Sample records for single-payer program similar
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Prospects of Single Tax Payers
Directory of Open Access Journals (Sweden)
Tofan Ivan M.
2014-03-01
Full Text Available The article speaks about problem aspects of taxation, which were set by the state for the single tax administering due to permanent and system changes in the tax legislation. It shows the necessity of search for alternative methods of administering in the process of taxation of single tax payers by fiscal services. The goal of the article is the study of prospects of further taxation of entrepreneurs – single tax payers on the basis of analysis of conditions and principles created by the state for the business. The article used methods of system analysis, comparison, forecasting and modelling. It analyses the process of evolution of the simplified taxation system, accounting and reporting from the moment of its adoption until today. The article presents the structure of the quantitative composition of single tax payers depending on the selected groups. It marks out and characterises administrative and fiscal factors that do not facilitate further development of entrepreneurship in Ukraine. In the result of the conducted studies the article outlines problem aspects of organisation of taxation of the small business and offers specific and real ways of their overcoming or partial solution.
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Payer source influence on effectiveness of lifestyle medicine programs.
Vogelgesang, Joseph; Drozek, David; Nakazawa, Masato; Shubrook, Jay H
2015-09-01
Many chronic diseases are responsive to interventions focused on diet and physical activity. The Complete Health Improvement Program (CHIP) is an intensive, community-based lifestyle intervention that effectively treats many chronic diseases and their risk factors. This is a pilot study examining the effect of payer source for CHIP tuition on participants' outcomes. Seventy-nine self-selected participants (73.4% female) attended 1 of 3 CHIP classes (classes 7-9) offered January through May 2013 in Athens, Ohio. Participants were categorized into 3 groups based on the source(s) of their tuition payment: self-pay, employer-pay, or scholarship. Chronic disease risk factors for each individual were assessed at the beginning and conclusion of the program. Outcome variables included percent reduction between pre- and post CHIP measures in body mass index, systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and fasting blood glucose. Results were compared between type of payer source (out of pocket vs employer and/or scholarship) and between each individual CHIP class attended. There was no statistical difference in outcomes based on payer source. Those who received funding through their employer or a scholarship experienced similar effects from a lifestyle intervention program as those who paid out of pocket. This study demonstrates that the benefit of CHIP for reducing chronic disease risk factors exists independent of payment source, and thus suggests its benefit may cross socioeconomic lines.
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The Little State That Couldn't Could? The Politics of "Single-Payer" Health Coverage in Vermont.
Fox, Ashley M; Blanchet, Nathan J
2015-06-01
In May 2011, a year after the passage of the Affordable Care Act (ACA), Vermont became the first state to lay the groundwork for a single-payer health care system, known as Green Mountain Care. What can other states learn from the Vermont experience? This article summarizes the findings from interviews with nearly 120 stakeholders as part of a study to inform the design of the health reform legislation. Comparing Vermont's failed effort to adopt single-payer legislation in 1994 to present efforts, we find that Vermont faced similar challenges but greater opportunities in 2010 that enabled reform. A closely contested gubernatorial election and a progressive social movement opened a window of opportunity to advance legislation to design three comprehensive health reform options for legislative consideration. With a unified Democratic government under the leadership of a single-payer proponent, a high-profile policy proposal, and relatively weak opposition, a framework for a single-payer system was adopted by the legislature - though with many details and political battles to be fought in the future. Other states looking to reform their health systems more comprehensively than national reform can learn from Vermont's design and political strategy. Copyright © 2015 by Duke University Press.
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"Managed competition" for Ireland? The single versus multiple payer debate.
LENUS (Irish Health Repository)
Mikkers, Misja
2014-09-01
A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.
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WHY DO AMERICANS STILL NEED SINGLE-PAYER HEALTH CARE AFTER MAJOR HEALTH REFORM?
Chaufan, Claudia
2015-01-01
Many observers have considered the Affordable Care Act (ACA) the most significant health care overhaul since Medicare, in the tradition of Great Society programs. And yet, in opinion polls, Americans across the political spectrum repeatedly express their strong support for Medicare, alongside their disapproval of the ACA. This feature of American public opinion is often seen as a contradiction and often explained as "incoherence," a mere feature of Americans' "muddled mind." In this article I argue that what explains this seeming contradiction is not any peculiarity of Americans' psychology but rather the grip of the corporate class on the political process and on key social institutions (e.g., mass media, judiciary), no less extraordinary today than in the past. I also argue that ordinary Americans, like millions of their counterparts in the world, would eagerly support a single-payer national health program that speaks to their interests rather than to those of the 1 percent. I will describe the ACA, compare it to Medicare, explain the concept of single payer, and conclude that the task is not to persuade presumably recalcitrant Americans to support the ACA but rather to organize a mass movement to struggle for what is right and join the rest of the world in the road toward health justice.
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Health Expenditure Growth under Single-Payer Systems: Comparing South Korea and Taiwan.
Cheng, Shou-Hsia; Jin, Hyun-Hyo; Yang, Bong-Min; Blank, Robert H
2018-05-03
Achieving universal health coverage has been an important goal for many countries worldwide. However, the rapid growth of health expenditures has challenged all nations, both those with and without such universal coverage. Single-payer systems are considered more efficient for administrative affairs and may be more effective for containing costs than multipayer systems. However, South Korea, which has a typical single-payer scheme, has almost the highest growth rate in health expenditures among industrialized countries. The aim of the present study is to explicate this situation by comparing South Korea with Taiwan. This study analyzed statistical reports published by government departments in South Korea and Taiwan from 2001 to 2015, including population and economic statistics, health statistics, health expenditures, and social health insurance reports. Between 2001 and 2015, the per capita national health expenditure (NHE) in South Korea grew 292%, whereas the corresponding growth of per capita NHE in Taiwan was only 83%. We find that the national health insurance (NHI) global budget cap in Taiwan may have restricted the growth of health expenditures. Less comprehensive benefit coverage for essential diagnosis/treatment services under the South Korean NHI program may have contributed to the growth of out-of-pocket payments. The expansion of insurance coverage for vulnerable individuals may also contribute to higher growth in NHE in South Korea. Explicit regulation of health care resource distribution may also lead to more limited provisioning and utilization of health services in Taiwan. Under analogous single-payer systems, South Korea had a much higher growth in health spending than Taiwan. The annual budget cap for total reimbursement, more comprehensive coverage for essential diagnosis and treatment services, and the regulation of health care resource distribution are important factors associated with the growth of health expenditures. Copyright © 2018
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Geyman, John P
2005-01-01
Recent years have seen the rapid growth of private think tanks within the neoconservative movement that conduct "policy research" biased to their own agenda. This article provides an evidence-based rebuttal to a 2002 report by one such think tank, the Dallas-based National Center for Policy Analysis (NCPA), which was intended to discredit 20 alleged myths about single-payer national health insurance as a policy option for the United States. Eleven "myths" are rebutted under eight categories: access, cost containment, quality, efficiency, single-payer as solution, control of drug prices, ability to compete abroad (the "business case"), and public support for a single-payer system. Six memes (self-replicating ideas that are promulgated without regard to their merits) are identified in the NCPA report. Myths and memes should have no place in the national debate now underway over the future of a failing health care system, and need to be recognized as such and countered by experience and unbiased evidence.
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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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Chen, Chi-Chen; Cheng, Shou-Hsia
2010-11-01
To examine the effects of market competition on patient-perceived quality of care under a single-payer system in Taiwan. Data came from two nationwide surveys conducted on discharged patients and National Health Insurance (NHI) hospital claim datasets in 2002 and 2004. Competition was measured by the Herfindahl-Hirschman Index (HHI). Quality of care was measured by patient-rated hospital performance including interpersonal skills and clinical competence domains. We used the instrumental variable approach to address the endogeneity between competition and patient-perceived quality of care. The results showed that HHI was significantly associated with a decrease in the perceived interpersonal skills (coefficient of -0.460; pcompetition. A similar association was found for the perceived clinical competence (coefficient of -0.457; p=0.001). Quality of care from the patients' perspective is sensitive to the degree of competition. By using patient-reported data, this study provides new evidence concerning competition and quality of care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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The payers perspective on MIH-CP programs. How to make a case for funding your project.
Zavadsky, Matt
2015-07-01
Here are some key points to consider when engaging in conversations with potential payers for EMS-based MIH-CP programs. The realignment of fiscal incentives within the healthcare system has created an environment that encourages providers and payers to work together to right-size utilization. Providers and payers are often unaware of the true value EMS agencies can bring to their patients through proactive and innovative patient navigation services. You need to tell them--or, better yet, show them. You may need to do a small demonstration project with a handful of patients to prove you can make a difference. In order to understand the new environment, you need to become well-versed in healthcare metrics, specifically as they relate to the partners to whom you'll be proposing. Be sure you know things like readmission rates and penalties, value-based purchasing penalties, HCAHPS scores, MSPB and other motivating factors you. can use to help build the business case for your audience. For many in EMS, crafting partnerships for. payment of services not related to ambulance transport is a new and scary thing. Hopefully the examples provided here from payers paying for MIH services have demonstrated that their perspective is not much different from ours. We are all trying to do the right things for our patients, improve their experience of care and reduce the cost of the healthcare system.
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Impact of the New Jersey all-payer rate-setting system: an analysis of financial ratios.
Rosko, M D
1989-01-01
Although prospective payment may contain costs, many analysts are concerned about the unintended consequences of rate regulation. This article presents the results of a case-study analysis of the New Jersey rate-setting programs during the period 1977-1985. Using measures of profitability, liquidity, and leverage, data for New Jersey, the Northeast, and the United States as a whole are used to contrast the impact of two forms of prospective payment. After attempting alternative cost-containment methods, the New Jersey Department of Health implemented an all-payer system in which prospective rates of compensation were established for DRGs. The new rate-setting system was designed to control costs, improve access to care, maintain quality of services, ensure financial viability of efficient providers, and limit the payment differentials associated with cost shifting. The results of this study have a number of implications for the evaluation of all-payer rate regulation. First, although the New Jersey all-payer system was more successful than the partial-payer program in restraining the rate of increase in cost per case, savings were achieved without adversely affecting the viability of regulated hospitals. Second, the large differentials among payers that were associated with the partial-payer program were reduced dramatically by the all-payer program. Third, using the financial position of inner-city hospitals relative to suburban hospitals as a measure of equity, the all-payer system appeared to be a fairer method of regulating rates.
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Health Spending By State 1991-2014: Measuring Per Capita Spending By Payers And Programs.
Lassman, David; Sisko, Andrea M; Catlin, Aaron; Barron, Mary Carol; Benson, Joseph; Cuckler, Gigi A; Hartman, Micah; Martin, Anne B; Whittle, Lekha
2017-07-01
As the US health sector evolves and changes, it is informative to estimate and analyze health spending trends at the state level. These estimates, which provide information about consumption of health care by residents of a state, serve as a baseline for state and national-level policy discussions. This study examines per capita health spending by state of residence and per enrollee spending for the three largest payers (Medicare, Medicaid, and private health insurance) through 2014. Moreover, it discusses in detail the impacts of the Affordable Care Act implementation and the most recent economic recession and recovery on health spending at the state level. According to this analysis, these factors affected overall annual growth in state health spending and the payers and programs that paid for that care. They did not, however, substantially change state rankings based on per capita spending levels over the period. Project HOPE—The People-to-People Health Foundation, Inc.
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Differences in Hospital Readmission Risk across All Payer Groups in South Carolina.
Chakraborty, Hrishikesh; Axon, Robert Neal; Brittingham, Jordan; Lyons, Genevieve Ray; Cole, Laura; Turley, Christine B
2017-06-01
To evaluate differences in hospital readmission risk across all payers in South Carolina (SC). South Carolina Revenue and Fiscal Affairs Office (SCRFA) statewide all payer claims database including 2,476,431 hospitalizations in SC acute care hospitals between 2008 and 2014. We compared the odds of unplanned all-cause 30-day readmission for private insurance, Medicare, Medicaid, uninsured, and other payers and examined interaction effects between payer and index admission characteristics using generalized estimating equations. SCRFA receives claims and administrative health care data from all SC health care facilities in accordance with SC state law. Odds of readmission were lower for females compared to males in private, Medicare, and Medicaid payers. African Americans had higher odds of readmission compared to whites across private insurance, Medicare, and Medicaid, but they had lower odds among the uninsured. Longer length of stay had the strongest association with readmission for private and other payers, whereas an increased number of comorbidities related to the highest readmission odds within Medicaid. Associations between index admission characteristics and readmission likelihood varied significantly with payer. Findings should guide the development of payer-specific quality improvement programs. © Health Research and Educational Trust.
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2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement obligations of primary payers and... Provisions § 411.22 Reimbursement obligations of primary payers and entities that received payment from... reimburse CMS for any payment if it is demonstrated that the primary payer has or had a responsibility to...
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UnitedHealthcare experience illustrates how payers can enable patient engagement.
Sandy, Lewis G; Tuckson, Reed V; Stevens, Simon L
2013-08-01
Patient engagement is crucial to better outcomes and a high-performing health system, but efforts to support it often focus narrowly on the role of physicians and other care providers. Such efforts miss payers' unique capabilities to help patients achieve better health. Using the experience of UnitedHealthcare, a large national payer, this article demonstrates how health plans can analyze and present information to both patients and providers to help close gaps in care; share detailed quality and cost information to inform patients' choice of providers; and offer treatment decision support and value-based benefit designs to help guide choices of diagnostic tests and therapies. As an employer, UnitedHealth Group has used these strategies along with an "earn-back" program that provides positive financial incentives through reduced premiums to employees who adopt healthful habits. UnitedHealth's experience provides lessons for other payers and for Medicare and Medicaid, which have had minimal involvement with demand-side strategies and could benefit from efforts to promote activated beneficiaries.
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Proposal of the Physicians' Working Group for Single-Payer National Health Insurance.
Woolhandler, Steffie; Himmelstein, David U; Angell, Marcia; Young, Quentin D
2003-08-13
The United States spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet more than 41 million Americans have no health insurance. Many more are underinsured. Confronted by the rising costs and capabilities of modern medicine, other nations have chosen national health insurance (NHI). The United States alone treats health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In this market-driven system, insurers and providers compete not so much by increasing quality or lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers. This creates the paradox of a health care system based on avoiding the sick. It generates huge administrative costs that, along with profits, divert resources from clinical care to the demands of business. In addition, burgeoning satellite businesses, such as consulting firms and marketing companies, consume an increasing fraction of the health care dollar. We endorse a fundamental change in US health care--the creation of an NHI program. Such a program, which in essence would be an expanded and improved version of traditional Medicare, would cover every American for all necessary medical care. An NHI program would save at least 200 billion dollars annually (more than enough to cover all of the uninsured) by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Physicians and hospitals would be freed from the concomitant burdens and expenses of paperwork created by having to deal with multiple insurers with different rules, often designed to avoid payment. National health insurance would make it possible to set and enforce overall spending limits for the health care system, slowing cost growth over the long run. An NHI program
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Variation in Private Payer Coverage of Rheumatoid Arthritis Drugs.
Chambers, James D; Wilkinson, Colby L; Anderson, Jordan E; Chenoweth, Matthew D
2016-10-01
Payers in the United States issue coverage determinations to guide how their enrolled beneficiaries use prescription drugs. Because payers create their own coverage policies, how they cover drugs can vary, which in turn can affect access to care by beneficiaries. To examine how the largest private payers based on membership cover drugs indicated for rheumatoid arthritis and to determine what evidence the payers reported reviewing when formulating their coverage policies. Coverage policies issued by the 10 largest private payers that make their policies publicly available were identified for rheumatoid arthritis drugs. Each coverage determination was compared with the drug's corresponding FDA label and categorized according to the following: (a) consistent with the label, (b) more restrictive than the label, (c) less restrictive than the label, or (d) mixed (i.e., more restrictive than the label in one way but less restrictive in another). Each coverage determination was also compared with the American College of Rheumatology (ACR) 2012 treatment recommendations and categorized using the same relative restrictiveness criteria. The policies were then reviewed to identify the evidence that the payers reported reviewing. The identified evidence was divided into the following 6 categories: randomized controlled trials; other clinical studies (e.g., observational studies); health technology assessments; clinical reviews; cost-effectiveness analyses; and clinical guidelines. Sixty-nine percent of coverage determinations were more restrictive than the corresponding FDA label; 15% were consistent; 3% were less restrictive; and 13% were mixed. Thirty-four percent of coverage determinations were consistent with the ACR recommendations, 33% were more restrictive; 17% were less restrictive; and 17% were mixed. Payers most often reported reviewing randomized controlled trials for their coverage policies (an average of 2.3 per policy). The payers reported reviewing an average of
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Kaufman, Joel M
2010-05-01
Negotiating with payers for better reimbursement, contract language, support for practice enhancement, or changes in policies and procedures is a critical function that may greatly enhance a practice's success over time. This article discusses keys to successful negotiating and several specific areas beyond reimbursement that deserve the reader's attention. Copyright 2010 Elsevier Inc. All rights reserved.
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Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris
2009-01-01
To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to
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Variation in provider vaccine purchase prices and payer reimbursement.
Freed, Gary L; Cowan, Anne E; Gregory, Sashi; Clark, Sarah J
2009-12-01
The purpose of this work was to collect data regarding vaccine prices and reimbursements in private practices. Amid reports of physicians losing money on vaccines, there are limited supporting data to show how much private practices are paying for vaccines and how much they are being reimbursed by third-party payers. We conducted a cross-sectional survey of a convenience sample of private practices in 5 states (California, Georgia, Michigan, New York, and Texas) that purchase vaccines for administration to privately insured children/adolescents. Main outcome measures included prices paid to purchase vaccines recommended for children and adolescents and reimbursement from the 3 most common, non-Medicaid payers for vaccine purchase and administration. Detailed price and reimbursement data were provided by 76 practices. There was a considerable difference between the maximum and minimum prices paid by practices, ranging from $4 to more than $30 for specific vaccines. There was also significant variation in insurance reimbursement for vaccine purchase, with maximum and minimum reimbursements for a single vaccine differing from $8 to more than $80. Mean net yield per dose (reimbursement for vaccine purchase minus price paid per dose) varied across vaccines from a low of approximately $3 to more than $24. Reimbursement for the first dose of vaccine administered ranged from $0 to more than $26, with a mean of $16.62. There is a wide range of prices paid by practices for the same vaccine product and in the reimbursement for vaccines and administration fees by payers. This variation highlights the need for individual practices to understand their own costs and reimbursements and to seek opportunities to reduce costs and increase reimbursements.
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Billing third party payers for pharmaceutical care services.
Poirier, S; Buffington, D E; Memoli, G A
1999-01-01
To describe the steps pharmacists must complete when seeking compensation from third party payers for pharmaceutical care services. Government publications; professional publications, including manuals and newsletters; authors' personal experience. Pharmacists in increasing numbers are meeting with success in getting reimbursed by third party payers for patient care activities. However, many pharmacists remain reluctant to seek compensation because they do not understand the steps involved. Preparatory steps include obtaining a provider/supplier number, procuring appropriate claim forms, developing data collection and documentation systems, establishing professional fees, creating a marketing plan, and developing an accounting system. To bill for specific patient care services, pharmacists need to collect the patient's insurance information, obtain a statement of medical necessity from the patient's physician, complete the appropriate claim form accurately, and submit the claim with supporting documentation to the insurer. Although many claims from pharmacists are rejected initially, pharmacists who work with third party payers to understand the reasons for denial of payment often receive compensation when claims are resubmitted. Pharmacists who follow these guidelines for billing third party payers for pharmaceutical care services should notice an increase in the number of paid claims.
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Guidelines and Value-Based Decision Making: An Evolving Role for Payers.
McCauley, Janet L
2015-01-01
Payers use evidence-based guidelines to promote effective health diagnoses and treatments for their members and to ensure that members are not subject to harmful or wasteful care. Payer guidelines inform coverage, but the content of these guidelines relies on the same evidentiary base as clinical treatment guidelines. Recent strategies to foster value through benefit design and alternative reimbursement methodologies illustrate emerging applications for evidence-based guidelines. The current focus on cost effectiveness within health technology assessment, comparative effectiveness research in collaboration with payers, and transparency around payer evidence assessment could better align payers' interests in evidence-based care with those of other stakeholders. The move to value in health care will depend upon credible clinical evidence to enable informed decision making. ©2015 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
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2013-02-14
... National Committee on Quality Assurance Patient Centered Medical Home (PPC-PCMH) recognition criteria... quality improvements. TMA Defense Health Cost Assessment and Evaluation (DHCAPE) staff will calculate... Maryland Multi-Payer Patient Centered Medical Home Program (MMPCMHP) Demonstration AGENCY: Department of...
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A payer-provider partnership for integrated care of patients receiving dialysis.
Kindy, Justin; Roer, David; Wanovich, Robert; McMurray, Stephen
2018-04-01
Patients with end-stage renal disease (ESRD) are clinically complex, requiring intensive and costly care. Coordinated care may improve outcomes and reduce costs. The objective of this study was to determine the impact of a payer-provider care partnership on key clinical and economic outcomes in enrolled patients with ESRD. Retrospective observational study. Data on patient demographics and clinical outcomes were abstracted from the electronic health records of the dialysis provider. Data on healthcare costs were collected from payer claims. Data were collected for a baseline period prior to initiation of the partnership (July 2011-June 2012) and for two 12-month periods following initiation (April 2013-March 2014 and April 2014-March 2015). Among both Medicare Advantage and commercial insurance program members, the rate of central venous catheter use for vascular access was lower following initiation of the partnership compared with the baseline period. Likewise, hospital admission rates, emergency department visit rates, and readmission rates were lower following partnership initiation. Rates of influenza and pneumococcal vaccination were higher than 95% throughout all 3 time periods. Total medical costs were lower for both cohorts of members in the second 12-month period following partnership initiation compared with the baseline period. Promising trends were observed among members participating in this payer-provider care partnership with respect to both clinical and economic outcomes. This suggests that collaborations with shared incentives may be a valuable approach for patients with ESRD.
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Biosimilars: How Can Payers Get Long-Term Savings?
Mestre-Ferrandiz, Jorge; Towse, Adrian; Berdud, Mikel
2016-06-01
The term 'biosimilar' refers to an alternative similar version of an off-patent innovative originator biotechnology product (the 'reference product'). Several biosimilars have been approved in Europe, and a number of top-selling biological medicines have lost, or will lose, patent protection over the next 5 years. We look at the experience in Europe so far. The USA has finally implemented a regulatory route for biosimilar approval. We recommend that European and US governments and payers take a strategic approach to get value for money from the use of biosimilars by (1) supporting and incentivising generation of high-quality comprehensive outcomes data on the effectiveness and safety of biosimilars and originator products; and (2) ensuring that incentives are in place for budget holders to benefit from price competition. This may create greater willingness on the part of budget holders and clinicians to use biosimilar and originator products with comparable outcomes interchangeably, and may drive down prices. Other options, such as direct price cuts for originator products or substitution rules without outcomes data, are likely to discourage biosimilar entry. With such approaches, governments may achieve a one-off cut in originator prices but may put at risk the creation of a more competitive market that would, in time, produce much greater savings. It was the creation of competitive markets for chemical generic drugs-notably, in the USA, the UK and Germany-rather than price control, that enabled payers to achieve the high discounts now taken for granted.
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Payer Perspectives on Patient-Reported Outcomes in Health Care Decision Making: Oncology Examples.
Brogan, Andrew P; DeMuro, Carla; Barrett, Amy M; D'Alessio, Denise; Bal, Vasudha; Hogue, Susan L
2017-02-01
Health authorities and payers increasingly recognize the importance of patient perspectives and patient-reported outcomes (PROs) in health care decision making. However, given the broad variety of PRO endpoints included in clinical programs and variations in the timing of PRO data collection and country-specific needs, the role of PRO data in reimbursement decisions requires characterization. To (a) determine the effect of PRO data on market access and reimbursement decisions for oncology products in multiple markets and (b) assess the effect of PRO data collected after clinical progression on payer decision making. A 3-part assessment (targeted literature review, qualitative one-on-one interviews, and online survey) was undertaken. Published literature was identified through searches in PubMed/MEDLINE and Embase. In addition, a targeted search was conducted of health technology assessment (HTA) agency websites in the United States, the United Kingdom, France, and Germany. Qualitative one-on-one interviews were conducted with 16 payers from the RTI Health Solutions global advisory panel in 14 markets (Australia, Brazil, France, Germany, Italy, South Korea, Netherlands, Poland, Spain, Sweden, Taiwan, Turkey, the United Kingdom, and the United States [n = 3]). Of the 200 payers and payer advisors from the global advisory panel invited to participate in the online survey, 20 respondents (China, France, Germany, Spain [n = 2], Taiwan, the United Kingdom, and the United States [n = 13]) completed the survey, and 6 respondents (Australia, South Korea, and the United States [n = 4]) partially completed the survey. Reviews of the literature and publicly available HTAs and reimbursement decisions suggested that HTA bodies and payers have varying experience with and confidence in PRO data. Payers participating in the survey indicated that PRO data may be especially influential in oncology compared with other therapeutic areas. Payers surveyed offered little differentiation
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Primary Payer at DX: Issues with Collection and Assessment of Data Quality.
Sherman, Recinda L; Williamson, Laura; Andrews, Patricia; Kahn, Amy
2016-01-01
An individual's access to health insurance influences the amount and type of health services a patient receives for prevention and treatment, and, ultimately, influences survival. The North American Association of Central Cancer Registries (NAACCR) Item #630, Primary Payer at DX, is a required field intended to document health insurance status for the purpose of supporting patterns-of-care studies and other research. However, challenges related to the uniformity of collection and availability of data needed to populate this field diminish the value of the Primary Payer at DX data. A NAACCR taskforce worked on issues surrounding the collection of Primary Payer at DX; including proposing a crosswalk between Primary Payer at DX and the new Public Health Payment Typology standard, often available in hospital discharge databases. However, there are issues with compatibility between coding systems, intent of data collection, timelines for coding insurance, and changes in insurance coverage (partly due to the Affordable Care Act) that continue to complicate the collection and use of Primary Payer at DX data.
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Cost of transfusion-dependent myelodysplastic syndrome (MDS) from a German payer?s perspective
2010-01-01
Abstract No curative treatment exists for patients with myelodysplastic syndrome (MDS) besides allogeneic stem cell transplantation. Hence, palliative treatment is provided for a life time accruing high health care cost. As no study in cost of MDS exists in Germany, the objective of this study was to assess and analyze costs of transfusion-dependent low/intermediate-1-risk MDS in Germany from a payers? perspective. From seven centers, 116 low/intermediate-1-risk transfusion-depende...
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Adaptive Pathways: Possible Next Steps for Payers in Preparation for Their Potential Implementation
Vella Bonanno, Patricia; Ermisch, Michael; Godman, Brian; Martin, Antony P.; Van Den Bergh, Jesper; Bezmelnitsyna, Liudmila; Bucsics, Anna; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Eriksson, Irene; Fürst, Jurij; Gad, Mohamed; Greičiūtė-Kuprijanov, Ieva; van der Graaff, Martin; Gulbinovic, Jolanta; Jones, Jan; Joppi, Roberta; Kalaba, Marija; Laius, Ott; Langner, Irene; Mardare, Ileana; Markovic-Pekovic, Vanda; Magnusson, Einar; Melien, Oyvind; Meshkov, Dmitry O.; Petrova, Guenka I.; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Schuurman, Ad; Ramos, Ricardo; Rodrigues, Jorge; Zara, Corinne; Zebedin-Brandl, Eva; Haycox, Alan
2017-01-01
Medicines receiving a conditional marketing authorization through Medicines Adaptive Pathways to Patients (MAPPs) will be a challenge for payers. The “introduction” of MAPPs is already seen by the European Medicines Agency (EMA) as a fait accompli, with payers not consulted or involved. However, once medicines are approved through MAPPs, they will be evaluated for funding by payers through different activities. These include Health Technology Assessment (HTA) with often immature clinical data and high uncertainty, financial considerations, and negotiations through different types of agreements, which can require monitoring post launch. Payers have experience with new medicines approved through conditional approval, and the fact that MAPPs present additional challenges is a concern from their perspective. There may be some activities where payers can collaborate. The final decisions on whether to reimburse a new medicine via MAPPs will have more variation than for medicines licensed via conventional processes. This is due not only to increasing uncertainty associated with medicines authorized through MAPPs but also differences in legal frameworks between member states. Moreover, if the financial and side-effect burden from the period of conditional approval until granting full marketing authorization is shifted to the post-authorization phase, payers may have to bear such burdens. Collection of robust data during routine clinical use is challenging along with high prices for new medicines during data collection. This paper presents the concept of MAPPs and possible challenges. Concerns and potential ways forward are discussed and a number of recommendations are presented from the perspective of payers. PMID:28878667
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Adaptive Pathways: Possible Next Steps for Payers in Preparation for Their Potential Implementation
Directory of Open Access Journals (Sweden)
Patricia Vella Bonanno
2017-08-01
Full Text Available Medicines receiving a conditional marketing authorization through Medicines Adaptive Pathways to Patients (MAPPs will be a challenge for payers. The “introduction” of MAPPs is already seen by the European Medicines Agency (EMA as a fait accompli, with payers not consulted or involved. However, once medicines are approved through MAPPs, they will be evaluated for funding by payers through different activities. These include Health Technology Assessment (HTA with often immature clinical data and high uncertainty, financial considerations, and negotiations through different types of agreements, which can require monitoring post launch. Payers have experience with new medicines approved through conditional approval, and the fact that MAPPs present additional challenges is a concern from their perspective. There may be some activities where payers can collaborate. The final decisions on whether to reimburse a new medicine via MAPPs will have more variation than for medicines licensed via conventional processes. This is due not only to increasing uncertainty associated with medicines authorized through MAPPs but also differences in legal frameworks between member states. Moreover, if the financial and side-effect burden from the period of conditional approval until granting full marketing authorization is shifted to the post-authorization phase, payers may have to bear such burdens. Collection of robust data during routine clinical use is challenging along with high prices for new medicines during data collection. This paper presents the concept of MAPPs and possible challenges. Concerns and potential ways forward are discussed and a number of recommendations are presented from the perspective of payers.
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Adaptive Pathways: Possible Next Steps for Payers in Preparation for Their Potential Implementation.
Vella Bonanno, Patricia; Ermisch, Michael; Godman, Brian; Martin, Antony P; Van Den Bergh, Jesper; Bezmelnitsyna, Liudmila; Bucsics, Anna; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Eriksson, Irene; Fürst, Jurij; Gad, Mohamed; Greičiūtė-Kuprijanov, Ieva; van der Graaff, Martin; Gulbinovic, Jolanta; Jones, Jan; Joppi, Roberta; Kalaba, Marija; Laius, Ott; Langner, Irene; Mardare, Ileana; Markovic-Pekovic, Vanda; Magnusson, Einar; Melien, Oyvind; Meshkov, Dmitry O; Petrova, Guenka I; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Schuurman, Ad; Ramos, Ricardo; Rodrigues, Jorge; Zara, Corinne; Zebedin-Brandl, Eva; Haycox, Alan
2017-01-01
Medicines receiving a conditional marketing authorization through Medicines Adaptive Pathways to Patients (MAPPs) will be a challenge for payers. The "introduction" of MAPPs is already seen by the European Medicines Agency (EMA) as a fait accompli, with payers not consulted or involved. However, once medicines are approved through MAPPs, they will be evaluated for funding by payers through different activities. These include Health Technology Assessment (HTA) with often immature clinical data and high uncertainty, financial considerations, and negotiations through different types of agreements, which can require monitoring post launch. Payers have experience with new medicines approved through conditional approval, and the fact that MAPPs present additional challenges is a concern from their perspective. There may be some activities where payers can collaborate. The final decisions on whether to reimburse a new medicine via MAPPs will have more variation than for medicines licensed via conventional processes. This is due not only to increasing uncertainty associated with medicines authorized through MAPPs but also differences in legal frameworks between member states. Moreover, if the financial and side-effect burden from the period of conditional approval until granting full marketing authorization is shifted to the post-authorization phase, payers may have to bear such burdens. Collection of robust data during routine clinical use is challenging along with high prices for new medicines during data collection. This paper presents the concept of MAPPs and possible challenges. Concerns and potential ways forward are discussed and a number of recommendations are presented from the perspective of payers.
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Tan, Elise Chia-Hui; Pwu, Raoh-Fang; Chen, Duan-Rung; Yang, Ming-Chin
2014-03-01
In October 2001, a pay-for-performance (P4P) program for diabetes was implemented by the National Health Insurance (NHI), a single-payer program, in Taiwan. However, only limited information is available regarding the influence of this program on the patient's health-related quality of life. The aim of this study was to estimate the costs and consequences of enrolling patients in the P4P program from a single-payer perspective. A retrospective observational study of 529 diabetic patients was conducted between 2004 and 2005. The data used in the study were obtained from the National Health Interview Survey (NHIS) in Taiwan. Direct cost data were obtained from NHI claims data, which were linked to respondents in the NHIS using scrambled individual identification. The generic SF36 health instrument was employed to measure the quality-of-life-related health status and transformed into a utility index. Patients enrolled in the P4P program for at least 3 months were categorized as the P4P group. Following propensity score matching, 260 patients were included in the study. Outcomes included life-years, quality-adjusted life-years (QALYs), diabetes-related medical costs, overall medical costs, and incremental cost-effectiveness ratios (ICERs). A single-payer perspective was assumed, and costs were expressed in US dollars. Nonparametric bootstrapping was conducted to estimate confidence intervals for cost-effectiveness ratios. Following matching, no significant difference was noted between two groups with regard to the patients' age, gender, education, family income, smoking status, BMI, or whether insulin was used. The P4P group had an increase of 0.08 (95 % CI 0.077-0.080) in QALYs, and the additional diabetes-related medical cost was US$422.74 (95 % CI US$413.58-US$435.05), yielding an ICER of US$5413.93 (95 % CI US$5226.83-US$5562.97) per QALY gained. Our results provides decision makers with valuable information regarding the impact of the P4P program of diabetes care
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Villelli, Nicolas W; Yan, Hong; Zou, Jian; Barbaro, Nicholas M
2017-12-01
OBJECTIVE Several similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors' prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US. METHODS Using the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012. Payer-mix status was assigned as Medicare, Medicaid, private insurance, uninsured, or other, which included government-funded programs and workers' compensation. A comparison of the payer-mix status and patient age, both before and after the policy, was performed. The New York State data were used as a control. RESULTS The authors analyzed 81,821 spine surgeries performed in Massachusetts and 248,757 in New York. After 2008, there was a decrease in uninsured and private insurance spine surgeries, with a subsequent increase in the Medicare and "other" categories for Massachusetts. Medicaid case numbers did not change. This correlated to an increase in surgeries performed in the age group of patients 65-84 years old, with a decrease in surgeries for those 18-44 years old. New York showed an increase in all insurance categories and all adult age groups. CONCLUSIONS After the Massachusetts reform, spine surgery decreased in private insurance and uninsured categories, with the majority of these surgeries transitioning to Medicare. Moreover, individuals who were younger than 65 years did not show an increase in spine surgeries, despite having greater access to health insurance. In a health care system that requires insurance, the decrease in private insurance is primarily due to an increasing elderly
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Akhmetov, Ildar; Bubnov, Rostyslav V
2017-12-01
As reimbursement authorities are gaining greater power to influence the prescription behavior of physicians, it remains critical for life science companies focusing on personalized medicine to develop "tailor-made" payer engagement strategies to secure reimbursement and assure timely patient access to their innovative products. Depending on the types of such engagement, pharmaceutical and diagnostic companies may benefit by obtaining access to medical and pharmacy claims data, getting invaluable upfront inputs on evidence requirements and clinical trial design, and strengthening trust by payers, therefore avoiding uncertainties with regards to pricing, reimbursement, and research and development reinvestment. This article aims to study the evolving trend of partnering among two interdependent, yet confronting, stakeholder groups-payers and producers-as well as to identify the most promising payer engagement strategies based on cocreation of value introduced by life science companies in the past few years. We analyzed the recent case studies from both therapeutic and diagnostic realms considered as the "best practices" in payer engagement. The last 5 years were a breakout period for deals between life science companies and reimbursement authorities in the area of personalized medicine with a number of felicitous collaborative practices established already, and many more yet to emerge. We suggest that there are many ways for producers and payers to collaborate throughout the product life cycle-from data exchange and scientific counseling to research collaboration aimed at reducing healthcare costs, addressing adherence issues, and diminishing risks associated with future launches. The presented case studies provide clear insights on how successful personalized medicine companies customize their state-of-the-art payer engagement strategies to ensure closer proximity with payers and establish longer-term trust-based relationships.
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An obesity/cardiometabolic risk reduction disease management program: a population-based approach.
Villagra, Victor G
2009-04-01
Obesity is a critical health concern that has captured the attention of public and private healthcare payers who are interested in controlling costs and mitigating the long-term economic consequences of the obesity epidemic. Population-based approaches to obesity management have been proposed that take advantage of a chronic care model (CCM), including patient self-care, the use of community-based resources, and the realization of care continuity through ongoing communications with patients, information technology, and public policy changes. Payer-sponsored disease management programs represent an important conduit to delivering population-based care founded on similar CCM concepts. Disease management is founded on population-based disease identification, evidence-based care protocols, and collaborative practices between clinicians. While substantial clinician training, technology infrastructure commitments, and financial support at the payer level will be needed for the success of disease management programs in obesity and cardiometabolic risk reduction, these barriers can be overcome with the proper commitment. Disease management programs represent an important tool to combat the growing societal risks of overweight and obesity.
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Directory of Open Access Journals (Sweden)
Christine D. Jones MD, MS
2015-08-01
Full Text Available Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P < .001, uninsured encounters decreased (18.4% to 6.3%, P < 0.001, and private payer encounters also decreased (14.1% to 13.3%, P = .001. The median reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P < .001. In a sensitivity analysis, changes in length of stay, proportions in encounter type by payer, payer mix, and reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion.
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International Nuclear Information System (INIS)
Fischerhof, H.
1980-01-01
In a decision dated December 20, 1979, the Federal Constitutional Court refused to accept the complaint of unconstitutionality brought by the Technische Werke (Municipal Utilities) of the city of Stuttgart (TWS) against two decisions by the Stuttgart Municipal Court in favor of non-payers and part payers of electricity bills. The reasons given for the refusal to accept the complaint state that there was every indication of the Stuttgart judgements being faulty. On the basis of this finding, TWS can continue to demand payment in full of their electricity bills. The Federal Constitutional Court maintains that civil rights could not be applied to TWS as a corporation under private law, whose activities exclusively consisted in providing the public with means of existence and whose shares were held in full by an agency with rights of jurisdiction. In a footnote, the author argues that the refusal to grant protection of civil rights to TWS was in conflict with the equal rights principle. (HSCH) [de
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Provider-Payer Partnerships as an Engine for Continuous Quality Improvement.
Balfour, Margaret E; Zinn, Tylar E; Cason, Karena; Fox, Jerimya; Morales, Myra; Berdeja, Cesar; Gray, Jay
2018-03-01
The authors describe a quality improvement approach in which a crisis center and a payer collaborate to improve care. Each crisis visit is considered as a potentially missed opportunity for community stabilization. Daily data on crisis visits are sent to the payer for a more up-to-date analysis of trends than is possible with financial claims data, which may lag behind services provided by up to 90 days. Using these trend data, the two organizations collaborate to identify patterns that lead to opportunities for improvement and develop multiple rapid-cycle projects for better management of services, resulting in significant decreases in readmissions and in the number of high utilizers.
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Is overall similarity classification less effortful than single-dimension classification?
Wills, Andy J; Milton, Fraser; Longmore, Christopher A; Hester, Sarah; Robinson, Jo
2013-01-01
It is sometimes argued that the implementation of an overall similarity classification is less effortful than the implementation of a single-dimension classification. In the current article, we argue that the evidence securely in support of this view is limited, and report additional evidence in support of the opposite proposition--overall similarity classification is more effortful than single-dimension classification. Using a match-to-standards procedure, Experiments 1A, 1B and 2 demonstrate that concurrent load reduces the prevalence of overall similarity classification, and that this effect is robust to changes in the concurrent load task employed, the level of time pressure experienced, and the short-term memory requirements of the classification task. Experiment 3 demonstrates that participants who produced overall similarity classifications from the outset have larger working memory capacities than those who produced single-dimension classifications initially, and Experiment 4 demonstrates that instructions to respond meticulously increase the prevalence of overall similarity classification.
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Coupet, Edouard; Karp, David; Wiebe, Douglas J; Kit Delgado, M
2018-03-28
Investment in violence prevention programs is hampered by lack of clearly identifiable stakeholders with a financial stake in prevention. We determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. We analyzed all emergency department (ED) visits from 2009 to 2014 with diagnosis codes for violent injury in the Nationwide Emergency Department Sample (NEDS). We used sample weights to estimate total charges with adjusted generalized linear models to estimate charges for the 15% of ED visits with missing charge data. We then calculated the share attributable by payer and determined the difference in proportion by payer from 2013 to 2014. Between 2009 and 2013, the uninsured accounted for 28.2-31.3% of annual charges for the acute care of violent injury, while Medicaid was responsible for a similar amount (29.0-31.0%). In 2014, there were $10.7 billion in total charges for violent injury. Medicaid assumed the greatest share, 39.8% (95% CI: 38.0-41.5%, $3.5-5.1 billion), while the uninsured accounted for 23.6% (95% CI: 22.2-24.9%, $2.0-3.0 billion), and Medicare accounted for 7.8% (95% CI: 7.7-8.0%, $0.7-1.0 billion). After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. These findings highlight the benefit to state Medicaid programs of preventing interpersonal violence. Published by Elsevier Inc.
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Brown, Joshua D; Sheer, Rich; Pasquale, Margaret; Sudharshan, Lavanya; Axelsen, Kirsten; Subedi, Prasun; Wiederkehr, Daniel; Brownfield, Fred; Kamal-Bahl, Sachin
2018-01-01
Considerable interest exists among health care payers and pharmaceutical manufacturers in designing outcomes-based agreements (OBAs) for medications for which evidence on real-world effectiveness is limited at product launch. To build hypothetical OBA models in which both payer and manufacturer can benefit. Models were developed for a hypothetical hypercholesterolemia OBA, in which the OBA was assumed to increase market access for a newly marketed medication. Fixed inputs were drug and outcome event costs from the literature over a 1-year OBA period. Model estimates were developed using a range of inputs for medication effectiveness, medical cost offsets, and the treated population size. Positive or negative feedback to the manufacturer was incorporated on the basis of expectations of drug performance through changes in the reimbursement level. Model simulations demonstrated that parameters had the greatest impact on payer cost and manufacturer reimbursement. Models suggested that changes in the size of the population treated and drug effectiveness had the largest influence on reimbursement and costs. Despite sharing risk for potential product underperformance, manufacturer reimbursement increased relative to having no OBA, if the OBA improved market access for the new product. Although reduction in medical costs did not fully offset the cost of the medication, the payer could still save on net costs per patient relative to having no OBA by tying reimbursement to drug effectiveness. Pharmaceutical manufacturers and health care payers have demonstrated interest in OBAs, and under a certain set of assumptions both may benefit. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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Howrigon, Ron
2016-01-01
Because of their involvement with the Affordable Care exchanges, the national insurance companies have reported significant financial losses. As a result, there will soon be significant payer pressure to reduce medical expenses. To succeed in future negotiations with the payers, medical practices must understand the needs of the payers and then play to those needs. The author is a former managed care executive with more than 25 years of experience managing provider networks and implementing payer strategies for some of the largest payers in the United States. In this article, he outlines important things medical practices should be doing to prepare for the new world of value-based contracting. Medical practices that embrace this change and work hard to evolve with the future are the ones that are going to survive and succeed.
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A new "loyalty rewards" program in health care customer relationships.
Macstravic, Scott
2006-01-01
"Loyalty rewards" in sponsored DM and HRM programs can apply to both providers and consumers. Physicians and hospitals can be paid to "loyally" adhere to payers' guidelines for managing diseases and risks. Many payer and their outsourced vendor programs include significant efforts to create collaborations between payer and provider, rather than relying on unilateral efforts. And growing numbers are rewarding providers for their efforts and results achieved.
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Saleh, S; Ammar, W; Natafgi, N; Mourad, Y; Dimassi, H; Harb, H
2015-09-08
This study aimed to examine the association between the payer mix and the financial performance of public and private hospitals in Lebanon. The sample comprised 24 hospitals, representing the variety of hospital characteristics in Lebanon. The distribution of the payer mix revealed that the main sources of revenue were public sources (61.1%), out-of-pocket (18.4%) and private insurance (18.2%). Increases in the percentage of revenue from public sources were associated with lower total costs and revenues, but not profit margins. An inverse association was noted between increased revenue from private insurance and profitability, attributed to increased costs. Increased percentage of out of- pocket payments was associated with lower costs and higher profitability. The study provides evidence that payer mix is associated with hospital costs, revenues and profitability. This should initiate/inform discussions between public and private payers and hospitals about the level of payment and its association with hospital sector financial viability.
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Jones, Christine D.; Scott, Serena J.; Anoff, Debra L.; Pierce, Read G.; Glasheen, Jeffrey J.
2015-01-01
Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion. PMID:26310500
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Mookencherry, Shefali
2012-01-01
It makes strategic and business sense for payers and providers to collaborate on how to take substantial cost out of the healthcare delivery system. Acting independently, neither medical groups, hospitals nor health plans have the optimal mix of resources and incentives to significantly reduce costs. Payers have core assets such as marketing, claims data, claims processing, reimbursement systems and capital. It would be cost prohibitive for all but the largest providers to develop these capabilities in order to compete directly with insurers. Likewise, medical groups and hospitals are positioned to foster financial interdependence among providers and coordinate the continuum of patient illnesses and care settings. Payers and providers should commit to reasonable clinical and cost goals, and share resources to minimize expenses and financial risks. It is in the interest of payers to work closely with providers on risk-management strategies because insurers need synergy with ACOs to remain cost competitive. It is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks. Hence, it is essential to have payer interoperability and data sharing integrated in an ACO model.
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Relative efficacy of drugs: an emerging issue between regulatory agencies and third-party payers.
Eichler, Hans-Georg; Bloechl-Daum, Brigitte; Abadie, Eric; Barnett, David; König, Franz; Pearson, Steven
2010-04-01
Drug regulatory agencies have traditionally assessed the quality, safety and efficacy of drugs, and the current paradigm dictates that a new drug should be licensed when the benefits outweigh the risks. By contrast, third-party payers base their reimbursement decisions predominantly on the health benefits of the drug relative to existing treatment options (termed relative efficacy; RE). Over the past decade, the role of payers has become more prominent, and time-to-market no longer means time-to-licensing but time-to-reimbursement. Companies now have to satisfy the sometimes divergent needs of both regulators and payers, and to address RE during the pre-marketing stages. This article describes the current political background to the RE debate and presents the scientific and methodological challenges as they relate to RE assessment. In addition, we explain the impact of RE on drug development, and speculate on future developments and actions that are likely to be required from key players.
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Kerr, Christopher W; Donohue, Kathleen A; Tangeman, John C; Serehali, Amin M; Knodel, Sarah M; Grant, Pei C; Luczkiewicz, Debra L; Mylotte, Kathleen; Marien, Melanie J
2014-12-01
In the United States, 5% of the population is responsible for nearly half of all health care expenditures, with a large concentration of spending driven by individuals with expensive chronic conditions in their last year of life. Outpatient palliative care under the Medicare Hospice Benefit excludes a large proportion of the chronically ill and there is widespread recognition that innovative strategies must be developed to meet the needs of the seriously ill while reducing costs. This study aimed to evaluate the impact of a home-based palliative care program, implemented through a hospice-private payer partnership, on health care costs and utilization. This was a prospective, observational database study where insurance enrollment and claims data were analyzed. The study population consisted of Home Connections (HC) program patients enrolled between January 1, 2010 and December 31, 2012 who subsequently expired (n=149) and who were also Independent Health members. A control group (n=537) was derived using propensity-score matching. The primary outcome variable was overall costs within the last year of life. Costs were also examined at six months, three months, one month, and two weeks. Inpatient, outpatient, ancillary, professional, and pharmacy costs were compared between the two groups. Medical service utilization and hospice enrollment and length of stay were also evaluated. Cost savings were apparent in the last three months of life—$6,804 per member per month (PMPM) cost for palliative care participants versus $10,712 for usual care. During the last two weeks of life, total allowed PMPM was $6,674 versus $13,846 for usual care. Enhanced hospice entry (70% versus 25%) and longer length of stay in hospice (median 34 versus 9 days) were observed. Palliative care programs partnered with community hospice providers may achieve cost savings while helping provide care across the continuum.
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Jensen, Ivar S; Wu, Elizabeth; Fan, Weihong; Lodise, Thomas P; Nicolau, David P; Dufour, Scott; Cyr, Philip L; Sulham, Katherine A
2016-06-01
It is estimated that acute bacterial skin and skin structure infections (ABSSSI) account for nearly 10% of hospital admissions and 3.4-3.8 million emergency department visits per year in the United States. Analyses of hospital discharge records indicate 74% of ABSSSI admissions involve empiric treatment with methicillin-resistant Staphylococcus aureus (MRSA) active antibiotics. Analysis has shown that payer costs could be reduced if moderate-to-severe ABSSSI patients were treated to a greater extent in the observational unit followed by discharge to outpatient parenteral antibiotic therapy (OPAT). Oritavancin is a lipoglycopeptide antibiotic with bactericidal activity against gram-positive bacteria, including MRSA. To estimate the impact on a U.S. payer's budget of using single-dose oritavancin in ABSSSI patients with suspected MRSA involvement who are indicated for intravenous antibiotics. A decision analytic model based on current clinical practice was developed to estimate the economic value of decreased hospital resource consumption by using single-dose oritavancin over a 1-year time horizon. Use of antibiotics was informed by an analysis of the Premier Research Database. Demographic and clinical data were derived from a targeted literature review. Emergency department, observation, laboratory, and administration costs used were Medicare National Limitation amounts. Drug costs were 2014 wholesale acquisition costs. For a hypothetical U.S. payer with 1,000,000 members, it is expected that approximately 14,285 members per year will be diagnosed with ABSSSI severe enough to indicate intravenous antibiotics with MRSA activity. Based on this simulation, use of single-dose oritavancin in 26% of these patients was estimated to reduce the number of inpatient admissions, reduce length of stay for patients requiring admission, and reduce the number of days a patient needs to receive daily infusions in the OPAT clinic. The total patient days decreased from 171,125 to 133
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MacLeod, Tatjana E; Harris, Anthony H; Mahal, Ajay
2016-06-01
The growing focus on patient-centred care has encouraged the inclusion of patient and public input into payer drug reimbursement decisions. Yet, little is known about patient/public priorities for funding high-cost medicines, and how they compare to payer priorities applied in public funding decisions for new cancer drugs. The aim was to identify and compare the funding preferences of cancer patients and the general public against the criteria used by payers making cancer drug funding decisions. A thorough review of the empirical, peer-reviewed English literature was conducted. Information sources were PubMed, EMBASE, MEDLINE, Web of Science, Business Source Complete, and EconLit. Eligible studies (1) assessed the cancer drug funding preferences of patients, the general public or payers, (2) had pre-defined measures of funding preference, and (3) had outcomes with attributes or measures of 'value'. The quality of included studies was evaluated using a health technology assessment-based assessment tool, followed by extraction of general study characteristics and funding preferences, which were categorized using an established WHO-based framework. Twenty-five preference studies were retrieved (11 quantitative, seven qualitative, seven mixed-methods). Most studies were published from 2005 onward, with the oldest dating back to 1997. Two studies evaluated both patient and public perspectives, giving 27 total funding perspectives (41 % payer, 33 % public, 26 % patients). Of 41 identified funding criteria, payers consider the most (35), the general public considers fewer (23), and patients consider the fewest (12). We identify four unique patient criteria: financial protection, access to medical information, autonomy in treatment decision making, and the 'value of hope'. Sixteen countries/jurisdictions were represented. Our results suggest that (1) payers prioritize efficiency (health gains per dollar), while citizens (patients and the general public) prioritize
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Card index of coal user-payers in the system of accounting and analysis of coal marketing
Energy Technology Data Exchange (ETDEWEB)
Czapka, D
1980-01-01
A card index of coal users-payers was formed on the basis of an existing card file of payers which functions in development of an earlier subsystem of financial accounting of coal users by means of a corresponding reorganization of the available set of data and supplementing it with new data on users. The card index performs a monitor and address function. Checked and refined data are input in subsequent technological cycles of data conversion. The structure of the card file, its functions, realization conditions with output of necessary following results are examined.
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Contract law: relationship between dermatologists and third-party payers.
Askanas, A V
1993-04-01
The relationship between third-party payers and dermatologists is generally governed by a written contract. That relationship can be more beneficial to the dermatologist, and chances of liability may be decreased, both for breach of contract and for malpractice, if the dermatologist pays close attention to the language in the contract. All contracts are generally negotiable; detrimental language in the contract often may be removed or changed. This article presents information to help prepare dermatologists to review and negotiate contracts.
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Detecting earthquakes over a seismic network using single-station similarity measures
Bergen, Karianne J.; Beroza, Gregory C.
2018-06-01
New blind waveform-similarity-based detection methods, such as Fingerprint and Similarity Thresholding (FAST), have shown promise for detecting weak signals in long-duration, continuous waveform data. While blind detectors are capable of identifying similar or repeating waveforms without templates, they can also be susceptible to false detections due to local correlated noise. In this work, we present a set of three new methods that allow us to extend single-station similarity-based detection over a seismic network; event-pair extraction, pairwise pseudo-association, and event resolution complete a post-processing pipeline that combines single-station similarity measures (e.g. FAST sparse similarity matrix) from each station in a network into a list of candidate events. The core technique, pairwise pseudo-association, leverages the pairwise structure of event detections in its network detection model, which allows it to identify events observed at multiple stations in the network without modeling the expected moveout. Though our approach is general, we apply it to extend FAST over a sparse seismic network. We demonstrate that our network-based extension of FAST is both sensitive and maintains a low false detection rate. As a test case, we apply our approach to 2 weeks of continuous waveform data from five stations during the foreshock sequence prior to the 2014 Mw 8.2 Iquique earthquake. Our method identifies nearly five times as many events as the local seismicity catalogue (including 95 per cent of the catalogue events), and less than 1 per cent of these candidate events are false detections.
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Payers' Views of the Changes Arising through the Possible Adoption of Adaptive Pathways.
Ermisch, Michael; Bucsics, Anna; Vella Bonanno, Patricia; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Fürst, Jurij; Garuolienė, Kristina; van der Graaff, Martin; Gulbinovič, Jolanta; Haycox, Alan; Jones, Jan; Joppi, Roberta; Laius, Ott; Langner, Irene; Martin, Antony P; Markovic-Pekovic, Vanda; McCullagh, Laura; Magnusson, Einar; Nilsen, Ellen; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Sauermann, Robert; Schuurman, Ad; Ramos, Ricardo; Vlahovic-Palcevski, Vera; Zara, Corinne; Godman, Brian
2016-01-01
Payers are a major stakeholder in any considerations and initiatives concerning adaptive licensing of new medicinal products, also referred to as Medicines Adaptive Pathways to patients (MAPPs). Firstly, the scope and necessity of MAPPs need further scrutiny, especially with regard to the definition of unmet need. Conditional approval pathways already exist for new medicines for seriously debilitating or life-threatening diseases and only a limited number of new medicines are innovative. Secondly, MAPPs will result in new medicines on the market with limited evidence about their effectiveness and safety. Additional data are to be collected after approval. Consequently, adaptive pathways may increase the risk of exposing patients to ineffective or unsafe medicines. We have already seen medicines approved conventionally that subsequently proved ineffective or unsafe amongst a wider, more co-morbid population as well as medicines that could have been considered for approval under MAPPs but subsequently proved ineffective or unsafe in Phase III trials and were never licensed. Thirdly, MAPPs also put high demands on payers. Routine collection of patient level data is difficult with high transaction costs. It is not clear who will fund these. Other challenges for payers include shifts in the risk governance framework, implications for evaluation and HTA, increased complexity of setting prices, difficulty with ensuring equity in the allocation of resources, definition of responsibility and liability and implementation of stratified use. Exit strategies also need to be agreed in advance, including price reductions, rebates, or reimbursement withdrawals when price premiums are not justified. These issues and concerns will be discussed in detail including potential ways forward.
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Zimmerman, Christina
2011-11-01
(1) In Canadian office practices, physicians spent 2.2 hours per week interacting with payers, nurses spent 2.5 hours, and clerical staff spent 15.9 hours. In U.S. practices, physicians spent 3.4 hours per week interacting with payers, nurses spent 20.6 hours, and clerical staff spent 53.1 hours. (2) Canadian physician practices spent $22,205 per physician per year on interactions with health plans. U.S. physician practices spent $82,975 per physician per year. (3) U.S. physician practices spend $60,770 per physician per year more (approximately four times as much) than their Canadian counterparts.
