Expanded health data from the new birth certificate, 2006

by Michelle J.K. Osterman, Joyce A. Martin, and Fay Menacker.Objectives: This report presents 2006 data on new checkbox items exclusive to the 2003 U.S. Standard Certificate of Live Birth. Information is shown for checkboxes in the following categories: "risk factors in this pregnancy," "obstetric procedures," "characteristics of labor and delivery," "method of delivery," "abnormal conditions of the newborn," and "congenital anomalies of the newborn." These categories are included on both the 1989 and the 2003 U.S. Standard Certificates of Live Birth; however, many of the specific checkboxes were modified, or are new to the 2003 certificate. Data on selected new (not modified) checkboxes are presented in this report.Methods: Descriptive statistics are presented on births occurring in 2006 to residents of the 19 states that had implemented the 2003 U.S. Standard Certificate of Live Birth as of January 1, 2006.Results: There were 2,073,368 births to residents of the 19-state reporting area, representing 49 percent of 2006 U.S. births. The rate of prepregnancy diabetes was 6.8 per 1,000 births and gestational diabetes was 38.7; risk of both types of diabetes rose rapidly with advancing maternal age. Cervical cerclage was reported at a rate of 2.9 per 1,000. External cephalic version was used in 3.2 of every 1,000 births; its success rate decreased with increasing maternal age. Almost all attempts at forceps or vacuum delivery were successful. About 25 percent of women who had a cesarean delivery attempted a trial of labor. Fifteen percent of women received antibiotics during labor. Rates for antenatal steroids (8.4) and surfactant replacement therapy (3.2) decreased with increasing gestational age. Large differences by race and Hispanic origin were generally seen for the receipt of steroids and surfactant replacement therapy regardless of gestational age. Six percent of all infants were admitted to a neonatal intensive care unit (NICU).Includes bibliographical references (p. 10-11).2008519

Geographic and Age-Based Variations in Medicare Reimbursement Among ASSH Members.

Background: The purpose of this study was to investigate how American Society for Surgery of the Hand (ASSH) members\u27 Medicare reimbursement depends on their geographical location and number of years in practice. Methods: Demographic data for surgeons who were active members of the ASSH in 2012 were obtained using information publicly available through the US Centers for Medicare and Medicaid Services (CMS). Hand-surgeons-per-capita and average reimbursement per surgeon were calculated for each state. Regression analysis was performed to determine a relationship between (1) each state\u27s average reimbursement versus the number of ASSH members in that state, (2) average reimbursement versus number of hand surgeons per capita, and (3) total reimbursement from Medicare versus number of years in practice. Analysis of variance (ANOVA) was used to detect a difference in reimbursement based on categorical range of years as an ASSH member. Results: A total of 1667 ASSH members satisfied inclusion in this study. Although there was significant variation among states\u27 average reimbursement, reimbursement was not significantly correlated with the state\u27s hand surgeons per capita or total number of hand surgeons in that given state. Correlation between years as an ASSH member and average reimbursement was significant but non-linear; the highest reimbursements were seen in surgeons who had been ASSH members from 8 to 20 years. Conclusions: Peak reimbursement from Medicare for ASSH members appears to be related to the time of surgeons\u27 peak operative volume, rather than any age-based bias for or against treating Medicare beneficiaries. In addition, though geographic variation in reimbursement does exist, this does not appear to correlate with density or availability of hand surgeons

A 12.5 GHz-Spaced Optical Frequency Comb Spanning >400 nm for near-Infrared Astronomical Spectrograph Calibration

A 12.5 GHz-spaced optical frequency comb locked to a Global Positioning disciplined oscillator for near-IR spectrograph calibration is presented. The comb is generated via filtering a 250 MHz-spaced comb. Subsequency nonlinear broadening of the 12.5 GHz comb extends the wavelength range to cover 1380 nm to 1820 nm, providing complete coverage over the H-band transmission widow of Earth's atmosphere. Finite suppression of spurious sidemodes, optical linewidth and instability of the comb have been examined to estmiate potential wavelength biases in spectrograph calibration. Sidemode suppression varies between 20 db and 45 dB, and the optical linewidth is ~350 kHz at 1550 nm. The comb frequency uncertainty is bounded by +/- 30 kHz (corresponding to a radial velocity of +/- 5 cm/s), limited by the Global Positioning System disciplined oscillator reference. These results indicate this comb can readily support radial velocity measurements below 1 m/s in the near-IR.Comment: 16 pages, 12 figures, new file fixes some readability problems on Mac

