included in this document, we are changing the effective date for otherwise eligible hospitals and critical access hospitals that have been reclassified from urban to rural under section 1886(d)(8)(E) of the Social Security
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75 FR 8391 - Assisted Living Conversion Program (ALCP) and Emergency Capital Repair Program (ECRP)
2010-02-24
... Conversion Program (ALCP) provides funding for the physical costs of converting some or all the units of an... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-10] Assisted Living Conversion... rehabilitate, modernize, or retrofit aging structure, common areas, or individual dwelling units through the...
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10 CFR 36.27 - Fire protection.
2010-01-01
... 10 Energy 1 2010-01-01 2010-01-01 false Fire protection. 36.27 Section 36.27 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Design and Performance Requirements for Irradiators § 36.27 Fire protection. (a) The radiation room at a panoramic irradiator must...
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2010-04-23
... includes payment for premiums for Medicare Part B. Section 4732 of the Balanced Budget Act of 1997 (BBA... formula for determining State allotments. However, since certain States projected a deficit in their... minimize the impact on States with FY QI allotments that might be greater than their QI expenditures for...
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Reconstructing an f(R) model from holographic dark energy: using the observational evidence
International Nuclear Information System (INIS)
Saaidi, Kh; Aghamohammadi, A
2012-01-01
We investigate the correspondence relation between f(R) gravity and an interacting holographic dark energy (HDE). By obtaining the conditions needed for some observational evidence such as positive acceleration expansion of the Universe, crossing the phantom divide line and validity of the thermodynamics second law in an interacting HDE model and corresponding it with the f(R) model of gravity, we find a viable f(R) model that can explain the present Universe. We also obtain the explicit evolutionary forms of the corresponding scalar field, potential and scale factor of the Universe. (paper)
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75 FR 38748 - Medicaid Program; Premiums and Cost Sharing; Correction
2010-07-06
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 447 and 457 [CMS-2244-CN] RIN 0938-AP73 Medicaid Program; Premiums and Cost Sharing; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS ACTION: Correction of final rule with comment period...
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String duality transformations in f(R) gravity from Noether symmetry approach
Energy Technology Data Exchange (ETDEWEB)
Capozziello, Salvatore [Dipartimento di Fisica, Università di Napoli ' ' Federico II' ' , Compl. Univ. di Monte S. Angelo, Edificio G, Via Cinthia, I-80126, Napoli (Italy); Gionti, Gabriele S.J. [Specola Vaticana, Vatican City, V-00120, Vatican City State (Vatican City State, Holy See); Vernieri, Daniele, E-mail: capozziello@na.inf.it, E-mail: ggionti@as.arizona.edu, E-mail: vernieri@iap.fr [Sorbonne Universités, UPMC Univ Paris 6 et CNRS, UMR 7095, Institut d' Astrophysique de Paris, GReCO, 98bis Bd Arago, 75014 Paris (France)
2016-01-01
We select f(R) gravity models that undergo scale factor duality transformations. As a starting point, we consider the tree-level effective gravitational action of bosonic String Theory coupled with the dilaton field. This theory inherits the Busher's duality of its parent String Theory. Using conformal transformations of the metric tensor, it is possible to map the tree-level dilaton-graviton string effective action into f(R) gravity, relating the dilaton field to the Ricci scalar curvature. Furthermore, the duality can be framed under the standard of Noether symmetries and exact cosmological solutions are derived. Using suitable changes of variables, the string-based f(R) Lagrangians are shown in cases where the duality transformation becomes a parity inversion.
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String duality transformations in f(R) gravity from Noether symmetry approach
International Nuclear Information System (INIS)
Capozziello, Salvatore; Gionti, Gabriele S.J.; Vernieri, Daniele
2016-01-01
We select f(R) gravity models that undergo scale factor duality transformations. As a starting point, we consider the tree-level effective gravitational action of bosonic String Theory coupled with the dilaton field. This theory inherits the Busher's duality of its parent String Theory. Using conformal transformations of the metric tensor, it is possible to map the tree-level dilaton-graviton string effective action into f(R) gravity, relating the dilaton field to the Ricci scalar curvature. Furthermore, the duality can be framed under the standard of Noether symmetries and exact cosmological solutions are derived. Using suitable changes of variables, the string-based f(R) Lagrangians are shown in cases where the duality transformation becomes a parity inversion
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Directory of Open Access Journals (Sweden)
Faraj C.
2008-12-01
Full Text Available Dans le but d’estimer le risque de réintroduction du paludisme au Maroc, nous avons analysé le potentiel paludogène d’une zone rizicole au nord du pays. Nos résultats ont montré que la capacité vectorielle d’An. labranchiae, vecteur du paludisme au Maroc, était particulièrement élevée pendant la période estivale qui correspond à la période de culture du riz. Le risque d’une reprise de la transmission du paludisme autochtone est élevé du fait de l’éventuelle présence de porteurs de parasite dans le dernier foyer de paludisme limitrophe de la zone d’étude. Le risque d’une introduction du paludisme tropical est faible, vu la faible vulnérabilité de la région et la compétence de ses vecteurs, considérée comme faible. Toutefois, ce risque doit faire l’objet d’une grande attention.
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Vicente, José; Chicote, María-Teresa; Guerrero, Rita; Jones, Peter G.; Ramírez De Arellano, M. Carmen
1997-09-24
The complexes [Au(acac-kappaC(2))(PR(3))] (acac = acetylacetonate, R = Ph, C(6)H(4)OMe-4) react with (NH(4))ClO(4) to give amminegold(I), [Au(NH(3))(PR(3))]ClO(4), amidogold(I), [(AuPR(3))(2)(&mgr;(2)-NH(2))]ClO(4), or nitridogold(I), [(AuPR(3))(4)(&mgr;(4)-N)]ClO(4), complexes, depending on the reaction conditions. Similarly, [Au(acac-kappaC(2))(PPh(3))] reacts with (NH(3)R')OTf (OTf = CF(3)SO(3)) (1:1) or with [H(3)N(CH(2))(2)NH(2)]OTf (1:1) to give (amine)gold(I) complexes [Au(NH(2)R')(PPh(3))]OTf (R' = Me, C(6)H(4)NO(2)-4) or [(AuPPh(3))(2){&mgr;(2)-H(2)N(CH(2))(2)NH(2)}](OTf)(2), respectively. The ammonium salts (NH(2)R'(2))OTf (R' = Et, Ph) react with [Au(acac-kappaC(2))(PR(3))] (R = Ph, C(6)H(4)OMe-4) (1:2) to give, after hydrolysis, the oxonium salts [(AuPR(3))(3)(&mgr;(3)-O)]OTf (R = Ph, C(6)H(4)OMe-4). When NH(3) is bubbled through a solution of [AuCl(tht)] (tht = tetrahydrothiophene), the complex [Au(NH(3))(2)]Cl precipitates. Addition of [Au(NH(3))(2)]Cl to a solution of AgClO(4) or TlOTf leads to the isolation of [Au(NH(3))(2)]ClO(4) or [Au(NH(3))(2)]OTf, respectively. The crystal structure of [(AuPR(3))(3)(&mgr;(3)-O)]OTf.Me(2)CO (R = C(6)H(4)OMe-4) has been determined: triclinic, space group P&onemacr;, a = 14.884(3) Å, b = 15.828(3) Å, c = 16.061(3) Å, alpha = 83.39(3) degrees, beta = 86.28(3) degrees, gamma = 65.54(3) degrees, R1 (wR2) = 0.0370 (0.0788). The [(AuPR(3))(3)(&mgr;(3)-O)](+) cation shows an essentially trigonal pyramidal array of three gold atoms and one oxygen atom with O-Au-P bond angles of ca. 175 degrees and Au.Au contacts in the range 2.9585(7)-3.0505(14) Å. These cations are linked into centrosymmetric dimers through two short Au.Au [2.9585(7), 3.0919(9) Å] contacts. The gold atoms of the dimer form a six-membered ring with a chair conformation.
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Unifying inflation with dark energy in modified F(R) Horava-Lifshitz gravity
International Nuclear Information System (INIS)
Elizalde, E.; Saez-Gomez, D.; Nojiri, S.; Odintsov, S.D.
2010-01-01
We study FRW cosmology for a non-linear modified F(R) Horava-Lifshitz gravity which has a viable convenient counterpart. A unified description of early-time inflation and late-time acceleration is possible in this theory, but the cosmological dynamic details are generically different from the ones of the convenient viable F(R) model. Remarkably, for some specific choice of parameters they do coincide. The emergence of finite-time future singularities is investigated in detail. It is shown that these singularities can be cured by adding an extra, higher-derivative term, which turns out to be qualitatively different when compared with the corresponding one of the convenient F(R) theory. (orig.)
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Katamea, Tina; Mukuku, Olivier; Kamona, Lewis; Mukelenge, Kethye; Mbula, Otikeke; Baledi, Lambert; Ntambwe, Emile; Mutombo, Augustin Mulangu; Wembonyama, Stanis Okitotsho; Luboya, Oscar Numbi
2014-01-01
Introduction La mortalité néonatale reste préoccupante dans notre milieu et plusieurs facteurs dont ceux liés à l'organisation du transfert de nouveau-nés au niveau des structures de prise en charge y contribuent. Les objectifs de notre étude sont de déterminer la fréquence du transfert néonatal extrahospitalier à l'unité de néonatologie et identifier les facteurs de risque de mortalité dans notre milieu. Méthodes Il s'agit d'une étude prospective et analytique menée sur une période de douze mois allant du 1er Janvier 2012 au 31 décembre 2012 ayant ciblé tous les nouveau-nés transférés des maternités extérieurs, traités et suivis dans le service de néonatologie de l'hôpital Sendwe. Les caractéristiques maternelles (âge, parité, état-civil, profession, niveau d’étude, antécédents médicaux et toxicologiques) et perpartales (âge gestationnel, état de la poche des eaux, voie d'accouchement) et néonataux (âge lors du transfert, sexe, poids de naissance, moyen de transfert, motif de transfert et évolution (guérison ou décès)) ont été étudiés. La saisie et l'analyse des données ont été faites sur le logiciel Epi Info 2011 (version 7.0.8.3) et le seuil de signification de 5%. Résultats La fréquence du transfert néonatal extrahospitalier est de 12,9%. La mortalité était significativement liée à la profession (vendeuse ou travailleuse) de la mère (OR = 7,43 (1,38-39,97)), au niveau d’étude élevé (OR = 4,22 (1,18-15,10)), à l’âge gestationnel sexe masculin du nouveau-né (OR=2,43 (1,08-5,46)), au poids de naissance <1500 grammes (OR=15,3 (5,73-40,78)) et à la prématurité comme motif de transfert (OR=5,56 (1,47-20,98)). Conclusion Le bilan de la mortalité néonatale est lourd dans les pays en développement où les nouveau-nés continuent de mourir pour des causes souvent évitables. La réduction de la morbidité et la mortalité néonatales passe par une amélioration du système de référence des
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2010-10-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the NTP Board of Scientific Counselors: Amended Notice AGENCY: National....gov ). Dated: October 21, 2010. John R. Bucher, Associate Director, National Toxicology Program. [FR...
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Late time acceleration of the universe in f(R) gravity model
International Nuclear Information System (INIS)
Mukherjee, Ankan
2014-01-01
In this work, a new way to look at the nature of late time dynamics of the universe for f(R) gravity models using the contracted Bianchi Identity has been proposed. As the Einstein field equations contain derivatives of the curvature scalar R, the contracted Bianchi identity yields a second order nonlinear differential equation in H, the Hubble parameter. This equation is studied for two particular forms of f(R), and the late time behaviour of the model is discussed. (author)
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Medicare and Medicaid programs; advance directives--HCFA. Final rule.
1995-06-27
This final rule responds to public comments on the March 6, 1992 interim final rule with comment period that amended the Medicare and Medicaid regulations governing provider agreements and contracts to establish requirements for States, hospitals, nursing facilities, skilled nursing facilities, providers of home health care or personal care services, hospice programs and managed care plans concerning advance directives. An advance directive is a written instruction, such as a living will or durable power of attorney for health care, recognized under State law, relating to the provision of health care when an individual's condition makes him or her unable to express his or her wishes. The intent of the advance directives provisions is to enhance an adult individual's control over medical treatment decisions. This rule confirms the interim final rule with several minor changes based on our review and consideration of public comments.
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2011-11-18
... a diagnosis affects the management of the patient. Use of the device significantly improves clinical... Payments Under the Hospital Inpatient Prospective Payment System AGENCY: Centers for Medicare & Medicaid... and technologies under the hospital inpatient prospective payment system (IPPS). Interested parties...
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2013-11-20
... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5683-N-102] 10-Day Notice of Proposed Information Collection: Generic Customer Satisfaction Surveys; Physical Inspection Pilot Program...
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Stability of the Einstein static universe in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Shabani, Hamid [University of Sistan and Baluchestan, Physics Department, Faculty of Sciences, Zahedan (Iran, Islamic Republic of); Ziaie, Amir Hadi [Kahnooj Branch, Islamic Azad University, Department of Physics, Kerman (Iran, Islamic Republic of)
2017-01-15
The Einstein static (ES) universe has played a major role in various emergent scenarios recently proposed in order to cure the problem of the initial singularity of the standard model of cosmology. In the model we address, we study the existence and stability of an ES universe in the context of f(R, T) modified theories of gravity. Considering specific forms of the f(R, T) function, we seek for the existence of solutions representing ES state. Using dynamical system techniques along with numerical analysis, we find two classes of solutions: the first one is always unstable of the saddle type, while the second is always stable so that its dynamical behavior corresponds to a center equilibrium point. The importance of the second class of solutions is due to the significant role they play in constructing non-singular emergent models in which the universe could have experienced past-eternally a series of infinite oscillations about such an initial static state after which it enters, through a suitable physical mechanism, to an inflationary era. Considering specific forms for the functionality of f(R, T), we show that this theory is capable of providing cosmological solutions which admit emergent universe (EU) scenarios. We also investigate homogeneous scalar perturbations for the mentioned models. The stability regions of the solutions are parametrized by a linear equation of state (EoS) parameter and other free parameters that will be introduced for the models. Our results suggest that modifications in f(R, T) gravity would lead to stable solutions which are unstable in f(R) gravity model. (orig.)
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Stability of the Einstein static universe in f(R, T) gravity
International Nuclear Information System (INIS)
Shabani, Hamid; Ziaie, Amir Hadi
2017-01-01
The Einstein static (ES) universe has played a major role in various emergent scenarios recently proposed in order to cure the problem of the initial singularity of the standard model of cosmology. In the model we address, we study the existence and stability of an ES universe in the context of f(R, T) modified theories of gravity. Considering specific forms of the f(R, T) function, we seek for the existence of solutions representing ES state. Using dynamical system techniques along with numerical analysis, we find two classes of solutions: the first one is always unstable of the saddle type, while the second is always stable so that its dynamical behavior corresponds to a center equilibrium point. The importance of the second class of solutions is due to the significant role they play in constructing non-singular emergent models in which the universe could have experienced past-eternally a series of infinite oscillations about such an initial static state after which it enters, through a suitable physical mechanism, to an inflationary era. Considering specific forms for the functionality of f(R, T), we show that this theory is capable of providing cosmological solutions which admit emergent universe (EU) scenarios. We also investigate homogeneous scalar perturbations for the mentioned models. The stability regions of the solutions are parametrized by a linear equation of state (EoS) parameter and other free parameters that will be introduced for the models. Our results suggest that modifications in f(R, T) gravity would lead to stable solutions which are unstable in f(R) gravity model. (orig.)
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42 CFR 411.53 - Basis for conditional Medicare payment in no-fault cases.
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Basis for conditional Medicare payment in no-fault... Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.53 Basis for conditional Medicare payment in no-fault cases. (a) A conditional Medicare payment may be made in no-fault...
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Exact solutions for scalar field cosmology in f(R) gravity
Maharaj, S. D.; Goswami, R.; Chervon, S. V.; Nikolaev, A. V.
2017-09-01
We study scalar field FLRW cosmology in the content of f(R) gravity. Our consideration is restricted to the spatially flat Friedmann universe. We derived the general evolution equations of the model, and showed that the scalar field equation is automatically satisfied for any form of the f(R) function. We also derived representations for kinetic and potential energies, as well as for the acceleration in terms of the Hubble parameter and the form of the f(R) function. Next we found the exact cosmological solutions in modified gravity without specifying the f(R) function. With negligible acceleration of the scalar curvature, we found that the de Sitter inflationary solution is always attained. Also we obtained new solutions with special restrictions on the integration constants. These solutions contain oscillating, accelerating, decelerating and even contracting universes. For further investigation, we selected special cases which can be applied with early or late inflation. We also found exact solutions for the general case for the model with negligible acceleration of the scalar curvature in terms of special Airy functions. Using initial conditions which represent the universe at the present epoch, we determined the constants of integration. This allows for the comparison of the scale factor in the new solutions with that for current stage of the universe evolution in the ΛCDM model.
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Looking at CER from Medicare's perspective.
