The Swiss and Dutch Health Insurance Systems: Universal Coverage and Regulated Competitive Insurance Markets

Compares systems of universal insurance coverage based on individual mandates, consumer choice of health plans, and regulated insurance market competition in Switzerland and the Netherlands. Discusses insights and implications for U.S. reform efforts

Thiopurines are negatively associated with anthropometric parameters in pediatric Crohn's disease.

AimTo determine the distribution of anthropometric parameter (AP)-z-scores and characterize associations between medications/serum biomarkers and AP-z-scores in pediatric Crohn's disease (CD).MethodsCD patients [< chronological age (CA) 21 years] were enrolled in a cross-sectional study. Descriptive statistics were generated for participants' demographic characteristics and key variables of interest. Paired t-tests were used to compare AP-z-scores calculated based on CA (CA z-scores) and bone age (BA) (BA z-scores) for interpretation of AP's. Linear regression was utilized to examine associations between medications and serum biomarkers with AP-z-scores calculated based on CA (n = 82) and BA (n = 49). We reported regression coefficients as well as their corresponding p-values and 95% confidence intervals.ResultsMean CA at the time of the study visit was 15.3 ± 3.5 (SD; range = 4.8-20.7) years. Mean triceps skinfold (P = 0.039), subscapular skinfold (P = 0.002) and mid-arm circumference (MAC) (P = 0.001) BA z-scores were higher than corresponding CA z-scores. Medications were positively associated with subscapular skinfold [adalimumab (P = 0.018) and methotrexate (P = 0.027)] and BMI CA z-scores [adalimumab (P = 0.029)]. Azathioprine/6-mercaptopurine were negatively associated with MAC (P = 0.045), subscapular skinfold (P = 0.014), weight (P = 0.002) and BMI (P = 0.013) CA z-scores. ESR, CRP, and WBC count were negatively associated, while albumin and IGF-1 BA z-scores were positively associated, with specific AP z-scores (P < 0.05). Mean height CA z-scores were higher in females, not males, treated with infliximab (P = 0.038). Hemoglobin (P = 0.018) was positively associated, while platelets (P = 0.005), ESR (P = 0.003) and CRP (P = 0.039) were negatively associated with height CA z-scores in males, not females.ConclusionOur results suggest poor efficacy of thiopurines and a possible sex difference in statural growth response to infliximab in pediatric CD. Prospective longitudinal studies are required

Planning Optimal Robot Trajectories by Cell Mapping

A cell-mapping method is introduced for planning global trajectories of robotic manipulators in cases where the cell space is composed of combination pairs of plane cells. With the proposed method, optimal trajectory problems in the free field and in the obstacle-constrained field are studied. Two numerical examples are given to show the obtained optimal trajectories and controls

Supplementation of Beef Cows Grazing Corn Stalk Residue: A Demonstration

Controlling feed costs is imperative for cow-calf producers to remain cost-competitive. During fall and early winter, these projected costs can be significantly reduced by utilizing cornstalks. By effectively grazing corn residues, Iowa cow-calf producers have the opportunity to extend the grazing season and reduce winter feed costs. The ISU distillers’ dry grain (DDG) supplementation demonstration suggests that pregnant beef cows utilizing a strip-grazed system with appropriate supplementation can maintain their body condition scores (BCS) during challenging weather conditions. The supplemented group maintained a 5.7 BCS and the control group lost 0.3 BCS during the 49-day demonstration. The DDG supplemented system was projected to be more cost-competitive ($18.82 per head advantage) than the continuous grazed control group

Introduction to and Screening Visit Results of the Multicenter Pediatric Crohn's Disease Growth Study.

BackgroundStatural growth impairment is more common in males with Crohn's disease (CD). We assessed sex differences in height Z score differences and bone age (BA) Z scores and characterized age of menarche in a novel contemporary cohort of pediatric CD patients undergoing screening for enrollment in the multicenter longitudinal Growth Study.MethodsCrohn's disease patients (females with chronological age [CA] 5 years and older and younger than 14 years; males with CA 6 years and older and younger than 16 years) participated in a screening visit for the Growth Study. Height BA-Z scores are height Z scores calculated based on BA. Height CA-Z scores are height Z scores calculated based on CA. The height Z score difference equals height CA-Z score minus height BA-Z score.ResultsOne hundred seventy-one patients (60% male) qualified for this analysis. Mean CA was 12.2 years. Mean height CA-Z score was -0.4, and mean height BA-Z score was 0.4 in females. Mean height CA-Z score was -0.1, and mean height BA-Z score was 0.2 in males. The absolute value of the mean height Z score difference was significantly greater in females (0.8) than males (0.3; P = 0.005). The mean BA-Z score in females (-1.0) was significantly lower than in males (-0.2; P = 0.002). The median CA at menarche was 13.6 (95% CI, 12.6-14.6) years.ConclusionsOur screening visit data suggest that standardized height gain is lower in males with skeletal maturation and delayed puberty is common in females in CD. We are investigating these findings in the ongoing Growth Study

Adsorption of HO_x on Aerosol Surfaces: Implications for the Atmosphere of Mars

The potential impact of heterogeneous chemistry on the abundance and distribution of HO_x in the atmosphere of Mars has been assessed by combining observational data of dust and ice aerosol distributions with an updated photochemical model. Critical parameters include the altitude distributions of aerosols, and the surface loss coefficients (γ) of HO_2 on dust and ice in the lower atmosphere, and H on ice above 40 km. We find that adsorption of HO_2 on dust (γHO_2 ≥ 0.01), or ice near 30 km (γHO_2 ≥ 0.1), can deplete OH abundances in the lower atmosphere by 10% or more. Such depletions approach those obtained by lowering the water vapor abundance by an order of magnitude below the global average observed by Viking (≈ 25%). Since the oxidation of CO is catalyzed by HO_x in the lower atmosphere via the reaction CO + OH → CO_2 + H, loss of OH due to adsorption of HO_2 on dust or ice at low altitudes could have a significant effect on the ratio CO : CO_2. The adsorption of H on ice at 50 km (γ_H ≥ 0.01) can result in even larger OH depletions. However, this effect is localized to altitudes > 40 km, where CO oxidation is relatively unimportant. Laboratory data suggest that γHO_2 ≈ 0.01 is a reasonable estimate for adsorption on dust. Larger values are plausible, but are not strongly supported by experimental evidence. The reactivity of HO_2 on ice is unknown, while γH on ice appears to be < 0.001. There is a need for measurements of HO_x adsorption on surfaces representative of Martian aerosols at temperatures < 220 K