New Opportunities for Integrating and Improving Health Care for Women, Children, and Their Families

Outlines provisions in the Affordable Care Act for integrating healthcare services for low-income women and children to improve outcomes and cut costs. Examines public-private partnerships and other efforts in Colorado, Florida, Ohio, and Vermont

U.S. Variations in Child Health System Performance: A State Scorecard

Ranks state child health systems on thirteen measurements of five dimensions: access, quality, costs, equity, and potential to lead healthy lives. Highlights variations, regional patterns, and correlations between indicators and with demographic factors

Health Care Opinion Leaders' Views on Health Reform and the Role of States

Presents findings of a survey of experts about the relative authority of states and the federal government over the individual mandate, health insurance exchanges, provider payment methods, and other reform provisions and barriers to implementation

Securing a Healthy Future: The Commonwealth Fund State Scorecard on Child Health System Performance, 2011

Ranks states on twenty indicators of healthcare access, affordability, prevention and treatment, potential for healthy lives, and health system equity for children. Examines the need for targeted initiatives and policy implications for better performance

Steam generator tube rupture study

This report describes our investigation of steam generator behavior during a postulated tube rupture accident. Our study was performed using the steam generator, thermal-hydraulic analysis code THERMIT-UTSG. The purpose of our work was to provide an independent assessment of the Los Alamos National Laboratory system code TRAC-PF1 with respect to steam generator tube rupture analysis. Results of our work are presented and compared with previous TRAC-PF1 results. There are substantial differences in the results of the two codes. These discrepancies are discussed and deficiencies in both codes are noted. Our results lead us to believe that further investigation and code development are necessary to gain more than a basic understanding of steam generator behavior during such accidents and to provide a simulation capability that is acceptable

A four-equation two-phase flow model for sodium boiling simulation of LMFBR fuel assemblies

A three-dimensional numerical model for the simulation of sodium boiling transients has been developed. The model uses mixture mass and energy equations, while employing a separate momentum equation for each phase. Thermal equilibrium on the saturation line between coexisting phases is assumed.The four governing equations are supplemented by a number of constitutive relations, addressing the interphase and intraphase exchanges, as well as the fluid-solid interactions. It should be noted that this four-equation two-phase flow model requires only one interfacial relation, i.e., the momentum exchange, compared to the six-equation model which needs two additional relations, describing the mass and energy exchanges. Consequently, the relatively high degree of uncertainty currently associated with the interfacial exchange phenomena is considerably reduced.From a numerical point of view, the basic approach in this work is a semi-implicit method, in which pressure pulse propagation and local effects characterized by short characteristic times are treated implicitly, while convective transport and diffusion heat transfer phenomena, associated with longer time constants, are handled explicitly. The method remains tractable and efficient in multidimensional applications.Simulation of a number of experiments has yielded very encouraging results. The numerical method and the constitutive relations have performed well, especially so in light of the extreme severity of the conditions involving sodium boiling

The numerical treatment of condensation.

The simulation of complete condensation continues to challenge the numerical methods currently used for multi-phase flow modeling; especially at low pressures, the change of phase process from a two-phase mixture to liquid leads to severe pressure field perturbations and often failure of the calculations. During condensation, the local void fraction and pressure decrease rapidly; at the time of complete condensation, the strong nonlinearities of the equations at the phase-change point lead to convergence difficulties and/or unacceptably large mass or energy errors.Various ad-hoc "fixes" for this phenomenon - often referred to as "water packing" - have been proposed and/or implemented over the last few years. However, they have failed to clarify the core of the problem and are still unsatisfactory. Indeed these solutions cast doubt on the numerical predictions and occasionally are unable to prevent the breakdown of the calculations.The present investigations have focused on the roots of these difficulties, particularly on the nonlinear effects involved. A time-step control strategy was developed which removes or at least, greatly mitigates the aforementioned computational problems. Numerical experiments as well as a mathematical analysis have both demonstrated the existence of a critical time-step size beyond which larger time-steps shall accommodate the liquid flow field to any perturbations; smaller time-steps shall cause the pressure to bounce, going out of range as it is indeed witnessed for condensation simulations where the time-steps are drastically reduced when the two phases are still coexisting.Similar studies have been conduced on variety of numerical methods yielding some unexpected results in terms of time-step limit.Sponsored by Northeast Utilities Co., Foxboro Co

Extracellular vesicles: structure, function, and potential clinical uses in renal diseases

Interest in the role of extracellular vesicles in various diseases including cancer has been increasing. Extracellular vesicles include microvesicles, exosomes, apoptotic bodies, and argosomes, and are classified by size, content, synthesis, and function. Currently, the best characterized are exosomes and microvesicles. Exosomes are small vesicles (40- 100 nm) involved in intercellular communication regardless of the distance between them. They are found in various biological fluids such as plasma, serum, and breast milk, and are formed from multivesicular bodies through the inward budding of the endosome membrane. Microvesicles are 100-1000 nm vesicles released from the cell by the outward budding of the plasma membrane. the therapeutic potential of extracellular vesicles is very broad, with applications including a route of drug delivery and as biomarkers for diagnosis. Extracellular vesicles extracted from stem cells may be used for treatment of many diseases including kidney diseases. This review highlights mechanisms of synthesis and function, and the potential uses of wellcharacterized extracellular vesicles, mainly exosomes, with a special focus on renal functions and diseases.Univ Fed Paulista, Dept Med, Div Nefrol, Escola Paulista Med, São Paulo, BrazilUniv Cruzeiro Sul, Programa Posgrad Ciencias Saude Ciencias Biol & S, São Paulo, BrazilUniv Fed Paulista, Dept Med, Div Nefrol, Escola Paulista Med, São Paulo, BrazilWeb of Scienc

Stimulation by a low-molecular-weight angiogenic factor of capillary endothelial cells in culture.

A low-mol.-wt compound isolated from rat Walker 256 carcinoma and found to induce neovascularization in vivo was tested on cultures of cow brain-derived endothelial cells (CBEC) growing on plastic and collagen substrates. This factor had a mitogenic effect on CBEC cultured on native collagen gels and for this reason has been called "endothelial-cell-stimulating angiogenesis factor" (ESAF). CBEC growing on plastic culture dishes or denatured collagen films were not stimulated by ESAF. The mitogenic effect of ESAF was equally apparent when added to cells already attached to the native collagen substrate or when the collagen substrate was pre-incubated with ESAF before plating the cells. A floating collagen gel pre-incubated with ESAF in cultures of CBEC growing on plastic dishes did not stimulate cell growth. Our data indicate that the substrate influences cell behaviour and that CBEC only respond to ESAF when growing on a native collagen substrate

Advanced information processing system for advanced launch system: Avionics architecture synthesis

The Advanced Information Processing System (AIPS) is a fault-tolerant distributed computer system architecture that was developed to meet the real time computational needs of advanced aerospace vehicles. One such vehicle is the Advanced Launch System (ALS) being developed jointly by NASA and the Department of Defense to launch heavy payloads into low earth orbit at one tenth the cost (per pound of payload) of the current launch vehicles. An avionics architecture that utilizes the AIPS hardware and software building blocks was synthesized for ALS. The AIPS for ALS architecture synthesis process starting with the ALS mission requirements and ending with an analysis of the candidate ALS avionics architecture is described