Mohr, Penny
2012-05-01
Comparative effectiveness research (CER) is rapidly adding to the amount of data available to health care coverage and payment decision makers. Medicare's decisions have a large effect on coverage and reimbursement policies throughout the health insurance industry and will likely influence the entire U.S. health care system; thus, examining its role in integrating CER into policy is crucial. To describe the potential benefits of CER to support payment and coverage decisions in the Medicare program, limitations on its use,the role of the Centers for Medicare & Medicaid Services (CMS) in improving the infrastructure for CER, and to discuss challenges that must be addressed to integrate CER into CMS's decision-making process. A defining feature of CER is that it provides the type of evidence that will help decision makers, such as patients, clinicians, and payers,make more informed treatment and policy decisions. Because CMS is responsible for more than 47 million elderly and disabled beneficiaries, the way that Medicare uses CER has the potential to have a large impact on public and individual health. Currently many critical payment and coverage decisions within the Medicare program are made on the basis of poor quality evidence, and CER has the potential to greatly improve the quality of decision making. Despite common misconceptions, CMS is not prohibited by law from using CER apart from some reasonable limitations. CMS is,however, required to support the development of the CER infrastructure by making their data more readily available to researchers. While CER has substantial potential to improve the quality of the agency's policy decisions,challenges remain to integrate CER into Medicare's processes. These challenges include statutory ambiguities, lack of sufficient staff and internal resources to take advantage of CER, and the lack of an active voice in setting priorities for CER and study design. Although challenges exist, CER has the potential to greatly
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Geographic variation in Medicare and the military healthcare system.
Adesoye, Taiwo; Kimsey, Linda G; Lipsitz, Stuart R; Nguyen, Louis L; Goodney, Philip; Olaiya, Samuel; Weissman, Joel S
2017-08-01
To compare geographic variation in healthcare spending and utilization between the Military Health System (MHS) and Medicare across hospital referral regions (HRRs). Retrospective analysis. Data on age-, sex-, and race-adjusted Medicare per capita expenditure and utilization measures by HRR were obtained from the Dartmouth Atlas for 2007 to 2010. Similarly, adjusted data from 2007 and 2010 were obtained from the MHS Data Repository and patients assigned to HRRs. We compared high- and low-spending regions, and computed coefficient of variation (CoV) and correlation coefficients for healthcare spending, hospital inpatient days, hip surgery, and back surgery between MHS and Medicare patients. We found significant variation in spending and utilization across HRRs in both the MHS and Medicare. CoV for spending was higher in the MHS compared with Medicare, (0.24 vs 0.15, respectively) and CoV for inpatient days was 0.36 in the MHS versus 0.19 in Medicare. The CoV for back surgery was also greater in the MHS compared with Medicare (0.47 vs 0.29, respectively). Per capita Medicare spending per HRR was significantly correlated to adjusted MHS spending (r = 0.3; P spending markets in both systems were not comparable; lower spending markets were located mostly in the Midwest. In comparing 2 systems with similar pricing schemes, differences in spending likely reflect variation in utilization and the influence of local provider culture.
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Chameleon halo modeling in f(R) gravity
International Nuclear Information System (INIS)
Li Yin; Hu, Wayne
2011-01-01
We model the chameleon effect on cosmological statistics for the modified gravity f(R) model of cosmic acceleration. The chameleon effect, required to make the model compatible with local tests of gravity, reduces force enhancement as a function of the depth of the gravitational potential wells of collapsed structure and so is readily incorporated into a halo model by including parameters for the chameleon mass threshold and rapidity of transition. We show that the abundance of halos around the chameleon mass threshold is enhanced by both the merging from below and the lack of merging to larger masses. This property also controls the power spectrum in the nonlinear regime and we provide a description of the transition to the linear regime that is valid for a wide range of f(R) models.
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2012-11-23
... evidence that use of the device to make a diagnosis affects the management of the patient. Use of the... the device. ++ Decreased pain, bleeding or other quantifiable symptoms. ++ Reduced recovery time. In... technology that substantially improves the diagnosis or treatment of Medicare beneficiaries before...
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2013-11-29
... evidence that use of the device to make a diagnosis affects the management of the patient. Use of the... the device. ++ Decreased pain, bleeding or other quantifiable symptoms. ++ Reduced recovery time. In... technology that substantially improves the diagnosis or treatment of Medicare beneficiaries before...
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International Nuclear Information System (INIS)
Lee, Myeongsoon; Kim, Don
2016-01-01
The Au nanoparticles attached carbon nanotubes (Au-CNTs), diameter ranged from 40 to 250 nm, were prepared and discussed their chemical and electrical properties. The shape and crystallinity of the carbon nanotubes (CNTs) phase depended main2ly on the diameter of CNTs (r_A_u_-_C_N_T). Highly crystalline, straight CNTs were observed when the r_A_u_-_C_N_T exceeded 80 nm, and less crystalline noodle-shaped CNTs were observed when the r_A_u_-_C_N_T was smaller than 80 nm. The crystallinity of the CNT phase was confirmed by analyzing the G and D bands in their Raman spectra and the electrical conductivities of the Au-CNTs. The electrical conductivity of the highly crystalline carbon phase of Au-CNTs (r_A_u_-_C_N_T = 250 nm) was ∼10"4 S/cm. The back-gated field effect transistors (FETs) based on the Au-CNTs, which were assembled on a SiO_2/Si wafer using the dielectrophoresis technique, showed that the Au-CNTs would be a good functional electronic material for future electronic and sensing applications. The transconductance and hole mobility of the FETs, which were assembled with the highly crystalline Au-CNTs (r_A_u_-_C_N_T = 250 nm), reached to 3.6 × 10"−"4 A/V and 3.1 × 10"4 cm"2/V s, respectively. These values are in the middle of those of reported for single walled carbon nanotubes and graphene. However, we could not find any field effect in a CNTFET, which assembled without Au nanoparticles, through the same process. - Highlights: • The shape and crystallinity of the CNTs depended mainly on the diameter of CNTs. • The electrical conductivity of the highly crystalline Au-CNTs was ∼10"4 S/cm. • The Au-CNT FET shows typical p-channel gate effect with the on/off ratio of ∼10"4. • The Au-CNT FET shows very high transconductance (g_m) and carrier mobility (μ_h).
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Frakt, Austin B; Pizer, Steven D; Hendricks, Ann M
2008-12-01
Medicare and the Veterans Health Administration (VA) both finance large outpatient prescription drug programs, though in very different ways. In the ongoing debate on how to control Medicare spending, some suggest that Medicare should negotiate directly with drug manufacturers, as the VA does. In this article we relate the role of interest groups to policy differences between Medicare and the VA and, in doing so, explain why such a large change to the Medicare drug program is unlikely. We argue that key policy differences are attributable to stable differences in interest group involvement. While this stability makes major changes in Medicare unlikely, it suggests the possibility of leveraging VA drug purchasing to achieve savings in Medicare. This could be done through a VA-administered drug-only benefit for Medicare-enrolled veterans. Such a partnership could incorporate key elements of both programs: capacity to accept large numbers of enrollees (like Medicare) and leverage to negotiate prescription drug prices (like the VA). Moreover, it could be implemented at no cost to the VA while achieving savings for Medicare and beneficiaries.
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78 FR 28551 - Medicaid Program; State Disproportionate Share Hospital Allotment Reductions
2013-05-15
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 447 [CMS-2367-P] RIN 0938-AR31 Medicaid Program; State Disproportionate Share Hospital Allotment Reductions AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: The statute...
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78 FR 57293 - Medicaid Program; State Disproportionate Share Hospital Allotment Reductions
2013-09-18
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 447 [CMS-2367-F] RIN 0938-AR31 Medicaid Program; State Disproportionate Share Hospital Allotment Reductions AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final rule. SUMMARY: The statute, as...
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Medicare Prescription Drug Coverage - General Information
U.S. Department of Health & Human Services — The MMA legislation provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program, the...
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Medicare depreciation; useful life guidelines--HCFA. Proposed rule.
1982-09-30
We are proposing to amend Medicare regulations to clarify which useful life guidelines providers of health care services may use to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize HHS useful life guidelines or, if none have been published by HHS, the American Hospital Association (AHA) useful life guidelines of 1973 or IRS guidelines. We are proposing to eliminate the reference to IRS guidelines because those previously acceptable for Medicare purposes are outdated and have been made obsolete by the IRS or by statutory change. We would also delete the specific reference to the 1973 AHA guidelines. In addition, we intend this amendment to clarify that certain tax legislation on accelerated depreciation, recently passed by Congress, does not apply to the Medicare program.
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2012-11-15
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).
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42 CFR 424.540 - Deactivation of Medicare billing privileges.
2010-10-01
... change in practice location, a change of any managing employee, and a change in billing services. A... 42 Public Health 3 2010-10-01 2010-10-01 false Deactivation of Medicare billing privileges. 424.540 Section 424.540 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...
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International Nuclear Information System (INIS)
Le Rigoleur, Claude; Arnaud, Andre; Taste, Jean.
1976-10-01
The total energy weighting technique has been applied to measuring absolute neutron capture cross sections for 23 Na, Cr, 55 Mn, Fe, Ni, 103 Rh, Ta, 197 Au, 238 U in the 10-600keV energy range. A non hydrogeneous liquid scintillator was used to detect the gamma from the cascade. The neutron flux was measured with a 10 B INa(Tl) detector or a 6 Li glass scintillator of well known efficiency. The fast time-of-flight technique was used with on line digital computer data processing [fr
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Thick brane in f(R) gravity with Palatini dynamics
Energy Technology Data Exchange (ETDEWEB)
Bazeia, D.; Losano, L. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, PB (Brazil); Menezes, R. [Universidade Federal da Paraiba, Departamento de Ciencias Exatas, Rio Tinto, PB (Brazil); Universidade Federal de Campina Grande, Departamento de Fisica, Campina Grande, PB (Brazil); Olmo, Gonzalo J. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, PB (Brazil); Universidad de Valencia, Departamento de Fisica Teorica, IFIC, Centro Mixto Universidad de Valencia-CSIC, Burjassot, Valencia (Spain); Rubiera-Garcia, D. [Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, PB (Brazil); Universidade de Lisboa, Faculdade de Ciencias, Instituto de Astrofisica e Ciencias do Espaco, Lisbon (Portugal); Fudan University, Department of Physics, Center for Field Theory and Particle Physics, Shanghai (China)
2015-12-15
This work deals with modified gravity in five-dimensional space-time. We study a thick Palatini f(R) brane, that is, a braneworld scenario described by an anti-de Sitter warped geometry with a single extra dimension of infinite extent, sourced by a real scalar field under the Palatini approach, where the metric and the connection are regarded as independent degrees of freedom. We consider a first-order framework which we use to provide exact solutions for the scalar field and warp factor. We also investigate a perturbative scenario such that the Palatini approach is implemented through a Lagrangian f(R) = R + εR{sup n}, where the small parameter ε controls the deviation from the standard thick brane case. In both cases it is found that the warp factor tends to localize the extra dimension due to the nonlinear corrections. (orig.)
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Towards a complete Δ(27) × SO(10) GUT of flavour
Björkeroth, Fredrik
2017-09-01
We propose a renormalisable model based on Δ(27) family symmetry with an SO(10) grand unified theory (GUT) leading to a novel form of spontaneous geometrical CP violation. The symmetries are broken close to the GUT breaking scale to yield the minimal supersymmetric standard model with standard R-parity. Low-scale Yukawa structure is dictated by the coupling of matter to Δ(27) antitriplets \\bar φ whose vacuum expectation values are aligned in the CSD3 directions by the superpotential. Light physical Majorana neutrinos masses emerge from the seesaw mechanism within SO(10). The model predicts a normal neutrino mass hierarchy with the best-fit lightest neutrino mass m 1 ∼ 0.3 meV, CP-violating oscillation phase δl ≈ 280° and the remaining neutrino parameters all within 1σ of their best-fit experimental values.
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Physical attributes of anisotropic compact stars in f(R, G) gravity
Energy Technology Data Exchange (ETDEWEB)
Shamir, M.F.; Zia, Saeeda [National University of Computer and Emerging Sciences, Department of Sciences and Humanities, Lahore (Pakistan)
2017-07-15
Modified gravity is one of the potential candidates to explain the accelerated expansion of the universe. Current study highlights the materialization of anisotropic compact stars in the context of f(R, G) theory of gravity. In particular, to gain insight in the physical behavior of three stars namely, Her X1, SAX J 1808-3658 and 4U 1820-30, energy density, and radial and tangential pressures are calculated. The f(R, G) gravity model is split into a Starobinsky like f(R) model and a power law f(G) model. The main feature of the work is a 3-dimensional graphical analysis in which, anisotropic measurements, energy conditions and stability attributes of these stars are discussed. It is shown that all three stars behave as usual for positive values of the f(G) model parameter n. (orig.)
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75 FR 76987 - Agency Information Collection Activities: Submission for OMB Review; Comment Request
2010-12-10
... office or Medicare carrier. Frequency: Reporting--On occasion; Affected Public: State, Local, or Tribal Government, Business or other-for-profit, Not-for-profit institutions; Number of Respondents: 1,048,243... Strategic Operations and Regulatory Affairs. [FR Doc. 2010-31075 Filed 12-9-10; 8:45 am] BILLING CODE 4120...
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Ramery, Eve
2010-01-01
L’ORVR ou obstruction récurrente des voies respiratoires (ORVR) est la cause la plus fréquente de maladie pulmonaire chronique chez le cheval adulte. La maladie se caractérise par une hyperréactivité bronchique, une production excessive de mucus et une inflammation neutrophilique pulmonaire qui ont pour effet de réduire la compliance dynamique du poumon et d’augmenter la résistance des voies respiratoires au débit aérien. Alors que la maladie est une entité documentée dans la littérature depu...
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Directory of Open Access Journals (Sweden)
Michael Paßens
2015-06-01
Full Text Available Disordered and uniform (2√3 × 2√3R30° superstructures of fullerenes on the Au(111 surface have been studied using scanning tunneling microscopy and spectroscopy. It is shown that the deposition and growth process of a fullerene monolayer on the Au(111 surface determine the resulting superstructure. The supply of thermal energy is of importance for the activation of a Au vacancy forming process and thus, one criterion for the selection of the respective superstructure. However, here it is depicted that a vacancy–adatom pair can be formed even at room temperature. This latter process results in C60 molecules that appear slightly more bright in scanning tunnelling microscopy images and are identified in disordered (2√3 x 2√3R30° superstructures based on a detailed structure analysis. In addition, these slightly more bright C60 molecules form uniform (2√3 x 2√3R30° superstructures, which exhibit intermolecular interactions, likely mediated by Au adatoms. Thus, vacancy–adatom pairs forming at room temperature directly affect the resulting C60 superstructure. Differential conductivity spectra reveal a lifting of the degeneracy of the LUMO and LUMO+1 orbitals in the uniform (2√3 x 2√3R30° superstructure and in addition, hybrid fullerene–Au(111 surface states suggest partly covalent interactions.
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An Atomically Precise Au10 Ag2 Nanocluster with Red-Near-IR Dual Emission.
Lei, Zhen; Guan, Zong-Jie; Pei, Xiao-Li; Yuan, Shang-Fu; Wan, Xian-Kai; Zhang, Jin-Yuan; Wang, Quan-Ming
2016-08-01
A red-near-IR dual-emissive nanocluster with the composition [Au10 Ag2 (2-py-C≡C)3 (dppy)6 ](BF4 )5 (1; 2-py-C≡C is 2-pyridylethynyl, dppy=2-pyridyldiphenylphosphine) has been synthesized. Single-crystal X-ray structural analysis reveals that 1 has a trigonal bipyramidal Au10 Ag2 core that contains a planar Au4 (2-py-C≡C)3 unit sandwiched by two Au3 Ag(dppy)3 motifs. Cluster 1 shows intense red-NIR dual emission in solution. The visible emission originates from metal-to-ligand charge transfer (MLCT) from silver atoms to phosphine ligands in the Au3 Ag(dppy)3 motifs, and the intense NIR emission is associated with the participation of 2-pyridylethynyl in the frontier orbitals of the cluster, which is confirmed by a time-dependent density functional theory (TD-DFT) calculation. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Medicare Data to Calculate Your Primary Service Areas
U.S. Department of Health & Human Services — The following data is being made available to applicants to the Medicare Shared Savings Program (Shared Savings Program), in order to allow them to calculate their...
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Medicare Modernization Act (MMA) IRS Medicare Part D
Social Security Administration — SSA uses the Internal Revenue Service (IRS) information in determing the eligibility of Medicare recipients to receive subsidy payments for Medicare premiums. SSA...
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Nuclear modification factors of phi mesons in d+Au, Cu+Cu and Au+Au collisions at sqrt(S_NN)=200 GeV
Czech Academy of Sciences Publication Activity Database
Adare, A.; Afanasiev, S.; Aidala, C.; Mašek, L.; Mikeš, P.; Růžička, Pavel; Tomášek, Lukáš; Vrba, Václav
2011-01-01
Roč. 83, č. 2 (2011), "024909-1"-"024909-10" ISSN 0556-2813 R&D Projects: GA MŠk LA08015 Institutional research plan: CEZ:AV0Z10100502 Keywords : PHENIX experiment * d+AU collisions Subject RIV: BF - Elementary Particles and High Energy Physics Impact factor: 3.308, year: 2011
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Collision course? Donald Trump, Paul Ryan, and the fate of Medicare.
Oberlander, Jonathan
2018-04-10
The election of Donald Trump as president of the United States raises questions about the future of Medicare. How will Medicare fare under Republican-led government? There are several compelling reasons that the Trump administration and Congressional Republicans might avoid Medicare reform, including the political risks of taking on a popular program, the difficulties the party has encountered in trying to dismantle the Patient Protection and Affordable Care Act (ACA), the importance of older Americans to the GOP coalition, and President Trump's views about Medicare. However, because of fiscal pressures and the commitment of Speaker of the House Paul Ryan and other Republicans to entitlement reform, the GOP nonetheless could end up attempting to make major changes in Medicare. Alternatively, Republican efforts to repeal and undermine the ACA could unintentionally enhance the political fortunes of proposals to expand Medicare. Consequently, the fate of Medicare during the Trump administration remains highly uncertain.
