Health Care Reform: Why Not Best Practices?

The passage of the Affordable Care Act (“ACA” or “Obamacare”) in 2010 promises to bring about significant changes in the way that health care is provided and paid for in the United States of America (USA). Supporters of ACA point to a 2000 WHO study of worldwide health care systems in which the USA ranked 37th as justification for proposed changes, and many of them have expressed a preference for ultimately implementing a single-payer or single-provider system (such as currently exists in Canada or the United Kingdom). Detractors, who generally label the act Obamacare, have expressed concerns about whether the act can achieve its stated objectives, whether it represents a negative step instead of a positive one, and whether the ultimate goal of a single-payer or single-provider system is desirable one or even an achievable one. In the context of the ongoing debate over health care in the USA, this paper reviews the WHO study and subsequent comparative analyses of world health care systems to address the following questions:Does the USA really have the 37th best health care system in the world?Does either a “single-payer” health care system or a “single-provider” health care system offer prospects for significant improvement?What model or models for delivery of health care services represent “best practices” and how can and should they be emulated?

Dual Gate Graphene FETs with fT of 50 GHz

A dual-gate graphene field-effect transistors is presented, which shows improved RF performance by reducing the access resistance using electrostatic doping. With a carrier mobility of 2700 cm2/Vs, a cutoff frequency of 50 GHz is demonstrated in a 350-nm gate length device. This fT value is the highest frequency reported to date for any graphene transistor, and it also exceeds that of Si MOSFETs at the same gate length, illustrating the potential of graphene for RF applications

Operation of Graphene Transistors at GHz Frequencies

Top-gated graphene transistors operating at high frequencies (GHz) have been fabricated and their characteristics analyzed. The measured intrinsic current gain shows an ideal 1/f frequency dependence, indicating an FET-like behavior for graphene transistors. The cutoff frequency fT is found to be proportional to the dc transconductance gm of the device. The peak fT increases with a reduced gate length, and fT as high as 26 GHz is measured for a graphene transistor with a gate length of 150 nm. The work represents a significant step towards the realization of graphene-based electronics for high-frequency applications

A multi-stage stochastic replacement decision model : application to replacement of dairy cows

Published April 1963. Facts and recommendations in this publication may no longer be valid. Please look for up-to-date information in the OSU Extension Catalog: http://extension.oregonstate.edu/catalo

Entomology research in southeast Missouri 1960.

Cover title.This report summarized research on crop pest control conducted by the Agricultural Experiment Station in southeast Missouri during 1960.Cotton insect research / Keith Harrendorf -- Corn insects / Armon J. Keaster, Mahlon L. Fairchild, B. Dean Barry -- Nematode control / Lee Jenkins

Mass and pressure constraints on galaxy clusters from interferometric SZ observations

Following on our previous study of an analytic parametric model to describe the baryonic and dark matter distributions in clusters of galaxies with spherical symmetry, we perform an SZ analysis of a set of simulated clusters and present their mass and pressure profiles. The simulated clusters span a wide range in mass, 2.0 x 10^14 Msun < M200 < 1.0 x 10^15Msun, and observations with the Arcminute Microkelvin Imager (AMI) are simulated through their Sunyaev- Zel'dovich (SZ) effect. We assume that the dark matter density follows a Navarro, Frenk and White (NFW) profile and that the gas pressure is described by a generalised NFW (GNFW) profile. By numerically exploring the probability distributions of the cluster parameters given simulated interferometric SZ data in the context of Bayesian methods, we investigate the capability of this model and analysis technique to return the simulated clusters input quantities. We show that considering the mass and redshift dependency of the cluster halo concentration parameter is crucial in obtaining an unbiased cluster mass estimate and hence deriving the radial profiles of the enclosed total mass and the gas pressure out to r200.Comment: 5 pages, 2 tables, 3 figure

High-frequency performance of scaled carbon nanotube array field-effect transistors

