Current Approaches to Improving the Value of Care: A Physician's Perspective

Evaluates the utility of judgment-based approaches to quality improvement -- pay-for-performance, public reporting, consumer-directed health plans, and tiering -- as ways to control costs. Recommends incentive- and accountability-based programs

National Register Eligibility Testing of Site 41BO184, Brazoria County, Texas

Site 41BO184 is located within the right-of-way for the proposed expansion of State Highway 35 at the Oyster Creek crossing in southern Brazoria County. It was originally recorded as a multicomponent site in 1994 and was the subject of three distinct and limited archeological investigations by Texas Department of Transportation (TxDOT) staff. In 2003, TxDOT contracted with the Center for Archaeological Research (CAR) of The University of Texas at San Antonio to test the National Register of Historic Places and State Archeological Landmark eligibility of the site. Systematic mechanical auger borings, ten hand-excavated 1-x-1-meter test units, and Gradall scrapings helped identify a very sparse Late Prehistoric, possibly Rockport, component at the site. Although it is possible that at least some of the prehistoric artifacts come from the shell-paved driveway that cross-cut the site, it is also possible that some of the prehistoric artifacts represent in situ finds. The historic component, rich in temporally diagnostic ceramic fragments, dates to the mid-nineteenth century. The lack of intact features, the small size of the artifact assemblage, and the reduced size of the available materials, severely limits the research potential of the site. Therefore, it is recommended that site 41BO184 is not eligible for listing on the National Register of Historic Places nor does it warrant designation as a State Archeological Landmark

National Register Eligibility Testing of 41MM340 and 41MM341, along Little River, Milam County, Texas

From January through March 2000, the Center for Archaeological Research, The University of Texas at San Antonio conducted National Register of Historic Places eligibility testing for archaeological sites 41MM340 and 41MM341, under contract with Texas Department of Transportation. The investigations were conducted under Texas Antiquities Permit Number 2319. The Phase II testing fieldwork consisted of excavation of 20 test units across both sites to investigate significant cultural deposits encountered during the previous survey phase. Four distinct stratified cultural zones at 41MM340 and at least two cultural zones at 41MM341 were identified during the testing efforts. In concert with the archaeological field investigations, the following special analyses and studies were performed to aid the determination of site integrity and eligibility: geoarchaeology, radiocarbon, lithic, aboriginal ceramic, vertebrate faunal, freshwater mussel shell, macrobotanical, pollen, phytolith, land snail shell, amino acid racemization, and diatom. The synthesis of these analyses has provided adequate data to determine temporal integrity and recommendation of National Register eligibility for both sites. Further cultural resources investigations in the form of Phase III data recovery excavations are thus recommended for both sites prior to development

Low frequency VLBI in space using GAS-Can satellites: Report on the May 1987 JPL Workshop

Summarized are the results of a workshop held at JPL on May 28 and 29, 1987, to study the feasibility of using small, very inexpensive spacecraft for a low-frequency radio interferometer array. Many technical aspects of a mission to produce high angular resolution images of the entire sky at frequencies from 2 to 20 MHz were discussed. The workshop conclusion was that such a mission was scientifically valuable and technically practical. A useful array could be based on six or more satellites no larger than those launched from Get-Away-Special canisters. The cost of each satellite could be $1-2M, and the mass less than 90 kg. Many details require further study, but as this report shows, there is good reason to proceed. No fundamental problems have been discovered involving the use of untraditional, very inexpensive spacecraft for this type of mission

The Medio Creek Site (41BX1421): National Register Test Excavations, Bexar County Texas

During April 2001, the Center for Archaeological Research of The University of Texas at San Antonio conducted National Register of Historic Places eligibility testing for archeological site 41BX1421, located in southwest Bexar County, Texas, under contract with the Texas Department of Transportation. The investigations were conducted under Texas Antiquities Permit Number 2569. The Phase II testing fieldwork consisted of excavation of five test units across the site to investigate cultural deposits encountered during the previous survey phase. A single sheet midden consisting of burned limestone cobbles was encountered across the majority of the site. In concert with the archeological field investigations, the following special analyses and studies were performed to aid the determination of site integrity and eligibility: radiocarbon, lithic, aboriginal ceramic, vertebrate faunal. and magnetic sediment susceptibility. The synthesis of these analyses has provided adequate data to determine 41BX1421 ineligible for the National Register of Historic Places. It is therefore recommended that the Loop 1604 improvements proceed without further cultural resources investigations