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Wang, Shukui; Liu, Xiangxiang; Pan, Bei; Sun, Li; Chen, Xiaoxiang; Zeng, Kaixuan; Hu, Xiuxiu; Xu, Tao; Xu, Mu
2018-05-08
Colorectal cancer (CRC) is one of the most common cancers worldwide usually with poor prognosis due to the advanced stage when diagnosed. This study aimed to investigate whether specific circulating exosomal miRNAs could act as biomarkers for early diagnosis of CRC. A total of 369 peripheral blood samples were included in this study. In the discovery phase, circulating exosomal miR-27a and miR-130a were selected after synthetical analysis of two GEO datasets and TCGA database. The differential expression and diagnostic utility of miR-27a and miR-130a panel were validated using quantitative reverse-transcriptase PCR (qRT-PCR) and Receiver operating characteristic (ROC) curve analysis in subsequent training phase, validation phase and external validation phase. The prognosis of circulating exosomal miR-27a and miR-130a were investigated using the Kaplan-Meier method. The expression of exosomal miR-27a and miR-130a in plasma significantly increased in CRC. The area under ROC curves (AUCs) of miR-27a (miR-130a) were 0.773 (0.742) in the training phase, 0.82 (0.787) in the validation phase, and 0.746 (0.697) in the external validation phase. The combination of two miRNAs presented higher diagnostic utility for CRC (AUCs = 0.846, 0.898 and 0.801 for the training, validation, and external validation phases, respectively). CRC patients with high expression of circulating exosomal miR-27a or miR-130a underwent poorer prognosis. We identified a circulating exosomal miRNAs panel for the detection of CRC. The exosomal miR-27a and miR-130a panel in plasma may act as a non-invasive biomarker for early detection and predicting prognosis of CRC. Copyright ©2018, American Association for Cancer Research.
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Förändrat omhändertagande av patienter med uretärsten : - Lärdomar från ett förbättringsarbete
Khatami, Annelie
2014-01-01
Bakgrund: Omkring 10-15 % av befolkningen, oftast i arbetsför ålder, riskerar att någon gång drabbas av njursten. Nationella riktlinjer för njurstensbehandling saknas, men studier stödjer behandling inom 48 timmar för snabb symtomlindring och minskade besvär för patienten. Inom studerad verksamhet var tiden från diagnos till behandling lång och återinläggningarna var många, varför ett förbättringsarbete initierades. Syfte: Syftet med förbättringsarbetet var att halvera tiden från diagnos till...
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Chemlal, Abdeljalil; Ismaili, Fatiha Alaoui; Karimi, Ilham; Elharraqui, Ryme; Benabdellah, Nawal; Bekaoui, Samira; Haddiya, Intissar; Bentata, Yassamine
2015-01-01
L'infection urinaire chez l'insuffisant rénal est fréquente et particulière dans sa prise en charge diagnostique et thérapeutique. L'objectif de notre étude est de déterminer le profil bactériologique et d’étudier les facteurs de risque des infections urinaires chez le patient insuffisant rénal chronique en milieu de néphrologie. Etude prospective débutée en Septembre 2012 menée au service de néphrologie à l'hôpital régional d'Oujda de l'oriental Marocain. Ont été inclus tous les patients hospitalisés en néphrologie avec une infection urinaire documentée. Nous avons analysé les données démographiques, cliniques, biologiques, et thérapeutiques de nos patients à l'admission et au cours de leurs hospitalisations. 48 épisodes d'infections urinaires chez 43 patients ont été colligés dont 3 enfants. L'incidence de l'infection urinaire dans notre étude était de 4,65%. La médiane d’âge était de 53 (32-66) années. 60,4% étaient de sexe féminin. Le germe isolé était un Escheria Coli dans 58,3% et un Klebsiella dans 29,2%. Le germe isolé était résistant à l'amoxicilline-acide clavulanique dans 83% des cas. L'antibiotique prescris en premiére intention chez nos patients était une céphalosporine de 3 éme génération dans 50%. L’évolution chez nos patients était favorable dans 89,6% des cas. 33,3% avaient présenté un sepsis et on a noté le décès dans 10,4% des cas. Les infections urinaires chez l'insuffisant rénal chronique reste très grave vu leur lourde morbi-mortalié d'où l'intêrét d'un dépistage précoce chez cette population. Un usage raisonné des antibiotiques est nécessaire afin de prévenir l'extension des résistances bactériennes. PMID:26213601
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Generalisation for regular black holes on general relativity to f(R) gravity
Energy Technology Data Exchange (ETDEWEB)
Rodrigues, Manuel E. [Universidade Federal do Para Campus Universitario de Abaetetuba, Faculdade de Ciencias Exatas e Tecnologia, Abaetetuba, Para (Brazil); Universidade Federal do Para, Faculdade de Fisica, PPGF, Belem, Para (Brazil); Fabris, Julio C. [Universidade Federal do Espirito Santo, Vitoria, ES (Brazil); National Research Nuclear University MEPhI, Moscow (Russian Federation); Junior, Ednaldo L.B. [Universidade Federal do Para, Faculdade de Fisica, PPGF, Belem, Para (Brazil); Universidade Federal do Para, Campus Universitario de Tucurui, Faculdade de Engenharia da Computacao, Tucurui, Para (Brazil); Marques, Glauber T. [Universidade Federal Rural da Amazonia ICIBE - LASIC, Belem, PA (Brazil)
2016-05-15
IIn this paper, we determine regular black hole solutions using a very general f(R) theory, coupled to a nonlinear electromagnetic field given by a Lagrangian L{sub NED}. The functions f(R) and L{sub NED} are in principle left unspecified. Instead, the model is constructed through a choice of the mass function M(r) presented in the metric coefficients. Solutions which have a regular behaviour of the geometric invariants are found. These solutions have two horizons, the event horizon and the Cauchy horizon. All energy conditions are satisfied in the whole space-time, except the strong energy condition (SEC), which is violated near the Cauchy horizon.We present also a new theorem related to the energy conditions in f(R) gravity, re-obtaining the well-known conditions in the context of general relativity when the geometry of the solution is the same. (orig.)
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CENTERS for MEDICARE & MEDICAID SERVICES Medicare Hospice Benefits This official government booklet includes information about Medicare hospice benefits: Who’s eligible for hospice care What services are included in hospice care How ...
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Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis
Directory of Open Access Journals (Sweden)
Shin Jaeun
2006-04-01
Full Text Available Abstract Background Medicare-Medicaid dual eligibles are the beneficiaries of both Medicare and Medicaid. Dual eligibles satisfy the eligibility conditions for Medicare benefit. Dual eligibles also qualify for Medicaid because they are aged, blind, or disabled and meet the income and asset requirements for receiving Supplement Security Income (SSI assistance. The objective of this study is to explore the relationship between dual eligibility and health care utilization among Medicare beneficiaries. Methods The household component of the nationally representative Medical Expenditure Panel Survey (MEPS 1996–2000 is used for the analysis. Total 8,262 Medicare beneficiaries are selected from the MEPS data. The Medicare beneficiary sample includes individuals who are covered by Medicare and do not have private health insurance during a given year. Zero-inflated negative binomial (ZINB regression model is used to analyse the count data regarding health care utilization: office-based physician visits, hospital inpatient nights, agency-sponsored home health provider days, and total dental visits. Results Dual eligibility is positively correlated with the likelihood of using hospital inpatient care and agency-sponsored home health services and the frequency of agency-sponsored home health days. Frequency of dental visits is inversely associated with dual eligibility. With respect to racial differences, dually eligible Afro-Americans use more office-based physician and dental services than white duals. Asian duals use more home health services than white duals at the 5% statistical significance level. The dual eligibility programs seem particularly beneficial to Afro-American duals. Conclusion Dual eligibility has varied impact on health care utilization across service types. More utilization of home healthcare among dual eligibles appears to be the result of delayed realization of their unmet healthcare needs under the traditional Medicare-only program
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Reforming Medicare through 'version 2.0' of accountable care.
Lieberman, Steven M
2013-07-01
Medicare needs fundamental reform to achieve fiscal sustainability, improve value and quality, and preserve beneficiaries' access to physicians. Physician fees will fall by one-quarter in 2014 under current law, and the dire federal budget outlook virtually precludes increasing Medicare spending. There is a growing consensus among policy makers that reforming fee-for-service payment, which has long served as the backbone of Medicare, is unavoidable. Accountable care organizations (ACOs) provide a new payment alternative but currently have limited tools to control cost growth or engage and reward beneficiaries and providers. To fundamentally reform Medicare, this article proposes an enhanced version of ACOs that would eliminate the scheduled physician fee cuts, allow fees to increase with inflation, and enhance ACOs' ability to manage care. In exchange, the proposal would require modest reductions in overall Medicare spending and require ACOs to accept increased accountability and financial risk. It would cause per beneficiary Medicare spending by 2023 to fall 4.2 percent below current Congressional Budget Office projections and help the program achieve fiscal sustainability.
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Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua
2016-06-01
Administrative claims data are used for a wide variety of research and quality assurance purposes; however, they are prone to medication exposure misclassification if medications are purchased without using an insurance benefit. Low-cost generic drug programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted, and the exposure may go unobserved in claims data. As heavy users of medications, Medicare beneficiaries have much to gain from the affordable medications offered through LCGPs. This use may put them at increased risk of exposure misclassification in claims data. Many high-risk medications (HRMs) and medications tracked for adherence and utilization quality metrics are available through LCGPs, and exposure misclassification of these medications may impact the quality assurance efforts reliant on administrative claims data. Presently, there is little information regarding the use of these programs among a geriatric population. To (a) quantify the prevalence of LCGP users in a nationally representative population of Medicare beneficiaries; (b) compare clinical and demographic characteristics of LCGP users and nonusers; (c) assess determinants of LCGP use and medications acquired through these programs; and (d) analyze patterns of LCGP use during the years 2007-2012. This study relied on data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2012. The first 3 objectives were completed with a cohort of individuals in the most recent MEPS panel, while the fourth objective was completed with a separate cohort composed of individuals who participated in MEPS from 2007 to 2012. Inclusion in either study cohort required that individuals were Medicare beneficiaries aged 65 years or greater, used at least 1 prescription drug during their 2-year panel period, and participated in all 5
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Lehmann, C U; Longhurst, C A; Hersh, W; Mohan, V; Levy, B P; Embi, P J; Finnell, J T; Turner, A M; Martin, R; Williamson, J; Munger, B
2015-01-01
In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecialties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency. Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.
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42 CFR 421.304 - Medicare integrity program contractor functions.
2010-10-01
... services for which Medicare payment may be made either directly or indirectly. (b) Auditing, settling and... and benefit quality assurance issues. (e) Developing, and periodically updating, a list of items of...
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77 FR 5317 - Medicaid Program; Covered Outpatient Drugs
2012-02-02
... for Medicare & Medicaid Services 42 CFR Part 447 Medicaid Program; Covered Outpatient Drugs; Proposed... Part 447 [CMS-2345-P] RIN 0938-AQ41 Medicaid Program; Covered Outpatient Drugs AGENCY: Centers for... requirements pertaining to Medicaid reimbursement for covered outpatient drugs to implement provisions of the...
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Fitzpatrick, Stephanie L; Wilson, Dawn K; Pagoto, Sherry L
2017-06-01
Beginning in January 2018, the Centers for Medicare and Medicaid Services (CMS) plans to cover the Diabetes Prevention Program (DPP), also referred to as Medicare DPP. The American Psychological Association Society for Health Psychology (SfHP) and the Society for Behavioral Medicine (SBM) reviewed the proposed plan. SfHP and SBM are in support of the CMS decision to cover DPP for Medicare beneficiaries but have a significant concern that aspects of the proposal will limit the public health impact. Concerns include the emphasis on weight outcomes to determine continued coverage and the lack of details regarding requirements for coaches. SfHP and SBM are in strong support of modifications to the proposal that would remove the minimum weight loss stipulation to determine coverage and to specify type and qualifications of "coaches."
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Medicare Update: Annual Wellness Visit
... counseling services or programs, designed to reduce risk factors, such as for weight loss, smoking cessation, fall prevention, and nutrition. • Review of the responses to the Health Risk Assessment Prepared by Leslie Fried, Alzheimer’s Association Medicare Advocacy Project. Rev. Feb 1, 2012 ...
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Static spherically symmetric wormholes in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Zubair, M.; Ahmad, Yasir [Institute Of Information Technology, Department of Mathematics, COMSATS, Lahore (Pakistan); Waheed, Saira [Prince Mohammad Bin Fahd University, Al Khobar (Saudi Arabia)
2016-08-15
In this work, we explore wormhole solutions in f(R, T) theory of gravity, where R is the scalar curvature and T is the trace of stress-energy tensor of matter. To investigate this, we consider a static spherically symmetric geometry with matter contents as anisotropic, isotropic, and barotropic fluids in three separate cases. By taking into account the Starobinsky f(R) model, we analyze the behavior of energy conditions for these different kinds of fluids. It is shown that the wormhole solutions can be constructed without exotic matter in few regions of space-time. We also give the graphical illustration of the results obtained and discuss the equilibrium picture for the anisotropic case only. It is concluded that the wormhole solutions with anisotropic matter are realistic and stable in this theory of gravity. (orig.)
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Direct flow in 10.8 GeV/nucleon Au+Au collisions measured in experiment E917 at the AGS
International Nuclear Information System (INIS)
Back, B. B.; Betts, R. R.; Britt, H. C.; Chang, J.; Chang, W. C.; Gillitzer, A.; Henning, W. F.; Hofman, D. J.; Nanal, V.; Wuosmaa, A. H.
1999-01-01
Analysis of directed flow observable for protons and pions from Au+Au collisions at 10.8 GeV/nucleon from experiment E917 at the AGS is presented. Using a Fourier series expansion, the first Fourier component, ν 1 ,was extracted as a function of rapidity for mid-central collisions (17-24%). Clear evidence for positive directed flow is found in the proton data, and a weak, possibly negative directed flow signal is observed for π + and π -
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2010-12-08
... recommendations to the Medicare Trustees on how the Trustees might more accurately estimate health spending in the long run. The Panel's discussion is expected to be very technical in nature and will focus on the... Trustees on how the Trustees might more accurately estimate the long term rate of health spending in the...
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2010-05-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Toxicology Program (NTP) Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2010-10958 Filed 5-7-10; 8:45 am...
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2012-05-25
... Organization Under the Clinical Laboratory Improvement Amendments of 1988 AGENCY: Centers for Medicare... Commission for re-approval as an accreditation organization for clinical laboratories under the Clinical... On October 31, 1988, the Congress enacted the Clinical Laboratory Improvement Amendments of 1988...
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2007-01-01
pour les professions d’électronicien(ne) et de laborantin(e) en physique L’apprentissage au CERN est régi par les lois, règlements et contrats en vigueur dans le canton de Genève. En cas de réussite à l’examen de fin d’apprentissage, les apprentis obtiennent le Certificat fédéral de capacité suisse (CFC). 6 places au total sont ouvertes au recrutement pour les deux professions. L’apprentissage dure 4 ans. Minima requis pour faire acte de candidature : avoir au moins 15 ans et moins de 21 ans à la date de début de l’apprentissage ; avoir terminé la scolarité obligatoire, au minimum 9e du Cycle d’orientation genevois (3e en France) ; être ressortissant d’un pays membre du CERN (Allemagne, Autriche, Belgique, Bulgarie, Danemark, Espagne, Finlande, France, Grèce, Hongrie, Italie, Norvège, Pays-Bas, Pologne, Portugal, Royaume-Uni, République tchèque, République slovaque , Suède, Suisse) ; pour les résidents en Suisse : être ressortissant su...
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Au-Pt-Au nanoraspberry structures used for mercury ion detection
Huang, Jiang-Hao; Huang, Shuai; Wen, Xiaoyan; Li, Min; Lu, Haifei
2017-12-01
Detection of Hg2+ with high sensitivity is of great significance in the biochemical sensing field. Quantitative of Hg2+ was realized based on the influence of Hg2+ on the UV-vis absorption performance of Au-Pt-Au core-shell nanoraspberry (APA)-rhodamine-6G (R6G) structure. First, APA sol was added into R6G indicator solution and the UV-vis absorption signal intensity of R6G was evidently promoted. The signal intensity monotonously increased as more APA sol was added. However, when HgCl2 solution was introduced, the signal intensity declined. A linear relationship between Hg2+ concentration and signal intensity at 527 nm was revealed, based on which quantitative determination of Hg2+ could be realized. Hg2+ detection sensitivity was measured to be 0.031 a.u./M with a limit of detection of 10-7 M and the response time was 20 s. A high Hg2+ detection selectivity over Cu2+, Na+, Li+, and K+ was demonstrated. Due to its simplicity and high sensitivity, the proposed method could find an extensive application prospect in the Hg2+ detection field.
