Estimates of hospital and physician costs of epilepsy in the United States for 1995 comparing the provider -based survey method and a patient -based medical charts and billing method

This investigation compares two different methodologies for calculating the national cost of epilepsy: provider-based survey method (PBSM) and the patient-based medical charts and billing method (PBMC&BM). The PBSM uses the National Hospital Discharge Survey (NHDS), the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Ambulatory Medical Care Survey (NAMCS) as the sources of utilization. The PBMC&BM uses patient data, charts and billings, to determine utilization rates for specific components of hospital, physician and drug prescriptions. ^ The 1995 hospital and physician cost of epilepsy is estimated to be $722 million using the PBSM and $1,058 million using the PBMC&BM. The difference of $336 million results from $136 million difference in utilization and $200 million difference in unit cost. ^ Utilization. The utilization difference of $136 million is composed of an inpatient variation of $129 million, $100 million hospital and $29 million physician, and an ambulatory variation of $7 million. The $100 million hospital variance is attributed to inclusion of febrile seizures in the PBSM, $−79 million, and the exclusion of admissions attributed to epilepsy, $179 million. The former suggests that the diagnostic codes used in the NHDS may not properly match the current definition of epilepsy as used in the PBMC&BM. The latter suggests NHDS errors in the attribution of an admission to the principal diagnosis. ^ The $29 million variance in inpatient physician utilization is the result of different per-day-of-care physician visit rates, 1.3 for the PBMC&BM versus 1.0 for the PBSM. The absence of visit frequency measures in the NHDS affects the internal validity of the PBSM estimate and requires the investigator to make conservative assumptions. ^ The remaining ambulatory resource utilization variance is $7 million. Of this amount, $22 million is the result of an underestimate of ancillaries in the NHAMCS and NAMCS extrapolations using the patient visit weight. ^ Unit cost. The resource cost variation is $200 million, inpatient is $22 million and ambulatory is $178 million. The inpatient variation of $22 million is composed of $19 million in hospital per day rates, due to a higher cost per day in the PBMC&BM, and $3 million in physician visit rates, due to a higher cost per visit in the PBMC&BM. ^ The ambulatory cost variance is $178 million, composed of higher per-physician-visit costs of $97 million and higher per-ancillary costs of $81 million. Both are attributed to the PBMC&BM's precise identification of resource utilization that permits accurate valuation. ^ Conclusion. Both methods have specific limitations. The PBSM strengths are its sample designs that lead to nationally representative estimates and permit statistical point and confidence interval estimation for the nation for certain variables under investigation. However, the findings of this investigation suggest the internal validity of the estimates derived is questionable and important additional information required to precisely estimate the cost of an illness is absent. ^ The PBMC&BM is a superior method in identifying resources utilized in the physician encounter with the patient permitting more accurate valuation. However, the PBMC&BM does not have the statistical reliability of the PBSM; it relies on synthesized national prevalence estimates to extrapolate a national cost estimate. While precision is important, the ability to generalize to the nation may be limited due to the small number of patients that are followed. ^

Effect of colchicine and amiprophos-methyl on the production of in vitro doubled haploid onion plants and correlation assessment between ploidy level and stomatal size

Doubled haploid onion (Allium cepa L.) plants allow the production of completely homozygous lines for a later production of hybrids. The haploid plants are normally produced using in vitro gynogenesis. The obtained haploid plantlets must be treated with different agents for doubling chromosomes. It is necessary to adjust the concentration and the length of treatment of the doubling agent. In this case, the effect of 250 and 500 mg.L-1 colchicine and 15.2; 30 and 60 mg.L- 1 amiprophos-methyl during 24 and 48 h was assessed over the rate of onion haploid plantlets chromosome doubling. The best duplication treatment was 250 mg.L-1 colchicine for 48 h, which yielded 100% of doubled haploid plants. On the other hand, a positive correlation resulted from the ploidy level and stomatal size, and a negative correlation between the level of ploidy and stomatal density. Significant differences between the stomatal length, width and density in haploid and doubled haploid plantlets were observed. An economical and quick method to test ploidy level in onion plantlets is proposed through the measurement of stomatal size and density.