Random Projections For Large-Scale Regression

Fitting linear regression models can be computationally very expensive in large-scale data analysis tasks if the sample size and the number of variables are very large. Random projections are extensively used as a dimension reduction tool in machine learning and statistics. We discuss the applications of random projections in linear regression problems, developed to decrease computational costs, and give an overview of the theoretical guarantees of the generalization error. It can be shown that the combination of random projections with least squares regression leads to similar recovery as ridge regression and principal component regression. We also discuss possible improvements when averaging over multiple random projections, an approach that lends itself easily to parallel implementation.Comment: 13 pages, 3 Figure

Archeological Data Recovery Excavations along Becerra Creek (41WB556), Webb County, Texas

From June through August 2000, The Center for Archaeological Research of The University of Texas at San Antonio conducted archeological data recovery for prehistoric site 41WB556, under contract with Texas Department of Transportation. The investigations were conducted under Texas Antiquities Permit Number 2412. The Phase III data recovery consisted of excavation of 64 1-m2 units across the site in order to investigate significant cultural deposits encountered during the previous survey and testing phases. In concert with the archeological field investigations, the following special analyses and studies were performed to aid the determination of site integrity and chronology: geoarcheology, radiocarbon dating, lithic, lipid residue, vertebrate faunal, carbon/nitrogen isotope, macrobotanical, and magnetic soil susceptibility. The synthesis of these analyses provides substantive insights into the lifeways of the region’s prehistoric hunter-gatherers

Caloric restriction in C57BL/6J mice mimics therapeutic fasting in humans

BACKGROUND: Caloric restriction (CR) has long been recognized as a dietary therapy that improves health and increases longevity. Little is known about the persistent effects of CR on plasma biomarkers (glucose, ketone bodies, and lipids) following re-feeding in mice. It is also unclear how these biomarker changes in calorically restricted mice relate to those observed previously in calorically restricted humans. RESULTS: Three groups of individually housed adult female C57BL/6J (B6) mice (n = 4/group) were fed a standard rodent chow diet either: (1) unrestricted (UR); (2) restricted for three weeks to reduce body weight by approximately 15–20% (R); or (3) restricted for three weeks and then re-fed unrestricted (ad libitum) for an additional three weeks (R-RF). Body weight and food intake were measured throughout the study, while plasma lipids and levels of glucose and ketone bodies (β-hydroxybutyrate) were measured at the termination of the study. Plasma glucose, phosphatidylcholine, cholesterol, and triglycerides were significantly lower in the R mice than in the UR mice. In contrast, plasma fatty acids and β-hydroxybutyrate were significantly higher in the R mice than in the UR mice. CR had no effect on plasma phosphatidylinositol levels. While body weight and plasma lipids of the R-RF mice returned to unrestricted levels upon re-feeding, food intake and glucose levels remained significantly lower than those prior to the initiation of CR. CONCLUSION: CR establishes a new homeostatic state in B6 mice that persists for at least three weeks following ad libitum re-feeding. Moreover, the plasma biomarker changes observed in B6 mice during CR mimic those reported in humans on very low calorie diets or during therapeutic fasting

PCV53 COST ANALYSIS ON ANTICOAGULANT DRUG MARKET

Primer pla d'una finestra de fusta situada al costat dret d'un petit altar de pedra blanca, a la torre de Sant Rafael al Monestir de Pedralbes

Insourcing Health Care Innovation

Many health care professionals find it irritating when management gurus recommend solving health care\u27s problems with approaches they would “copy and paste” from unrelated industries — a former chief executive of a manufacturing company claims that the same simple lessons that enabled him to transform his own industry can improve value in health care, or a business-school professor offers an eight-point leadership plan that she\u27s translated into health care as easily as if she\u27d translated it into French. Many people who work in health care value outside perspectives and are open to new approaches — and yet bristle at facile recommendations emerging from these translations