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La Cyberdépendance: Cas de l’addiction au réseau social Facebook
Directory of Open Access Journals (Sweden)
Houssem Edine Nasr
2015-09-01
Full Text Available La démocratisation de l’internet et la forte pénétration des réseaux sociaux dans la vie de tous les jours des internautes a montré un comportement d’addiction au réseau social Facebook. Malgré l’importance de ce phénomène, très peu de recherches en marketing se sont intéressées à son étude. La présente recherche a pour objectif de mesurer l’addiction des internautes aux réseaux sociaux et d’en déterminer les antécédents. La revue de la littérature relative à l’internet a mis en relief que l’estime de soi et la personnalité sont des antécédents psychologiques de l’addiction. L’enquête par questionnaire que nous avons menée sur Facebook auprès d’un échantillon de convenance de 252 internautes a révélé que trois dimensions sur cinq de la personnalité à savoir l’ouverture aux expériences, l’agréabilité et le névrosisme, sont en relation faible avec la cyberdépendance au réseau social Facebook. Par ailleurs, la variable âge et le nombre d’amis sur Facebook sont en corrélation avec la cyberdépendance à ce réseau social.
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U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
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Saleh, Shadi S; Freire, Chris; Morris-Dickinson, Gwendolyn; Shannon, Trip
2012-06-01
To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. Randomized controlled trial. A general hospital in upstate New York State. Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. Cost-benefit ratio of the PDCT program; self-management skills and abilities. The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
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Lachachi-taleb, Meriem
2014-01-01
Le premier chapitre présente les fondements théoriques relatifs au marketing des services ainsi qu'au concept de servuction et enfin au marketing mix des services dans le deuxiéme chapitre.Le troisiéme chapitre est consacré au marketing bancaire et au plan marketing dans le chapitre suivant, une étude de cas au sein de la B.A.D.R.Banque.
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Power-law cosmic expansion in f(R) gravity models
International Nuclear Information System (INIS)
Goheer, Naureen; Larena, Julien; Dunsby, Peter K. S.
2009-01-01
We show that within the class of f(R) gravity theories, Friedmann-Lemaitre-Robertson-Walker power-law perfect fluid solutions only exist for R n gravity. This significantly restricts the set of exact cosmological solutions which have similar properties to what is found in standard general relativity.
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Ionizing Radiation–Inducible miR-27b Suppresses Leukemia Proliferation via Targeting Cyclin A2
Energy Technology Data Exchange (ETDEWEB)
Wang, Bo; Li, Dongping; Kovalchuk, Anna; Litvinov, Dmitry; Kovalchuk, Olga, E-mail: olga.kovalchuk@uleth.ca
2014-09-01
Purpose: Ionizing radiation is a common carcinogen that is important for the development of leukemia. However, the underlying epigenetic mechanisms remain largely unknown. The goal of the study was to explore microRNAome alterations induced by ionizing radiation (IR) in murine thymus, and to determine the role of IR-inducible microRNA (miRNA/miR) in the development of leukemia. Methods and Materials: We used the well-established C57BL/6 mouse model and miRNA microarray profiling to identify miRNAs that are differentially expressed in murine thymus in response to irradiation. TIB152 human leukemia cell line was used to determine the role of estrogen receptor–α (ERα) in miR-27b transcription. The biological effects of ectopic miR-27b on leukemogenesis were measured by western immunoblotting, cell viability, apoptosis, and cell cycle analyses. Results: Here, we have shown that IR triggers the differential expression of miR-27b in murine thymus tissue in a dose-, time- and sex-dependent manner. miR-27b was significantly down-regulated in leukemia cell lines CCL119 and TIB152. Interestingly, ERα was overexpressed in those 2 cell lines, and it was inversely correlated with miR-27b expression. Therefore, we used TIB152 as a model system to determine the role of ERα in miR-27b expression and the contribution of miR-27b to leukemogenesis. β-Estradiol caused a rapid and transient reduction in miR-27b expression reversed by either ERα-neutralizing antibody or ERK1/2 inhibitor. Ectopic expression of miR-27b remarkably suppressed TIB152 cell proliferation, at least in part, by inducing S-phase arrest. In addition, it attenuated the expression of cyclin A2, although it had no effect on the levels of PCNA, PPARγ, CDK2, p21, p27, p-p53, and cleaved caspase-3. Conclusion: Our data reveal that β-estradiol/ERα signaling may contribute to the down-regulation of miR-27b in acute leukemia cell lines through the ERK1/2 pathway, and that miR-27b may function as a tumor
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Ionizing Radiation–Inducible miR-27b Suppresses Leukemia Proliferation via Targeting Cyclin A2
International Nuclear Information System (INIS)
Wang, Bo; Li, Dongping; Kovalchuk, Anna; Litvinov, Dmitry; Kovalchuk, Olga
2014-01-01
Purpose: Ionizing radiation is a common carcinogen that is important for the development of leukemia. However, the underlying epigenetic mechanisms remain largely unknown. The goal of the study was to explore microRNAome alterations induced by ionizing radiation (IR) in murine thymus, and to determine the role of IR-inducible microRNA (miRNA/miR) in the development of leukemia. Methods and Materials: We used the well-established C57BL/6 mouse model and miRNA microarray profiling to identify miRNAs that are differentially expressed in murine thymus in response to irradiation. TIB152 human leukemia cell line was used to determine the role of estrogen receptor–α (ERα) in miR-27b transcription. The biological effects of ectopic miR-27b on leukemogenesis were measured by western immunoblotting, cell viability, apoptosis, and cell cycle analyses. Results: Here, we have shown that IR triggers the differential expression of miR-27b in murine thymus tissue in a dose-, time- and sex-dependent manner. miR-27b was significantly down-regulated in leukemia cell lines CCL119 and TIB152. Interestingly, ERα was overexpressed in those 2 cell lines, and it was inversely correlated with miR-27b expression. Therefore, we used TIB152 as a model system to determine the role of ERα in miR-27b expression and the contribution of miR-27b to leukemogenesis. β-Estradiol caused a rapid and transient reduction in miR-27b expression reversed by either ERα-neutralizing antibody or ERK1/2 inhibitor. Ectopic expression of miR-27b remarkably suppressed TIB152 cell proliferation, at least in part, by inducing S-phase arrest. In addition, it attenuated the expression of cyclin A2, although it had no effect on the levels of PCNA, PPARγ, CDK2, p21, p27, p-p53, and cleaved caspase-3. Conclusion: Our data reveal that β-estradiol/ERα signaling may contribute to the down-regulation of miR-27b in acute leukemia cell lines through the ERK1/2 pathway, and that miR-27b may function as a tumor
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Autopistas: AU-1 25 de Mayo y AU-6 Perito Moreno
Directory of Open Access Journals (Sweden)
Editorial, Equipo
1981-02-01
Full Text Available Highways AU-1 and AU-6, approximately 17 km. long, were constructed for the purpose of solving the serious traffic problems in Buenos Aires, a city of nine million inhabitants and an evergrowing number of cars. A computer program was created for the design based on the geometric shape of the highway and the position of the supports. Using this, all elements composing the structure were calculated and the framework was sized. This programme made it possible to complete a stretch of 150 metres per week. The very rapid construction was carried out through self-supporting arches made of metallic beams held in place by brackets. The brackets were fitted in specially designed grooves in the major supports of the highway.
Las autopistas AU-1 y AU-6, con una longitud aproximada de 17 km, se realizaron con objeto de resolver el grave problema de infraestructura vial del Municipio de Buenos Aires, ciudad de nueve millones de habitantes y con un parque de vehículos en rápido crecimiento. Para el proyecto se creó un programa de ordenador con el que, partiendo de la definición geométrica de la autopista y de la posición de las pilas, se calculan todos los elementos que componen la estructura y se dimensionan las armaduras. Este programa permitió proyectar un tramo (150 m por semana. La construcción, a un ritmo muy rápido, se llevó a cabo mediante cimbras autoportantes compuestas por vigas metálicas apoyadas sobre ménsulas, las cuales a su vez apoyan en unos nichos dejados en las pilas. -
76 FR 2453 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program
2011-01-13
... program based on conditions for coverage. This new program will necessarily be a fluid model, subject to... rewarding better value, outcomes, and innovations instead of merely volume. Use of Measures: Public....hospitalcompare.hhs.gov , after a 30-day preview period. An interactive Web tool, this Web site assists...
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miR-27 regulates mitochondrial networks by directly targeting the mitochondrial fission factor.
Tak, Hyosun; Kim, Jihye; Jayabalan, Aravinth Kumar; Lee, Heejin; Kang, Hoin; Cho, Dong-Hyung; Ohn, Takbum; Nam, Suk Woo; Kim, Wook; Lee, Eun Kyung
2014-11-28
Mitochondrial morphology is dynamically regulated by forming small, fragmented units or interconnected networks, and this is a pivotal process that is used to maintain mitochondrial homeostasis. Although dysregulation of mitochondrial dynamics is related to the pathogenesis of several human diseases, its molecular mechanism is not fully elucidated. In this study, we demonstrate the potential role of miR-27 in the regulation of mitochondrial dynamics. Mitochondrial fission factor (MFF) mRNA is a direct target of miR-27, whose ectopic expression decreases MFF expression through binding to its 3'-untranslated region. Expression of miR-27 results in the elongation of mitochondria as well as an increased mitochondrial membrane potential and mitochondrial ATP level. Our results suggest that miR-27 is a novel regulator affecting morphological mitochondrial changes by targeting MFF.
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... schedule a lung cancer screening counseling and shared decision making visit with your doctor to discuss the benefits ... when they’re available in your MyMedicare.gov account. 58 Section 3: For more information Visit Medicare. gov for general information about Medicare ...
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2001-12-03
This interim final rule with comment period delays for 1 year the effective date of the last sentence of 42 CFR 411.354(d)(1). Section 411.354(d)(1) was promulgated in the final rule entitled "Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships," published in the Federal Register on January 4, 2001 (66 FR 856). A 1-year delay in the effective date of the last sentence in Section 411.354(d)(1) will give Department officials the opportunity to reconsider the definition of compensation that is "set in advance" as it relates to percentage compensation methodologies in order to avoid unnecessarily disrupting existing contractual arrangements for physician services. Accordingly, the last sentence of Section 411.354(d)(1), which would have become effective January 4, 2002, will not become effective until January 6,2003.
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Trish, Erin; Ginsburg, Paul; Gascue, Laura; Joyce, Geoffrey
2017-09-01
(HCPCS code E0143; 95% CI, 66.3%-68.5%) to 75.8% for a complete blood cell count (CPT 85025; 95% CI, 75.0%-76.6%). Traditional Medicare's administratively set rates act as a strong anchor for physician reimbursement in the MA market, although MA plans succeed in negotiating lower prices for other health care services for which TM overpays. Reforms that transition the Medicare program toward some premium support models could substantially affect how physicians and other clinicians are paid.
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75 FR 47797 - Privacy Act of 1974; System of Records
2010-08-09
... Officer, Department of Defense. Deletion: S330.40 CAHS System name: Employee Assistance Program Records (August 27, 1999; 64 FR 46889). Reason: This collection is covered under the existing DHHS/FOH EAP Privacy notice 09-90-0010, entitled ``Employee Assistance Program (EAP) Records, HHS/OS/ASAM/OHR.'' [FR Doc. 2010...
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The simplest non-minimal matter-geometry coupling in the f(R, T) cosmology
Energy Technology Data Exchange (ETDEWEB)
Moraes, P.H.R.S. [ITA - Instituto Tecnologico de Aeronautica, Departamento de Fisica, Sao Paulo (Brazil); Sahoo, P.K. [Birla Institute of Technology and Science-Pilani, Department of Mathematics, Hyderabad (India)
2017-07-15
f(R, T) gravity is an extended theory of gravity in which the gravitational action contains general terms of both the Ricci scalar R and the trace of the energy-momentum tensor T. In this way, f(R, T) models are capable of describing a non-minimal coupling between geometry (through terms in R) and matter (through terms in T). In this article we construct a cosmological model from the simplest non-minimal matter-geometry coupling within the f(R, T) gravity formalism, by means of an effective energy-momentum tensor, given by the sum of the usual matter energy-momentum tensor with a dark energy contribution, with the latter coming from the matter-geometry coupling terms. We apply the energy conditions to our solutions in order to obtain a range of values for the free parameters of the model which yield a healthy and well-behaved scenario. For some values of the free parameters which are submissive to the energy conditions application, it is possible to predict a transition from a decelerated period of the expansion of the universe to a period of acceleration (dark energy era). We also propose further applications of this particular case of the f(R, T) formalism in order to check its reliability in other fields, rather than cosmology. (orig.)
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The simplest non-minimal matter-geometry coupling in the f(R, T) cosmology
International Nuclear Information System (INIS)
Moraes, P.H.R.S.; Sahoo, P.K.
2017-01-01
f(R, T) gravity is an extended theory of gravity in which the gravitational action contains general terms of both the Ricci scalar R and the trace of the energy-momentum tensor T. In this way, f(R, T) models are capable of describing a non-minimal coupling between geometry (through terms in R) and matter (through terms in T). In this article we construct a cosmological model from the simplest non-minimal matter-geometry coupling within the f(R, T) gravity formalism, by means of an effective energy-momentum tensor, given by the sum of the usual matter energy-momentum tensor with a dark energy contribution, with the latter coming from the matter-geometry coupling terms. We apply the energy conditions to our solutions in order to obtain a range of values for the free parameters of the model which yield a healthy and well-behaved scenario. For some values of the free parameters which are submissive to the energy conditions application, it is possible to predict a transition from a decelerated period of the expansion of the universe to a period of acceleration (dark energy era). We also propose further applications of this particular case of the f(R, T) formalism in order to check its reliability in other fields, rather than cosmology. (orig.)
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Camps de réfugiés et environnement au Kenya : enjeux et contradictions
Cambrézy, Luc
2001-01-01
Dans les camps de réfugiés de Dadaab, au Kenya, un programme de protection environnementale et de réhabilitation du couvert végétal a été mis en place plusieurs années avant tout réel diagnostic sur l'ampleur et l'origine réelle des dégradations constatées. Des études ultérieures ont montré que les auréoles de dégradation autour des camps semblent essentiellement imputables aux besoins ligneux pour la construction et la maintenance des nombreuses infrastructures et non pas à la collecte de bo...
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Directory of Open Access Journals (Sweden)
Halima Ferhat
2010-09-01
Full Text Available Au lendemain de la bataille des Trois Rois, plus connue au Maroc sous le nom de Ouad al Makhazin, de redoutables acteurs s’affrontent : les Habsbourgs d’Espagne et leurs ennemis protestants aux Pays Bas, l’Angleterre, le Portugal dont l’autonomie est désormais remise en question, ainsi que de multiples petits princes locaux et les maîtres des zaouyas sans oublier les corsaires qui, il faut le rappeler, forment un réseau qui n’est pas toujours à l’ordre d’un pays. Plusieurs excellents livres r...
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Faut-il réformer la caisse de compensation au Maroc ?
Tarbalouti, Mr
2014-01-01
Faut-il réformer la caisse de compensation au Maroc? Par Essaid Tarbalouti Version, Mars 2014 The debate on the efficiency of the subsidy of the prices of foodstuffs granted by the policy of compensation and his reform are deeply livened up between the government and the opposition in terms of its cost and its ineffectiveness. This debate concentrate on the social earnings to replace this mechanism of assistant by the granting of a minimum income to the poor people. We...
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27 CFR 10.21 - Commercial bribery.
2010-04-01
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Commercial bribery. 10.21 Section 10.21 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS COMMERCIAL BRIBERY Commercial Bribery § 10.21 Commercial bribery. It is...
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27 CFR 10.22 - Employee associations.
2010-04-01
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Employee associations. 10.22 Section 10.22 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS COMMERCIAL BRIBERY Commercial Bribery § 10.22 Employee associations. Gifts...
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Microstructures and coherent phase diagram for the pseudobinary system (AuCu)1-xPd x with x ≤ 0.10
International Nuclear Information System (INIS)
Luciano, Rhodora H.; Shiraishi, Takanobu; Udoh, Koh-ichi; Tanaka, Yasuhiro; Hisatsune, Kunihiro
2005-01-01
A coherent phase diagram for the pseudobinary system (AuCu) 1-x Pd x with x ≤ 0.10 was constructed based on phase identification and microstructural analysis by transmission electron microscopy. It was confirmed that the addition of palladium exceeding 1.0 at.% to the equiatomic AuCu eliminated the AuCu II long-period superstructure from the phase equilibria and stabilized the AuCu I superstructure. The AuCu-0.5 at.% Pd and AuCu-1.0 at.% Pd alloys isothermally aged for long time at temperatures ranging from 380 to 420 deg. C exhibited seven distinguishable regions; a single-phase region of disordered solid solution (α); a single-phase region of AuCu I ordered phase; a single-phase region of AuCu II ordered phase; a region of the coexisting AuCu I and AuCu II ordered phases; a region of the coexisting AuCu I ordered and α phases; a region of the coexisting AuCu II ordered and α phases; and a region of the coexisting AuCu I and AuCu II ordered and α phases
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Compact stars in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Das, Amit; Guha, B.K. [Indian Institute of Engineering Science and Technology, Department of Physics, Howrah, West Bengal (India); Rahaman, Farook [Jadavpur University, Department of Mathematics, Kolkata, West Bengal (India); Ray, Saibal [Government College of Engineering and Ceramic Technology, Department of Physics, Kolkata, West Bengal (India)
2016-12-15
In the present paper we generate a set of solutions describing the interior of a compact star under f(R, T) theory of gravity which admits conformal motion. An extension of general relativity, the f(R, T) gravity is associated to Ricci scalar R and the trace of the energy-momentum tensor T. To handle the Einstein field equations in the form of differential equations of second order, first of all we adopt the Lie algebra with conformal Killing vectors (CKV) which enable one to get a solvable form of such equations and second we consider the equation of state (EOS) p = ωρ with 0 < ω < 1 for the fluid distribution consisting of normal matter, ω being the EOS parameter. We therefore analytically explore several physical aspects of the model to represent behavior of the compact stars such as - energy conditions, TOV equation, stability of the system, Buchdahl condition, compactness and redshift. It is checked that the physical validity and the acceptability of the present model within the specified observational constraint in connection to a dozen of the compact star candidates are quite satisfactory. (orig.)
