Cost calculation and prediction in adult intensive care: A ground-up utilization study

Publisher's copy made available with the permission of the publisherThe ability of various proxy cost measures, including therapeutic activity scores (TISS and Omega) and cumulative daily severity of illness scores, to predict individual ICU patient costs was assessed in a prospective “ground-up” utilization costing study over a six month period in 1991. Daily activity (TISS and Omega scores) and utilization in consecutive admissions to three adult university associated ICUs was recorded by dedicated data collectors. Cost prediction used linear regression with determination (80%) and validation (20%) data sets. The cohort, 1333 patients, had a mean (SD) age 57.5 (19.4) years, (41% female) and admission APACHE III score of 58 (27). ICU length of stay and mortality were 3.9 (6.1) days and 17.6% respectively. Mean total TISS and Omega scores were 117 (157) and 72 (113) respectively. Mean patient costs per ICU episode (1991 $AUS) were$6801 ($10311), with median costs of$2534, range $106 to$95,602. Dominant cost fractions were nursing 43.3% and overheads 16.9%. Inflation adjusted year 2002 (mean) costs were $9343 ($ AUS). Total costs in survivors were predicted by Omega score, summed APACHE III score and ICU length of stay; determination R2, 0.91; validation 0.88. Omega was the preferred activity score. Without the Omega score, predictors were age, summed APACHE III score and ICU length of stay; determination R2, 0.73; validation 0.73. In non-survivors, predictors were age and ICU length of stay (plus interaction), and Omega score (determination R2, 0.97; validation 0.91). Patient costs may be predicted by a combination of ICU activity indices and severity scores.J. L. Moran, A. R. Peisach, P. J. Solomon, J. Martinhttp://www.aaic.net.au/Article.asp?D=200403

The Sudbury Neutrino Observatory

The Sudbury Neutrino Observatory is a second generation water Cherenkov detector designed to determine whether the currently observed solar neutrino deficit is a result of neutrino oscillations. The detector is unique in its use of D2O as a detection medium, permitting it to make a solar model-independent test of the neutrino oscillation hypothesis by comparison of the charged- and neutral-current interaction rates. In this paper the physical properties, construction, and preliminary operation of the Sudbury Neutrino Observatory are described. Data and predicted operating parameters are provided whenever possible.Comment: 58 pages, 12 figures, submitted to Nucl. Inst. Meth. Uses elsart and epsf style files. For additional information about SNO see http://www.sno.phy.queensu.ca . This version has some new reference

Do soil fertilization and forest canopy foliage affect the growth and photosynthesis of Amazonian saplings?

Most Amazonian soils are highly weathered and poor in nutrients. Therefore, photosynthesis and plant growth should positively respond to the addition of mineral nutrients. Surprisingly, no study has been carried out in situ in the central Amazon to address this issue for juvenile trees. The objective of this study was to determine how photosynthetic rates and growth of tree saplings respond to the addition of mineral nutrients, to the variation in leaf area index of the forest canopy, and to changes in soil water content associated with rainfall seasonality. We assessed the effect of adding a slow-release fertilizer. We determined plant growth from 2010 to 2012 and gas exchange in the wet and dry season of 2012. Rainfall seasonality led to variations in soil water content, but it did not affect sapling growth or leaf gas exchange parameters. Although soil amendment increased phosphorus content by 60 %, neither plant growth nor the photosynthetic parameters were influenced by the addition of mineral nutrients. However, photosynthetic rates and growth of saplings decreased as the forest canopy became denser. Even when Amazonian soils are poor in nutrients, photosynthesis and sapling growth are more responsive to slight variations in light availability in the forest understory than to the availability of nutrients. Therefore, the response of saplings to future increases in atmospheric [CO2] will not be limited by the availability of mineral nutrients in the soil

Eutrophication Analysis Procedures for Texas Lakes and Reservoirs

Texas Water Commission Interagency Cooperation Contract (84-85)-0896Center for Water and the Environmen

Eutrophication Analysis Procedures for Texas Lakes and Reservoirs

Texas Water Commission Interagency Cooperation Contract (84-85)-0896Center for Water and the Environmen

Advanced materials for space nuclear power systems

Research on monolithic refractory metal alloys and on metal matrix composites is being conducted at the NASA Lewis Research Center, Cleveland, Ohio, in support of advanced space power systems. The overall philosophy of the research is to develop and characterize new high-temperature power conversion and radiator materials and to provide spacecraft designers with material selection options and design information. Research on three candidate materials (carbide strengthened niobium alloy PWC-11 for fuel cladding, graphite fiber reinforced copper matrix composites (Gr/Cu) for heat rejection fins, and tungsten fiber reinforced niobium matrix composites (W/NB) for fuel containment and structural supports) considered for space power system applications is discussed. Each of these types of materials offers unique advantages for space power applications