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Directory of Open Access Journals (Sweden)
Alejandro Arrieta
Full Text Available The introduction of Proprotein covertase subtilisin/kexin type 9 (PCSK9 inhibitors has been heralded as a major advancement in reducing low-density lipoprotein cholesterol levels by nearly 50%. However, concerns have been raised on the added value to the health care system in terms of their costs and benefits. We assess the cost-effectiveness of PCSK9 inhibitors based on a decision-analytic model with existing clinical evidence. The model compares a lipid-lowering therapy based on statin plus PCSK9 inhibitor treatment with statin treatment only (standard therapy. From health system perspective, incremental cost per quality adjusted life years (QALYs gained are presented. From a private payer perspective, return-on-investment and net present values over patient lifespan are presented. At the current annual cost of $14,000 to $15,000, PCSK9 inhibitors are not cost-effective at an incremental cost of about $350,000 per QALY. Moreover, for every dollar invested in PCSK9 inhibitors, the private payer loses $1.98. Our study suggests that the annual treatment price should be set at $4,250 at a societal willingness-to-pay of $100,000 per QALY. However, we estimate the breakeven price for private payer is only $600 per annual treatment. At current prices, our study suggests that PCSK9 inhibitors do not add value to the U.S. health system and their provision is not profitable for private payers. To be the breakthrough drug in the fight against cardiovascular disease, the current price of PCSK9 inhibitors must be reduced by more than 70%.
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Does good medication adherence really save payers money?
Stuart, Bruce C; Dai, Mingliang; Xu, Jing; Loh, Feng-Hua E; S Dougherty, Julia
2015-06-01
Despite a growing consensus that better adherence with evidence-based medications can save payers money, assertions of cost offsets may be incomplete if they fail to consider additional drug costs and/or are biased by healthy adherer behaviors unobserved in typical medical claims-based analyses. The objective of this study was to determine whether controlling for healthy adherer bias (HAB) materially affected estimated medical cost offsets and additional drug spending associated with higher adherence. A total of 1273 Medicare beneficiaries with diabetes enrolled in Part D plans between 2006 and 2009. Using survey and claims data from the Medicare Current Beneficiary Survey, we measured medical and drug costs associated with good and poor adherence (proportion of days covered ≥ 80% and <80%, respectively) to oral antidiabetic drugs, ACE inhibitors/ARBs, and statins over 2 years. To test for HAB, we estimated pairs of regression models, one set containing variables typically controlled for in conventional claims analysis and a second set with survey-based variables selected to capture HAB effects. We found consistent evidence that controlling for HAB reduces estimated savings in medical costs from better adherence, and likewise, reduces estimates of additional adherence-related drug spending. For ACE inhibitors/ARBs we estimate that controlling for HAB reduced adherence-related medical cost offsets from $6389 to $4920 per person (P<0.05). Estimates of additional adherence-related drug costs were 26% and 14% lower in HAB-controlled models (P < 0.05). These results buttress the economic case for action by health care payers to improve medication adherence among insured persons with chronic disease. However, given the limitations of our research design, further research on larger samples with other disease states is clearly warranted.
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Single Shell Tank (SST) Program Plan
International Nuclear Information System (INIS)
HAASS, C.C.
2000-01-01
This document provides an initial program plan for retrieval of the single-shell tank waste. Requirements, technical approach, schedule, organization, management, and cost and funding are discussed. The program plan will be refined and updated in fiscal year 2000
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Single Shell Tank (SST) Program Plan
Energy Technology Data Exchange (ETDEWEB)
HAASS, C.C.
2000-03-21
This document provides an initial program plan for retrieval of the single-shell tank waste. Requirements, technical approach, schedule, organization, management, and cost and funding are discussed. The program plan will be refined and updated in fiscal year 2000.
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Toumi, Mondher; Jadot, Guy
2014-01-01
Recently, collaboration between regulators and payers was set up and was mainly focused on evidence generation along product clinical development. However, neither the regulatory path nor the new active substance status (NASs) was considered. Granting NASs will provide the product with 8 years of data protection and 2 years of market exclusivity during which no generic could enter the market. To review the economic impact (for payers) of NASs granted by the European Medicines Agency (EMA) for dimethyl fumarate (DMF), developed by Biogen and approved for multiple sclerosis (MS) as Tecfidera(®) on 3 February 2014. We reviewed the available DMF-containing products and identified their indication and price through relevant databases and official Web sites. The economic impact of Tecfidera(®) on payers' budgets was calculated assuming NASs was or was not granted. The forecast was identified in Datamonitor. Results identified four products already containing DMF as the main or unique active substance. This would have potentially prevented Tecfidera(®) from being granted NASs. The EMA Committee for Medicinal Products for Human Use (CHMP) denied Tecfidera(®) NASs and, following a company appeal, reversed its position opening as polemic. The impact of that decision has been evaluated at €7 to €10 billion over a 10-year period. NASs is a critical decision because it does have a major budget impact for payers, and it prevents generic competition. Current European Union (EU) regulations on that topic are unclear and open up too many interpretations thus distorting fair trade and affecting payers' bills. Greater clarity and more stringent rules are required to prevent mistrust of this EMA decision.
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A space-efficient algorithm for local similarities.
Huang, X Q; Hardison, R C; Miller, W
1990-10-01
Existing dynamic-programming algorithms for identifying similar regions of two sequences require time and space proportional to the product of the sequence lengths. Often this space requirement is more limiting than the time requirement. We describe a dynamic-programming local-similarity algorithm that needs only space proportional to the sum of the sequence lengths. The method can also find repeats within a single long sequence. To illustrate the algorithm's potential, we discuss comparison of a 73,360 nucleotide sequence containing the human beta-like globin gene cluster and a corresponding 44,594 nucleotide sequence for rabbit, a problem well beyond the capabilities of other dynamic-programming software.
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2010-07-01
... Homemakers, and Single Pregnant Women Program be offered? 403.82 Section 403.82 Education Regulations of the... Secretary Assist Under the Basic Programs? Single Parents, Displaced Homemakers, and Single Pregnant Women Program § 403.82 In what settings may the Single Parents, Displaced Homemakers, and Single Pregnant Women...
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LeGear, Tyler; LeGear, Mark; Preradovic, Dejan; Wilson, Geoffrey; Kirkham, Ashley; Camp, Pat G
2016-05-01
The chronic obstructive pulmonary disease (COPD) population can experience lower activity and fitness levels than the non-COPD population. The Nintendo Wii may be an appropriate at-home training device for the COPD population, which could be used as a supplement for a pulmonary rehabilitation program. This study was a randomized, within-subject, cross-over study involving 10 adults with COPD previously enrolled in St Paul's Hospital's pulmonary rehabilitation program. This study attempted to determine if specific Wii activities resulted in similar energy expenditures to that of a more traditional pulmonary rehabilitation activity. Participants completed two 15-min exercise interventions in a single session, with a washout period of 30 min in-between. The interventions were an experimental Wii intervention and a traditional treadmill intervention. There was no significant difference in total energy expenditure between the two 15-min exercise interventions [mean difference 36.3 joules; 95% confidence interval (CI): 31.4, 104]. There was no significant difference in heart rate (mean difference -0.167 beats per minute; 95% CI: -4.83, 4.50), rating of perceived exertion (mean difference 0.100; 95% CI: -0.416, 0.616) and Borg dyspnea scale (mean difference 0.267; 95% CI: -0.004, 0.537) between the two 15-min exercise interventions. There was a significant difference in SpO2 between the two 15-min exercise interventions (Wii intervention mean difference 2.33% > treadmill intervention; 95% CI: 1.52, 3.15). Gaming technology can provide an exercise program that has similar cardiovascular demands to traditional pulmonary rehabilitation programs for patients with COPD. Further research is necessary to address feasibility and long-term adherence. © 2014 John Wiley & Sons Ltd.
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Musical structure analysis using similarity matrix and dynamic programming
Shiu, Yu; Jeong, Hong; Kuo, C.-C. Jay
2005-10-01
Automatic music segmentation and structure analysis from audio waveforms based on a three-level hierarchy is examined in this research, where the three-level hierarchy includes notes, measures and parts. The pitch class profile (PCP) feature is first extracted at the note level. Then, a similarity matrix is constructed at the measure level, where a dynamic time warping (DTW) technique is used to enhance the similarity computation by taking the temporal distortion of similar audio segments into account. By processing the similarity matrix, we can obtain a coarse-grain music segmentation result. Finally, dynamic programming is applied to the coarse-grain segments so that a song can be decomposed into several major parts such as intro, verse, chorus, bridge and outro. The performance of the proposed music structure analysis system is demonstrated for pop and rock music.
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Single-shell tank retrieval program mission analysis report
Energy Technology Data Exchange (ETDEWEB)
Stokes, W.J.
1998-08-11
This Mission Analysis Report was prepared to provide the foundation for the Single-Shell Tank (SST) Retrieval Program, a new program responsible for waste removal for the SSTS. The SST Retrieval Program is integrated with other Tank Waste Remediation System activities that provide the management, technical, and operations elements associated with planning and execution of SST and SST Farm retrieval and closure. This Mission Analysis Report provides the basis and strategy for developing a program plan for SST retrieval. This Mission Analysis Report responds to a US Department of Energy request for an alternative single-shell tank retrieval approach (Taylor 1997).
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Single-shell tank retrieval program mission analysis report
International Nuclear Information System (INIS)
Stokes, W.J.
1998-01-01
This Mission Analysis Report was prepared to provide the foundation for the Single-Shell Tank (SST) Retrieval Program, a new program responsible for waste removal for the SSTS. The SST Retrieval Program is integrated with other Tank Waste Remediation System activities that provide the management, technical, and operations elements associated with planning and execution of SST and SST Farm retrieval and closure. This Mission Analysis Report provides the basis and strategy for developing a program plan for SST retrieval. This Mission Analysis Report responds to a US Department of Energy request for an alternative single-shell tank retrieval approach (Taylor 1997)
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A note on similarity in single-phase and porous-medium natural convection
International Nuclear Information System (INIS)
Lyall, H.G.
1981-03-01
The similarity laws for single-phase and porous-medium natural convection are developed. For single-phase flow Nu = Nu(Ra) implies that inertial effects are negligible, while Nu = Nu(Ra.Pr) implies that viscous effects are. The first correlation is adequate for Pr>10, while the second applies for Pr<0.01. For intermediate values of Pr, a more general correlation, Nu = Nu(Ra,Pr) is necessary. For a porous-medium, if inertial effects and dispersion are negligible, Nu* = Nu*(Ra*). However dispersion will only be negligible if the ratio of grain size d to the width of the region L is very small (d/L<< l). If this condition does not hold it is necessary to model d/L. If inertial effects are significant, i.e. the Reynolds number is too large for Darcy's law to apply, a group containing the effective Prandtl number, Pr*, also needs to be modelled for similarity. (author)
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A study of concept-based similarity approaches for recommending program examples
Hosseini, Roya; Brusilovsky, Peter
2017-07-01
This paper investigates a range of concept-based example recommendation approaches that we developed to provide example-based problem-solving support in the domain of programming. The goal of these approaches is to offer students a set of most relevant remedial examples when they have trouble solving a code comprehension problem where students examine a program code to determine its output or the final value of a variable. In this paper, we use the ideas of semantic-level similarity-based linking developed in the area of intelligent hypertext to generate examples for the given problem. To determine the best-performing approach, we explored two groups of similarity approaches for selecting examples: non-structural approaches focusing on examples that are similar to the problem in terms of concept coverage and structural approaches focusing on examples that are similar to the problem by the structure of the content. We also explored the value of personalized example recommendation based on student's knowledge levels and learning goal of the exercise. The paper presents concept-based similarity approaches that we developed, explains the data collection studies and reports the result of comparative analysis. The results of our analysis showed better ranking performance of the personalized structural variant of cosine similarity approach.
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76 FR 31217 - Single Family Housing Guaranteed Loan Program
2011-05-31
... Farm Service Agency 7 CFR Part 1980 RIN 0575-AC83 Single Family Housing Guaranteed Loan Program... the Rural Housing Service (RHS) Section 502 Single Family Housing Guaranteed Loan Program (SFHGLP) by eliminating the lender's published Department of Veterans Affairs (VA) rate for first mortgage loans with no...
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Program computes single-point failures in critical system designs
Brown, W. R.
1967-01-01
Computer program analyzes the designs of critical systems that will either prove the design is free of single-point failures or detect each member of the population of single-point failures inherent in a system design. This program should find application in the checkout of redundant circuits and digital systems.
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Calculation of cosmic ray induced single event upsets: Program CRUP (Cosmic Ray Upset Program)
Shapiro, P.
1983-09-01
This report documents PROGRAM CRUP, COSMIC RAY UPSET PROGRAM. The computer program calculates cosmic ray induced single-event error rates in microelectronic circuits exposed to several representative cosmic-ray environments.
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Payer leverage and hospital compliance with a benchmark: a population-based observational study
Directory of Open Access Journals (Sweden)
DeMonner Sonya
2007-07-01
Full Text Available Abstract Background Since 1976, Medicare has linked reimbursement for hospitals performing organ transplants to the attainment of certain benchmarks, including transplant volume. While Medicare is a stakeholder in all transplant services, its role in renal transplantation is likely greater, given its coverage of end-stage renal disease. Thus, Medicare's transplant experience allows us to examine the role of payer leverage in motivating hospital benchmark compliance. Methods Nationally representative discharge data for kidney (n = 29,272, liver (n = 7,988, heart (n = 3,530, and lung (n = 1,880 transplants from the Nationwide Inpatient Sample (1993 – 2003 were employed. Logistic regression techniques with robust variance estimators were used to examine the relationship between hospital volume compliance and Medicare market share; generalized estimating equations were used to explore the association between patient-level operative mortality and hospital volume compliance. Results Medicare's transplant market share varied by organ [57%, 28%, 27%, and 18% for kidney, lung, heart, and liver transplants, respectively (P P Conclusion These data highlight the influence of payer leverage–an important contextual factor in value-based purchasing initiatives. For uncommon diagnoses, these data suggest that at least 30% of a provider's patients might need to be "at risk" for an incentive to motivate compliance.
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Similarity measures for face recognition
Vezzetti, Enrico
2015-01-01
Face recognition has several applications, including security, such as (authentication and identification of device users and criminal suspects), and in medicine (corrective surgery and diagnosis). Facial recognition programs rely on algorithms that can compare and compute the similarity between two sets of images. This eBook explains some of the similarity measures used in facial recognition systems in a single volume. Readers will learn about various measures including Minkowski distances, Mahalanobis distances, Hansdorff distances, cosine-based distances, among other methods. The book also summarizes errors that may occur in face recognition methods. Computer scientists "facing face" and looking to select and test different methods of computing similarities will benefit from this book. The book is also useful tool for students undertaking computer vision courses.
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A novel numerical framework for self-similarity in plasticity: Wedge indentation in single crystals
DEFF Research Database (Denmark)
Juul, K. J.; Niordson, C. F.; Nielsen, K. L.
2018-01-01
-viscoplastic single crystal. However, the framework may be readily adapted to any constitutive law of interest. The main focus herein is the development of the self-similar framework, while the indentation study serves primarily as verification of the technique by comparing to existing numerical and analytical......A novel numerical framework for analyzing self-similar problems in plasticity is developed and demonstrated. Self-similar problems of this kind include processes such as stationary cracks, void growth, indentation etc. The proposed technique offers a simple and efficient method for handling...
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Wei, Wenhui; Jiang, Jenny; Lou, Youbei; Ganguli, Sohini; Matusik, Mark S
2017-03-01
Treatment persistence with basal insulins is crucial to achieving sustained glycemic control, which is associated with a reduced risk of microvascular disease and other complications of type 2 diabetes (T2D). However, studies suggest that persistence with basal insulin treatment is often poor. To measure and benchmark real-world basal insulin treatment persistence among patients with T2D across different payer segments in the United States. This was a retrospective observational study of data from a national pharmacy database (Walgreen Co., Deerfield, IL). The analysis included patients with T2D aged ≥ 18 years who filled ≥ 1 prescription for basal insulins between January 2013 and June 2013 (the index prescription) and who had also filled prescriptions for ≥ 1 oral antidiabetes drug in the database. Patients with claims for premixed insulin were excluded. Treatment persistence was defined as remaining on the study medication(s) during the 1-year follow-up period. Patients were stratified according to treatment history (existing basal insulin users vs. new insulin users), payer segments (commercially insured, Medicare, Medicaid, or cash-pay), type of basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin [NPH]), and device for insulin administration (pen or vial/syringe). A total of 274,102 patients were included in this analysis, 82% of whom were existing insulin users. In terms of payer segments, 45.3% of patients were commercially insured, 47.8% had Medicare, 5.9% had Medicaid, and 1.1% were cash-pay. At the 1-year follow-up, basal insulin treatment persistence rate was 66.8% overall, 61.7% for new users, and 67.9% for existing users. In general, for both existing and new basal insulin users, higher persistence rate and duration were associated with Medicare versus cash-pay patients, use of insulin pens versus vial/syringe, and use of insulin glargine versus NPH. This large-scale study provides a benchmark of basal insulin
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Self-Similar Nanocavity Design with Ultrasmall Mode Volume for Single-Photon Nonlinearities
DEFF Research Database (Denmark)
Choi, Hyeongrak; Heuck, Mikkel; Englund, Dirk R.
2017-01-01
We propose a photonic crystal nanocavity design with self-similar electromagnetic boundary conditions, achieving ultrasmall mode volume (V-eff). The electric energy density of a cavity mode can be maximized in the air or dielectric region, depending on the choice of boundary conditions. We illust...... at the single-photon level. These features open new directions in cavity quantum electrodynamics, spectroscopy, and quantum nonlinear optics....
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LDA-Based Unified Topic Modeling for Similar TV User Grouping and TV Program Recommendation.
Pyo, Shinjee; Kim, Eunhui; Kim, Munchurl
2015-08-01
Social TV is a social media service via TV and social networks through which TV users exchange their experiences about TV programs that they are viewing. For social TV service, two technical aspects are envisioned: grouping of similar TV users to create social TV communities and recommending TV programs based on group and personal interests for personalizing TV. In this paper, we propose a unified topic model based on grouping of similar TV users and recommending TV programs as a social TV service. The proposed unified topic model employs two latent Dirichlet allocation (LDA) models. One is a topic model of TV users, and the other is a topic model of the description words for viewed TV programs. The two LDA models are then integrated via a topic proportion parameter for TV programs, which enforces the grouping of similar TV users and associated description words for watched TV programs at the same time in a unified topic modeling framework. The unified model identifies the semantic relation between TV user groups and TV program description word groups so that more meaningful TV program recommendations can be made. The unified topic model also overcomes an item ramp-up problem such that new TV programs can be reliably recommended to TV users. Furthermore, from the topic model of TV users, TV users with similar tastes can be grouped as topics, which can then be recommended as social TV communities. To verify our proposed method of unified topic-modeling-based TV user grouping and TV program recommendation for social TV services, in our experiments, we used real TV viewing history data and electronic program guide data from a seven-month period collected by a TV poll agency. The experimental results show that the proposed unified topic model yields an average 81.4% precision for 50 topics in TV program recommendation and its performance is an average of 6.5% higher than that of the topic model of TV users only. For TV user prediction with new TV programs, the average
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Almeida, Álvaro S
2017-06-01
The national health services (NHS) of England, Portugal, Finland and other single-payer universalist systems financed by general taxation, are based on the theoretical principle of an integrated public sector payer-provider. However, in practice one can find different forms of participation of non-public healthcare providers in those NHS, including private for profit providers, but also third sector non-profit organizations (NPO). This paper reviews the role of non-public non-profit healthcare organizations in NHS systems. By crossing a literature review on privatization of national health services with a literature review on the comparative performance of non-profit and for-profit healthcare organizations, this paper assesses the impact of contracting private non-profit healthcare organizations on the efficiency, quality and responsiveness of services, in public universal health care systems. The results of the review were then compared to the existing evidence on the Portuguese hospital devolution to NPO program. The evidence in this paper suggests that NHS health system reforms that transfer some public-sector hospitals to NPO should deliver improvements to the health system with minimal downside risks. The very limited existing evidence on the Portuguese hospital devolution program suggests it improved efficiency and access, without sacrificing quality. Copyright © 2017 Elsevier B.V. All rights reserved.
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2012-10-01
... Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee; Exception to... Competition--Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program... supplement award to the University of Guam School of Nursing, an Area Health Education Center (AHEC) Program...
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International Nuclear Information System (INIS)
Botelho, David A.; Faccini, Jose L.H.
2002-01-01
The main topic in this paper is a new device being considered to improve nuclear reactor safety employing the natural circulation. A scaled experiment used to demonstrate the performance of the device is also described. We also applied a similarity analysis method for single and two-phase natural convection loop flow to the IEN CCN experiment and to an APEX like experiment to verify the degree of similarity relative to a full-scale prototype like the AP600. Most of the CCN similarity numbers that represent important single and two-phase similarity conditions are comparable to the APEX like loop non-dimensional numbers calculated employing the same methodology. Despite the much smaller geometric, pressure, and power scales, we conclude that the IEN CCN has single and two-phase natural circulation similarity numbers that represent fairly well the full-scale prototype. even lacking most complementary primary and safety systems, this IEN circuit provided a much valid experience to develop human, experimental, and analytical resources, besides its utilization as a training tool. (author)
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Natanaelsson, Jennie; Hakkarainen, Katja M; Hägg, Staffan; Andersson Sundell, Karolina; Petzold, Max; Rehnberg, Clas; Jönsson, Anna K; Gyllensten, Hanna
2017-11-01
Adverse drug events (ADEs) cause considerable costs in hospitals. However, little is known about costs caused by ADEs outside hospitals, effects on productivity, and how the costs are distributed among payers. To describe the direct and indirect costs caused by ADEs, and their distribution among payers. Furthermore, to describe the distribution of patient out-of-pocket costs and lost productivity caused by ADEs according to socio-economic characteristics. In a random sample of 5025 adults in a Swedish county, prevalence-based costs for ADEs were calculated. Two different methods were used: 1) based on resource use judged to be caused by ADEs, and 2) as costs attributable to ADEs by comparing costs among individuals with ADEs to costs among matched controls. Payers of costs caused by ADEs were identified in medical records among those with ADEs (n = 596), and costs caused to individual patients were described by socio-economic characteristics. Costs for resource use caused by ADEs were €505 per patient with ADEs (95% confidence interval €345-665), of which 38% were indirect costs. Compared to matched controls, the costs attributable to ADEs were €1631, of which €410 were indirect costs. The local health authorities paid 58% of the costs caused by ADEs. Women had higher productivity loss than men (€426 vs. €109, p = 0.018). Out-of-pocket costs displaced a larger proportion of the disposable income among low-income earners than higher income earners (0.7% vs. 0.2%-0.3%). We used two methods to identify costs for ADEs, both identifying indirect costs as an important component of the overall costs for ADEs. Although the largest payers of costs caused by ADEs were the local health authorities responsible for direct costs, employers and patients costs for lost productivity contributed substantially. Our results indicate inequalities in costs caused by ADEs, by sex and income. Copyright © 2016 Elsevier Inc. All rights reserved.
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Jain, Nikhil; Virk, Sohrab S; Phillips, Frank M; Yu, Elizabeth; Khan, Safdar N
2018-04-01
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59.7% to 73.6% of total payments, followed by surgeon's fees, which accounted for 13.7% to 18.5%. Postacute services made up 8.8% to 15.8% of the total reimbursement. Surgeries performed in the inpatient setting were significantly more expensive as compared with surgeries performed in the outpatient setting (P<0.01). The average 90-day bundle amount was estimated at $11,091, $6571, and $6239 for Commercial payers, Medicare Advantage, and Medicare, respectively. Overall, service providers in the Southern region were reimbursed the lowest from Commercial payers and Medicare, compared with other regions. Postacute services are not as major cost drivers after discectomy as after total joint arthroplasty or hip fracture repair.
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Prestigiacomo, Jennifer
2011-11-01
Getting effective stakeholder engagement, including that of payers, and creating innovative value-added services that provide alternate revenue streams beyond basic subscription services, are just a couple of the common traits of the flourishing health information exchanges profiled in the sustainability report released in August by the National eHealth Collaborative.
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Economic evaluation of routine infant rotavirus immunisation program in Japan.
Hoshi, Shu-Ling; Kondo, Masahide; Okubo, Ichiro
2017-05-04
Two rotavirus vaccines are currently available in Japan. We estimated the incremental cost-effectiveness ratio (ICER) of routine infant rotavirus immunisation program without defining which vaccine to be evaluated, which reflects the current deliberation at the Health Science Council in charge of Immunisation and Vaccine established by the Ministry of Health, Labor and Welfare of Japan. Three ICERs were estimated, one from payers' perspective and 2 from societal perspective depending on the scenarios to uptake vaccines. The health statuses following the birth cohort were as follows: not infected by rotavirus, asymptomatic infection, outpatients after infection, hospitalised after infection, developing encephalitis/encephalopathy followed by recovery, sequelae, and death. Costs of per course of vaccination was ¥30,000 (US$283; US$1 = ¥106). The model runs for 60 months with one month cycle. From payers' perspective, estimated ICERs were ¥6,877,000 (US$64,877) per QALY. From societal perspective, immunisation program turns out to be cost-saving for 75% simultaneous vaccination scenario, while it is at ¥337,000 (US$3,179) per QALY gained with vaccine alone scenario. The probability of rotavirus immunisation program to be under ¥5,000,000 (US$47,170) per QALY was at 19.8%, 40.7%, and 75.6% when costs per course of vaccination were set at ¥30,000 (US$283), ¥25,000 (US$236), and ¥20,000 (US$189), respectively. Rotavirus immunisation program has a potential to be cost-effective from payers' perspective and even cost-saving from societal perspective in Japan, however, caution should be taken with regard to the interpretation of the results as cost-effectiveness is critically dependent on vaccination costs.
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Single event upset test programs
International Nuclear Information System (INIS)
Russen, L.C.
1984-11-01
It has been shown that the heavy ions in cosmic rays can give rise to single event upsets in VLSI random access memory devices (RAMs). Details are given of the programs written to test 1K, 4K, 16K and 64K memories during their irradiation with heavy charged ions, in order to simulate the effects of cosmic rays in space. The test equipment, which is used to load the memory device to be tested with a known bit pattern, and subsequently interrogate it for upsets, or ''flips'', is fully described. (author)
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[Thoughts on the Witnessed Audit in Medical Device Single Audit Program].
Wen, Jing; Xiao, Jiangyi; Wang, Aijun
2018-02-08
Medical Device Single Audit Program is one of the key projects in International Medical Device Regulators Forum, which has much experience to be used for reference. This paper briefly describes the procedures and contents of the Witnessed Audit in Medical Device Single Audit Program. Some revelations about the work of Witnessed Audit have been discussed, for reference by the Regulatory Authorities and the Auditing Organizations.
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vanVonno, Catherine J; Ozminkowski, Ronald J; Smith, Mark W; Thomas, Eileen G; Kelley, Doniece; Goetzel, Ron; Berg, Gregory D; Jain, Susheel K; Walker, David R
2005-12-01
In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout.
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Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E
Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for
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International Nuclear Information System (INIS)
Ishii, M.; Kataoka, I.
1983-03-01
Scaling criteria for a natural circulation loop under single phase and two-phase flow conditions have been derived. For a single phase case the continuity, integral momentum, and energy equations in one-dimensional area average forms have been used. From this, the geometrical similarity groups, friction number, Richardson number, characteristic time constant ratio, Biot number, and heat source number are obtained. The Biot number involves the heat transfer coefficient which may cause some difficulties in simulating the turbulent flow regime. For a two-phase flow case, the similarity groups obtained from a perturbation analysis based on the one-dimensional drift-flux model have been used. The physical significance of the phase change number, subcooling number, drift-flux number, friction number are discussed and conditions imposed by these groups are evaluated. In the two-phase flow case, the critical heat flux is one of the most important transients which should be simulated in a scale model. The above results are applied to the LOFT facility in case of a natural circulation simulation. Some preliminary conclusions on the feasibility of the facility have been obtained
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Energy Technology Data Exchange (ETDEWEB)
Ishii, M.; Kataoka, I.
1983-03-01
Scaling criteria for a natural circulation loop under single phase and two-phase flow conditions have been derived. For a single phase case the continuity, integral momentum, and energy equations in one-dimensional area average forms have been used. From this, the geometrical similarity groups, friction number, Richardson number, characteristic time constant ratio, Biot number, and heat source number are obtained. The Biot number involves the heat transfer coefficient which may cause some difficulties in simulating the turbulent flow regime. For a two-phase flow case, the similarity groups obtained from a perturbation analysis based on the one-dimensional drift-flux model have been used. The physical significance of the phase change number, subcooling number, drift-flux number, friction number are discussed and conditions imposed by these groups are evaluated. In the two-phase flow case, the critical heat flux is one of the most important transients which should be simulated in a scale model. The above results are applied to the LOFT facility in case of a natural circulation simulation. Some preliminary conclusions on the feasibility of the facility have been obtained.
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Scaling Analysis of the Single-Phase Natural Circulation: the Hydraulic Similarity
International Nuclear Information System (INIS)
Yu, Xin-Guo; Choi, Ki-Yong
2015-01-01
These passive safety systems all rely on the natural circulation to cool down the reactor cores during an accident. Thus, a robust and accurate scaling methodology must be developed and employed to both assist in the design of a scaled-down test facility and guide the tests in order to mimic the natural circulation flow of its prototype. The natural circulation system generally consists of a heat source, the connecting pipes and several heat sinks. Although many applauding scaling methodologies have been proposed during last several decades, few works have been dedicated to systematically analyze and exactly preserve the hydraulic similarity. In the present study, the hydraulic similarity analyses are performed at both system and local level. By this mean, the scaling criteria for the exact hydraulic similarity in a full-pressure model have been sought. In other words, not only the system-level but also the local-level hydraulic similarities are pursued. As the hydraulic characteristics of a fluid system is governed by the momentum equation, the scaling analysis starts with it. A dimensionless integral loop momentum equation is derived to obtain the dimensionless numbers. In the dimensionless momentum equation, two dimensionless numbers, the dimensionless flow resistance number and the dimensionless gravitational force number, are identified along with a unique hydraulic time scale, characterizing the system hydraulic response. A full-height full-pressure model is also made to see which model among the full-height model and reduced-height model can preserve the hydraulic behavior of the prototype. From the dimensionless integral momentum equation, a unique hydraulic time scale, which characterizes the hydraulic response of a single-phase natural circulation system, is identified along with two dimensionless parameters: the dimensionless flow resistance number and the dimensionless gravitational force number. By satisfying the equality of both dimensionless numbers
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Scaling Analysis of the Single-Phase Natural Circulation: the Hydraulic Similarity
Energy Technology Data Exchange (ETDEWEB)
Yu, Xin-Guo; Choi, Ki-Yong [KAERI, Daejeon (Korea, Republic of)
2015-05-15
These passive safety systems all rely on the natural circulation to cool down the reactor cores during an accident. Thus, a robust and accurate scaling methodology must be developed and employed to both assist in the design of a scaled-down test facility and guide the tests in order to mimic the natural circulation flow of its prototype. The natural circulation system generally consists of a heat source, the connecting pipes and several heat sinks. Although many applauding scaling methodologies have been proposed during last several decades, few works have been dedicated to systematically analyze and exactly preserve the hydraulic similarity. In the present study, the hydraulic similarity analyses are performed at both system and local level. By this mean, the scaling criteria for the exact hydraulic similarity in a full-pressure model have been sought. In other words, not only the system-level but also the local-level hydraulic similarities are pursued. As the hydraulic characteristics of a fluid system is governed by the momentum equation, the scaling analysis starts with it. A dimensionless integral loop momentum equation is derived to obtain the dimensionless numbers. In the dimensionless momentum equation, two dimensionless numbers, the dimensionless flow resistance number and the dimensionless gravitational force number, are identified along with a unique hydraulic time scale, characterizing the system hydraulic response. A full-height full-pressure model is also made to see which model among the full-height model and reduced-height model can preserve the hydraulic behavior of the prototype. From the dimensionless integral momentum equation, a unique hydraulic time scale, which characterizes the hydraulic response of a single-phase natural circulation system, is identified along with two dimensionless parameters: the dimensionless flow resistance number and the dimensionless gravitational force number. By satisfying the equality of both dimensionless numbers
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Computing single step operators of logic programming in radial basis function neural networks
Hamadneh, Nawaf; Sathasivam, Saratha; Choon, Ong Hong
2014-07-01
Logic programming is the process that leads from an original formulation of a computing problem to executable programs. A normal logic program consists of a finite set of clauses. A valuation I of logic programming is a mapping from ground atoms to false or true. The single step operator of any logic programming is defined as a function (Tp:I→I). Logic programming is well-suited to building the artificial intelligence systems. In this study, we established a new technique to compute the single step operators of logic programming in the radial basis function neural networks. To do that, we proposed a new technique to generate the training data sets of single step operators. The training data sets are used to build the neural networks. We used the recurrent radial basis function neural networks to get to the steady state (the fixed point of the operators). To improve the performance of the neural networks, we used the particle swarm optimization algorithm to train the networks.
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Computing single step operators of logic programming in radial basis function neural networks
Energy Technology Data Exchange (ETDEWEB)
Hamadneh, Nawaf; Sathasivam, Saratha; Choon, Ong Hong [School of Mathematical Sciences, Universiti Sains Malaysia, 11800 USM, Penang (Malaysia)
2014-07-10
Logic programming is the process that leads from an original formulation of a computing problem to executable programs. A normal logic program consists of a finite set of clauses. A valuation I of logic programming is a mapping from ground atoms to false or true. The single step operator of any logic programming is defined as a function (T{sub p}:I→I). Logic programming is well-suited to building the artificial intelligence systems. In this study, we established a new technique to compute the single step operators of logic programming in the radial basis function neural networks. To do that, we proposed a new technique to generate the training data sets of single step operators. The training data sets are used to build the neural networks. We used the recurrent radial basis function neural networks to get to the steady state (the fixed point of the operators). To improve the performance of the neural networks, we used the particle swarm optimization algorithm to train the networks.
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Computing single step operators of logic programming in radial basis function neural networks
International Nuclear Information System (INIS)
Hamadneh, Nawaf; Sathasivam, Saratha; Choon, Ong Hong
2014-01-01
Logic programming is the process that leads from an original formulation of a computing problem to executable programs. A normal logic program consists of a finite set of clauses. A valuation I of logic programming is a mapping from ground atoms to false or true. The single step operator of any logic programming is defined as a function (T p :I→I). Logic programming is well-suited to building the artificial intelligence systems. In this study, we established a new technique to compute the single step operators of logic programming in the radial basis function neural networks. To do that, we proposed a new technique to generate the training data sets of single step operators. The training data sets are used to build the neural networks. We used the recurrent radial basis function neural networks to get to the steady state (the fixed point of the operators). To improve the performance of the neural networks, we used the particle swarm optimization algorithm to train the networks
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Institute of Scientific and Technical Information of China (English)
L(U) Wei-cai; XU Shao-quan
2004-01-01
Using similar single-difference methodology(SSDM) to solve the deformation values of the monitoring points, there is unstability of the deformation information series, at sometimes.In order to overcome this shortcoming, Kalman filtering algorithm for this series is established,and its correctness and validity are verified with the test data obtained on the movable platform in plane. The results show that Kalman filtering can improve the correctness, reliability and stability of the deformation information series.
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Spencer, Christine S; Roberts, Eric T; Gaskin, Darrell J
2015-06-01
The reduction of adverse patient safety events and the equitable treatment of patients in hospitals are clinical and policy priorities. Health services researchers have identified disparities in the quality of care provided to patients, both by demographic characteristics and insurance status. However, less is known about the extent to which disparities reflect differences in the places where patients obtain care, versus disparities in the quality of care provided to different groups of patients in the same hospital. In this study, we examine whether the rate of adverse patient safety events differs by the insurance status of patients within the same hospital. Using discharge data from hospitals in 11 states, we compared risk-adjusted rates for 13 AHRQ Patient Safety Indicators by Medicare, Medicaid, and Private payer insurance status, within the same hospitals. We used multivariate regression to assess the relationship between insurance status and rates of adverse patient safety events within hospitals. Medicare and Medicaid patients experienced significantly more adverse safety events than private pay patients for 12 and 7 Patient Safety Indicators, respectively (at P patients had significantly lower event rates than private payers on 2 Patient Safety Indicators. Risk-adjusted Patient Safety Indicator rates varied with patients' insurance within the same hospital. More research is needed to determine the cause of differences in care quality received by patients at the same hospital, especially if quality measures are to be used for payment.
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Gregory, David; Scotti, Dennis J; Buck, Daniel; Triadafilopoulos, George
2016-05-01
A minimally invasive endoscopic treatment that utilizes radio-frequency energy (RFE) has received increased attention as an appropriate middle-ground approach in the treatment of refractory gastroesophageal reflux disease (GERD) and as an alternative to complicated and invasive surgical procedures. The objective of this study was to develop a longitudinal budget impact analysis from the payer perspective to estimate the direct medical costs of treatment for the refractory GERD patient population and to estimate the budgetary impact of further extending the RFE treatment option to other target populations. A retrospective analysis of claims designed to assess the longitudinal costs and budget impact on payer expenditures associated with managing and treating GERD surgically (Nissen fundoplication [NF]), endoscopically (RFE), or medically was performed. Both Medicare and commercially insured claims databases were interrogated for such population-level analyses. At current adoption rates (less than 1% of procedures), RFE demonstrated overall cost savings ranging from 7.3% to 50.5% in the 12-month time period following the index procedure (inclusive of procedure costs) when compared to medical management and fundoplication across the commercial and Medicare patient populations. Increasing the total number of RFE procedures to 2% of total cases performed generated per-member, per-month (PMPM) savings of $0.28 in the Medicare population and $0.37 in the commercially insured population. Further increases yielded higher PMPM savings. Adding to the clinical importance of RFE in filling the gap between medical and surgical management, this economic analysis demonstrates to payers that the adoption of RFE can create notable savings to their plans when compared to surgery or medical management.
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Bariatric Surgery Coverage: a Comprehensive Budget Impact Analysis from a Payer Perspective.
Palli, Swetha R; Rizzo, John A; Heidrich, Natalie
2018-06-01
The objective of this study was to estimate a payer's budget impact of bariatric surgery coverage under (1) unrestricted, (2) budget-restricted ($500,000/year), and (3) quantity-restricted (100/year) medical benefit plan scenarios versus non-coverage in general and type 2 diabetes mellitus (T2DM) populations over a 10-year period. Using recently published literature and health technology assessment reports, the model evaluated a hypothetical payer population of 100,000 members under current real-world trends: BMI-defined obesity groups (31.3% normal/underweight, 33% overweight, 20.4% obese, 9% severely obese and 6.3% morbidly obese), T2DM prevalence (6.7-27.5%; 100% for the T2DM model), surgery type (LAGB, BPD/DS, VSG, and RYGB), and differential outcomes (T2DM resolution, costs, and reoperation and complications rates). Assuming a surgery election rate of 1.42% among eligible candidates with a 3% discount rate and 10% annual surgery turnover rate, the model calculated the incremental cost per-member-per-month (PMPM) by estimating the difference in total non-T2DM and T2DM-related expected costs and savings. One-way (± 25%) sensitivity analysis was performed. The impact of covering bariatric surgery under multiple scenarios for a general (or T2DM) population ranged from an additional $0.3 to $3.6 (T2DM: $0.3 to $10.5) PMPM in year 1. Incremental costs diminished over time, breaking even between years 5 and 9 (T2DM: 5-6), and by year 10, cost savings were estimated to be between $1.5 and $4.8 (T2DM: $1.2 and $31.8). Providing bariatric surgery coverage may have a modest short-term budget impact increase but would lead to long-term net cost savings in a general population model. The cost savings were much more pronounced in the T2DM model.
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Automated dating of the world’s language families based on lexical similarity
Holman, E.; Brown, C.; Wichmann, S.; Müller, A.; Velupillai, V.; Hammarström, H.; Sauppe, S.; Jung, H.; Bakker, D.; Brown, P.; Belyaev, O.; Urban, M.; Mailhammer, R.; List, J.; Egorov, D.
2011-01-01
This paper describes a computerized alternative to glottochronology for estimating elapsed time since parent languages diverged into daughter languages. The method, developed by the Automated Similarity Judgment Program (ASJP) consortium, is different from glottochronology in four major respects: (1) it is automated and thus is more objective, (2) it applies a uniform analytical approach to a single database of worldwide languages, (3) it is based on lexical similarity as determined from Leve...
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A novel numerical framework for self-similarity in plasticity: Wedge indentation in single crystals
Juul, K. J.; Niordson, C. F.; Nielsen, K. L.; Kysar, J. W.
2018-03-01
A novel numerical framework for analyzing self-similar problems in plasticity is developed and demonstrated. Self-similar problems of this kind include processes such as stationary cracks, void growth, indentation etc. The proposed technique offers a simple and efficient method for handling this class of complex problems by avoiding issues related to traditional Lagrangian procedures. Moreover, the proposed technique allows for focusing the mesh in the region of interest. In the present paper, the technique is exploited to analyze the well-known wedge indentation problem of an elastic-viscoplastic single crystal. However, the framework may be readily adapted to any constitutive law of interest. The main focus herein is the development of the self-similar framework, while the indentation study serves primarily as verification of the technique by comparing to existing numerical and analytical studies. In this study, the three most common metal crystal structures will be investigated, namely the face-centered cubic (FCC), body-centered cubic (BCC), and hexagonal close packed (HCP) crystal structures, where the stress and slip rate fields around the moving contact point singularity are presented.
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Schwerner, Henry; Mellody, Timothy; Goldstein, Allan B; Wansink, Daryl; Sullivan, Virginia; Yelenik, Stephan N; Charlton, Warwick; Lloyd, Kelley; Courtemanche, Ted
2006-02-01
The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to identify members eligible for the program in a 12-month baseline year (October 2001 to September 2002) and a subsequent 12-month program year (October 2002 to September 2003). Two payers were analyzed: one health plan with members primarily in New Jersey (AmeriHealth New Jersey [AHNJ]), where the disease management program was offered, and one affiliated large plan with members primarily in the metro Philadelphia area, where the program was not offered. The claims payment policy for both plans is identical. Intervention and control groups were analyzed for equivalence. The analysis was conducted in both groups over identical time periods. The intervention group showed statistically significant (p control group. Intervention group members showed a reduction in expenditures of -8%, while control group members showed an increase of +10% over identical time periods. Subsequent analyses controlling for outliers and product lines served to confirm the overall results. The disease management program is likely responsible for the observed difference between the intervention and control group results. A well-designed, targeted disease management program offered by a motivated, supportive health plan can play an important role in cost improvement strategies for members with complex, chronic conditions.
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Hu, Xiaohu; Hong, Liang; Dean Smith, Micholas; Neusius, Thomas; Cheng, Xiaolin; Smith, Jeremy C.
2016-02-01
Internal motions of proteins are essential to their function. The time dependence of protein structural fluctuations is highly complex, manifesting subdiffusive, non-exponential behaviour with effective relaxation times existing over many decades in time, from ps up to ~102 s (refs ,,,). Here, using molecular dynamics simulations, we show that, on timescales from 10-12 to 10-5 s, motions in single proteins are self-similar, non-equilibrium and exhibit ageing. The characteristic relaxation time for a distance fluctuation, such as inter-domain motion, is observation-time-dependent, increasing in a simple, power-law fashion, arising from the fractal nature of the topology and geometry of the energy landscape explored. Diffusion over the energy landscape follows a non-ergodic continuous time random walk. Comparison with single-molecule experiments suggests that the non-equilibrium self-similar dynamical behaviour persists up to timescales approaching the in vivo lifespan of individual protein molecules.
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Kimball, Chloe C; Nichols, Christine I; Vose, Joshua G
2018-01-01
Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP) costs, and complication risk, among those requiring at least 1 open procedure following PCNB. This retrospective study used the Truven Commercial database (2009-2014). Women who underwent PCNB, with continuous insurance, and no history of cancer, chemotherapy, radiation, or breast surgery in the prior year were included. Open procedures were defined as open biopsy or lumpectomy. Study follow-up ended at chemotherapy, radiation, mastectomy, or 90 days-whichever occurred first. In total, 143 771 patients (mean age 48) met selection criteria; 85.1% underwent isolated PCNB, 12.4% one open procedure, and 2.5% re-excision. Incidence of complications was significantly lower among those with PCNB alone (9.2%) vs 1 open procedure (15.6%) or re-excision (25.3%, P open procedure vs PCNB alone (US $17 125 vs US $3935, P open procedure vs PCNB alone (US $1527 vs US $669), and US $247 greater for re-excision vs 1 procedure. A meaningful proportion of patients underwent open procedure(s) following PCNB which was associated with increased complication risk and costs to both the payer and the patient. These results suggest a need for technologies to reduce the proportion of cases requiring open surgery and, in some cases, re-excision.
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Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D
2018-02-08
To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.
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Policies and programs to facilitate access to targeted cancer therapies in Thailand.
Directory of Open Access Journals (Sweden)
Rosarin Sruamsiri
Full Text Available Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time.We selected two medicines on the 2013 Thai national list of essential medicines (NLEM [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product.Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007-2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366-923 to 3683 (95% CI 2,748-4,618; for imatinib from 103 (95% CI 72-174 to 350 (95% CI 307-398; and for trastuzumab from 68 (95% CI 45-118 to 412 (95% CI 344-563.Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to assess clinical and economic impacts of these
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Financing care for the uninsured: the dilemma vexes New Jersey hospitals and payers.
Wells, E V
1996-05-01
New Jersey's diverse constituencies and special interest groups don't usually agree on a public policy issue. However, almost everyone in the public policy arena agrees that hospitals should treat people who show up in emergency departments with problems requiring medical attention. For over a decade, Garden State policymakers, payers, and providers have faced the dilemma of excess demand on hospitals that treat the uninsured. This demand has risen due to increasing health care costs, development of costly technology, state deregulation of hospital payments, and employers' reluctance to insure workers and their families coupled with a mobile workforce holding part-time and seasonal jobs. The fiscal solvency of inner-city hospitals is threatened yet the problem continues to elude resolution.
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Directory of Open Access Journals (Sweden)
Miller JD
2015-01-01
, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar results were shown for NovaSure treatment versus hysterectomy. Conclusion: Model results demonstrate strong financial favorability for NovaSure ablation versus other GEA modalities and hysterectomy from commercial and Medicaid payer perspectives. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. Keywords: NovaSure, abnormal uterine bleeding, menorrhagia, hysterectomy, global endometrial ablation, cost-effectiveness analysis
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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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Automatic storage of single gamma spectra on magnetic tape. Programs Longo, Dire
International Nuclear Information System (INIS)
Los Arcos Merino, J.M.
1978-01-01
The program Longo provides the block size and the black number in a binary file on magnetic tape. It has been applied to analyse the structure of the nine-track magnetic tapes storing single or coincidence gamma spectra files, recorded in octet form by a Multi-8 minicomputer in the Nuclear Spectrometry Laboratory of J.E.N. Then the program Dire has been written to transform the single gamma spectra into a new Fastrand disk file, storing the information in 36 bit words. A copy of this file is obtained on magnetic tape and the single gamma spectra are then availables by standard Fortran V reading sentences. (author)
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Automatic storing of single gamma spectra on magnetic tape. Programs LONGO, DIRE
International Nuclear Information System (INIS)
Los Arcos Merino, J. M.
1978-01-01
The program LONGO provides the block size and the block number in a binary file on magnetic tape. It has been applied to analyse the structure of the nine-track magnetic tapes storing single or coincidence gamma spectra files, recorded in octet form by a MULTI-8 minicomputer in the Nuclear Spectrometry Laboratory of J.E.N. Then the program DIRE has been written to transform the single gamma spectra into a new FASTRAND disk file, storing the information in-36 bit words. A copy of this file is obtained on magnetic tape and the single gamma spectra are then available by standard FORTRAN V reading sentences. (Author) 3 refs
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Quality assessment of protein model-structures based on structural and functional similarities.
Konopka, Bogumil M; Nebel, Jean-Christophe; Kotulska, Malgorzata
2012-09-21
Experimental determination of protein 3D structures is expensive, time consuming and sometimes impossible. A gap between number of protein structures deposited in the World Wide Protein Data Bank and the number of sequenced proteins constantly broadens. Computational modeling is deemed to be one of the ways to deal with the problem. Although protein 3D structure prediction is a difficult task, many tools are available. These tools can model it from a sequence or partial structural information, e.g. contact maps. Consequently, biologists have the ability to generate automatically a putative 3D structure model of any protein. However, the main issue becomes evaluation of the model quality, which is one of the most important challenges of structural biology. GOBA--Gene Ontology-Based Assessment is a novel Protein Model Quality Assessment Program. It estimates the compatibility between a model-structure and its expected function. GOBA is based on the assumption that a high quality model is expected to be structurally similar to proteins functionally similar to the prediction target. Whereas DALI is used to measure structure similarity, protein functional similarity is quantified using standardized and hierarchical description of proteins provided by Gene Ontology combined with Wang's algorithm for calculating semantic similarity. Two approaches are proposed to express the quality of protein model-structures. One is a single model quality assessment method, the other is its modification, which provides a relative measure of model quality. Exhaustive evaluation is performed on data sets of model-structures submitted to the CASP8 and CASP9 contests. The validation shows that the method is able to discriminate between good and bad model-structures. The best of tested GOBA scores achieved 0.74 and 0.8 as a mean Pearson correlation to the observed quality of models in our CASP8 and CASP9-based validation sets. GOBA also obtained the best result for two targets of CASP8, and
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Kang, Jong Ho
2015-12-01
[Purpose] The purpose of the present study was to compare the sensory thresholds of healthy subjects using pre-programmed or single-frequency transcutaneous electrical nerve stimulation. [Subjects] Ninety healthy adult subjects were randomly assigned to pre-programmed or single-frequency stimulation groups, each consisting of 45 participants. [Methods] Sensory thresholds were measured in the participants' forearms using von Frey filaments before and after pre-programmed or single-frequency transcutaneous electrical nerve stimulation, and the result in values were analyzed. [Results] Significant increases in sensory threshold after stimulation were observed in both groups. However, there were no significant differences between the two groups in sensory thresholds after stimulation or in the magnitude of threshold increases following stimulation. [Conclusion] Our results show that there are no differences between sensory threshold increases induced by pre-programmed and single-frequency transcutaneous electrical nerve stimulation.
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Linear program differentiation for single-channel speech separation
DEFF Research Database (Denmark)
Pearlmutter, Barak A.; Olsson, Rasmus Kongsgaard
2006-01-01
Many apparently difficult problems can be solved by reduction to linear programming. Such problems are often subproblems within larger systems. When gradient optimisation of the entire larger system is desired, it is necessary to propagate gradients through the internally-invoked LP solver....... For instance, when an intermediate quantity z is the solution to a linear program involving constraint matrix A, a vector of sensitivities dE/dz will induce sensitivities dE/dA. Here we show how these can be efficiently calculated, when they exist. This allows algorithmic differentiation to be applied...... to algorithms that invoke linear programming solvers as subroutines, as is common when using sparse representations in signal processing. Here we apply it to gradient optimisation of over complete dictionaries for maximally sparse representations of a speech corpus. The dictionaries are employed in a single...
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Mehr, Stanton R
2016-02-01
The new proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can have significant budget effects, depending on the breadth of the US Food and Drug Administration (FDA)'s approved labeling. American Health & Drug Benefits asked Stephen Gorshow, MD, Regional Medical Director, UnitedHealthcare, and James T. Kenney, RPh, MBA, Manager, Specialty and Pharmacy Contracts, Harvard Pilgrim Health Care, to participate in a teleconference to better understand how payers are approaching the management of these agents.
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Directory of Open Access Journals (Sweden)
Misja Mikkers
2016-02-01
Full Text Available An important determinant of health system performance is contracting. Providers often respond to financial incentives, despite the ethical underpinnings of medicine, and payers can craft contracts to influence performance. Yet contracting is highly imperfect in both single-payer and multi-payer health systems. Arguably, in a competitive, multi-payer environment, contractual innovation may occur more rapidly than in a single-payer system. This innovation in contract design could enhance performance. However, contractual innovation often fails to improve performance as payer incentives are misaligned with public policy objectives. Numerous countries seek to improve healthcare contracts, but thus far no health system has demonstrably crafted the necessary blend of incentives to stimulate optimal contracting.
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Encouraging more women into computer science: Initiating a single-sex intervention program in Sweden
Brandell, Gerd; Carlsson, Svante; Ekblom, Håkan; Nord, Ann-Charlotte
1997-11-01
The process of starting a new program in computer science and engineering, heavily based on applied mathematics and only open to women, is described in this paper. The program was introduced into an educational system without any tradition in single-sex education. Important observations made during the process included the considerable interest in mathematics and curiosity about computer science found among female students at the secondary school level, and the acceptance of the single-sex program by the staff, administration, and management of the university as well as among male and female students. The process described highlights the importance of preparing the environment for a totally new type of educational program.
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Rauscher, Simone; Wheeler, John R C
2010-01-01
The continuing efforts of government payers to contain hospital costs have raised concerns among hospital managers that serving publicly insured patients may undermine their ability to manage the revenue cycle successfully. This study uses financial information from two sources-Medicare cost reports for all US hospitals for 2002 to 2007 and audited financial statements for all bond-issuing, not-for-profit hospitals for 2000 to 2006 to examine the relationship between hospitals' shares of Medicare and Medicaid patients and the amount of patient care revenue they generate as well as the speed with which they collect their revenue. Hospital-level fixed effects regression analysis finds that hospitals with higher Medicare and Medicaid payer mix collect somewhat higher average patient care revenues than hospitals with more privately insured and self-pay patients. Hospitals with more Medicare patients also collect on this revenue faster; serving more Medicaid patients is not associated with the speed of patient revenue collection. For hospital managers, these findings may represent good news. They suggest that, despite increases in the number of publicly insured patients served, managers have frequently been able to generate adequate amounts of patient revenue and collect it in a timely fashion.
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A Cost Analysis Study of the Radiography Program at Middlesex Hospital Using Shock's Analysis Model.
Spence, Weymouth
Federal and state governments want to decrease payments for medical education, and other payers are trying to restrict payouts to direct and necessary patient care services. Teaching hospitals are increasing tuition and fees, reducing education budgets and, in many instances, closing education programs. Hospital administrators are examining the…
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When could a stigma program to address mental illness in the workplace break even?
Dewa, Carolyn S; Hoch, Jeffrey S
2014-10-01
To explore basic requirements for a stigma program to produce sufficient savings to pay for itself (that is, break even). A simple economic model was developed to compare reductions in total short-term disability (SDIS) cost relative to a stigma program's costs. A 2-way sensitivity analysis is used to illustrate conditions under which this break-even scenario occurs. Using estimates from the literature for the SDIS costs, this analysis shows that a stigma program can provide value added even if there is no reduction in the length of an SDIS leave. To break even, a stigma program with no reduction in the length of an SDIS leave would need to prevent at least 2.5 SDIS claims in an organization of 1000 workers. Similarly, a stigma program can break even with no reduction in the number of SDIS claims if it is able to reduce SDIS episodes by at least 7 days in an organization of 1000 employees. Modelling results, such as those presented in our paper, provide information to help occupational health payers become prudent buyers in the mental health market place. While in most cases, the required reductions seem modest, the real test of both the model and the program occurs once a stigma program is piloted and evaluated in a real-world setting.
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2012-06-26
....676] Office of Refugee Resettlement; Announcing the Award of a Single- Source Program Expansion... (BCFS) in San Antonio, TX AGENCY: Office of Refugee Resettlement, ACF, HHS. ACTION: The Office of Refugee Resettlement announces the award of a single-source program expansion supplement grant from its...
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U.S. physicians' views on financing options to expand health insurance coverage: a national survey.
McCormick, Danny; Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H; Himmelstein, David U
2009-04-01
Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. To assess physician views on financing options for expanding health care coverage and on access to health care. Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.
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Performance-Based Risk-Sharing Arrangements: U.S. Payer Experience.