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2011-10-11
... (Sec. 423.2300) b. Definitions (Sec. 423.2305) (1) Applicable Beneficiary (2) Applicable Drug (3... marketing, including agent/broker training; payments to MA organizations based on quality ratings; standards... program; payment rules for non-contract health care providers; extending current network adequacy...
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Improving the design of competitive bidding in Medicare Advantage.
Cawley, John H; Whitford, Andrew B
2007-04-01
In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which required that in 2006 the Centers for Medicare and Medicaid Services (CMS) implement a system of competitive bids to set payments for the Medicare Advantage program. Managed care plans now bid for the right to enroll Medicare beneficiaries. Data from the first year of bidding suggest that imperfect competition is limiting the success of the bidding system. This article offers suggestions to improve this system based on findings from auction theory and previous government-run auctions. In particular, CMS can benefit by adjusting its system of competitive bids in four ways: credibly committing to regulations governing bidding; limiting the scope for collusion, entry deterrence, and predatory behavior among bidders; adjusting how benchmark reimbursement rates are set; and accounting for asymmetric information among bidders.
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Cotto, Kelig-Yann
2013-01-01
Identifiant de l'opération archéologique : 8306 Date de l'opération : 2007 (EX) Inventeur(s) : Ctto Kelig-Yann (COL) La Société d’économie mixte « Fréjus-Aménagement » ayant en projet la construction d’une vaste zone de logements au lieu-dit Chemins de Valescure, elle a, en 2007, saisi la DRAC d’une demande anticipée de réalisation de diagnostic. Celui-ci a porté sur une surface d’environ 3 ha. Seule la partie sud s’est révélée positive, permettant la mise au jour d’une vaste zone archéologiq...
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Brane f(R) gravity and the dark side of the universe
International Nuclear Information System (INIS)
Borzou, A.; Sepangi, H. R.; Shahidi, S.; Yousefi, R.
2009-01-01
We consider a brane world scenario in which the bulk action is assumed to have the form of a generic function of the Ricci scalar f(R) and derive the resulting Einstein field equation on the brane. In a constant curvature bulk a conserved geometric quantity appears in the field equations which can be associated with matter. We present spherically symmetric solutions which account for galaxy rotation curves in a specific form. Then cosmological solutions by assuming a specific form for f(R) are derived which can explain an accelerated expanding universe.
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Model citizens. Outsourcing helps start-up Medicare HMO.
Slavic, B; Adami, S
1999-04-01
Health Plans of Pennsylvania (HPP), the managed care arm of Crozer-Keystone Health System, in Media, Pa. Selecting the information systems and building the infrastructure to support the start-up of a new Medicare HMO product. HPP chose to outsource the information systems needed to integrate all the components of managed care administration into a cost-effective and cohesive program. Because of its aggressive programming and start-up of the MedCarePlus product offering, HPP became the first plan in the country to submit Medicare claims data electronically for encounter reporting to the Health Care Financing Administration (HCFA). "Through an integrated team approach, an organization truly can benefit from the economies of scale gained through outsourcing."
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12 CFR 27.6 - Substitute monitoring program.
2010-01-01
... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Substitute monitoring program. 27.6 Section 27.6 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN... (12 CFR 202.13(d)). A bank collecting the data in compliance with § 27.3 of this part will be in...
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75 FR 56946 - Medicaid Program; Review and Approval Process for Section 1115 Demonstrations
2010-09-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 431 [CMS-2325-P] RIN 0938-AQ46 Medicaid Program; Review and Approval Process for Section 1115 Demonstrations AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This...
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2010-09-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); NTP Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM); Availability of Interagency..., Associate Director, National Toxicology Program. [FR Doc. 2010-23262 Filed 9-16-10; 8:45 am] BILLING CODE...
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2010-06-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); NTP Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM): Availability of the Biennial... Toxicology Program. [FR Doc. 2010-13952 Filed 6-9-10; 8:45 am] BILLING CODE 4140-01-P ...
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2012-09-17
... FEDERAL COMMUNICATIONS COMMISSION [AU Docket No. 12-25; DA 12-1446] Mobility Fund Phase I Auction... Mobility Fund Phase I support to be offered in Auction 901, which is to be held on September 27, 2012, and..., 77 FR 32092, May 31, 2012, the Bureaus identified census blocks eligible for the Mobility Fund Phase...
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Study of some chaotic inflationary models in f(R) gravity
Sharif, M.; Nawazish, Iqra
2018-04-01
In this paper, we discuss an inflationary scenario via scalar field and fluid cosmology for an anisotropic homogeneous universe model in f(R) gravity. We consider an equation of state which corresponds to a quasi-de Sitter expansion and investigate the effect of the anisotropy parameter for different values of the deviation parameter. We evaluate potential models like linear, quadratic and quartic models which correspond to chaotic inflation. We construct the observational parameters for a power-law model of f(R) gravity and construct the graphical analysis of tensor-scalar ratio and spectral index which indicates the consistency of these parameters with Planck 2015 data.
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Medication adherence and Medicare expenditure among beneficiaries with heart failure.
Lopert, Ruth; Shoemaker, J Samantha; Davidoff, Amy; Shaffer, Thomas; Abdulhalim, Abdulla M; Lloyd, Jennifer; Stuart, Bruce
2012-09-01
To (1) measure utilization of and adherence to heart failure medications and (2) assess whether better adherence is associated with lower Medicare spending. Pooled cross-sectional design using six 3-year cohorts of Medicare beneficiaries with congestive heart failure (CHF) from 1997 through 2005 (N = 2204). Adherence to treatment was measured using average daily pill counts. Bivariate and multivariate methods were used to examine the relationship between medication adherence and Medicare spending. Multivariate analyses included extensive variables to control for confounding, including healthy adherer bias. Approximately 58% of the cohort were taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), 72% a diuretic, 37% a beta-blocker, and 34% a cardiac glycoside. Unadjusted results showed that a 10% increase in average daily pill count for ACE inhibitors or ARBs, beta-blockers, diuretics, or cardiac glycosides was associated with reductions in Medicare spending of $508 (not significant [NS]), $608 (NS), $250 (NS), and $1244 (P <.05), respectively. Estimated adjusted marginal effects of a 10% increase in daily pill counts for beta-blockers and cardiac glycosides were reductions in cumulative 3-year Medicare spending of $510 to $561 and $750 to $923, respectively (P <.05). Higher levels of medication adherence among Medicare beneficiaries with CHF were associated with lower cumulative Medicare spending over 3 years, with savings generally exceeding the costs of the drugs in question.
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Revisiting van der Waals like behavior of f(R AdS black holes via the two point correlation function
Directory of Open Access Journals (Sweden)
Jie-Xiong Mo
2017-05-01
Full Text Available Van der Waals like behavior of f(R AdS black holes is revisited via two point correlation function, which is dual to the geodesic length in the bulk. The equation of motion constrained by the boundary condition is solved numerically and both the effect of boundary region size and f(R gravity are probed. Moreover, an analogous specific heat related to δL is introduced. It is shown that the T−δL graphs of f(R AdS black holes exhibit reverse van der Waals like behavior just as the T−S graphs do. Free energy analysis is carried out to determine the first order phase transition temperature T⁎ and the unstable branch in T−δL curve is removed by a bar T=T⁎. It is shown that the first order phase transition temperature is the same at least to the order of 10−10 for different choices of the parameter b although the values of free energy vary with b. Our result further supports the former finding that charged f(R AdS black holes behave much like RN-AdS black holes. We also check the analogous equal area law numerically and find that the relative errors for both the cases θ0=0.1 and θ0=0.2 are small enough. The fitting functions between log|T−Tc| and log|δL−δLc| for both cases are also obtained. It is shown that the slope is around 3, implying that the critical exponent is about 2/3. This result is in accordance with those in former literatures of specific heat related to the thermal entropy or entanglement entropy.
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Glassmire, David M; Jhawar, Amandeep; Burchett, Danielle; Tarescavage, Anthony M
2017-05-01
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F(p) (Infrequency-Psychopathology) scale was developed to measure overreporting in a manner that was minimally confounded by genuine psychopathology, which was a problem with using the MMPI-2 F (Infrequency) scale among patients with severe mental illness. Although revised versions of both of these scales are included on the MMPI-2-Restructured Form and used in a forensic context, no item-level research has been conducted on their sensitivity to genuine psychopathology among forensic psychiatric inpatients. Therefore, we examined the psychometric properties of the scales in a sample of 438 criminally committed forensic psychiatric inpatients who were adjudicated as not guilty by reason of insanity and had no known incentive to overreport. We found that 20 of the 21 Fp-r items (95.2%) demonstrated endorsement rates ≤ 20%, with 14 of the items (66.7%) endorsed by less than 10% of the sample. Similar findings were observed across genders and across patients with mood and psychotic disorders. The one item endorsed by more than 20% of the sample had a 23.7% overall endorsement rate and significantly different endorsement rates across ethnic groups, with the highest endorsements occurring among Hispanic/Latino (43.3% endorsement rate) patients. Endorsement rates of F-r items were generally higher than for Fp-r items. At the scale level, we also examined correlations with the Restructured Clinical Scales and found that Fp-r demonstrated lower correlations than F-r, indicating that Fp-r is less associated with a broad range of psychopathology. Finally, we found that Fp-r demonstrated slightly higher specificity values than F-r at all T score cutoffs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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R data analysis without programming
Gerbing, David W
2013-01-01
This book prepares readers to analyze data and interpret statistical results using R more quickly than other texts. R is a challenging program to learn because code must be created to get started. To alleviate that challenge, Professor Gerbing developed lessR. LessR extensions remove the need to program. By introducing R through less R, readers learn how to organize data for analysis, read the data into R, and produce output without performing numerous functions and programming exercises first. With lessR, readers can select the necessary procedure and change the relevant variables without pro
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Medicare Appeals Council Decisions
U.S. Department of Health & Human Services — Decisions of the Departmental Appeals Board's Medicare Appeals Council involving claims for entitlement to Medicare and individual claims for Medicare coverage and...
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Importprocessen för inrednings- och gåvoartiklar från USA till Finland : En handbok för företagaren
Smeds, Desiré; Backlund, Johanna
2016-01-01
Det här examensarbetet handlar om import från USA med fokus på inrednings- och gåvoartiklar. I arbetet lyfter vi steg för steg fram de delar som utgör importprocessen hela vägen från hur man hittar en pålitlig leverantör till förtullningen av produkterna här i Finland. Syftet med arbetet är att det skall kunna fungera som en handbok för företag som vill starta en småskalig importverksamhet av inrednings- och gåvoartiklar. Vi tar även upp information om import och internationell handel i a...
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The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.
Keohane, Laura M; Trivedi, Amal N; Mor, Vincent
2018-04-01
To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.
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Chambers, James D; May, Katherine E; Neumann, Peter J
2013-06-01
The Food and Drug Administration (FDA) and Medicare use different standards to determine, first, whether a new drug or medical device can be marketed to the public and, second, if the federal health insurance program will pay for use of the drug or device. This discrepancy creates hurdles and uncertainty for drug and device manufacturers. We analyzed discrepancies between FDA approval and Medicare national coverage determinations for sixty-nine devices and Part B drugs approved during 1999-2011. We found that Medicare covered FDA-approved drugs or devices 80 percent of the time. However, Medicare often added conditions beyond FDA approval, particularly for devices and most often restricting coverage to patients with the most severe disease. In some instances, Medicare was less restrictive than the FDA. Our findings highlight the importance for drug and device makers of anticipating Medicare's needs when conducting clinical studies to support their products. Our findings also provide important insights for the FDA's and Medicare's pilot parallel review program.
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Chemical modifications of Au/SiO2 template substrates for patterned biofunctional surfaces.
Briand, Elisabeth; Humblot, Vincent; Landoulsi, Jessem; Petronis, Sarunas; Pradier, Claire-Marie; Kasemo, Bengt; Svedhem, Sofia
2011-01-18
The aim of this work was to create patterned surfaces for localized and specific biochemical recognition. For this purpose, we have developed a protocol for orthogonal and material-selective surface modifications of microfabricated patterned surfaces composed of SiO(2) areas (100 μm diameter) surrounded by Au. The SiO(2) spots were chemically modified by a sequence of reactions (silanization using an amine-terminated silane (APTES), followed by amine coupling of a biotin analogue and biospecific recognition) to achieve efficient immobilization of streptavidin in a functional form. The surrounding Au was rendered inert to protein adsorption by modification by HS(CH(2))(10)CONH(CH(2))(2)(OCH(2)CH(2))(7)OH (thiol-OEG). The surface modification protocol was developed by testing separately homogeneous SiO(2) and Au surfaces, to obtain the two following results: (i) SiO(2) surfaces which allowed the grafting of streptavidin, and subsequent immobilization of biotinylated antibodies, and (ii) Au surfaces showing almost no affinity for the same streptavidin and antibody solutions. The surface interactions were monitored by quartz crystal microbalance with dissipation monitoring (QCM-D), and chemical analyses were performed by polarization modulation-reflexion absorption infrared spectroscopy (PM-RAIRS) and X-ray photoelectron spectroscopy (XPS) to assess the validity of the initial orthogonal assembly of APTES and thiol-OEG. Eventually, microscopy imaging of the modified Au/SiO(2) patterned substrates validated the specific binding of streptavidin on the SiO(2)/APTES areas, as well as the subsequent binding of biotinylated anti-rIgG and further detection of fluorescent rIgG on the functionalized SiO(2) areas. These results demonstrate a successful protocol for the preparation of patterned biofunctional surfaces, based on microfabricated Au/SiO(2) templates and supported by careful surface analysis. The strong immobilization of the biomolecules resulting from the described
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De l’acceptabilité sociale au développement local résilient
Raufflet, Emmanuel
2014-01-01
Au cours des dernières années, les enjeux liés à l’acceptabilité sociale des activités économiques, en particulier dans le secteur extractif, se sont imposées comme des enjeux significatifs tant pour les entreprises, en tant qu’investisseurs directs et opérateurs des projets que pour les pouvoirs publics, comme promoteurs de projets de développement économique local et régional. Notre argument principal est que le mode de pensée vers le développement local résilient devrait remplacer celui pr...
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40 CFR 52.870 - Identification of plan.
2010-07-01
... FR 1420 K.A.R. 28-19-23 Hydrocarbon Emissions—Stationary Sources 12/27/72 11/8/73, 38 FR 30876 K.A.R... Operations 10/7/91 6/23/92, 57 FR 27936 K.A.R. 28-19-77 Chemical Processing Facilities That Operate Alcohol... published 3/2/76. (7) Analysis and Recommendations Concerning Designation of Air Quality Maintenance Areas...
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Wormholes in viable f(R) modified theories of gravity and weak energy condition
Energy Technology Data Exchange (ETDEWEB)
Pavlovic, Petar [Universitaet Hamburg, II. Institut fuer Theoretische Physik, Hamburg (Germany); Sossich, Marko [University of Zagreb, Department of Physics, Faculty of Electrical Engineering and Computing, Zagreb (Croatia)
2015-03-01
In this work wormholes in viable f(R) gravity models are analyzed. We are interested in exact solutions for stress-energy tensor components depending on different shape and redshift functions. Several solutions of gravitational equations for different f(R) models are examined. The solutions found imply no need for exotic material, while this need is implied in the standard general theory of relativity. A simple expression for weak energy condition (WEC) violation near the throat is derived and analyzed. High curvature regime is also discussed, as well as the question of the highest possible values of the Ricci scalar for which the WEC is not violated near the throat, and corresponding functions are calculated for several models. The approach here differs from the one that has been common since no additional assumptions to simplify the equations have been made, and the functions in f(R) models are not considered to be arbitrary functions, but rather a feature of the theory that has to be evaluated on the basis of consistency with observations for the Solar System and cosmological evolution. Therefore in this work we show that the existence of wormholes without exotic matter is not only possible in simple arbitrary f(R) models, but also in models that are in accordance with empirical data. (orig.)
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2010-10-01
... 46 Shipping 3 2010-10-01 2010-10-01 false Alternative Hull Examination (AHE) program options...-27 Alternative Hull Examination (AHE) program options: Divers or underwater remotely operated vehicle... operations; (2) Provide permanent hull markings, a temporary grid system of wires or cables spaced not more...
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42 CFR 460.124 - Additional appeal rights under Medicare or Medicaid.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Additional appeal rights under Medicare or Medicaid. 460.124 Section 460.124 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... or Medicaid. A PACE organization must inform a participant in writing of his or her appeal rights...
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MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE
ROBBINS, JACOB A.
2015-01-01
The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687
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2011-10-31
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed National Toxicology... Session AGENCY: Division of the National Toxicology Program (DNTP), National Institute of Environmental.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2011-28132 Filed 10-28-11; 8:45 am...
