Medicaid in the orthodontic community: provider trends and perceptions

Background and Objectives: Medicaid is a federal and state insurance program aimed at helping economically disadvantaged individuals and families with gaining access to health care. Lack of provider participation in the Medicaid program leaves many Medicaid-eligible individuals with the inability to obtain certain medical services, such as orthodontic care. The objective of this study was to use an electronic survey to better understand the beliefs and behaviors of orthodontists in regard to participation in the Medicaid program, and to determine if differences exist between Medicaid providers and non-Medicaid providers. Experimental Design and Methods: Survey: Requests to participate in an electronic survey were submitted to private practicing orthodontists located in Ohio, Pennsylvania and West Virginia (n = 580). Contact information was obtained from the member directory listed on the American Association of Orthodontists (AAO) website. Participants’ responses were categorized based on Medicaid participation; current, former, or never accepted. Results: One hundred nine practitioners responded to the survey (19%). A total of 58 practitioners currently accepted Medicaid patients, 13 formerly accepted Medicaid patients, and 39 had never accepted Medicaid patients. All three groups cited low fees as a major deterrent to participating in the Medicaid program. More providers in the state of West Virginia accept Medicaid patients than those in Pennsylvania and Ohio. Providers who felt confident with their own and their administrative staff’s ability to navigate the Medicaid system participated in the Medicaid program in higher numbers than those that felt less confident. There were no significant differences in perceptions of Medicaid patient’s compliance in appointment keeping, breakage of appliances or oral hygiene among the different Medicaid participation statuses. Conclusions: Fee reimbursement, reimbursement schedule, and lack of confidence in navigating the Medicaid system are major barriers to orthodontic provider participation

Exploring the Proximity Effect in Mo/Au Bilayers

We report on the sensitivity of superconducting transition temperature (T c ) to the individual layers' thickness in Mo/Au proximity bilayers to be used in transition-edge sensors (TESs). The achieved good reproducibility and quality of the bilayers allow a clear determination of the superconducting critical temperature T c as a function of the Mo and Au thicknesses. One objective of this work is to analyse the quality of the Mo/Au interface and to assess the possible effects of the double Au layer we use to fabricate these bilayers and TESs based on them. Experimental data are analysed on the basis of Usadel equations using the model developed by Martinis and co-workers, in which the proximity effect in the bilayer is mainly governed by the interface transparency between the superconductor and the normal metal. We find that this model describes quite well the behavior of T c , even for quite thick Au layers, and that the double Au layer does not play any relevant role on the proximity effect

Large current-induced broadening of the superconducting transition in Mo/Au transition edge sensors

The R(T, I) shape of the superconducting transition in transition edge sensors (TESs) is of crucial importance to determine their ultimate performance. This paper reports a study of the temperature and current dependences of the transition of Mo/Au TESs, focused on the low resistance region, where these devices preferentially operate. A large broadening of the transition is observed when increasing the applied current. An empirical analytic expression for R(T, I) is found, which describes the transition of devices with different critical temperatures, from R = 0 up to at least 30% R-n (in some cases nearly 80% R-n). Several mechanisms for this behaviour are considered; results show that a current assisted vortex pair unbinding mechanism (Berezinskii-Kosterlitz-Thouless transition) could be the possible origin for this behaviour. Finally, the consequences of the current-induced transition broadening for TES properties and operation are outlined

Effect of filtering in dense WDM metro networks adopting VCSEL-based multi-Tb/s transmitters

Long-wavelength vertical cavity surface emitting lasers (VCSELs) can represent an alternative solution for the development of transmitters with reduced cost, power consumption and footprint for very-high capacity metropolitan area systems. Multi-Tb/s transmitter modules with fine wavelength division multiplexing (WDM) granularity can be obtained adopting direct modulation (DM) with advanced modulation formats, such as discrete multitone (DMT), and aggregating multiple DM-VCSELs emitting in the C-band with WDM multiplexers in SOI chips. Due to numerous hops between nodes inside metropolitan area networks the effect of filtering can severely impact the transmission performance; we evaluate the transported capacity in function of nodes number taking into account the actual VCSEL parameters and simplified coherent detection

Design and Fabrication of Coplanar YBCO Structures on Lithium Niobate Substrates

YBa2Cu3O7-δ (YBCO) with low RF losses has been successfully deposited onto lithium niobate (LNO) to improve the performance of electrooptic Mach-Zender modulators. Epitaxial, c-axis oriented superconducting YBCO thin films have been grown on X-cut LNO single crystals with a yttria-stabilized zirconia (YSZ) buffer layer by RF magnetron sputtering. This buffer layer is needed to obtain good superconducting properties of the YBCO grown. Numerical tools have been developed to analyze CPW structures based on YBCO/YSZ/LNO trilayers, and they indicate that YSZ thickness has to be kept to the minimum necessary for good YBCO growth. With this restriction, the RF losses of YBCO/YSZ/LNO samples have been measured. The results from these measurements are used to quantify the performance enhancement in a Mach-Zender modulator using YBCO electrodes

