Rationales of Mortgage Insurance Premium Structures

This paper examines the rationales for the design of mortgage insurance premium structures. The actuarially sound premium prices of several widely used structures are formally derives. Two types of cross-subsidization are identified in different structures: (1) subsidization across termination years and (2) extra-subsidization of defaulters by non-defaulters. Because these two types of subsidization exist to different degree among the structures, a borrower may self-select into certain structures to maximize (minimize) the benefits (losses) of cross-subsidies. Adverse selection arises when the borrower's characteristics cannot be completely observed by the insurer. The actuarially sound premium prices should be adjusted for such adverse selection behaviors. Numerical examples are provided to illustrate such adjustments.

On the Scaling of Small, Heat Simulated Jet Noise Measurements to Moderate Size Exhaust Jets

Modern military aircraft jet engines are designed with variable geometry nozzles to provide optimum thrust in different operating conditions, depending on the flight envelope. However, the acoustic measurements for such nozzles are scarce, due to the cost involved in making full scale measurements and the lack of details about the exact geometry of these nozzles. Thus the present effort at The Pennsylvania State University and the NASA Glenn Research Center- in partnership with GE Aviation is aiming to study and characterize the acoustic field produced by supersonic jets issuing from converging-diverging military style nozzles. An equally important objective is to validate methodology for using data obtained from small and moderate scale experiments to reliably predict the most important components of full scale engine noise. The experimental results presented show reasonable agreement between small scale and moderate scale jet acoustic data, as well as between heated jets and heat-simulated ones. Unresolved issues however are identified that are currently receiving our attention, in particular the effect of the small bypass ratio airflow. Future activities will identify and test promising noise reduction techniques in an effort to predict how well such concepts will work with full scale engines in flight conditions

Structural complexities in the Alishan area of the Taiwan fold-and-thrust belt inherited from the margin's shelf-slope transition

This article is subject to a CC Attribution 3.0 License.The Alishan area of Taiwan includes a sector of the fold-and-thrust belt that spans the transition from the platform with full thickness of the Eurasian continental margin in the north to the thinning crust of its slope in the south. This part of the fold-and-thrust belt with the highest elevations includes important along-strike changes in structure, stratigraphy, and seismic velocities. Here we present the results of new geological mapping from which we build geological cross sections both across and along the regional structural trend. Fault contour, stratigraphic cut-off, and branch line maps provide 3-D consistency between the cross sections. Minimum shortening is estimated to be 15 km, with displacement overall to the northwest. A P wave velocity model helps constrain the structure at depth by providing insight into the possible rock units that are present there. P wave velocities of > 5.2 km/s point toward the presence of basement rocks in the shallow subsurface throughout much of the south-eastern part of the area, forming a basement culmination. The changes in strike of thrusts and fold axial traces, the changing elevation of thrusts and stratigraphic contacts, and the growing importance of Middle Miocene sediments that take place from north to south are interpreted to be associated with a roughly northeast striking lateral structure coincident with the northern flank of this basement culmination. These transverse structures appear to be associated with the inversion of Eocene- and Miocene-age extensional faults, deeply rooted in the pre Cenozoic basement that were along what was the shelf-slope transition in the Early Oligocene. Inversion causes uplift of the margin sediments and their higher P wave velocity basement during Pliocene-Pleistocene thrusting.Peer Reviewe

Histologic findings in mucosa and muscularis propria biopsied during peroral endoscopic myotomy in patients with achalasia

Background: Peroral endoscopic myotomy (POEM) has been increasingly used to treat achalasia. Previous studies have reported high frequency of muscular eosinophilic infiltration in achalasia. Esophageal mucosal changes in achalasia have only been studied in esophagectomy specimens. Cardia mucosal changes in achalasia have not been reported previously. We aimed to further characterize the esophageal, gastric cardia, and muscularis propria changes in achalasia. Methods: This was a pilot study. Patients with clinically and radiographically confirmed achalasia who underwent POEM were enrolled in the study. Mucosal biopsies were taken 1 cm proximal and 1 cm distal to the gastroesophageal junction, and muscularis propria biopsies were taken from the mid esophagus. Tissues were submitted for histological evaluation. Results: Eighteen patients (10 male and eight female, mean age: 60.7 (standard deviation (SD): 13) years) were enrolled in this pilot study. Nine patients had type II achalasia, two type III, one type I, five esophageal gastric outlet obstruction, and one unspecific type achalasia. The mean duration of symptoms prior to POEM was 79 (range 1 - 480) months. All patients had a dilated esophagus on examination, but no endoscopic evidence of Barrett\u27s esophagus. Esophageal, gastric cardia, and muscular biopsies were performed in 17, 13, and 17 patients, respectively. Basal hyperplasia, spongiosis, ballooning, and parakeratosis were seen in 92.3%, 100%, 100%, and 76.5% of cases, respectively. Intraepithelial lymphocytosis was seen in 70.5% of cases, and active esophagitis was seen in 23.5% of case. Six (35.3%) cases had few intraepithelial eosinophils, but none of them had \u3e 15 eosinophils per high power field. Histologic findings in gastric cardia mucosa included carditis (69.2%), Conclusions: Muscular biopsies in our study revealed loss of ganglion cells, supporting the view that achalasia is a primary esophageal disease with ganglion cell depletion. Squamous mucosa in achalasia showed changes mimicking reflux and lymphocytic esophagitis. Cardia mucosa in achalasia patients often were inflamed and uncommonly showed intestinal metaplasia and glandular dysplasia