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Directory of Open Access Journals (Sweden)
Tariq Hussain
2018-01-01
Full Text Available Mycobacterium avium subspecies paratuberculosis (MAP persistently survive and replicate in mononuclear phagocytic cells by adopting various strategies to subvert host immune response. Interleukin-10 (IL-10 upregulation via inhibition of macrophage bactericidal activity is a critical step for MAP survival and pathogenesis within the host cell. Mitogen-activated protein kinase p38 signaling cascade plays a crucial role in the elevation of IL-10 and progression of MAP pathogenesis. The contribution of microRNAs (miRNAs and their influence on the activation of macrophages during MAP pathogenesis are still unclear. In the current study, we found that miRNA-27a-3p (miR-27a expression is downregulated during MAP infection both in vivo and in vitro. Moreover, miR-27a is also downregulated in toll-like receptor 2 (TLR2-stimulated murine macrophages (RAW264.7 and bone marrow-derived macrophage. ELISA and real-time qRT-PCR results confirm that overexpression of miR-27a inhibited MAP-induced IL-10 production in macrophages and upregulated pro-inflammatory cytokines, while miR-27a inhibitor counteracted these effects. Luciferase reporter assay results revealed that IL-10 and TGF-β-activated protein kinase 1 binding protein 2 (TAB 2 are potential targets of miR-27a. In addition, we demonstrated that miR-27a negatively regulates TAB 2 expression and diminishes TAB 2-dependent p38/JNK phosphorylation, ultimately downregulating IL-10 expression in MAP-infected macrophages. Furthermore, overexpression of miR-27a significantly inhibited the intracellular survival of MAP in infected macrophages. Our data show that miR-27a augments antimicrobial activities of macrophages and inhibits the expression of IL-10, demonstrating that miR-27a regulates protective innate immune responses during MAP infection and can be exploited as a novel therapeutic target in the control of intracellular pathogens, including paratuberculosis.
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76 FR 10735 - Medicaid Program; Community First Choice Option
2011-02-25
... for Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option... Part 441 [CMS-2337-P] RIN 0938-AQ35 Medicaid Program; Community First Choice Option AGENCY: Centers for... Section 2401 of the Affordable Care Act (ACA) which establishes a new State option to provide home and...
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2013-06-03
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 433 [CMS-2327-CN] RIN 0938-AR38 Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable Care Act of 2010; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS...
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Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B
2013-10-01
Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.
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75 FR 30043 - Medicare Program; Meeting of the Advisory Panel on Medicare Education
2010-05-28
... imposed * * * by law.'' Such duties are imposed by section 1804 of the Social Security Act (the Act...; Stephen P. Fera, M.B.A., Vice President, Social Mission Programs, Independence Blue Cross; Nan-Kirsten... Education Strategies. Public Comment. Listening Session with CMS Leadership. Next Steps. Individuals or...
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Apprentissages techniques : L'apprentissage au CERN
2004-01-01
APPRENTISSAGES TECHNIQUES GESTION ET DEVELOPPEMENT DU PERSONNEL HR/PMD L'APPRENTISSAGE AU CERN pour les professions d'électronicien(ne) et de laborantin(e) en physique L'apprentissage au CERN est régi par les lois, règlements et contrats en vigueur dans le Canton de Genève. En cas de réussite à l'examen de fin d'apprentissage, les apprentis obtiennent le Certificat Fédéral de Capacité Suisse (CFC). 7 places au total sont ouvertes au recrutement pour les deux professions. L'apprentissage dure 4 ans. Minima requis pour faire acte de candidature : avoir au moins 15 ans et moins de 21 ans à la date de début de l'apprentissage avoir terminé la scolarité obligatoire, au minimum 9ème du Cycle d'orientation genevois (3ème en France) être ressortissant d'un pays membre du CERN (Allemagne, Autriche, Belgiqu...
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Black, Kelly
2014-01-01
This book is designed for people with some experience in basic programming practices. It is also assumed that they have some basic experience using R and are familiar using the command line in an R environment. Our primary goal is to raise a beginner to a more advanced level to make him/her more comfortable creating programs and extending R to solve common problems.
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County-Level Population Economic Status and Medicare Imaging Resource Consumption.
Rosenkrantz, Andrew B; Hughes, Danny R; Prabhakar, Anand M; Duszak, Richard
2017-06-01
The aim of this study was to assess relationships between county-level variation in Medicare beneficiary imaging resource consumption and measures of population economic status. The 2013 CMS Geographic Variation Public Use File was used to identify county-level per capita Medicare fee-for-service imaging utilization and nationally standardized costs to the Medicare program. The County Health Rankings public data set was used to identify county-level measures of population economic status. Regional variation was assessed, and multivariate regressions were performed. Imaging events per 1,000 Medicare beneficiaries varied 1.8-fold (range, 2,723-4,843) at the state level and 5.3-fold (range, 1,228-6,455) at the county level. Per capita nationally standardized imaging costs to Medicare varied 4.2-fold (range, $84-$353) at the state level and 14.1-fold (range, $33-$471) at the county level. Within individual states, county-level utilization varied on average 2.0-fold (range, 1.1- to 3.1-fold), and costs varied 2.8-fold (range, 1.1- to 6.4-fold). For both large urban populations and small rural states, Medicare imaging resource consumption was heterogeneously variable at the county level. Adjusting for county-level gender, ethnicity, rural status, and population density, countywide unemployment rates showed strong independent positive associations with Medicare imaging events (β = 26.96) and costs (β = 4.37), whereas uninsured rates showed strong independent positive associations with Medicare imaging costs (β = 2.68). Medicare imaging utilization and costs both vary far more at the county than at the state level. Unfavorable measures of county-level population economic status in the non-Medicare population are independently associated with greater Medicare imaging resource consumption. Future efforts to optimize Medicare imaging use should consider the influence of local indigenous socioeconomic factors outside the scope of traditional beneficiary-focused policy
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Etude séro-épidémiologique de la leishmaniose canine au centre du Maroc
Fellah, Hajiba; Doughmi, Oursula; Maniar, Saâd; Lalami, Abdelhakim El Ouali
2014-01-01
Dans le monde, la leishmaniose viscérale humaine est connue pour avoir comme principale source d'infection les Canidés domestiques et sauvages. Au centre du Maroc, les données épidémiologiques, cliniques et parasitologiques sur la leishmaniose canine, sont quasiment inexistantes. Ce travail traite une étude prospective au cours de laquelle 61 sérums canins ont été analysés par un test rapide et par l'immunofluorescence indirecte. La sensibilité du test rapide par rapport à celle de l'immunofluorescence indirecte (IFI) est de 33,33%. La fréquence de la maladie chez les chiens s’élève à 9,83% (Test Rapide) et 24,59% (IFI). 73,33% des cas canins positifs à la sérologie sont asymptomatiques. Ce sont les jeunes chiens de moins de 5 ans qui sont les plus fréquemment atteints avec une sensibilité de la race Berger Allmand à l'infection. Cette étude a permis de mettre en évidence la présence de chiens leishmaniens (15 chiens séropositifs parmi 61) et de prouver l'existence du réservoir canin. Une stratégie de prévention active doit être mise en place. PMID:25852791
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Advanced Object-Oriented Programming in R
DEFF Research Database (Denmark)
Mailund, Thomas
2017-01-01
Learn how to write object-oriented programs in R and how to construct classes and class hierarchies in the three object-oriented systems available in R. This book gives an introduction to object-oriented programming in the R programming language and shows you how to use and apply R in an object......-oriented manner. You will then be able to use this powerful programming style in your own statistical programming projects to write flexible and extendable software. After reading Advanced Object-Oriented Programming in R, you'll come away with a practical project that you can reuse in your own analytics coding...... of data being manipulated. You will: Define and use classes and generic functions using R Work with the R class hierarchies Benefit from implementation reuse Handle operator overloading Apply the S4 and R6 classes...
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Advanced Object-Oriented Programming in R
DEFF Research Database (Denmark)
Mailund, Thomas
Learn how to write object-oriented programs in R and how to construct classes and class hierarchies in the three object-oriented systems available in R. This book gives an introduction to object-oriented programming in the R programming language and shows you how to use and apply R in an object......-oriented manner. You will then be able to use this powerful programming style in your own statistical programming projects to write flexible and extendable software. After reading Advanced Object-Oriented Programming in R, you'll come away with a practical project that you can reuse in your own analytics coding...... of data being manipulated. You will: Define and use classes and generic functions using R Work with the R class hierarchies Benefit from implementation reuse Handle operator overloading Apply the S4 and R6 classes...
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Examining Measures of Income and Poverty in Medicare Administrative Data.
Samson, Lok Wong; Finegold, Kenneth; Ahmed, Azeem; Jensen, Matthew; Filice, Clara E; Joynt, Karen E
2017-12-01
Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, because Medicare administrative data contains limited information about individual economic status. Information gleaned from other sources-such as the Medicaid and Supplemental Security Income programs-can be used in some cases to approximate the income of Medicare beneficiaries. However, such information is limited in its availability and applicability to all beneficiaries. Neighborhood-level measures of income can be used to infer individual-level income, but level of neighborhood aggregation impacts accuracy and usability of the data. Community-level composite measures of economic status have been shown to be associated with health and health outcomes of Medicare beneficiaries and may capture neighborhood effects that are separate from individual effects, but are not readily available in Medicare data and do not serve to replace information about individual economic status. There is no single best method of obtaining income data from Medicare files, but understanding strengths and limitations of different approaches to identifying economic status will help researchers choose the best method for their particular purpose, and help policymakers interpret studies using measures of income.
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Paying Medicare Advantage plans: To level or tilt the playing field.
Glazer, Jacob; McGuire, Thomas G
2017-12-01
Medicare beneficiaries are eligible for health insurance through the public option of traditional Medicare (TM) or may join a private Medicare Advantage (MA) plan. Both are highly subsidized but in different ways. Medicare pays for most of costs directly in TM, and subsidizes MA plans based on a "benchmark" for each beneficiary choosing a private plan. The level of this benchmark is arguably the most important policy decision Medicare makes about the MA program. Many analysts recommend equalizing Medicare's subsidy across the options - referred to in policy circles as a "level playing field." This paper studies the normative question of how to set the level of the benchmark, applying the versatile model developed by Einav and Finkelstein (EF) to Medicare. The EF framework implies unequal subsidies to counteract risk selection across plan types. We also study other reasons to tilt the field: the relative efficiency of MA vs. TM, market power of MA plans, and institutional features of the way Medicare determines subsidies and premiums. After review of the empirical and policy literature, we conclude that in areas where the MA market is competitive, the benchmark should be set below average costs in TM, but in areas characterized by imperfect competition in MA, it should be raised in order to offset output (enrollment) restrictions by plans with market power. We also recommend specific modifications of Medicare rules to make demand for MA more price elastic. Copyright © 2016. Published by Elsevier B.V.
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Westrick, Salisa C; Hastings, Tessa J; McFarland, Stuart J; Hohmann, Lindsey A; Hohmann, Natalie S
2016-09-01
Many Medicare beneficiaries have limited income and report problems paying for their medications. Programs are available to assist these low-income individuals. However, these programs are underused because of lack of general awareness and perceived complexity of program applications. To (a) determine the frequency of encounters by pharmacists with Medicare beneficiaries who cannot afford prescription drugs; (b) identify strategies that pharmacists use to assist Medicare beneficiaries who cannot afford prescription drugs; and (c) explore what pharmacists know about programs for Medicare beneficiaries with limited income. This study used a mixed-mode survey of 350 randomly sampled community pharmacies located in 32 counties in Alabama with a high proportion of Medicare beneficiaries who were potentially eligible for low-income subsidy programs. Measures included frequency of encounters by pharmacists with Medicare beneficiaries who could not afford their medications, strategies used to assist Medicare beneficiaries, and pharmacists' knowledge of programs for Medicare beneficiaries with limited income. Of 350 surveys sent, 12 were nondeliverable, and 151 were completed (response rate=44.6%). About 50% of respondents reported encountering Medicare beneficiaries who could not afford their medications at least weekly. Various strategies were reported, including refiling claims that were previously denied every day (40.7%), contacting insurance companies at least once per week (43.2%), and loaning medications at least 2-3 times per month (29.1%). Only 12.6% reported referring beneficiaries to the Aging and Disability Resource Centers (ADRCs) to assess eligibility for limited-income programs. When asked about programs for beneficiaries with limited income, the answers were predominantly "don't know for sure." Several strategies were used by pharmacists in an attempt to help limited-income Medicare beneficiaries obtain their medications. Lack of knowledge about financial
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Voyager observations of solar wind proton temperature - 1-10 AU
Gazis, P. R.; Lazarus, A. J.
1982-01-01
Simultaneous measurements are made of the solar wind proton temperatures by the Voyager 1 and 2 spacecraft, far from earth, and the IMP 8 spacecraft in earth orbit. This technique permits a separation of radial and temporal variations of solar wind parameters. The average value of the proton temperature between 1 and 9 AU is observed to decrease as r (the heliocentric radius) to the -(0.7 + or - 0.2). This is slower than would be expected for adiabatic expansion. A detailed examination of the solar wind stream structure shows that considerable heating occurs at the interface between high and low speed streams.
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MEDICARE: Improvements Needed in Provider Communications and Contracting Procedures
National Research Council Canada - National Science Library
Aronovitz, Leslie
2001-01-01
.... Under Medicare's fee-for-service system-which accounts for over 80 percent of program beneficiaries physicians, hospitals, and other providers submit claims to receive reimbursement for services...
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2012-02-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6034-N] Medicaid Program; Announcement of Medicaid Recovery Audit Contractors (RACs) Contingency Fee Update AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces an...
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Ryan, Andrew M; Damberg, Cheryl L
2013-06-01
The Medicare program has implemented pay-for-performance (P4P), or Value-Based Purchasing, for inpatient care and for Medicare Advantage plans, and plans to implement a program for physicians in 2015. In this paper, we review evidence on the effectiveness of P4P and identify design criteria deemed to be best practice in P4P. We then assess the extent to which Medicare's existing and planned Value-Based Purchasing programs align with these best practices. Of the seven identified best practices in P4P program design, the Hospital Value-Based Purchasing program is strongly aligned with two of the best practices, moderately aligned with three, weakly aligned with one, and has unclear alignment with one best practice. The Physician Value-Based Purchasing Modifier is strongly aligned with two of the best practices, moderately aligned with one, weakly aligned with three, and has unclear alignment with one of the best practices. The Medicare Advantage Quality Bonus Program is strongly aligned with four of the best practices, moderately aligned with two, and weakly aligned with one of the best practices. We identify enduring gaps in P4P literature as it relates to Medicare's plans for Value-Based Purchasing and discuss important issues in the future of these implementations in Medicare. Copyright © 2013 Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Nathalie Auger
2018-01-01
Full Text Available Introduction. On sait que les intervalles courts comme les intervalles longs entre les grossesses sont associés à des issues périnatales défavorables, comme des fausses couches et des accouchements prématurés, mais les différences culturelles à ce sujet sont mal connues. Repérer les inégalités culturelles dans les intervalles entre les grossesses est nécessaire afin d'améliorer les résultats relatifs à la santé de la mère et de l’enfant. Nous avons ainsi évalué les intervalles entre les grossesses chez les anglophones et les francophones du Québec. Méthodologie. Nous avons obtenu les dossiers de naissance de tous les enfants nés au Québec entre 1989 et 2011. Nous avons recensé 571 461 femmes ayant eu au moins deux naissances et déterminé l’intervalle entre leurs grossesses. Les intervalles courts entre les grossesses (moins de 18 mois ont été définis comme étant le 20e percentile de la distribution, et les intervalles longs (60 mois ou plus, comme le 80e percentile. À l’aide de régressions quantiles, nous avons évalué l’association entre la langue et les intervalles courts et longs, ajustés en fonction des caractéristiques de la mère. Nous avons évalué les différences au fil du temps et selon l’âge de la mère pour les groupes défavorisés, qui ont été définis par l’absence de diplôme d’études secondaires, la résidence en milieu rural et le fait de vivre dans un quartier défavorisé matériellement. Résultats. Dans les modèles de régression ajustés, les anglophones sans diplôme d’études secondaires avaient des intervalles plus courts de 1,0 mois (intervalle de confiance [IC] à 95 % : −1,5 à −0,4 par rapport à leurs homologues francophones au 20e percentile de la distribution et plus longs de 1,9 mois (−0,5 à 4,3 au 80e percentile. Les résultats étaient similaires pour les anglophones des régions rurales et des quartiers matériellement défavorisés. Les
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Canadian Medicare: prognosis guarded.
Naylor, C D; Fooks, C; Williams, J I
1995-01-01
Beset by unprecedented fiscal pressures, Canadian medicare has reached a crossroads. The authors review the impact of recent cuts in federal transfer payments on provincial health care programs and offer seven suggestions to policymakers trying to accommodate these reductions. (1) Go slowly: public health care spending is no longer rising and few provinces have the necessary systems in place to manage major reductions. (2) Target reductions, rewarding quality and efficiency instead of making ...
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75 FR 14454 - National Protection and Programs Directorate; National Infrastructure Advisory Council
2010-03-25
..., National Infrastructure Advisory Council. [FR Doc. 2010-6633 Filed 3-24-10; 8:45 am] BILLING CODE 9110-9P-P ... Directorate; National Infrastructure Advisory Council AGENCY: National Protection and Programs Directorate... Infrastructure Advisory Council (NIAC) will meet on Tuesday, April 13, 2010, at the National Press Club's...
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In-plane and out-of-plane emission of nuclear matter in Au+Au collisions
International Nuclear Information System (INIS)
Bastid, N.; Dupieux, P.; Ramillien, V.; Alard, J.P.; Amouroux, V.; Berger, L.; Boussange, S.; Fraysse, L.; Ibnouzahir, M.; Montarou, G.