Goble, Joseph A; Ung, Brian; van Boemmel-Wegmann, Sascha; Navarro, Robert P; Parece, Andrew
2017-10-01
As a result of global concern about rising drug costs, many U.S. payers and European agencies such as the National Health Service have partnered with pharmaceutical companies in performance-based risk-sharing arrangements (PBRSAs) by which manufacturers share financial risk with health care purchasing entities and authorities. However, PBRSAs present many administrative and legal challenges that have minimized successful contract experiences in the United States. To (a) identify drug and disease characteristics and contract components that contribute to successful PBRSA experiences and the primary barriers to PBRSA execution and (b) explore solutions to facilitate contract negotiation and execution. A 37-item, web-based survey instrument (Qualtrics), approximately 20 minutes in duration, was open during July and August 2016. The survey was emailed to 90 pharmacy and medical directors of various health care organizations. Statistical analysis included the Kruskal-Wallis test and chi-square tests to examine differences among payer responses. Survey responses were anonymized and data were aggregated. Twenty-seven individuals completed the survey (30% completion rate). The majority of respondents worked for regional health plans (52%, n = 14), covering at least 1 million lives (63%, n = 17), with at least 7 years of managed care experience (81%, n = 22). A total of 51 PBRSAs were active among respondents at the time of the survey. Easily obtainable and evaluable drug data and medical data were the most important drug and disease attributes for successful PBRSAs, respectively. Pharmacy claims and patient demographic data were assessed as "very easy and inexpensive" to collect. Type and amount of manufacturer payment for drug outcome performance failure, endpoint measurement, and necessary clinical data for drug performance measurement were all critical factors for successful PBRSAs. Standardized contract templates and transparent contract financial risk evaluation and
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Hagenaars, Luc L; Klazinga, Niek S; Mueller, Michael; Morgan, David J; Jeurissen, Patrick P T
2018-01-01
Administration is vital for health care. Its importance may increase as health care systems become more complex, but academic attention has remained minimal. We investigated trends in administrative expenditure across OECD countries, cross-country spending differences, spending differences between health care system typologies, and differences in the scale and scope of administrative functions across typologies. We used OECD data, which include health system governance and financing-related administrative activities by regulators, governance bodies, and insurers (macrolevel), but exclude administrative expenditure by health care providers (mesolevel and microlevel). We find that governance and financing-related administrative spending at the macrolevel has remained stable over the last decade at slightly over 3% of total health spending. Cross-country differences range from 1.3% of health spending in Iceland to 8.3% in the United States. Voluntary private health insurance bears much higher administrative costs than compulsory schemes in all countries. Among compulsory schemes, multiple payers exhibit significantly higher administrative spending than single payers. Among single-payer schemes, those where entitlements are based on residency have significantly lower administrative spending than those with single social health insurance, albeit with a small difference. These differences can partially be explained because multi-payer and voluntary private health insurance schemes require additional administrative functions and enjoy less economies of scale. Studies in hospitals and primary care indicate similar differences in administrative costs across health system typologies at the mesolevel and microlevel of health care delivery, which warrants more research on total administrative costs at all the levels of health systems. Copyright © 2017 John Wiley & Sons, Ltd.
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How alternative payment models in emergency medicine can benefit physicians, payers, and patients.
Harish, Nir J; Miller, Harold D; Pines, Jesse M; Zane, Richard D; Wiler, Jennifer L
2017-06-01
While there has been considerable effort devoted to developing alternative payment models (APMs) for primary care physicians and for episodes of care beginning with inpatient admissions, there has been relatively little attention by payers to developing APMs for specialty ambulatory care, and no efforts to develop APMs that explicitly focus on emergency care. In order to ensure that emergency care is appropriately integrated and valued in future payment models, emergency physicians (EPs) must engage with the stakeholders within the broader health care system. In this article, we describe a framework for the development of APMs for emergency medicine and present four examples of APMs that may be applicable in emergency medicine. A better understanding of how APMs can work in emergency medicine will help EPs develop new APMs that improve the cost and quality of care, and leverage the value that emergency care brings to the system. Copyright © 2017 Elsevier Inc. All rights reserved.
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Solving the Single-Sink, Fixed-Charge, Multiple-Choice Transportation Problem by Dynamic Programming
DEFF Research Database (Denmark)
Christensen, Tue; Andersen, Kim Allan; Klose, Andreas
2013-01-01
This paper considers a minimum-cost network flow problem in a bipartite graph with a single sink. The transportation costs exhibit a staircase cost structure because such types of transportation cost functions are often found in practice. We present a dynamic programming algorithm for solving...... this so-called single-sink, fixed-charge, multiple-choice transportation problem exactly. The method exploits heuristics and lower bounds to peg binary variables, improve bounds on flow variables, and reduce the state-space variable. In this way, the dynamic programming method is able to solve large...... instances with up to 10,000 nodes and 10 different transportation modes in a few seconds, much less time than required by a widely used mixed-integer programming solver and other methods proposed in the literature for this problem....
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Pediatric Critical Care Telemedicine Program: A Single Institution Review.
Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P
2016-01-01
Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.
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Energy Technology Data Exchange (ETDEWEB)
Brown, M.A.; Berry, L.G.; Balzer, R.A.; Faby, E.
1993-05-01
Since 1976, the US Department of Energy (DOE) has operated one of the largest energy conservation programs in the nation -- the low-income Weatherization Assistance Program. The program strives to increase the energy efficiency of dwellings occupied by low-income persons in order to reduce their energy consumption, lower their fuel bills, increase the comfort of their homes, and safeguard their health. It targets vulnerable groups including the elderly, people with disabilities, and families with children. The most recent national evaluation of the impacts of the Program was completed in 1984 based on energy consumption data for households weatherized in 1981. DOE Program regulations and operations have changed substantially since then: new funding sources, management principles, diagnostic procedures, and weatherization technologies have been incorporated. Many of these new features have been studied in isolation or at a local level; however, no recent evaluation has assessed their combined, nationwide impacts to date or their potential for the future. In 1990, DOE initiated such an evaluation. This evaluation is comprised of three ``impact`` studies (the Single-Family Study, High-Density Multifamily Study, and Fuel-Oil Study) and two ``policy`` studies. Altogether, these five studies will provide a comprehensive national assessment of the Weatherization Assistance Program as it existed in the 1989 Program Year (PY 1989). This report presents the results of the first phase of the Single-Family Study. It evaluates the energy savings and cost effectiveness of the Program as it has been applied to the largest portion of its client base -- low-income households that occupy single-family dwellings, mobile homes, and small (2- to 4-unit) multifamily dwellings. It is based upon a representative national sample that covers the full range of conditions under which the program was implemented in PY 1989.
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Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.
2018-01-01
A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…
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Gandhi, Pranav K; Gentry, William M; Ma, Qinli; Bottorff, Michael B
2015-02-01
Gout is a chronic inflammatory condition associated with poor urate metabolism. Xanthine oxidase inhibitors such as allopurinol and febuxostat are recommended to reduce uric acid levels and to prevent gout attacks in adult patients. Under budget-driven constraints, health care payers are faced with the broader challenge of assessing the economic value of these agents for formulary placement. However, the economic value of allopurinol versus febuxostat has not be assessed in patients with gout over a 5-year time period in the United States. To evaluate the cost-effectiveness of allopurinol versus febuxostat in adult patients with gout over a 5-year time period from a U.S. health care payer's perspective. A Markov model was developed to compare the total direct costs and success of serum uric acid (sUA) level reduction associated with allopurinol and febuxostat. Treatment success was defined as patient achievement of a sUA level less than 6 mg/dL (0.36 mmol/L) at 6 months. Event probabilities were based on published phase III randomized clinical trials and included long-term sequelae from open-label extension studies. A hypothetical cohort of 1,000 adult gout patients with sUA levels of ≥ 8 mg/dL (0.48 mmol/L) who had received either allopurinol 300 mg or febuxostat 80 mg at model entry transitioned among the 4 health states defined by treatment success, treatment failure and switch, treatment dropout, and death. The length of each Markov cycle was 6 months. Costs were gathered from the RED BOOK, Medicare fee schedules, Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, and for a limited number of inputs, expert consultation. Direct costs included treatment drug costs, costs for prophylaxis drugs, diagnostic laboratory tests, and the treatment and management of acute gout flare. Resource utilization was based on clinical evidence and expert consultation. All costs were inflated to 2014 U.S. dollars and were discounted at 3% in the base case
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2012-10-05
... training on money management and consumer issues. Grant recipients must finance the projects with a....602] Announcement of the Award of Single-Source Program Expansion Supplement Grants to Seven Assets... the award of single-source program expansion supplements to seven FY 2012 grantees under the Assets...
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Malone, Daniel C; Brown, Mary; Hurwitz, Jason T; Peters, Loretta; Graff, Jennifer S
2018-03-01
To examine how real-world evidence (RWE) is currently perceived and used in managed care environments, especially to inform pharmacy and therapeutic (P&T) committee decisions, to assess which study factors (e.g., data, design, and funding source) contribute to RWE utility in decisions, and to identify barriers to consideration of RWE studies in P&T decision making. We conducted focus groups/telephone-based interviews and surveys to understand perceptions of RWE and assess awareness, quality, and relevance of two high-profile examples of published RWE studies. A purposive sample comprised 4 physicians, 15 pharmacists, and 1 researcher representing 18 US health plans and health system organizations. Participants reported that RWE was generally used, or useful, to inform safety monitoring, utilization management, and cost analysis, but less so to guide P&T decisions. Participants were not aware of the two sample RWE studies but considered both studies to be valuable. Relevant research questions and outcomes, transparent methods, study quality, and timely results contribute to the utility of published RWE. Perceived organizational barriers to the use of published RWE included lack of skill, training, and timely study results. Payers recognize the value of RWE, but use of such studies to inform P&T decisions varies from organization to organization and is limited. Relevance to payers, timeliness, and transparent methods were key concerns with RWE. Participants recognized the need for continuing education on evaluating and using RWE to better understand the study methods, findings, and applicability to their organizations. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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Morgan, Steven G; Vogler, Sabine; Wagner, Anita K
2017-04-01
Institutional payers for pharmaceuticals worldwide appear to be increasingly negotiating confidential discounts off of the official list price of pharmaceuticals purchased in the community setting. We conducted an anonymous survey about experiences with and attitudes toward confidential discounts on patented pharmaceuticals in a sample of high-income countries. Confidential price discounts are now common among the ten health systems that participated in our study, though some had only recently begun to use these pricing arrangements on a routine basis. Several health systems had used a wide variety of discounting schemes in the past two years. The most frequent discount received by participating health systems was between 20% and 29% of official list prices; however, six participants reported their health system received one or more discount over the past two years that was valued at 60% or more of the list prices. On average, participants reported that confidential discounts were more common, complex, and significant for specialty pharmaceuticals than for primary care pharmaceuticals. Participants had a more favorable view of the impact of confidential discount schemes on their health systems than on the global marketplace. Overall, the frequency, complexity, and scale of confidential discounts being routinely negotiated suggest that the list prices for medicines bear limited resemblance to what many institutional payers actually pay. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
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Gschwind, Michael K
2013-04-16
Mechanisms for generating and executing programs for a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA) are provided. A computer program product comprising a computer recordable medium having a computer readable program recorded thereon is provided. The computer readable program, when executed on a computing device, causes the computing device to receive one or more instructions and execute the one or more instructions using logic in an execution unit of the computing device. The logic implements a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA), based on data stored in a vector register file of the computing device. The vector register file is configured to store both scalar and floating point values as vectors having a plurality of vector elements.
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2013-09-24
... Development Initiative (SSDI) Grant Program; Single- Case Deviation From Competition Requirements AGENCY...). ACTION: Notice of Single-Case Deviation from Competition Requirements for the Maternal and Child Health... and quality data that is timely. SUPPLEMENTARY INFORMATION: Intended Recipient of the Award...
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Cornelius, Judith Bacchus
2009-01-01
This exploratory study examined single mothers' ideas on the development of a faith-based sexuality program. Twenty African American single mothers with adolescent children (11 to 13 years of age) who were of the same faith and members of one church, participated in two focus groups about how a faith-based sexuality program could be designed and implemented. The findings call attention to the need for research on the design of faith-based sexuality education programs for ethnic minority families headed by single mothers.
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International Nuclear Information System (INIS)
Domanus, H.M.; Schmitt, R.C.; Sha, W.T.; Shah, V.L.
1983-12-01
The COMMIX-1A computer program is an updated and improved version of COMMIX-1 designed to analyze steady-state/transient, single-phase, three-dimensional fluid flow with heat transfer in reactor components and multicomponent systems. A new porous-media formulation via local volume averaging has been derived and employed in the COMMIX code. The concepts of volume porosity, directional surface permeability, distributed resistance, and distributed heat source or sink is used in the new porous-media formulation to model a flow domain with stationary structures. The concept of directional surface permeability is new and greatly facilitates modeling of velocity and temperature fields in anisotropic media. The new porous-media formulation represents the first unified approach to thermal-hydraulic analysis. It is now possible to perform a multidimensional thermal-hydraulic simulation of either a single component, such as a rod bundle, reactor plenum, piping system, heat exchanger, etc., or a multicomponent system that is a combination of these components. The conservation equations of mass, momentum, and energy based on the new porous-media formulation are solved as a boundary-value problem in space and an initial-value problem in time. Two other unique features provided in the COMMIX-1A code are (1) two solution procedures - a semi-implicit procedure modified from ICE and a fully-implicit procedure, named SIMPLEST-ANL, similar to the SIMPLE/SIMPLER algorithms - available a user's option and (2) a geometrical package capable of approximating many geometries. This report (Volume I) describes in detail the basic equations, formulations, solution procedures, flow charts, rebalancing scheme for faster convergence, options available to users, models to describe the auxiliary phenomena, input instructions, and two sample problems. The Volume II assembles and summarizes the results of many simulations that have been performed with COMMIX-1A computer program
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Reimbursement issues facing patients, providers, and payers.
Antman, K
1993-11-01
Escalating costs of health care delivery and the current constraints imposed by the federal budget deficit seriously threaten to compromise patient care and innovative biomedical research. Recent third-party refusal to cover some patients treated in protocols has had considerable impact on trial research. In addition, reimbursement for conventional care sometimes has been refused if delivered as part of a study (e.g., MOPP therapy versus ABVD therapy) or for an indication that is not specifically cited on the Food and Drug Administration label. Who should cover the patient care costs of patients participating in clinical trials? One approach would have patients cover these costs themselves. A second approach is the reinstitution of patient care costs into research grants. A third possibility is that the pharmaceutical industry support patient care costs of clinical research. Historically, hospital expenses of patients participating in studies have been paid by health insurance policies. In the absence of a clinical trial, many patients would be treated with Food and Drug Administration-approved therapies despite a lack of substantial benefit. Such marginal treatments are compensated by third-party payers routinely. The current system is arbitrary and expensive, compromises research and development, and equates new treatment with no treatment. By refusing to reimburse the patient care costs of investigational therapy, third-party carriers are, in fact, making medical decisions. There is a growing and legitimate concern that the pace of clinical research will be impeded significantly at a time when many exciting developments will be ready for clinical trials. The molecular steps in carcinogenesis are being documented rapidly for common malignancies, such as colon cancer. Immunologic, biologic, and hormonal approaches, and emerging technologies, such as marrow transplant or antibody toxin conjugates, already are being studied in the clinic. Health policy legislation
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Umansky, Moti; Weihs, Daphne
2012-08-01
In many physical and biophysical studies, single-particle tracking is utilized to reveal interactions, diffusion coefficients, active modes of driving motion, dynamic local structure, micromechanics, and microrheology. The basic analysis applied to those data is to determine the time-dependent mean-square displacement (MSD) of particle trajectories and perform time- and ensemble-averaging of similar motions. The motion of particles typically exhibits time-dependent power-law scaling, and only trajectories with qualitatively and quantitatively comparable MSD should be ensembled. Ensemble averaging trajectories that arise from different mechanisms, e.g., actively driven and diffusive, is incorrect and can result inaccurate correlations between structure, mechanics, and activity. We have developed an algorithm to automatically and accurately determine power-law scaling of experimentally measured single-particle MSD. Trajectories can then categorized and grouped according to user defined cutoffs of time, amplitudes, scaling exponent values, or combinations. Power-law fits are then provided for each trajectory alongside categorized groups of trajectories, histograms of power laws, and the ensemble-averaged MSD of each group. The codes are designed to be easily incorporated into existing user codes. We expect that this algorithm and program will be invaluable to anyone performing single-particle tracking, be it in physical or biophysical systems. Catalogue identifier: AEMD_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEMD_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 25 892 No. of bytes in distributed program, including test data, etc.: 5 572 780 Distribution format: tar.gz Programming language: MATLAB (MathWorks Inc.) version 7.11 (2010b) or higher, program
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Contini, D.; Dalla Mora, A.; Di Sieno, L.; Cubeddu, R.; Tosi, A.; Boso, G.; Pifferi, A.
2013-03-01
In recent years, emerging applications, such as diffuse optical imaging and spectroscopy (e.g., functional brain imaging and optical mammography), in which a wide dynamic range is crucial, have turned the interest towards Single-Photon Avalanche Diode (SPAD). In these fields, the use of a fast-gated SPAD has proven to be a successful technique to increase the measurement sensitivity of different orders of magnitude. However, an unknown background noise has been observed at high illumination during the gate-OFF time, thus setting a limit to the maximum increase of the dynamic range. In this paper we describe this noise in thin-junction silicon single-photon avalanche diode when a large amount of photons reaches the gated detector during the OFF time preceding the enabling time. This memory effect increases the background noise with respect to primary dark count rate similarly to a classical afterpulsing process, but differently it is not related to a previous avalanche ignition in the detector. We discovered that memory effect increases linearly with the power of light impinging on the detector and it has an exponential trend with time constants far different from those of afterpulsing and independently of the bias voltage applied to the junction. For these reasons, the memory effect is not due to the same trapping states of afterpulsing and must be described as a different process.
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2010-03-11
... provided on the same website noted above. Any questions related to use of FMRs or voucher payment standards... the Housing Choice Voucher Program and Moderate Rehabilitation Single Room Occupancy Program for... County, ND. Both areas were having significant problems administering the Housing Choice Voucher program...
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Application of the Single Hardening Model in the Finite Element Program ABAQUS
DEFF Research Database (Denmark)
Jakobsen, Kim Parsberg
model, developed by Lade and Kim (Kim & Lade 1988, Lade & Kim 1988a, Lade & Kim 1988b) is implemented as a user defined material module, UMAT, in the commercial finite element program, ABAQUS. The advantages of the Single Hardening Model Iie in its ability to predict elastic and plastic displacements...
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Lipman, Ellen L; Boyle, Michael H
2005-12-06
Members of families headed by single mothers are at increased risk of psychosocial disadvantage and mental health problems. We assessed the effect of a community-based program of social support and education groups for single mothers of young children on maternal well-being and parenting. We recruited 116 single mothers of children 3 to 9 years old through community advertisements. Eligible mothers were randomly assigned either to participate in a 10-week program of group sessions (1.5 hours per week) offering social support and education, with a parallel children's activity group, or to receive a standard list of community resources and the option to participate in group sessions at the end of the follow-up period. Interviewers blinded to the randomization collected assessment data from all mothers at baseline and at 3 follow-up visits (immediately after the intervention and at 3 and 6 months after the intervention). Outcome measures were self-reported mood, self-esteem, social support and parenting. Between February 2000 and April 2003, the program was offered to 9 groups of single mothers. Most of the mothers in the trial reported high levels of financial and mental health problems. In the short term (after the intervention), mothers in the intervention group had improved scores for mood (p effect = 0.55) and self-esteem (p effect = 0.29) compared with mothers in the control group; scores for the other 2 measures did not differ between the groups. Growth curve analysis of program effects over the follow-up period showed improvement in all 4 outcomes, with no significant difference between the intervention and control groups. This community-based program of group sessions offering social support and education to low-income single mothers had positive short-term effects on mood and self-esteem but not on social support and parenting. Longer follow-up showed attenuation of these effects.
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[Introduction of Quality Management System Audit in Medical Device Single Audit Program].
Wen, Jing; Xiao, Jiangyi; Wang, Aijun
2018-01-30
The audit of the quality management system in the medical device single audit program covers the requirements of several national regulatory authorities, which has a very important reference value. This paper briefly described the procedures and contents of this audit. Some enlightenment on supervision and inspection are discussed in China, for reference by the regulatory authorities and auditing organizations.
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Baker, Christine L; Ferrufino, Cheryl P; Bruno, Marianna; Kowal, Stacey
2017-01-01
Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice. This study presents current cessation patterns, real-world drug costs and plan benefit design data, and estimates the 1- to 5-year pharmacy budget impact of providing ACA-required coverage for smoking cessation products to understand the fiscal impact to a US healthcare plan. A closed cohort budget impact model was developed in Microsoft Excel ® to estimate current and projected costs for US payers (commercial, Medicare, Medicaid) covering smoking cessation medicines, with assumptions for coverage and smoking cessation product utilization based on current, real-world national and state-level trends for hypothetical commercial, Medicare, and Medicaid plans with 1 million covered lives. A Markov methodology with five health states captures quit attempt and relapse patterns. Results include the number of smokers attempting to quit, number of successful quitters, annual costs, and cost per-member per-month (PMPM). The projected PMPM cost of providing coverage for smoking cessation medications is $0.10 for commercial, $0.06 for Medicare, and $0.07 for Medicaid plans, reflecting a low incremental PMPM impact of covering two attempts ranging from $0.01 for Medicaid to $0.02 for commercial and Medicare payers. The projected PMPM impact of covering two quit attempts with access to all seven cessation medications at no patient cost share remains low. Results of this study reinforce that the impact of adopting the ACA requirements for smoking cessation coverage will have a limited near-term impact
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International Nuclear Information System (INIS)
Garner, P.L.; Blomquist, R.N.; Gelbard, E.M.
1992-09-01
The COMMIX-1AR/P computer program is designed for analyzing the steady-state and transient aspects of single-phase fluid flow and heat transfer in three spatial dimensions. This version is an extension of the modeling in COMMIX-1A to include multiple fluids in physically separate regions of the computational domain, modeling descriptions for pumps, radiation heat transfer between surfaces of the solids which are embedded in or surround the fluid, a k-var-epsilon model for fluid turbulence, and improved numerical techniques. The porous-medium formulation in COMMIX allows the program to be applied to a wide range of problems involving both simple and complex geometrical arrangements. The input preparation and execution procedures are presented for the COMMIX-1AR/P program and several postprocessor programs which produce graphical displays of the calculated results
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Energy Technology Data Exchange (ETDEWEB)
Garner, P.L.; Blomquist, R.N.; Gelbard, E.M.
1992-09-01
The COMMIX-1AR/P computer program is designed for analyzing the steady-state and transient aspects of single-phase fluid flow and heat transfer in three spatial dimensions. This version is an extension of the modeling in COMMIX-1A to include multiple fluids in physically separate regions of the computational domain, modeling descriptions for pumps, radiation heat transfer between surfaces of the solids which are embedded in or surround the fluid, a k-[var epsilon] model for fluid turbulence, and improved numerical techniques. The porous-medium formulation in COMMIX allows the program to be applied to a wide range of problems involving both simple and complex geometrical arrangements. The input preparation and execution procedures are presented for the COMMIX-1AR/P program and several postprocessor programs which produce graphical displays of the calculated results.
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Energy Technology Data Exchange (ETDEWEB)
Pang, Judy W.L., E-mail: pangj@ornl.gov [Materials Science and Technology Division, Oak Ridge National Laboratory, 1 Behtel Valley Road, Oak Ridge, TN 37831 (United States); Ice, Gene E. [Materials Science and Technology Division, Oak Ridge National Laboratory, 1 Behtel Valley Road, Oak Ridge, TN 37831 (United States); Liu Wenjun [Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439 (United States)
2010-11-25
We report on novel 3D spatially resolved X-ray diffraction microscopy studies of self-affine behavior in deformed single crystals. This study extends surface profile measurements of self-affined morphology changes in single crystals during deformation to include local lattice rotations and sub-surface behavior. Investigations were made on the spatial correlation of the local lattice rotations in 8% tensile deformed Cu single crystals oriented with [1 2 3], [1 1 1] and [0 0 1] axes parallel to the tensile axis. The nondestructive depth-resolved measurements were made over a length scale of one to hundreds of micrometers. Self-affined correlation was found both at the surface and below the surface of the samples. A universal exponent for the power-law similar to that observed with surface profile methods is found at the surface of all samples but crystallographically sensitive changes are observed as a function of depth. Correlation lengths of the self-affine behavior vary with the [1 2 3] crystal exhibiting the longest self-affine length scale of 70 {mu}m with only 18 {mu}m for the [1 1 1] and [0 0 1] crystals. These measurements illuminate the transition from surface-like to bulk-like deformation behavior and provide new quantitative information to guide emerging models of self-organized structures in plasticity.
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Neutrosophic Refined Similarity Measure Based on Cosine Function
Directory of Open Access Journals (Sweden)
Said Broumi
2014-12-01
Full Text Available In this paper, the cosine similarity measure of neutrosophic refined (multi- sets is proposed and its properties are studied. The concept of this cosine similarity measure of neutrosophic refined sets is the extension of improved cosine similarity measure of single valued neutrosophic. Finally, using this cosine similarity measure of neutrosophic refined set, the application of medical diagnosis is presented.
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Brauer, David G; Hawkins, William G; Strasberg, Steven M; Brunt, L Michael; Jaques, David P; Mercurio, Nicholas R; Hall, Bruce L; Fields, Ryan C
2015-01-01
Background Payers and regulatory bodies are increasingly placing emphasis on cost containment, quality/outcome measurement and transparent reporting. Significant cost variation occurs in many operative procedures without a clear relationship with outcomes. Clear cost-benefit associations will be necessary to justify expenditures in the era of bundled payment structures. Methods All laparoscopic cholecystectomies (LCCKs) performed within a single health system over a 1-year period were analysed for operating room (OR) supply cost. The cost was correlated with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) outcomes. Results From July 2013 to June 2014, 2178 LCCKs were performed by 55 surgeons at seven hospitals. The median case OR supply cost was $513 ± 156. There was variation in cost between individual surgeons and within an individual surgeon's practice. There was no correlation between cost and ACS NSQIP outcomes. The majority of cost variation was explained by selection of trocar and clip applier constructs. Conclusions Significant case OR cost variation is present in LCCK across a single health system, and there is no clear association between increased cost and NSQIP outcomes. Placed within the larger context of overall cost, the opportunity exists for improved resource utilization with no obvious risk for a reduction in the quality of care. PMID:26345351
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Keast, Shellie L; Pham, Timothy; Teel, Ashley; Nesser, Nancy J
2017-08-01
Patient review and restriction programs (PRRPs), used by state Medicaid programs to limit potential abuse and misuse of opioids and related controlled medications, often restrict members to a single pharmacy for controlled medications. While most states use a restricted pharmacy access model, not all states include restricted prescriber access. Oklahoma Medicaid (MOK) added a restricted prescriber access feature to its PRRP in July 2014. To evaluate the incremental effect that the addition of a prescriber restriction to MOK's pharmacy-only PRRP had on the pharmacy and resource utilization of the enrolled members. MOK members with at least 6 months of enrollment in the pharmacy-only PRRP were restricted to a maximum of 3 prescribers for controlled substances in July 2014 and were identified as "cases." Using a propensity score method, cases were matched to controls from the MOK non-PRRP enrolled population based on demographics and baseline health care utilization. Data from January 1, 2014, through December 31, 2014, were evaluated. Each member's monthly health care resource utilization, defined in terms of medical and pharmacy costs, prescription counts, and opioid use per member per month (PMPM), was analyzed. A difference-indifferences (DID) regression estimated the change in resource utilization following the July 2014 policy change. This study included 378 controls and 126 cases after propensity matching. No differences were noted for daily morphine equivalents, benzodiazepine prescriptions, or maintenance prescriptions. There were decreases in mean PMPM use for both groups for short-acting opioid (SAO) claims (P evidence that overall opioid claims were affected, the addition of prescriber restrictions may have resulted in an incremental change to SAO, prescriber, and pharmacy use in the PRPP population. Use of PRRPs may be an effective tool in reducing inappropriate use of prescription opioids within payer systems. The question remains whether these changes
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2012-10-25
... for Children and Families, Health and Human Services. ACTION: Notice of award of four single-source... Administration for Children and Families, Office of Head Start, announces the award of single-source program... systems and improved outcomes for young children and families including strategies to support parent...
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International Nuclear Information System (INIS)
Cannell, G.R.
2009-01-01
The Department of Energy, Richland Operations (DOE-RL) recently restructured its Hanford work scope, awarding two new contracts over the past several months for a total of three contracts to manage the sites cleanup efforts. DOE-RL met with key contractor personnel prior to and during contract transition to ensure site welding activities had appropriate oversight and maintained code compliance. The transition also provided an opportunity to establish a single site-wide function that would provide welding and materials engineering services to the Hanford site contractors: CH2M HILL Plateau Remediation Company (CHPRC); Mission Support Alliance (MSA); Washington River Protection Solutions (WRPS); and Washington Closure Hanford (WCH). Over the years, multiple and separate welding programs (amongst the several contractors) existed at the Hanford site leading to inefficiencies resulting from duplication of administrative efforts, maintenance of welding procedures, welder performance certifications, etc. The new, single program eliminates these inefficiencies. The new program, co-managed by two of the sites' new contractors, the CHPRC ('owner' of the program and responsible for construction welding services) and the MSA (provides maintenance welding services), provides more than just the traditional construction and maintenance welding services. Also provided, are welding engineering, specialty welding development/qualification for the closure of radioactive materials containers and materials evaluation/failure analysis. The following describes the new Hanford site welding program.
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Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L
2016-07-01
Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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A Benchmark Study of a Seismic Analysis Program for a Single Column of a HTGR Core
Energy Technology Data Exchange (ETDEWEB)
Kang, Ji Ho [KAERI, Daejeon (Korea, Republic of)
2016-05-15
A seismic analysis program, SAPCOR (Seismic Analysis of Prismatic HTGR Core), was developed in Korea Atomic Energy Research Institute. The program is used for the evaluation of deformed shapes and forces on the graphite blocks which using point-mass rigid bodies with Kelvin-Voigt impact models. In the previous studies, the program was verified using theoretical solutions and benchmark problems. To validate the program for more complicated problems, a free vibration analysis of a single column of a HTGR core was selected and the calculation results of the SAPCOR and a commercial FEM code, Abaqus, were compared in this study.
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Negotiating with third party payers: one community pharmacy's experience.
Fridy, Kimberly; DeHart, Renee M; Monk-Tutor, Mary R
2002-01-01
attempts at contract negotiation between one pharmacy and nine third party payers. The difficulty of achieving successful results and the necessity of carefully considering the time and cost of contract negotiations underscore how important it is for independent pharmacists to concentrate their efforts on contracts and terms they have an opportunity to change.
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Self-similar analysis of the spherical implosion process
International Nuclear Information System (INIS)
Ishiguro, Yukio; Katsuragi, Satoru.
1976-07-01
The implosion processes caused by laser-heating ablation has been studied by self-similarity analysis. Attention is paid to the possibility of existence of the self-similar solution which reproduces the implosion process of high compression. Details of the self-similar analysis are reproduced and conclusions are drawn quantitatively on the gas compression by a single shock. The compression process by a sequence of shocks is discussed in self-similarity. The gas motion followed by a homogeneous isentropic compression is represented by a self-similar motion. (auth.)
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Health Care Reform: a Socialist Vision
Directory of Open Access Journals (Sweden)
Martha Livingston
2010-04-01
Full Text Available At first glance, it doesn't seem as though socialism and health-care reform have a whole lot to do with each other. After all, the most visible "left" position in the current discussion of health-care reform merely advocates for the government to assume the function of national insurer, leaving the delivery of health care - from its often-questionable content to its hierarchical relationships - firmly in place. As such, a single payer, Medicare-for-All insurance program is a modest, even tepid reform. Those of us on the left who have been active in the single payer movement have always seen it as a steppingstone toward health-care justice: until the question of access to care is solved, how do we even begin to address not only health care but also health inequities? How, for example, can working-class Americans, Americans of color, and women demand appropriate, respectful, humane, first-rate care when our ability to access any health-care services at all is so tightly constrained?
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Improved cosine similarity measures of simplified neutrosophic setsfor medical diagnoses
Jun Ye
2014-01-01
In pattern recognition and medical diagnosis, similarity measure is an important mathematicaltool. To overcome some disadvantages of existing cosine similarity measures of simplified neutrosophicsets (SNSs) in vector space, this paper proposed improved cosine similarity measures of SNSs based oncosine function, including single valued neutrosophic cosine similarity measures and interval neutro-sophic cosine similarity measures. Then, weighted cosine similarity measures of SNSs were introduced...
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Comparative analysis on the probability of being a good payer
Mihova, V.; Pavlov, V.
2017-10-01
Credit risk assessment is crucial for the bank industry. The current practice uses various approaches for the calculation of credit risk. The core of these approaches is the use of multiple regression models, applied in order to assess the risk associated with the approval of people applying for certain products (loans, credit cards, etc.). Based on data from the past, these models try to predict what will happen in the future. Different data requires different type of models. This work studies the causal link between the conduct of an applicant upon payment of the loan and the data that he completed at the time of application. A database of 100 borrowers from a commercial bank is used for the purposes of the study. The available data includes information from the time of application and credit history while paying off the loan. Customers are divided into two groups, based on the credit history: Good and Bad payers. Linear and logistic regression are applied in parallel to the data in order to estimate the probability of being good for new borrowers. A variable, which contains value of 1 for Good borrowers and value of 0 for Bad candidates, is modeled as a dependent variable. To decide which of the variables listed in the database should be used in the modelling process (as independent variables), a correlation analysis is made. Due to the results of it, several combinations of independent variables are tested as initial models - both with linear and logistic regression. The best linear and logistic models are obtained after initial transformation of the data and following a set of standard and robust statistical criteria. A comparative analysis between the two final models is made and scorecards are obtained from both models to assess new customers at the time of application. A cut-off level of points, bellow which to reject the applications and above it - to accept them, has been suggested for both the models, applying the strategy to keep the same Accept Rate as
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GESIT: a thermodynamic program for single cycle gas turbine plants with and without intercoolers
Energy Technology Data Exchange (ETDEWEB)
Heil, J
1973-08-01
A computer program for the thermodynamic modeling of singlecycle gas turbine plants is described. A high-temperature reactor is assumed as a heat source in the program, but the HTR can be replaced with another heat source without difficulty. Starting from a set of independent data, the program calculates efficiencies and mass flows. It indicates all values for a heat and power balance and prints out the temperatures and pressures for the different parts of the cycle. Besides this, the program is able to optimize the compression ratios for minimal power input. It also takes into account turbine rotor cooling (at the roots of the blades). Furthermore, the program is able to use either total pressure loss or specified losses in different parts of the cycle. The program GESlT can also handle systems with one or two intercoolers, or with no intercooler. GESIT gives all input and output values for the heat exchangers and turbo-machines. First the single-cycle gas turbine plant is described. After that the computational basis for the program and the program structure is explained. Instructions for data input are given so that the program can be immediately utilized. An example of input data together with the associated output is presented. (auth)
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The study on the cephalometric similarity between parents and offspring
Energy Technology Data Exchange (ETDEWEB)
Kang, Woo Ghon; Ahn, Hyung Kyu [Department of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)
1975-11-15
The study was performed to investigate cephalometric similarity between parents and offspring of the Korean family by lateral cephalometric analysis. The lateral cephalograms consist of the 8 families comprising 16 parents, 5 sons and 7 daughters. In order to make an investigation of the similarity, 12 measuring points were set up, and 22 linear measurements on each depth, height and 5 angular measurements were made. The author drew up the profilograms to compare parents with offspring in each family group. The obtained results were as follows: 1. There was no common similarity on specific region between parents and offspring in each family group. 2. There was partial similarity between single parent and offspring. 3. The partial similarity between single parent and offspring was noted on the upper face in general.
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The study on the cephalometric similarity between parents and offspring
International Nuclear Information System (INIS)
Kang, Woo Ghon; Ahn, Hyung Kyu
1975-01-01
The study was performed to investigate cephalometric similarity between parents and offspring of the Korean family by lateral cephalometric analysis. The lateral cephalograms consist of the 8 families comprising 16 parents, 5 sons and 7 daughters. In order to make an investigation of the similarity, 12 measuring points were set up, and 22 linear measurements on each depth, height and 5 angular measurements were made. The author drew up the profilograms to compare parents with offspring in each family group. The obtained results were as follows: 1. There was no common similarity on specific region between parents and offspring in each family group. 2. There was partial similarity between single parent and offspring. 3. The partial similarity between single parent and offspring was noted on the upper face in general.
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Catanzaro, Daniele; Shackney, Stanley E; Schaffer, Alejandro A; Schwartz, Russell
2016-01-01
Ductal Carcinoma In Situ (DCIS) is a precursor lesion of Invasive Ductal Carcinoma (IDC) of the breast. Investigating its temporal progression could provide fundamental new insights for the development of better diagnostic tools to predict which cases of DCIS will progress to IDC. We investigate the problem of reconstructing a plausible progression from single-cell sampled data of an individual with synchronous DCIS and IDC. Specifically, by using a number of assumptions derived from the observation of cellular atypia occurring in IDC, we design a possible predictive model using integer linear programming (ILP). Computational experiments carried out on a preexisting data set of 13 patients with simultaneous DCIS and IDC show that the corresponding predicted progression models are classifiable into categories having specific evolutionary characteristics. The approach provides new insights into mechanisms of clonal progression in breast cancers and helps illustrate the power of the ILP approach for similar problems in reconstructing tumor evolution scenarios under complex sets of constraints.
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Similar or different? The role of the ventrolateral prefrontal cortex in similarity detection.
Directory of Open Access Journals (Sweden)
Béatrice Garcin
Full Text Available Patients with frontal lobe syndrome can exhibit two types of abnormal behaviour when asked to place a banana and an orange in a single category: some patients categorize them at a concrete level (e.g., "both have peel", while others continue to look for differences between these objects (e.g., "one is yellow, the other is orange". These observations raise the question of whether abstraction and similarity detection are distinct processes involved in abstract categorization, and that depend on separate areas of the prefrontal cortex (PFC. We designed an original experimental paradigm for a functional magnetic resonance imaging (fMRI study involving healthy subjects, confirming the existence of two distinct processes relying on different prefrontal areas, and thus explaining the behavioural dissociation in frontal lesion patients. We showed that: 1 Similarity detection involves the anterior ventrolateral PFC bilaterally with a right-left asymmetry: the right anterior ventrolateral PFC is only engaged in detecting physical similarities; 2 Abstraction per se activates the left dorsolateral PFC.
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Directory of Open Access Journals (Sweden)
Ananda Balayogi Bhavanani
2015-06-01
Conclusion: There is a healthy reduction in HR, BP and derived cardiovascular indices following a single yoga session in geriatric subjects. These changes may be attributed to enhanced harmony of cardiac autonomic function as a result of coordinated breath-body work and mind-body relaxation due to an integrated and #8220;Silver Yoga and #8221; program. [J Intercult Ethnopharmacol 2015; 4(2.000: 134-137
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Directory of Open Access Journals (Sweden)
Gholamreza Rajabi
2017-11-01
Full Text Available Introduction: The present study aimed to examine the effectiveness of premarital education based on interpersonal choice and knowledge program in reducing fear of marriage and increase motivation of marriage. Methods: This research was designed as an experimental study with pretest-posttest and follow-up with a control group. Thirty-nine volunteer single students were selected from universities of Ahvaz city if they obtained a standard deviation higher than the mean score of fear subscale and were assigned randomly to experimental group (n=20 and control group (n=19. The experiment group was given a premarital interpersonal choice and knowledge program of nine 90-minute sessions twice a week. Results: The results of repeated measures analysis of variance showed that the premarital interpersonal choice and knowledge program reduced fear of marriage and increased motivation for marriage in the experimental group as compared with the control group at posttest and follow-up. Conclusion: Our results showed that the premarital interpersonal choice and knowledge program is a suitable method for reducing fear of marriage and increasing motivation for marriage in single students.
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A Numerical Framework for Self-Similar Problems in Plasticity: Indentation in Single Crystals
DEFF Research Database (Denmark)
Juul, Kristian Jørgensen; Niordson, Christian Frithiof; Nielsen, Kim Lau
A new numerical framework specialized for analyzing self-similar problems in plasticity is developed. Self-similarity in plasticity is encountered in a number of different problems such as stationary cracks, void growth, indentation etc. To date, such problems are handled by traditional Lagrangian...... procedures that may be associated with severe numerical difficulties relating to sufficient discretization, moving contact points, etc. In the present work, self-similarity is exploited to construct the numerical framework that offers a simple and efficient method to handle self-similar problems in history...... numerical simulations [3] when possible. To mimic the condition for the analytical predictions, the wedge indenter is considered nearly flat and the material is perfectly plastic with a very low yield strain. Under these conditions, [1][2] proved analytically the existence of discontinuities in the slip...
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From Single- to Multi-Objective Auto-Tuning of Programs: Advantages and Implications
Directory of Open Access Journals (Sweden)
Juan Durillo
2014-01-01
Full Text Available Automatic tuning (auto-tuning of software has emerged in recent years as a promising method that tries to automatically adapt the behaviour of a program to attain different performance objectives on a given computing system. This method is gaining momentum due to the increasing complexity of modern multicore-based hardware architectures. Many solutions to auto-tuning have been explored ranging from simple random search to more sophisticate methods like machine learning or evolutionary search. To this day, it is still unclear whether these approaches are general enough to encompass all the complexities of the problem (e.g. search space, parameters influencing the search space, input data sensitivity, etc., or which approach is best suited for a given problem. Furthermore, the growing interest in auto-tuning a program for several objectives is increasing this confusion even further. The goal of this paper is to formally describe the problem addressed by auto-tuning programs and review existing solutions highlighting the advantages and drawbacks of different techniques for single-objective as well as multi-objective auto-tuning approaches.
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Rocco, Philip; Kelly, Andrew S; Béland, Daniel; Kinane, Michael
2017-02-01
Prices are a significant driver of health care cost in the United States. Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs' efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices. Drawing on pragmatist institutional theory, this article shows how APCDs emerged as the dominant model for reforming health care prices. While APCD advocates faced significant institutional barriers to policy change, we show how they reconfigured existing ideas, tactical repertoires, and legal-technical infrastructures to develop a politically and technologically robust reform. Our analysis has important implications for theories of how change agents overcome structural barriers to health reform. Copyright © 2017 by Duke University Press.
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Energy Technology Data Exchange (ETDEWEB)
Bargalló, Xavier, E-mail: xbarga@clinic.cat [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Santamaría, Gorane; Amo, Montse del; Arguis, Pedro [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Ríos, José [Biostatistics and Data Management Core Facility, IDIBAPS, (Hospital Clinic) C/ Mallorca, 183. Floor -1. Office #60. 08036 Barcelona (Spain); Grau, Jaume [Preventive Medicine and Epidemiology Unit, Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Burrel, Marta; Cores, Enrique; Velasco, Martín [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain)
2014-11-15
Highlights: • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The cancer detection rate improved at the cost of increasing recall rate. • 3-CAD, used by breast radiologists, did not help to detect more cancers. - Abstract: Objectives: To assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by computer-aided detection (CAD) in a breast cancer screening program. Methods: This was a prospective study approved by the ethics committee. Data from 21,321 consecutive screening mammograms in incident rounds (2010–2012) were read following a single reading plus CAD protocol and compared with data from 47,462 consecutive screening mammograms in incident rounds (2004–2010) that were interpreted following a double reading plus arbitration protocol. For the single reading, radiologists were selected on the basis of the appraisement of their previous performance. Results: Period 2010–2012 vs. period 2004–2010: Cancer detection rate (CDR): 6.1‰ (95% confidence interval: 5.1–7.2) vs. 5.25‰; Recall rate (RR): 7.02% (95% confidence interval: 6.7–7.4) vs. 7.24% (selected readers before arbitration) and vs. 3.94 (all readers after arbitration); Predictive positive value of recall: 8.69% vs. 13.32%. Average size of invasive cancers: 14.6 ± 9.5 mm vs. 14.3 ± 9.5 mm. Stage: 0 (22.3/26.1%); I (59.2/50.8%); II (19.2/17.1%); III (3.1/3.3%); IV (0/1.9%). Specialized breast radiologists performed better than general radiologists. Conclusions: The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration.
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Programming scheme based optimization of hybrid 4T-2R OxRAM NVSRAM
Majumdar, Swatilekha; Kingra, Sandeep Kaur; Suri, Manan
2017-09-01
In this paper, we present a novel single-cycle programming scheme for 4T-2R NVSRAM, exploiting pulse engineered input signals. OxRAM devices based on 3 nm thick bi-layer active switching oxide and 90 nm CMOS technology node were used for all simulations. The cell design is implemented for real-time non-volatility rather than last-bit, or power-down non-volatility. Detailed analysis of the proposed single-cycle, parallel RRAM device programming scheme is presented in comparison to the two-cycle sequential RRAM programming used for similar 4T-2R NVSRAM bit-cells. The proposed single-cycle programming scheme coupled with the 4T-2R architecture leads to several benefits such as- possibility of unconventional transistor sizing, 50% lower latency, 20% improvement in SNM and ∼20× reduced energy requirements, when compared against two-cycle programming approach.
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Carpenter, Dick M., II; Kaka, Sarah J.; Tygret, Jennifer A.; Cathcart, Katy
2018-01-01
This study examines the efficacy of a scholarship program designed to assist single parent, post-freshmen, full time undergraduate students and predictors of success among a sample of said students, where success is defined as progress toward completion, academic achievement, and degree completion. Results of fixed effects regression and…
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SS-Wrapper: a package of wrapper applications for similarity searches on Linux clusters
Directory of Open Access Journals (Sweden)
Lefkowitz Elliot J
2004-10-01
the memory of a single node. Conclusions Used together, QS-search and DS-BLAST provide a flexible solution to adapt sequential similarity searching applications in high performance computing environments. Their ease of use and their ability to wrap a variety of database search programs provide an analytical architecture to assist both the seasoned bioinformaticist and the wet-bench biologist.
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SS-Wrapper: a package of wrapper applications for similarity searches on Linux clusters.
Wang, Chunlin; Lefkowitz, Elliot J
2004-10-28
Large-scale sequence comparison is a powerful tool for biological inference in modern molecular biology. Comparing new sequences to those in annotated databases is a useful source of functional and structural information about these sequences. Using software such as the basic local alignment search tool (BLAST) or HMMPFAM to identify statistically significant matches between newly sequenced segments of genetic material and those in databases is an important task for most molecular biologists. Searching algorithms are intrinsically slow and data-intensive, especially in light of the rapid growth of biological sequence databases due to the emergence of high throughput DNA sequencing techniques. Thus, traditional bioinformatics tools are impractical on PCs and even on dedicated UNIX servers. To take advantage of larger databases and more reliable methods, high performance computation becomes necessary. We describe the implementation of SS-Wrapper (Similarity Search Wrapper), a package of wrapper applications that can parallelize similarity search applications on a Linux cluster. Our wrapper utilizes a query segmentation-search (QS-search) approach to parallelize sequence database search applications. It takes into consideration load balancing between each node on the cluster to maximize resource usage. QS-search is designed to wrap many different search tools, such as BLAST and HMMPFAM using the same interface. This implementation does not alter the original program, so newly obtained programs and program updates should be accommodated easily. Benchmark experiments using QS-search to optimize BLAST and HMMPFAM showed that QS-search accelerated the performance of these programs almost linearly in proportion to the number of CPUs used. We have also implemented a wrapper that utilizes a database segmentation approach (DS-BLAST) that provides a complementary solution for BLAST searches when the database is too large to fit into the memory of a single node. Used together
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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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Rapee, Ronald M; Lyneham, Heidi J; Wuthrich, Viviana; Chatterton, Mary Lou; Hudson, Jennifer L; Kangas, Maria; Mihalopoulos, Cathrine
2017-10-01
Stepped care is embraced as an ideal model of service delivery but is minimally evaluated. The aim of this study was to evaluate the efficacy of cognitive-behavioral therapy (CBT) for child anxiety delivered via a stepped-care framework compared against a single, empirically validated program. A total of 281 youth with anxiety disorders (6-17 years of age) were randomly allocated to receive either empirically validated treatment or stepped care involving the following: (1) low intensity; (2) standard CBT; and (3) individually tailored treatment. Therapist qualifications increased at each step. Interventions did not differ significantly on any outcome measures. Total therapist time per child was significantly shorter to deliver stepped care (774 minutes) compared with best practice (897 minutes). Within stepped care, the first 2 steps returned the strongest treatment gains. Stepped care and a single empirically validated program for youth with anxiety produced similar efficacy, but stepped care required slightly less therapist time. Restricting stepped care to only steps 1 and 2 would have led to considerable time saving with modest loss in efficacy. Clinical trial registration information-A Randomised Controlled Trial of Standard Care Versus Stepped Care for Children and Adolescents With Anxiety Disorders; http://anzctr.org.au/; ACTRN12612000351819. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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Solving the Single-Sink, Fixed-Charge, Multiple-Choice Transportation Problem by Dynamic Programming
DEFF Research Database (Denmark)
Rauff Lind Christensen, Tue; Klose, Andreas; Andersen, Kim Allan
important aspects of supplier selection, an important application of the SSFCTP, this does not reflect the real life situation. First, transportation costs faced by many companies are in fact piecewise linear. Secondly, when suppliers offer discounts, either incremental or all-unit discounts, such savings......The Single-Sink, Fixed-Charge, Multiple-Choice Transportation Problem (SSFCMCTP) is a problem with versatile applications. This problem is a generalization of the Single-Sink, Fixed-Charge Transportation Problem (SSFCTP), which has a fixed-charge, linear cost structure. However, in at least two...... are neglected in the SSFCTP. The SSFCMCTP overcome this problem by incorporating a staircase cost structure in the cost function instead of the usual one used in SSFCTP. We present a dynamic programming algorithm for the resulting problem. To enhance the performance of the generic algorithm a number...
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Visual reconciliation of alternative similarity spaces in climate modeling
J Poco; A Dasgupta; Y Wei; William Hargrove; C.R. Schwalm; D.N. Huntzinger; R Cook; E Bertini; C.T. Silva
2015-01-01
Visual data analysis often requires grouping of data objects based on their similarity. In many application domains researchers use algorithms and techniques like clustering and multidimensional scaling to extract groupings from data. While extracting these groups using a single similarity criteria is relatively straightforward, comparing alternative criteria poses...
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2012-09-20
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Refugee Resettlement [CFDA Number 93.676... Children's Shelter Care Grantees AGENCY: Office of Refugee Resettlement, ACF, HHS. ACTION: The Office of Refugee Resettlement announces the award of three single-source program expansion supplement grants from...
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Schonberger, Robert B; Dutton, Richard P; Dai, Feng
2016-01-01
Modifications in physician billing patterns have been shown to occur in response to payer incentives, but the phenomenon remains largely unexplored in billing for anesthesia services. Within the field of anesthesiology, Medicare's policy not to provide additional reimbursement for higher ASA physical status scores contrasts with the practices of most private payers, and this pattern of reimbursement introduces a change in billing incentives once patients attain Medicare eligibility. We hypothesized that, coincident with the onset of widespread Medicare eligibility at age 65 years, a discontinuity in reported ASA physical status scores would be observed after controlling for the underlying trend of increasing ASA physical status scores with age. This phenomenon would manifest as a pattern of upcoding of ASA physical status scores for patients younger than 65 years that would become less common in patients age 65 years and older. Using data on age, sex, ASA physical status scores, and type of surgery from the National Anesthesia Clinical Outcomes Registry, we used a quasi-experimental regression discontinuity design to analyze whether there was evidence for a discontinuity in reported ASA physical status scores occurring at age 65 years for the nondeferrable anesthesia services accompanying hip, femur, or lower leg fracture repair. A total of 49,850 records were analyzed. In models designed to detect regression discontinuity at 65 years of age, neither the binary variable "age ≥ 65" nor the interaction term of age × age ≥ 65 was a statistically significant predictor of the outcome of ASA physical status score. The statistical inference was unchanged when ASA physical status scores were reclassified as a binary outcome (I-II vs III-V) and when different bandwidths around age 65 years were used. To test the validity of our study design for detecting regression discontinuity, simulations of the occurrence of deliberate upcoding of ASA physical status scores
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Mixed quantization dimensions of self-similar measures
International Nuclear Information System (INIS)
Dai Meifeng; Wang Xiaoli; Chen Dandan
2012-01-01
Highlights: ► We define the mixed quantization dimension of finitely many measures. ► Formula of mixed quantization dimensions of self-similar measures is given. ► Illustrate the behavior of mixed quantization dimension as a function of order. - Abstract: Classical multifractal analysis studies the local scaling behaviors of a single measure. However recently mixed multifractal has generated interest. The purpose of this paper is some results about the mixed quantization dimensions of self-similar measures.
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A Computer Program for Flow-Log Analysis of Single Holes (FLASH)
Day-Lewis, F. D.; Johnson, C.D.; Paillet, Frederick L.; Halford, K.J.
2011-01-01
A new computer program, FLASH (Flow-Log Analysis of Single Holes), is presented for the analysis of borehole vertical flow logs. The code is based on an analytical solution for steady-state multilayer radial flow to a borehole. The code includes options for (1) discrete fractures and (2) multilayer aquifers. Given vertical flow profiles collected under both ambient and stressed (pumping or injection) conditions, the user can estimate fracture (or layer) transmissivities and far-field hydraulic heads. FLASH is coded in Microsoft Excel with Visual Basic for Applications routines. The code supports manual and automated model calibration. ?? 2011, The Author(s). Ground Water ?? 2011, National Ground Water Association.
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An analysis of potential costs of adverse events based on Drug Programs in Poland. Pulmonology focus
Directory of Open Access Journals (Sweden)
Szkultecka-Debek Monika
2014-06-01
Full Text Available The project was performed within the Polish Society for Pharmacoeconomics (PTFE. The objective was to estimate the potential costs of treatment of side effects, which theoretically may occur as a result of treatment of selected diseases. We analyzed the Drug Programs financed by National Health Fund in Poland in 2012 and for the first analysis we selected those Programs where the same medicinal products were used. We based the adverse events selection on the Summary of Product Characteristics of the chosen products. We extracted all the potential adverse events defined as frequent and very frequent, grouping them according to therapeutic areas. This paper is related to the results in the pulmonology area. The events described as very common had an incidence of ≥ 1/10, and the common ones ≥ 1/100, <1/10. In order to identify the resources used, we performed a survey with the engagement of clinical experts. On the basis of the collected data we allocated direct costs incurred by the public payer. We used the costs valid in December 2013. The paper presents the estimated costs of treatment of side effects related to the pulmonology disease area. Taking into account the costs incurred by the NHF and the patient separately e calculated the total spending and the percentage of each component cost in detail. The treatment of adverse drug reactions generates a significant cost incurred by both the public payer and the patient.
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Present State of the Single and Twin Aperture Short Dipole Model Program for the LHC
Andreyev, N I; Kurtyka, T; Leroy, D; Oberli, L R; Perini, D; Russenschuck, Stephan; Siegel, N; Siemko, A; Tommasini, D; Vanenkov, I; Walckiers, L; Weterings, W
1998-01-01
The LHC model program for main dipoles is based on the design, fabrication and testing at CERN of a number of single and twin aperture 1m long magnets. So far, a number of single aperture models, each with specific characteristics, were tested at 2 K at a rate of about one per month. These magnets are the main tool used to check coil performance as a function of design and assembly options in view of optimizing and finalizing choices of components and procedures. Initial quenching field levels of 8.8 T were obtained and the short sample limit of the cable at 1.9 K was reached corresponding to a central bore field of 10 T. A few twin aperture dipole models were also built and tested, using the same structural components as for the long magnets which are now being built in industry. The paper discusses the main characteristics of the models built so far, the instrumentation developed to date and the experience obtained. Finally it describes the plans aimed at continuing a vigorous program to provide input to th...
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76 FR 26489 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program
2011-05-06
... also be aligned with best practices among other payers and the needs of the end users of the measures... have been subsequently shown to not represent the best clinical practice. We interpreted this provision... of measures, including clinical process of care measures, risk adjusted outcome measures, the HCAHPS...
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2010-07-01
..., Displaced Homemakers, and Single Pregnant Women Program? 403.81 Section 403.81 Education Regulations of the... Secretary Assist Under the Basic Programs? Single Parents, Displaced Homemakers, and Single Pregnant Women... individuals who are single parents, displaced homemakers, or single pregnant women only to— (a) Provide...
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Reinventing primary care: lessons from Canada for the United States.
Starfield, Barbara
2010-05-01
Canada is, in many respects, culturally and economically similar to the United States, and until relatively recently, the two countries had similar health systems. However, since passage of the Canada Health Act in the 1970s, that nation's health statistics have become increasingly superior. Although the costs of Canada's health system are high by international standards, they are much lower than U.S. costs. This paper describes several factors likely to be responsible for Canada's better health at lower cost: universal financial coverage through a so-called single payer; features conducive to a strong primary care infrastructure; and provincial autonomy under general principles set by national law.
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A marketing clinical doctorate programs.
Montoya, Isaac D; Kimball, Olive M
2007-01-01
Over the past decade, clinical doctorate programs in health disciplines have proliferated amid both support and controversy among educators, professional organizations, practitioners, administrators, and third-party payers. Supporters argue that the explosion of new knowledge and increasing sophistication of technology have created a need for advanced practice models to enhance patient care and safety and to reduce costs. Critics argue that necessary technological advances can be incorporated into existing programs and believe that clinical doctorates will increase health care costs, not reduce them. Despite the controversy, many health disciplines have advanced the clinical doctorate (the most recent is the doctor of nursing practice in 2004), with some professions mandating the doctorate as the entry-level degree (i.e., psychology, pharmacy, audiology, and so on). One aspect of the introduction of clinical doctoral degrees has been largely overlooked, and that is the marketing aspect. Because of marketing considerations, some clinical doctorates have been more successfully implemented and accepted than others. Marketing is composed of variables commonly known as "the four P's of marketing": product, price, promotion, and place. This report explores these four P's within the context of clinical doctorates in the health disciplines.