Educational Technology Primer: A Guide for Pre-Service Teachers

The Educational Technology Primer grew out of the realization that today’s teacher education students have different needs than their predecessors. Current students arrive on campus less intimidated by technology and more experienced with the use of technology in instruction. However, many introductory educational technology texts still highlight the acquisition of basic technology operations; knowledge and skills that made sense when students entering an introductory educational technology course lacked technology experiences, but not today

Care Coordination for Children With Medical Complexity: Whose Care Is It, Anyway?

Children with medical complexity (CMC) have multiple chronic conditions and require an array of medical- and community-based providers. Dedicated care coordination is increasingly seen as key to addressing the fragmented care that CMC often encounter. Often conceptually misunderstood, care coordination is a team-driven activity that organizes and drives service integration. In this article, we examine models of care coordination and clarify related terms such as care integration and case management. The location of care coordination resources for CMC may range from direct practice provision to external organizations such as hospitals and accountable care organizations. We discuss the need for infrastructure building, design and implementation leadership, use of care coordination tools and training modules, and appropriate resource allocation under new payment models

Family-Centered Care: Current Applications and Future Directions in Pediatric Health Care

Family-centered care (FCC) is a partnership approach to health care decision-making between the family and health care provider. FCC is considered the standard of pediatric health care by many clinical practices, hospitals, and health care groups. Despite widespread endorsement, FCC continues to be insufficiently implemented into clinical practice. In this paper we enumerate the core principles of FCC in pediatric health care, describe recent advances applying FCC principles to clinical practice, and propose an agenda for practitioners, hospitals, and health care groups to translate FCC into improved health outcomes, health care delivery, and health care system transformation

Autonomous nuclear waste management

Redundant and non-operational buildings at nuclear sites are decommissioned over a period of time. The process involves demolition of physical infrastructure resulting in large quantities of residual waste material. The resulting waste materials are packed into import containers to be delivered for post-processing, containing either sealed canisters or assortments of miscellaneous objects. At present post-processing does not happen within the United Kingdom. Sellafield Ltd. and National Nuclear Laboratory are developing a process for future operation so that upon an initial inspection, imported waste materials undergo two stages of post-processing before being packed into export containers, namely sort and segregate or sort and disrupt. The post-processing facility will remotely treat and export a wide range of wastes before downstream encapsulation. Certain wastes require additional treatment, such as disruption, before export to ensure suitability for long-term disposal. This article focuses on the design, development, and demonstration of a reconfigurable rational agent-based robotic system that aims to highly automate these processes removing the need for close human supervision. The proposed system is being demonstrated through a downsized, lab-based setup incorporating a small-scale robotic arm, a time-of-flight camera, and high-level rational agent-based decision making and control framework

Dithiolethione ACDT suppresses neuroinflammation and ameliorates disease severity in experimental autoimmune encephalomyelitis

Multiple sclerosis (MS) is an autoimmune disorder characterized by the central nervous system (CNS) infiltration of myelin-specific pathogenic T cells followed by brain inflammation in association with demyelination. Similarly, experimental autoimmune encephalomyelitis (EAE), the animal model of MS, also exhibits increased CNS infiltration of pathogenic T cells, including Th1 and Th17, leading to detrimental effects of neuroinflammation and demyelination. We previously reported that 3H-1,2-dithiole-3-thione (D3T), the structurally-simplest of the sulfur-containing dithiolethiones, exerted a promising therapeutic effect in EAE. In the current study we report that 5-Amino-3-thioxo-3H-(1,2)dithiole-4-carboxylic acid ethyl ester (ACDT), a substituted derivative of D3T, exhibits anti-inflammatory properties in EAE. ACDT, administered post immunization, delayed disease onset and reduced disease severity in chronic C57BL/6 EAE, and ACDT, administered during disease remission, suppressed disease relapse in relapsing-remitting SJL/J EAE. Further analysis of the cellular and molecular mechanisms underlying the protective effects of ACDT in EAE revealed that ACDT inhibited pathogenic T cell infiltration, suppressed microglia activation, repressed neurotoxic A1 astrocyte generation, lessened blood-brain barrier disruption, and diminished MMP3/9 production in the CNS of EAE. In summary, we demonstrate that ACDT suppresses neuroinflammation and ameliorates disease severity in EAE through multiple cellular mechanisms. Our findings suggest the potential of developing ACDT as a novel therapeutic agent for the treatment of MS/EAE