Contents of Ag, Bi, In, and Tl in suspended and aerosol matter at Station DM8-579 in the Peru Basin, Southeast Pacific

A new electrothermal atomizer for use in direct determination of Ag, Bi, In, and Tl in marine, riverine, and aeolian particulate matter on membrane filters is described. A sample capsule and atomization cell are heated separately. That is why it is possible to separate and optimize decomposition of a sample, vaporization of elements and atomization of their vapors. Noise reduction and design, which localizes the vapors in a light absorption zone, decrease detection limits of these four elements by factor of at least 3 to 10. Some analytical results are given.

Thermodynamical Phase Noise in Oscillators Based on L-C Resonators

Using a new Admittance-based model for electrical noise able to handle Fluctuations and Dissipations of electrical energy, we explain the phase noise of oscillators that use feedback around L-C resonators. We show that Fluctuations produce the Line Broadening of their output spectrum around its mean frequency f0 and that the Pedestal of phase noise far from f0 comes from Dissipations modified by the feedback electronics. The charge noise power 4FkT/R C2/s that disturbs the otherwise periodic fluctuation of charge these oscillators aim to sustain in their L-C-R resonator, is what creates their phase noise proportional to Leeson’s noise figure F and to the charge noise power 4kT/R C2/s of their capacitance C that today’s modelling would consider as the current noise density in A2/Hz of their resistance R. Linked with this (A2/Hz?C2/s) equivalence, R becomes a random series in time of discrete chances to Dissipate energy in Thermal Equilibrium (TE) giving a similar series of discrete Conversions of electrical energy into heat when the resonator is out of TE due to the Signal power it handles. Therefore, phase noise reflects the way oscillators sense thermal exchanges of energy with their environment.

Thermodynamical Phase Noise in Oscillators Based on L-C Resonators (Foundations)

Using a new Admittance-based model for electrical noise able to handle Fluctuations and Dissipations of electrical energy, we explain the phase noise of oscillators that use feedback around L-C resonators. We show that Fluctuations produce the Line Broadening of their output spectrum around its mean frequency f0 and that the Pedestal of phase noise far from f0 comes from Dissipations modified by the feedback electronics. The charge noise power 4FkT/R C2/s that disturbs the otherwise periodic fluctuation of charge these oscillators aim to sustain in their L-C-R resonator, is what creates their phase noise proportional to Leeson’s noise figure F and to the charge noise power 4kT/R C2/s of their capacitance C that today’s modelling would consider as the current noise density in A2/Hz of their resistance R. Linked with this (A2/Hz?C2/s) equivalence, R becomes a random series in time of discrete chances to Dissipate energy in Thermal Equilibrium (TE) giving a similar series of discrete Conversions of electrical energy into heat when the resonator is out of TE due to the Signal power it handles. Therefore, phase noise reflects the way oscillators sense thermal exchanges of energy with their environment

Self-adaptive grids for noise mapping refinement

Noise maps are usually represented as contour or isolines maps describing the sound levels in a region. Using this kind of representation the user can easily find the noise level assigned to every location in the map. But the acoustic calculations behind the map are not performed for every single location on it; they are only performed in a grid of receivers. The results in this calculation grid are interpolated to draw the isolines or contours. Therefore, the resolution of the calculation grid and the way it was created (rectangular, triangulated, random…) have an effect on the resulting map. In this paper we describe a smart iterative procedure to optimize the quality of the map at a really low additional computational cost, using self-adaptive grids for the acoustic calculations. These self-adaptive grids add new receivers to the sampling grid in those locations where they are expected to be more useful, so that the performance at the output of the interpolator is enhanced. Self-adaptive sampling grids can be used for minimizing the overall error of the map (improving its quality), or for reducing calculation times, and can be also applied selectively to target areas or contour lines. This can be done by the user customizing the maximum number of iterations, the number of new receivers for each iteration, the target isolines, the target quality…

Evidence of charge carrier number fluctuations in InN thin films?