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Kim, Hyunjee; McConnell, K John; Sun, Benjamin C
2017-08-01
The high rate of emergency department (ED) use by Medicaid patients is not fully understood. The objective of this paper is (1) to provide context for ED service use by comparing Medicaid and commercial patients' differences across ED and non-ED health service use, and (2) to assess the extent to which Medicaid-commercial differences in ED use can be explained by observable factors in administrative data. Statistical decomposition methods were applied to ED, mental health, and inpatient care using 2011-2013 Medicaid and commercial insurance claims from the Oregon All Payer All Claims database. Demographics, comorbidities, health services use, and neighborhood characteristics accounted for 44% of the Medicaid-commercial difference in ED use, compared to 83% for mental health care and 75% for inpatient care. This suggests that relative to mental health and inpatient care, a large portion of ED use cannot be explained by administrative data. Models that further accounted for patient access to different primary care physicians explained an additional 8% of the Medicaid-commercial difference in ED use, suggesting that the quality of primary care may influence ED use. The remaining unexplained difference suggests that appropriately reducing ED use remains a credible target for policy makers, although success may require knowledge about patients' perceptions and behaviors as well as social determinants of health.
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Energy Technology Data Exchange (ETDEWEB)
Pigg, Scott [Energy Center of Wisconsin, Madison, WI (United States); Cautley, Dan [Energy Center of Wisconsin, Madison, WI (United States); Francisco, Paul [Univ. of Illinois, Urbana-Champaign, IL (United States); Hawkins, Beth A [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brennan, Terry M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
2014-09-01
This report summarizes findings from a national field study of indoor air quality parameters in homes treated under the Weatherization Assistance Program (WAP). The study involved testing and monitoring in 514 single-family homes (including mobile homes) located in 35 states and served by 88 local weatherization agencies.
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Automatic generation of computer programs servicing TFTR console displays
International Nuclear Information System (INIS)
Eisenberg, H.
1983-01-01
A number of alternatives were considered in providing programs to support the several hundred displays required for control and monitoring of TFTR equipment. Since similar functions were performed, an automated method of creating programs was suggested. The complexity of a single program servicing as many as thirty consoles mitigated against that approach. Similarly, creation of a syntactic language while elegant, was deemed to be too time consuming, and had the disadvantage of requiring a working knowledge of the language on a programming level. It was elected to pursue a method of generating an individual program to service a particular display. A feasibility study was conducted and the Control and Monitor Display Generator system (CMDG) was developed. A Control and Monitor Display Service Program (CMDS) provides a means of performing monitor and control functions for devices associated with TFTR subsystems, as well as other user functions, via TFTR Control Consoles. This paper discusses the specific capabilities provided by CMDS in a usage context, as well as the mechanics of implementation
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International Nuclear Information System (INIS)
Sato, Haruo
2001-01-01
A program (TDROCK1. FOR) for simulation and analysis of through-diffusion experiments for a single layer of diffusion media was developed. This program was made by Pro-Fortran language, which was suitable for scientific and technical calculations, and relatively easy explicit difference method was adopted for an analysis. In the analysis, solute concentration in the tracer cell as a function of time that we could not treat to date can be input and the decrease in the solute concentration as a function of time by diffusion from the tracer cell to the measurement cell, the solute concentration distribution in the porewater of diffusion media and the solute concentration in the measurement cell as a function of time can be calculated. In addition, solution volume in both cells and diameter and thickness of the diffusion media are also variable as an input condition. This simulation program could well explain measured result by simulating solute concentration in the measurement cell as a function of time for case which apparent and effective diffusion coefficients were already known. Based on this, the availability and applicability of this program to actual analysis and simulation were confirmed. This report describes the theoretical treatment for the through-diffusion experiments for a single layer of diffusion media, analytical model, an example of source program and the manual. (author)
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Directory of Open Access Journals (Sweden)
FD Richard Hobbs
2007-11-01
Full Text Available FD Richard HobbsUniversity of Birmingham, Edgbaston, Birmingham B15 2TT, UK.Abstract: In order to prevent cardiovascular events, it is essential to effectively manage overall risk of cardiovascular disease. However, despite guideline recommendations to this effect, current management of the major, modifiable cardiovascular risk factors such as hypertension and dyslipidemia is disconnected and patient adherence to therapy is poor. This is particularly important for patients with multiple cardiovascular risk factors, who are often prescribed multiple medications. The JEWEL study program investigated the use of single-pill amlodipine/atorvastatin as a strategy to improve management of these patients. The JEWEL program consisted of two 16-week, international, openlabel, multicenter, titration-to-goal studies in patients with hypertension and dyslipidemia. The two studies differed based on country of enrollment and certain tertiary endpoints, but the overall designs were very similar. Patients were enrolled from 255 centers across Canada and 13 European countries. The study was designed to assess the efficacy, safety, and utility of amlodipine/atorvastatin single pill therapy in a real-world setting. Patients were initiated at a dose of amlodipine 5 mg/atorvastatin 10 mg, unless previously treated, and were uptitrated as necessary. The primary efficacy parameter was the percentage of patients, at different levels of cardiovascular risk, achieving country-specific guideline-recommended target levels for blood pressure and lipids. A secondary analysis of efficacy measured attainment of the same single goal for blood pressure across all study participants (JEWEL I and II and the same single goal for LDL-C across all study participants (JEWEL I and II. The program utilized a newly developed questionnaire to gain better understanding of participants’ beliefs and behaviors towards medical treatment of their multiple risk factors. Approximately 2850
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Energy Technology Data Exchange (ETDEWEB)
Garner, P.L.; Blomquist, R.N.; Gelbard, E.M.
1992-09-01
The COMMIX-1AR/P computer program is designed for analyzing the steady-state and transient aspects of single-phase fluid flow and heat transfer in three spatial dimensions. This version is an extension of the modeling in COMMIX-1A to include multiple fluids in physically separate regions of the computational domain, modeling descriptions for pumps, radiation heat transfer between surfaces of the solids which are embedded in or surround the fluid, a k-{var_epsilon} model for fluid turbulence, and improved numerical techniques. The porous-medium formulation in COMMIX allows the program to be applied to a wide range of problems involving both simple and complex geometrical arrangements. The input preparation and execution procedures are presented for the COMMIX-1AR/P program and several postprocessor programs which produce graphical displays of the calculated results.
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Diabetes benefit management: evolving strategies for payers.
Tzeel, Albert L
2011-11-01
Over the next quarter century, the burden of type 2 diabetes mellitus (T2DM) is expected to at least double. Currently, 1 in every 10 healthcare dollars is spent on diabetes management; by 2050, it has been projected that the annual costs of managing T2DM will rise to $336 billion. Without substantial, systemic changes, T2DM management costs will lead to a potentially untenable strain on the healthcare system. However, the appropriate management of diabetes can reduce associated mortality and delay comorbidities. In addition, adequate glycemic control can improve patient outcomes and significantly reduce diabetes-related complications. This article provides an overview of key concepts associated with a value-based insurance design (VBID) approach to T2DM coverage. By promoting the use of services or treatments that provide high benefits relative to cost, and by alternatively discouraging patients from utilizing services whose benefits do not justify their cost, VBID improves the quality of healthcare while simultaneously reining in spending. VBID initiatives tend to focus on chronic disease management and generally target prescription drug use. However, some programs have expanded their scope by incorporating services traditionally offered by wellness and disease management programs. The concept of VBID is growing, and it is increasingly being implemented by a diverse and growing number of public and private entities, including pharmacy benefit managers, health plans, and employers. This article provides key background on VBID strategies, with a focus on T2DM management. It also provides a road map for health plans seeking to implement VBID as part of their programs.
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The use of a break-even analysis: financial analysis of a fast-track program.
Saywell, R M; Cordell, W H; Nyhuis, A W; Giles, B K; Culler, S D; Woods, J R; Chu, D K; McKinzie, J P; Rodman, G H
1995-08-01
To calculate the financial break-even point and illustrate how changes in third-party reimbursement and eligibility could affect a program's fiscal standing. Demographic, clinical, and financial data were collected retrospectively for 446 patients treated in a fast-track program during June 1993. The fast-track program is located within the confines of the emergency medicine and trauma center at a 1,050-bed tertiary care Midwestern teaching hospital and provides urgent treatment to minimally ill patients. A financial break-even analysis was performed to determine the point where the program generated enough revenue to cover its total variable and fixed costs, both direct and indirect. Given the relatively low average collection rate (62%) and high percentage of uninsured patients (31%), the analysis showed that the program's revenues covered its direct costs but not all of the indirect costs. Examining collection rates or payer class mix without examining both costs and revenues may lead to an erroneous conclusion about a program's fiscal viability. Sensitivity analysis also shows that relatively small changes in third-party coverage or eligibility (income) requirements can have a large impact on the program's financial solvency and break-even volumes.
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Content and goals of preclinical prosthodontic programs at german-language dental schools.
Hey, Jeremias; Stimmelmayr, Michael; Hirsch, Christian; Beuer, Florian
2014-04-01
The Association for Dental Education in Europe (ADEE) makes recommendations regarding the skills graduates of European dental schools need to achieve and advises dental schools regarding necessary changes to be made to the curriculum. In 2010 to 2011, a survey was conducted in German-language dental schools to validate the curricula and goals of preclinical prosthodontic programs with regard to laboratory work. The survey was mailed to the course instructors of the preclinical programs at 37 dental schools. Of these, 35 schools returned the completed survey, resulting in a response rate of 95%. Bent wire, wax-up exercises, metal-ceramic single crowns, fixed dental prostheses, cast metal single crowns, temporary removable dental prostheses, and full dentures were part of the dental laboratory work at most schools; however, most instructors considered laboratory work as less important, and there were few similarities among the programs in this area. According to the instructors responsible for preclinical education, honing of fine motor skills, realistic self-assessment, and the ability to work independently were the main goals of the programs. The results of this survey show that with regard to laboratory work, there were more differences than similarities among preclinical prosthodontic programs at German-language dental schools, contrary to the recommendations of the ADEE. These findings should be taken into account when program reforms are planned. © 2013 by the American College of Prosthodontists.
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Energy Technology Data Exchange (ETDEWEB)
Goldberg, Amelie [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hedman, Bruce [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Taylor, Robert P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Russell, Christopher [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
2015-10-01
Many states have implemented ratepayer-funded programs to acquire energy efficiency as a predictable and reliable resource for meeting existing and future energy demand. These programs have become a fixture in many U.S. electricity and natural gas markets as they help postpone or eliminate the need for expensive generation and transmission investments. Industrial energy efficiency (IEE) is an energy efficiency resource that is not only a low cost option for many of these efficiency programs, but offers productivity and competitive benefits to manufacturers as it reduces their energy costs. However, some industrial customers are less enthusiastic about participating in these programs. IEE ratepayer programs suffer low participation by industries across many states today despite a continual increase in energy efficiency program spending across all types of customers, and significant energy efficiency funds can often go unused for industrial customers. This paper provides four detailed case studies of companies that benefited from participation in their utility’s energy efficiency program offerings and highlights the business value brought to them by participation in these programs. The paper is designed both for rate-payer efficiency program administrators interested in improving the attractiveness and effectiveness of industrial efficiency programs for their industrial customers and for industrial customers interested in maximizing the value of participating in efficiency programs.
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Liew, K. H.; Urip, E.; Yang, S. L.; Marek, C. J.
2004-01-01
Droplet interaction with a high temperature gaseous crossflow is important because of its wide application in systems involving two phase mixing such as in combustion requiring quick mixing of fuel and air with the reduction of pollutants and for jet mixing in the dilution zone of combustors. Therefore, the focus of this work is to investigate dispersion of a two-dimensional atomized and evaporating spray jet into a two-dimensional crossflow. An interactive Microsoft Excel program for tracking a single droplet in crossflow that has previously been developed will be modified to include droplet evaporation computation. In addition to the high velocity airflow, the injected droplets are also subjected to combustor temperature and pressure that affect their motion in the flow field. Six ordinary differential equations are then solved by 4th-order Runge-Kutta method using Microsoft Excel software. Microsoft Visual Basic programming and Microsoft Excel macrocode are used to produce the data and plot graphs describing the droplet's motion in the flow field. This program computes and plots the data sequentially without forcing the user to open other types of plotting programs. A user's manual on how to use the program is included.
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A designated centre for people with disabilities operated by Health Service Executive, Meath
LENUS (Irish Health Repository)
Mikkers, Misja
2014-09-01
A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.
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Self-similar photonic crystal cavity with ultrasmall mode volume for single-photon nonlinearities
DEFF Research Database (Denmark)
Choi, Hyeongrak; Heuck, Mikkel; Englund, Dirk
2017-01-01
We propose a photonic crystal cavity design with self-similar structure to achieve ultrasmall mode volume. We describe the concept with a silicon-air nanobeam cavity at λ ∼ 1550nm, reaching a mode volume of ∼ 7.01 × 10∼5λ3.......We propose a photonic crystal cavity design with self-similar structure to achieve ultrasmall mode volume. We describe the concept with a silicon-air nanobeam cavity at λ ∼ 1550nm, reaching a mode volume of ∼ 7.01 × 10∼5λ3....
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Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B
2016-06-01
Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.
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Jones, Rachel A; Kelly, Jacque; Cliff, Dylan P; Batterham, Marijka; Okely, Anthony D
2015-11-01
Single sex after-school physical activity programs show potential to prevent unhealthy weight gain. The aim of this study was to assess the acceptability and potential efficacy of single-sex after-school physical activity programs for overweight and at-risk children from low-income communities. 7-month, 2-arm parallel-group, RCT, conducted at an elementary school in a disadvantaged area in Wollongong, Australia (March-November 2010). 20 boys and 17 girls were randomized to intervention (PA) or active comparison groups (HL). Primary outcomes included implementation, acceptability, percentage body fat and BMI z-score. The PA programs were acceptable with high implementation and enjoyment rates. At 7 months postintervention girls in the PA group displayed greater changes in percentage body fat (adjust diff. = -1.70, [95% CI -3.25, -0.14]; d = -0.83) and BMI z-score (-0.19 [-0.36, -0.03]; d= -1.00). At 7 months boys in the PA group showed greater changes in waist circumference (-3.87 cm [-7.80, 0.15]; d= -0.90) and waist circumference z-score (-0.33 [-0.64, -0.03]; d= -0.98). For both boys' and girls' PA groups, changes in adiposity were not maintained at 12-month follow-up. Single-sex after-school physical activity programs are acceptable and potentially efficacious in preventing unhealthy weight gain among overweight and at-risk children. However improvements are hard to sustain once programs finish operating.
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International Nuclear Information System (INIS)
Knebel, J.U.
1995-01-01
The SUCO program is a three-step series of scaled model experiments investigating the optional sump cooling concept of the EPR. This concept is entirely based on passive safety features. This report presents the basic physical phenomena and scaling criteria of decay heat removal from a large coolant pool by single-phase and two-phase natural circulation flow. The physical significance of the dimensionless similarity groups derived is evaluated. The report gives first measurement results of the 1:20 linearly scaled plane two-dimensional SUCOS-2D test facility. The real height SUCOT test facility that is in its building up phase is presented. (orig.)
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BLAST and FASTA similarity searching for multiple sequence alignment.
Pearson, William R
2014-01-01
BLAST, FASTA, and other similarity searching programs seek to identify homologous proteins and DNA sequences based on excess sequence similarity. If two sequences share much more similarity than expected by chance, the simplest explanation for the excess similarity is common ancestry-homology. The most effective similarity searches compare protein sequences, rather than DNA sequences, for sequences that encode proteins, and use expectation values, rather than percent identity, to infer homology. The BLAST and FASTA packages of sequence comparison programs provide programs for comparing protein and DNA sequences to protein databases (the most sensitive searches). Protein and translated-DNA comparisons to protein databases routinely allow evolutionary look back times from 1 to 2 billion years; DNA:DNA searches are 5-10-fold less sensitive. BLAST and FASTA can be run on popular web sites, but can also be downloaded and installed on local computers. With local installation, target databases can be customized for the sequence data being characterized. With today's very large protein databases, search sensitivity can also be improved by searching smaller comprehensive databases, for example, a complete protein set from an evolutionarily neighboring model organism. By default, BLAST and FASTA use scoring strategies target for distant evolutionary relationships; for comparisons involving short domains or queries, or searches that seek relatively close homologs (e.g. mouse-human), shallower scoring matrices will be more effective. Both BLAST and FASTA provide very accurate statistical estimates, which can be used to reliably identify protein sequences that diverged more than 2 billion years ago.
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Directory of Open Access Journals (Sweden)
Stanimirović Ivan
2009-01-01
Full Text Available We introduce a heuristic method for the single resource constrained project scheduling problem, based on the dynamic programming solution of the knapsack problem. This method schedules projects with one type of resources, in the non-preemptive case: once started an activity is not interrupted and runs to completion. We compare the implementation of this method with well-known heuristic scheduling method, called Minimum Slack First (known also as Gray-Kidd algorithm, as well as with Microsoft Project.
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Virk, Sohrab S; Phillips, Frank M; Khan, Safdar N
2018-03-01
OBJECTIVE Cervical spondylotic myelopathy (CSM) is a progressive spinal condition that often requires surgery. Studies have shown the clinical equivalency of anterior versus posterior approaches for CSM surgery. The purpose of this study was to determine the amount and type of resources used for anterior and posterior surgical treatment of CSM by using large national databases of clinical and financial information from patients. METHODS This study consists of 2 large cohorts of patients who underwent either an anterior or posterior approach for treatment of CSM. These patients were selected from the Medicare 5% National Sample Administrative Database (SAF5) and the Humana orthopedic database (HORTHO), which is a database of patients with private payer health insurance. The outcome measures were the cost of a 90-day episode of care, as well as a breakdown of the cost components for each surgical procedure between 2005 and 2014. RESULTS A total of 16,444 patients were included in this analysis. In HORTHO, there were 10,332 and 1556 patients treated with an anterior or posterior approach for CSM, respectively. In SAF5, there were 3851 and 705 patients who were treated by an anterior or posterior approach for CSM, respectively. The mean ± SD reimbursements for anterior and posterior approaches in the HORTHO database were $20,863 ± $2014 and $23,813 ± $4258, respectively (p = 0.048). The mean ± SD reimbursements for anterior and posterior approaches in the SAF5 database were $18,219 ± $1053 and $25,598 ± $1686, respectively (p reimbursements for a rehabilitation/skilled nursing facility and hospital/inpatient care for patients who underwent a posterior approach in both the private payer and Medicare databases. In all cohorts in this study, the hospital-related reimbursement was more than double the surgeon-related reimbursement. CONCLUSIONS This study provides resource utilization information for a 90-day episode of care for both anterior and posterior approaches
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Pythoscape: a framework for generation of large protein similarity networks.
Barber, Alan E; Babbitt, Patricia C
2012-11-01
Pythoscape is a framework implemented in Python for processing large protein similarity networks for visualization in other software packages. Protein similarity networks are graphical representations of sequence, structural and other similarities among proteins for which pairwise all-by-all similarity connections have been calculated. Mapping of biological and other information to network nodes or edges enables hypothesis creation about sequence-structure-function relationships across sets of related proteins. Pythoscape provides several options to calculate pairwise similarities for input sequences or structures, applies filters to network edges and defines sets of similar nodes and their associated data as single nodes (termed representative nodes) for compression of network information and output data or formatted files for visualization.
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Evaluation of single photon and Geiger mode Lidar for the 3D Elevation Program
Stoker, Jason M.; Abdullah, Qassim; Nayegandhi, Amar; Winehouse, Jayna
2016-01-01
Data acquired by Harris Corporation’s (Melbourne, FL, USA) Geiger-mode IntelliEarth™ sensor and Sigma Space Corporation’s (Lanham-Seabrook, MD, USA) Single Photon HRQLS sensor were evaluated and compared to accepted 3D Elevation Program (3DEP) data and survey ground control to assess the suitability of these new technologies for the 3DEP. While not able to collect data currently to meet USGS lidar base specification, this is partially due to the fact that the specification was written for linear-mode systems specifically. With little effort on part of the manufacturers of the new lidar systems and the USGS Lidar specifications team, data from these systems could soon serve the 3DEP program and its users. Many of the shortcomings noted in this study have been reported to have been corrected or improved upon in the next generation sensors.
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Directory of Open Access Journals (Sweden)
Dewi Kusuma Wardani
2017-10-01
Full Text Available This study aimed to examine the effect of knowledge of the taxpayer, the taxpayer awareness, and Program SAMSAT Corner on tax compliance in the Motor Vehicle Galeria Mall. The data used in this study are primary data from the results of questionnaires. Respondents in this study Motor Vehicle Taxpayers who make tax payments in SAMSAT Corner Galeria Mall Yogyakarta. The questionnaire was distributed to 108 respondents and data that can be processed as many as 105 questionnaires. The sampling method using Accidental Sampling. Data analysis techniques in this study using multiple linear regression techniques. Results of regression analysis showed that awareness of the taxpayer and Corner Program SAMSAT positive effect on tax compliance while the Motor Vehicle Tax Payer knowledge no significant effect on motor vehicle tax compliance. Keywords: Taxpayer Knowledge, Consciousness Taxpayer, SAMSAT Corner and Compliance Program Compulsory Motor Vehicle Tax
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Directory of Open Access Journals (Sweden)
Kai-Chun Chang
2012-01-01
Full Text Available Programmed ribosomal frameshifting (PRF serves as an intrinsic translational regulation mechanism employed by some viruses to control the ratio between structural and enzymatic proteins. Most viral mRNAs which use PRF adapt an H-type pseudoknot to stimulate −1 PRF. The relationship between the thermodynamic stability and the frameshifting efficiency of pseudoknots has not been fully understood. Recently, single-molecule force spectroscopy has revealed that the frequency of −1 PRF correlates with the unwinding forces required for disrupting pseudoknots, and that some of the unwinding work dissipates irreversibly due to the torsional restraint of pseudoknots. Complementary to single-molecule techniques, computational modeling provides insights into global motions of the ribosome, whose structural transitions during frameshifting have not yet been elucidated in atomic detail. Taken together, recent advances in biophysical tools may help to develop antiviral therapies that target the ubiquitous −1 PRF mechanism among viruses.
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Typology of taxpayers and tax policy
Directory of Open Access Journals (Sweden)
Niesiobedzka Malgorzata
2014-09-01
Full Text Available The issue how to reduce of tax evasion is widely discussed in the literature. A public authority may affect the behavior of taxpayers, not only through economic factors, but also by strengthen fiscal discipline. In this process especially role play such issues as tax morale, tax mentality and perceived tax justice. The purpose of the study was to identify groups of taxpayers with similar attitudes towards taxes and similar tax behaviors. Cluster analysis elicited four types of tax payers: Intrinsic Tax Payer, External Tax Payer, Intrinsic Tax Evader, External Tax Evader. In the study the most common were the first two types of taxpayers. Elicited types correspond with motivational tax postures identified by Braithwaite(2001, 2003 and Torgler (2003. The conclusions sum up the key issues discussed, policy implications and the limitation of the analysis.
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Energy Technology Data Exchange (ETDEWEB)
Shipman, Galen M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
2016-06-13
These are the slides for a presentation on programming models in HPC, at the Los Alamos National Laboratory's Parallel Computing Summer School. The following topics are covered: Flynn's Taxonomy of computer architectures; single instruction single data; single instruction multiple data; multiple instruction multiple data; address space organization; definition of Trinity (Intel Xeon-Phi is a MIMD architecture); single program multiple data; multiple program multiple data; ExMatEx workflow overview; definition of a programming model, programming languages, runtime systems; programming model and environments; MPI (Message Passing Interface); OpenMP; Kokkos (Performance Portable Thread-Parallel Programming Model); Kokkos abstractions, patterns, policies, and spaces; RAJA, a systematic approach to node-level portability and tuning; overview of the Legion Programming Model; mapping tasks and data to hardware resources; interoperability: supporting task-level models; Legion S3D execution and performance details; workflow, integration of external resources into the programming model.
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Directory of Open Access Journals (Sweden)
Livingston James M
2007-06-01
Full Text Available Abstract Background Claims data provide rapid indicators of SSIs for coronary artery bypass surgery and have been shown to successfully rank hospitals by SSI rates. We now operationalize this method for use by payers without transfer of protected health information, or any insurer data, to external analytic centers. Results We performed a descriptive study testing the operationalization of software for payers to routinely assess surgical infection rates among hospitals where enrollees receive cardiac procedures. We developed five SAS programs and a user manual for direct use by health plans and payers. The manual and programs were refined following provision to two national insurers who applied the programs to claims databases, following instructions on data preparation, data validation, analysis, and verification and interpretation of program output. A final set of programs and user manual successfully guided health plan programmer analysts to apply SSI algorithms to claims databases. Validation steps identified common problems such as incomplete preparation of data, missing data, insufficient sample size, and other issues that might result in program failure. Several user prompts enabled health plans to select time windows, strata such as insurance type, and the threshold number of procedures performed by a hospital before inclusion in regression models assessing relative SSI rates among hospitals. No health plan data was transferred to outside entities. Programs, on default settings, provided descriptive tables of SSI indicators stratified by hospital, insurer type, SSI indicator (inpatient, outpatient, antibiotic, and six-month period. Regression models provided rankings of hospital SSI indicator rates by quartiles, adjusted for comorbidities. Programs are publicly available without charge. Conclusion We describe a free, user-friendly software package that enables payers to routinely assess and identify hospitals with potentially high SSI
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Aluminum-rich mesoporous MFI - type zeolite single crystals
DEFF Research Database (Denmark)
Kustova, Marina; Kustov, Arkadii; Christensen, Christina Hviid
2005-01-01
Zeolitcs are crystalline materials, which are widely used as solid acid catalysts and supports in many industrial processes. Recently, mesoporous MFI-type zeolite single crystals were synthesized by use of carbon particles as a mesopore template and sodium aluminate as the aluminum Source....... With this technique, only zeolites with relatively low Al contents were reported (Si/Al ratio about 100). In this work, the preparation of aluminum-rich mesoporous MFI-type zeolite single crystals (Si/Al similar to 16-50) using aluminum isopropoxide as the aluminum Source is reported for the first time. All samples...... are characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM), ammonia temperature programmed desorption (NH3-TPD), and N-2 adsorption measurements. The obtained zeolites combine the high crystallinity and the characteristic micropores of zeolites with an intracrystalline mesopore system...
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Computer programs in accelerator physics
International Nuclear Information System (INIS)
Keil, E.
1984-01-01
Three areas of accelerator physics are discussed in which computer programs have been applied with much success: i) single-particle beam dynamics in circular machines, i.e. the design and matching of machine lattices; ii) computations of electromagnetic fields in RF cavities and similar objects, useful for the design of RF cavities and for the calculation of wake fields; iii) simulation of betatron and synchrotron oscillations in a machine with non-linear elements, e.g. sextupoles, and of bunch lengthening due to longitudinal wake fields. (orig.)
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76 FR 26147 - Caregivers Program
2011-05-05
... furnish directly, by contract, or through provision of case management by another provider or payer.'') VA... injury, psychological trauma, or other mental disorder, incurred or aggravated in the line of duty in the... and servicemembers whose serious injury is a psychological trauma or mental disorder, and who have...
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Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina
2012-01-01
Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.
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Nuijten, Mark; Marczewska, Agnieszka; Araujo Torress, Krysmaru; Rasouli, Bahareh; Perugini, Moreno
2018-04-20
Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. High prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer's perspective. Within the variety of weight management techniques, OPTIFAST ® is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities. The objective of this study is assess potential cost-savings of OPTIFAST ® program in the USA, as compared to "no intervention" and pharmacotherapy. An event-driven decision analytic model was used to estimate payer's cost-savings from reimbursement of the 1-year OPTIFAST ® program over 3 years in the USA. The analysis was performed for the broad population of obese persons (BMI >30 kg/m 2 ) undergoing the OPTIFAST ® program versus liraglutide 3 mg, naltrexone/bupropion and versus "no intervention". The model included risk of complications related to increased BMI. Data sources included published literature, clinical trials, official USA price/tariff lists and national population statistics. The primary perspective was that of a USA payer; costs provided in 2016 US dollars. OPTIFAST ® leads over a period of 3 years to cost-savings of USD 9,285 per class I and II obese patient (BMI 30-39.9 kg/m 2 ) as compared to liraglutide and USD 685 as compared to naltrexone/bupropion. In the same time perspective, the OPTIFAST ® program leads to a reduction of cost of obesity complications of USD 1,951 as compared to "no intervention" with the incremental cost-effectiveness ratio of USD 6,475 per QALY. Scenario analyses show also substantial cost-savings in patients with class III obesity (BMI ≥40.0 kg/m 2 ) and patients with obesity (BMI 30-39.9 kg/m2) and type 2 diabetes versus all three previous comparators and bariatric surgery. Reimbursing OPTIFAST ® leads to meaningful cost
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Energy Technology Data Exchange (ETDEWEB)
Los Arcos Merino, J M
1978-07-01
The program LONGO provides the block size and the block number in a binary file on magnetic tape. It has been applied to analyse the structure of the nine-track magnetic tapes storing single or coincidence gamma spectra files, recorded in octet form by a MULTI-8 minicomputer in the Nuclear Spectrometry Laboratory of J.E.N. Then the program DIRE has been written to transform the single gamma spectra into a new FASTRAND disk file, storing the information in-36 bit words. A copy of this file is obtained on magnetic tape and the single gamma spectra are then available by standard FORTRAN V reading sentences. (Author) 3 refs.
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Early intervention for stuttering: similarities and differences between two programs
Aumont-Boucand, V.; Millard, S.; Packman, A.
2014-01-01
In this paper, two proponents of different approaches to early stuttering discuss how they would manage a hypothetical case of stuttering in a preschool-age girl. Two evidence-based approaches are discussed: Palin Parent-Child Interaction Therapy and the Lidcombe Program. This paper arose from an oral discussion session held at the International Fluency Association Conference in Tours, France in 2012.
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Wu, David Bin-Chia; Roberts, Craig; Lee, Vivian Wing Yan; Hong, Li-Wen; Tan, Kah Kee; Mak, Vivienne; Lee, Kenneth Kwing Chin
2016-01-01
Pneumococcal disease causes large morbidity, mortality and health care utilization and medical and non-medical costs, which can all be reduced by effective infant universal routine immunization programs with pneumococcal conjugate vaccines (PCV). We evaluated the clinical and economic benefits of such programs with either 10- or 13-valent PCVs in Malaysia and Hong Kong by using an age-stratified Markov cohort model with many country-specific inputs. The incremental cost per quality-adjusted life year (QALY) was calculated to compare PCV10 or PCV13 against no vaccination and PCV13 against PCV10 over a 10-year birth cohort's vaccination. Both payer and societal perspectives were used. PCV13 had better public health and economic outcomes than a PCV10 program across all scenarios considered. For example, in the base case scenario in Malaysia, PCV13 would reduce more cases of IPD (+2,296), pneumonia (+705,281), and acute otitis media (+376,967) and save more lives (+6,122) than PCV10. Similarly, in Hong Kong, PCV13 would reduce more cases of IPD cases (+529), pneumonia (+172,185), and acute otitis media (+37,727) and save more lives (+2,688) than PCV10. During the same time horizon, PCV13 would gain over 74,000 and 21,600 additional QALYs than PCV10 in Malaysia and Hong Kong, respectively. PCV13 would be cost saving when compared against similar program with PCV10, under both payer and societal perspective in both countries. PCV13 remained a better choice over PCV10 in multiple sensitivity, scenario, and probabilistic analyses. PCV13s broader serotype coverage in its formulation and herd effect compared against PCV10 were important drivers of differences in outcomes. PMID:26451658
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Wu, David Bin-Chia; Roberts, Craig; Lee, Vivian Wing Yan; Hong, Li-Wen; Tan, Kah Kee; Mak, Vivienne; Lee, Kenneth Kwing Chin
2016-01-01
Pneumococcal disease causes large morbidity, mortality and health care utilization and medical and non-medical costs, which can all be reduced by effective infant universal routine immunization programs with pneumococcal conjugate vaccines (PCV). We evaluated the clinical and economic benefits of such programs with either 10- or 13-valent PCVs in Malaysia and Hong Kong by using an age-stratified Markov cohort model with many country-specific inputs. The incremental cost per quality-adjusted life year (QALY) was calculated to compare PCV10 or PCV13 against no vaccination and PCV13 against PCV10 over a 10-year birth cohort's vaccination. Both payer and societal perspectives were used. PCV13 had better public health and economic outcomes than a PCV10 program across all scenarios considered. For example, in the base case scenario in Malaysia, PCV13 would reduce more cases of IPD (+2,296), pneumonia (+705,281), and acute otitis media (+376,967) and save more lives (+6,122) than PCV10. Similarly, in Hong Kong, PCV13 would reduce more cases of IPD cases (+529), pneumonia (+172,185), and acute otitis media (+37,727) and save more lives (+2,688) than PCV10. During the same time horizon, PCV13 would gain over 74,000 and 21,600 additional QALYs than PCV10 in Malaysia and Hong Kong, respectively. PCV13 would be cost saving when compared against similar program with PCV10, under both payer and societal perspective in both countries. PCV13 remained a better choice over PCV10 in multiple sensitivity, scenario, and probabilistic analyses. PCV13s broader serotype coverage in its formulation and herd effect compared against PCV10 were important drivers of differences in outcomes.
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Restructured site characterization program at Yucca Mountain
International Nuclear Information System (INIS)
Dyer, J.R.; Vawter, R.G.
1995-01-01
During 1994 and the early part of 1995, the US Department of Energy's Yucca Mountain Site Characterization Office (YMSCO) and its parent organization, the Office of Civilian Radioactive Waste Management (OCRWM) underwent a significant restructuring. Senior Department officials provided the leadership to reorient the management, technical, programmatic, and public interaction approach to the US High Level Radioactive Waste Disposal Program. The restructuring involved reorganizing the federal staff, conducting meaningful strategic planning, improving the management system, rationalizing contractor responsibilities, focusing upon major products, and increasing stakeholder involvement. The restructured program has prioritized technical and scientific activities toward meeting major regulatory milestones in a timely and cost-effective manner. This approach has raised concern among elements of technical, scientific, and oversight bodies that suitability and licensing decisions could be made without obtaining sufficient technical information for this first-of-its-kind endeavor. Other organizations, such as congressional committees, industrial groups, and rate payers believe characterization goals can be met in a timely manner and within the limitation of available funds. To balance these contrasting views in its decision making process, OCRWM management has made a special effort to communicate its strategy to oversight bodies, the scientific community and other stakeholders and to use external independent peer review as a key means of demonstrating scientific credibility. Site characterization of Yucca Mountain in Nevada is one of the key elements of the restructured program
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Multi-scale structural similarity index for motion detection
Directory of Open Access Journals (Sweden)
M. Abdel-Salam Nasr
2017-07-01
Full Text Available The most recent approach for measuring the image quality is the structural similarity index (SSI. This paper presents a novel algorithm based on the multi-scale structural similarity index for motion detection (MS-SSIM in videos. The MS-SSIM approach is based on modeling of image luminance, contrast and structure at multiple scales. The MS-SSIM has resulted in much better performance than the single scale SSI approach but at the cost of relatively lower processing speed. The major advantages of the presented algorithm are both: the higher detection accuracy and the quasi real-time processing speed.
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Single-edition quadrangle maps
,
1998-01-01
In August 1993, the U.S. Geological Survey's (USGS) National Mapping Division and the U.S. Department of Agriculture's Forest Service signed an Interagency Agreement to begin a single-edition joint mapping program. This agreement established the coordination for producing and maintaining single-edition primary series topographic maps for quadrangles containing National Forest System lands. The joint mapping program saves money by eliminating duplication of effort by the agencies and results in a more frequent revision cycle for quadrangles containing national forests. Maps are revised on the basis of jointly developed standards and contain normal features mapped by the USGS, as well as additional features required for efficient management of National Forest System lands. Single-edition maps look slightly different but meet the content, accuracy, and quality criteria of other USGS products. The Forest Service is responsible for the land management of more than 191 million acres of land throughout the continental United States, Alaska, and Puerto Rico, including 155 national forests and 20 national grasslands. These areas make up the National Forest System lands and comprise more than 10,600 of the 56,000 primary series 7.5-minute quadrangle maps (15-minute in Alaska) covering the United States. The Forest Service has assumed responsibility for maintaining these maps, and the USGS remains responsible for printing and distributing them. Before the agreement, both agencies published similar maps of the same areas. The maps were used for different purposes, but had comparable types of features that were revised at different times. Now, the two products have been combined into one so that the revision cycle is stabilized and only one agency revises the maps, thus increasing the number of current maps available for National Forest System lands. This agreement has improved service to the public by requiring that the agencies share the same maps and that the maps meet a
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Dissecting human cerebral organoids and fetal neocortex using single-cell RNAseq
Treutlein, Barbara
Cerebral organoids - three-dimensional cultures of human cerebral tissue derived from pluripotent stem cells - have emerged as models of human cortical development. However, the extent to which in vitro organoid systems recapitulate neural progenitor cell proliferation and neuronal differentiation programs observed in vivo remains unclear. Here we use single-cell RNA sequencing (scRNA-seq) to dissect and compare cell composition and progenitor-to-neuron lineage relationships in human cerebral organoids and fetal neocortex. Covariation network analysis using the fetal neocortex data reveals known and novel interactions among genes central to neural progenitor proliferation and neuronal differentiation. In the organoid, we detect diverse progenitors and differentiated cell types of neuronal and mesenchymal lineages, and identify cells that derived from regions resembling the fetal neocortex. We find that these organoid cortical cells use gene expression programs remarkably similar to those of the fetal tissue in order to organize into cerebral cortex-like regions. Our comparison of in vivo and in vitro cortical single cell transcriptomes illuminates the genetic features underlying human cortical development that can be studied in organoid cultures.
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Hao, Yanni; Thomas, Adrian
2013-08-01
We briefly review the characteristics of several established health technology assessment (HTA) programs in industrialized societies including Germany, the UK and France. Special attention is paid on two issues: the position of HTA in coverage decision making and the role of economic assessment in evaluation processes. Although law makers in the USA have barred the use of NICE's cost/quality-adjusted life year or similar health economics approaches by public payers for coverage decision making, there are suggestions of prioritizing relative efficacy evaluation over economic assessment under a comparative effectiveness research (CER) framework to inform payment rates of public payers (an approach similar to German and French HTA processes). However, such an approach is unlikely to prove viable. It should also be noted that, if cost considerations are made explicit in US CER policy decisions, CER may become an unsustainable approach undermined by a conflicting emphasis on both cost containment and a demand for costly comparative evidence. On the other hand, properly designed CER initiatives can serve as a facilitator of more efficient research activities and drug development models. With these points in mind, the likely pathway of US CER is explored and the plausible impact on industry innovation is discussed.
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Grossman, Douglas; Farnham, James M; Hyngstrom, John; Klapperich, Marki E; Secrest, Aaron M; Empey, Sarah; Bowen, Glen M; Wada, David; Andtbacka, Robert H I; Grossmann, Kenneth; Bowles, Tawnya L; Cannon-Albright, Lisa A
2018-03-01
Survival data are mixed comparing patients with multiple primary melanomas (MPM) to those with single primary melanomas (SPM). We compared MPM versus SPM patient survival using a matching method that avoids potential biases associated with other analytic approaches. Records of 14,138 individuals obtained from the Surveillance, Epidemiology, and End Results registry of all melanomas diagnosed or treated in Utah between 1973 and 2011 were reviewed. A single matched control patient was selected randomly from the SPM cohort for each MPM patient, with the restriction that they survived at least as long as the interval between the first and second diagnoses for the matched MPM patient. Survival curves (n = 887 for both MPM and SPM groups) without covariates showed a significant survival disadvantage for MPM patients (chi-squared 39.29, P < .001). However, a multivariate Cox proportional hazards model showed no significant survival difference (hazard ratio 1.07, P = .55). Restricting the multivariate analysis to invasive melanomas also showed no significant survival difference (hazard ratio 0.99, P = .96). Breslow depth, ulceration status, and specific cause of death were not available for all patients. Patients with MPM had similar survival times as patients with SPM. Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
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Performance management and goal ambiguity: managerial implications in a single payer system.
Calciolari, Stefano; Cantù, Elena; Fattore, Giovanni
2011-01-01
Goal ambiguity influences the effectiveness of performance management systems to drive organizations toward enhanced results. The literature analyzes the antecedents of goal ambiguity and shows the influence of goal ambiguity on the performance of U.S. federal agencies. However, no study has analyzed goal ambiguity in other countries or in health care systems. This study has three aims: to test the validity of a measurement instrument for goal ambiguity, to investigate its main antecedents, and to explore the relationship between goal ambiguity and organizational performance in a large, public, Beveridge-type health care system. A nationwide survey of general managers of the Italian national health system was performed. A factor analysis was used to validate the mono-dimensionality of an instrument that measured goal ambiguity. Structural equation modeling was used to test both the antecedents and the influence of goal ambiguity on organizational performance. Data from 135 health care organizations (53% response rate) were available for analysis. The results confirm the mono-dimensionality of the instrument, the existence of two environmental sources of ambiguity (political endorsement and governance commitment), and the negative relationship between goal ambiguity and organizational performance. Goal ambiguity matters because it may hamper organizational performance. Therefore, performance should be fostered by reducing goal ambiguity (e.g., goal-setting model, funding arrangements, and political support). Mutatis mutandis, our results may apply to public health care systems of other countries or other "public interest" sectors, such as social care and education.
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Konak, H E; Kibar, S; Ergin, E S
2016-11-01
Osteoporosis is a serious disease characterized by muscle weakness in the lower extremities, shortened length of trunk, and increased dorsal kyphosis leading to poor balance performance. Although balance impairment increases in adults with osteoporosis, falls and fall-related injuries have been shown to occur mainly during the dual-task performance. Several studies have shown that dual-task performance was improved with specific repetitive dual-task exercises. The aims of this study were to compare the effect of single- and dual-task balance exercise programs on static balance, dynamic balance, and activity-specific balance confidence in adults with osteoporosis and to assess the effectiveness of dual-task balance training on gait speed under dual-task conditions. Older adults (N = 42) (age range, 45-88 years) with osteoporosis were randomly assigned into two groups. Single-task balance training group was given single-task balance exercises for 4 weeks, whereas dual-task balance training group received dual-task balance exercises. Participants received 45-min individualized training session, three times a week. Static balance was evaluated by one-leg stance (OLS) and a kinesthetic ability trainer (KAT) device. Dynamic balance was measured by the Berg Balance Scale (BBS), Time Up and Go (TUG) test, and gait speed. Self-confidence was assessed with the Activities-specific Balance Confidence (ABC-6) scale. Assessments were performed at baseline and after the 4-week program. At the end of the treatment periods, KAT score, BBS score, time in OLS and TUG, gait speeds under single- and dual-task conditions, and ABC-6 scale scores improved significantly in all patients (p gait speeds under single- and dual-task conditions showed significantly greater improvement in the dual-task balance training group than in the single-task balance training group (p gait speeds showed greater improvement following the application of a specific type of dual-task exercise programs
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Evolving provider payment models and patient access to innovative medical technology.
Long, Genia; Mortimer, Richard; Sanzenbacher, Geoffrey
2014-12-01
Abstract Objective: To investigate the evolving use and expected impact of pay-for-performance (P4P) and risk-based provider reimbursement on patient access to innovative medical technology. Structured interviews with leading private payers representing over 110 million commercially-insured lives exploring current and planned use of P4P provider payment models, evidence requirements for technology assessment and new technology coverage, and the evolving relationship between the two topics. Respondents reported rapid increases in the use of P4P and risk-sharing programs, with roughly half of commercial lives affected 3 years ago, just under two-thirds today, and an expected three-quarters in 3 years. All reported well-established systems for evaluating new technology coverage. Five of nine reported becoming more selective in the past 3 years in approving new technologies; four anticipated that in the next 3 years there will be a higher evidence requirement for new technology access. Similarly, four expected it will become more difficult for clinically appropriate but costly technologies to gain coverage. All reported planning to rely more on these types of provider payment incentives to control costs, but didn't see them as a substitute for payer technology reviews and coverage limitations; they each have a role to play. Interviews limited to nine leading payers with models in place; self-reported data. Likely implications include a more uncertain payment environment for providers, and indirectly for innovative medical technology and future investment, greater reliance on quality and financial metrics, and increased evidence requirements for favorable coverage and utilization decisions. Increasing provider financial risk may challenge the traditional technology adoption paradigm, where payers assumed a 'gatekeeping' role and providers a countervailing patient advocacy role with regard to access to new technology. Increased provider financial risk may result in an
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Biorthogonal projected energies of a Gutzwiller similarity transformed Hamiltonian.
Wahlen-Strothman, J M; Scuseria, G E
2016-12-07
We present a method incorporating biorthogonal orbital-optimization, symmetry projection, and double-occupancy screening with a non-unitary similarity transformation generated by the Gutzwiller factor [Formula: see text], and apply it to the Hubbard model. Energies are calculated with mean-field computational scaling with high-quality results comparable to coupled cluster singles and doubles. This builds on previous work performing similarity transformations with more general, two-body Jastrow-style correlators. The theory is tested on 2D lattices ranging from small systems into the thermodynamic limit and is compared to available reference data.
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Is the swiss health care system a model for the United States?
Chaufan, Claudia
2014-01-01
Both supporters and critics of the Patient Protection and Affordable Care Act (ACA) have argued that it is similar to Switzerland's Federal Law on Health Insurance (LAMal), which currently governs Swiss health care, and have either praised or condemned the ACA on the basis of this alleged similarity. I challenge these observers on the grounds that they overlook critical problems with the Swiss model, such as its inequities in access, and critical differences between it and the ACA, such as the roots in, and continuing commitment to, social insurance of the Swiss model. Indeed, the daunting challenge of attempting to impose the tightly regulated model of operation of the Swiss model on mega-corporations like UnitedHealth, WellPoint, or Aetna is likely to trigger no less ferocious resistance than a fully public, single-payer system would. I also conclude that the ACA might unravel in ways unintended or even opposed by its designers and supporters, as employers, confronted with ever-rising costs, retreat from sponsoring insurance, and workers react in outrage as they confront the unaffordable underinsurance mandated by the ACA. A new political and ideological landscape may then ensue that finally ushers in a truly national health program.
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Directory of Open Access Journals (Sweden)
Albert Corominas
Full Text Available A non-linear discrete-time mathematical program model is proposed to determining the optimal extraction policy for a single primary supplier of a durable non-renewable resource, such as gemstones or some metals. Karush, Kuhn and Tucker conditions allow obtaining analytic solutions and general properties of them in some specific settings. Moreover, provided that the objective function (i.e., the discounted value of the incomes throughout the planning horizon is concave, the model can be easily solved, even using standard commercial solver. However, the analysis of the solutions obtained for different assumptions of the values of the parameters show that the optimal extraction policies and the corresponding prices do not exhibit a general shape. Keywords: Durable non-renewable resources, Single primary supplier, Non-linear programming
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Chacko, Anil; Wymbs, Brian T.; Flammer-Rivera, Lizette M.; Pelham, William E.; Walker, Kathryn S.; Arnold, Fran W.; Visweswaraiah, Hema; Swanger-Gagne, Michelle; Girio, Erin L.; Pirvics, Lauma L.; Herbst, Laura
2008-01-01
Objective: The Strategies to Enhance Positive Parenting (STEPP) program was developed to address putative factors related to poor engagement in and outcomes following traditional behavioral parent training (BPT) for single mothers of children diagnosed with ADHD. Method: Twelve single mothers of children with ADHD were enrolled in an initial…
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Sneath, P. H. A.
A BASIC program is presented for significance tests to determine whether a dendrogram is derived from clustering of points that belong to a single multivariate normal distribution. The significance tests are based on statistics of the Kolmogorov—Smirnov type, obtained by comparing the observed cumulative graph of branch levels with a graph for the hypothesis of multivariate normality. The program also permits testing whether the dendrogram could be from a cluster of lower dimensionality due to character correlations. The program makes provision for three similarity coefficients, (1) Euclidean distances, (2) squared Euclidean distances, and (3) Simple Matching Coefficients, and for five cluster methods (1) WPGMA, (2) UPGMA, (3) Single Linkage (or Minimum Spanning Trees), (4) Complete Linkage, and (5) Ward's Increase in Sums of Squares. The program is entitled DENBRAN.
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Li, Elton; Stoecker, Arthur
1995-01-01
Describes a computer software program where students define alternative policy sets and compare their effects on the welfare of consumers, producers, and the public sector. Policy sets may be a single tax or quota or a mix of taxes, subsidies, and/or price supports implemented in the marketing chain. (MJP)
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Ackerman, Stacey J; Polly, David W; Knight, Tyler; Holt, Tim; Cummings, John
2014-01-01
Introduction Low back pain is common and originates in the sacroiliac (SI) joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US). Methods A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3), an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date), and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars) were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592) per privately-insured patient (N=78,533). Among patients with lumbar spinal fusion (N=434), attributable 3-year mean costs were $91,720 (SD $75,502) per patient compared to $15,776 (SD $27,542) per patient among patients without lumbar spinal fusion (N=78,099). Overall, inpatient hospitalizations (19.4%), hospital outpatient visits and procedures (14.0%), and outpatient pain medications (9.6%) accounted for the largest proportion of costs. The estimated 3-year insurance payments attributable to SI joint disruption
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Energy Technology Data Exchange (ETDEWEB)
Knebel, J.U.
1995-08-01
The SUCO program is a three-step series of scaled model experiments investigating the optional sump cooling concept of the EPR. This concept is entirely based on passive safety features. This report presents the basic physical phenomena and scaling criteria of decay heat removal from a large coolant pool by single-phase and two-phase natural circulation flow. The physical significance of the dimensionless similarity groups derived is evaluated. The report gives first measurement results of the 1:20 linearly scaled plane two-dimensional SUCOS-2D test facility. The real height SUCOT test facility that is in its building up phase is presented. (orig.)
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Wong, Jennifer
2016-01-01
School-based substance use prevention programs are a common method to approaching drug use in youths. Project SOS is a single-session drug prevention program developed by police officers and delivered by elite junior hockey players to students in grades 6 and 7. The current study evaluates the effects of Project SOS at achieving its objectives of…
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Rynkiewicz, Evelyn C; Brown, Julia; Tufts, Danielle M; Huang, Ching-I; Kampen, Helge; Bent, Stephen J; Fish, Durland; Diuk-Wasser, Maria A
2017-02-06
Wild hosts are commonly co-infected with complex, genetically diverse, pathogen communities. Competition is expected between genetically or ecologically similar pathogen strains which may influence patterns of coexistence. However, there is little data on how specific strains of these diverse pathogen species interact within the host and how this impacts pathogen persistence in nature. Ticks are the most common disease vector in temperate regions with Borrelia burgdorferi, the causative agent of Lyme disease, being the most common vector-borne pathogen in North America. Borrelia burgdorferi is a pathogen of high public health concern and there is significant variation in infection phenotype between strains, which influences predictions of pathogen dynamics and spread. In a laboratory experiment, we investigated whether two closely-related strains of B. burgdorferi (sensu stricto) showed similar transmission phenotypes, how the transmission of these strains changed when a host was infected with one strain, re-infected with the same strain, or co-infected with two strains. Ixodes scapularis, the black-legged tick, nymphs were used to sequentially infect laboratory-bred Peromyscus leucopus, white-footed mice, with one strain only, homologous infection with the same stain, or heterologous infection with both strains. We used the results of this laboratory experiment to simulate long-term persistence and maintenance of each strain in a simple simulation model. Strain LG734 was more competitive than BL206, showing no difference in transmission between the heterologous infection groups and single-infection controls, while strain BL206 transmission was significantly reduced when strain LG734 infected first. The results of the model show that this asymmetry in competition could lead to extinction of strain BL206 unless there was a tick-to-host transmission advantage to this less competitive strain. This asymmetric competitive interaction suggests that strain identity and
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Peters, L.W.H.; Wiefferink, C.H.; Hoekstra, F.; Buijs, G.J.; Ten Dam, G.T.M.; Paulussen, T.G.W.M.
2009-01-01
Schools are overloaded with health promotion programs that, altogether, focus on a broad array of behavioral domains, including substance abuse, sexuality and nutrition. Although the specific content of programs varies according to the domain focus, programs usually address similar concepts:
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Song, Chao; Liu, Emelline; Tackett, Scott; Shi, Lizheng; Marcus, Daniel
2017-06-01
This analysis aimed to evaluate trends in volumes and costs of primary elective incisional ventral hernia repairs (IVHRs) and investigated potential cost implications of moving procedures from inpatient to outpatient settings. A time series study was conducted using the Premier Hospital Perspective ® Database (Premier database) for elective IVHR identified by International Classification of Diseases, Ninth revision, Clinical Modification codes. IVHR procedure volumes and costs were determined for inpatient, outpatient, minimally invasive surgery (MIS), and open procedures from January 2008-June 2015. Initial visit costs were inflation-adjusted to 2015 US dollars. Median costs were used to analyze variation by site of care and payer. Quantile regression on median costs was conducted in covariate-adjusted models. Cost impact of potential outpatient migration was estimated from a Medicare perspective. During the study period, the trend for outpatient procedures in obese and non-obese populations increased. Inpatient and outpatient MIS procedures experienced a steady growth in adoption over their open counterparts. Overall median costs increased over time, and inpatient costs were often double outpatient costs. An economic model demonstrated that a 5% shift of inpatient procedures to outpatient MIS procedures can have a cost surplus of ∼ US $1.8 million for provider or a cost-saving impact of US $1.7 million from the Centers for Medicare & Medicaid Services perspective. The study was limited by information in the Premier database. No data were available for IVHR cases performed in free-standing ambulatory surgery centers or federal healthcare facilities. Volumes and costs of outpatient IVHRs and MIS procedures increased from January 2008-June 2015. Median costs were significantly higher for inpatients than outpatients, and the difference was particularly evident for obese patients. A substantial cost difference between inpatient and outpatient MIS cases
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Financial Analysis of an Intensive Pediatric Continuous Positive Airway Pressure Program.
Riley, E Brooks; Fieldston, Evan S; Xanthopoulos, Melissa S; Beck, Suzanne E; Menello, Mary Kate; Matthews, Edward; Marcus, Carole L
2017-02-01
Continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnea in children, but adherence to therapy is low. Our center created an intensive program that aimed to improve adherence. Our objective was to estimate the program's efficacy, cost, revenue and break-even point in a generalizable manner relative to a standard approach. The intensive program included device consignment, behavioral psychology counseling, and follow-up telephone calls. Economic modeling considered the costs, revenue and break-even point. Costs were derived from national salary reports and the Pediatric Health Information System. The 2015 Medicare reimbursement schedule provided revenue estimates. Prior to the intensive CPAP program, only 67.6% of 244 patients initially prescribed CPAP appeared for follow-up visits and only 38.1% had titration polysomnograms. In contrast, 81.4% of 275 patients in the intensive program appeared for follow-up visits (p break-even points would need to be 1.29-2.08 times higher to cover the costs. An intensive CPAP program leads to substantially higher follow-up and CPAP titration rates, but costs are higher. While affordable at our institution due to the local payer mix and revenue, Medicare reimbursement levels would not cover estimated costs. This study highlights the need for enhanced funding for pediatric CPAP programs, due to the special needs of this population and the long-term health risks of suboptimally treated obstructive sleep apnea. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.
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Steele, Joseph R; Schomer, Don F
2009-07-01
Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.
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A reference standard-based quality assurance program for radiology.
Liu, Patrick T; Johnson, C Daniel; Miranda, Rafael; Patel, Maitray D; Phillips, Carrie J
2010-01-01
The authors have developed a comprehensive radiology quality assurance (QA) program that evaluates radiology interpretations and procedures by comparing them with reference standards. Performance metrics are calculated and then compared with benchmarks or goals on the basis of published multicenter data and meta-analyses. Additional workload for physicians is kept to a minimum by having trained allied health staff members perform the comparisons of radiology reports with the reference standards. The performance metrics tracked by the QA program include the accuracy of CT colonography for detecting polyps, the false-negative rate for mammographic detection of breast cancer, the accuracy of CT angiography detection of coronary artery stenosis, the accuracy of meniscal tear detection on MRI, the accuracy of carotid artery stenosis detection on MR angiography, the accuracy of parathyroid adenoma detection by parathyroid scintigraphy, the success rate for obtaining cortical tissue on ultrasound-guided core biopsies of pelvic renal transplants, and the technical success rate for peripheral arterial angioplasty procedures. In contrast with peer-review programs, this reference standard-based QA program minimizes the possibilities of reviewer bias and erroneous second reviewer interpretations. The more objective assessment of performance afforded by the QA program will provide data that can easily be used for education and management conferences, research projects, and multicenter evaluations. Additionally, such performance data could be used by radiology departments to demonstrate their value over nonradiology competitors to referring clinicians, hospitals, patients, and third-party payers. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Samson Abramsky
2015-11-01
Full Text Available Maxwell's Demon, 'a being whose faculties are so sharpened that he can follow every molecule in its course', has been the centre of much debate about its abilities to violate the second law of thermodynamics. Landauer's hypothesis, that the Demon must erase its memory and incur a thermodynamic cost, has become the standard response to Maxwell's dilemma, and its implications for the thermodynamics of computation reach into many areas of quantum and classical computing. It remains, however, still a hypothesis. Debate has often centred around simple toy models of a single particle in a box. Despite their simplicity, the ability of these systems to accurately represent thermodynamics (specifically to satisfy the second law and whether or not they display Landauer Erasure, has been a matter of ongoing argument. The recent Norton-Ladyman controversy is one such example. In this paper we introduce a programming language to describe these simple thermodynamic processes, and give a formal operational semantics and program logic as a basis for formal reasoning about thermodynamic systems. We formalise the basic single-particle operations as statements in the language, and then show that the second law must be satisfied by any composition of these basic operations. This is done by finding a computational invariant of the system. We show, furthermore, that this invariant requires an erasure cost to exist within the system, equal to kTln2 for a bit of information: Landauer Erasure becomes a theorem of the formal system. The Norton-Ladyman controversy can therefore be resolved in a rigorous fashion, and moreover the formalism we introduce gives a set of reasoning tools for further analysis of Landauer erasure, which are provably consistent with the second law of thermodynamics.