1995-01-01
Collective flow effects in Au (E/A = 150 to 800 MeV) on Au collisions measured with the phase I setup of the FOPI detector at GSI - Darmstadt are presented. Directed side ward flow is studied, by the mean transverse momentum in the reaction plane x (y)>, without reaction plane reconstruction. A more quantitative measurement of the global amount of directed side ward flow is also made and some comparisons with the predictions of different QMD versions are given. Experimental results concerning the preferential emission of particles in a direction perpendicular to the reaction plane are also presented. Azimuthal distributions of fragments around the beam axis, with respect to the reaction plane are studied in the mid-rapidity region and the associated R N (out-of-plane/in-plane ratios) are extracted. The dependence of R N upon transverse momentum, centrality, fragment charge and bombarding energy is studied. (authors). 24 refs., 10 figs., 1 tab
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U.S. Department of Health & Human Services — Medicare certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. The cost report contains provider...
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The bribery statute: a new weapon against Medicare fraud.
Cozort, L A
2001-03-01
A May 2000 U.S. Supreme Court decision determining when a Federal bribery statute can be used to fight Medicare fraud has ramifications for healthcare providers. In Fischer v. United States, the Court concluded that healthcare providers that participate in Medicare are considered to receive benefits as set forth in the bribery statute and thus can be prosecuted for fraudulent activities against the government under the statute. The statute mandates a fine, imprisonment for up to 10 years, or both for anyone convicted under it. Provider organizations that receive Medicare payments and business associates of such organizations should be aware that the government may step up its use of the bribery law in prosecuting fraudulent activity. In addition, although the case pertained specifically to healthcare providers that participate in Medicare, providers that do not participate in Medicare may wish to evaluate the advisability of accepting other Federal funding because of the possible reach of the bribery statute.
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78 FR 71565 - Secretarial Infrastructure Business Development Mission to Mexico
2013-11-29
... DEPARTMENT OF COMMERCE Office of Business Liaison Secretarial Infrastructure Business Development... amending the Notice published at 78 FR 48855, August 12, 2013, regarding the Secretarial Infrastructure..., Trade Program Assistant. [FR Doc. 2013-28579 Filed 11-27-13; 8:45 am] BILLING CODE 3510-FP-P ...
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Opioid Prescribing Practices of Neurosurgeons: Analysis of Medicare Part D.
Khalid, Syed I; Adogwa, Owoicho; Lilly, Daniel T; Desai, Shyam A; Vuong, Victoria D; Mehta, Ankit I; Cheng, Joseph
2018-04-01
The Centers for Disease Control have declared that the United States is amidst a continuing opioid epidemic, with drug overdose-related death tripling between 1999 and 2014. Among the 47,055 overdose-related deaths that occurred in 2014, 28,647 (60.9%) of them involved an opioid. The Part D Prescriber Public Use File, which is based on beneficiaries enrolled in the Medicare Part D prescription drug program, was used to query information on prescription drug events incurred by Medicare beneficiaries with a Part D prescription drug plan from 31 June 2014 to 30 June 2015. Only those providers with the specialty description of neurosurgeon, as reported on the provider's Part B claims, were included in this study. A total of 271,502 beneficiaries, accounting for 971,581 claims and 22,152,689 day supplies of medication, accounted for the $52,956,428.40 paid by the Centers for Medicare and Medicaid Services for medication that the 4085 neurosurgeons submitted to the Centers for Medicare and Medicaid Services Part D program in the 2014 calendar year. During the same year, 402,767 (41.45%) claims for 158,749 (58.47%) beneficiaries accounted for 6,458,624 (29.16%) of the day supplies of medications and $13,962,630.11 (26.37%) of the total money spent by the Centers for Medicare and Medicaid Services Part D that year. Nationwide, the ratio of opioid claims to total Medicare Part D beneficiaries was 1.48. No statistically significant regional differences were found. The opioid misuse epidemic is a complex and national issue with patterns of prescription not significantly different between regions. All neurosurgeons must be cognizant of their prescribing practices so as to best support the resolution of this public health crisis. Copyright © 2017. Published by Elsevier Inc.
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Kumar, Amit; Yogisharadhya, Revanaiah; Venkatesan, Gnanavel; Bhanuprakash, Veerakyathappa; Pandey, Awadh Bihari; Shivachandra, Sathish Bhadravati
2017-05-01
Buffalopox virus (BPXV) and other vaccinia-like viruses (VLVs) are causing an emerging/re-emerging zoonosis affecting buffaloes, cattle and humans in India and other countries. A27L and H3L are immuno-dominant major envelope proteins of intracellular mature virion (IMV) of orthopoxviruses (OPVs) and are highly conserved with an ability to elicit neutralizing antibodies. In the present study, two recombinant proteins namely; rA27L ( 21 S to E 110 ; ∼30 kDa) and rH3L( 1 M to I 280 ; ∼50 kDa) of BPXV-Vij/96 produced from Escherichia coli were used in vaccine formulation. A combined recombinant subunit vaccine comprising rA27L and rH3L antigens (10 μg of each) was used for active immunization of adult mice (20μg/dose/mice) with or without adjuvant (FCA/FIA) by intramuscular route. Immune responses revealed a gradual increase in antigen specific serum IgG as well as neutralizing antibody titers measured by using indirect-ELISA and serum neutralization test (SNT) respectively, which were higher as compared to that elicited by individual antigens. Suckling mice passively administered with combined anti-A27L and anti-H3L sera showed a complete (100%) pre-exposure protection upon challenge with virulent BPXV. Conclusively, this study highlights the potential utility of rA27L and rH3L proteins as safer candidate prophylactic antigens in combined recombinant subunit vaccine for buffalopox as well as passive protective efficacy of combined sera in employing better pre-exposure protection against virulent BPXV. Copyright © 2017 Elsevier B.V. All rights reserved.
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MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists.
Rosenkrantz, Andrew B; Nicola, Gregory N; Allen, Bibb; Hughes, Danny R; Hirsch, Joshua A
2017-03-01
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 advances the goal of tying Medicare payments to quality and value. In April 2016, CMS published an initial proposed rule for MACRA, renaming it the Quality Payment Program (QPP). Under QPP, clinicians receive payments through either advanced alternative payment models or the Merit-Based Incentive Payment System (MIPS), a consolidation of existing federal performance programs that applies positive or negative adjustments to fee-for-service payments. Most physicians will participate in MIPS. This review highlights implications of the QPP and MIPS for radiologists. Although MIPS incorporates radiology-specific quality measures, radiologists will also be required to participate in other practice improvement activities, including patient engagement. Recognizing physicians' unique practice patterns, MIPS will provide special considerations in performance evaluation for physicians with limited face-to-face patient interaction. Although such considerations will affect radiologists' likelihood of success under QPP, many practitioners will be ineligible for the considerations under currently proposed criteria. Reporting using qualified clinical data registries will benefit radiologists' performance by allowing expanded arrays of MIPS and non-MIPS specialty-specific measures. A group practice reporting option will substantially reduce administrative burden but introduce new challenges by requiring uniform determination of patient-facing status and performance measurement for all of the group's physicians (diagnostic radiologists, interventional radiologists, and nonradiologists) under the same taxpayer identification number. Given that the initial MIPS performance period begins in 2017, radiologists must begin preparing for QPP and taking actions to ensure their future success under this new quality-based payment system. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights
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Variation in Payment Rates under Medicare's Inpatient Prospective Payment System.
Krinsky, Sam; Ryan, Andrew M; Mijanovich, Tod; Blustein, Jan
2017-04-01
To measure variation in payment rates under Medicare's Inpatient Prospective Payment System (IPPS) and identify the main payment adjustments that drive variation. Medicare cost reports for all Medicare-certified hospitals, 1987-2013, and Dartmouth Atlas geographic files. We measure the Medicare payment rate as a hospital's total acute inpatient Medicare Part A payment, divided by the standard IPPS payment for its geographic area. We assess variation using several measures, both within local markets and nationally. We perform a factor decomposition to identify the share of variation attributable to specific adjustments. We also describe the characteristics of hospitals receiving different payment rates and evaluate changes in the magnitude of the main adjustments over time. Data downloaded from the Centers for Medicare and Medicaid Services, the National Bureau of Economic Research, and the Dartmouth Atlas. In 2013, Medicare paid for acute inpatient discharges at a rate 31 percent above the IPPS base. For the top 10 percent of discharges, the mean rate was double the IPPS base. Variations were driven by adjustments for medical education and care to low-income populations. The magnitude of variation has increased over time. Adjustments are a large and growing share of Medicare hospital payments, and they create significant variation in payment rates. © Health Research and Educational Trust.
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2010-05-12
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the Scientific Advisory Committee on Alternative Toxicological Methods... Director, National Toxicology Program. [FR Doc. 2010-11318 Filed 5-11-10; 8:45 am] BILLING CODE 4140-01-P ...
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Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D
2011-10-14
Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.
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75 FR 37971 - Providing Stability and Security for Medicare Reimbursements
2010-06-30
... Part IV The President Memorandum of June 25, 2010--Providing Stability and Security for Medicare Reimbursements #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 75, No. 125 / Wednesday...
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1979-01-01
CERN : Nouveaux records lors d'une période d'exploitation au PS/SPS ; Un nouveau rôle pour les ISR ; Deuxième région d'intersection pour le système pp du SPS ; Détermination de la durée de vie du charme ; Calcul en Sicile et au CERN
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Azuma, Yasuo; Onuma, Yuto; Sakamoto, Masanori; Teranishi, Toshiharu; Majima, Yutaka
2016-02-28
Rhombic Coulomb diamonds are clearly observed in a chemically anchored Au nanoparticle single-electron transistor. The stability diagrams show stable Coulomb blockade phenomena and agree with the theoretical curve calculated using the orthodox model. The resistances and capacitances of the double-barrier tunneling junctions between the source electrode and the Au core (R1 and C1, respectively), and those between the Au core and the drain electrode (R2 and C2, respectively), are evaluated as 4.5 MΩ, 1.4 aF, 4.8 MΩ, and 1.3 aF, respectively. This is determined by fitting the theoretical curve against the experimental Coulomb staircases. Two-methylene-group short octanedithiols (C8S2) in a C8S2/hexanethiol (C6S) mixed self-assembled monolayer is concluded to chemically anchor the core of the Au nanoparticle at both ends between the electroless-Au-plated nanogap electrodes even when the Au nanoparticle is protected by decanethiol (C10S). This is because the R1 value is identical to that of R2 and corresponds to the tunneling resistances of the octanedithiol chemically bonded with the Au core and the Au electrodes. The dependence of the Coulomb diamond shapes on the tunneling resistance ratio (R1/R2) is also discussed, especially in the case of the rhombic Coulomb diamonds. Rhombic Coulomb diamonds result from chemical anchoring of the core of the Au nanoparticle at both ends between the electroless-Au-plated nanogap electrodes.
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MiR-27a Promotes Hemin-Induced Erythroid Differentiation of K562 Cells by Targeting CDC25B
Directory of Open Access Journals (Sweden)
Dongsheng Wang
2018-03-01
Full Text Available Background/Aims: MicroRNAs (miRNAs play a crucial role in erythropoiesis. MiR-23a∼27a∼24-2 clusters have been proven to take part in erythropoiesis via some proteins. CDC25B (cell division control Cdc2 phosphostase B is also the target of mir-27a; whether it regulates erythropoiesis and its mechanism are unknown. Methods: To evaluate the potential role of miR-27a during erythroid differentiation, we performed miR-27a gain- and loss-of-function experiments on hemin-induced K562 cells. We detected miR-27a expression after hemin stimulation at different time points. At the same time, the γ-globin gene also was measured via real-time PCR. According to the results of the chips, we screened the target protein of miR-27a through a dual-luciferase reporter assay and identified it via Western blot analyses. To evaluate the function of CDC25B, benzidine staining and flow cytometry were employed to detect the cell differentiation and cell cycle. Results: We found that miR-27a promotes hemin-induced erythroid differentiation of human K562 cells by targeting cell division cycle 25 B (CDC25B. Overexpression of miR-27a promotes the differentiation of hemin-induced K562 cells, as demonstrated by γ-globin overexpression. The inhibition of miR-27a expression suppresses erythroid differentiation, thus leading to a reduction in the γ-globin gene. CDC25B was identified as a new target of miR-27a during erythroid differentiation. Overexpression of miR-27a led to decreased CDC25B expression after hemin treatment, and CDC25B was up-regulated when miR-27a expression was inhibited. Moreover, the inhibition of CDC25B affected erythroid differentiation, as assessed by γ-globin expression. Conclusion: This study is the first report of the interaction between miR-27a and CDC25B, and it improves the understanding of miRNA functions during erythroid differentiation.
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27 CFR 10.24 - Sales promotion contests.
2010-04-01
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Sales promotion contests. 10.24 Section 10.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS COMMERCIAL BRIBERY Commercial Bribery § 10.24 Sales promotion contests...
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Pärimuslik ajalugu ja Fr. R. Kreutzwald / Tiiu Jaago
Jaago, Tiiu, 1960-
2005-01-01
Pärimuslik ajalugu kui rahvapärane ajalookäsitus, mida saab uurida folkloorse jutustamise kaudu. Fr. R. Kreutzwaldi ja F. K. H. Kruse sõnavõttudest Aruküla koobaste päritolu kohta ajakirjas "Das Inland" aastast 1844
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Competitive bidding in Medicare Advantage: effect of benchmark changes on plan bids.
Song, Zirui; Landrum, Mary Beth; Chernew, Michael E
2013-12-01
Bidding has been proposed to replace or complement the administered prices that Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006-2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. Copyright © 2013 Elsevier B.V. All rights reserved.
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COMPETITIVE BIDDING IN MEDICARE ADVANTAGE: EFFECT OF BENCHMARK CHANGES ON PLAN BIDS
Song, Zirui; Landrum, Mary Beth; Chernew, Michael E.
2013-01-01
Bidding has been proposed to replace or complement the administered prices in Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006–2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. PMID:24308881
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Physician trainees' decision making and information processing: choice size and Medicare Part D.
Barnes, Andrew J; Hanoch, Yaniv; Martynenko, Melissa; Wood, Stacey; Rice, Thomas; Federman, Alex D
2013-01-01
Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, pinformation on each attribute (pdecision strategies focusing on comparing alternate plans across a single attribute (search pattern, pdecision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (pdecision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs and then referring them to the Medicare website or helpline.
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2010-11-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP): Office of Liaison... Materials The agenda topic is the peer review of the findings and conclusions of draft NTP TRs of toxicology.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2010-29945 Filed 11-26-10; 8:45 am...
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Dynamical analysis of cylindrically symmetric anisotropic sources in f(R, T) gravity
Energy Technology Data Exchange (ETDEWEB)
Zubair, M.; Azmat, Hina [COMSATS Institute of Information Technology, Department of Mathematics, Lahore (Pakistan); Noureen, Ifra [University of Management and Technology, Department of Mathematics, Lahore (Pakistan)
2017-03-15
In this paper, we have analyzed the stability of cylindrically symmetric collapsing object filled with locally anisotropic fluid in f(R, T) theory, where R is the scalar curvature and T is the trace of stress-energy tensor of matter. Modified field equations and dynamical equations are constructed in f(R, T) gravity. The evolution or collapse equation is derived from dynamical equations by performing a linear perturbation on them. The instability range is explored in both the Newtonian and the post-Newtonian regimes with the help of an adiabatic index, which defines the impact of the physical parameters on the instability range. Some conditions are imposed on the physical quantities to secure the stability of the gravitating sources. (orig.)
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Medicare Hospital Spending Per Patient - National
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
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Medicare Hospital Spending Per Patient - Hospital
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
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Medicare Hospital Spending Per Patient - State
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
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Appui au réseautage et au renforcement des télécentres ...
International Development Research Centre (IDRC) Digital Library (Canada)
En Afrique de l'Ouest francophone, les télécentres luttent pour atteindre la viabilité financière tout en demeurant au diapason des collectivités, une situation qui tient au fait qu'ils ont accès à un moins grand nombre de ressources en ligne et à une communauté d'utilisateurs plus restreinte que les télécentres anglophones.
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International Nuclear Information System (INIS)
Balabaud, C.; Roche, M.-C.; Dangoumau, Jacques
1975-01-01
Hepatic blood flow was measured in the unanesthetized rabbit using the clearance technique of 198 Au and 125 I RB. The values are: 71.82+-16.24ml.min -1 .kg -1 for 198 Au, and 60.21+-9.94ml.min -1 .kg -1 for 125 I RB (P 198 Au [fr
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Wang, Shitan; Niu, Dongmei; Lyu, Lu; Huang, Yingbao; Wei, Xuhui; Wang, Can; Xie, Haipeng; Gao, Yongli
2017-09-01
The interfacial electronic structure and morphology of 2,7-dioctyl[1]benzothieno[3,2-b]benzothiophene(C8-BTBT) on polycrystalline Au film was investigated with photoemission spectroscopy (PES), atomic force microscopy (AFM) and grazing incidence X-ray diffraction (GIXRD). The transport barriers of holes and electrons at the interface are 1.72 eV and 2.12 eV, respectively, from the UPS measurement. There is no chemical reaction of C8-BTBT with Au from the XPS investigation of core levels Au 4f, C 1s and S 2p. The upmost molecules adopt a standing up configuration deduced from the diffraction peaks in GIXRD and the step height in AFM. Increasing order of the upright orientation of C8-BTBT molecules with film growth result in decreasing work function of the C8-BTBT thin film by forming an outward pointing dipole layer with the ordered end Csbnd H bonds.