Due to its small band-gap and its high mobility, InN is a promising material for a large number of key applications like band-gap engineering for high efficiency solar cells, light emitting diodes, and high speed devices. Unfortunately, it has been reported that this material exhibits strong surface charge accumulation which may depend on the type of surface. Current investigations are conducted in order to explain the mechanisms which govern such a behavior and to look for ways of avoiding it and/or finding applications that may use such an effect. In this framework, low frequency noise measurements have been performed at different temperatures on patterned MBE grown InN layers. The evolution of the 1/f noise level with temperature in the 77 K-300 K range is consistent with carrier number fluctuations thus indicating surface mechanisms: the surface charge accumulation is confirmed by the noise measurements.

Preliminary test to characterize the soundscape of the Plaza Mayor in Madrid

This paper is a first step of a research about the analysis of the richness of the existing sounds in the Plaza Mayor, due to the old and traditional shops and bars under its porticoes together with the huge daily affluence of people. In this paper we study the sound preferences of the salesmen and bar tenders at those traditional shops. These sound preferences include particular sounds, time of occurrence and date of specific annoying and pleasant sounds perceived at the square and the shops surrounding it. To carry out this study, several noise level measurements and socio-acoustic surveys were held. We will also try to correlate sound preferences and annoyance with noise levels of specific events existing at this particular square.

Influence of the semantic content of urban sounds in the identity of outer spaces

This paper shows the influence of the semantic content of urban sounds in the subjective evaluation of outer spaces. The study is based on the analysis conducted in three neighboring and integrated urban spaces with a different form of social ownership in the city of Cordoba, Argentina. It shows that the type of sound source present at each site influence, by its semantic content, in the user´s identification and permanence in the place. The noise present in a soundscape is able to have a high semantic content, and therefore the sound has a particular meaning for the perceiver. Every particular social group influences the production of their own sounds and how they perceive them. This allows to consider the sound as one of the factors that define the sense of "place" or "no place" of a certain urban space. Evidently the sounds, and their ability to evoke and characterize the environment, cannot be ignored in the construction and recovery of anthropological sites. This urban culture is unique and specific to every society. Thepublic spaces, with their soundscape, are part of the construction of the urban identity of a city. It is shown that for identical general sound levels present in each of the spaces, the level of annoyance or discomfort, in relation to the subjective acoustic quality, is different. This is the result of the influence of semantic content of the sounds present in each urban space. Coinciding with other similar research, the level of discomfort or annoyance decreases as the presence of natural sounds such as water, the wind in the trees or the birds singing increases, even when the objective values of noise level of natural sounds are higher.