Managed moves: schools collaborating for collective gain

Government guidance in the United Kingdom encourages groups of schools to take collective responsibility for supporting and making provision for excluded pupils and those at risk of exclusion. Managed-moves are one way that some schools and authorities are enacting such guidance. This paper presents the results of an evaluation of one such scheme. The scheme, involving seven neighbouring secondary schools, was nearing its first year of completion. The paper draws primarily on interview data with pupils, parents and school staff to describe a number of positive outcomes associated with the scheme and to explore how these were achieved. We found that while some of these could be attributed directly to the managed-move, others arose from the more inclusive ethos and practices of particular schools. The concepts of tailored support, care and commitment emerged as strong themes that underpinned the various practical ways in which some schools in the cluster were able to re-engage 'at-risk' pupils. As managed moves become more widely practiced it will be important to remember that it is how the move proceeds and develops rather than the move itself that will ultimately make the difference for troubled and troublesome pupils

Concentration of rocuronium in cerebrospinal fluid of patients undergoing cerebral aneurysm clipping†

Background. This study assessed the concentration of rocuronium in the cerebrospinal fluid (CSF) of patients undergoing cerebral aneurysm clipping, and investigated whether the mode of administration (single bolus vs continuous infusion) influenced the CSF concentration. Methods. Twenty patients with subarachnoid haemorrhage were randomly allocated to receive a bolus dose (bolus group), or a bolus followed by a continuous infusion of rocuronium (infusion group) (n=10 for each group). Arterial blood and ventricular CSF were sampled 2 h after the rocuronium bolus. Samples were analysed by liquid chromatography electrospray ionization‐tandem mass spectrometry. Results. Rocuronium could be detected in all the CSF samples. The mean (range) CSF concentration was 2.2 (0.9-4.6) ng ml-1 in the bolus group and 12.4 (2.4-34.6) ng ml-1 in the infusion group; P<0.01. Conclusions. This study demonstrated that rocuronium, normally not considered to cross the blood-brain barrier, is regularly found in the CSF of patients undergoing cerebral clipping; continuous infusion of the drug led to higher plasma and CSF concentrations than after a single bolus dose. Br J Anaesth 2004; 92: 419-2

Parasite Occurrence and Parasite Management in Swedish Horses Presenting with Gastrointestinal Disease - A Case-Control Study

Simple Summary: Abdominal pain, colic, is a common clinical sign in horses, sometimes reflecting life-threatening disease. One cause of colic is parasitic infection of the gut. Various drugs, anthelmintics, can be used to reduce or eliminate such parasites. However, frequent use has led to problems of drug resistance, whereby many countries now allow anthelmintics to be used on a prescription-only basis. In Sweden, this has led to a concern that parasitic-related colic in horses is increasing. This study aimed to investigate whether horses with colic differed in parasitological status compared to horses without colic. A secondary aim was to collect information regarding current parasite control measures used by horse owners. Exposure to S. vulgaris, a parasite with the potential to cause life-threatening disease, appeared high as determined by the presence of antibodies in the blood. Horses with inflammation in the abdominal cavity had higher antibody levels than other causes of colic. Despite new legislation, 29% of owners did not use fecal analyses for parasites and the use of extended methods to diagnose specific parasites was low. Also, owners rarely used alternative methods to reduce the pasture parasite burden. The study suggests a need for education in the use of both fecal analyses and pasture management.Abstract All grazing horses are exposed to intestinal parasites, which have the potential to cause gastrointestinal disease. In Sweden, there is a concern about an increase in parasite-related equine gastrointestinal disease, in particular Strongylus vulgaris, since the implementation of prescription-only anthelmintics approximately 10 years ago. In a prospective case-control study, parasitological status, using fecal analyses for strongyle egg counts, the presence of Anoplocephala perfoliata eggs and S. vulgaris Polymerase chain reaction (PCR) as well as serology for S. vulgaris, were compared between horses presenting with or without gastrointestinal disease at a University hospital during a one-year period. Information regarding anthelmintic routines and pasture management was gathered with an owner-filled questionnaire. Although the prevalence of S. vulgaris PCR was 5.5%, 62% of horses were positive in the enzyme-linked immunosorbent assay (ELISA) test and horses with peritonitis showed higher antibody levels for S. vulgaris, as compared to other diagnoses or controls. Overall, 36% of the horse owners used only fecal egg counts (FEC), 32% used FEC combined with specific diagnostics for S. vulgaris or A. perfoliata, and 29% dewormed routinely without prior parasite diagnostics. Effective management methods to reduce the parasitic burden on pastures were rare and considering exposure to S. vulgaris appears high; the study indicates a need for education in specific fecal diagnostics and pasture management

Validation of northern latitude Tropospheric Emission Spectrometer stare ozone profiles with ARC-IONS sondes during ARCTAS: sensitivity, bias and error analysis

