Report on privatization /

Also known as: The Grace report.

Report on the Department of Health and Human Services--Public Health Service, Health Care Financing Administration /

Also known as: The Grace report.

Report on the Office of the Secretary of Defense /

Also known as: The Grace report.

Analysis of the Grace Commission's major proposals for cost control.

Mode of access: Internet.

The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus

Objective: To compare the effects of a 4-month strength training (ST) versus aerobic endurance training (ET) program on metabolic control, muscle strength, and cardiovascular endurance in subjects with type 2 diabetes mellitus (T2D). Design: Randomized controlled trial. Setting: Large public tertiary hospital. Participants: Twenty-two T21) participants (I I men, I I women; mean age +/- standard error, 56.2 +/- 1.1 y; diabetes duration, 8.8 +/- 3.5y) were randomized into a 4-month ST program and 17 T2D participants (9 men, 8 women; mean age, 57.9 +/- 1.4y; diabetes duration, 9.2 +/- 1.7y) into a 4-month ET program. Interventions: ST (up to 6 sets per muscle group per week) and ET (with an intensity of maximal oxygen consumption of 60% and a volume beginning at 15min and advancing to a maximum of 30min 3X/wk) for 4 months. Main Outcome Measures: Laboratory tests included determinations of blood glucose, glycosylated hemoglobin (Hb A(1c)), insulin, and lipid assays. Results: A significant decline in Hb A, was only observed in the ST group (8.3% +/- 1.7% to 7.1% +/- 0.2%, P=.001). Blood glucose (204 +/- 16mg/dL to 147 +/- 8mg/dL, P <.001) and insulin resistance (9.11 +/- 1.51 to 7.15 +/- 1.15, P=.04) improved significantly in the ST group, whereas no significant changes were observed in the ET group. Baseline levels of total cholesterol (207 +/- 8mg/dL to 184 +/- 7mg/dL, P <.001), low-density lipoprotein cholesterol (120 +/- 8mg/dL to 106 +/- 8mg/dL, P=.001), and triglyceride levels (229 +/- 25mg/dL to 150 +/- 15mg/dL, P=.001) were significantly reduced and high-density lipoprotein cholesterol (43 +/- 3mg/dL to 48 +/- 2mg/dL, P=.004) was significantly increased in the ST group; in contrast, no such changes were seen in the ET group. Conclusions: ST was more effective than ET in improving glycemic control. With the added advantage of an improved lipid profile, we conclude that ST may play an important role in the treatment of T2D.

Optimal control and operation of drum granulation processes

Process optimisation and optimal control of batch and continuous drum granulation processes are studied in this paper. The main focus of the current research has been: (i) construction of optimisation and control relevant, population balance models through the incorporation of moisture content, drum rotation rate and bed depth into the coalescence kernels; (ii) investigation of optimal operational conditions using constrained optimisation techniques; (iii) development of optimal control algorithms based on discretized population balance equations; and (iv) comprehensive simulation studies on optimal control of both batch and continuous granulation processes. The objective of steady state optimisation is to minimise the recycle rate with minimum cost for continuous processes. It has been identified that the drum rotation-rate, bed depth (material charge), and moisture content of solids are practical decision (design) parameters for system optimisation. The objective for the optimal control of batch granulation processes is to maximize the mass of product-sized particles with minimum time and binder consumption. The objective for the optimal control of the continuous process is to drive the process from one steady state to another in a minimum time with minimum binder consumption, which is also known as the state-driving problem. It has been known for some time that the binder spray-rate is the most effective control (manipulative) variable. Although other possible manipulative variables, such as feed flow-rate and additional powder flow-rate have been investigated in the complete research project, only the single input problem with the binder spray rate as the manipulative variable is addressed in the paper to demonstrate the methodology. It can be shown from simulation results that the proposed models are suitable for control and optimisation studies, and the optimisation algorithms connected with either steady state or dynamic models are successful for the determination of optimal operational conditions and dynamic trajectories with good convergence properties. (c) 2005 Elsevier Ltd. All rights reserved.