Using array based techniques for noise source identification in cars

Una de las principales causas del ruido en nuestras ciudades es el tráfico rodado. El ruido generado por los vehículos no es sólo debido al motor, sino que existen diversas fuentes de ruido en los mismos, entre las que se puede destacar el ruido de rodadura. Para localizar las causas del ruido e identificar las principales fuentes del mismo se han utilizado en diversos estudios las técnicas de coherencia y las técnicas basadas en arrays. Sin embargo, en la bibliografía existente, no es habitual encontrar el uso de estas técnicas en el sector automovilístico. En esta tesis se parte de la premisa de la posibilidad de usar estas técnicas de medida en coches, para demostrar a la largo de la misma su factibilidad y su bondad para evaluar las fuentes de ruido en dos condiciones distintas: cuando el coche está parado y cuando está en movimiento. Como técnica de coherencia se elige la de Intensidad Selectiva, utilizándose la misma para evaluar la coherencia existente entre el ruido que llega a los oídos del conductor y la intensidad radiada por distintos puntos del motor. Para la localización de fuentes de ruido, las técnicas basadas en array son las que mejores resultados ofrecen. Statistically Optimized Near-field Acoustical Holography (SONAH) es la técnica elegida para la localización y caracterización de las fuentes de ruido en el motor a baja frecuencia. En cambio, Beamforming es la técnica seleccionada para el caso de media-alta frecuencia y para la evaluación de las fuentes de ruido cuando el coche se encuentra en movimiento. Las técnicas propuestas no sólo pueden utilizarse en medidas reales, sino que además proporcionan abundante información y frecen una gran versatilidad a la hora de caracterizar fuentes de ruido. ABSTRACT One of the most important noise causes in our cities is the traffic. The noise generated by the vehicles is not only due to the engine, but there are some other noise sources. Among them the tyre/road noise can be highlighted. Coherence and array based techniques have been used in some research to locate the noise causes and identify the main noise sources. Nevertheless, it is not usual in the literature to find the application of this kind of techniques in the car sector. This Thesis starts taking into account the possibility of using this kind of measurement techniques in cars, to demonstrate their feasability and their quality to evaluate the noise sources under two different conditions: when the car is stopped and when it is in movement. Selective Intensity was chosen as coherence technique, evaluating the coherence between the noise in the driver’s ears and the intensity radiated in different points of the engine. Array based techniques carry out the best results to noise source location. Statistically Optimized Near-field Acoustical Holography (SONAH) is the measurement technique chosen for noise source location and characterization in the engine at low frequency. On the other hand, Beamforming is the technique chosen in the case of medium-high frequency and to characterize the noise sources when the car is in movement. The proposed techniques not only can be used in actual measurements, but also provide a lot of information and are very versatile to noise source characterization.

Dynamic mapping at the laminar level of odor-elicited responses in rat olfactory bulb by functional MRI

We have applied functional MRI (fMRI) based on blood oxygenation level-dependent (BOLD) image-contrast to map odor-elicited olfactory responses at the laminar level in the rat olfactory bulb (OB) elicited by iso-amyl acetate (10−2 dilution of saturated vapor) with spatial and temporal resolutions of 220×220×1,000 μm and 36 s. The laminar structure of the OB was clearly depicted by high-resolution in vivo anatomical MRI with spatial resolution of 110×110×1,000 μm. In repeated BOLD fMRI measurements, highly significant (P < 0.001) foci were located in the outer layers of both OBs. The occurrence of focal OB activity within a domain at the level of individual glomeruli or groups of glomeruli was corroborated on an intra- and inter-animal basis under anesthetized conditions with this noninvasive method. The dynamic studies demonstrated that the odor-elicited BOLD activations were highly reproducible on a time scale of minutes, whereas over tens of minutes the activations sometimes varied slowly. We found large BOLD signal (ΔS/S = 10–30%) arising from the olfactory nerve layer, which is devoid of synapses and composed of unmyelinated fibers and glial cells. Our results support previous studies with other methods showing that odors elicit activity within glomerular layer domains in the mammalian OB, and extend the analysis to shorter time periods at the level of individual glomeruli or groups of glomeruli. With further improvement, BOLD fMRI should be ideal for systematic analysis of the functional significance of individual glomeruli in olfactory information encoding and of spatiotemporal processing within the olfactory system.

Perceptual learning reflects external noise filtering and internal noise reduction through channel reweighting

To investigate the nature of plasticity in the adult visual system, perceptual learning was measured in a peripheral orientation discrimination task with systematically varying amounts of external (environmental) noise. The signal contrasts required to achieve threshold were reduced by a factor or two or more after training at all levels of external noise. The strong quantitative regularities revealed by this novel paradigm ruled out changes in multiplicative internal noise, changes in transducer nonlinearites, and simple attentional tradeoffs. Instead, the regularities specify the mechanisms of perceptual learning at the behavioral level as a combination of external noise exclusion and stimulus enhancement via additive internal noise reduction. The findings also constrain the neural architecture of perceptual learning. Plasticity in the weights between basic visual channels and decision is sufficient to account for perceptual learning without requiring the retuning of visual mechanisms.

The level of mRNA encoding the amphotropic retrovirus receptor in mouse and human hematopoietic stem cells is low and correlates with the efficiency of retrovirus transduction.