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78 FR 6273 - Rules Relating to Additional Medicare Tax
2013-01-30
... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 31 [REG-130074-11] RIN 1545-BK54 Rules Relating to Additional Medicare Tax Correction In proposed rule document 2012-29237, appearing on pages 72268- 72277 in the issue of Wednesday, December 5, 2012, make the following correction...
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Mayani, Vishal J; Mayani, Suranjana V; Kim, Sang Wook
2017-08-03
Up to now, a very few catalysts have been developed approaching the heterogeneous catalytic degradation of Eosin Y and Chromotrope 2R dyes (Acid Red 29). The present study provides a complete perspective of recyclable nanocomposite Au(Salen)@CC for catalytic degradation of hazardous water pollutant dyes viz., Eosin Y & Chromotrope 2R using mild reaction conditions. New gold Salen complex doped carbon nanocomposite Au(Salen)@CC was developed by easy methodology using nano carbon cage (CC) prepared from low-priced Pyrolysis fuel oil (PFO) residue based Pitch. The UV-Vis adsorption spectroscopy results of Eosin Y and Chromotrope 2R dyes indicated complete degradation into acidic compounds which can be further mineralized to CO 2 and H 2 O under mild reaction conditions. The heterogeneous catalyst recycled and reused successfully for four repeated experiments without loss in its adequate performance. This new sustainable and eco-friendly catalyst delivered significant degradation activity compared to existing reports and it can be further utilized for new multifunctional applications such as, radiopharmaceutical activities, heterogeneous catalysis and chiral resolution.
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Leslie, R Scott; Tirado, Breanne; Patel, Bimal V; Rein, Philip J
2014-12-01
The Centers for Medicare Medicaid Services (CMS) Plan Quality and Performance Program, or Star Ratings Program, allows Medicare beneficiaries to compare quality of care among available Medicare Advantage prescription drug (MA-PD) plans and stand-alone prescription drug plans (PDPs). Health plans have increased intervention efforts and applied existing care management infrastructure as an approach to improving member medication adherence and subsequent Part D star rating performance. Independent Care Health Plan (iCare), an MA-PD plan; MedImpact Healthcare Systems, Inc. (MedImpact), a pharmacy benefits manager; and US MED, a mail order pharmacy, partnered to engage and enroll iCare's dual-eligible special needs population in an intervention designed to improve patient medication adherence and health plan performance for 3 Part D patient safety outcome measures: Medication Adherence for Oral Diabetes Medications (ODM), Medication Adherence for Hypertension (HTN), and Medication Adherence for Cholesterol (CHOL). To (a) assess the effectiveness of a coordinated member-directed medication adherence intervention and (b) determine the overall impact of the intervention on adherence rates and CMS Part D star rating adherence measures. Administrative pharmacy claims and health plan eligibility data from MedImpact's databases were used to identify members using 3 target medication classes. Adherence was estimated by the proportion of days covered (PDC) for all members. Those members considered at high risk for nonadherence were prioritized for care management services. Risk factors were based on members' use of more than 1 target medication class, newly started therapy, and suboptimal adherence (PDC less than 80%) in the most recent 6-month period. Data files listing member adherence rates and contact information were formatted and loaded monthly into iCare's care management system, which triggered an alert for care coordinators to counsel members on the importance
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2010-11-09
... Retirement Act and certain others do not have to pay premiums for Medicare Part A.) Section 1818A of the Act... specifies that the premium that these individuals will pay for CY 2011 will be equal to the premium for... consequential effect on State, local, or tribal governments or on the private sector. However, States are...
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Le travail des femmes à Frías: modèle andin et variante régionale
Directory of Open Access Journals (Sweden)
1993-01-01
Full Text Available À Frías, dans les Andes de Piura, les femmes sont absentes des tâches de production agricole au sens strict. Une comparaison avec des études menées dans dautres régions montre en quoi cette organisation diffère dun modèle andin. Mais ce modèle est trompeur. Il recouvre une grande variété de situations. Entre autres facteurs, la reconstitution du passé dun système de production est nécessaire pour comprendre son orientation actuelle. EL TRABAJO DE LAS MUJERES EN FRÍAS: MODELO ANDINO Y VARIANTE REGIONAL. En Frías, en la sierra de Piura, las mujeres no participan en las tareas de producción agrícola en el sentido estricto. Una comparación con estudios realizados en otras regiones indica cómo esta organización difiere de un modelo andino. Pero, este modelo, que hemos construido, encubre una gran diversidad de casos. Entre otros factores, la reconstitución del pasado de un sistema de producción es necesaria para entender su orientación actual. WOMEN S WORK: ANDEAN PATTERN AND LOCAL VARIATION. Women are not present in agricultural working stricto sensu in Frías, in the Piura highlands. A comparison of the pattern of organization with case studies in other regions of Peru shows differences with the Andean pattern. But the pattern described here covers a great diversity of situations. Among many factors, the historical reconstitution of a farming system is necessary to understand its current orientation.
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miR-494 represses HOXA10 expression and inhibits cell proliferation in oral cancer.
Libório-Kimura, Tatiana N; Jung, Hyun Min; Chan, Edward K L
2015-02-01
miR-494 was identified as a candidate of the most significantly underexpressed microRNAs (miRNAs) in our oral cancer screen. The aim of this study was to validate whether miR-494 has a functional role in oral cancer. Quantitative miRNA analyses were performed on oral tumor RNA and oral cancer cell lines. HOXA10 was selected for further analysis based on bioinformatics analysis of miR-494 targets and a previous report of overexpression of HOXA10 in oral cancer. Transient transfection of miRNA-mimic and inhibitor were performed in SCC-25 (tongue), CAL 27 (tongue), and FaDu (pharynx) cancer cells and regulation of HOXA10 by miR-494 was investigated. Dual luciferase assay was used to verify the interaction between miR-494 and HOXA10 in reporter cells. The effect of miR-494 on cell proliferation was examined. Our data showed that miR-494 was underexpressed whereas HOXA10 was overexpressed in oral cancer compared to normal tissues. An inverse correlation between miR-494 and HOXA10 was observed in the human tissues (pcancer cell lines significantly reduced the expression of HOXA10 mRNA. The luciferase reporter that contains the 3'UTR of HOXA10 showed a significantly reduced luciferase activity by miR-494 indicating a direct interaction between HOXA10 and miR-494. Significant reduction in cell proliferation was demonstrated in tongue cancer cells transfected with miR-494. miR-494 repressed the expression of HOXA10 and also reduced the proliferation of oral cancer cells. These data give more evidence of the role of miR-494 as a tumor suppressor miRNA in oral cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Simberg, Maximilian
2014-01-01
Det här arbetet behandlar kreativ frihet och konstnärligt oberoende i filmskapande, utgående från begreppet independent film och regissörerna David Lynch, Jim Jarmusch och Steven Soderbergh. Den centrala frågeställningen är hur det har varit möjligt för en filmkonstnär att uppnå konstnärligt oberoende och samtidigt ha en långlivad och framgångsrik karriär. Arbetets fokus ligger på de tre regissörernas genombrottsfilmer; Eraserhead, Stranger Than Paradise och sex, lies, and videotape, och förs...
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Directory of Open Access Journals (Sweden)
A. Söding
2001-07-01
Full Text Available Directional discontinuities (DD from 5 missions at 7 different locations between 0.3 and 19 AU and −80° and +10° in the 3D heliosphere are investigated during minimum solar activity. The data are surveyed using the identification criteria of Burlaga (1969 (B and Tsurutani and Smith (1979 (TS. The rate of occurrence depends linearly on the solar wind velocity caused by the geometric effect of investigating a larger plasma volume if the solar wind velocity νsw increases. The radial dependence is proportional to r–0.78 (TS criterion and r–1.28 (B criterion, respectively. This dependence is not only due to an increasing miss rate with increasing distance. The DDs must be unstable or some other physical effect must exist. After normalization of the daily rates to 400 km/s and 1 AU, no dependence on heliographic latitude or on solar wind structures is observable. This means that the DDs are uniformly distributed on a spherical shell. Normalized 64 DD per day are identified with both criteria. But large variations of the daily rate still occur, indicating that other influences must exist. The ratio of the rates of rotational (RDs and tangential discontinuities (TDs depends on the solar wind structures. In high speed streams, relatively more RDs exist than in low speed streams. In the inner heliosphere (r < 10 AU, no radial or latitudinal dependence of the portions of the DD types occur. 55% clear RDs, 10% clear TDs and 33% EDs (either discontinuities are observed, but the portions differ with regard to the criteria used. In the middle heliosphere (10 AU< r < 40 AU, the DD types are more uniformly distributed. The distribution of the directional change ω over the transition evolves to an increase of smaller ω with increasing distance from the sun. The evolution is yielded by the anisotropic RDs with small ω. The spatial thickness dkm in kilometers increases with distance. The thickness drg normalized to the proton gyro radius decreases by a
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International Nuclear Information System (INIS)
Klusoň, Josef; Nojiri, Shin'ichi; Odintsov, Sergei D.
2013-01-01
We propose new version of massive F(R) gravity which is natural generalization of convenient massive ghost-free gravity. Its Hamiltonian formulation in scalar-tensor frame is developed. We show that such F(R) theory is ghost-free. The cosmological evolution of such theory is investigated. Despite the strong Bianchi identity constraint the possibility of cosmic acceleration (especially, in the presence of cold dark matter) is established. Ghost-free massive F(R,T) gravity is also proposed
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Evolution de certains composés volatils du bois de chêne au cours de son séchage premiers résultats
Directory of Open Access Journals (Sweden)
Pascal Chatonnet
1994-12-01
Full Text Available Pendant le séchage des merrains sur parc à l'air libre, on assiste à une profonde modification de la composition chimique et du profil aromatique du bois de chêne. La teneur en eugénol, en aldéhydes phénols et en Β-méthyl-y-octalactone augmente régulièrement pendant le vieillissement du bois. Principalement sous forme trans au début du séchage, la Β-méthyl-y-octalactone s'accumule finalement sous la forme cis plus aromatique. Dans le même temps, on observe également une accumulation importante du précurseur inodore de Β-méthyl-y-octalactone. L'intervention des micro-organismes fréquemment isolés sur le bois en cours de séchage naturel sur la formation de composés aromatiques a été étudiée. La culture de diverses moisissures isolées de bois en cours de séchage naturel sur extraits de bois et directement sur sciure de chêne aboutit dans tous les cas à une forte diminution des teneurs en aldéhydes phénols, notamment de la vanilline. En effet, tous les micro-organismes étudiés (Penicilium sp., Trichoderma sp., Aureobasidium sp. sont incapables de dégrader la lignine car ils ne possèdent pas d'activité ligninase. En revanche, ces champignons possèdent une forte activité oxydo-réductase capable de réduire la vanilline en alcool vanillique inodore. En conséquence, les aldéhydes phénols apparaissant au cours du séchage naturel du merrain ne dérivent pas d'une attaque enzymatique mais plus vraisemblablementde l'acidolyse et de l'oxydation chimique de la lignine du bois. Le stockage du bois à l'air libre en présence d'eau et d'oxygène doit permettre une évolution favorable de son potentiel aromatique tant que la vanilline et la cis Β-méthyly-octalactone s'accumulent.
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Aarab, Chadya; Elghazouani, Fatima; Aalouane, Rachid; Rammouz, Ismail
2014-01-01
Au Maroc, les tentatives de suicide (TS) demeurent un sujet mal évalué à cause de considérations socioculturelles et l'absence d'approche longitudinale. L'objectif principal était d’évaluer le devenir des suicidants après 5ans au centre universitaire psychiatrique de Fès, les objectifs secondaires étaient l'estimation de la prévalence des TS, préciser les étiologies les plus fréquentes, et établir une corrélation entre les paramètres sociodémographiques, cliniques et évolutifs. Etude prospective à visée transversale et longitudinale, incluant les suicidants vus à l'hôpital psychiatrique de Fès, avec un suivi longitudinal sur 5ans. L’évaluation a été faite par un hétéro-questionnaire et le Mini International Neuropsychiatric Interview (MINI) cherchant le trouble psychiatrique sous jacent. On a recruté 105 patients suicidants, 62% des femmes, l’âge moyen est de 29,23ans. La prévalence des tentatives de suicide est de 3% sur l'ensemble des consultants à l’établissement. Les troubles de l'humeur, psychotiques et de personnalité ont occupé respectivement 37,6%, 27,7%, et 25,7% des cas. La récidive suicidaire a été notée chez 54% des patients, était significativement corrélée à la vie solitaire (P: 0,039) et à la présence d'antécédents familiaux de TS (P: 0,046). L'utilisation de moyens violents était significativement fréquente chez les patients psychotiques. Après 5ans, 32 patients ont répondu à notre appel. Le taux de récidive était de 15%. On a noté trois cas de décès dont deux suicides confirmés. Les résultats confirment les données de la littérature scientifique avec certaines particularités cliniques et évolutives. PMID:25478042
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Disease management and the Medicare Modernization Act: "It's the insurance, stupid".
Sidorov, Jaan; Schlosberg, Claudia
2005-12-01
While definitions of "disease management" (DM) emphasize quality of care for populations with chronic illness, proponents argue it reduces healthcare costs. Buyers may find disease management organizations' (DMOs') use of clinical guidelines, physician collaboration, and promotion of patient self-management intuitively sound, but it is performance guarantees, combined with retrospective effectiveness cost studies, that have driven DMOs' penetration of the commercial insurance market with revenues that exceed $500 million per year. The success of DMOs contributed to the creation of the Chronic Care Improvement Program (CCIP), which is designed to prospectively test the impact of DM on both the quality and cost of care for fee-for-service Medicare beneficiaries with chronic illness. This may lead to an expansion of DM in Medicare, and even greater opportunities for DMOs beyond the $10 billion in 10- year projected growth. For community-based physicians caring for patients with chronic illness, the sharpened focus on chronic care and the growth of DMOs creates some potential advantages. These include more time to treat more patients with acute illness, lower practice costs, opportunities to collaborate over quality, and a greater ability to achieve quality targets set by pay-for-performance arrangements.
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PHENIX results on jets in d + Au
Energy Technology Data Exchange (ETDEWEB)
Hanks, J. Ali
2016-12-15
We present recently published results [A. Adare, et al., (arXiv:1509.04657)] on fully reconstructed R=0.3 anti-k{sub t} jets measured in p+p and d+Au collisions at 200 GeV center-of-mass energy. The jet yields for four centrality classes along with the p+p reference are presented, as well as both the minimum bias R{sub dAu} and centrality dependent R{sub dAu} and R{sub CP}. We find that while the minimum bias R{sub dA} is consistent with unity, providing a strong constraint on models including cold-nuclear-matter effects or energy loss in small systems, the centrality dependent R{sub dAu} show a striking variation which presents a challenge to models attempting to describe the interplay between soft and hard processes in these systems.
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75 FR 16149 - Medicaid and CHIP Programs; Meeting of the CHIP Working Group-April 26, 2010
2010-03-31
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-2312-N] DEPARTMENT OF LABOR Employee Benefits Security Administration Medicaid and CHIP Programs; Meeting of the CHIP Working Group-- April 26, 2010 AGENCIES: Centers for Medicare & Medicaid Services (CMS), Department of...
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Applying the 2003 Beers Update to Elderly Medicare Enr...
U.S. Department of Health & Human Services — Applying the 2003 Beers Update to Elderly Medicare Enrollees in the Part D Program Inappropriate prescribing of certain medications known as Beers drugs may be...
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Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care
Davitt, Joan K.
2014-01-01
Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…
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Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N; Mor, Vincent
2015-10-01
Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. Project HOPE—The People-to-People Health Foundation, Inc.
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Solar System constraints on a cosmologically viable f(R) theory
Energy Technology Data Exchange (ETDEWEB)
Bisabr, Yousef, E-mail: y-bisabr@srttu.ed [Department of Physics, Shahid Rajaee Teacher Training University, Lavizan, Tehran 16788 (Iran, Islamic Republic of)
2010-01-18
Recently, a model f(R) theory is proposed (Miranda et al. (2009)) which is cosmologically viable and distinguishable from LAMBDACDM. We use chameleon mechanism to investigate viability of the model in terms of Solar System experiments.
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Paying Medicare Advantage Plans: To Level or Tilt the Playing Field
Glazer, Jacob; McGuire, Thomas G.
2017-01-01
Medicare beneficiaries are eligible for health insurance through the public option of traditional Medicare (TM) or may join a private Medicare Advantage (MA) plan. Both are highly subsidized but in different ways. Medicare pays for most of costs directly in TM, and makes a subsidy payment to an MA plan based on a “benchmark” for each beneficiary choosing a private plan. The level of this benchmark is arguably the most important policy decision Medicare makes about the MA program. Presently, about 30% of beneficiaries are in MA, and Medicare subsidizes MA plans more on average than TM. Many analysts recommend equalizing Medicare’s subsidy across the options – referred to in policy circles as a “level playing field.” This paper studies the normative question of how to set the level of the benchmark, applying the versatile model of plan choice developed by Einav and Finkelstein (EF) to Medicare. The EF framework implies unequal subsidies to counteract risk selection across plan types. We also study other reasons to tilt the field: the relative efficiency of MA vs. TM, market power of MA plans, and institutional features of the way Medicare determines subsidies and premiums. After review of the empirical and policy literature, we conclude that in areas where the MA market is competitive, the benchmark should be set below average costs in TM, but in areas characterized by imperfect competition in MA, it should be raised in order to offset output (enrollment) restrictions by plans with market power. We also recommend specific modifications of Medicare rules to make demand for MA more price elastic. PMID:28318667