TERRA regulate the transcriptional landscape of pluripotent cells through TRF1-dependent recruitment of PRC2

The mechanisms that regulate pluripotency are still largely unknown. Here, we show that Telomere Repeat Binding Factor 1 (TRF1), a component of the shelterin complex, regulates the genome-wide binding of polycomb and polycomb H3K27me3 repressive marks to pluripotency genes, thereby exerting vast epigenetic changes that contribute to the maintenance of mouse ES cells in a na\uefve state. We further show that TRF1 mediates these effects by regulating TERRA, the lncRNAs transcribed from telomeres. We find that TERRAs are enriched at polycomb and stem cell genes in pluripotent cells and that TRF1 abrogation results in increased TERRA levels and in higher TERRA binding to those genes, coincidental with the induction of cell-fate programs and the loss of the na\uefve state. These results are consistent with a model in which TRF1-dependent changes in TERRA levels modulate polycomb recruitment to pluripotency and differentiation genes. These unprecedented findings explain why TRF1 is essential for the induction and maintenance of pluripotency

On the Filter Narrowing Issues in Elastic Optical Networks

This paper describes the problematic filter narrowing effect in the context of next-generation elastic optical networks. First, three possible scenarios are introduced: the transition from an actual fixed-grid to a flexigrid network, the generic full flexi-grid network, and a proposal for a filterless optical network. Next, we investigate different transmission techniques and evaluate the penalty introduced by the filtering effect when considering Nyquist wavelength division multiplexing, single side-band direct-detection orthogonal frequency division multiplexing, and symbol-rate variable dual polarization quadrature amplitude modulation. Also, different approaches to compensate for the filter narrowing effect are discussed. Results show that the specific needs per each scenario can be fulfilled by the aforementioned technologies and techniques or a combination of them, when balancing performance, network reach, and cost

An environmentally benign antimicrobial nanoparticle based on a silver-infused lignin core

Silver nanoparticles have antibacterial properties, but their use has been a cause for concern because they persist in the environment. Here, we show that lignin nanoparticles infused with silver ions and coated with a cationic polyelectrolyte layer form a biodegradable and green alternative to silver nanoparticles. The polyelectrolyte layer promotes the adhesion of the particles to bacterial cell membranes and, together with silver ions, can kill a broad spectrum of bacteria, including Escherichia coli, Pseudomonas aeruginosa and quaternary-amine-resistant Ralstonia sp. Ion depletion studies have shown that the bioactivity of these nanoparticles is time-limited because of the desorption of silver ions. High-throughput bioactivity screening did not reveal increased toxicity of the particles when compared to an equivalent mass of metallic silver nanoparticles or silver nitrate solution. Our results demonstrate that the application of green chemistry principles may allow the synthesis of nanoparticles with biodegradable cores that have higher antimicrobial activity and smaller environmental impact than metallic silver nanoparticles

NMR and NQR Fluctuation Effects in Layered Superconductors

We study the effect of thermal fluctuations of the s-wave order parameter of a quasi two dimensional superconductor on the nuclear spin relaxation rate near the transition temperature Tc. We consider both the effects of the amplitude fluctuations and the Berezinskii-Kosterlitz-Thouless (BKT) phase fluctuations in weakly coupled layered superconductors. In the treatment of the amplitude fluctuations we employ the Gaussian approximation and evaluate the longitudinal relaxation rate 1/T1 for a clean s-wave superconductor, with and without pair breaking effects, using the static pair fluctuation propagator D. The increase in 1/T1 due to pair breaking in D is overcompensated by the decrease arising from the single particle Green's functions. The result is a strong effect on 1/T1 for even a small amount of pair breaking. The phase fluctuations are described in terms of dynamical BKT excitations in the form of pancake vortex-antivortex (VA) pairs. We calculate the effect of the magnetic field fluctuations caused by the translational motion of VA excitations on 1/T1 and on the transverse relaxation rate 1/T2 on both sides of the BKT transitation temperature T(BKT)<Tc. The results for the NQR relaxation rates depend strongly on the diffusion constant that governs the motion of free and bound vortices as well as the annihilation of VA pairs. We discuss the relaxation rates for real multilayer systems where the diffusion constant can be small and thus increase the lifetime of a VA pair, leading to an enhancement of the rates. We also discuss in some detail the experimental feasibility of observing the effects of amplitude fluctuations in layered s-wave superconductors such as the dichalcogenides and the effects of phase fluctuations in s- or d-wave superconductors such as the layered cuprates.Comment: 38 pages, 12 figure

Modular SDN-enabled S-BVT Adopting Widely Tunable MEMS VCSEL for Flexible/Elastic Optical Metro Networks

We propose an SDN-enabled S-BVT adopting directly-modulated tunable VCSEL with direct-detection for optical metro networks and spectrum defragmentation. We experimentally assess it over different network paths up to 185km and in presence of adjacent slices