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A method for rapid similarity analysis of RNA secondary structures
Directory of Open Access Journals (Sweden)
Liu Na
2006-11-01
Full Text Available Abstract Background Owing to the rapid expansion of RNA structure databases in recent years, efficient methods for structure comparison are in demand for function prediction and evolutionary analysis. Usually, the similarity of RNA secondary structures is evaluated based on tree models and dynamic programming algorithms. We present here a new method for the similarity analysis of RNA secondary structures. Results Three sets of real data have been used as input for the example applications. Set I includes the structures from 5S rRNAs. Set II includes the secondary structures from RNase P and RNase MRP. Set III includes the structures from 16S rRNAs. Reasonable phylogenetic trees are derived for these three sets of data by using our method. Moreover, our program runs faster as compared to some existing ones. Conclusion The famous Lempel-Ziv algorithm can efficiently extract the information on repeated patterns encoded in RNA secondary structures and makes our method an alternative to analyze the similarity of RNA secondary structures. This method will also be useful to researchers who are interested in evolutionary analysis.
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Ware, Patrick; Ross, Heather J; Cafazzo, Joseph A; Laporte, Audrey; Seto, Emily
2018-05-03
Meta-analyses of telemonitoring for patients with heart failure conclude that it can lower the utilization of health services and improve health outcomes compared with the standard of care. A smartphone-based telemonitoring program is being implemented as part of the standard of care at a specialty care clinic for patients with heart failure in Toronto, Canada. The objectives of this study are to (1) evaluate the impact of the telemonitoring program on health service utilization, patient health outcomes, and their ability to self-care; (2) identify the contextual barriers and facilitators of implementation at the physician, clinic, and institutional level; (3) describe patient usage patterns to determine adherence and other behaviors in the telemonitoring program; and (4) evaluate the costs associated with implementation of the telemonitoring program from the perspective of the health care system (ie, public payer), hospital, and patient. The evaluation will use a mixed-methods approach. The quantitative component will include a pragmatic pre- and posttest study design for the impact and cost analyses, which will make use of clinical data and questionnaires administered to at least 108 patients at baseline and 6 months. Furthermore, outcome data will be collected at 1, 12, and 24 months to explore the longitudinal impact of the program. In addition, quantitative data related to implementation outcomes and patient usage patterns of the telemonitoring system will be reported. The qualitative component involves an embedded single case study design to identify the contextual factors that influenced the implementation. The implementation evaluation will be completed using semistructured interviews with clinicians, and other program staff at baseline, 4 months, and 12 months after the program start date. Interviews conducted with patients will be triangulated with usage data to explain usage patterns and adherence to the system. The telemonitoring program was launched in
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Query-dependent banding (QDB for faster RNA similarity searches.
Directory of Open Access Journals (Sweden)
Eric P Nawrocki
2007-03-01
Full Text Available When searching sequence databases for RNAs, it is desirable to score both primary sequence and RNA secondary structure similarity. Covariance models (CMs are probabilistic models well-suited for RNA similarity search applications. However, the computational complexity of CM dynamic programming alignment algorithms has limited their practical application. Here we describe an acceleration method called query-dependent banding (QDB, which uses the probabilistic query CM to precalculate regions of the dynamic programming lattice that have negligible probability, independently of the target database. We have implemented QDB in the freely available Infernal software package. QDB reduces the average case time complexity of CM alignment from LN(2.4 to LN(1.3 for a query RNA of N residues and a target database of L residues, resulting in a 4-fold speedup for typical RNA queries. Combined with other improvements to Infernal, including informative mixture Dirichlet priors on model parameters, benchmarks also show increased sensitivity and specificity resulting from improved parameterization.
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Directory of Open Access Journals (Sweden)
Paul Jansons
2017-07-01
Trial registration: ACTRN12610001035011. [Jansons P, Robins L, O’Brien L, Haines T (2017 Gym-based exercise and home-based exercise with telephone support have similar outcomes when used as maintenance programs in adults with chronic health conditions: a randomised trial. Journal of Physiotherapy 63: 154–160
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The effects of moisture on LiD single crystals studied by temperature-programmed decomposition
International Nuclear Information System (INIS)
Dinh, L.N.; Cecala, C.M.; Leckey, J.H.; Balooch, M.
2001-01-01
Temperature-programmed decomposition (TPD) technique was performed on LiOH powders and LiD single crystals previously exposed to different moisture levels. Our results show that the LiOH decomposition process is rate-limited by an inward moving reaction front mechanism with an activation energy barrier of ∼122-149 kJ/mol. The LiOH structure is stable even if kept at 320 K. However, LiOH structures formed on the surface of LiD single crystals during moisture exposure at low dosages may have multiple activation energy barriers, some of which may be much lower than 122 kJ/mol. The rate-limiting mechanism for the decomposition of LiOH structures with reduced activation energy barriers is consistent with a unimolecular nucleation model. We attribute the lowering of the activation energy barrier for the LiOH decomposition to the existence of sub-stoichiometric Li(OH) x with x 2 O formation is observed. The release of H 2 O molecules from LiOH · H 2 O structure has small activation energy barriers in the range of 48-69 kJ/mol and follows a unimolecular nucleation process. The loosely bonded H 2 O molecules in the LiOH · H 2 O structure can be easily pumped away at room temperature in a reasonable amount of time. Our experiments also suggest that handling LiD single crystals at an elevated temperature of 340 K or more reduces the growth rate of LiOH and LiOH · H 2 O significantly
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Hughes, Roxanne M.; Nzekwe, Brandon; Molyneaux, Kristen J.
2013-10-01
Currently, there are policy debates regarding the efficacy and legality of single sex formal and informal education programs. This issue is particularly poignant in science education due to the historical marginalization of women in these fields. This marginalization has resulted in women being positioned as a stigmatized group within many science, technology, engineering, and mathematics (STEM) related fields. Research points to adolescence as the age where this sense of marginalization begins to develop. As a result, policy responses have utilized various frameworks such as: increased access for women, changing pedagogy to address women's learning styles, changing the language and culture of science to prevent marginalization of stigmatized groups, and finally exploring the role that individual identity plays in the marginalization of women. This study adds to the policy debate as it applies to single sex education by comparing middle school participants' STEM identity formation during two informal science learning environments (an all girls' STEM camp and a co-educational STEM camp). Additionally, this study focuses on the influence of camp activities within two informal science education programs: particularly the provision of role models and authentic STEM research activities, as means to improve STEM identity and make these fields relevant to the lives of middle school students. The results indicate that both camps improved girls' STEM identities. These findings suggest that the single sex environment is not as important to STEM identity as the pedagogy used within the program.
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Silva, Marcilene Rezende; Sendin, Shimene Mascarenhas; Araujo, Isabela Couto de Oliveira; Pimentel, Fernanda Silva; Viana, Marcos Borato
2013-01-01
To characterize alpha-chain variant hemoglobins with electric mobility similar to that of hemoglobin S in a newborn screening program. β(S) allele and alpha-thalassemia deletions were investigated in 14 children who had undefined hemoglobin at birth and an electrophoretic profile similar to that of hemoglobin S when they were six months old. Gene sequencing and restriction enzymes (DdeI, BsaJI, NlaIV, Bsu36I and TaqI) were used to identify hemoglobins. Clinical and hematological data were obtained from children who attended scheduled medical visits. THE FOLLOWING ALPHA CHAIN VARIANTS WERE FOUND: seven children with hemoglobin Hasharon [alpha2 47(CE5) Asp>His, HbA2:c.142G>C], all associated with alpha-thalassemia, five with hemoglobin Ottawa [alpha1 15(A13) Gly>Arg, HBA1:c.46G>C], one with hemoglobin St Luke's [alpha1 95(G2) Pro>Arg, HBA1:c.287C>G] and another one with hemoglobin Etobicoke [alpha212 84(F5) Ser>Arg, HBA212:c.255C>G]. Two associations with hemoglobin S were found: one with hemoglobin Ottawa and one with hemoglobin St Luke's. The mutation underlying hemoglobin Etobicoke was located in a hybrid α212 allele in one child. There was no evidence of clinically relevant hemoglobins detected in this study. Apparently these are the first cases of hemoglobin Ottawa, St Luke's, Etobicoke and the α212 gene described in Brazil. The hemoglobins detected in this study may lead to false diagnosis of sickle cell trait or sickle cell disease when only isoelectric focusing is used in neonatal screening. Additional tests are necessary for the correct identification of hemoglobin variants.
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Pain medicine: The case for an independent medical specialty and training programs.
Dubois, Michel Y; Follett, Kenneth A
2014-06-01
Over the last 30 years, pain has become one of the most dynamic areas of medicine and a public health issue. According to a recent Institute of Medicine report, pain affects approximately 100 million Americans at an estimated annual economic cost of $560 to $635 billion and is poorly treated overall. The American Board of Medical Specialties (ABMS) recognizes a pain subspecialty, but pain care delivery has struggled with increasing demand and developed in an inconsistent and uncoordinated fashion. Pain education is insufficient and highly variable. Multiple pain professional organizations have led to fragmentation of the field and lack of interdisciplinary agreement, resulting in confusion regarding who speaks for pain medicine. In this Perspective, the authors argue that ABMS recognition of pain medicine as an independent medical specialty would provide much needed structure and oversight for the field and would generate credibility for the specialty and its providers among medical peers, payers, regulatory and legislative agencies, and the public at large. The existing system, managed by three ABMS boards, largely excludes other specialties that contribute to pain care, fails to provide leadership from a single professional organization, provides suboptimal training exposure to pain medicine, and lengthens training, which results in inefficient use of time and educational resources. The creation of a primary ABMS conjoint board in pain medicine with its own residency programs and departments would provide better coordinated training, ensure the highest degree of competence of pain medicine specialists, and improve the quality of pain care and patient safety.
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Protein structural similarity search by Ramachandran codes
Directory of Open Access Journals (Sweden)
Chang Chih-Hung
2007-08-01
Full Text Available Abstract Background Protein structural data has increased exponentially, such that fast and accurate tools are necessary to access structure similarity search. To improve the search speed, several methods have been designed to reduce three-dimensional protein structures to one-dimensional text strings that are then analyzed by traditional sequence alignment methods; however, the accuracy is usually sacrificed and the speed is still unable to match sequence similarity search tools. Here, we aimed to improve the linear encoding methodology and develop efficient search tools that can rapidly retrieve structural homologs from large protein databases. Results We propose a new linear encoding method, SARST (Structural similarity search Aided by Ramachandran Sequential Transformation. SARST transforms protein structures into text strings through a Ramachandran map organized by nearest-neighbor clustering and uses a regenerative approach to produce substitution matrices. Then, classical sequence similarity search methods can be applied to the structural similarity search. Its accuracy is similar to Combinatorial Extension (CE and works over 243,000 times faster, searching 34,000 proteins in 0.34 sec with a 3.2-GHz CPU. SARST provides statistically meaningful expectation values to assess the retrieved information. It has been implemented into a web service and a stand-alone Java program that is able to run on many different platforms. Conclusion As a database search method, SARST can rapidly distinguish high from low similarities and efficiently retrieve homologous structures. It demonstrates that the easily accessible linear encoding methodology has the potential to serve as a foundation for efficient protein structural similarity search tools. These search tools are supposed applicable to automated and high-throughput functional annotations or predictions for the ever increasing number of published protein structures in this post-genomic era.
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Strange Bedfellows: A Local Insurer/Physician Practice Partnership to Fund Innovation.
Kraft, Sally; Strutz, Elizabeth; Kay, Lawrence; Welnick, Richard; Pandhi, Nancy
2015-01-01
Despite an unprecedented urgency to control healthcare costs while simultaneously improving quality, there are many barriers to investing in quality improvement. Traditional fee-for-service reimbursement models fail to reward providers whose improved processes lead to decreases in billable clinical activity. In addition, providers may lack the necessary skills for improvement, or the organizational infrastructure to conduct these activities. Insurance firms lack incentives to invest in healthcare delivery system improvements that lead to benefits for all patients, even those covered by competitors. In this article, we describe a novel program in its sixth year of existence that funds ambulatory care improvements through a collaborative partnership between a local academic healthcare delivery system and an insurance firm. The program is designed as a competitive grant program and the payer and healthcare organization jointly benefit from completed improvement projects. Factors contributing to the ongoing success of the program and lessons learned are discussed in order to inform the potential development of similar programs in other markets.
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How Google Web Search copes with very similar documents
W. Mettrop (Wouter); P. Nieuwenhuysen; H. Smulders
2006-01-01
textabstractA significant portion of the computer files that carry documents, multimedia, programs etc. on the Web are identical or very similar to other files on the Web. How do search engines cope with this? Do they perform some kind of “deduplication”? How should users take into account that
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The effects of prospective mate quality on investments in healthy body weight among single women.
Harris, Matthew C; Cronin, Christopher J
2017-02-01
This paper examines how a single female's investment in healthy body weight is affected by the quality of single males in her marriage market. A principle concern in estimation is the presence of market-level unobserved heterogeneity that may be correlated with changes in single male quality, measured as earning potential. To address this concern, we employ a differencing strategy that normalizes the exercise behaviors of single women to those of their married counterparts. Our main results suggest that when potential mate quality in a marriage market decreases, single black women invest less in healthy body weight. For example, we find that a 10 percentage point increase in the proportion of low quality single black males leads to a 5-10% decrease in vigorous exercise taken by single black females. Results for single white women are qualitatively similar, but not consistent across specifications. These results highlight the relationship between male and female human capital acquisition that is driven by participation in the marriage market. Our results suggest that programs designed to improve the economic prospects of single males may yield positive externalities in the form of improved health behaviors, such as more exercise, particularly for single black females. Copyright © 2016 Elsevier B.V. All rights reserved.
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Shapiro, Amy J.; Heath, Nancy L.; Carsley, Dana
2016-01-01
The present study reports the pilot evaluation of the feasibility and acceptability of StressOFF Strategies, a "single-session" (45 min) adolescent-targeted, school-based psychoeducational program, which introduces cognitive behavioral techniques and mindfulness-based techniques. Five hundred and sixty-five Grade 9 students (57% female;…
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Log-periodic self-similarity: an emerging financial law?
S. Drozdz; F. Grummer; F. Ruf; J. Speth
2002-01-01
A hypothesis that the financial log-periodicity, cascading self-similarity through various time scales, carries signatures of a law is pursued. It is shown that the most significant historical financial events can be classified amazingly well using a single and unique value of the preferred scaling factor lambda=2, which indicates that its real value should be close to this number. This applies even to a declining decelerating log-periodic phase. Crucial in this connection is identification o...
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Caries risk assessment/treatment programs in U.S. dental schools: an eleven-year follow-up.
Yorty, Jack S; Walls, Allan Todd; Wearden, Stanley
2011-01-01
The purpose of this survey was to identify the number and characteristics of caries risk assessment/treatment (CRA/ Tx) programs in U.S. dental schools in 2009 and compare the results to those of the 1998 survey. A survey of U.S. dental schools was conducted in 2009 using the same eleven-question survey instrument as in 1998. Results were analyzed using stratified random sampling and chi-square tests for six of the questions. Additionally, data from the other questions were directly compared. Two questions showed a statistically significant difference: an increase in programs supervised by one school department and the number of schools using CRA as a graduation requirement. Positive changes are occurring in the development of CRA/Tx programs in U.S. dental schools. A wide variety of approaches to teaching this subject, including use of terminology and treatment philosophies, is evident. The evolution of this subject has been slow and varied over the past eleven years. Changing from a mainly surgical approach model to a medical model is occurring, but a more integrated method is needed to clarify terminology, diagnosis, treatment, and communications with researchers, clinicians, teachers, patients, and third-party payers.
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Benefits of a single payment system: case study of Abu Dhabi health system reforms.
Vetter, Philipp; Boecker, Klaus
2012-12-01
In 2005 leaders in the wealthy Emirate of Abu Dhabi inherited an health system from their predecessors that was well-intentioned in its historic design, but that did not live up to aspirations in any dimension. First, the Emirate defined a vision to deliver "world-class" quality care in response to citizen's needs. It has since introduced tiered mandatory health insurance for all inhabitants linked to a single standard payment system, which generates accurate data as an invaluable by-product. A newly created independent health system regulator monitors these data and licenses, audits, and inspects all health service professionals, facilities, and insurers accordingly. We analyse these health system reforms using the "Getting Health Reform Right" framework. Our analysis suggests that an integrated set of reforms addressing all reform levers is critical to achieving the outcomes observed. The reform programme has improved access, by giving all residents health cards. The approximate doubling of demand has been matched by flexible supply, with the private sector adding 5 new hospitals and 93 clinics to the health system infrastructure since 2006. The focus on reliable raw-data flows through the single standard payment system functions as a motor for improvement services, innovation, and investment, for instance by allowing payers to 'pay for quality', which may well be applicable in other contexts. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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Single-column data assimilation for the Atmospheric Radiation Measurement (ARM) Program
International Nuclear Information System (INIS)
Louis, J.F.
1994-01-01
The main purpose of the ARM program is to provide the necessary data to develop, test and validate the parameterization of clouds and of their interactions with the radiation field, and the computation of radiative transfer in climate models. For various reasons, much of the ARM observations will be imperfect, incomplete, redundant, indirect and unrepresentative. Various techniques of data assimilation have been developed to deal with these problems. The variational data assimilation and adjoint method applied to a single column model is described here. A model is used to simulate the evolution of the atmosphere during an assimilation period. As the model is run, a cost function is computed which is essentially a measure of simulation errors. The method then consists in adjusting some model parameters to minimize the cost function. Optimization of the model parameters needs to be done with a much longer series of data, to cover different meteorological situations. Once parameters are set, nudging terms are used as control variables. The Derber nudging method will require considerable tuning, especially in defining the vertical profiles of the nudging terms. Extensive tests are currently underway of both model optimization and data assimilation
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Energy Technology Data Exchange (ETDEWEB)
Kramer, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Martin, E. Fadrhonc [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
2015-02-01
Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources with the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.
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Directory of Open Access Journals (Sweden)
Marcilene Rezende Silva
2013-01-01
Full Text Available OBJECTIVE: To characterize alpha-chain variant hemoglobins with electric mobility similar to that of hemoglobin S in a newborn screening program. METHODS: βS allele and alpha-thalassemia deletions were investigated in 14 children who had undefined hemoglobin at birth and an electrophoretic profile similar to that of hemoglobin S when they were six months old. Gene sequencing and restriction enzymes (DdeI, BsaJI, NlaIV, Bsu36I and TaqI were used to identify hemoglobins. Clinical and hematological data were obtained from children who attended scheduled medical visits. RESULTS: The following alpha chain variants were found: seven children with hemoglobin Hasharon [alpha2 47(CE5 Asp>His, HbA2:c.142G>C], all associated with alpha-thalassemia, five with hemoglobin Ottawa [alpha1 15(A13 Gly>Arg, HBA1:c.46G>C], one with hemoglobin St Luke's [alpha1 95(G2 Pro>Arg, HBA1:c.287C>G] and another one with hemoglobin Etobicoke [alpha212 84(F5 Ser>Arg, HBA212:c.255C>G]. Two associations with hemoglobin S were found: one with hemoglobin Ottawa and one with hemoglobin St Luke's. The mutation underlying hemoglobin Etobicoke was located in a hybrid α212 allele in one child. There was no evidence of clinically relevant hemoglobins detected in this study. CONCLUSION: Apparently these are the first cases of hemoglobin Ottawa, St Luke's, Etobicoke and the α212 gene described in Brazil. The hemoglobins detected in this study may lead to false diagnosis of sickle cell trait or sickle cell disease when only isoelectric focusing is used in neonatal screening. Additional tests are necessary for the correct identification of hemoglobin variants.
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Distributional and Knowledge-Based Approaches for Computing Portuguese Word Similarity
Directory of Open Access Journals (Sweden)
Hugo Gonçalo Oliveira
2018-02-01
Full Text Available Identifying similar and related words is not only key in natural language understanding but also a suitable task for assessing the quality of computational resources that organise words and meanings of a language, compiled by different means. This paper, which aims to be a reference for those interested in computing word similarity in Portuguese, presents several approaches for this task and is motivated by the recent availability of state-of-the-art distributional models of Portuguese words, which add to several lexical knowledge bases (LKBs for this language, available for a longer time. The previous resources were exploited to answer word similarity tests, which also became recently available for Portuguese. We conclude that there are several valid approaches for this task, but not one that outperforms all the others in every single test. Distributional models seem to capture relatedness better, while LKBs are better suited for computing genuine similarity, but, in general, better results are obtained when knowledge from different sources is combined.
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Levin, David C; Bree, Robert L; Rao, Vijay M; Johnson, Jean
2010-01-01
Radiology benefits management companies have evolved in recent years to meet the need to control the rapid growth in advanced diagnostic imaging. The Obama administration and other key policymakers have proposed using them as a cost-control mechanism, but little is known about how they operate or what results they have produced. The main tool they use is prior authorization. The authors describe the inner workings of the call center of one radiology benefits management company and how its prior authorization program seems to have slowed the growth in the utilization of MRI, CT, and PET in the large markets of one commercial payer. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Amar R Marathe
2015-08-01
Full Text Available Brain computer interaction (BCI technologies have proven effective in utilizing single-trial classification algorithms to detect target images in rapid serial visualization presentation tasks. While many factors contribute to the accuracy of these algorithms, a critical aspect that is often overlooked concerns the feature similarity between target and non-target images. In most real-world environments there are likely to be many shared features between targets and non-targets resulting in similar neural activity between the two classes. It is unknown how current neural-based target classification algorithms perform when qualitatively similar target and non-target images are presented. This study address this question by comparing behavioral and neural classification performance across two conditions: first, when targets were the only infrequent stimulus presented amongst frequent background distracters; and second when targets were presented together with infrequent non-targets containing similar visual features to the targets. The resulting findings show that behavior is slower and less accurate when targets are presented together with similar non-targets; moreover, single-trial classification yielded high levels of misclassification when infrequent non-targets are included. Furthermore, we present an approach to mitigate the image misclassification. We use confidence measures to assess the quality of single-trial classification, and demonstrate that a system in which low confidence trials are reclassified through a secondary process can result in improved performance.
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Seismic analysis program group: SSAP
International Nuclear Information System (INIS)
Uchida, Masaaki
2002-05-01
A group of programs SSAP has been developed, each member of which performs seismic calculation using simple single-mass system model or multi-mass system model. For response of structures to a transverse s-wave, a single-mass model program calculating response spectrum and a multi-mass model program are available. They perform calculation using the output of another program, which produces simulated earthquakes having the so-called Ohsaki-spectrum characteristic. Another program has been added, which calculates the response of one-dimensional multi-mass systems to vertical p-wave input. It places particular emphasis on the analysis of the phenomena observed at some shallow earthquakes in which stones jump off the ground. Through a series of test calculations using these programs, some interesting information has been derived concerning the validity of superimposing single-mass model calculation, and also the condition for stones to jump. (author)
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Reducing single-use plastic shopping bags in the USA.
Wagner, Travis P
2017-12-01
In the USA, local governments have the primary responsibility to manage MSW. However, local governments lack the authority to explicitly shift costs or responsibility back onto the producer for specific problem wastes. A particularly problematic waste for local governments is the single-use plastic bag. In 2014, in the USA, 103.465 billion single-use plastic shopping bags were consumed. Because of their extremely low recyclability rate, plastic bags remain a significant source of land-based litter and marine debris and impair stormwater management systems. They also reduce the effectiveness of automated recycling systems. In response, local governments increasingly have adopted a variety of measures specifically intended to reduce the store-level consumption of single-use shopping bags in 5 major categories: bans, imposition of fees and taxes, establishing minimum product design of bags, requiring consumer education, and mandating retailer take-back programs. As of September 2017, there were 271 local governments in the USA with plastic bag ordinances covering 9.7% of the nation's population. The majority (95%) of the ordinances is a ban on single-use plastic bags; 56.9% of these bans also include a mandatory fee on paper and/or reusable bags. For the fee-based ordinances, the mode is $0.10 per bag; every tax/fee ordinance allows retailers to retain some or all the collected fee. As local governments continue to increase their actions on plastic bags, 11 states have enacted laws to prohibit local governments from regulating single-use plastic bags. Because of the success with single-use bags, local governments are also enacting similar ordinances on single-use expanded polystyrene consumer products and other single-use plastic products. Copyright © 2017 Elsevier Ltd. All rights reserved.
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78 FR 65582 - Single Family Housing Direct Loan Program
2013-11-01
.... Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity....) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program...
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Papp, K; Bachelez, H; Costanzo, A; Foley, P; Gooderham, M; Kaur, P; Philipp, S; Spelman, L; Zhang, N; Strober, B
2017-12-01
ABP 501, a U.S.A. Food and Drug Administration- and European Medicines Agency-approved biosimilar, is highly similar to adalimumab in structure, function and pharmacokinetics. To demonstrate similarity in efficacy, safety and immunogenicity of ABP 501 vs. adalimumab for moderate-to-severe plaque psoriasis (clinical trial: NCT01970488). Patients were randomized (1 : 1) to receive ABP 501 or adalimumab 40 mg every 2 weeks for 16 weeks. At week 16, patients with ≥ 50% improvement from baseline in Psoriasis Area and Severity Index (PASI) score were eligible to continue to week 52. Patients receiving ABP 501 continued; adalimumab patients were rerandomized (1 : 1) to continue adalimumab or undergo a single transition to ABP 501. Key efficacy assessments included percentage PASI improvement from baseline, PASI responders and mean change in affected body surface area from baseline to weeks 16, 32 and 50. Safety was monitored via adverse events (AEs) and antidrug antibodies (ADAs) were assessed. A total of 308 patients were rerandomized at week 16 (ABP 501/ABP 501, n = 152; adalimumab/adalimumab, n = 79; adalimumab/ABP 501, n = 77). PASI percentage improvements from baseline were similar across groups for weeks 16, 32 and 50 (range: 85·8-88·2%), with no significant differences detected across groups in percentages of PASI 50, 75, 90 and 100 responders. Changes from baseline in percentage body surface area affected were similar across groups and time points. No new safety signals were detected. AEs were balanced between groups. Percentages of patients with binding and neutralizing ADAs were similar across treatments. ABP 501 and adalimumab have similar clinical efficacy, safety and immunogenicity profiles over 52 weeks, including after single transition, in this patient population. © 2017 British Association of Dermatologists.
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An adverse events potential costs analysis based on Drug Programs in Poland. Dermatology focus
Directory of Open Access Journals (Sweden)
Szkultecka-Debek Monika
2014-09-01
Full Text Available The aim of the project, carried out within the Polish Society for Pharmacoeconomics (PTFE, was to estimate the potential costs of treatment of the side effects which (theoretically may occur as a result of treatments for the selected diseases. This paper deals solely with dermatology related events. Herein, several Drug Programs financed by the National Health Fund in Poland, in 2012, were analyzed. The adverse events were selected based on the Summary of Product Characteristics of the chosen products. We focused the project on those potential adverse events which were defined in SPC as frequent and very frequent. The results are presented according to their therapeutic areas, and in this paper, the focus is upon that which is related to dermatology. The events described as ‘very common’ had an incidence of ≥ 1/10, and that which is ‘common’ - ≥ 1/100, <1 /10. In order to identify the resources used, we, with the engagement of clinical experts, performed a survey. In our work, we employed only the total direct costs incurred by the public payer, based on valid individual cost data in February 2014. Moreover, we calculated the total spending from the public payer’s perspective, as well as the patient’s perspective, and the percentage of each component of the total cost in detail. The paper, thus, informs the reader of the estimated costs of treatment of side effects related to the dermatologic symptoms and reactions. Based on our work, we can state that the treatment of skin adverse drug reactions generates a significant cost - one incurred by both the public payer and the patient.
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Kazemian, Majid; Suryamohan, Kushal; Chen, Jia-Yu; Zhang, Yinan; Samee, Md Abul Hassan; Halfon, Marc S; Sinha, Saurabh
2014-09-01
Many genes familiar from Drosophila development, such as the so-called gap, pair-rule, and segment polarity genes, play important roles in the development of other insects and in many cases appear to be deployed in a similar fashion, despite the fact that Drosophila-like "long germband" development is highly derived and confined to a subset of insect families. Whether or not these similarities extend to the regulatory level is unknown. Identification of regulatory regions beyond the well-studied Drosophila has been challenging as even within the Diptera (flies, including mosquitoes) regulatory sequences have diverged past the point of recognition by standard alignment methods. Here, we demonstrate that methods we previously developed for computational cis-regulatory module (CRM) discovery in Drosophila can be used effectively in highly diverged (250-350 Myr) insect species including Anopheles gambiae, Tribolium castaneum, Apis mellifera, and Nasonia vitripennis. In Drosophila, we have successfully used small sets of known CRMs as "training data" to guide the search for other CRMs with related function. We show here that although species-specific CRM training data do not exist, training sets from Drosophila can facilitate CRM discovery in diverged insects. We validate in vivo over a dozen new CRMs, roughly doubling the number of known CRMs in the four non-Drosophila species. Given the growing wealth of Drosophila CRM annotation, these results suggest that extensive regulatory sequence annotation will be possible in newly sequenced insects without recourse to costly and labor-intensive genome-scale experiments. We develop a new method, Regulus, which computes a probabilistic score of similarity based on binding site composition (despite the absence of nucleotide-level sequence alignment), and demonstrate similarity between functionally related CRMs from orthologous loci. Our work represents an important step toward being able to trace the evolutionary history of gene
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Zhang, Yinan; Samee, Md. Abul Hassan; Halfon, Marc S.; Sinha, Saurabh
2014-01-01
Many genes familiar from Drosophila development, such as the so-called gap, pair-rule, and segment polarity genes, play important roles in the development of other insects and in many cases appear to be deployed in a similar fashion, despite the fact that Drosophila-like “long germband” development is highly derived and confined to a subset of insect families. Whether or not these similarities extend to the regulatory level is unknown. Identification of regulatory regions beyond the well-studied Drosophila has been challenging as even within the Diptera (flies, including mosquitoes) regulatory sequences have diverged past the point of recognition by standard alignment methods. Here, we demonstrate that methods we previously developed for computational cis-regulatory module (CRM) discovery in Drosophila can be used effectively in highly diverged (250–350 Myr) insect species including Anopheles gambiae, Tribolium castaneum, Apis mellifera, and Nasonia vitripennis. In Drosophila, we have successfully used small sets of known CRMs as “training data” to guide the search for other CRMs with related function. We show here that although species-specific CRM training data do not exist, training sets from Drosophila can facilitate CRM discovery in diverged insects. We validate in vivo over a dozen new CRMs, roughly doubling the number of known CRMs in the four non-Drosophila species. Given the growing wealth of Drosophila CRM annotation, these results suggest that extensive regulatory sequence annotation will be possible in newly sequenced insects without recourse to costly and labor-intensive genome-scale experiments. We develop a new method, Regulus, which computes a probabilistic score of similarity based on binding site composition (despite the absence of nucleotide-level sequence alignment), and demonstrate similarity between functionally related CRMs from orthologous loci. Our work represents an important step toward being able to trace the evolutionary
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Corrective action strategy for single-shell tanks containing organic chemicals
International Nuclear Information System (INIS)
Turner, D.A.
1993-08-01
A Waste Tank Organic Safety Program (Program) Plan is to be transmitted to the U.S. Department of Energy, Richland Operations Office (RL) for approval by December 31, 1993. In April 1993 an agreement was reached among cognizant U.S. Department of Energy - Headquarters (HQ), RL and Westinghouse Hanford Company (WHC) staff that the Program Plan would be preceded by a ''Corrective Action Strategy,'' which addressed selected planning elements supporting the Program Plan. The ''Corrective Action Strategy'' would be reviewed and consensus reached regarding the planning elements. A Program Plan reflecting this consensus would then be prepared. A preliminary ''corrective action strategy'' is presented for resolving the organic tanks safety issue based on the work efforts recommended in the ISB (Interim Safety Basis for Hanford Site tank farm facilities). A ''corrective action strategy'' logic was prepared for individual SSTs (single-shell tanks), or a group of SSTs having similar characteristics, as appropriate. Four aspects of the organic tanks safety issue are addressed in the ISB: SSTs with the potential for combustion in the tank's headspace; combustion of a floating organic layer as a pool fire; surface fires in tanks that formerly held floating organic layers; SSTs with the potential for organic-nitrate reactions. A preliminary ''corrective action strategy'' for each aspect of the organic tanks safety issue is presented
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Programmed Switching of Single Polymer Conformation on DNA Origami
DEFF Research Database (Denmark)
Krissanaprasit, Abhichart; Madsen, Mikael; Knudsen, Jakob Bach
2016-01-01
-molecule conjugated polymer. The polymer is functionalized with short single-stranded (ss) DNA strands that extend from the backbone of the polymer and serve as handles. The DNA polymer conjugate can be aligned on DNA origami in three well-defined geometries (straight line, left-turned, and right-turned pattern......) by DNA hybridization directed by single-stranded guiding strands and ssDNA tracks extending from the origami surface and polymer handle. We demonstrate switching of a conjugated organic polymer conformation between left- and right-turned conformations of the polymer on DNA origami based on toehold...
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Billing third party payers for vaccines: state and local health department perspectives.
Quintanilla, Carlos; Duncan, Lorraine; Luther, Lydia
2009-01-01
The cost of adequately immunizing a child has risen steadily with recommendations of new, more expensive vaccines. The Vaccines for Children (VFC) program, a federal entitlement, has continued to fund all recommended vaccines for eligible children. The one other federal vaccine-funding source, Section 317 of the Public Health Service Act, has not kept pace with rising vaccine costs. For local health departments to immunize children not eligible for VFC, but whose families are underinsured or otherwise unable to pay for vaccines, state immunization programs have often relied on Section 317 funds. Recognizing this funding challenge and having learned that children covered by health insurance were being immunized in public clinics with publicly supplied vaccines, the Oregon Immunization Program (OIP) launched a project to expand billing of health plans by local health departments for vaccines administered to covered persons. This has resulted in significant savings of Section 317 funds, allowing the Oregon program to provide more vaccines for high-need persons.
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SINGLE HEATER TEST FINAL REPORT
International Nuclear Information System (INIS)
J.B. Cho
1999-01-01
The Single Heater Test is the first of the in-situ thermal tests conducted by the U.S. Department of Energy as part of its program of characterizing Yucca Mountain in Nevada as the potential site for a proposed deep geologic repository for the disposal of spent nuclear fuel and high-level nuclear waste. The Site Characterization Plan (DOE 1988) contained an extensive plan of in-situ thermal tests aimed at understanding specific aspects of the response of the local rock-mass around the potential repository to the heat from the radioactive decay of the emplaced waste. With the refocusing of the Site Characterization Plan by the ''Civilian Radioactive Waste Management Program Plan'' (DOE 1994), a consolidated thermal testing program emerged by 1995 as documented in the reports ''In-Situ Thermal Testing Program Strategy'' (DOE 1995) and ''Updated In-Situ Thermal Testing Program Strategy'' (CRWMS M and O 1997a). The concept of the Single Heater Test took shape in the summer of 1995 and detailed planning and design of the test started with the beginning fiscal year 1996. The overall objective of the Single Heater Test was to gain an understanding of the coupled thermal, mechanical, hydrological, and chemical processes that are anticipated to occur in the local rock-mass in the potential repository as a result of heat from radioactive decay of the emplaced waste. This included making a priori predictions of the test results using existing models and subsequently refining or modifying the models, on the basis of comparative and interpretive analyses of the measurements and predictions. A second, no less important, objective was to try out, in a full-scale field setting, the various instruments and equipment to be employed in the future on a much larger, more complex, thermal test of longer duration, such as the Drift Scale Test. This ''shake down'' or trial aspect of the Single Heater Test applied not just to the hardware, but also to the teamwork and cooperation between
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de França, Henrique Silvestre; Branco, Paulo Alexandre Nordeste; Guedes Junior, Dilmar Pinto; Gentil, Paulo; Steele, James; Teixeira, Cauê Vazquez La Scala
2015-08-01
The aim of this study was compare changes in upper body muscle strength and size in trained men performing resistance training (RT) programs involving multi-joint plus single-joint (MJ+SJ) or only multi-joint (MJ) exercises. Twenty young men with at least 2 years of experience in RT were randomized in 2 groups: MJ+SJ (n = 10; age, 27.7 ± 6.6 years) and MJ (n = 10; age, 29.4 ± 4.6 years). Both groups trained for 8 weeks following a linear periodization model. Measures of elbow flexors and extensors 1-repetition maximum (1RM), flexed arm circumference (FAC), and arm muscle circumference (AMC) were taken pre- and post-training period. Both groups significantly increased 1RM for elbow flexion (4.99% and 6.42% for MJ and MJ+SJ, respectively), extension (10.60% vs 9.79%, for MJ and MJ+SJ, respectively), FAC (1.72% vs 1.45%, for MJ and MJ+SJ, respectively), and AMC (1.33% vs 3.17% for MJ and MJ+SJ, respectively). Comparison between groups revealed no significant difference in any variable. In conclusion, 8 weeks of RT involving MJ or MJ+SJ resulted in similar alterations in muscle strength and size in trained participants. Therefore, the addition of SJ exercises to a RT program involving MJ exercises does not seem to promote additional benefits to trained men, suggesting MJ-only RT to be a time-efficient approach.
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Similarity of satellite DNA properties in the order Rodentia
Energy Technology Data Exchange (ETDEWEB)
Mazrimas, J A; Hatch, F T
1977-09-01
We have characterized satellite DNAs from 9 species of kangaroo rat (Dipodomys) and have shown that the HS-..cap alpha.. and HS-..beta.. satellites, where present, are nearly identical in all species as to melting transition midpoint (Tm), and density in neutral CsCl, alkaline CsCl, and Cs/sub 2/SO/sub 4/-Ag/sup +/ gradients. However, the MS satellites exist in two internally similar classes. The satellite DNAs from three other rodents were characterized (densities listed are in neutral CsCl). The pocket gopher, Thomomys bottae, contains Th-..cap alpha.. (1.713 g/ml) and Th-..beta.. (1.703 g/ml). The guinea pig (Cavia porcellus) contains Ca-..cap alpha.., Ca-..beta.., and Ca-..gamma.. at densities of 1.706 g/ml, 1.704 g/ml, and 1.704 g/ml, respectively. The antelope ground squirrel (Ammospermophilus harrisi) contains Am-..cap alpha.., 1.708 g/ml, Am-..beta.., 1.717 g/ml, and Am-..gamma.., 1.707 g/ml. The physical and chemical properties of the alpha-satellites from the above four rodents representing four different families in two suborders of Rodentia were compared. They show nearly identical Tm, nucleoside composition of single strands, and single strand densities in alkaline CsCl. Similar comparisons on the second or third satellite DNAs from these rodents also indicate a close relationship to each other. Thus the high degree of similarity of satellite sequences found in such a diverse group of rodents suggests a cellular function that is subject to natural selection, and implies that these sequences have been conserved over a considerable span of evolutionary time since the divergence of these rodents about 50 million years ago.
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Similarity of satellite DNA properties in the order Rodentia
Energy Technology Data Exchange (ETDEWEB)
Mazrimas, J A; Hatch, F T
1977-09-01
Satellite DNAs from 9 species of kangaroo rat (Dipodomys) have been characterized and have shown that the HS-..cap alpha.. and HS-..beta.. satellites, where present, are nearly identical in all species as to melting transition midpoint (Tm), and density in neutral CsCl, alkaline CsCl, and Cs/sub 2/SO/sub 4/-Ag/sup +/ gradients. However, the MS satellites exist in two internally similar classes. The satellite DNAs from three other rodents were characterized (densities listed are in neutral CsCl). The pocket gopher, Thomomys bottae, contains Th-..cap alpha.. (1.713 g/ml) and Th..beta.. (1.703 g/ml). The guinea pig (Cavia porcellus) contains Ca-..cap alpha.., Ca-..beta.. and Ca-..gamma.. at densities of 1.706 g/ml, 1.704 g/ml and 1.704 g/ml, respectively. The antelope ground squirrel (Ammospermophilus harrisi) contains Am-..cap alpha.., 1.708 g/ml, Am-..beta.., 1.717 g/ml, and Am-..gamma.., 1.707 g/ml. The physical and chemical properties of the alpha-satellites from the above four rodents representing four different families in two suborders of Rodentia were compared. They show nearly identical Tm, nucleoside composition of single strands, and single strand densities in alkaline CsCl. Similar comparisons on the second or third satellite DNAs from these rodents also indicate a close relationship to each other. Thus the high degree of similarity of satellite sequences found in such a diverse group of rodents suggests a cellular function that is subject to natural selection, and implies that these sequences have been conserved over a considerable span of evolutionary time since the divergence of these rodents about 50 million years ago.
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Meeting your match: How attractiveness similarity affects approach behavior in mixed-sex dyads
Straaten, I. van; Engels, R.C.M.E.; Finkenauer, C.; Holland, R.W.
2009-01-01
This experimental study investigated approach behavior toward opposite-sex others of similar versus dissimilar physical attractiveness. Furthermore, it tested the moderating effects of sex. Single participants interacted with confederates of high and low attractiveness. Observers rated their
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Directory of Open Access Journals (Sweden)
Ackerman SJ
2014-02-01
Full Text Available Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Tim Holt,4 John Cummings5 1Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 5Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and originates in the sacroiliac (SI joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US. Methods: A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3, an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date, and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results: The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592 per privately-insured patient (N=78,533. Among patients with lumbar spinal fusion (N=434, attributable 3-year
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Areal Feature Matching Based on Similarity Using Critic Method
Kim, J.; Yu, K.
2015-10-01
In this paper, we propose an areal feature matching method that can be applied for many-to-many matching, which involves matching a simple entity with an aggregate of several polygons or two aggregates of several polygons with fewer user intervention. To this end, an affine transformation is applied to two datasets by using polygon pairs for which the building name is the same. Then, two datasets are overlaid with intersected polygon pairs that are selected as candidate matching pairs. If many polygons intersect at this time, we calculate the inclusion function between such polygons. When the value is more than 0.4, many of the polygons are aggregated as single polygons by using a convex hull. Finally, the shape similarity is calculated between the candidate pairs according to the linear sum of the weights computed in CRITIC method and the position similarity, shape ratio similarity, and overlap similarity. The candidate pairs for which the value of the shape similarity is more than 0.7 are determined as matching pairs. We applied the method to two geospatial datasets: the digital topographic map and the KAIS map in South Korea. As a result, the visual evaluation showed two polygons that had been well detected by using the proposed method. The statistical evaluation indicates that the proposed method is accurate when using our test dataset with a high F-measure of 0.91.
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34 CFR 403.60 - What are the basic programs?
2010-07-01
... and State Leadership Activities. (b) Programs for Single Parents, Displaced Homemakers, and Single Pregnant Women. (c) Sex Equity Programs. (d) Programs for Criminal Offenders. (e) Secondary School...
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A grammar-based semantic similarity algorithm for natural language sentences.
Lee, Ming Che; Chang, Jia Wei; Hsieh, Tung Cheng
2014-01-01
This paper presents a grammar and semantic corpus based similarity algorithm for natural language sentences. Natural language, in opposition to "artificial language", such as computer programming languages, is the language used by the general public for daily communication. Traditional information retrieval approaches, such as vector models, LSA, HAL, or even the ontology-based approaches that extend to include concept similarity comparison instead of cooccurrence terms/words, may not always determine the perfect matching while there is no obvious relation or concept overlap between two natural language sentences. This paper proposes a sentence similarity algorithm that takes advantage of corpus-based ontology and grammatical rules to overcome the addressed problems. Experiments on two famous benchmarks demonstrate that the proposed algorithm has a significant performance improvement in sentences/short-texts with arbitrary syntax and structure.
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Genetic similarity of soybean genotypes revealed by seed protein
Directory of Open Access Journals (Sweden)
Nikolić Ana
2005-01-01
Full Text Available More accurate and complete descriptions of genotypes could help determinate future breeding strategies and facilitate introgression of new genotypes in current soybean genetic pool. The objective of this study was to characterize 20 soybean genotypes from the Maize Research Institute "Zemun Polje" collection, which have good agronomic performances, high yield, lodging and drought resistance, and low shuttering by seed proteins as biochemical markers. Seed proteins were isolated and separated by PAA electrophoresis. On the basis of the presence/absence of protein fractions coefficients of similarity were calculated as Dice and Roger and Tanamoto coefficient between pairs of genotypes. The similarity matrix was submitted for hierarchical cluster analysis of un weighted pair group using arithmetic average (UPGMA method and necessary computation were performed using NTSYS-pc program. Protein seed analysis confirmed low level of genetic diversity in soybean. The highest genetic similarity was between genotypes P9272 and Kador. According to obtained results, soybean genotypes were assigned in two larger groups and coefficients of similarity showed similar results. Because of the lack of pedigree data for analyzed genotypes, correspondence with marker data could not be determined. In plant with a narrow genetic base in their gene pool, such as soybean, protein markers may not be sufficient for characterization and study of genetic diversity.
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An Effectiveness Analysis of the U.S. Federal Government Executive Branch Ethics Policy and Program
National Research Council Canada - National Science Library
Stewart, Chanet
2003-01-01
.... As public servants, whether elected or non-elected, Executive Branch employees are expected to make decisions and spend tax-payer dollars in ways that promote the overall interests of the American public...
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Initial Single-Shell Tank Retrieval System mission analysis report
International Nuclear Information System (INIS)
Hertzel, J.S.
1996-03-01
This document provides the mission analysis for the Initial Single-Shell Tank Retrieval System task, which supports the Single-Shell Tank Waste Retrieval Program in its commitment to remove waste from single-shell tanks for treatment and final closure
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Directory of Open Access Journals (Sweden)
Zhi-Jun Fu
2017-01-01
Full Text Available In view of the performance requirements (e.g., ride comfort, road holding, and suspension space limitation for vehicle suspension systems, this paper proposes an adaptive optimal control method for quarter-car active suspension system by using the approximate dynamic programming approach (ADP. Online optimal control law is obtained by using a single adaptive critic NN to approximate the solution of the Hamilton-Jacobi-Bellman (HJB equation. Stability of the closed-loop system is proved by Lyapunov theory. Compared with the classic linear quadratic regulator (LQR approach, the proposed ADP-based adaptive optimal control method demonstrates improved performance in the presence of parametric uncertainties (e.g., sprung mass and unknown road displacement. Numerical simulation results of a sedan suspension system are presented to verify the effectiveness of the proposed control strategy.
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Hybrid single node genetic programming for symbolic regression
Kubalìk, Jiřì; Alibekov, Eduard; Žegklitz, Jan; Babuska, R.; Nguyen, NT; Kowalczyk, R; Filipe, J
2016-01-01
This paper presents a first step of our research on designing an effective and efficient GP-based method for symbolic regression. First, we propose three extensions of the standard Single Node GP, namely (1) a selection strategy for choosing nodes to be mutated based on depth and performance of
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Energy Technology Data Exchange (ETDEWEB)
Huang, Y.J.; Ritschard, R.; Bull, J.; Byrne, S.; Turiel, I.; Wilson, D.; Hsui, C.; Foley, D.
1987-01-01
This report provides technical documentation for a software package called PEAR (Program for Energy Analysis of Residences) developed by LBL. PEAR offers an easy-to-use and accurate method of estimating the energy savings associated with various energy conservation measures used in site-built, single-family homes. This program was designed for use by non-technical groups such as home builders, home buyers or others in the buildings industry, and developed as an integral part of a set of voluntary guidelines entitled Affordable Housing Through Energy Conservation: A Guide to Designing and Constructing Energy Efficient Homes. These guidelines provide a method for selecting and evaluating cost-effective energy conservation measures based on the energy savings estimated by PEAR. This work is part of a Department of Energy program aimed at conducting research that will improve the energy efficiency of the nation's stock of conventionally-built and manufactured homes, and presenting the results to the public in a simplified format.
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Automated dating of the world’s language families based on lexical similarity
Holman, E.W.; Brown, C.H.; Wichmann, S.; Müller, A.; Velupillai, V.; Hammarström, H.; Sauppe, S.; Jung, H.; Bakker, D.; Brown, P.; Belyaev, O.; Urban, M.; Mailhammer, R.; List, J.-M.; Egorov, D.
2011-01-01
This paper describes a computerized alternative to glottochronology for estimating elapsed time since parent languages diverged into daughter languages. The method, developed by the Automated Similarity Judgment Program (ASJP) consortium, is different from glottochronology in four major respects:
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Hughes, Roxanne M.; Nzekwe, Brandon; Molyneaux, Kristen J.
2013-01-01
Currently, there are policy debates regarding the efficacy and legality of single sex formal and informal education programs. This issue is particularly poignant in science education due to the historical marginalization of women in these fields. This marginalization has resulted in women being positioned as a stigmatized group within many…
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A COMPARISON OF SEMANTIC SIMILARITY MODELS IN EVALUATING CONCEPT SIMILARITY
Directory of Open Access Journals (Sweden)
Q. X. Xu
2012-08-01
Full Text Available The semantic similarities are important in concept definition, recognition, categorization, interpretation, and integration. Many semantic similarity models have been established to evaluate semantic similarities of objects or/and concepts. To find out the suitability and performance of different models in evaluating concept similarities, we make a comparison of four main types of models in this paper: the geometric model, the feature model, the network model, and the transformational model. Fundamental principles and main characteristics of these models are introduced and compared firstly. Land use and land cover concepts of NLCD92 are employed as examples in the case study. The results demonstrate that correlations between these models are very high for a possible reason that all these models are designed to simulate the similarity judgement of human mind.
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Gasparini, Maurizio; Lunati, Maurizio G; Proclemer, Alessandro; Arenal, Angel; Kloppe, Axel; Martínez Ferrer, Josè B; Hersi, Ahmad S; Gulaj, Marcin; Wijffels, Maurits C E; Santi, Elisabetta; Manotta, Laura; Varma, Niraj
2017-11-01
This study sought to evaluate the effects of programming a long detection in single-chamber (VVI) implantable cardioverter-defibrillators (ICDs) in the multicenter prospective ADVANCE III (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III) trial. Programming strategies may reduce unnecessary ICD shocks and their adverse effects but to date have been described only for dual-chamber ICDs. A total of 545 subjects (85% male; atrial fibrillation 25%, left ventricular ejection fraction 31%, ischemic etiology 68%, secondary prevention indications 32%) receiving a VVI ICD were randomized to long detection (30 of 40 intervals) or standard programming (18 of 24 intervals) based on device type, atrial fibrillation history, and indication. In both arms, antitachycardia pacing (ATP) therapy during charging was programmed for episodes with cycle length 320 to 200 ms and shock only for cycle length functions enabled. Therapies delivered were compared using a negative binomial regression model. A total of 267 patients were randomized to long detection and 278 to the control group. Median follow-up was 12 months. One hundred twelve therapies (shocks and ATP) occurred in the long detection arm versus 257 in the control arm, for a 48% reduction with 30 of 40 intervals (95% confidence interval [CI]: 0.36 to 0.76; p = 0.002). In the long detection arm, overall shocks were reduced by 40% compared to the control arm (48 vs. 24; 95% CI: 0.38 to 0.94; p = 0.026) and appropriate shocks by 51% (34 vs. 74; 95% CI: 0.26 to 0.94; p = 0.033). Syncopal events did not differ between arms, but survival improved in the long detection arm. Among patients implanted with a VVI ICD, programming with the long detection interval significantly reduced appropriate therapies, shocks, and all-cause mortality. (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III [ADVANCEIII]; NCT00617175). Copyright © 2017 The Authors. Published by Elsevier Inc. All
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On theory of single-molecule transistor
International Nuclear Information System (INIS)
Tran Tien Phuc
2009-01-01
The results of the study on single-molecule transistor are mainly investigated in this paper. The structure of constructed single-molecule transistor is similar to a conventional MOSFET. The conductive channel of the transistors is a single-molecule of halogenated benzene derivatives. The chemical simulation software CAChe was used to design and implement for the essential parameter of the molecules utilized as the conductive channel. The GUI of Matlab has been built to design its graphical interface, calculate and plot the output I-V characteristic curves for the transistor. The influence of temperature, length and width of the conductive channel, and gate voltage is considered. As a result, the simulated curves are similar to the traditional MOSFET's. The operating temperature range of the transistors is wider compared with silicon semiconductors. The supply voltage for transistors is only about 1 V. The size of transistors in this research is several nanometers.
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Single-Sex Education in the 21st Century. Education Policy Brief. Volume 6, Number 9, Fall 2008
Cable, Kelly E.; Spradlin, Terry E.
2008-01-01
Single-sex education describes a diverse range of situations, including individual classes, programs after school, required programs, voluntary programs, and programs to remedy gender inequities and encourage cultural and racial pride. This brief addresses the genesis and legality of single-sex classrooms, the merits and critiques of single-sex…
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Towards Personalized Medicine: Leveraging Patient Similarity and Drug Similarity Analytics
Zhang, Ping; Wang, Fei; Hu, Jianying; Sorrentino, Robert
2014-01-01
The rapid adoption of electronic health records (EHR) provides a comprehensive source for exploratory and predictive analytic to support clinical decision-making. In this paper, we investigate how to utilize EHR to tailor treatments to individual patients based on their likelihood to respond to a therapy. We construct a heterogeneous graph which includes two domains (patients and drugs) and encodes three relationships (patient similarity, drug similarity, and patient-drug prior associations). We describe a novel approach for performing a label propagation procedure to spread the label information representing the effectiveness of different drugs for different patients over this heterogeneous graph. The proposed method has been applied on a real-world EHR dataset to help identify personalized treatments for hypercholesterolemia. The experimental results demonstrate the effectiveness of the approach and suggest that the combination of appropriate patient similarity and drug similarity analytics could lead to actionable insights for personalized medicine. Particularly, by leveraging drug similarity in combination with patient similarity, our method could perform well even on new or rarely used drugs for which there are few records of known past performance. PMID:25717413
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A Grammar-Based Semantic Similarity Algorithm for Natural Language Sentences
Chang, Jia Wei; Hsieh, Tung Cheng
2014-01-01
This paper presents a grammar and semantic corpus based similarity algorithm for natural language sentences. Natural language, in opposition to “artificial language”, such as computer programming languages, is the language used by the general public for daily communication. Traditional information retrieval approaches, such as vector models, LSA, HAL, or even the ontology-based approaches that extend to include concept similarity comparison instead of cooccurrence terms/words, may not always determine the perfect matching while there is no obvious relation or concept overlap between two natural language sentences. This paper proposes a sentence similarity algorithm that takes advantage of corpus-based ontology and grammatical rules to overcome the addressed problems. Experiments on two famous benchmarks demonstrate that the proposed algorithm has a significant performance improvement in sentences/short-texts with arbitrary syntax and structure. PMID:24982952
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A Grammar-Based Semantic Similarity Algorithm for Natural Language Sentences
Directory of Open Access Journals (Sweden)
Ming Che Lee
2014-01-01
Full Text Available This paper presents a grammar and semantic corpus based similarity algorithm for natural language sentences. Natural language, in opposition to “artificial language”, such as computer programming languages, is the language used by the general public for daily communication. Traditional information retrieval approaches, such as vector models, LSA, HAL, or even the ontology-based approaches that extend to include concept similarity comparison instead of cooccurrence terms/words, may not always determine the perfect matching while there is no obvious relation or concept overlap between two natural language sentences. This paper proposes a sentence similarity algorithm that takes advantage of corpus-based ontology and grammatical rules to overcome the addressed problems. Experiments on two famous benchmarks demonstrate that the proposed algorithm has a significant performance improvement in sentences/short-texts with arbitrary syntax and structure.
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California State Dept. of Education, Sacramento. Div. of School Facilities Planning.
This report examines single- and multi-track educational programs as found in California's public school system, explores the pros and cons of using year-round education (YRE) programs, and how to implement these programs. Each year-round tracking system is detailed using each of their calendars in a side-by-side comparison along with the…
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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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AREAL FEATURE MATCHING BASED ON SIMILARITY USING CRITIC METHOD
Directory of Open Access Journals (Sweden)
J. Kim
2015-10-01
Full Text Available In this paper, we propose an areal feature matching method that can be applied for many-to-many matching, which involves matching a simple entity with an aggregate of several polygons or two aggregates of several polygons with fewer user intervention. To this end, an affine transformation is applied to two datasets by using polygon pairs for which the building name is the same. Then, two datasets are overlaid with intersected polygon pairs that are selected as candidate matching pairs. If many polygons intersect at this time, we calculate the inclusion function between such polygons. When the value is more than 0.4, many of the polygons are aggregated as single polygons by using a convex hull. Finally, the shape similarity is calculated between the candidate pairs according to the linear sum of the weights computed in CRITIC method and the position similarity, shape ratio similarity, and overlap similarity. The candidate pairs for which the value of the shape similarity is more than 0.7 are determined as matching pairs. We applied the method to two geospatial datasets: the digital topographic map and the KAIS map in South Korea. As a result, the visual evaluation showed two polygons that had been well detected by using the proposed method. The statistical evaluation indicates that the proposed method is accurate when using our test dataset with a high F-measure of 0.91.