We report the radio-frequency performance of carbon nanotube array transistors that have been realized through the aligned assembly of highly separated, semiconducting carbon nanotubes on a fully scalable device platform. At a gate length of 100 nm, we observe output current saturation and obtain as-measured, extrinsic current gain and power gain cut-off frequencies, respectively, of 7 GHz and 15 GHz. While the extrinsic current gain is comparable to the state-of-the-art the extrinsic power gain is improved. The de-embedded, intrinsic current gain and power gain cut-off frequencies of 153 GHz and 30 GHz are the highest values experimentally achieved to date. We analyze the consistency of DC and AC performance parameters and discuss the requirements for future applications of carbon nanotube array transistors in high-frequency electronics.Comment: 15 pages, 4 figures + Supplementary Informatio

Risk algorithm using serial biomarker measurements doubles the number of screen-detected cancers compared with a single-threshold rule in the United Kingdom collaborative trial of ovarian cancer screening

PURPOSE: Cancer screening strategies have commonly adopted single-biomarker thresholds to identify abnormality. We investigated the impact of serial biomarker change interpreted through a risk algorithm on cancer detection rates. PATIENTS AND METHODS: In the United Kingdom Collaborative Trial of Ovarian Cancer Screening, 46,237 women, age 50 years or older underwent incidence screening by using the multimodal strategy (MMS) in which annual serum cancer antigen 125 (CA-125) was interpreted with the risk of ovarian cancer algorithm (ROCA). Women were triaged by the ROCA: normal risk, returned to annual screening; intermediate risk, repeat CA-125; and elevated risk, repeat CA-125 and transvaginal ultrasound. Women with persistently increased risk were clinically evaluated. All participants were followed through national cancer and/or death registries. Performance characteristics of a single-threshold rule and the ROCA were compared by using receiver operating characteristic curves. RESULTS: After 296,911 women-years of annual incidence screening, 640 women underwent surgery. Of those, 133 had primary invasive epithelial ovarian or tubal cancers (iEOCs). In all, 22 interval iEOCs occurred within 1 year of screening, of which one was detected by ROCA but was managed conservatively after clinical assessment. The sensitivity and specificity of MMS for detection of iEOCs were 85.8% (95% CI, 79.3% to 90.9%) and 99.8% (95% CI, 99.8% to 99.8%), respectively, with 4.8 surgeries per iEOC. ROCA alone detected 87.1% (135 of 155) of the iEOCs. Using fixed CA-125 cutoffs at the last annual screen of more than 35, more than 30, and more than 22 U/mL would have identified 41.3% (64 of 155), 48.4% (75 of 155), and 66.5% (103 of 155), respectively. The area under the curve for ROCA (0.915) was significantly (P = .0027) higher than that for a single-threshold rule (0.869). CONCLUSION: Screening by using ROCA doubled the number of screen-detected iEOCs compared with a fixed cutoff. In the context of cancer screening, reliance on predefined single-threshold rules may result in biomarkers of value being discarded

Bayesian modelling of clusters of galaxies from multi-frequency pointed Sunyaev--Zel'dovich observations

We present a Bayesian approach to modelling galaxy clusters using multi-frequency pointed observations from telescopes that exploit the Sunyaev--Zel'dovich effect. We use the recently developed MultiNest technique (Feroz, Hobson & Bridges, 2008) to explore the high-dimensional parameter spaces and also to calculate the Bayesian evidence. This permits robust parameter estimation as well as model comparison. Tests on simulated Arcminute Microkelvin Imager observations of a cluster, in the presence of primary CMB signal, radio point sources (detected as well as an unresolved background) and receiver noise, show that our algorithm is able to analyse jointly the data from six frequency channels, sample the posterior space of the model and calculate the Bayesian evidence very efficiently on a single processor. We also illustrate the robustness of our detection process by applying it to a field with radio sources and primordial CMB but no cluster, and show that indeed no cluster is identified. The extension of our methodology to the detection and modelling of multiple clusters in multi-frequency SZ survey data will be described in a future work.Comment: 12 pages, 7 figures, submitted to MNRA