The low level of amphotropic retrovirus-mediated gene transfer into human hematopoietic stem cells (HSC) has been a major impediment to gene therapy for hematopoietic diseases. In the present study, we have examined amphotropic retrovirus receptor (amphoR) and ecotropic retrovirus receptor mRNA expression in highly purified populations of mouse and human HSC. Murine HSC with low to undetectable levels of amphoR mRNA and relatively high levels of ecotropic retrovirus receptor mRNA were studied. When these HSC were analyzed simultaneously for ecotropic and amphotropic retrovirus transduction, ecotropic provirus sequences were detected in 10 of 13 long-term repopulated animals, while amphotropic proviral sequences were detected in only one recipient. A second distinct population of murine HSC were isolated that express 3-fold higher levels of amphoR mRNA. When these HSC were analyzed simultaneously for ecotropic and amphotropic retrovirus transduction, 11 of 11 repopulated mice contained ecotropic provirus and 6 of 11 contained amphotropic provirus sequences, a significant increase in the amphotropic retrovirus transduction (P = 0.018). These results indicate that, among the heterogeneous populations of HSC present in adult mouse bone marrow, the subpopulation with the highest level of amphoR mRNA is more efficiently transduced by amphotropic retrovirus. In a related study, we found low levels of human amphoR mRNA in purified populations of human HSC (CD34+ CD38-) and higher levels in committed progenitor cells (CD34+ CD38+). We conclude that the amphoR mRNA level in HSC correlates with amphotropic retrovirus transduction efficiency.

Relationship between piezometric level and ground deformations measured by means of DInSAR in the Vega Media of the Segura River (Spain)

Differential SAR Interferometry (DInSAR) is a remote sensing method with the well demonstrated ability to monitor geological hazards like earthquakes, landslides and subsidence. Among all these hazards, subsidence involves the settlement of the ground surface affecting wide areas. Frequently, subsidence is induced by overexploitation of aquifers and constitutes a common problem that affects developed societies. The excessive pumping of underground water decreases the piezometric level in the subsoil and, as a consequence, increases the effective stresses with depth causing a consolidation of the soil column. This consolidation originates a settlement of ground surface that must be withstood by civil structures built on these areas. In this paper we make use of an advanced DInSAR approach - the Coherent Pixels Technique (CPT) [1] - to monitor subsidence induced by aquifer overexploitation in the Vega Media of the Segura River (SE Spain) from 1993 to the present. 28 ERS-1/2 scenes covering a time interval of about 10 years were used to study this phenomenon. The deformation map retrieved with CPT technique shows settlements of up to 80 mm at some points of the studied zone. These values agree with data obtained by means of borehole extensometers, but not with the distribution of damaged buildings, well points and basements, because the occurrence of damages also depends on the structural quality of the buildings and their foundations. The most interesting relationship observed is the one existing between piezometric changes, settlement evolution and local geology. Three main patterns of ground surface and piezometric level behaviour have been distinguished for the study zone during this period: 1) areas where deformation occurs while ground conditions remain altered (recent deformable sediments), 2) areas with no deformation (old and non-deformable materials), and 3) areas where ground deformation mimics piezometric level changes (expansive soils). The temporal relationship between deformation patterns and soil characteristics has been analysed in this work, showing a delay between them. Moreover, this technique has allowed the measurement of ground subsidence for a period (1993-1995) where no instrument information was available.

Intrinsic spin noise in MgO magnetic tunnel junctions

We consider two intrinsic sources of noise in ultra-sensitive magnetic field sensors based on MgO magnetic tunnel junctions, coming both from 25 Mg nuclear spins (I = 5/2, 10% natural abundance) and S = 1 Mg-vacancies. While nuclear spins induce noise peaked in the MHz frequency range, the vacancies noise peaks in the GHz range. We find that the nuclear noise in submicron devices has a similar magnitude than the 1/f noise, while the vacancy-induced noise dominates in the GHz range. Interestingly, the noise spectrum under a finite magnetic field gradient may provide spatial information about the spins in the MgO layer.