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A versatile optical microscope for time-dependent single-molecule and single-particle spectroscopy
Li, Hao; Yang, Haw
2018-03-01
This work reports the design and implementation of a multi-function optical microscope for time-dependent spectroscopy on single molecules and single nanoparticles. It integrates the now-routine single-object measurements into one standalone platform so that no reconfiguration is needed when switching between different types of sample or spectroscopy modes. The illumination modes include evanescent field through total internal reflection, dark-field illumination, and epi-excitation onto a diffraction-limited spot suitable for confocal detection. The detection modes include spectrally resolved line imaging, wide-field imaging with dual-color capability, and two-color single-element photon-counting detection. The switch between different spectroscopy and data acquisition modes is fully automated and executed through computer programming. The capability of this microscope is demonstrated through selected proof-of-principle experiments.
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A versatile optical microscope for time-dependent single-molecule and single-particle spectroscopy.
Li, Hao; Yang, Haw
2018-03-28
This work reports the design and implementation of a multi-function optical microscope for time-dependent spectroscopy on single molecules and single nanoparticles. It integrates the now-routine single-object measurements into one standalone platform so that no reconfiguration is needed when switching between different types of sample or spectroscopy modes. The illumination modes include evanescent field through total internal reflection, dark-field illumination, and epi-excitation onto a diffraction-limited spot suitable for confocal detection. The detection modes include spectrally resolved line imaging, wide-field imaging with dual-color capability, and two-color single-element photon-counting detection. The switch between different spectroscopy and data acquisition modes is fully automated and executed through computer programming. The capability of this microscope is demonstrated through selected proof-of-principle experiments.
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Anderson, R. D.
1985-01-01
Single-rotation propfan-powered regional transport aircraft were studied to identify key technology development issues and programs. The need for improved thrust specific fuel consumption to reduce fuel burned and aircraft direct operating cost is the dominant factor. Typical cycle trends for minimizing fuel consumption are reviewed, and two 10,000 shp class engine configurations for propfan propulsion systems for the 1990's are presented. Recommended engine configurations are both three-spool design with dual spool compressors and free power turbines. The benefits of these new propulsion system concepts were evaluated using an advanced airframe, and results are compared for single-rotation propfan and turbofan advanced technology propulsion systems. The single-rotation gearbox is compared to a similar design with current technology to establish the benefits of the advanced gearbox technology. The conceptual design of the advanced pitch change mechanism identified a high pressure hydraulic system that is superior to the other contenders and completely external to the gearboxes.
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Šmit, Matej
2016-01-01
Most operating systems are written in the C programming language. Similar is with system software, for example, device drivers, compilers, debuggers, disk checkers, etc. Recently some new programming languages emerged, which are supposed to be suitable for system programming. In this thesis we present programming languages D, Go, Nim and Rust. We defined the criteria which are important for deciding whether programming language is suitable for system programming. We examine programming langua...
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SINGLE HEATER TEST FINAL REPORT
Energy Technology Data Exchange (ETDEWEB)
J.B. Cho
1999-05-01
The Single Heater Test is the first of the in-situ thermal tests conducted by the U.S. Department of Energy as part of its program of characterizing Yucca Mountain in Nevada as the potential site for a proposed deep geologic repository for the disposal of spent nuclear fuel and high-level nuclear waste. The Site Characterization Plan (DOE 1988) contained an extensive plan of in-situ thermal tests aimed at understanding specific aspects of the response of the local rock-mass around the potential repository to the heat from the radioactive decay of the emplaced waste. With the refocusing of the Site Characterization Plan by the ''Civilian Radioactive Waste Management Program Plan'' (DOE 1994), a consolidated thermal testing program emerged by 1995 as documented in the reports ''In-Situ Thermal Testing Program Strategy'' (DOE 1995) and ''Updated In-Situ Thermal Testing Program Strategy'' (CRWMS M&O 1997a). The concept of the Single Heater Test took shape in the summer of 1995 and detailed planning and design of the test started with the beginning fiscal year 1996. The overall objective of the Single Heater Test was to gain an understanding of the coupled thermal, mechanical, hydrological, and chemical processes that are anticipated to occur in the local rock-mass in the potential repository as a result of heat from radioactive decay of the emplaced waste. This included making a priori predictions of the test results using existing models and subsequently refining or modifying the models, on the basis of comparative and interpretive analyses of the measurements and predictions. A second, no less important, objective was to try out, in a full-scale field setting, the various instruments and equipment to be employed in the future on a much larger, more complex, thermal test of longer duration, such as the Drift Scale Test. This ''shake down'' or trial aspect of the Single Heater Test applied
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Managing orthopedics and neurosciences costs through standard treatment protocols.
McGinnity, E S; Pluth, T E
1994-06-01
High-cost, high-volume specialty programs such as orthopedics and neurosciences find themselves in a position of evaluating the costs and in some cases the appropriateness of medical practices in response to payer scrutiny and provider selection processes. Orthopedics and neurosciences programs are at a stage of development analogous to that of cardiovascular care several years ago. Many of the same trends have come into play, such as payer "carve-outs" for orthopedic services, payer selection of centers of excellence based on cost and quality, reduction of Medicare reimbursement, greater use of high-cost technology, the decline of profitability due to "older, sicker, and tougher" patients, and the recent emergence of national orthopedic specialty networks oriented to national contracts for care. In an era in which payers demand value on both sides of the cost-plus-quality equation, programs are challenged to maximize the return on a patient population rife with "no-win" situations. In the orthopedic service line these include a high proportion of Medicare patients and chronic conditions such as workers' compensation medical back cases or repetitive motion injuries, which can be elusive to diagnose and expensive to treat. Many hospitals continue to lose money on joint replacement surgeries, the largest-volume orthopedic inpatient service, primarily because of the high Medicare population and the cost of implants. Neuroservices, while still relatively well reimbursed, face a rising proportion of Medicare payments as patients live longer and develop chronic, degenerative conditions. Inpatient days are decreasing due to payer pressures to limit hospital stays and to shift inpatient care to outpatient services. Some hospitals "have lost interest in (the orthopedic) service line during the last five years because of recent trends in orthopedic-related inpatient volume and payment." But by managing costs strategically, both the neurosciences and orthopedics service lines
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Advances in single chain technology.
Gonzalez-Burgos, Marina; Latorre-Sanchez, Alejandro; Pomposo, José A
2015-10-07
The recent ability to manipulate and visualize single atoms at atomic level has given rise to modern bottom-up nanotechnology. Similar exquisite degree of control at the individual polymeric chain level for producing functional soft nanoentities is expected to become a reality in the next few years through the full development of so-called "single chain technology". Ultra-small unimolecular soft nano-objects endowed with useful, autonomous and smart functions are the expected, long-term valuable output of single chain technology. This review covers the recent advances in single chain technology for the construction of soft nano-objects via chain compaction, with an emphasis in dynamic, letter-shaped and compositionally unsymmetrical single rings, complex multi-ring systems, single chain nanoparticles, tadpoles, dumbbells and hairpins, as well as the potential end-use applications of individual soft nano-objects endowed with useful functions in catalysis, sensing, drug delivery and other uses.
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Corriero, Rosemary; Redmon, Ginger
Before participating in a project funded by the Centers for Disease Control and Prevention, most state and local health departments (LHDs) were not seeking reimbursement or being fully reimbursed by insurance plans for the cost of immunization services (including vaccine costs and administration fees) they provided to insured patients. Centers for Disease Control and Prevention's Billables Project was designed to enable state and LHDs to bill public and private insurance plans for immunization services provided to insured patients. Identify and describe key barriers state and LHDs may encounter while planning and implementing a billing program, as well as possible solutions for overcoming those barriers. This study used reports from Billables Project participants to explore barriers they encountered when planning and implementing a billing program and steps taken to address those barriers. Thirty-eight state immunization programs. Based on project participants' reports, barriers were noted in 7 categories: (1) funding and costs, (2) staff, (3) health department characteristics, (4) third-party payers and insurance plans, (5) software, (6) patient insurance status, and (7) other barriers. Possible solutions for overcoming those barriers included hiring or seeking external help, creating billing guides and training modules, streamlining workflows, and modifying existing software systems. Overcoming barriers during planning and implementation of a billing program can be challenging for state and LHDs, but the experiences and suggestions of past Billables Project participants can help guide future billing program efforts.
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Single-electron tunnel junction array
International Nuclear Information System (INIS)
Likharev, K.K.; Bakhvalov, N.S.; Kazacha, G.S.; Serdyukova, S.I.
1989-01-01
The authors have carried out an analysis of statics and dynamics of uniform one-dimensional arrays of ultrasmall tunnel junctions. The correlated single-electron tunneling in the junctions of the array results in its behavior qualitatively similar to that of the Josephson transmission line. In particular, external electric fields applied to the array edges can inject single-electron-charged solitons into the array interior. Shape of such soliton and character of its interactions with other solitons and the array edges are very similar to those of the Josephson vortices (sine-Gordon solitons) in the Josephson transmission line. Under certain conditions, a coherent motion of the soliton train along the array is possible, resulting in generation of narrowband SET oscillations with frequency f/sub s/ = /e where is the dc current flowing along the array
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Directory of Open Access Journals (Sweden)
Feazadeh Avraham
2007-01-01
Full Text Available Patello-femoral pain syndrome (PFPS is a common knee joint disability. The integration of hip soft tissue regimens are not always emphasized, although current literature implies that there is a significant relationship between the two and there is a lack of randomized clinical trials to substantiate this relationship in clinical practice. A randomized controlled assessor blinded trial was designed to explore different rehabilitation programs related to PFPS. The study was conducted at RAZIEL institute of physical therapy, Netania, Israel with a total of 30 consecutive patients (mean age 35y, diagnosed with PFPS. All patients were randomly allocated into 3 groups. Group I conventional knee rehabilitation program. Included quadriceps strengthening and Trans Electric Neuromuscular Stimulation (TENS. Group II hip oriented rehabilitation program. included stretching, Hip external rotators strengthening and TENS. Group III a combination of the two above programs. Pain and function were documented on initial of the program and again 3 weeks later, on the completion. Pain was assessed by a numeric visual analogue scale (VAS; function was assessed by Patello-femoral joint evaluation scale (PFJES (0-100 points. At end of trial, all groups showed significant improvements in VAS and PFJES (p<0.0001; these improvements did not vary significantly between the 3 groups. The conclusions were that the explored different rehabilitation programs showed a similar beneficial effect.
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Herzfeld, T.; Jongeneel, R.A.
2012-01-01
Agricultural production experiences a shift in underlying institutions during the last years., Importance of private stakeholders like retailers, processors, consumers as well as tax payers is, emerging. Eligibility for single farm payments and marketing of products is linked to compliance with,
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Molecular similarity measures.
Maggiora, Gerald M; Shanmugasundaram, Veerabahu
2011-01-01
Molecular similarity is a pervasive concept in chemistry. It is essential to many aspects of chemical reasoning and analysis and is perhaps the fundamental assumption underlying medicinal chemistry. Dissimilarity, the complement of similarity, also plays a major role in a growing number of applications of molecular diversity in combinatorial chemistry, high-throughput screening, and related fields. How molecular information is represented, called the representation problem, is important to the type of molecular similarity analysis (MSA) that can be carried out in any given situation. In this work, four types of mathematical structure are used to represent molecular information: sets, graphs, vectors, and functions. Molecular similarity is a pairwise relationship that induces structure into sets of molecules, giving rise to the concept of chemical space. Although all three concepts - molecular similarity, molecular representation, and chemical space - are treated in this chapter, the emphasis is on molecular similarity measures. Similarity measures, also called similarity coefficients or indices, are functions that map pairs of compatible molecular representations that are of the same mathematical form into real numbers usually, but not always, lying on the unit interval. This chapter presents a somewhat pedagogical discussion of many types of molecular similarity measures, their strengths and limitations, and their relationship to one another. An expanded account of the material on chemical spaces presented in the first edition of this book is also provided. It includes a discussion of the topography of activity landscapes and the role that activity cliffs in these landscapes play in structure-activity studies.
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Abduction, ASP and Open Logic Programs
Bonatti, Piero A.
2002-01-01
Open logic programs and open entailment have been recently proposed as an abstract framework for the verification of incomplete specifications based upon normal logic programs and the stable model semantics. There are obvious analogies between open predicates and abducible predicates. However, despite superficial similarities, there are features of open programs that have no immediate counterpart in the framework of abduction and viceversa. Similarly, open programs cannot be immediately simul...
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Toy Control Program evaluation.
Stewart, H A; Ormond, C; Seeger, B R
1991-08-01
The Toy Control Program for the Apple IIe microcomputer is a software and hardware package developed for the training of single-switch scanning skills. The specially designed scanning programs provide on screen visual feedback and activate a battery-powered toy to reinforce performance. This study examined whether the training of preschool subjects in single-switch scanning skills with the Toy Control Program would result in increased task completion scores and increased levels of attention to task, as compared with conditions of toy activation only and microcomputer programs with screen reinforcement only. The results showed that the subjects paid significantly more attention to the toys as reinforcers (p less than .01). No significant difference was found for the performance results of the three conditions. These findings support the use of a program like the Toy Control Program, which integrates the instructional capabilities of a computer with the reinforcement potential of a toy and the creativity of a therapist.
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Khot, Umesh N; Johnson-Wood, Michele L; Geddes, Jason B; Ramsey, Curtis; Khot, Monica B; Taillon, Heather; Todd, Randall; Shaikh, Saeed R; Berg, William J
2009-07-26
The impact of reducing door-to-balloon time on hospital revenues, costs, and net income is unknown. We prospectively determined the impact on hospital finances of (1) emergency department physician activation of the catheterization lab and (2) immediate transfer of the patient to an immediately available catheterization lab by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse. We collected financial data for 52 consecutive ST-elevation myocardial infarction patients undergoing emergency percutaneous intervention from October 1, 2004-August 31, 2005 and compared this group to 80 consecutive ST-elevation myocardial infarction patients from September 1, 2005-June 26, 2006 after protocol implementation. Per hospital admission, insurance payments (hospital revenue) decreased ($35,043 +/- $36,670 vs. $25,329 +/- $16,185, P = 0.039) along with total hospital costs ($28,082 +/- $31,453 vs. $18,195 +/- $9,242, P = 0.009). Hospital net income per admission was unchanged ($6962 vs. $7134, P = 0.95) as the drop in hospital revenue equaled the drop in costs. For every $1000 reduction in total hospital costs, insurance payments (hospital revenue) dropped $1077 for private payers and $1199 for Medicare/Medicaid. A decrease in hospital charges ($70,430 +/- $74,033 vs. $53,514 +/- $23,378, P = 0.059), diagnosis related group relative weight (3.7479 +/- 2.6731 vs. 2.9729 +/- 0.8545, P = 0.017) and outlier payments with hospital revenue>$100,000 (7.7% vs. 0%, P = 0.022) all contributed to decreasing ST-elevation myocardial infarction hospitalization revenue. One-year post-discharge financial follow-up revealed similar results: Insurance payments: $49,959 +/- $53,741 vs. $35,937 +/- $23,125, P = 0.044; Total hospital costs: $39,974 +/- $37,434 vs. $26,778 +/- $15,561, P = 0.007; Net Income: $9984 vs. $9159, P = 0.855. All of the financial benefits of reducing door-to-balloon time in ST-elevation myocardial
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Meeting your match: how attractiveness similarity affects approach behavior in mixed-sex dyads.
van Straaten, Ischa; Engels, Rutger C M E; Finkenauer, Catrin; Holland, Rob W
2009-06-01
This experimental study investigated approach behavior toward opposite-sex others of similar versus dissimilar physical attractiveness. Furthermore, it tested the moderating effects of sex. Single participants interacted with confederates of high and low attractiveness. Observers rated their behavior in terms of relational investment (i.e., behavioral efforts related to the improvement of interaction fluency, communication of positive interpersonal affect, and positive self-presentation). As expected, men displayed more relational investment behavior if their own physical attractiveness was similar to that of the confederate. For women, no effects of attractiveness similarity on relational investment behavior were found. Results are discussed in the light of positive assortative mating, preferences for physically attractive mates, and sex differences in attraction-related interpersonal behaviors.
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34 CFR 403.180 - How must a State reserve funds for the basic programs?
2010-07-01
...) The Program for Single Parents, Displaced Homemakers, and Single Pregnant Women under § 403.81, and... the Program for Single Parents, Displaced Homemakers, and Single Pregnant Women described in § 403.81... Program for Single Parents, Displaced Homemakers, and Single Pregnant Women. (ii) Not less than three...
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Genetic similarity among commercial oil palm materials based on microsatellite markers
Directory of Open Access Journals (Sweden)
Diana Arias
2012-08-01
Full Text Available Microsatellite markers are used to determine genetic similarities among individuals and might be used in various applications in breeding programs. For example, knowing the genetic similarity relationships of commercial planting materials helps to better understand their responses to environmental, agronomic and plant health factors. This study assessed 17 microsatellite markers in 9 crosses (D x P of Elaeis guineensis Jacq. from various commercial companies in Malaysia, France, Costa Rica and Colombia, in order to find possible genetic differences and/or similarities. Seventy-seven alleles were obtained, with an average of 4.5 alleles per primer and a range of 2-8 amplified alleles. The results show a significant reduction of alleles, compared to the number of alleles reported for wild oil palm populations. The obtained dendrogram shows the formation of two groups based on their genetic similarity. Group A, with ~76% similarity, contains the commercial material of 3 codes of Deli x La Mé crosses produced in France and Colombia, and group B, with ~66% genetic similarity, includes all the materials produced by commercial companies in Malaysia, France, Costa Rica and Colombia
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Improved cosine similarity measures of simplified neutrosophic sets for medical diagnoses.
Ye, Jun
2015-03-01
In pattern recognition and medical diagnosis, similarity measure is an important mathematical tool. To overcome some disadvantages of existing cosine similarity measures of simplified neutrosophic sets (SNSs) in vector space, this paper proposed improved cosine similarity measures of SNSs based on cosine function, including single valued neutrosophic cosine similarity measures and interval neutrosophic cosine similarity measures. Then, weighted cosine similarity measures of SNSs were introduced by taking into account the importance of each element. Further, a medical diagnosis method using the improved cosine similarity measures was proposed to solve medical diagnosis problems with simplified neutrosophic information. The improved cosine similarity measures between SNSs were introduced based on cosine function. Then, we compared the improved cosine similarity measures of SNSs with existing cosine similarity measures of SNSs by numerical examples to demonstrate their effectiveness and rationality for overcoming some shortcomings of existing cosine similarity measures of SNSs in some cases. In the medical diagnosis method, we can find a proper diagnosis by the cosine similarity measures between the symptoms and considered diseases which are represented by SNSs. Then, the medical diagnosis method based on the improved cosine similarity measures was applied to two medical diagnosis problems to show the applications and effectiveness of the proposed method. Two numerical examples all demonstrated that the improved cosine similarity measures of SNSs based on the cosine function can overcome the shortcomings of the existing cosine similarity measures between two vectors in some cases. By two medical diagnoses problems, the medical diagnoses using various similarity measures of SNSs indicated the identical diagnosis results and demonstrated the effectiveness and rationality of the diagnosis method proposed in this paper. The improved cosine measures of SNSs based on cosine
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Maritime Pre-Positioning Force-Future: Bill Payer or Sea Basing Enabler?
National Research Council Canada - National Science Library
Grotewold, William R
2008-01-01
.... The Maritime Prepositioning Force-Future (MPF-F) program, envisioned as a key enabler of sea basing, may be funded through further cuts in amphibious ships or fall victim to an untenable Navy ship building plan...
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Trefney, Charles J.
1999-01-01
This paper presents the "Three Pillars of Success" for the Trailblazer Program. The topics include: 1) The "Rocket Equation" for SSTO (Single Stage To Orbit); 2) The Rocket I* Barrier; 3) Rocket-Based Combined-Cycle Engine; 4) Potential for Reusability; 5) Factors Mitigating RBCC Performance; 6) The "Trailblazer" Program; 7) Trailblazer Performance Goals; 8) Trailblazer Reference Vehicle; and 9) Trailblazer Program Architecture.
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Attenuation of thermal neutrons by an imperfect single crystal
Energy Technology Data Exchange (ETDEWEB)
Naguib, K.; Adib, M. [National Research Centre, Cairo (Egypt). Reactor and Neutron Physics Dept.
1996-06-14
A semi-empirical formula is given which allows one to calculate the total thermal cross section of an imperfect single crystal as a function of crystal constants, temperature and neutron energy E, in the energy range between 3 meV and 10 eV. The formula also includes the contribution of the parasitic Bragg scattering to the total cross section that takes into account the crystal mosaic spread value and its orientation with respect to the neutron beam direction. A computer program (ISCANF) was developed to calculate the total attenuation of neutrons using the proposed formula. The ISCANF program was applied to investigate the neutron attenuation through a copper single crystal. The calculated values of the neutron transmission through the imperfect copper single crystal were fitted to the measured ones in the energy range 3-40 meV at different crystal orientations. The result of fitting shows that use of the computer program ISCANF allows one to predict the behaviour of the total cross section of an imperfect copper single crystal for the whole energy range. (author).
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Attenuation of thermal neutrons by an imperfect single crystal
Naguib, K.; Adib, M.
1996-06-01
A semi-empirical formula is given which allows one to calculate the total thermal cross section of an imperfect single crystal as a function of crystal constants, temperature and neutron energy E, in the energy range between 3 meV and 10 eV. The formula also includes the contribution of the parasitic Bragg scattering to the total cross section that takes into account the crystal mosaic spread value and its orientation with respect to the neutron beam direction. A computer program (ISCANF) was developed to calculate the total attenuation of neutrons using the proposed formula. The ISCANF program was applied to investigate the neutron attenuation through a copper single crystal. The calculated values of the neutron transmission through the imperfect copper single crystal were fitted to the measured ones in the energy range 3 - 40 meV at different crystal orientations. The result of fitting shows that use of the computer program ISCANF allows one to predict the behaviour of the total cross section of an imperfect copper single crystal for the whole energy range.
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Coffman, Kirsten E; Taylor, Bryan J; Carlson, Alex R; Wentz, Robert J; Johnson, Bruce D
2016-01-15
Alveolar-capillary membrane conductance (D(M,CO)) and pulmonary-capillary blood volume (V(C)) are calculated via lung diffusing capacity for carbon monoxide (DL(CO)) and nitric oxide (DL(NO)) using the single breath, single oxygen tension (single-FiO2) method. However, two calculation parameters, the reaction rate of carbon monoxide with blood (θ(CO)) and the D(M,NO)/D(M,CO) ratio (α-ratio), are controversial. This study systematically determined optimal θ(CO) and α-ratio values to be used in the single-FiO2 method that yielded the most similar D(M,CO) and V(C) values compared to the 'gold-standard' multiple-FiO2 method. Eleven healthy subjects performed single breath DL(CO)/DL(NO) maneuvers at rest and during exercise. D(M,CO) and V(C) were calculated via the single-FiO2 and multiple-FiO2 methods by implementing seven θ(CO) equations and a range of previously reported α-ratios. The RP θ(CO) equation (Reeves, R.B., Park, H.K., 1992. Respiration Physiology 88 1-21) and an α-ratio of 4.0-4.4 yielded DM,CO and VC values that were most similar between methods. The RP θ(CO) equation and an experimental α-ratio should be used in future studies. Copyright © 2015 Elsevier B.V. All rights reserved.
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Klumpp, A. R.; Lawson, C. L.
1988-01-01
Routines provided for common scalar, vector, matrix, and quaternion operations. Computer program extends Ada programming language to include linear-algebra capabilities similar to HAS/S programming language. Designed for such avionics applications as software for Space Station.
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Similarly shaped letters evoke similar colors in grapheme-color synesthesia.
Brang, David; Rouw, Romke; Ramachandran, V S; Coulson, Seana
2011-04-01
Grapheme-color synesthesia is a neurological condition in which viewing numbers or letters (graphemes) results in the concurrent sensation of color. While the anatomical substrates underlying this experience are well understood, little research to date has investigated factors influencing the particular colors associated with particular graphemes or how synesthesia occurs developmentally. A recent suggestion of such an interaction has been proposed in the cascaded cross-tuning (CCT) model of synesthesia, which posits that in synesthetes connections between grapheme regions and color area V4 participate in a competitive activation process, with synesthetic colors arising during the component-stage of grapheme processing. This model more directly suggests that graphemes sharing similar component features (lines, curves, etc.) should accordingly activate more similar synesthetic colors. To test this proposal, we created and regressed synesthetic color-similarity matrices for each of 52 synesthetes against a letter-confusability matrix, an unbiased measure of visual similarity among graphemes. Results of synesthetes' grapheme-color correspondences indeed revealed that more similarly shaped graphemes corresponded with more similar synesthetic colors, with stronger effects observed in individuals with more intense synesthetic experiences (projector synesthetes). These results support the CCT model of synesthesia, implicate early perceptual mechanisms as driving factors in the elicitation of synesthetic hues, and further highlight the relationship between conceptual and perceptual factors in this phenomenon. Copyright © 2011 Elsevier Ltd. All rights reserved.
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International Nuclear Information System (INIS)
Condron, Eoin; Nolan, Brien C
2014-01-01
We investigate self-similar scalar field solutions to the Einstein equations in whole cylinder symmetry. Imposing self-similarity on the spacetime gives rise to a set of single variable functions describing the metric. Furthermore, it is shown that the scalar field is dependent on a single unknown function of the same variable and that the scalar field potential has exponential form. The Einstein equations then take the form of a set of ODEs. Self-similarity also gives rise to a singularity at the scaling origin. We extend the work of Condron and Nolan (2014 Class. Quantum Grav. 31 015015), which determined the global structure of all solutions with a regular axis in the causal past of the singularity. We identified a class of solutions that evolves through the past null cone of the singularity. We give the global structure of these solutions and show that the singularity is censored in all cases. (paper)
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Browning, Lauren M; Lee, Kerry J; Cherukuri, Pavan K; Huang, Tao; Songkiatisak, Preeyaporn; Warren, Seth; Xu, Xiao-Hong Nancy
2018-03-26
ATP-binding cassette (ABC) membrane transporters serve as self-defense transport apparatus in many living organisms and they can selectively extrude a wide variety of substrates, leading to multidrug resistance (MDR). The detailed molecular mechanisms remain elusive. Single nanoparticle plasmonic spectroscopy highly depends upon their sizes, shapes, chemical and surface properties. In our previous studies, we have used the size-dependent plasmonic spectra of single silver nanoparticles (Ag NPs) to study the real-time efflux kinetics of the ABC (BmrA) transporter and MexAB-OprM transporter in single live cells (Gram-positive and Gram-negative bacterium), respectively. In this study, we prepared and used purified, biocompatible and stable (non-aggregated) gold nanoparticles (Au NPs) (12.4 ± 0.9 nm) to study the efflux kinetics of single BmrA membrane transporters of single live Bacillus subtillis cells, aiming to probe chemical dependent efflux functions of BmrA transporters and their potential chemical sensing capability. Similar to those observed using Ag NPs, accumulation of the intracellular Au NPs in single live cells (WT and ΔBmrA) highly depends upon the cellular expression of BmrA and the NP concentration (0.7 and 1.4 nM). The lower accumulation of intracellular Au NPs in WT (normal expression of BmrA) than ΔBmrA (deletion of bmrA) indicates that BmrA extrudes the Au NPs out of the WT cells. The accumulation of Au NPs in the cells increases with NP concentration, suggesting that the Au NPs most likely passively diffuse into the cells, similar to antibiotics. The result demonstrates that such small Au NPs can serve as imaging probes to study the efflux function of the BmrA membrane transporter in single live cells. Furthermore, the dependence of the accumulation rate of intracellular Au NPs in single live cells upon the expression of BmrA and the concentration of the NPs is about twice higher than that of the same sized Ag NPs. This interesting finding
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Ikram, Najmul; Qadir, Muhammad Abdul; Afzal, Muhammad Tanvir
2018-01-01
Sequence similarity is a commonly used measure to compare proteins. With the increasing use of ontologies, semantic (function) similarity is getting importance. The correlation between these measures has been applied in the evaluation of new semantic similarity methods, and in protein function prediction. In this research, we investigate the relationship between the two similarity methods. The results suggest absence of a strong correlation between sequence and semantic similarities. There is a large number of proteins with low sequence similarity and high semantic similarity. We observe that Pearson's correlation coefficient is not sufficient to explain the nature of this relationship. Interestingly, the term semantic similarity values above 0 and below 1 do not seem to play a role in improving the correlation. That is, the correlation coefficient depends only on the number of common GO terms in proteins under comparison, and the semantic similarity measurement method does not influence it. Semantic similarity and sequence similarity have a distinct behavior. These findings are of significant effect for future works on protein comparison, and will help understand the semantic similarity between proteins in a better way.
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DEFF Research Database (Denmark)
Yazdani, Hossein; Ortiz-Arroyo, Daniel; Kwasnicka, Halina
2016-01-01
spaces, in addition to their similarity in the vector space. Prioritized Weighted Feature Distance (PWFD) works similarly as WFD, but provides the ability to give priorities to desirable features. The accuracy of the proposed functions are compared with other similarity functions on several data sets....... Our results show that the proposed functions work better than other methods proposed in the literature....
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12 CFR 613.3300 - Participations and other interests in loans to similar entities.
2010-01-01
... outstanding under paragraph (b) of this section to a single credit risk shall not exceed 10 percent of its... similar entities. 613.3300 Section 613.3300 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT... purchase, sale, or transfer of interests in loans, or other extensions of credit, or other technical and...
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2010-10-15
... public agency or its delegate that has legal responsibility and authority for responding to an incident... legal responsibility and authority for responding to an incident, based on political or geographical (e... future, or that may have a legal or contractual obligation to do so. These payers include, but are not...
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Rapidly rotating single late-type giants: New FK Comae stars?
Fekel, Francis C.
1986-01-01
A group of rapidly rotating single late-type giants was found from surveys of chromospherically active stars. These stars have V sin I's ranging from 6 to 46 km/sec, modest ultraviolet emission line fluxes, and strong H alpha absorption lines. Although certainly chromospherically active, their characteristics are much less extreme than those of FK Com and one or two other similar systems. One possible explanation for the newly identified systems is that they have evolved from stars similar to FK Com. The chromospheric activity and rotation of single giant stars like FK Com would be expected to decrease with time as they do in single dwarfs. Alternatively, this newly identified group may have evolved from single rapidly rotating A, or early F stars.
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Reducing Health Services for Refugees Through Reforms to the Interim Federal Health Program
Directory of Open Access Journals (Sweden)
Andrew C. Stevenson
2018-04-01
Full Text Available Since 1957 the Interim Federal Health Program (IFHP has provided temporary health care coverage to refugees and refugee claimants, but in 2012 the Conservative government reformed the IFHP, reducing, or eliminating access to health services for these groups. The government framed the changes around fairness and safety, stating that it would save tax payers $100 million over five years, reduce incentive for migrants with unfounded refugee claims from coming to Canada, protect public health and safety, and defend the integrity of the immigration system. With a Conservative majority, the reform was easily implemented despite a lack of evidence supporting these claims. In 2014, the Federal Court rejected the government's notion of fairness and safety, ruling that the cuts were cruel and unusual treatment of an already vulnerable population. The government appealed this ruling but, in 2016, the Liberals took power and restored funding to the IFHP to pre-2012 levels. Ad hoc evaluations predicted inequitable and adverse impacts on refugees, negative impacts on health, and increased costs to refugees, provincial governments, and health providers. Overall the threats and weaknesses of this reform clearly outweighed the few and unconvincing opportunities and strengths of the program, leading to its demise.
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GPU Accelerated Chemical Similarity Calculation for Compound Library Comparison
Ma, Chao; Wang, Lirong; Xie, Xiang-Qun
2012-01-01
Chemical similarity calculation plays an important role in compound library design, virtual screening, and “lead” optimization. In this manuscript, we present a novel GPU-accelerated algorithm for all-vs-all Tanimoto matrix calculation and nearest neighbor search. By taking advantage of multi-core GPU architecture and CUDA parallel programming technology, the algorithm is up to 39 times superior to the existing commercial software that runs on CPUs. Because of the utilization of intrinsic GPU instructions, this approach is nearly 10 times faster than existing GPU-accelerated sparse vector algorithm, when Unity fingerprints are used for Tanimoto calculation. The GPU program that implements this new method takes about 20 minutes to complete the calculation of Tanimoto coefficients between 32M PubChem compounds and 10K Active Probes compounds, i.e., 324G Tanimoto coefficients, on a 128-CUDA-core GPU. PMID:21692447
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Single nucleus genome sequencing reveals high similarity among nuclei of an endomycorrhizal fungus.
Directory of Open Access Journals (Sweden)
Kui Lin
2014-01-01
Full Text Available Nuclei of arbuscular endomycorrhizal fungi have been described as highly diverse due to their asexual nature and absence of a single cell stage with only one nucleus. This has raised fundamental questions concerning speciation, selection and transmission of the genetic make-up to next generations. Although this concept has become textbook knowledge, it is only based on studying a few loci, including 45S rDNA. To provide a more comprehensive insight into the genetic makeup of arbuscular endomycorrhizal fungi, we applied de novo genome sequencing of individual nuclei of Rhizophagus irregularis. This revealed a surprisingly low level of polymorphism between nuclei. In contrast, within a nucleus, the 45S rDNA repeat unit turned out to be highly diverged. This finding demystifies a long-lasting hypothesis on the complex genetic makeup of arbuscular endomycorrhizal fungi. Subsequent genome assembly resulted in the first draft reference genome sequence of an arbuscular endomycorrhizal fungus. Its length is 141 Mbps, representing over 27,000 protein-coding gene models. We used the genomic sequence to reinvestigate the phylogenetic relationships of Rhizophagus irregularis with other fungal phyla. This unambiguously demonstrated that Glomeromycota are more closely related to Mucoromycotina than to its postulated sister Dikarya.
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An Efficient Similarity Digests Database Lookup - A Logarithmic Divide & Conquer Approach
Directory of Open Access Journals (Sweden)
Frank Breitinger
2014-09-01
Full Text Available Investigating seized devices within digital forensics represents a challenging task due to the increasing amount of data. Common procedures utilize automated file identification, which reduces the amount of data an investigator has to examine manually. In the past years the research field of approximate matching arises to detect similar data. However, if n denotes the number of similarity digests in a database, then the lookup for a single similarity digest is of complexity of O(n. This paper presents a concept to extend existing approximate matching algorithms, which reduces the lookup complexity from O(n to O(log(n. Our proposed approach is based on the well-known divide and conquer paradigm and builds a Bloom filter-based tree data structure in order to enable an efficient lookup of similarity digests. Further, it is demonstrated that the presented technique is highly scalable operating a trade-off between storage requirements and computational efficiency. We perform a theoretical assessment based on recently published results and reasonable magnitudes of input data, and show that the complexity reduction achieved by the proposed technique yields a 220-fold acceleration of look-up costs.
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A Single Long-Term Acute Care Hospital Experience with a Pressure Ulcer Prevention Program.
Young, Daniel L; Borris-Hale, Cathy; Falconio-West, Margaret; Chakravarthy, Debashish
2015-01-01
The occurrence of pressure ulcers (PrUs) challenges care facilities. Few studies report PrU reduction efforts in long-term acute care (LTAC). This study described the PrU reduction efforts of a single, LTAC facility using the Medline Pressure Ulcer Prevention Program (mPUPP). This study was a quasi-experimental, quality improvement project, with pre- and postmeasurement design. Outcomes were tracked for 24 months. The mPUPP was implemented in month 11. Education for caregivers was provided through an interactive web-based suite. In addition, all Patient Care Technicians attended a 4-week 1-hour inservice. New skin care products were implemented. The facility also implemented an algorithm for treatment of wounds. There was a significant reduction in the mean monthly hospital-acquired PrU (nPrU) rate when preprogram is compared to postprogram. Sustainable nPrU reduction can be achieved with mPUPP. LTAC hospitals could expect to reduce nPrU with education and incentive of caregivers. © 2014 Association of Rehabilitation Nurses.
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Liu, Yongsuo; Meng, Qinghua; Jiang, Shumin; Hu, Yuzhu
2005-03-01
The similarity evaluation of the fingerprints is one of the most important problems in the quality control of the traditional Chinese medicine (TCM). Similarity measures used to evaluate the similarity of the common peaks in the chromatogram of TCM have been discussed. Comparative studies were carried out among correlation coefficient, cosine of the angle and an improved extent similarity method using simulated data and experimental data. Correlation coefficient and cosine of the angle are not sensitive to the differences of the data set. They are still not sensitive to the differences of the data even after normalization. According to the similarity system theory, an improved extent similarity method was proposed. The improved extent similarity is more sensitive to the differences of the data sets than correlation coefficient and cosine of the angle. And the character of the data sets needs not to be changed compared with log-transformation. The improved extent similarity can be used to evaluate the similarity of the chromatographic fingerprints of TCM.
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Ammerman, Robert T; Mallow, Peter J; Rizzo, John A; Putnam, Frank W; Van Ginkel, Judith B
2017-01-15
To determine the cost-effectiveness of In-Home Cognitive Behavioral Therapy (IH-CBT) for low-income mothers enrolled in a home visiting program. A cost-utility analysis was conducted using results from a clinical trial of IH-CBT and standard of care for depression derived from the literature. A probabilistic, patient-level Markov model was developed to determine Quality Adjusted Life Years (QALYs). Costs were determined using the Medical Expenditure Panel Survey. A three-year time horizon and payer perspective were used. Sensitivity analyses were employed to determine robustness of the model. IH-CBT was cost-effective relative to standard of care. IH-CBT was expected to be cost-effective at a three-year time horizon 99.5%, 99.7%, and 99.9% of the time for willingness-to-pay thresholds of US$25,000, US$50,000, and US$100,000, respectively. Patterns were upheld at one-year and five-year time horizons. Over the three-year time horizon, mothers receiving IH-CBT were expected to have 345.6 fewer days of depression relative to those receiving standard home visiting and treatment in the community. IH-CBT is a more cost-effective treatment for low-income, depressed mothers than current standards of practice. These findings add to the growing literature demonstrating the cost-effectiveness of CBT for depression, and expand it to cover new mothers. From a payer perspective, IH-CBT is a sound option for treatment of depressed, low-income mothers. Limitations include a restricted time horizon and estimating of standard of care costs. Copyright © 2016 Elsevier B.V. All rights reserved.
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Detecting high-order interactions of single nucleotide polymorphisms using genetic programming.
Nunkesser, Robin; Bernholt, Thorsten; Schwender, Holger; Ickstadt, Katja; Wegener, Ingo
2007-12-15
Not individual single nucleotide polymorphisms (SNPs), but high-order interactions of SNPs are assumed to be responsible for complex diseases such as cancer. Therefore, one of the major goals of genetic association studies concerned with such genotype data is the identification of these high-order interactions. This search is additionally impeded by the fact that these interactions often are only explanatory for a relatively small subgroup of patients. Most of the feature selection methods proposed in the literature, unfortunately, fail at this task, since they can either only identify individual variables or interactions of a low order, or try to find rules that are explanatory for a high percentage of the observations. In this article, we present a procedure based on genetic programming and multi-valued logic that enables the identification of high-order interactions of categorical variables such as SNPs. This method called GPAS cannot only be used for feature selection, but can also be employed for discrimination. In an application to the genotype data from the GENICA study, an association study concerned with sporadic breast cancer, GPAS is able to identify high-order interactions of SNPs leading to a considerably increased breast cancer risk for different subsets of patients that are not found by other feature selection methods. As an application to a subset of the HapMap data shows, GPAS is not restricted to association studies comprising several 10 SNPs, but can also be employed to analyze whole-genome data. Software can be downloaded from http://ls2-www.cs.uni-dortmund.de/~nunkesser/#Software
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How Prospective Physical Medicine and Rehabilitation Trainees Rank Residency Training Programs.
Auriemma, Michael J; Whitehair, Curtis L
2018-03-01
Since the inception of the National Resident Matching Program, multiple studies have investigated the factors applicants consider important to ranking prospective residency programs. However, only 2 previous studies focused on prospective physical medicine and rehabilitation (PM&R) trainees, and the most recent of these studies was published in 1993. It is unknown whether these previous studies are reflective of current prospective PM&R residents. To assess various factors that contribute to prospective PM&R residents' decision making in choosing a residency program and compare these findings with previous studies. An anonymous, voluntary questionnaire. A single PM&R residency program. All applicants to a single PM&R residency program. All applicants to our PM&R residency program were invited to participate in a 44-item, 5-point Likert-based questionnaire. Applicants were asked to rate the importance of various factors as they related to constructing their residency rank list. Means and standard deviations were calculated for items included in the survey. A response rate of 26% was obtained, with the responses of 98 applicants (20%) ultimately analyzed. The highest rated factors included "perceived happiness of current residents," "opportunities for hands-on procedure training," "perceived camaraderie among current residents," "perceived camaraderie among faculty and current residents," "perceived quality of current residents," and "perceived work/life balance among current residents." Although male and female respondents demonstrated similar ranking preferences, an apparent difference was detected between how genders rated the importance of "whether the program projects a favorable environment for women" and "whether the program projects a favorable environment for minorities." As compared with previous PM&R applicants, current prospective trainees seem to place greater importance on skill acquisition over didactic teaching. Prospective PM&R residents highly value
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Electroconvulsive Therapy (ECT) and Race: A Report of ECT Use and Sociodemographic Trends in Texas.
Williams, Julie; Chiu, Lawrence; Livingston, Robin
2017-06-01
Minimal research on race and other sociodemographic disparities in patients receiving electroconvulsive therapy (ECT) exists. One previously noted national trend reveals whites receiving ECT disproportionately more than other races. The aim of this study is to determine whether a county ECT program demonstrates similar disparities observed at the state and national levels. This study examined 21 years of ECT data, between 1993 and 2014, provided by the Texas Department of State Health Services, focusing on race, sex, age, and payer source and 2.5 years of the same variables from a Harris County hospital ECT program. In addition, population demographic data for Harris County and the state of Texas during the same period were obtained from the Department of State Health Services Web site. Despite an overall decrease in the population of whites countywide and statewide, whites continue to use more ECT than African Americans, Latinos, and Asians in both Harris County and Texas. However, the rates of ECT use in minorities increased overall. Both countywide and statewide, ECT was used more than twice as often in women than men. Statewide, elderly patients (>65 years old) saw decreases in ECT use, and there was an increase in private third-party payer source. Electroconvulsive therapy remains underused among African Americans, Latinos, and Asians. Hypotheses and areas for future study include cultural beliefs, stigma, patient and provider knowledge of ECT, and access to care. Despite this, the general use of ECT in Texas has increased overall, and minority use is slowly on the rise.
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34 CFR 200.12 - Single State accountability system.
2010-07-01
... 34 Education 1 2010-07-01 2010-07-01 false Single State accountability system. 200.12 Section 200... Improving Basic Programs Operated by Local Educational Agencies State Accountability System § 200.12 Single State accountability system. (a)(1) Each State must demonstrate in its State plan that the State has...
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2010-03-04
... Discontinuation of the Notice of Availability of Funding; Multi- Family Housing, Single Family Housing AGENCY... its existing and continuing Multi-Family and Single-Family Housing programs for which it receives... Analyst, Multi- Family Housing Programs, telephone 202-720-1753 and Myron Wooden, Loan Specialist, Single...
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2008-01-01
The first time that single particle effects from cosmic rays on electronics were observed was in 1991, when one of the instruments aboard an ESA satellite broke down after only five days in space. On 5 July, the TS-LEA group will have completed the installation of monitors that will help to reduce similar dangerous effects on LHC electronics.
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Directory of Open Access Journals (Sweden)
Mi-Ra Won
2013-01-01
Full Text Available Purpose. In Korea, it has been estimated that the number of the single-household elderly increased 45% from 2005 to 2010. This research was conducted to provide empirical resources for development of a community mental health program by an explorative investigation on depression, coping mechanism, and life satisfaction of a single-household elderly population. Design and Methods. This research applied a descriptive survey research design. Participants were 225 single-household elderlies residing in Seoul, Korea. The geriatric depression scale and the satisfaction with life scale were used to check the level of depression and life satisfaction of the participants. Results. Results showed that 46.3 percent of the participants were categorized as having light-to-severe level of depression, and 80.5 percent of the participants responded that they were dissatisfied with their lives. This research demonstrated that the level of depression and life satisfaction of the Korean single-household elderly is statistically significantly related to age and gender as well as coping resources and human resources. Implications. Current public health services in Korea for the single-household elderly are still lacking and require active support, intervention, and research to provide effective programs and services. Case management, counseling, and various programs based on Korean culture including support from family members and community-based assistance are recommended to help the vulnerable population.
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Prosodic Similarity Effects in Short-Term Memory in Developmental Dyslexia.
Goswami, Usha; Barnes, Lisa; Mead, Natasha; Power, Alan James; Leong, Victoria
2016-11-01
Children with developmental dyslexia are characterized by phonological difficulties across languages. Classically, this 'phonological deficit' in dyslexia has been investigated with tasks using single-syllable words. Recently, however, several studies have demonstrated difficulties in prosodic awareness in dyslexia. Potential prosodic effects in short-term memory have not yet been investigated. Here we create a new instrument based on three-syllable words that vary in stress patterns, to investigate whether prosodic similarity (the same prosodic pattern of stressed and unstressed syllables) exerts systematic effects on short-term memory. We study participants with dyslexia and age-matched and younger reading-level-matched typically developing controls. We find that all participants, including dyslexic participants, show prosodic similarity effects in short-term memory. All participants exhibited better retention of words that differed in prosodic structure, although participants with dyslexia recalled fewer words accurately overall compared to age-matched controls. Individual differences in prosodic memory were predicted by earlier vocabulary abilities, by earlier sensitivity to syllable stress and by earlier phonological awareness. To our knowledge, this is the first demonstration of prosodic similarity effects in short-term memory. The implications of a prosodic similarity effect for theories of lexical representation and of dyslexia are discussed. © 2016 The Authors. Dyslexia published by John Wiley & Sons Ltd. © 2016 The Authors. Dyslexia published by John Wiley & Sons Ltd.
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Evaluation of high myopia complications prevention program in university freshmen.
Tseng, Gow-Lieng; Chen, Cheng-Yu
2016-10-01
High myopia is a global eye health problem because of its high incidence of sight-threatening complications. Due to the role of awareness, self-examination, and preventive behavior in prevention of morbidity of high myopia complications, promoting knowledge, capabilities, and attitude of high myopic personnel are required in this regard.In this quasi-experiment study, 31 freshmen with high myopia in a national university were enrolled in 2014. The data were collected by validated and reliable questionnaire based on health belief model (HBM) and self-efficacy theory. The intervention program consisted of 1 educational session lasting 150 minutes by lecturing of high myopia complications, virtual reality experiencing, similarity modeling, and quibbling a film made on high myopia complications preventive concepts.Implementing the educational program showed immediate effect in knowledge, perceived susceptibility, perceived severity, self-efficacy, and preventive behavior intention. While 6 weeks after the educational program, significant increases were observed in cues to action, self-efficacy, and preventive behavior intention.This article provided that, after a single session, there was positive improvement in high myopia complication prevention behavior intention among participants. These positive effects confirmed the efficacy of the education program and will probably induce behavior change.
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Self-similar pattern formation and continuous mechanics of self-similar systems
Directory of Open Access Journals (Sweden)
A. V. Dyskin
2007-01-01
Full Text Available In many cases, the critical state of systems that reached the threshold is characterised by self-similar pattern formation. We produce an example of pattern formation of this kind – formation of self-similar distribution of interacting fractures. Their formation starts with the crack growth due to the action of stress fluctuations. It is shown that even when the fluctuations have zero average the cracks generated by them could grow far beyond the scale of stress fluctuations. Further development of the fracture system is controlled by crack interaction leading to the emergence of self-similar crack distributions. As a result, the medium with fractures becomes discontinuous at any scale. We develop a continuum fractal mechanics to model its physical behaviour. We introduce a continuous sequence of continua of increasing scales covering this range of scales. The continuum of each scale is specified by the representative averaging volume elements of the corresponding size. These elements determine the resolution of the continuum. Each continuum hides the cracks of scales smaller than the volume element size while larger fractures are modelled explicitly. Using the developed formalism we investigate the stability of self-similar crack distributions with respect to crack growth and show that while the self-similar distribution of isotropically oriented cracks is stable, the distribution of parallel cracks is not. For the isotropically oriented cracks scaling of permeability is determined. For permeable materials (rocks with self-similar crack distributions permeability scales as cube of crack radius. This property could be used for detecting this specific mechanism of formation of self-similar crack distributions.
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Energy Technology Data Exchange (ETDEWEB)
Azar, Richard Julian, E-mail: julianazar2323@berkeley.edu; Head-Gordon, Martin, E-mail: mhg@cchem.berkeley.edu [Kenneth S. Pitzer Center for Theoretical Chemistry, Department of Chemistry, University of California and Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States)
2015-05-28
Your correspondents develop and apply fully nonorthogonal, local-reference perturbation theories describing non-covalent interactions. Our formulations are based on a Löwdin partitioning of the similarity-transformed Hamiltonian into a zeroth-order intramonomer piece (taking local CCSD solutions as its zeroth-order eigenfunction) plus a first-order piece coupling the fragments. If considerations are limited to a single molecule, the proposed intermolecular similarity-transformed perturbation theory represents a frozen-orbital variant of the “(2)”-type theories shown to be competitive with CCSD(T) and of similar cost if all terms are retained. Different restrictions on the zeroth- and first-order amplitudes are explored in the context of large-computation tractability and elucidation of non-local effects in the space of singles and doubles. To accurately approximate CCSD intermolecular interaction energies, a quadratically growing number of variables must be included at zeroth-order.
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77 FR 40785 - Single Family Housing Guaranteed Loan Program
2012-07-11
... Statement The USDA prohibits discrimination in all its programs and activities on the basis of race, color... SFHGLP. Four commenters expressed understanding of the budgetary motivation for RHS shifting to an up...
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The art of multiprocessor programming
Herlihy, Maurice
2012-01-01
Revised and updated with improvements conceived in parallel programming courses, The Art of Multiprocessor Programming is an authoritative guide to multicore programming. It introduces a higher level set of software development skills than that needed for efficient single-core programming. This book provides comprehensive coverage of the new principles, algorithms, and tools necessary for effective multiprocessor programming. Students and professionals alike will benefit from thorough coverage of key multiprocessor programming issues. This revised edition incorporates much-demanded updates t
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Similarity estimation for reference image retrieval in mammograms using convolutional neural network
Muramatsu, Chisako; Higuchi, Shunichi; Morita, Takako; Oiwa, Mikinao; Fujita, Hiroshi
2018-02-01
Periodic breast cancer screening with mammography is considered effective in decreasing breast cancer mortality. For screening programs to be successful, an intelligent image analytic system may support radiologists' efficient image interpretation. In our previous studies, we have investigated image retrieval schemes for diagnostic references of breast lesions on mammograms and ultrasound images. Using a machine learning method, reliable similarity measures that agree with radiologists' similarity were determined and relevant images could be retrieved. However, our previous method includes a feature extraction step, in which hand crafted features were determined based on manual outlines of the masses. Obtaining the manual outlines of masses is not practical in clinical practice and such data would be operator-dependent. In this study, we investigated a similarity estimation scheme using a convolutional neural network (CNN) to skip such procedure and to determine data-driven similarity scores. By using CNN as feature extractor, in which extracted features were employed in determination of similarity measures with a conventional 3-layered neural network, the determined similarity measures were correlated well with the subjective ratings and the precision of retrieving diagnostically relevant images was comparable with that of the conventional method using handcrafted features. By using CNN for determination of similarity measure directly, the result was also comparable. By optimizing the network parameters, results may be further improved. The proposed method has a potential usefulness in determination of similarity measure without precise lesion outlines for retrieval of similar mass images on mammograms.
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Design of single-walled NaK capsules for fast breeder fuel pins irradiation (IVO-FR2-Vg7 program)
International Nuclear Information System (INIS)
Lopez Jimenez, J.; Hafner, H.E.
1979-01-01
In Frame of the Joint Irradiation Program IVO-FR2 between the Nuclear Research Centre of Karlsruhe (RFA) and the Junta de Energia Nuclear (Spain) is carried out in the FR2 reactor (Karlsruhe) the irradiation of 12 mixed-oxide fuel rods of 172 mm length. These test rods are first irradiated under various conditions in four modified FR2 capsule (Typ 7). Two versions of single-walled NaK (78% K) are used for this purpose. This report contains the design and description of these two capsule versions as well as the considerations required to oftain the operations licence, supplemented by the relevant figures. (author)
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Single Parenthood and Children's Reading Performance in Asia
Park, Hyunjoon
2007-01-01
Using the data from Program for International Student Assessment, I examine the gap in reading performance between 15-year-old students in single-parent and intact families in 5 Asian countries in comparison to the United States. The ordinary least square regression analyses show negligible disadvantages of students with a single parent in Hong…
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Adolescents' Chunking of Computer Programs.
Magliaro, Susan; Burton, John K.
To investigate what children learn during computer programming instruction, students attending a summer computer camp were asked to recall either single lines or chunks of computer programs from either coherent or scrambled programs. The 16 subjects, ages 12 to 17, were divided into three instructional groups: (1) beginners, who were taught to…
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Survey on Sentence Similarity Evaluation using Deep Learning
Ramaprabha, J.; Das, Sayan; Mukerjee, Pronay
2018-04-01
Two questions asking the same thing can have di erent set of vocabulary set and syntactic structure. Which makes detecting the semantics equivalence between the sentences challenging. In online user forums like Quora, Stack Over ow, Stack Exchange, etc. its important to maintain high quality knowledge base by ensuring each unique question exists only once. Writers shouldn't have to write the same answer to each of the similar question and the reader must get a single page of the question they are looking for. For example, consider questions like What are the best ways to lose weight?, How can a person reduce weight?, and What are elective weight loss plans? to be duplicate questions because they all have the same intent.
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Summary of Green Building Programs
Energy Technology Data Exchange (ETDEWEB)
2002-08-01
In early 2002, the National Association of Home Builders completed a census of residential green building programs across the United States to assess differences and similarities among programs. This report catalogs different ways that builders participate in residential green building programs.
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Keys to success: Ten case studies of effective weatherization programs
Energy Technology Data Exchange (ETDEWEB)
Brown, M.A.; Berry, L.G.; Kolb, J.O.; White, D.L. [Oak Ridge National Lab., TN (United States); Kinney, L.F.; Wilson, T. [Synertech Systems Corp., Syracuse, NY (United States)
1993-11-01
In 1990, DOE initiated a nationwide evaluation of its Weatherization Program, with assistance from Oak Ridge National Laboratory and an advisory group of 40 weatherization professionals, program managers, and researchers. The evaluation is comprised of three impact studies covering the Program`s major market segments: Single-family homes, mobile homes, and dwellings in small (2 to 4-unit) multifamily buildings (the Single-Family Study), Single-family homes heated primarily with fuel oil (the Fuel-Oil Study), and Dwellings in buildings with five or more units (the Multifamily Study). The Single-Family Study, the subject of this report, is a critical part of this coordinated evaluation effort. Its focus on single-family dwellings, mobile homes, and dwellings in small multifamily buildings covers 83% of the income-eligible population and 96% of the dwellings weatherized during Program Year 1989. The first phase of the Single-Family Study involved the analysis of a massive data base of information collected from 368 local weatherization agencies and 543 electric and gas utilities. This analysis resulted in energy-saving and cost-effectiveness estimates for the Weatherization Program and the identification of a set of ten high-performing agencies located throughout the country. The second phase, which is the subject of this report, involves a ``process`` evaluation of these ten high performers, aimed at identifying those weatherization practices that explain their documented success.
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Multicriteria Similarity-Based Anomaly Detection Using Pareto Depth Analysis.
Hsiao, Ko-Jen; Xu, Kevin S; Calder, Jeff; Hero, Alfred O
2016-06-01
We consider the problem of identifying patterns in a data set that exhibits anomalous behavior, often referred to as anomaly detection. Similarity-based anomaly detection algorithms detect abnormally large amounts of similarity or dissimilarity, e.g., as measured by the nearest neighbor Euclidean distances between a test sample and the training samples. In many application domains, there may not exist a single dissimilarity measure that captures all possible anomalous patterns. In such cases, multiple dissimilarity measures can be defined, including nonmetric measures, and one can test for anomalies by scalarizing using a nonnegative linear combination of them. If the relative importance of the different dissimilarity measures are not known in advance, as in many anomaly detection applications, the anomaly detection algorithm may need to be executed multiple times with different choices of weights in the linear combination. In this paper, we propose a method for similarity-based anomaly detection using a novel multicriteria dissimilarity measure, the Pareto depth. The proposed Pareto depth analysis (PDA) anomaly detection algorithm uses the concept of Pareto optimality to detect anomalies under multiple criteria without having to run an algorithm multiple times with different choices of weights. The proposed PDA approach is provably better than using linear combinations of the criteria, and shows superior performance on experiments with synthetic and real data sets.