Effect of knee joint angle on motor unit synchronization

Activity of the vasti has been argued to vary through knee range of movement due to changes in passive support of the patellofemoral joint and the relative contribution of these muscles to knee extension. Efficient function of the knee is dependent on optimal control of the patellofemoral joint, largely through coordinated activity of the medial and lateral quadriceps. Motor unit synchronization may provide a mechanism to coordinate the activity of vastus medialis (VMO) and vastus lateralis (VL), and may be more critical in positions of reduced passive support for the patellofemoral joint (i.e., full extension). Therefore, the aim of this study was to determine whether the degree of motor unit synchronization between the vasti muscles is dependent on joint angle. Electromyographic (EMG) recordings of single motor unit action potentials (MUAPs) were made from VMO and multiunit recordings from VL during isometric contractions of the quadriceps at 0 degrees, 30 degrees, and 60 degrees of knee flexion. The degree of synchronization between motor unit firing was evaluated by identification of peaks in the rectified EMG averages of VL, triggered from MUA-Ps in VMO. The proportion of cases in which there was a significant peak in the triggered averages was calculated. There was no significant difference in the degree of synchronization between the vasti at different knee angles (p = 0.57). These data suggest that this basic coordinative mechanism between the vasti muscles is controlled consistently throughout knee range of motion, and is not augmented at specific angles where the requirement for dynamic control of stability is increased. (D 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Community center-based resistance training for the maintenance of glycemic control in adults with type 2 diabetes

OBJECTIVE - The purpose of this study was to determine whether beneficial effects on glycemic control of an initial laboratory-supervised resistance training program could be sustained through a community center-based maintenance program. RESEARCH DESIGN AND METHODS - We studied 57 overweight (BMI >= 27 kg/m(2)) sedentary men and women aged 40-80 years with established (> 6 months) type 2 diabetes. initially, all participants attended a twice-weekly 2-month supervised resistance training program conducted in the exercise laboratory. Thereafter, participants undertook a resistance training maintenance program (2 times/week) for 12 months and were randomly assigned to carry this out either in a community fitness and recreation center (center) or in their domestic environment (home). Glycemic control (HbA(1c) [A1C]) was assessed at 0, 2, and 14 months. RESULTS - Pooling data from the two groups for the 2-month supervised resistance training program showed that compared with baseline, mean A1C fell by -0.4% [95% CI -0.6 to -0.2]. Within-group comparisons showed that A I C remained lower than baseline values at 14 months in the center group (- 0.4% [-0.7 to -0.03]) but not in the home group (-0.1% [-0.4 to 0.3]). However, no between-group differences were observed at each time point. Changes in AIC during the maintenance period were positively associated with exercise adherence in the center group only. CONCLUSIONS - Center-based but not home-based resistance training was associated with the maintenance of modestly improved glycemic control from baseline, which was proportional to program adherence. Our findings emphasize the need to develop and test behavioral methods to promote healthy lifestyles including increased physical activity in adults with type 2 diabetes.

Density evolution and power profile optimization for iterative multiuser decoders based on individually optimum multiuser detectors

Iterative multiuser joint decoding based on exact Belief Propagation (BP) is analyzed in the large system limit by means of the replica method. It is shown that performance can be improved by appropriate power assignment to the users. The optimum power assignment can be found by linear programming in most technically relevant cases. The performance of BP iterative multiuser joint decoding is compared to suboptimum approximations based on Interference Cancellation (IC). While IC receivers show a significant loss for equal-power users, they yield performance close to BP under optimum power assignment.

Progress in multichannel all-optical regeneration based on fiber technology

Multiwavelength all-optical regeneration has the potential to substantially increase both the capacity and scalability of future optical networks. In this paper, we review recent promising developments in this area. First, we recall the basic principles of multichannel regeneration of high bit rate signals in optical communication systems before discussing the current technological approaches. We then describe in detail two fiber-based multichannel 2R regeneration techniques for return-to-zero-on-off keying based on 1) dispersion managed systems and 2) direction and polarization multiplexing. We present results illustrating the levels of performance so far achieved and discuss various practical issues and prospects for further performance enhancement.