We compare Tropospheric Emission Spectrometer (TES) versions 3 and 4, V003 and V004, respectively, nadir-stare ozone profiles with ozonesonde profiles from the Arctic Intensive Ozonesonde Network Study (ARCIONS, http://croc.gsfc.nasa.gov/arcions/ during the Arctic Research on the Composition of the Troposphere from Aircraft and Satellites (ARCTAS) field mission. The ozonesonde data are from launches timed to match Aura's overpass, where 11 coincidences spanned 44° N to 71° N from April to July 2008. Using the TES "stare" observation mode, 32 observations are taken over each coincidental ozonesonde launch. By effectively sampling the same air mass 32 times, comparisons are made between the empirically-calculated random errors to the expected random errors from measurement noise, temperature and interfering species, such as water. This study represents the first validation of high latitude (>70°) TES ozone. We find that the calculated errors are consistent with the actual errors with a similar vertical distribution that varies between 5% and 20% for V003 and V004 TES data. In general, TES ozone profiles are positively biased (by less than 15%) from the surface to the upper-troposphere (~1000 to 100 hPa) and negatively biased (by less than 20%) from the upper-troposphere to the lower-stratosphere (100 to 30 hPa) when compared to the ozonesonde data. Lastly, for V003 and V004 TES data between 44° N and 71° N there is variability in the mean biases (from −14 to +15%), mean theoretical errors (from 6 to 13%), and mean random errors (from 9 to 19%)

Mass and Angular Momentum Transfer in the Massive Algol Binary RY Persei

We present an investigation of H-alpha emission line variations observed in the massive Algol binary, RY Per. We give new radial velocity data for the secondary based upon our optical spectra and for the primary based upon high dispersion UV spectra. We present revised orbital elements and an estimate of the primary's projected rotational velocity (which indicates that the primary is rotating 7 times faster than synchronous). We use a Doppler tomography algorithm to reconstruct the individual primary and secondary spectra in the region of H-alpha, and we subtract the latter from each of our observations to obtain profiles of the primary and its disk alone. Our H-alpha observations of RY Per show that the mass gaining primary is surrounded by a persistent but time variable accretion disk. The profile that is observed outside-of-eclipse has weak, double-peaked emission flanking a deep central absorption, and we find that these properties can be reproduced by a disk model that includes the absorption of photospheric light by the band of the disk seen in projection against the face of the star. We developed a new method to reconstruct the disk surface density distribution from the ensemble of H-alpha profiles observed around the orbit, and this method accounts for the effects of disk occultation by the stellar components, the obscuration of the primary by the disk, and flux contributions from optically thick disk elements. The resulting surface density distribution is elongated along the axis joining the stars, in the same way as seen in hydrodynamical simulations of gas flows that strike the mass gainer near trailing edge of the star. This type of gas stream configuration is optimal for the transfer of angular momentum, and we show that rapid rotation is found in other Algols that have passed through a similar stage.Comment: 39 pages, 12 figures, ApJ in press, 2004 June 20 issu

Long-term stability of TES satellite radiance measurements

The utilization of Tropospheric Emission Spectrometer (TES) Level 2 (L2) retrieval products for the purpose of assessing long term changes in atmospheric trace gas composition requires knowledge of the overall radiometric stability of the Level 1B (L1B) radiances. The purpose of this study is to evaluate the stability of the radiometric calibration of the TES instrument by analyzing the difference between measured and calculated brightness temperatures in selected window regions of the spectrum. The Global Modeling and Assimilation Office (GMAO) profiles for temperature and water vapor and the Real-Time Global Sea Surface Temperature (RTGSST) are used as input to the Optimal Spectral Sampling (OSS) radiative transfer model to calculate the simulated spectra. The TES reference measurements selected cover a 4-year period of time from mid 2005 through mid 2009 with the selection criteria being; observation latitudes greater than −30° and less than 30°, over ocean, Global Survey mode (nadir view) and retrieved cloud optical depth of less than or equal to 0.01. The TES cloud optical depth retrievals are used only for screening purposes and no effects of clouds on the radiances are included in the forward model. This initial screening results in over 55 000 potential reference spectra spanning the four year period. Presented is a trend analysis of the time series of the residuals (observation minus calculations) in the TES 2B1, 1B2, 2A1, and 1A1 bands, with the standard deviation of the residuals being approximately equal to 0.6 K for bands 2B1, 1B2, 2A1, and 0.9 K for band 1A1. The analysis demonstrates that the trend in the residuals is not significantly different from zero over the 4-year period. This is one method used to demonstrate that the relative radiometric calibration is stable over time, which is very important for any longer term analysis of TES retrieved products (L2), particularly well-mixed species such as carbon dioxide and methane