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Khashan, Raed S
2015-01-01
As the number of available ligand-receptor complexes is increasing, researchers are becoming more dedicated to mine these complexes to aid in the drug design and development process. We present free software which is developed as a tool for performing similarity search across ligand-receptor complexes for identifying binding pockets which are similar to that of a target receptor. The search is based on 3D-geometric and chemical similarity of the atoms forming the binding pocket. For each match identified, the ligand's fragment(s) corresponding to that binding pocket are extracted, thus forming a virtual library of fragments (FragVLib) that is useful for structure-based drug design. The program provides a very useful tool to explore available databases.
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2012-09-20
...] Announcing the Award of Two Urgent Single-Source Grants To Support Unaccompanied Alien Children Program...) announces the award of two urgent single-source grants from the Unaccompanied Alien Children's Program to... providing services under the Unaccompanied Alien Children's program. Award Grantee organization Location...
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Effective Analysis of C Programs by Rewriting Variability
DEFF Research Database (Denmark)
Iosif-Lazar, Alexandru Florin; Melo, Jean; Dimovski, Aleksandar
2017-01-01
and effective analysis and verification of real-world C program families. Importance. We report some interesting variability-related bugs that we discovered using various state-of-the-art single-program C verification tools, such as Frama-C, Clang, LLBMC.......Context. Variability-intensive programs (program families) appear in many application areas and for many reasons today. Different family members, called variants, are derived by switching statically configurable options (features) on and off, while reuse of the common code is maximized. Inquiry....... Verification of program families is challenging since the number of variants is exponential in the number of features. Existing single-program analysis and verification tools cannot be applied directly to program families, and designing and implementing the corresponding variability-aware versions is tedious...
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2013-03-06
... include any sensitive personal information, like anyone's Social Security number, date of birth, driver's... include competitively sensitive information such as costs, sales statistics, inventories, formulas... established rate, and payers administering the Mi Salud program paid the remaining 20 percent, known as the...
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Cost to primary care practices of responding to payer requests for quality and performance data.
Halladay, Jacqueline R; Stearns, Sally C; Wroth, Thomas; Spragens, Lynn; Hofstetter, Sara; Zimmerman, Sheryl; Sloane, Philip D
2009-01-01
We wanted to determine how much it costs primary care practices to participate in programs that require them to gather and report data on care quality indicators. Using mixed quantitative-qualitative methods, we gathered data from 8 practices in North Carolina that were selected purposively to be diverse by size, ownership, type, location, and medical records. Formal practice visits occurred between January 2008 and May 2008. Four quality-reporting programs were studied: Medicare's Physician Quality Reporting Initiative (PQRI), Community Care of North Carolina (CCNC), Bridges to Excellence (BTE), and Improving Performance in Practice (IPIP). We estimated direct costs to the practice and on-site costs to the quality organization for implementation and maintenance phases of program participation. Major expenses included personnel time for planning, training, registry maintenance, visit coding, data gathering and entry, and modification of electronic systems. Costs per full-time equivalent clinician ranged from less than $1,000 to $11,100 during program implementation phases and ranged from less than $100 to $4,300 annually during maintenance phases. Main sources of variation included program characteristics, amount of on-site assistance provided, experience and expertise of practice personnel, and the extent of data system problems encountered. The costs of a quality-reporting program vary greatly by program and are important to anticipate and understand when undertaking quality improvement work. Incentives that would likely improve practice participation include financial payment, quality improvement skills training, and technical assistance with electronic system troubleshooting.
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Phoneme Similarity and Confusability
Bailey, T.M.; Hahn, U.
2005-01-01
Similarity between component speech sounds influences language processing in numerous ways. Explanation and detailed prediction of linguistic performance consequently requires an understanding of these basic similarities. The research reported in this paper contrasts two broad classes of approach to the issue of phoneme similarity-theoretically…
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Self-similar factor approximants
International Nuclear Information System (INIS)
Gluzman, S.; Yukalov, V.I.; Sornette, D.
2003-01-01
The problem of reconstructing functions from their asymptotic expansions in powers of a small variable is addressed by deriving an improved type of approximants. The derivation is based on the self-similar approximation theory, which presents the passage from one approximant to another as the motion realized by a dynamical system with the property of group self-similarity. The derived approximants, because of their form, are called self-similar factor approximants. These complement the obtained earlier self-similar exponential approximants and self-similar root approximants. The specific feature of self-similar factor approximants is that their control functions, providing convergence of the computational algorithm, are completely defined from the accuracy-through-order conditions. These approximants contain the Pade approximants as a particular case, and in some limit they can be reduced to the self-similar exponential approximants previously introduced by two of us. It is proved that the self-similar factor approximants are able to reproduce exactly a wide class of functions, which include a variety of nonalgebraic functions. For other functions, not pertaining to this exactly reproducible class, the factor approximants provide very accurate approximations, whose accuracy surpasses significantly that of the most accurate Pade approximants. This is illustrated by a number of examples showing the generality and accuracy of the factor approximants even when conventional techniques meet serious difficulties
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AMCP Guide to Pharmaceutical Payment Methods, 2009 Update (Version 2.0).
2009-08-01
The methods by which the U.S. health care system pays for prescription drugs have faced increasing scrutiny in recent years. Two key developments have emerged: (a) congressional enactment of important changes in the basis for payments for prescription drugs in the Medicare and Medicaid programs; and (b) a March 2009 decision in a federal class action lawsuit that alleged fraudulent manipulation of the dominant pricing benchmark (average wholesale price, AWP), used primarily as the basis for payment for brand-name prescription drugs. The debate about prescription drug payment methods centers on determining the most appropriate basis for calculating how payers, including patients, government agencies, employers, and health plans, should pay pharmacies and other providers for drugs. Historically, payment for prescription drugs has been based on published prices that do not necessarily reflect the actual acquisition costs paid by providers, primarily pharmacies, physicians, and hospitals. This has led policymakers to believe that Medicare and Medicaid programs have paid more than is necessary for prescription drugs. Thus, in an effort to reform the payment system and reduce drug expenditures, policymakers have made significant changes to the benchmarks used by public programs to pay for drugs, and in some instances have created new benchmarks. Private payers have followed the government's lead and begun to change their own payment methods and benchmarks. They can be expected to accelerate the change as a result of the settlement agreement approved in the March 2009 federal court decision. The settlement will result in the lowering of the AWP for more than 400 generic and brand-name drugs. In addition - and technically unrelated to the litigation and any appeals that may be taken - 2 major price data reporting companies, First DataBank and Medi-Span, announced their intent to discontinue publication of AWP within 2 years of September 26, 2009. (At the time this report
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Multiprocessor programming environment
Energy Technology Data Exchange (ETDEWEB)
Smith, M.B.; Fornaro, R.
1988-12-01
Programming tools and techniques have been well developed for traditional uniprocessor computer systems. The focus of this research project is on the development of a programming environment for a high speed real time heterogeneous multiprocessor system, with special emphasis on languages and compilers. The new tools and techniques will allow a smooth transition for programmers with experience only on single processor systems.
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Single-Pilot Workload Management
Rogers, Jason; Williams, Kevin; Hackworth, Carla; Burian, Barbara; Pruchnicki, Shawn; Christopher, Bonny; Drechsler, Gena; Silverman, Evan; Runnels, Barry; Mead, Andy
2013-01-01
Integrated glass cockpit systems place a heavy cognitive load on pilots (Burian Dismukes, 2007). Researchers from the NASA Ames Flight Cognition Lab and the FAA Flight Deck Human Factors Lab examined task and workload management by single pilots. This poster describes pilot performance regarding programming a reroute while at cruise and meeting a waypoint crossing restriction on the initial descent.
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Adult eyewitness memory for single versus repeated traumatic events
Theunissen, T.P.M.; Meyer, T.; Memon, A.; Weinsheimer, C.C.
2017-01-01
Reports from individuals who have witnessed multiple, similar emotional events may differ from reports from witnesses of only a single event. To test this, we had participants (N = 65) view a video of a road traffic accident. Half of the participants saw two additional (similar) aversive films.
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Procedural and Logic Programming: A Comparison.
Watkins, Will; And Others
1988-01-01
Examines the similarities and fundamental differences between procedural programing and logic programing by comparing LogoWriter and PROLOG. Suggests that PROLOG may be a good first programing language for students to learn. (MVL)
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Kassam, Daud; Seki, Shingo; Horic, Michio; Yamaoka, Kosaku
2006-08-01
The apparent inter-lake morphological similarity among East African Great Lakes' cichlid species/genera has left evolutionary biologists asking whether such similarity is due to sharing of common ancestor or mere convergent evolution. In order to answer such question, we first used Geometric Morphometrics, GM, to quantify morphological similarity and then subsequently used Amplified Fragment Length Polymorphism, AFLP, to determine if similar morphologies imply shared ancestry or convergent evolution. GM revealed that not all presumed morphological similar pairs were indeed similar, and the dendrogram generated from AFLP data indicated distinct clusters corresponding to each lake and not inter-lake morphological similar pairs. Such results imply that the morphological similarity is due to convergent evolution and not shared ancestry. The congruency of GM and AFLP generated dendrograms imply that GM is capable of picking up phylogenetic signal, and thus GM can be potential tool in phylogenetic systematics.
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International Nuclear Information System (INIS)
Muramatsu, Chisako; Li Qiang; Schmidt, Robert A.; Shiraishi, Junji; Suzuki, Kenji; Newstead, Gillian M.; Doi, Kunio
2007-01-01
The presentation of images that are similar to that of an unknown lesion seen on a mammogram may be helpful for radiologists to correctly diagnose that lesion. For similar images to be useful, they must be quite similar from the radiologists' point of view. We have been trying to quantify the radiologists' impression of similarity for pairs of lesions and to establish a ''gold standard'' for development and evaluation of a computerized scheme for selecting such similar images. However, it is considered difficult to reliably and accurately determine similarity ratings, because they are subjective. In this study, we compared the subjective similarities obtained by two different methods, an absolute rating method and a 2-alternative forced-choice (2AFC) method, to demonstrate that reliable similarity ratings can be determined by the responses of a group of radiologists. The absolute similarity ratings were previously obtained for pairs of masses and pairs of microcalcifications from five and nine radiologists, respectively. In this study, similarity ranking scores for eight pairs of masses and eight pairs of microcalcifications were determined by use of the 2AFC method. In the first session, the eight pairs of masses and eight pairs of microcalcifications were grouped and compared separately for determining the similarity ranking scores. In the second session, another similarity ranking score was determined by use of mixed pairs, i.e., by comparison of the similarity of a mass pair with that of a calcification pair. Four pairs of masses and four pairs of microcalcifications were grouped together to create two sets of eight pairs. The average absolute similarity ratings and the average similarity ranking scores showed very good correlations in the first study (Pearson's correlation coefficients: 0.94 and 0.98 for masses and microcalcifications, respectively). Moreover, in the second study, the correlations between the absolute ratings and the ranking scores were also
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Directory of Open Access Journals (Sweden)
Amine Labriji
2017-07-01
Full Text Available The topic of identifying the similarity of graphs was considered as highly recommended research field in the Web semantic, artificial intelligence, the shape recognition and information research. One of the fundamental problems of graph databases is finding similar graphs to a graph query. Existing approaches dealing with this problem are usually based on the nodes and arcs of the two graphs, regardless of parental semantic links. For instance, a common connection is not identified as being part of the similarity of two graphs in cases like two graphs without common concepts, the measure of similarity based on the union of two graphs, or the one based on the notion of maximum common sub-graph (SCM, or the distance of edition of graphs. This leads to an inadequate situation in the context of information research. To overcome this problem, we suggest a new measure of similarity between graphs, based on the similarity measure of Wu and Palmer. We have shown that this new measure satisfies the properties of a measure of similarities and we applied this new measure on examples. The results show that our measure provides a run time with a gain of time compared to existing approaches. In addition, we compared the relevance of the similarity values obtained, it appears that this new graphs measure is advantageous and offers a contribution to solving the problem mentioned above.
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Kaptein, M.C.; Castaneda, D.; Fernandez, N.; Nass, C.
2014-01-01
The feeling of connectedness experienced in computer-mediated relationships can be explained by the similarity-attraction effect (SAE). Though SAE is well established in psychology, the effects of some types of similarity have not yet been explored. In 2 studies, we demonstrate similarity-attraction
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The semantic similarity ensemble
Directory of Open Access Journals (Sweden)
Andrea Ballatore
2013-12-01
Full Text Available Computational measures of semantic similarity between geographic terms provide valuable support across geographic information retrieval, data mining, and information integration. To date, a wide variety of approaches to geo-semantic similarity have been devised. A judgment of similarity is not intrinsically right or wrong, but obtains a certain degree of cognitive plausibility, depending on how closely it mimics human behavior. Thus selecting the most appropriate measure for a specific task is a significant challenge. To address this issue, we make an analogy between computational similarity measures and soliciting domain expert opinions, which incorporate a subjective set of beliefs, perceptions, hypotheses, and epistemic biases. Following this analogy, we define the semantic similarity ensemble (SSE as a composition of different similarity measures, acting as a panel of experts having to reach a decision on the semantic similarity of a set of geographic terms. The approach is evaluated in comparison to human judgments, and results indicate that an SSE performs better than the average of its parts. Although the best member tends to outperform the ensemble, all ensembles outperform the average performance of each ensemble's member. Hence, in contexts where the best measure is unknown, the ensemble provides a more cognitively plausible approach.
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Meeting your match: How attractiveness similarity affects approach behavior in mixed-sex dyads
van Straaten, I.; Engels, R.C.M.E.; Finkenauer, C.; Holland, R.W.
2009-01-01
This experimental study investigated approach behavior toward opposite-sex others of similar versus dissimilar physical attractiveness. Furthermore, it tested the moderating effects of sex. Single participants interacted with confederates of high and low attractiveness. Observers rated their behavior in terms of relational investment (i.e., behavioral efforts related to the improvement of interaction fluency, communication of positive interpersonal affect, and positive self-presentation). As ...
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McHugh, Matthew D; Berez, Julie; Small, Dylan S
2013-10-01
The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.
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78 FR 73927 - Single Family Housing Guaranteed Loan Program
2013-12-09
.... The term ``MSA (Metropolitan Statistical Area)'' was added as it is a term the Office of Management... statistics. The term ``new dwelling'' was amended to achieve consistency with other Agency program... Government. One respondent recommended establishing a delinquency goal to improve and monitor a lender's...
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Directory of Open Access Journals (Sweden)
U. Boles
2018-03-01
Full Text Available Background: Current algorithms and device morphology templates have been proposed in current Implantable Cardioverter-Defibrillators (ICDs to minimize inappropriate therapies (ITS, but this has not been completely successful. Aim: Assess the impact of a deliberate strategy of using an atrial lead implant with standardized parameters; based on all current ICD discriminators and technologies, on the burden of ITS. Method: A retrospective single-centre analysis of 250 patients with either dual chamber (DR ICDs or biventricular ICDs (CRTDs over a (41.9 ± 27.3 month period was performed. The incidence of ITS on all ICD and CRTD patients was chronicled after the implementation of standardized programming. Results: 39 events of anti-tachycardial pacing (ATP and/or shocks were identified in 20 patients (8% incidence rate among patients. The total number of individual therapies was 120, of which 34% were inappropriate ATP, and 36% were inappropriate shocks. 11 patients of the 250 patients received ITS (4.4%. Of the 20 patients, four had ICDs for primary prevention and 16 for a secondary prevention. All the episodes in the primary indication group were inappropriate, while seven patients (43% of the secondary indication group experienced inappropriate therapies. Conclusions: The burden of ITS in the population of patients receiving ICDs was 4.4% in the presence of atrial leads. The proposed rationalized programming criteria seems an effective strategy to minimize the burden of inappropriate therapies and will require further validation. Keywords: Implantable cardioverter-defibrillator (ICDs, Inappropriate therapies, Standardized programming
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Burnout and Resiliency Among Family Medicine Program Directors.
Porter, Maribeth; Hagan, Helen; Klassen, Rosemary; Yang, Yang; Seehusen, Dean A; Carek, Peter J
2018-02-01
Nearly one-half (46%) of physicians report at least one symptom of burnout. Family medicine residency program directors may have similar and potentially unique levels of burnout as well as resiliency. The primary aims of this study were to examine burnout and resiliency among family medicine residency directors and characterize associated factors. The questions used were part of a larger omnibus survey conducted by the Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) in 2016. Program and director-specific characteristics were obtained. Symptoms of burnout were assessed using two single-item measures adapted from the full Maslach Burnout Inventory, and level of resiliency was assessed using the Brief Resilience Scale. The overall response rate for the survey was 53.7% (245/465). Symptoms of high emotional exhaustion or high depersonalization were reported in 27.3% and 15.8% of program directors, respectively. More than two-thirds of program directors indicated that they associated themselves with characteristics of resiliency. Emotional exhaustion and depersonalization were significantly correlated with never having personal time, an unhealthy work-life balance, and the inability to stop thinking about work. The presence of financial stress was significantly correlated with higher levels of emotional exhaustion and depersonalization. In contrast, the level of resiliency reported was directly correlated with having a moderate to great amount of personal time, healthy work-life balance, and ability to stop thinking about work, and negatively correlated with the presence of financial stress. Levels of emotional exhaustion, depersonalization, and resiliency are significantly related to personal characteristics of program directors rather than characteristics of their program.
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Directory of Open Access Journals (Sweden)
Mistaul Amaliyah
2016-02-01
Full Text Available This research was conducted to see how perceptions tax extensification and intensification programe, tax identification number (NPWP, with sunset policy to tax compliance to the respondent an individual tax payer and the entity that reported as many as 250 tax on each KPP Pratama Yogyakarta, Sleman, wonosari, Wates, and Bantul taken by simple random sampling method. Data analysis using an analytical approach to structural equation models (SEM software using partial least square (PLS. Test results that the perception of tax extensification and intensification programe, NPWP with facility sunset policy that has been applied by the Directorate General of Taxes has not impacted significantly to tax compliance with t-statistic value of each (0.70, 0098, 0.436
programe has been implemented by the Directorate General of taxes can have a positive impact on facility sunset policy with t-statistics value of each of (1.742, 2.211> t-table (1.645. Test results that with the addition of NPWP provided by the Directorate General of Taxes can have a positive impact on tax compliance to the value of t-statistic (2.313> t-table (1.645. The perception of tax extensification programe and facilities sunset policy that have been implemented by the Directorate General of Taxes can have a positive impact on the addition NPWP with t-statistics value of each of (1.929, 2.626> t-table (1.645. The programs and facilities as well as NPWP implemented by Directorate General of Taxes should be increased and expanded again to the awareness of taxpayers in tax compliance to boost significantly impact (voluntary compliance -
2010-04-09
...) benefit and required her to acquire the employer health insurance plan in order to comply with this law... Group Health Plan (GHP) that is or would be primary to TRICARE. Benefits offered through cafeteria plans... priorities. TRICARE is, as is Medicare, a secondary payer to employer-provided health insurance. In all...
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2013-06-27
.... The LTC facility regulations clearly specify what services the facility is required to provide to... professional caregivers and are often paid by third-party payers, such as Medicaid. These facilities are... benefit. In regulations at 42 CFR 418.112(c), we specify what must be included in a written agreement...
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Cross software for microprocessor program development at CERN
International Nuclear Information System (INIS)
Eicken, H. von; Montuelle, J.; Willers, I.; Blake, J.
1981-01-01
Programs for a variety of microprocessors (including Intel 8080; Motorola 6800 and 6809 and 68000; and Texas Instruments 9900) can be prepared on different host computers (such as IBM 370, CDC 6000, and Nord 10) using portable programs developed at CERN. The range of cross software consists of: an assembler for each target microprocessor, a single linkage editor, a single object module librarian, and a variety of pre-loaders which convert object modules from CERN's format (CUFOM) into manufacturers' formats. The programs are written in BCPL and PASCAL, programming languages which are available on a wide range of computers. (orig.)
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Liang, Ru-Ze
2017-04-24
In this paper we study the problem of content-based image retrieval. In this problem, the most popular performance measure is the top precision measure, and the most important component of a retrieval system is the similarity function used to compare a query image against a database image. However, up to now, there is no existing similarity learning method proposed to optimize the top precision measure. To fill this gap, in this paper, we propose a novel similarity learning method to maximize the top precision measure. We model this problem as a minimization problem with an objective function as the combination of the losses of the relevant images ranked behind the top-ranked irrelevant image, and the squared Frobenius norm of the similarity function parameter. This minimization problem is solved as a quadratic programming problem. The experiments over two benchmark data sets show the advantages of the proposed method over other similarity learning methods when the top precision is used as the performance measure.
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Liang, Ru-Ze; Shi, Lihui; Wang, Haoxiang; Meng, Jiandong; Wang, Jim Jing-Yan; Sun, Qingquan; Gu, Yi
2017-01-01
In this paper we study the problem of content-based image retrieval. In this problem, the most popular performance measure is the top precision measure, and the most important component of a retrieval system is the similarity function used to compare a query image against a database image. However, up to now, there is no existing similarity learning method proposed to optimize the top precision measure. To fill this gap, in this paper, we propose a novel similarity learning method to maximize the top precision measure. We model this problem as a minimization problem with an objective function as the combination of the losses of the relevant images ranked behind the top-ranked irrelevant image, and the squared Frobenius norm of the similarity function parameter. This minimization problem is solved as a quadratic programming problem. The experiments over two benchmark data sets show the advantages of the proposed method over other similarity learning methods when the top precision is used as the performance measure.
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Self-similar current decay experiment in RFX-mod
International Nuclear Information System (INIS)
Zanca, Paolo
2007-01-01
The self-similar current decay (SSCD) has been suggested as a promising operation for reversed field pinch devices by numerical simulations, which show a decrease in modes amplitude and stochasticity when the magnetic field is forced to decay at a suitable rate at a fixed radial profile (Nebel et al 2002 Phys. Plasmas 9 4968). The first experimental test of SSCD has recently been performed in RFX-mod. An initial fast decrease in the mode amplitudes (about 40% of the initial value) is observed. After that, a regime characterized by transient states close to the single-helicity condition (Cappello and Paccagnella 1992 Phys. Fluids B 4 611, Finn et al 1992 Phys. Fluids B 4 1262) is established. This brings about a 50% increase in the global confinement parameters
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Similar Symmetries: The Role of Wallpaper Groups in Perceptual Texture Similarity
Directory of Open Access Journals (Sweden)
Fraser Halley
2011-05-01
Full Text Available Periodic patterns and symmetries are striking visual properties that have been used decoratively around the world throughout human history. Periodic patterns can be mathematically classified into one of 17 different Wallpaper groups, and while computational models have been developed which can extract an image's symmetry group, very little work has been done on how humans perceive these patterns. This study presents the results from a grouping experiment using stimuli from the different wallpaper groups. We find that while different images from the same wallpaper group are perceived as similar to one another, not all groups have the same degree of self-similarity. The similarity relationships between wallpaper groups appear to be dominated by rotations.
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Programming language structures
Organick, Elliott Irving; Plummer, Robert P
1978-01-01
Programming Language Structures deals with the structures of programming languages and introduces the reader to five important programming languages: Algol, Fortran, Lisp, Snobol, and Pascal. The fundamental similarities and differences among these languages are discussed. A unifying framework is constructed that can be used to study the structure of other languages, such as Cobol, PL/I, and APL. Several of the tools and methodologies needed to construct large programs are also considered.Comprised of 10 chapters, this book begins with a summary of the relevant concepts and principles about al
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Casella, Ivan Benaduce; Fukushima, Rodrigo Bono; Marques, Anita Battistini de Azevedo; Cury, Marcus Vinícius Martins; Presti, Calógero
2015-03-01
To compare a new dedicated software program and Adobe Photoshop for gray-scale median (GSM) analysis of B-mode images of carotid plaques. A series of 42 carotid plaques generating ≥50% diameter stenosis was evaluated by a single observer. The best segment for visualization of internal carotid artery plaque was identified on a single longitudinal view and images were recorded in JPEG format. Plaque analysis was performed by both programs. After normalization of image intensity (blood = 0, adventitial layer = 190), histograms were obtained after manual delineation of plaque. Results were compared with nonparametric Wilcoxon signed rank test and Kendall tau-b correlation analysis. GSM ranged from 00 to 100 with Adobe Photoshop and from 00 to 96 with IMTPC, with a high grade of similarity between image pairs, and a highly significant correlation (R = 0.94, p < .0001). IMTPC software appears suitable for the GSM analysis of carotid plaques. © 2014 Wiley Periodicals, Inc.
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2010-11-12
... assistance and provide security for such repayment by recordation of a HUD mortgage as a junior lien on the... current first lien mortgage loan payments for which the homeowner remains responsible. IV. Submission of.... Nondiscrimination and Civil Rights Requirements States operating existing programs that provide substantially...
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Single Assignment C (SAC): High Productivity meets High Performance
Grelck, C.; Zsók, V.; Horváth, Z.; Plasmeijer, R.
2012-01-01
We present the ins and outs of the purely functional, data parallel programming language SaC (Single Assignment C). SaC defines state- and side-effect-free semantics on top of a syntax resembling that of imperative languages like C/C++/C# or Java: functional programming with curly brackets. In
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International Nuclear Information System (INIS)
Falsafi, Hananeh; Zakariazadeh, Alireza; Jadid, Shahram
2014-01-01
This paper focuses on using DR (Demand Response) as a means to provide reserve in order to cover uncertainty in wind power forecasting in SG (Smart Grid) environment. The proposed stochastic model schedules energy and reserves provided by both of generating units and responsive loads in power systems with high penetration of wind power. This model is formulated as a two-stage stochastic programming, where first-stage is associated with electricity market, its rules and constraints and the second-stage is related to actual operation of the power system and its physical limitations in each scenario. The discrete retail customer responses to incentive-based DR programs are aggregated by DRPs (Demand Response Providers) and are submitted as a load change price and amount offer package to ISO (Independent System Operator). Also, price-based DR program behavior and random nature of wind power are modeled by price elasticity concept of the demand and normal probability distribution function, respectively. In the proposed model, DRPs can participate in energy market as well as reserve market and submit their offers to the wholesale electricity market. This approach is implemented on a modified IEEE 30-bus test system over a daily time horizon. The simulation results are analyzed in six different case studies. The cost, emission and multiobjective functions are optimized in both without and with DR cases. The multiobjective generation scheduling model is solved using augmented epsilon constraint method and the best solution can be chosen by Entropy and TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) methods. The results indicate demand side participation in energy and reserve scheduling reduces the total operation costs and emissions. - Highlights: • Simultaneous participation of loads in both energy and reserve scheduling. • Environmental/economical scheduling of energy and reserve. • Using demand response for covering wind generation forecast
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The cost-effectiveness of the Olweus Bullying Prevention Program: Results from a modelling study.
Beckman, Linda; Svensson, Mikael
2015-12-01
Exposure to bullying affects around 3-5 percent of adolescents in secondary school and is related to various mental health problems. Many different anti-bullying programmes are currently available, but economic evaluations are lacking. The aim of this study is to identify the cost effectiveness of the Olweus Bullying Prevention Program (OBPP). We constructed a decision-tree model for a Swedish secondary school, using a public payer perspective, and retrieved data on costs and effects from the published literature. Probabilistic sensitivity analysis to reflect the uncertainty in the model was conducted. The base-case analysis showed that using the OBPP to reduce the number of victims of bullying costs 131,250 Swedish kronor (€14,470) per victim spared. Compared to a relevant threshold of the societal value of bullying reduction, this indicates that the programme is cost-effective. Using a relevant willingness-to-pay threshold shows that the OBPP is a cost-effective intervention. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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International Nuclear Information System (INIS)
Bankert, S.F.; Evans, C.D.; Hardy, H.A.; Litteer, G.L.; Schulz, G.L.; Smith, N.C.
1978-01-01
The United States Nuclear Regulatory Commission (NRC) has established the NRC/Reactor Safety Research (RSR) Data Bank Program at the Idaho National Engineering Laboratory (INEL). The program provides the means of collecting, storing, and making available experimental data from the many water reactor safety research programs in the United States and other countries. The program collects qualified engineering data on a prioritized basis from experimental program data bases, stores the data in a single data bank in a common format, and makes the data available to users
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Reynolds, Stacey
2010-01-01
ABSTRACT The Centennial Vision of the American Occupational Therapy Association (AOTA) projects that by 2017 all occupational therapy (OT) practice areas will be supported by evidence. Achieving this goal requires preparing clinicians with the skills to assimilate, analyze, and apply research to their areas of practice and communicate the value of OT services to consumers and payers. These skills are at the heart of evidence-based practice (EBP). Educators must be prepared to teach EBP skills in both entry-level and postprofessional programs. This article outlines how EBP can be taught to postprofessional occupational therapy clinical doctoral students using a distance education format. Key features of a successful EBP course include having access to full-text electronic articles, opportunities for students to explore the literature in their own areas of interest, consistent and timely feedback on written work and discussion topics, and opportunities to collaborate with peers.
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van Drongelen, Stefan; Dreher, Thomas; Heitzmann, Daniel W. W.; Wolf, Sebastian I.
2013-01-01
To examine gait patterns and gait quality, 7 twins with cerebral palsy were measured preoperatively and after surgical intervention. The aim was to study differences and/or similarities in gait between twins, the influence of personal characteristics and birth conditions, and to describe the development of gait over time after single event…
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International Nuclear Information System (INIS)
Bankert, S.F.; Evans, C.D.; Hardy, H.A.; Litteer, G.L.; Schulz, G.L.; Smith, N.C.
1978-01-01
The United States Nuclear Regulatory Commission (NRC) has established at the Idaho National Engineering Laboratory (INEL) the NRC/Reactor Safety Research (RSR) Data Bank Program. The program is under the direction of EG and G Idaho, Inc., and is intended to provide the means of collecting, processing, and making available experimental data from the many water reactor safety research programs. The NRC/RSR Data Bank Program collects qualified engineering data on a prioritized basis from experimental program data bases, stores the data in a single data bank in a common format, and makes the data available to users. The NRC/RSR Data Bank specializes in water reactor safety experimental data, but it has a number of other scientific applications where large amounts of numeric data are or will be available. As an example of size, a single water reactor safety test may generate 10 million data words. Future examples of the use of a data bank might be in gathering data on low head hydraulics, solar projects, and liquid metal reactor safety data
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Vere-Jones' self-similar branching model
International Nuclear Information System (INIS)
Saichev, A.; Sornette, D.
2005-01-01
Motivated by its potential application to earthquake statistics as well as for its intrinsic interest in the theory of branching processes, we study the exactly self-similar branching process introduced recently by Vere-Jones. This model extends the ETAS class of conditional self-excited branching point-processes of triggered seismicity by removing the problematic need for a minimum (as well as maximum) earthquake size. To make the theory convergent without the need for the usual ultraviolet and infrared cutoffs, the distribution of magnitudes m ' of daughters of first-generation of a mother of magnitude m has two branches m ' ' >m with exponent β+d, where β and d are two positive parameters. We investigate the condition and nature of the subcritical, critical, and supercritical regime in this and in an extended version interpolating smoothly between several models. We predict that the distribution of magnitudes of events triggered by a mother of magnitude m over all generations has also two branches m ' ' >m with exponent β+h, with h=d√(1-s), where s is the fraction of triggered events. This corresponds to a renormalization of the exponent d into h by the hierarchy of successive generations of triggered events. For a significant part of the parameter space, the distribution of magnitudes over a full catalog summed over an average steady flow of spontaneous sources (immigrants) reproduces the distribution of the spontaneous sources with a single branch and is blind to the exponents β,d of the distribution of triggered events. Since the distribution of earthquake magnitudes is usually obtained with catalogs including many sequences, we conclude that the two branches of the distribution of aftershocks are not directly observable and the model is compatible with real seismic catalogs. In summary, the exactly self-similar Vere-Jones model provides an attractive new approach to model triggered seismicity, which alleviates delicate questions on the role of
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Doiron-Cadrin, Patrick; Kairy, Dahlia; Vendittoli, Pascal-André; Lowry, Véronique; Poitras, Stéphane; Desmeules, François
2016-12-15
The accessibility for total joint arthroplasty often comes up against long wait lists, and may lead to deleterious effects for the awaiting patients. This pilot single blind randomized controlled trial aims to evaluate the impact of a telerehabilitation prehabilitation program before a hip or knee arthroplasty compared to in-person prehabilitation or to usual wait for surgery. Thirty-six patients on a wait list for a total hip or knee arthroplasty will be recruited and randomly assigned to one of three groups. The in-person prehabilitation group (n = 12) will receive a 12-week rehabilitation program (2 sessions/week) including education, exercises of the lower limb and cardiovascular training. Patients in the tele-prehabilitation group (n = 12) will receive the same intervention using a telecommunication software. The control group (n = 12) will be provided with the hospital's usual documentation before surgery. The Lower Extremity Functional Scale (LEFS) will be the primary outcome measure taken at baseline and at 12 weeks. Secondary measures will include self-reported function and quality of life as well as performance tests. A mixed-model, 2-way repeated-measure ANOVA will be used to analyse the effects of the rehabilitation programs. This pilot study is the first to evaluate the feasibility and the impact of a telerehabilitation prehabilitation program for patients awaiting a total joint arthroplasty. The results of this pilot-RCT will set the foundations for further research in the fields of rehabilitation and tele-medicine for patients suffering from lower limb osteoarthritis. ClinicalTrials.gov: NCT02636751.
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Wu, Changzheng; Zhang, Xiaodong; Ning, Bo; Yang, Jinlong; Xie, Yi
2009-07-06
Solid templates have been long regarded as one of the most promising ways to achieve single-shelled hollow nanostructures; however, few effective methods for the construction of multishelled hollow objects from their solid template counterparts have been developed. We report here, for the first time, a novel and convenient route to synthesizing double-shelled hollow spheres from the solid templates via programming the reaction-temperature procedures. The programmed temperature strategy developed in this work then provides an essential and general access to multishelled hollow nanostructures based on the designed extension of single-shelled hollow objects, independent of their outside contours, such as tubes, hollow spheres, and cubes. Starting from the V(OH)(2)NH(2) solid templates, we show that the relationship between the hollowing rate and the reaction temperature obey the Van't Hoff rule and Arrhenius activation-energy equation, revealing that it is the chemical reaction rather than the diffusion process that guided the whole hollowing process, despite the fact that the coupled reaction/diffusion process is involved in the hollowing process. Using the double-shelled hollow spheres as the PCM (CaCl(2).6H(2)O) matrix grants much better thermal-storage stability than that for the nanoparticles counterpart, revealing that the designed nanostructures can give rise to significant improvements for the energy-saving performance in future "smart house" systems.
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Nagarur, Amulya; O'Neill, Regina M; Lawton, Donna; Greenwald, Jeffrey L
2018-02-01
The guidance of a mentor can have a tremendous influence on the careers of academic physicians. The lack of mentorship in the relatively young field of hospital medicine has been documented, but the efficacy of formalized mentorship programs has not been well studied. We implemented and evaluated a structured mentorship program for junior faculty at a large academic medical center. Of the 16 mentees who participated in the mentorship program, 14 (88%) completed preintervention surveys and 10 (63%) completed postintervention surveys. After completing the program, there was a statistically significant improvement in overall satisfaction within 5 specific domains: career planning, professional connectedness, self-reflection, research skills, and mentoring skills. All mentees reported that they would recommend that all hospital medicine faculty participate in similar mentorship programs. In this small, single-center pilot study, we found that the addition of a structured mentorship program based on training sessions that focus on best practices in mentoring was feasible and led to increased satisfaction in certain career domains among early-career hospitalists. Larger prospective studies with a longer follow-up are needed to assess the generalizability and durability of our findings. © 2017 Society of Hospital Medicine.
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A Novel Drug-Mouse Phenotypic Similarity Method Detects Molecular Determinants of Drug Effects.
Directory of Open Access Journals (Sweden)
Jeanette Prinz
2016-09-01
Full Text Available The molecular mechanisms that translate drug treatment into beneficial and unwanted effects are largely unknown. We present here a novel approach to detect gene-drug and gene-side effect associations based on the phenotypic similarity of drugs and single gene perturbations in mice that account for the polypharmacological property of drugs. We scored the phenotypic similarity of human side effect profiles of 1,667 small molecules and biologicals to profiles of phenotypic traits of 5,384 mouse genes. The benchmarking with known relationships revealed a strong enrichment of physical and indirect drug-target connections, causative drug target-side effect links as well as gene-drug links involved in pharmacogenetic associations among phenotypically similar gene-drug pairs. The validation by in vitro assays and the experimental verification of an unknown connection between oxandrolone and prokineticin receptor 2 reinforces the ability of this method to provide new molecular insights underlying drug treatment. Thus, this approach may aid in the proposal of novel and personalized treatments.
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Single-Family Energy Auditor Job Task Analysis
Energy Technology Data Exchange (ETDEWEB)
Head, Heather R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kurnik, Charles W [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
2018-05-02
The National Renewable Energy Laboratory (NREL) is contracted by the U.S. Department of Energy (DOE) Weatherization Assistance Program (WAP) to develop and maintain the resources under the Guidelines for Home Energy Professionals (GHEP) project. As part of the GHEP strategy to increase the quality of work conducted for single-family, residential energy-efficiency retrofits, the Home Energy Professionals Job Task Analysis are used as the foundation for quality training programs and trainers.
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Energy Technology Data Exchange (ETDEWEB)
Chen, De-Li [Univ. of Pittsburgh, PA (United States). Dept. of Chemical and Petroleum Engineering; Mandeltort, Lynn [Univ. of Virginia, Charlottesville, VA (United States). Dept. of Chemistry; Saidi, Wissam A. [Univ. of Pittsburgh, PA (United States). Dept. of Chemical and Petroleum Engineering; Yates, John T. [Univ. of Virginia, Charlottesville, VA (United States). Dept. of Chemistry; Cole, Milton W. [Pennsylvania State Univ., University Park, PA (United States). Dept of Physics; Johnson, J. Karl [Univ. of Pittsburgh, PA (United States). Dept. of Chemical and Petroleum Engineering; National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)
2013-03-01
Differences in polarizabilities of metallic (M) and semiconducting (S) single-walled carbon nanotubes (SWNTs) might give rise to differences in adsorption potentials. We show from experiments and van der Waals-corrected density functional theory (DFT) that binding energies of Xe adsorbed on M- and S-SWNTs are nearly identical. Temperature programmed desorption of Xe on purified M- and S-SWNTs give similar peak temperatures, indicating that desorption kinetics and binding energies are independent of the type of SWNT. Binding energies computed from vdW-corrected DFT are in good agreement with experiments.
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Impact of a Novel Cost-Saving Pharmacy Program on Pregabalin Use and Health Care Costs.
Martin, Carolyn; Odell, Kevin; Cappelleri, Joseph C; Bancroft, Tim; Halpern, Rachel; Sadosky, Alesia
2016-02-01
Pharmacy cost-saving programs often aim to reduce costs for members and payers by encouraging use of lower-tier or generic medications and lower-cost sales channels. In 2010, a national U.S. health plan began a novel pharmacy program directed at reducing pharmacy expenditures for targeted medications, including pregabalin. The program provided multiple options to avoid higher cost sharing: use mail order pharmacy or switch to a lower-cost alternative medication via mail order or retail. Members who did not choose any option eventually paid the full retail cost of pregabalin. To evaluate the impact of the pharmacy program on pregabalin and alternative medication use, health care costs, and health care utilization. This retrospective analysis of claims data included adult commercial health plan members with a retail claim for pregabalin in the first 13 months of the pharmacy program (identification [ID] period: February 1, 2010-February 28, 2011). Members whose benefit plan included the pharmacy program were assigned to the program cohort; all others were assigned to the nonprogram cohort. The program cohort index date was the first retail pregabalin claim during the ID period and after the program start; the nonprogram cohort index date was the first retail pregabalin claim during the ID period. All members were continuously enrolled for 12 months pre- and post-index and had at least 1 inpatient claim or ≥ 2 ambulatory visit claims for a pregabalin-indicated condition. Cohorts were propensity score matched (PSM) 1:1 with logistic regression on demographic and pre-index characteristics, including mail order and pregabalin use, comorbidity, health care costs, and health care utilization. Pregabalin, gabapentin and other alternative medication use, health care costs, and health care utilization were measured. The program cohort was also divided into 2 groups: members who changed to gabapentin post-index and those who did not. A difference-in-differences (Di
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Aura: A Multi-Featured Programming Framework in Python
Directory of Open Access Journals (Sweden)
2010-09-01
Full Text Available This paper puts forward the design, programming and application of innovative educational software, ‘Aura’ made using Python and PyQt Python bindings. The research paper presents a new concept of using a single tool to relate between syntaxes of various programming languages and algorithms. It radically increases their understanding and retaining capacity, since they can correlate between many programming languages. The software is a totally unorthodox attempt towards helping students who have their first tryst with programming languages. The application is designed to help students understand how algorithms work and thus, help them in learning multiple programming languages on a single platform using an interactive graphical user interface. This paper elucidates how using Python and PyQt bindings, a comprehensive feature rich application, that implements an interactive algorithm building technique, a web browser, multiple programming language framework, a code generator and a real time code sharing hub be embedded into a single interface. And also explains, that using Python as building tool, it requires much less coding than conventional feature rich applications coded in other programming languages, and at the same time does not compromise on stability, inter-operability and robustness of the application.
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Stress Level and Adversity Quotient among Single Working Mothers
Directory of Open Access Journals (Sweden)
Dianne Bautista Solis
2015-12-01
Full Text Available The study identified the profile of the single working mothers in terms of number of children, number of years as a single parent and reason for being a single parent; assessed the single mothers’ stress level and adversity quotient; determined the significant difference of stress level and adversity quotient of single mothers when grouped according to profile variables; determined the best predictor of stress level and adversity quotient. Moreover this research endeavoured to test significant relationship between the adversity quotient and stress level of single working mothers. Lastly, it proposed a stress management program for single working mothers for them to cope with their stress and adversities in life. The researcher employed quantitative method using standardized questionnaires namely Depression, Anxiety, Stress Scale (DASS and Adversity Response Profile (ARP. The respondents were twenty five (25 single working mothers of the students of Batangas State University. From the results, majority of the respondents have 3 children, widow and in early years as single parent; with a normal level of stress and an average adversity quotient.. There are no significant differences on the stress level and adversity quotient of the respondents when grouped according to profile variables. Finally, stress level has no significant effect on adversity quotient of single working mothers. From the findings, the researcher further recommends that the Office of Guidance and Counseling should update the student information database to determine students with a single working mother. The Parent-Teacher Association may form a single-parent subgroup for the single working mothers to be able to identify to other mothers with same situation. Moreover, the proposed stress management program may be reviewed and implemented by the Office of Guidance and Counseling in coordination with the Parent-Teacher Association of Batangas State University. Future researchers
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1979-01-01
A description and listing is presented of two computer programs: Hybrid Vehicle Design Program (HYVELD) and Hybrid Vehicle Simulation Program (HYVEC). Both of the programs are modifications and extensions of similar programs developed as part of the Electric and Hybrid Vehicle System Research and Development Project.
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On the nature and impact of self-similarity in real-time systems
Enrique Hernández-Orallo; Vila Carbó, Juan Antonio
2012-01-01
In real-time systems with highly variable task execution times simplistic task models are insufficient to accurately model and to analyze the system. Variability can be tackled using distributions rather than a single value, but the proper charac- terization depends on the degree of variability. Self-similarity is one of the deep- est kinds of variability. It characterizes the fact that a workload is not only highly variable, but it is also bursty on many time-scales. This paper identifies in...
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The costs of caring: medical costs of Alzheimer's disease and the managed care environment.
Murman, D L
2001-01-01
This review summarizes the medical costs associated with Alzheimer's disease (AD) and related dementias, as well as the payers responsible for these medical costs in the US health care system. It is clear from this review that AD and related dementias are associated with substantial medical costs. The payers responsible for a majority of these costs are families of patients with AD and the US government through the Medicare and Medicaid programs. In an attempt to control expenditures, Medicare and Medicaid have turned to managed care principles and managed care organizations. The increase in "managed" dementia care gives rise to several potential problems for patients with AD, along with many opportunities for systematic improvement in the quality of dementia care. Evidence-based disease management programs provide the greatest opportunities for improving managed dementia care but will require the development of dementia-specific quality of care measures to evaluate and continually improve them.
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Pressley, Joyce C; Dawson, Patrick; Carpenter, Dustin J
2012-10-01
Military deployment of one or both parents is associated with declines in school performance, behavioral difficulties, and increases in reported mental health conditions, but less is known regarding injury risks in pediatric military dependents. Kid Health Care Cost and Utilization Project 2006 (KID) was used to identify military dependents aged 0.1 year to 17 years through expected insurance payer being CHAMPUS, Tricare, or CHAMPVA (n = 12,310) and similarly aged privately insured nonmilitary in CHAMPUS, Tricare, or CHAMPVA states (n = 730,065). Mental health diagnoses per 1,000 hospitalizations and mechanisms of injury per 1,000 injury-related hospitalizations are reported. Unweighted univariate analyses used Fisher's exact, χ(2), and analysis of variance tests for significance. Odds ratios are age and sex adjusted with 95% confidence intervals. Injury-related admissions were higher in military than in nonmilitary dependents (15.5% vs. 13.2%, p sex-adjusted motor vehicle occupant and pedestrian injuries were significantly lower in all-age military dependents but not in age-stratified categories. Very young military dependents had higher all-cause injury admissions (p < 0.0001), drowning/near drowning (p < 0.0001), and intracranial injury (p < 0.0001) and showed a tendency toward higher suffocation (p = 0.055) and crushing injury (p = 0.065). Military adolescents and teenagers had higher suicide/suicide attempts (p = 0.0001) and poisonings from medicinal substances (p = 0.0001). Mental health diagnoses were significantly higher in every age category of military dependents. All-cause in-hospital mortality tended to be greater in military than in nonmilitary dependents (p = 0.052). This study suggests that military dependents are a vulnerable population with special needs and provides clues to areas where injury prevention professionals might begin to address their needs. Prognostic/epidemiologic study, level II.
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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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Exploring the relationship between sequence similarity and accurate phylogenetic trees.
Cantarel, Brandi L; Morrison, Hilary G; Pearson, William
2006-11-01
We have characterized the relationship between accurate phylogenetic reconstruction and sequence similarity, testing whether high levels of sequence similarity can consistently produce accurate evolutionary trees. We generated protein families with known phylogenies using a modified version of the PAML/EVOLVER program that produces insertions and deletions as well as substitutions. Protein families were evolved over a range of 100-400 point accepted mutations; at these distances 63% of the families shared significant sequence similarity. Protein families were evolved using balanced and unbalanced trees, with ancient or recent radiations. In families sharing statistically significant similarity, about 60% of multiple sequence alignments were 95% identical to true alignments. To compare recovered topologies with true topologies, we used a score that reflects the fraction of clades that were correctly clustered. As expected, the accuracy of the phylogenies was greatest in the least divergent families. About 88% of phylogenies clustered over 80% of clades in families that shared significant sequence similarity, using Bayesian, parsimony, distance, and maximum likelihood methods. However, for protein families with short ancient branches (ancient radiation), only 30% of the most divergent (but statistically significant) families produced accurate phylogenies, and only about 70% of the second most highly conserved families, with median expectation values better than 10(-60), produced accurate trees. These values represent upper bounds on expected tree accuracy for sequences with a simple divergence history; proteins from 700 Giardia families, with a similar range of sequence similarities but considerably more gaps, produced much less accurate trees. For our simulated insertions and deletions, correct multiple sequence alignments did not perform much better than those produced by T-COFFEE, and including sequences with expressed sequence tag-like sequencing errors did not
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Gender similarities and differences.
Hyde, Janet Shibley
2014-01-01
Whether men and women are fundamentally different or similar has been debated for more than a century. This review summarizes major theories designed to explain gender differences: evolutionary theories, cognitive social learning theory, sociocultural theory, and expectancy-value theory. The gender similarities hypothesis raises the possibility of theorizing gender similarities. Statistical methods for the analysis of gender differences and similarities are reviewed, including effect sizes, meta-analysis, taxometric analysis, and equivalence testing. Then, relying mainly on evidence from meta-analyses, gender differences are reviewed in cognitive performance (e.g., math performance), personality and social behaviors (e.g., temperament, emotions, aggression, and leadership), and psychological well-being. The evidence on gender differences in variance is summarized. The final sections explore applications of intersectionality and directions for future research.
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International Nuclear Information System (INIS)
Buck, J.W.; Peffers, M.S.; Hwang, S.T.
1991-11-01
The work described in this volume was conducted by Pacific Northwest Laboratory to provide preliminary recommendations on data quality objectives (DQOs) to support the Waste Characterization Plan (WCP) and closure decisions for the Hanford Site single-shell tanks (SSTs). The WCP describes the first of a two-phase characterization program that will obtain information to assess and implement disposal options for SSTs. This work was performed for the Westinghouse Hanford Company (WHC), the current operating contractor on the Hanford Site. The preliminary DQOs contained in this volume deal with the analysis of SST wastes in support of the WCP and final closure decisions. These DQOs include information on significant contributors and detection limit goals (DLGs) for SST analytes based on public health risk
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Single-Event Effects in Silicon Carbide Power Devices
Lauenstein, Jean-Marie; Casey, Megan C.; LaBel, Kenneth A.; Ikpe, Stanley; Topper, Alyson D.; Wilcox, Edward P.; Kim, Hak; Phan, Anthony M.
2015-01-01
This report summarizes the NASA Electronic Parts and Packaging Program Silicon Carbide Power Device Subtask efforts in FY15. Benefits of SiC are described and example NASA Programs and Projects desiring this technology are given. The current status of the radiation tolerance of silicon carbide power devices is given and paths forward in the effort to develop heavy-ion single-event effect hardened devices indicated.
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Kaptein, M.C.; Castaneda, D.; Fernandez, N.; Nass, C.
2014-01-01
The feeling of connectedness experienced in computer-mediated relationships can be explained by the similarity-attraction effect (SAE). Though SAE is well established in psychology, the effects of some types of similarity have not yet been explored. In 2 studies, we demonstrate similarity-attraction
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Boehm, Markus; Wu, Tong-Ying; Claussen, Holger; Lemmen, Christian
2008-04-24
Large collections of combinatorial libraries are an integral element in today's pharmaceutical industry. It is of great interest to perform similarity searches against all virtual compounds that are synthetically accessible by any such library. Here we describe the successful application of a new software tool CoLibri on 358 combinatorial libraries based on validated reaction protocols to create a single chemistry space containing over 10 (12) possible products. Similarity searching with FTrees-FS allows the systematic exploration of this space without the need to enumerate all product structures. The search result is a set of virtual hits which are synthetically accessible by one or more of the existing reaction protocols. Grouping these virtual hits by their synthetic protocols allows the rapid design and synthesis of multiple follow-up libraries. Such library ideas support hit-to-lead design efforts for tasks like follow-up from high-throughput screening hits or scaffold hopping from one hit to another attractive series.
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Fundamental study of single biomass particle combustion
Energy Technology Data Exchange (ETDEWEB)
Momeni, M.
2013-06-01
This thesis is a comprehensive study of single biomass particle combustion. The effect of particle shape and size and operating conditions on biomass conversion characteristics were investigated experimentally and theoretically. The experimental samples were divided in two groups: particles with regular shapes (spheres and cylinders) and particles with irregular shapes (almost flake-like). A CAMSIZER analyser (Retsch Technology GMBH) was used to determine the size and shape of the particles via Dynamical Digital Image Processing. The experiments were performed in a single particle reactor under well-defined conditions, and the complete combustion processes were recorded as video sequences by a CCD camera installed in the set-up. One of the project objectives is to simulate conditions reasonably close to the conditions in a power plant boiler, i.e., reasonably high temperatures (up to 1600 deg. C) and varying oxygen concentrations in the 5 to 20% range. A one-dimensional mathematical model was used to simulate all the intraparticle conversion processes (drying, recondensation, devolatilisation, char gasification/oxidation and heat/mass/momentum transfer) within single particles of different shapes and size under various conditions. The model also predicts the flame layer domain of a single particle. The model was validated by experimental results under different conditions; good agreement between the model predictions and the experimental data was observed. Both the experimental and modelling results showed that cylindrical particles lose mass faster than spherical particles of a similar volume (mass) and that the burnout time is reduced by increasing the particle aspect ratio (surface area to volume ratio). Very similar conversion times were observed for cylindrical particles with nearly identical surface area to volume ratios. Similar conversion times were also observed for two size classes of pulverised particles (with irregular shapes) made from the same type of
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New iteration of decommissioning program for NPP Krsko
International Nuclear Information System (INIS)
Lokner, V.; Levanat, I.; Rapic, A.; Zeleznik, N.; Mele, I.; Jenko, T.
2004-01-01
the price of loosening some of the boundary conditions. The forth step includes financial comparison of the estimated expenses for the chosen scenario with the available data on decommissioning expenses for similar power plants and LILW and spent fuel repositories. By variations of the original SID strategy, seven rational decommissioning scenarios were formulated respecting boundary conditions and other limitations. Three of them are ending with local disposal of spent fuel, and four of them are assuming permanent export of spent fuel. After financial analysis two scenarios could be singled out and optimized. They were labeled SID-45 with disposal and SID-45 with export. A choice on the one to be finally executed is up to the stake holders deciding on the scenario's social acceptability. Both of the scenarios are structurally similar with almost identical discounted expenses, enabling simple switching from one scenario to another and back for several decades from now. The next iteration of the Decommissioning program revision process should be started as soon as possible, because two or three years will be needed to accomplish all refinements suggested by this revision.(author)
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Fibrosis-Related Gene Expression in Single Ventricle Heart Disease.
Nakano, Stephanie J; Siomos, Austine K; Garcia, Anastacia M; Nguyen, Hieu; SooHoo, Megan; Galambos, Csaba; Nunley, Karin; Stauffer, Brian L; Sucharov, Carmen C; Miyamoto, Shelley D
2017-12-01
To evaluate fibrosis and fibrosis-related gene expression in the myocardium of pediatric subjects with single ventricle with right ventricular failure. Real-time quantitative polymerase chain reaction was performed on explanted right ventricular myocardium of pediatric subjects with single ventricle disease and controls with nonfailing heart disease. Subjects were divided into 3 groups: single ventricle failing (right ventricular failure before or after stage I palliation), single ventricle nonfailing (infants listed for primary transplantation with normal right ventricular function), and stage III (Fontan or right ventricular failure after stage III). To evaluate subjects of similar age and right ventricular volume loading, single ventricle disease with failure was compared with single ventricle without failure and stage III was compared with nonfailing right ventricular disease. Histologic fibrosis was assessed in all hearts. Mann-Whitney tests were performed to identify differences in gene expression. Collagen (Col1α, Col3) expression is decreased in single ventricle congenital heart disease with failure compared with nonfailing single ventricle congenital heart disease (P = .019 and P = .035, respectively), and is equivalent in stage III compared with nonfailing right ventricular heart disease. Tissue inhibitors of metalloproteinase (TIMP-1, TIMP-3, and TIMP-4) are downregulated in stage III compared with nonfailing right ventricular heart disease (P = .0047, P = .013 and P = .013, respectively). Matrix metalloproteinases (MMP-2, MMP-9) are similar between nonfailing single ventricular heart disease and failing single ventricular heart disease, and between stage III heart disease and nonfailing right ventricular heart disease. There is no difference in the prevalence of right ventricular fibrosis by histology in subjects with single ventricular failure heart disease with right ventricular failure (18%) compared with those with normal right
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Directory of Open Access Journals (Sweden)
Pier Federico Gherardini
Full Text Available Local structural comparison methods can be used to find structural similarities involving functional protein patches such as enzyme active sites and ligand binding sites. The outcome of such analyses is critically dependent on the representation used to describe the structure. Indeed different categories of functional sites may require the comparison program to focus on different characteristics of the protein residues. We have therefore developed superpose3D, a novel structural comparison software that lets users specify, with a powerful and flexible syntax, the structure description most suited to the requirements of their analysis. Input proteins are processed according to the user's directives and the program identifies sets of residues (or groups of atoms that have a similar 3D position in the two structures. The advantages of using such a general purpose program are demonstrated with several examples. These test cases show that no single representation is appropriate for every analysis, hence the usefulness of having a flexible program that can be tailored to different needs. Moreover we also discuss how to interpret the results of a database screening where a known structural motif is searched against a large ensemble of structures. The software is written in C++ and is released under the open source GPL license. Superpose3D does not require any external library, runs on Linux, Mac OSX, Windows and is available at http://cbm.bio.uniroma2.it/superpose3D.
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Neutrosophic Similarity Score Based Weighted Histogram for Robust Mean-Shift Tracking
Directory of Open Access Journals (Sweden)
Keli Hu
2017-10-01
Full Text Available Visual object tracking is a critical task in computer vision. Challenging things always exist when an object needs to be tracked. For instance, background clutter is one of the most challenging problems. The mean-shift tracker is quite popular because of its efficiency and performance in a range of conditions. However, the challenge of background clutter also disturbs its performance. In this article, we propose a novel weighted histogram based on neutrosophic similarity score to help the mean-shift tracker discriminate the target from the background. Neutrosophic set (NS is a new branch of philosophy for dealing with incomplete, indeterminate, and inconsistent information. In this paper, we utilize the single valued neutrosophic set (SVNS, which is a subclass of NS to improve the mean-shift tracker. First, two kinds of criteria are considered as the object feature similarity and the background feature similarity, and each bin of the weight histogram is represented in the SVNS domain via three membership functions T(Truth, I(indeterminacy, and F(Falsity. Second, the neutrosophic similarity score function is introduced to fuse those two criteria and to build the final weight histogram. Finally, a novel neutrosophic weighted mean-shift tracker is proposed. The proposed tracker is compared with several mean-shift based trackers on a dataset of 61 public sequences. The results revealed that our method outperforms other trackers, especially when confronting background clutter.