MAP detection for impairment compensation in coherent WDM systems

We propose a novel recursive-algorithm based maximum a posteriori probability (MAP) detector in spectrally-efficient coherent wavelength division multiplexing (CoWDM) systems, and investigate its performance in a 1-bit/s/Hz on-off keyed (OOK) system limited by optical-signal-to-noise ratio. The proposed method decodes each sub-channel using the signal levels not only of the particular sub-channel but also of its adjacent sub-channels, and therefore can effectively compensate deterministic inter-sub-channel crosstalk as well as inter-symbol interference arising from narrow-band filtering and chromatic dispersion (CD). Numerical simulation of a five-channel OOK-based CoWDM system with 10Gbit/s per channel using either direct or coherent detection shows that the MAP decoder can eliminate the need for phase control of each optical carrier (which is necessarily required in a conventional CoWDM system), and greatly relaxes the spectral design of the demultiplexing filter at the receiver. It also significantly improves back-to-back sensitivity and CD tolerance of the system.

Multi-wavelength regeneration of phase encoded signals based on phase sensitive amplifiers

Future high capacity optical links will have to make use of frequent signal regeneration to enable long distance transmission. In this respect, the role of all-optical signal processing becomes increasingly important because of its potential to mitigate signal impairments at low cost and power consumption. More substantial benefits are expected if regeneration is achieved simultaneously on a multiple signal band. Until recently, this had been achieved only for on-off keying modulation formats. However, as in future transmission links the information will be encoded also in the phase for enhancing the spectral efficiency, novel subsystem concepts will be needed for multichannel processing of such advanced signal formats. In this paper we show that phase sensitive amplifiers can be an ideal technology platform for developing such regenerators and we discuss our recent demonstration of the first multi-channel regenerator for phase encoded signals.

Social control in online communities of consumption:a framework for community management

Online communities of consumption (OCCs) represent highly diverse groups of consumers whose interests are not always aligned. Social control in OCCs aims to effectively manage problems arising from this heterogeneity. Extant literature on social control in OCCs is fragmented as some studies focus on the principles of social control, while others focus on the implementation. Moreover, the domain is undertheorized. This article integrates the disparate literature on social control in OCCs providing a first unified conceptualization of the topic. The authors conceptualize social control as a system, or configuration, of moderation practices. Moderation practices are executed during interactions operating under different governance structures (market, hierarchy, and clan) and serving different purposes (interaction initiation, maintenance, and termination). From this conceptualization, important areas of future research emerge and research questions are developed. The framework also serves as a community management tool for OCC managers, enabling the diagnosis of social control problems and the elaboration of strategies and tactics to address them.

Neural Network Based Optimal Control with Constraints

In the present paper the problems of the optimal control of systems when constraints are imposed on the control is considered. The optimality conditions are given in the form of Pontryagin’s maximum principle. The obtained piecewise linear function is approximated by using feedforward neural network. A numerical example is given.

Multi-wavelength regeneration of phase encoded signals based on phase sensitive amplifiers

Future high capacity optical links will have to make use of frequent signal regeneration to enable long distance transmission. In this respect, the role of all-optical signal processing becomes increasingly important because of its potential to mitigate signal impairments at low cost and power consumption. More substantial benefits are expected if regeneration is achieved simultaneously on a multiple signal band. Until recently, this had been achieved only for on-off keying modulation formats. However, as in future transmission links the information will be encoded also in the phase for enhancing the spectral efficiency, novel subsystem concepts will be needed for multichannel processing of such advanced signal formats. In this paper we show that phase sensitive amplifiers can be an ideal technology platform for developing such regenerators and we discuss our recent demonstration of the first multi-channel regenerator for phase encoded signals.