Comparative Analysis of Coronary Artery Bypass: Costs of Off-Pump vs. Conventional Techniques with Variable Bonded Circuits and Drug Strategies

As baby boomers age, estimated to reach 78.8 million Americans over the age of 65 by 2050, their health care costs are skyrocketing. Increased costs in coronary artery bypass surgery have been linked to length of stay (LOS), the inflammatory response, and blood loss related to conventional coronary artery bypass (C-CAB). Off-pump coronary artery bypass (OPCAB) has become a popular alternative to C-CAB. Utilizing proximal connector devices has truly made this option clampless. If detrimental outcomes can be linked to cross clamping, the use of cardiopulmonary bypass (CPB) may diminish. When the use of CPB is necessary, there are a number of circuit coatings available, along with drugs like Aprotinin, to decrease the inflammatory response, and Amicar, to decrease the amount of blood loss, all due to the exposure of the body to CPB. This study compares the cost and LOS involved with OPCAB vs. C-CAB, including a comparison of the inflammatory response and blood loss with each drug regime and circuit coating used. Analysis of the data revealed no significant difference in several cost areas. The total operating room (O.R.) costs showed that the C-CAB with Aprotinin group\u27s mean cost was $8559.13 (statistical difference [SD] of$1056.61; 95% confidence interval[CI] was reported as $8164.58 for lower bound and$8953.67 for the upper bound). The C-CAB with Amicar group\u27s mean cost was $9096.40 (SD of$1859.16; 95% CI was reported as $8402.17 for lower bound and$9790.62 for upper bound). The OPCAB group\u27s mean cost was reported as $8442.86 (SD of$1482.63; 95% CI was reported as $7621.81 for lower bound and$9263.92 for upper bound). The O.R. supply costs showed that the C-CAB with Aprotinin group\u27s mean cost was $3889.66 (SD of$685.91; 95% Cl was reported as $3633.54 for the lower bound and$4145.79 for the upper bound). The C-CAB with Amicar group\u27s mean cost was $3934.30 (SD of$1198.46; 95% CI was reported as $3486. 78 for the lower bound and$4381.81 for the upper bound). The OPCAB group\u27s mean cost was $4014.13 (SD of$1084. 77; 95% CI was reported as $3413.40 for the lower bound and$4614.86 for the upper bound). The pharmacy costs showed that the C-CAB with Aprotinin group\u27s mean cost was $2553.76 (SD of$1305.61; 95% CI was reported as $2066.24 for the lower bound and$3041.29 for the upper bound). The C-CAB with Amicar group\u27s mean cost was $2654.33 (SD of$3502.66; 95% CI was reported as $1346.41 for the lower bound and$3962.25 for the upper bound). The OPCAB group\u27s cost was reported as a mean of $1710.93 (SD of$1147.01; 95% CI was reported as $1075.73 for the lower bound and$2346.13 for the upper bound)

Observations on Short-Term and Long-Range Plans for Technology Transfer to State and Local Governments

Efforts to apply the scientific and technical resources of the hundreds of Federal laboratories to the solving of technical problems of industry, State and local governments have met with only limited success. In part, this is because of lack of understanding of how to bridge the gap between highly sophisticated sources of technical information and users less skilled in technical pursuits. The National Science Foundation, in cooperation with many of the major public interest groups, has been initiating and evaluating a number of networks to bridge the gap. It has also worked with State and local governments to improve their capabilities to define clearly their technical needs and seek solutions

Multi-Satellite Attitude Prediction program/Orbiting Solar Observatory-8 (MSAP/OSO-8) operating guide

The sun's lower corona and chromosphere and their interaction in the X-ray and ultraviolet (UV) spectral regions were investigated to better understand the transport of energy from the photosphere to the corona. The interaction between the solar electromagnetic and particle radiation and the earth's environment was studied and the background component of cosmic X-rays was discussed

The Nature of [Ar III] Bright Knots in the Crab Nebula

The kinematic and morphological properties of a string of [Ar III] bright knots in the Crab Nebula are examined using 1994 - 1999 HST WFPC-2 images of the remnant. We find that five southern [Ar III] bright knots exhibit ordinary radial motions away from the nebula's center of expansion with magnitudes consistent with their projected radial displacements. These results do not support the suggestion by MacAlpine et al.(1994) that these knots might be moving rapidly away from the Crab pulsar due to a collimated wind. The HST images also do not show that the [Ar III] knots have unusual morphologies relative to other features in the remnant. Our proper motion results, when combined with radial velocity estimates, suggest these knots have relatively low space velocities implying relatively interior remnant locations thus placing them closer to the ionizing radiation from the Crab's synchrotron nebula. This might lead to higher knot gas temperatures thereby explaining the knots' unusual line emission strengths as MacAlpine et al.(1994) suspected.Comment: 11 pages including three figures. Submitted to the Astronomical Journa

Spectroscopy and 3D imaging of the Crab nebula

Spectroscopy of the Crab nebula along different slit directions reveals the 3 dimensional structure of the optical nebula. On the basis of the linear radial expansion result first discovered by Trimble (1968), we make a 3D model of the optical emission. Results from a limited number of slit directions suggest that optical lines originate from a complicated array of wisps that are located in a rather thin shell, pierced by a jet. The jet is certainly not prominent in optical emission lines, but the direction of the piercing is consistent with the direction of the X-ray and radio jet. The shell's effective radius is ~ 79 seconds of arc, its thickness about a third of the radius and it is moving out with an average velocity 1160 km/s.Comment: 21 pages, 14 figures, submitted to ApJ, 3D movie of the Crab nebula available at http://www.fiz.uni-lj.si/~vidrih

Diluted Random Fields in Mixed Cyanide Crystals

A percolation argument and a dilute compressible random field Ising model are used to present a simple model for mixed cyanide crystals. The model reproduces quantitatively several features of the phase diagrams altough some crude approximations are made. In particular critical thresholds x_c at which ferroelastic first order transitions disappear, are calculated. Moreover, transitions are found to remain first order down to x_c for all mixtures except for bromine, for which the transition becomes continuous. All the results are in full agreement with experimental data.Comment: 8 pages, late

Localized Coating Removal Using Plastic Media Blasting

USBI, a Division of United Technologies/ is responsible for the assembly, checkout and refurbishment of the structural, guidance and recovery components of the Solid Rocket Booster (SRB) as part of the NASA Space Transportation system/ Space Shuttle. The work is performed at Kennedy Space Center/ Florida and the contract is administered by Marshall Space Flight Center (MSFC) in Huntsville/ Alabama. Figure 1 shows the SRB and associated hardware that USBI is responsible for. Recently/ a considerable effort was made to qualify the use of Plastic Media Blasting (PMB) for safely and effectively removing paint and other coatings from SRB aluminum structures. As a result of the effort an improvement was made in the design of surface finishing equipment for processing flight hardware/ in addition to a potentially patentable idea on improved plastic media composition

Electronic Correlations in Oligo-acene and -thiophene Organic Molecular Crystals

From first principles calculations we determine the Coulomb interaction between two holes on oligo-acene and -thiophene molecules in a crystal, as a function of the oligomer length. The relaxation of the molecular geometry in the presence of holes is found to be small. In contrast, the electronic polarization of the molecules that surround the charged oligomer, reduces the bare Coulomb repulsion between the holes by approximately a factor of two. In all cases the effective hole-hole repulsion is much larger than the calculated valence bandwidth, which implies that at high doping levels the properties of these organic semiconductors are determined by electron-electron correlations.Comment: 5 pages, 3 figure

Electronic properties of silica nanowires

Thin nanowires of silicon oxide were studied by pseudopotential density functional electronic structure calculations using the generalized gradient approximation. Infinite linear and zigzag Si-O chains were investigated. A wire composed of three-dimensional periodically repeated Si4O8 units was also optimized, but this structure was found to be of limited stability. The geometry, electronic structure, and Hirshfeld charges of these silicon oxide nanowires were computed. The results show that the Si-O chain is metallic, whereas the zigzag chain and the Si4O8 nanowire are insulators