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Dunn, Stephanie; Lark, Sally; Fallows, Stephen
2014-07-01
Cardiac Rehabilitation (CR) programs are the most cost-effective measure for reducing morbidity associated with Coronary Vascular Disease (CVD). To be more effective there is a need to understand what influences the maintenance of healthy behaviors. This study identifies similar and different influences in CR of the United Kingdom (UK) and New Zealand (NZ). A retrospective study. Participants had previously been discharged from CR for 6 to 12+ months within the UK (n = 22) and NZ (n = 21). Participant's attended a focus group. Discussions were digitally recorded, transcribed then thematically analyzed. The CR programs were observed over 2 months to enable comment on findings relating to 'theory in practice.' Similar positive patient experiences influencing behavior between groups and countries were; support, education, positive attitude, and motivation. Companionship and exercising alongside people with similar health problems was the major determinant for positive exercise behavior. Barriers to maintaining exercise included; physical disabilities, time constraints, and weather conditions. NZ participants were more affected by external factors (eg, opportunity, access, and time). Both CR programs were successful in facilitating the maintenance of healthy lifestyles. Exercising with other cardiac patients for support in a structured environment was the strongest influence in maintaining healthy lifestyles beyond CR programs.
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Pawęska, Justyna; Macioch, Tomasz; Perkowski, Piotr; Budaj, Andrzej; Niewada, Maciej
2014-01-01
Ticagrelor is the first reversibly binding oral P2Y12 receptor antagonist designed to reduce clinical thrombotic events in patients with acute coronary syndrome (ACS). Compared to clopidogrel, ticagrelor has been proven to significantly reduce the rate of death from vascular causes, myocardial infarction (MI), or stroke without an increase in the rate of overall major bleeding in patients who have an ACS with or without ST-segment elevation (STEMI and NSTEMI) or unstable angina (UA). To evaluate the cost-effectiveness and healthcare costs associated with secondary prevention of ACS using ticagrelor or clopidogrel in patients after STEMI, NSTEMI and UA. An economic model based on results from the PLATO trial was used to evaluate the cost-effectiveness of one-year therapy with ticagrelor or clopidogrel. The structure of the model consisted of two parts, i.e. the decision tree with one-year PLATO results and the Markov model with lifelong estimations, which exceeded PLATO follow-up data. The model was adjusted to Polish settings with country-specific data on death rates in the general population and direct medical costs calculated from the public payer's perspective. Costs were derived from the National Health Fund (NHF) and the Ministry of Health and presented in PLN 2013 values. Annual mean costs of second and subsequent years after stroke or MI were obtained from the literature. Uncertainty of assumed parameters was tested in scenarios and probabilistic sensitivity analyses. The adopted model allowed the estimation of an incremental cost-effectiveness ratio for life years gained (LYG) and an incremental cost-utility ratio for quality adjusted life years (QALY). Total direct medical costs to the public payer at a one year horizon were 2,905 PLN higher with ticagrelor than with clopidogrel. However, mean healthcare costs at a one year horizon (excluding drug costs and concomitant drugs) were 690 PLN higher for patients treated with clopidogrel. In a lifetime horizon
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Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George
2018-01-01
The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.
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The Harwell TAILS computer program user's manual
International Nuclear Information System (INIS)
Rouse, K.D.; Cooper, M.J.
1980-11-01
The Harwell TAILS computer program is a versatile program for crystal structure refinement through the analysis of neutron or X-ray diffraction data from single crystals or powders. The main features of the program are described and details are given of the data input and output specifications. (author)
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Physical Activity Experiences and Beliefs among Single Mothers: A Qualitative Study
Dlugonski, Deirdre; Motl, Robert W.
2016-01-01
Purpose: Single motherhood has been associated with negative health consequences such as depression and cardiovascular disease. Physical activity might reduce these consequences, but little is known about physical activity experiences and beliefs that might inform interventions and programs for single mothers. The present study used…
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Dependently typed array programs don’t go wrong
Trojahner, K.; Grelck, C.
2009-01-01
The array programming paradigm adopts multidimensional arrays as the fundamental data structures of computation. Array operations process entire arrays instead of just single elements. This makes array programs highly expressive and introduces data parallelism in a natural way. Array programming
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Dependently typed array programs don't go wrong
Trojahner, K.; Grelck, C.
2008-01-01
The array programming paradigm adopts multidimensional arrays as the fundamental data structures of computation. Array operations process entire arrays instead of just single elements. This makes array programs highly expressive and introduces data parallelism in a natural way. Array programming
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Similarities between the Hubbard and Periodic Anderson Models at Finite Temperatures
International Nuclear Information System (INIS)
Held, K.; Huscroft, C.; Scalettar, R. T.; McMahan, A. K.
2000-01-01
The single band Hubbard and the two band periodic Anderson Hamiltonians have traditionally been applied to rather different physical problems--the Mott transition and itinerant magnetism, and Kondo singlet formation and scattering off localized magnetic states, respectively. In this paper, we compare the magnetic and charge correlations, and spectral functions, of the two systems. We show quantitatively that they exhibit remarkably similar behavior, including a nearly identical topology of the finite temperature phase diagrams at half filling. We address potential implications of this for theories of the rare earth ''volume collapse'' transition. (c) 2000 The American Physical Society
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On different forms of self similarity
International Nuclear Information System (INIS)
Aswathy, R.K.; Mathew, Sunil
2016-01-01
Fractal geometry is mainly based on the idea of self-similar forms. To be self-similar, a shape must able to be divided into parts that are smaller copies, which are more or less similar to the whole. There are different forms of self similarity in nature and mathematics. In this paper, some of the topological properties of super self similar sets are discussed. It is proved that in a complete metric space with two or more elements, the set of all non super self similar sets are dense in the set of all non-empty compact sub sets. It is also proved that the product of self similar sets are super self similar in product metric spaces and that the super self similarity is preserved under isometry. A characterization of super self similar sets using contracting sub self similarity is also presented. Some relevant counterexamples are provided. The concepts of exact super and sub self similarity are introduced and a necessary and sufficient condition for a set to be exact super self similar in terms of condensation iterated function systems (Condensation IFS’s) is obtained. A method to generate exact sub self similar sets using condensation IFS’s and the denseness of exact super self similar sets are also discussed.
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Parasitic neutron bragg reflections from large imperfect single crystals
Energy Technology Data Exchange (ETDEWEB)
Naguib, K.; Adib, M
1998-12-01
A formula is given which allows to calculate the contribution of the total Bragg scattering from different (hkl) planes to the neutron transmission through a large imperfect single crystals. The formula takes into account the crystal structure type, its mosaic spread value, the plane along which the crystal surface is cut along and its orientation with respect to the neutron beam direction. A computer program ISCANF-1 was developed to calculate the total parasitic scattering cross-section from different (hkl) planes as well as the nuclear and diffuse scattering cross-sections. The ISCANF-1 program was applied to calculate the neutron attenuation through Cu and Zn single crystals, each of them cut along (002) planes. The calculated values of the neutron transmission through Cu and Zn crystals were compared with the measured ones in the wavelength range 0.21-0.47 nm and 0.04-0.52 nm respectively. The measured and calculated values were found to be in reasonable agreement within the statistical accuracy. The computer program ISCANF-1 was also applied to investigate the effect of parasitic Bragg scattering on the neutron filtering characteristics of both Zn and Cu single crystals as a function of their physical parameters.
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Parasitic neutron bragg reflections from large imperfect single crystals
International Nuclear Information System (INIS)
Naguib, K.; Adib, M.
1998-01-01
A formula is given which allows to calculate the contribution of the total Bragg scattering from different (hkl) planes to the neutron transmission through a large imperfect single crystals. The formula takes into account the crystal structure type, its mosaic spread value, the plane along which the crystal surface is cut along and its orientation with respect to the neutron beam direction. A computer program ISCANF-1 was developed to calculate the total parasitic scattering cross-section from different (hkl) planes as well as the nuclear and diffuse scattering cross-sections. The ISCANF-1 program was applied to calculate the neutron attenuation through Cu and Zn single crystals, each of them cut along (002) planes. The calculated values of the neutron transmission through Cu and Zn crystals were compared with the measured ones in the wavelength range 0.21-0.47 nm and 0.04-0.52 nm respectively. The measured and calculated values were found to be in reasonable agreement within the statistical accuracy. The computer program ISCANF-1 was also applied to investigate the effect of parasitic Bragg scattering on the neutron filtering characteristics of both Zn and Cu single crystals as a function of their physical parameters
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The marine corrosion program developed by Nuclebras
International Nuclear Information System (INIS)
Moreira, P.A.P.; Quinan, M.A.
1986-01-01
A marine corrosion program is being developed by NUCLEBRAS and NUCLEN. This program consists in carrying out non-accelerated experiments in marine atmosphere, with immersion in sewater and laboratory accelerated tests. The purpose is to obtain a correlation between the corrosion rates observed in non-accelerated conditions and laboratory tests. Through these results it is inteded, only with laboratory tests, to estimate the bahavior of similar materials when tsted in similar marine atmosphereic conditions. Some aspects observed in the implementation of the program and some results so far obtained are discussed. (Author) [pt
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DEFF Research Database (Denmark)
Villadsen, Anders Ryom
2013-01-01
While the organizational structures and strategies of public organizations have attracted substantial research attention among public management scholars, little research has explored how these organizational core dimensions are interconnected and influenced by pressures for similarity....... In this paper I address this topic by exploring the relation between expenditure strategy isomorphism and structure isomorphism in Danish municipalities. Different literatures suggest that organizations exist in concurrent pressures for being similar to and different from other organizations in their field......-shaped relation exists between expenditure strategy isomorphism and structure isomorphism in a longitudinal quantitative study of Danish municipalities....
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Processes of Similarity Judgment
Larkey, Levi B.; Markman, Arthur B.
2005-01-01
Similarity underlies fundamental cognitive capabilities such as memory, categorization, decision making, problem solving, and reasoning. Although recent approaches to similarity appreciate the structure of mental representations, they differ in the processes posited to operate over these representations. We present an experiment that…
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Bijmolt, THA; Wedel, M; Pieters, RGM; DeSarbo, WS
This paper provides empirical insight into the way consumers make pairwise similarity judgments between brands, and how familiarity with the brands, serial position of the pair in a sequence, and the presentation format affect these judgments. Within the similarity judgment process both the
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Renewing the Respect for Similarity
Directory of Open Access Journals (Sweden)
Shimon eEdelman
2012-07-01
Full Text Available In psychology, the concept of similarity has traditionally evoked a mixture of respect, stemmingfrom its ubiquity and intuitive appeal, and concern, due to its dependence on the framing of the problemat hand and on its context. We argue for a renewed focus on similarity as an explanatory concept, bysurveying established results and new developments in the theory and methods of similarity-preservingassociative lookup and dimensionality reduction — critical components of many cognitive functions, aswell as of intelligent data management in computer vision. We focus in particular on the growing familyof algorithms that support associative memory by performing hashing that respects local similarity, andon the uses of similarity in representing structured objects and scenes. Insofar as these similarity-basedideas and methods are useful in cognitive modeling and in AI applications, they should be included inthe core conceptual toolkit of computational neuroscience.
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International Nuclear Information System (INIS)
Lee, Sungjin; Heo, Gyunyoung; Chang, S.H.
2004-01-01
Human operations through a user interface are divided into two types. The one is the single operation that is performed on a static interface. The other is the sequential operation that achieves a goal by handling several displays through operator's navigation in the crt-based console. Sequential operation has similar meaning with continuous task. Most operations in recently developed computer applications correspond to the sequential operation, and the single operation can be considered as a part of the sequential operation. In the area of HCI (human computer interaction) evaluation, the Hick-Hyman law counts as the most powerful theory. The most important factor in the equation of Hick-Hyman law about choice reaction time is the quantified amount of information conveyed by a statement, stimulus, or event. Generally, we can expect that if there are some similarities between a series of interfaces, human operator is able to use his attention resource effectively. That is the performance of human operator is increased by the similarity. The similarity may be able to affect the allocation of attention resource based on separate STSS (short-term sensory store) and long-term memory. There are theories related with this concept, which are task switching paradigm and the law of practice. However, it is not easy to explain the human operator performance with only the similarity or the information amount. There are few theories to explain the performance with the combination of the similarity and the information amount. The objective of this paper is to purpose and validate the quantitative and predictive model on the user reaction time in CRT-based displays. Another objective is to validate various theories related with human cognition and perception, which are Hick-Hyman law and the law of practice as representative theories. (author)
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Strengthening Multipayer Collaboration: Lessons From the Comprehensive Primary Care Initiative.
Anglin, Grace; Tu, H A; Liao, Kristie; Sessums, Laura; Taylor, Erin Fries
2017-09-01
Policy Points: Collaboration across payers to align financial incentives, quality measurement, and data feedback to support practice transformation is critical, but challenging due to competitive market dynamics and competing institutional priorities. The Centers for Medicare & Medicaid Services or other entities convening multipayer initiatives can build trust with other participants by clearly outlining each participant's role and the parameters of collaboration at the outset of the initiative. Multipayer collaboration can be improved if participating payers employ neutral, proactive meeting facilitators; develop formal decision-making processes; seek input on decisions from practice representatives; and champion the initiative within their organizations. With increasing frequency, public and private payers are joining forces to align goals and resources for primary care transformation. However, sustaining engagement and achieving coordination among payers can be challenging. The Comprehensive Primary Care (CPC) initiative is one of the largest multipayer initiatives ever tested. Drawing on the experience of the CPC initiative, this paper examines the factors that influence the effectiveness of multipayer collaboration. This paper draws largely on semistructured interviews with CPC-participating payers and payer conveners that facilitated CPC discussions and on observation of payer meetings. We coded and analyzed these qualitative data to describe collaborative dynamics and outcomes and assess the factors influencing them. We found that several factors appeared to increase the likelihood of successful payer collaboration: contracting with effective, neutral payer conveners; leveraging the support of payer champions, and seeking input on decisions from practice representatives. The presence of these factors helped some CPC regions overcome significant initial barriers to achieve common goals. We also found that leadership from the Centers for Medicare & Medicaid
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Self-similar continued root approximants
International Nuclear Information System (INIS)
Gluzman, S.; Yukalov, V.I.
2012-01-01
A novel method of summing asymptotic series is advanced. Such series repeatedly arise when employing perturbation theory in powers of a small parameter for complicated problems of condensed matter physics, statistical physics, and various applied problems. The method is based on the self-similar approximation theory involving self-similar root approximants. The constructed self-similar continued roots extrapolate asymptotic series to finite values of the expansion parameter. The self-similar continued roots contain, as a particular case, continued fractions and Padé approximants. A theorem on the convergence of the self-similar continued roots is proved. The method is illustrated by several examples from condensed-matter physics.
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Moss and vascular plant indices in Ohio wetlands have similar environmental predictors
Stapanian, Martin A.; Schumacher, William; Gara, Brian; Adams, Jean V.; Viau, Nick
2016-01-01
Mosses and vascular plants have been shown to be reliable indicators of wetland habitat delineation and environmental quality. Knowledge of the best ecological predictors of the quality of wetland moss and vascular plant communities may determine if similar management practices would simultaneously enhance both populations. We used Akaike's Information Criterion to identify models predicting a moss quality assessment index (MQAI) and a vascular plant index of biological integrity based on floristic quality (VIBI-FQ) from 27 emergent and 13 forested wetlands in Ohio, USA. The set of predictors included the six metrics from a wetlands disturbance index (ORAM) and two landscape development intensity indices (LDIs). The best single predictor of MQAI and one of the predictors of VIBI-FQ was an ORAM metric that assesses habitat alteration and disturbance within the wetland, such as mowing, grazing, and agricultural practices. However, the best single predictor of VIBI-FQ was an ORAM metric that assessed wetland vascular plant communities, interspersion, and microtopography. LDIs better predicted MQAI than VIBI-FQ, suggesting that mosses may either respond more rapidly to, or recover more slowly from, anthropogenic disturbance in the surrounding landscape than vascular plants. These results supported previous predictive studies on amphibian indices and metrics and a separate vegetation index, indicating that similar wetland management practices may result in qualitatively the same ecological response for three vastly different wetland biological communities (amphibians, vascular plants, and mosses).
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Early Implementation of Public Single-Sex Schools: Perceptions and Characteristics
Riordan, Cornelius; Faddis, Bonnie J.; Beam, Margaret; Seager, Andrew; Tanney, Adam; DiBiase, Rebecca; Ruffin, Monya; Valentine, Jeffrey
2008-01-01
Although for most of the nation's history, coeducation has been the norm in public elementary and secondary school, recent years have marked an increasing interest in public single-sex education. The No Child Left Behind Act of 2001 (NCLB) authorized school districts to use local or innovative program funds to offer single-sex schools and…
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The duality of XML Markup and Programming notation
DEFF Research Database (Denmark)
Nørmark, Kurt
2003-01-01
In web projects it is often necessary to mix XML notation and program notation in a single document or program. In mono-lingual situations, the XML notation is either subsumed in the program or the program notation is subsumed in the XML document. As an introduction we analyze XML notation and pr...
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Number of Single-Sex Schools Growing
Barak, Tal
2004-01-01
The U.S. Department of Education's office for civil rights has proposed amending the regulations governing Title IX of the Education Amendments of 1972--which prohibits sex discrimination in programs that receive federal money--to allow more flexibility in offering single-sex schools or classes. This article discusses the rapid growth of…
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Training of tonal similarity ratings in non-musicians: a "rapid learning" approach.
Oechslin, Mathias S; Läge, Damian; Vitouch, Oliver
2012-01-01
Although cognitive music psychology has a long tradition of expert-novice comparisons, experimental training studies are rare. Studies on the learning progress of trained novices in hearing harmonic relationships are still largely lacking. This paper presents a simple training concept using the example of tone/triad similarity ratings, demonstrating the gradual progress of non-musicians compared to musical experts: In a feedback-based "rapid learning" paradigm, participants had to decide for single tones and chords whether paired sounds matched each other well. Before and after the training sessions, they provided similarity judgments for a complete set of sound pairs. From these similarity matrices, individual relational sound maps, intended to display mental representations, were calculated by means of non-metric multidimensional scaling (NMDS), and were compared to an expert model through procrustean transformation. Approximately half of the novices showed substantial learning success, with some participants even reaching the level of professional musicians. Results speak for a fundamental ability to quickly train an understanding of harmony, show inter-individual differences in learning success, and demonstrate the suitability of the scaling method used for learning research in music and other domains. Results are discussed in the context of the "giftedness" debate.
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Training of tonal similarity ratings in non-musicians: a rapid learning approach
Directory of Open Access Journals (Sweden)
Mathias S Oechslin
2012-05-01
Full Text Available Although music psychology has a long tradition of expert-novice comparisons, experimental training studies are rare. Studies on the learning progress of trained novices in hearing harmonic relationships are still largely lacking. This paper presents a simple training concept using the example of tone/triad similarity ratings, demonstrating the gradual progress of non-musicians compared to musical experts: In a feedback-based rapid learning paradigm, participants had to decide for single tones and chords whether paired sounds matched each other well. Before and after the training sessions, they provided similarity judgments for a complete set of sound pairs. From these similarity matrices, individual relational sound maps, aiming to map the mental representations, were calculated by means of non-metric multidimensional scaling (NMDS, which were compared to an expert model through procrustean transformation. Approximately half of the novices showed substantial learning success, with some participants even reaching the level of professional musicians. Results speak for a fundamental ability to quickly train an understanding of harmony, show inter-individual differences in learning success, and demonstrate the suitability of the scaling method used for music psychological research. Results are discussed in the context of the giftedness debate.
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Merchant, Shaila; Hameed, Morad; Melck, Adrienne
2011-12-01
Interest in general surgery has declined, and lack of adequate accommodation for pregnancy and parenting may be a deterrent. We explored resident experiences with these issues within a single general surgery program. We surveyed residents enrolled in the University of British Columbia general surgery program from 1997 to 2009 using a Web-based survey tool. Information regarding demographics, pregnancy, postpartum issues and issues pertaining to maternity/parenting policies was obtained. We used the Student t test, Z test and Fisher exact test for statistical comparisons. Of the 81 residents surveyed, 53 responded (65% response rate). There were fewer pregnancies during residency among female residents than among partners of male residents (PMRs; 9 pregnancies for 6 of 25 residents v. 23 pregnancies for 15 of 28 PMRs, p = 0.002). One of 9 pregnancies among female residents and 5 of 23 among PMRs ended in miscarriage (p > 0.99). Female residents and PMRs reported pregnancy-related complications with equal frequency. All female residents breastfed for at least 6 months; however, 67% (4 of 6) felt their resident role prevented them from breastfeeding as long as they would have liked. Most (5 of 6, 83%) pursued a graduate degree or research during their "maternity leave." More than 50% of residents reported that their own workload increased because of a colleague's pregnancy. Many (36 of 53, 68%) were unaware of the existence of any maternity/parenting policy, and most were in favour of instituting such a policy. Resident mothers do not breastfeed for the desired duration, and precluding factors must be explored. Contingency plans are needed so colleagues are not overburdened when pregnant residents cannot perform clinical duties. General surgery programs must have a formal policy addressing these issues.
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Strategic Planning Process and Organizational Structure: Impacts, Confluence and Similarities
Directory of Open Access Journals (Sweden)
Dyogo Felype Neis
2017-01-01
Full Text Available This article aims to analyze the relationship between the strategic planning process and organizational structure in the reality of a complex organization: the Public Prosecutor’s Office of Santa Catarina (MPSC. The research is set by the single case study research strategy and data were collected through the following instruments: bibliographical research, documentary research, semi-structured interviews and systematic observation. The conclusion indicates that the phases of the strategic planning process influence and are influenced by the elements of the organizational structure and highlights the confluences, the impacts and similarities between the stages of formulation and implementation of the strategic process with the various constituent elements of the organizational structure.
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FMEF Electrical single line diagram and panel schedule verification process
International Nuclear Information System (INIS)
Fong, S.K.
1998-01-01
Since the FMEF did not have a mission, a formal drawing verification program was not developed, however, a verification process on essential electrical single line drawings and panel schedules was established to benefit the operations lock and tag program and to enhance the electrical safety culture of the facility. The purpose of this document is to provide a basis by which future landlords and cognizant personnel can understand the degree of verification performed on the electrical single lines and panel schedules. It is the intent that this document be revised or replaced by a more formal requirements document if a mission is identified for the FMEF
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Personalized recommendation with corrected similarity
International Nuclear Information System (INIS)
Zhu, Xuzhen; Tian, Hui; Cai, Shimin
2014-01-01
Personalized recommendation has attracted a surge of interdisciplinary research. Especially, similarity-based methods in applications of real recommendation systems have achieved great success. However, the computations of similarities are overestimated or underestimated, in particular because of the defective strategy of unidirectional similarity estimation. In this paper, we solve this drawback by leveraging mutual correction of forward and backward similarity estimations, and propose a new personalized recommendation index, i.e., corrected similarity based inference (CSI). Through extensive experiments on four benchmark datasets, the results show a greater improvement of CSI in comparison with these mainstream baselines. And a detailed analysis is presented to unveil and understand the origin of such difference between CSI and mainstream indices. (paper)
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Prevention program for Clostridium difficile infection: a single-centre Serbian experience.
Brkic, Snezana; Pellicano, Rinaldo; Turkulov, Vesna; Radovanovic, Marija; Abenavoli, Ludovico
2016-06-01
Clostridium difficile (C. difficile) diarrhea is a common, iatrogenic, nosocomial disease with a worldwide diffusion. Recent studies reported that the incidence of C. difficile infection (CDI) is rising, due to aging of the population and to greater prevalence of hypervirulent strains. We investigated whether the application of a prevention program lead to a decline in the incidence of intrahospital CDI. The study was designed as observational, to compare the efficacy of Schülke preventive program with the standard protocols, in a period of 4 months. For every patient with community-onset healthcare facility-associated (HCFA) CDI, we randomly selected four controls (1:4) with the same ICD code but without HCFA CDI. For statistical analysis the nonparametric, one-way ANOVA, univariate regression analysis, univariate analysis of variance, and Welch and Brown-Forsythe Test were used. Clinical features of HCFA CDI were typical. HCFA CDI group was significantly older than control group (P=0.008 and F=6.686; Partial Eta Square=0.013). Patients with HCFA CDI stayed significantly longer in hospital (P=0.000 and F=69.379; Partial Eta Square=0.117). Acquiring CDI prolonged the hospitalization of 14.52 days. HCFA CDI significantly increases the total cost of hospitalization as well as each element of the price respectively. With the application of the prevention program the annual incidence of CDI dropped from 49.01 in 2013 to 18.22/10000 bed days in 2014. Applying Schülke preventive program, implemented in 2014, has led to significant savings for the hospital compared to previous methods.
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Jeuring, J.T.; Jansson, P.
1996-01-01
Many functions have to be written over and over again for different datatypes, either because datatypes change during the development of programs, or because functions with similar functionality are needed on different datatypes. Examples of such functions are pretty printers, debuggers, equality
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Single-Sex Schooling Gets New Showcase
McNeil, Michele
2008-01-01
Single-sex classrooms and schools are common in private education and have emerged as popular options in urban public school districts, such as New York City, particularly as a strategy for raising the achievement of African-American boys. South Carolina is at the forefront of implementing such programs statewide. Ninety-seven schools in South…
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Directory of Open Access Journals (Sweden)
Kihara Daisuke
2010-05-01
Full Text Available Abstract Background A new paradigm of biological investigation takes advantage of technologies that produce large high throughput datasets, including genome sequences, interactions of proteins, and gene expression. The ability of biologists to analyze and interpret such data relies on functional annotation of the included proteins, but even in highly characterized organisms many proteins can lack the functional evidence necessary to infer their biological relevance. Results Here we have applied high confidence function predictions from our automated prediction system, PFP, to three genome sequences, Escherichia coli, Saccharomyces cerevisiae, and Plasmodium falciparum (malaria. The number of annotated genes is increased by PFP to over 90% for all of the genomes. Using the large coverage of the function annotation, we introduced the functional similarity networks which represent the functional space of the proteomes. Four different functional similarity networks are constructed for each proteome, one each by considering similarity in a single Gene Ontology (GO category, i.e. Biological Process, Cellular Component, and Molecular Function, and another one by considering overall similarity with the funSim score. The functional similarity networks are shown to have higher modularity than the protein-protein interaction network. Moreover, the funSim score network is distinct from the single GO-score networks by showing a higher clustering degree exponent value and thus has a higher tendency to be hierarchical. In addition, examining function assignments to the protein-protein interaction network and local regions of genomes has identified numerous cases where subnetworks or local regions have functionally coherent proteins. These results will help interpreting interactions of proteins and gene orders in a genome. Several examples of both analyses are highlighted. Conclusion The analyses demonstrate that applying high confidence predictions from PFP
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Kaur, Primal; Chow, Vincent; Zhang, Nan; Moxness, Michael; Kaliyaperumal, Arunan; Markus, Richard
2017-03-01
To demonstrate pharmacokinetic (PK) similarity of biosimilar candidate ABP 501 relative to adalimumab reference product from the USA and European Union (EU) and evaluate safety, tolerability and immunogenicity of ABP 501. Randomised, single-blind, single-dose, three-arm, parallel-group study; healthy subjects were randomised to receive ABP 501 (n=67), adalimumab (USA) (n=69) or adalimumab (EU) (n=67) 40 mg subcutaneously. Primary end points were area under the serum concentration-time curve from time 0 extrapolated to infinity (AUC inf ) and the maximum observed concentration (C max ). Secondary end points included safety and immunogenicity. AUC inf and C max were similar across the three groups. Geometrical mean ratio (GMR) of AUC inf was 1.11 between ABP 501 and adalimumab (USA), and 1.04 between ABP 501 and adalimumab (EU). GMR of C max was 1.04 between ABP 501 and adalimumab (USA) and 0.96 between ABP 501 and adalimumab (EU). The 90% CIs for the GMRs of AUC inf and C max were within the prespecified standard PK equivalence criteria of 0.80 to 1.25. Treatment-related adverse events were mild to moderate and were reported for 35.8%, 24.6% and 41.8% of subjects in the ABP 501, adalimumab (USA) and adalimumab (EU) groups; incidence of antidrug antibodies (ADAbs) was similar among the study groups. Results of this study demonstrated PK similarity of ABP 501 with adalimumab (USA) and adalimumab (EU) after a single 40-mg subcutaneous injection. No new safety signals with ABP 501 were identified. The safety and tolerability of ABP 501 was similar to the reference products, and similar ADAb rates were observed across the three groups. EudraCT number 2012-000785-37; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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Lynch, Gordon S; Faulkner, John A; Brooks, Susan V
2008-07-01
The deficit in force generation is a measure of the magnitude of damage to sarcomeres caused by lengthening contractions of either single fibers or whole muscles. In addition, permeabilized single fibers may suffer breakages. Our goal was to understand the interaction between breakages and force deficits in "young" and "old" permeabilized single fibers from control muscles of young and old rats and "conditioned" fibers from muscles that completed a 6-wk program of in vivo lengthening contractions. Following single lengthening contractions of old-control fibers compared with young-control fibers, the twofold greater force deficits at a 10% strain support the concept of an age-related increase in the susceptibility of fibers to mechanical damage. In addition, the much higher breakage rates for old fibers at all strains tested indicate an increase with aging in the number of fibers at risk of being severely injured during any given stretch. Following the 6-wk program of lengthening contractions, young-conditioned fibers and old-conditioned fibers were not different with respect to force deficit or the frequency of breakages. A potential mechanism for the increased resistance to stretch-induced damage of old-conditioned fibers is that, through intracellular damage and subsequent degeneration and regeneration, weaker sarcomeres were replaced by stronger sarcomeres. These data indicate that, despite the association of high fiber breakage rates and large force deficits with aging, the detrimental characteristics of old fibers were improved by a conditioning program that altered both sarcomeric characteristics as well as the overall structural integrity of the fibers.
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Clark, Bobby; DuChane, Janeen; Hou, John; Rubinstein, Elan; McMurray, Jennifer; Duncan, Ian
2014-02-01
A major employer implemented a change to its employee health benefits program to allow beneficiaries with diabetes or high cholesterol to obtain preselected generic antidiabetic or generic antihyperlipidemic medications with a zero dollar copayment. To receive this benefit, plan beneficiaries were required to participate in a contracted vendor's case management and/or wellness program. To assess changes in medication adherence and the costs for generic antidiabetic and generic antihyperlipidemic medications resulting from participation in a zero copay (ZCP) program. This was a retrospective pre-post comparison group study, evaluating adherence and cost. Participants using an antihyperlipidemic and/or antidiabetic medication during the study identification period and post-implementation period for the program were considered eligible for the study. Eligible beneficiaries who enrolled in the ZCP program during the post-implementation period were considered participants, while those who did not enroll during this period were considered nonparticipants. ZCP program participants and nonparticipants were matched via a 1-to-1 propensity scoring method using age, gender, comorbidity count, medication type (antihyperlipidemic, antidiabetic, or both), and baseline adherence as matching criteria. The proportion of days covered (PDC) metric expressed as a mean percentage was used to assess adherence to medication therapy, while payer cost was examined using prescription drug utilization expressed as per member per year (PMPY) and cost change per 30 days of medication expressed in dollars. Among participants who were users of antidiabetic medications, the mean adherence rate was sustained from pre- to post-implementation (81.8% vs. 81.9%); however, it decreased in the matched nonparticipant group (81.9% vs. 73.1%). This difference in mean adherence over time between the participants and nonparticipants was statistically significant (0.1% vs. -8.8%, P less than 0
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Success Skills Curriculum for Teen Single Parents. Bulletin No. 96142.
Hendon, Sarah, Ed.; And Others
This guide contains the materials required to teach a 36-hour program of competency-based instruction designed to meet the needs of teen single parents who require additional skill building before entering the job market or a job training program. The course is divided into 4 learning modules that cover 18 competencies as follows: taking…
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Single port VATS: recent developments in Asia.
Yu, Peter S Y; Capili, Freddie; Ng, Calvin S H
2016-03-01
Single port video-assisted thoracic surgery (VATS) is the most recent evolution in minimally invasive thoracic surgery. With increasing global popularity, the single port VATS approach has been adopted by experienced thoracic surgeons in many Asian countries. From initial experience of single port VATS lobectomy to the more complex sleeve resection procedures now forming part of daily practice in some Asia institutes, the region has been the proving ground for single port VATS approaches' feasibility and safety. In addition, certain technical refinements in single port VATS lung resection and lymph node dissection have also sprung from Asia. Novel equipment designed to facilitate single port VATS allowing further reduce access trauma are being realized by the partnership between surgeons and the industries. Advanced thoracoscopes and staplers that are narrower and more maneuverable are particularly important in the smaller habitus of patients from Asia. These and similar new generation equipment are being applied to single port VATS in novel ways. As dedicated thoracic surgeons in the region continue to striving for excellence, innovative ideas in single incision access including subxiphoid and embryonic natural-orifice transluminal endoscopic surgery (e-NOTES) have been explored. Adjunct techniques and technology used in association with single port VATS such as non-intubated surgery, hybrid operating room image guidance and electromagnetic navigational bronchoscopy are all in rapid development in Asia.
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Biofilm growth program and architecture revealed by single-cell live imaging
Yan, Jing; Sabass, Benedikt; Stone, Howard; Wingreen, Ned; Bassler, Bonnie
Biofilms are surface-associated bacterial communities. Little is known about biofilm structure at the level of individual cells. We image living, growing Vibrio cholerae biofilms from founder cells to ten thousand cells at single-cell resolution, and discover the forces underpinning the architectural evolution of the biofilm. Mutagenesis, matrix labeling, and simulations demonstrate that surface-adhesion-mediated compression causes V. cholerae biofilms to transition from a two-dimensional branched morphology to a dense, ordered three-dimensional cluster. We discover that directional proliferation of rod-shaped bacteria plays a dominant role in shaping the biofilm architecture, and this growth pattern is controlled by a single gene. Competition analyses reveal the advantages of the dense growth mode in providing the biofilm with superior mechanical properties. We will further present continuum theory to model the three-dimensional growth of biofilms at the solid-liquid interface as well as solid-air interface.
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Similar or different?: the importance of similarities and differences for support between siblings
Voorpostel, M.; van der Lippe, T.; Dykstra, P.A.; Flap, H.
2007-01-01
Using a large-scale Dutch national sample (N = 7,126), the authors examine the importance of similarities and differences in the sibling dyad for the provision of support. Similarities are assumed to enhance attraction and empathy; differences are assumed to be related to different possibilities for
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Similar or Different? The Importance of Similarities and Differences for Support Between Siblings
Voorpostel, Marieke; Lippe, Tanja van der; Dykstra, Pearl A.; Flap, Henk
2007-01-01
Using a large-scale Dutch national sample (N = 7,126), the authors examine the importance of similarities and differences in the sibling dyad for the provision of support. Similarities are assumed to enhance attraction and empathy; differences are assumed to be related to different possibilities for
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Hydrogen, Fuel Cells & Infrastructure Technologies Program
Energy Technology Data Exchange (ETDEWEB)
2005-03-01
This plan details the goals, objectives, technical targets, tasks and schedule for EERE's contribution to the DOE Hydrogen Program. Similar detailed plans exist for the other DOE offices that make up the Hydrogen Program.
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Pascal, Emilia
2017-07-20
This study investigated the effects of similarity with the transgressor and the victim on the perceived immorality of the transgression. Participants read two stories describing a person that cheated on their partner and a police officer that mistreated somebody. In the first story we manipulated participants' personal similarity to the transgressor and in the second their personal similarity to the victim. In each story, participants' past situational similarity to the target character was assessed according to their previous experiences of being in the same position. Results show that both personal and past situational similarity to the transgressor determine less severe moral judgements, while personal and past situational similarity with the victim have the opposite effect. We also tested several potential mediators of these effects, derived from competing theoretical accounts of the influence of similarity on perceived responsibility. Empathy emerged as mediating most of the effects of similarity on moral judgements, except those induced by past situational similarity with the victim. The foreseen probability of being in a similar situation mediated only the effects of similarity to the transgressor, and not those of similarity to the victim. Overall, results highlight the complex mechanisms of the influences of similarity on moral judgements. © 2017 International Union of Psychological Science.
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Self-similar cosmological models
Energy Technology Data Exchange (ETDEWEB)
Chao, W Z [Cambridge Univ. (UK). Dept. of Applied Mathematics and Theoretical Physics
1981-07-01
The kinematics and dynamics of self-similar cosmological models are discussed. The degrees of freedom of the solutions of Einstein's equations for different types of models are listed. The relation between kinematic quantities and the classifications of the self-similarity group is examined. All dust local rotational symmetry models have been found.
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HIV-1 transmitting couples have similar viral load set-points in Rakai, Uganda.
Directory of Open Access Journals (Sweden)
T Déirdre Hollingsworth
2010-05-01
Full Text Available It has been hypothesized that HIV-1 viral load set-point is a surrogate measure of HIV-1 viral virulence, and that it may be subject to natural selection in the human host population. A key test of this hypothesis is whether viral load set-points are correlated between transmitting individuals and those acquiring infection. We retrospectively identified 112 heterosexual HIV-discordant couples enrolled in a cohort in Rakai, Uganda, in which HIV transmission was suspected and viral load set-point was established. In addition, sequence data was available to establish transmission by genetic linkage for 57 of these couples. Sex, age, viral subtype, index partner, and self-reported genital ulcer disease status (GUD were known. Using ANOVA, we estimated the proportion of variance in viral load set-points which was explained by the similarity within couples (the 'couple effect'. Individuals with suspected intra-couple transmission (97 couples had similar viral load set-points (p = 0.054 single factor model, p = 0.0057 adjusted and the couple effect explained 16% of variance in viral loads (23% adjusted. The analysis was repeated for a subset of 29 couples with strong genetic support for transmission. The couple effect was the major determinant of viral load set-point (p = 0.067 single factor, and p = 0.036 adjusted and the size of the effect was 27% (37% adjusted. Individuals within epidemiologically linked couples with genetic support for transmission had similar viral load set-points. The most parsimonious explanation is that this is due to shared characteristics of the transmitted virus, a finding which sheds light on both the role of viral factors in HIV-1 pathogenesis and on the evolution of the virus.
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Modeling and Development of Superconducting Nanowire Single Photon Detectors
National Aeronautics and Space Administration — This proposal outlines a research project as the central component of a Ph.D. program focused on the device physics of superconducting nanowire single photon...
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Pathak, Samir; Poston, Graeme J
2006-03-01
There is a commonly held belief that the development of a hernia can be attributed to a single strenuous or traumatic event. Hence, many litigants are successful in compensation claims, causing mounting financial burdens on employers, the courts, insurance companies and the tax-payer. However, there is very little scientific evidence to support this assertion. The aim of this study was to ascertain whether there was any causal link in this process. A total of 133 new patients with 135 abdominal herniae of all varieties (115 inguinal, 3 femoral, 9 umbilical, 4 incisional, and 4 ventral or epigastric), of which 25 were recurrent received structured questionnaires on arrival in the surgical clinic. These questionnaires covered all possible aetiological factors for hernia development (type of work, COAD, smoking, pregnancy, obesity, chronic bladder outflow obstruction, previous surgery including appendicectomy), in addition to any possible attribution to a single strenuous or traumatic event. We then reviewed the GP records in the surgery of all patients who answered positively to the latter possible cause. In the study group, 119 (89%) reported a gradual onset of symptoms. Of the 15 (12 male, 3 female; 11%) who believed that their hernia might be related to a single strenuous or traumatic event, 5 had no other aetiological factors. However, not one of the 15 was found to have contemporaneous forensic medical evidence to support their possible claim. We conclude that we are unable to find any clinical evidence to support the hypothesis that a hernia might develop as the result of one single strenuous or traumatic event. While we accept that this mechanism might still possibly occur, we believe that, at best, it is extremely uncommon. If a medical expert is preparing a report on such a case in a claim for personal injury, then they have a duty to the court to examine carefully all the contemporaneous medical records. If no clinical evidence exists to support the claim
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Symbolic Game Semantics for Model Checking Program Families
Dimovski, Aleksandar
2016-01-01
Program families can produce a (potentially huge) number of related programs from a common code base. Many such programs are safety critical. However, most verification techniques are designed to work on the level of single programs, and thus are too costly to apply to the entire program family. In this paper, we propose an efficient game semantics based approach for verifying open program families, i.e. program families with free (undefined) identifiers. We use symbolic representation of alg...
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A program for activation analysis data processing
International Nuclear Information System (INIS)
Janczyszyn, J.; Loska, L.; Taczanowski, S.
1978-01-01
An ALGOL program for activation analysis data handling is presented. The program may be used either for single channel spectrometry data or for multichannel spectrometry. The calculation of instrumental error and of analysis standard deviation is carried out. The outliers are tested, and the regression line diagram with the related observations are plotted by the program. (author)
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Directory of Open Access Journals (Sweden)
Du LinFang
2008-11-01
Full Text Available Abstract Background Researchers interested in analysing the expression patterns of functionally related genes usually hope to improve the accuracy of their results beyond the boundaries of currently available experimental data. Gene ontology (GO data provides a novel way to measure the functional relationship between gene products. Many approaches have been reported for calculating the similarities between two GO terms, known as semantic similarities. However, biologists are more interested in the relationship between gene products than in the scores linking the GO terms. To highlight the relationships among genes, recent studies have focused on functional similarities. Results In this study, we evaluated five functional similarity methods using both protein-protein interaction (PPI and expression data of S. cerevisiae. The receiver operating characteristics (ROC and correlation coefficient analysis of these methods showed that the maximum method outperformed the other methods. Statistical comparison of multiple- and single-term annotated proteins in biological process ontology indicated that genes with multiple GO terms may be more reliable for separating true positives from noise. Conclusion This study demonstrated the reliability of current approaches that elevate the similarity of GO terms to the similarity of proteins. Suggestions for further improvements in functional similarity analysis are also provided.
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Designing single phase Current-Programmed-Controlled rectifiers by harmonic currents
DEFF Research Database (Denmark)
Andersen, Gert Karmisholt; Blaabjerg, Frede
2002-01-01
The grid current harmonics of a Current-Programmed-Controlled (CPC) pfc rectifier strongly depends on the choice of switching frequency and switching inductance. This paper describes a new simple and vert fast method to calculate the grid current of a CPC controlled pfc converter. The method...
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Similarity increases altruistic punishment in humans.
Mussweiler, Thomas; Ockenfels, Axel
2013-11-26
Humans are attracted to similar others. As a consequence, social networks are homogeneous in sociodemographic, intrapersonal, and other characteristics--a principle called homophily. Despite abundant evidence showing the importance of interpersonal similarity and homophily for human relationships, their behavioral correlates and cognitive foundations are poorly understood. Here, we show that perceived similarity substantially increases altruistic punishment, a key mechanism underlying human cooperation. We induced (dis)similarity perception by manipulating basic cognitive mechanisms in an economic cooperation game that included a punishment phase. We found that similarity-focused participants were more willing to punish others' uncooperative behavior. This influence of similarity is not explained by group identity, which has the opposite effect on altruistic punishment. Our findings demonstrate that pure similarity promotes reciprocity in ways known to encourage cooperation. At the same time, the increased willingness to punish norm violations among similarity-focused participants provides a rationale for why similar people are more likely to build stable social relationships. Finally, our findings show that altruistic punishment is differentially involved in encouraging cooperation under pure similarity vs. in-group conditions.
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Raza, Sajjad; Blackstone, Eugene H; Houghtaling, Penny L; Koprivanac, Marijan; Ravichandren, Kirthi; Javadikasgari, Hoda; Bakaeen, Faisal G; Svensson, Lars G; Sabik, Joseph F
2017-12-01
The purpose of this study was to determine in patients with diabetes mellitus whether single internal thoracic artery (SITA) plus radial artery (RA) grafting yields outcomes similar to those of bilateral internal thoracic artery (BITA) grafting. From January 1994 to January 2011, 1,325 diabetic patients underwent primary isolated coronary artery bypass graft surgery with either (1) SITA plus RA with or without saphenous vein (SV) grafts (n = 965) or (2) BITA with or without SV grafts (n = 360); an internal thoracic artery was used in all patients to graft the left anterior descending coronary artery. Endpoints were in-hospital outcomes and time-related mortality. Median follow-up was 7.4 years, with a total follow-up of 9,162 patient-years. Propensity score matching was performed to identify 282 well-matched pairs for adjusted comparisons. Unadjusted in-hospital mortality was 0.52% for SITA plus RA with or without SV grafts and 0.28% for BITA with or without SV grafts, and prevalence of deep sternal wound infection was 3.2% and 1.7%, respectively. Unadjusted survival at 1, 5, 10, and 14 years was 97%, 88%, 68%, and 51% for SITA plus RA with or without SV grafts, and 97%, 95%, 80%, and 66% for BITA with or without SV grafts, respectively. Among propensity-matched patients, in-hospital mortality (0.35% versus 0.35%) and prevalence of deep sternal wound infection (1.4% versus 1.4%) were similar (p > 0.9) in the two groups, as was 1-, 5-, 10-, and 14-year survival: 97%, 90%, 70%, and 58% for SITA plus RA with or without SV grafting versus 97%, 93%, 79%, and 64% for BITA with or without SV grafting, respectively (early p = 0.8, late p = 0.2). For diabetic patients, SITA plus RA with or without SV grafting and BITA with or without SV grafting yield similar in-hospital outcomes and long-term survival after coronary artery bypass graft surgery. Therefore, both SITA plus RA and BITA plus SV grafting should be considered for these patients. Copyright © 2017 The Society
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Wang, Lixin; Brugge, Joan S; Janes, Kevin A
2011-10-04
Gene expression networks are complicated by the assortment of regulatory factors that bind DNA and modulate transcription combinatorially. Single-cell measurements can reveal biological mechanisms hidden by population averages, but their value has not been fully explored in the context of mRNA regulation. Here, we adapted a single-cell expression profiling technique to examine the gene expression program downstream of Forkhead box O (FOXO) transcription factors during 3D breast epithelial acinar morphogenesis. By analyzing patterns of mRNA fluctuations among individual matrix-attached epithelial cells, we found that a subset of FOXO target genes was jointly regulated by the transcription factor Runt-related transcription factor 1 (RUNX1). Knockdown of RUNX1 causes hyperproliferation and abnormal morphogenesis, both of which require normal FOXO function. Down-regulating RUNX1 and FOXOs simultaneously causes widespread oxidative stress, which arrests proliferation and restores normal acinar morphology. In hormone-negative breast cancers lacking human epidermal growth factor receptor 2 (HER2) amplification, we find that RUNX1 down-regulation is strongly associated with up-regulation of FOXO1, which may be required to support growth of RUNX1-negative tumors. The coordinate function of these two tumor suppressors may provide a failsafe mechanism that inhibits cancer progression.
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DEFF Research Database (Denmark)
Staak, Thorsten; Günzel, Franziska
this aim. To resolve this existing dichotomy between the motivation and the practical design of public intervention is the goal of this paper. To this end, we develop, using the Analytical Hierarchy Process, a decision tool, which incorporates the market failure theory as its foundation. With this study......, we contribute to the public policy research by introducing a new multi-attributive decision model as well as to the entrepreneurship arena by introducing the Analytical Hierarchy Process as a methodology that can be used to structure and solve complex public policy decision problems....
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Li, Chenyang; Verma, Prakash; Hannon, Kevin P.; Evangelista, Francesco A.
2017-08-01
We propose an economical state-specific approach to evaluate electronic excitation energies based on the driven similarity renormalization group truncated to second order (DSRG-PT2). Starting from a closed-shell Hartree-Fock wave function, a model space is constructed that includes all single or single and double excitations within a given set of active orbitals. The resulting VCIS-DSRG-PT2 and VCISD-DSRG-PT2 methods are introduced and benchmarked on a set of 28 organic molecules [M. Schreiber et al., J. Chem. Phys. 128, 134110 (2008)]. Taking CC3 results as reference values, mean absolute deviations of 0.32 and 0.22 eV are observed for VCIS-DSRG-PT2 and VCISD-DSRG-PT2 excitation energies, respectively. Overall, VCIS-DSRG-PT2 yields results with accuracy comparable to those from time-dependent density functional theory using the B3LYP functional, while VCISD-DSRG-PT2 gives excitation energies comparable to those from equation-of-motion coupled cluster with singles and doubles.
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Similarities in the Age-Specific Incidence of Colon and Testicular Cancers.
Soto-Ortiz, Luis; Brody, James P
2013-01-01
Colon cancers are thought to be an inevitable result of aging, while testicular cancers are thought to develop in only a small fraction of men, beginning in utero. These models of carcinogenesis are, in part, based upon age-specific incidence data. The specific incidence for colon cancer appears to monotonically increase with age, while that of testicular cancer increases to a maximum value at about 35 years of age, then declines to nearly zero by the age of 80. We hypothesized that the age-specific incidence for these two cancers is similar; the apparent difference is caused by a longer development time for colon cancer and the lack of age-specific incidence data for people over 84 years of age. Here we show that a single distribution can describe the age-specific incidence of both colon carcinoma and testicular cancer. Furthermore, this distribution predicts that the specific incidence of colon cancer should reach a maximum at about age 90 and then decrease. Data on the incidence of colon carcinoma for women aged 85-99, acquired from SEER and the US Census, is consistent with this prediction. We conclude that the age specific data for testicular cancers and colon cancers is similar, suggesting that the underlying process leading to the development of these two forms of cancer may be similar.
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Similarities in the Age-Specific Incidence of Colon and Testicular Cancers.
Directory of Open Access Journals (Sweden)
Luis Soto-Ortiz
Full Text Available Colon cancers are thought to be an inevitable result of aging, while testicular cancers are thought to develop in only a small fraction of men, beginning in utero. These models of carcinogenesis are, in part, based upon age-specific incidence data. The specific incidence for colon cancer appears to monotonically increase with age, while that of testicular cancer increases to a maximum value at about 35 years of age, then declines to nearly zero by the age of 80. We hypothesized that the age-specific incidence for these two cancers is similar; the apparent difference is caused by a longer development time for colon cancer and the lack of age-specific incidence data for people over 84 years of age. Here we show that a single distribution can describe the age-specific incidence of both colon carcinoma and testicular cancer. Furthermore, this distribution predicts that the specific incidence of colon cancer should reach a maximum at about age 90 and then decrease. Data on the incidence of colon carcinoma for women aged 85-99, acquired from SEER and the US Census, is consistent with this prediction. We conclude that the age specific data for testicular cancers and colon cancers is similar, suggesting that the underlying process leading to the development of these two forms of cancer may be similar.
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Wang, Chaolong; Zöllner, Sebastian; Rosenberg, Noah A.
2012-01-01
Multivariate statistical techniques such as principal components analysis (PCA) and multidimensional scaling (MDS) have been widely used to summarize the structure of human genetic variation, often in easily visualized two-dimensional maps. Many recent studies have reported similarity between geographic maps of population locations and MDS or PCA maps of genetic variation inferred from single-nucleotide polymorphisms (SNPs). However, this similarity has been evident primarily in a qualitative sense; and, because different multivariate techniques and marker sets have been used in different studies, it has not been possible to formally compare genetic variation datasets in terms of their levels of similarity with geography. In this study, using genome-wide SNP data from 128 populations worldwide, we perform a systematic analysis to quantitatively evaluate the similarity of genes and geography in different geographic regions. For each of a series of regions, we apply a Procrustes analysis approach to find an optimal transformation that maximizes the similarity between PCA maps of genetic variation and geographic maps of population locations. We consider examples in Europe, Sub-Saharan Africa, Asia, East Asia, and Central/South Asia, as well as in a worldwide sample, finding that significant similarity between genes and geography exists in general at different geographic levels. The similarity is highest in our examples for Asia and, once highly distinctive populations have been removed, Sub-Saharan Africa. Our results provide a quantitative assessment of the geographic structure of human genetic variation worldwide, supporting the view that geography plays a strong role in giving rise to human population structure. PMID:22927824
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Wang, Chaolong; Zöllner, Sebastian; Rosenberg, Noah A
2012-08-01
Multivariate statistical techniques such as principal components analysis (PCA) and multidimensional scaling (MDS) have been widely used to summarize the structure of human genetic variation, often in easily visualized two-dimensional maps. Many recent studies have reported similarity between geographic maps of population locations and MDS or PCA maps of genetic variation inferred from single-nucleotide polymorphisms (SNPs). However, this similarity has been evident primarily in a qualitative sense; and, because different multivariate techniques and marker sets have been used in different studies, it has not been possible to formally compare genetic variation datasets in terms of their levels of similarity with geography. In this study, using genome-wide SNP data from 128 populations worldwide, we perform a systematic analysis to quantitatively evaluate the similarity of genes and geography in different geographic regions. For each of a series of regions, we apply a Procrustes analysis approach to find an optimal transformation that maximizes the similarity between PCA maps of genetic variation and geographic maps of population locations. We consider examples in Europe, Sub-Saharan Africa, Asia, East Asia, and Central/South Asia, as well as in a worldwide sample, finding that significant similarity between genes and geography exists in general at different geographic levels. The similarity is highest in our examples for Asia and, once highly distinctive populations have been removed, Sub-Saharan Africa. Our results provide a quantitative assessment of the geographic structure of human genetic variation worldwide, supporting the view that geography plays a strong role in giving rise to human population structure.
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Single-Sex Computer Classes: An Effective Alternative.
Swain, Sandra L.; Harvey, Douglas M.
2002-01-01
Advocates single-sex computer instruction as a temporary alternative educational program to provide middle school and secondary school girls with access to computers, to present girls with opportunities to develop positive attitudes towards technology, and to make available a learning environment conducive to girls gaining technological skills.…
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Single-shell tank interim stabilization project plan
Energy Technology Data Exchange (ETDEWEB)
Ross, W.E.
1998-05-11
This project plan establishes the management framework for conduct of the TWRS Single-Shell Tank Interim Stabilization completion program. Specifically, this plan defines the mission needs and requirements; technical objectives and approach; organizational structure, roles, responsibilities, and interfaces; and operational methods. This plan serves as the project executional baseline.
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Scheer, Justin K; Sethi, Rajiv K; Hey, Lloyd A; LaGrone, Michael O; Keefe, Malla; Aryan, Henry E; Errico, Thomas J; Deviren, Vedat; Hart, Robert A; Lafage, Virginie; Schwab, Frank; Daubs, Michael D; Ames, Christopher P
2017-06-15
An electronic survey administered to Scoliosis Research Society (SRS) membership. To characterize surgeon practices and views regarding the use of two attending surgeons for adult spinal deformity (ASD) surgery. The use of two experienced attending surgeons can decrease the operative time, estimated blood loss, and perioperative complication rates. However, the current practice patterns for the use of two attending surgeons remains unknown. An electronic, 27-question survey regarding single/dual attending surgeons was administered to the SRS membership. Determinants included: surgeon/practice demographics, assistant type/level of training, and questions regarding use of two attending surgeons. Overall reporting and comparisons between groups were made: US versus international, academic versus private practice, and experience 15 years. A total of 199 surgeons responded from 27 different countries. Overall and between the groups, the respondents significantly reported believing that two attending spine surgeons improves safety, decreases complications, and improves outcomes (P < 0.01). Approximately, 67.3% reported using a second attending ≤25% of the time (33.2% do not), and 24.1% use one ≥51% of the time (similar between groups); 51.1% that have a second attending feel it's limited by reimbursement and access concerns and 71.9% have difficulty getting the second attending reimbursed. 72.3% use a second attending for ALL of the following reasons (no difference between groups): "it's safer/reduces complications," "it decreases operative time," "it decreases blood loss," "it results in improved outcomes," "it's less work and stress for me." If reimbursement was equal/assured for a second attending, 67.5% would use one "more often" or "always." The respondents feel that having a second attending surgeon improves patient care, however most do not use one often. Reasons include reimbursement/access concerns and the majority would use one if reimbursement was
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Single neuron dynamics during experimentally induced anoxic depolarization
Zandt, B.; Stigen, Tyler; ten Haken, Bernard; Netoff, Theoden; van Putten, Michel Johannes Antonius Maria
2013-01-01
We studied single neuron dynamics during anoxic depolarizations, which are often observed in cases of neuronal energy depletion. Anoxic and similar depolarizations play an important role in several pathologies, notably stroke, migraine, and epilepsy. One of the effects of energy depletion was
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Sample Size Induced Brittle-to-Ductile Transition of Single-Crystal Aluminum Nitride
2015-08-01
ARL-RP-0528 ● AUG 2015 US Army Research Laboratory Sample Size Induced Brittle-to- Ductile Transition of Single-Crystal Aluminum...originator. ARL-RP-0528 ● AUG 2015 US Army Research Laboratory Sample Size Induced Brittle-to- Ductile Transition of Single-Crystal...Sample Size Induced Brittle-to- Ductile Transition of Single-Crystal Aluminum Nitride 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT