Reimbursement Strategies and CPT Codes for Device Development

Reimbursement refers to the complicated process by which physicians and hospitals deliver products and services and then receive payment from third-party payers. Reimbursement consists of three factors: coding, coverage, and payment. The Current Procedural Terminology (CPT) codes include category I, II, and III codes, each with a different purpose and criteria. Requesting a new CPT code for a new device is a complicated and lengthy process, so an early understanding of the process is important to identifying the necessary resources. Working with CPT code consultants and a medical specialty society can help a startup obtain new CPT codes to ensure reimbursement for new medical devices, or determine if the new device fits within an existing CPT code

Peer Observation and Evaluation Tool (POET): A Formative Peer Review Supporting Scholarly Teaching

The Peer Observation and Evaluation Tool (POET) is a valid and reliable measure developed for formative peer evaluation of pharmacy faculty. The authors replicated a study conducted on the POET in pharmacy in order to report the instrument’s validity and reliability in occupational therapy and to explore its potential as a formative teaching evaluation for occupational therapy educators. To verify item importance, seven participants from the faculty in an occupational therapy department rated each item. To establish inter-rater reliability, the participants evaluated one videotaped 55 min lecture. The POET was reliable with ICC at 0.93. There were high levels of agreement with the importance ratings among the participants with all scales. The POET appears to be a valid and reliable formative measure of teaching. At a time of significant change in the level of occupational therapy education, this measure may be an important support for scholarly teaching in two ways: First, this measure offers several opportunities to document the instructor’s strengths and, second, it offers the instructor suggestions about ways to improve teaching quality. Finally, the POET may facilitate faculty professional growth and development through systematic, strategic, and constructive peer review feedback

Design of Composite Laminates Containing Pin Loaded Holes

Methods are presented for sizing composite laminates containing one, two, or several pin loaded holes, the holes being arranged either in a single row or in two parallel rows. It is shown how the design parameters (number of holes, hole diameter, hole positions) can be found, which result in the maximum failure load and in the max imum failure load per unit weight.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68243/2/10.1177_002199838401800306.pd

Low momentum nucleon-nucleon potential and shell model effective interactions

A low momentum nucleon-nucleon (NN) potential V-low-k is derived from meson exhange potentials by integrating out the model dependent high momentum modes of V_NN. The smooth and approximately unique V-low-k is used as input for shell model calculations instead of the usual Brueckner G matrix. Such an approach eliminates the nuclear mass dependence of the input interaction one finds in the G matrix approach, allowing the same input interaction to be used in different nuclear regions. Shell model calculations of 18O, 134Te and 135I using the same input V-low-k have been performed. For cut-off momentum Lambda in the vicinity of 2 fm-1, our calculated low-lying spectra for these nuclei are in good agreement with experiments, and are weakly dependent on Lambda.Comment: 5 pages, 5 figure

Investigating On-Orbit Attitude Determination Anomalies for the Solar Dynamics Observatory Mission

The Solar Dynamics Observatory (SDO) was launched on February 11, 2010 from Kennedy Space Center on an Atlas V launch vehicle into a geosynchronous transfer orbit. SDO carries a suite of three scientific instruments, whose observations are intended to promote a more complete understanding of the Sun and its effects on the Earth's environment. After a successful launch, separation, and initial Sun acquisition, the launch and flight operations teams dove into a commissioning campaign that included, among other things, checkout and calibration of the fine attitude sensors and checkout of the Kalman filter (KF) and the spacecraft s inertial pointing and science control modes. In addition, initial calibration of the science instruments was also accomplished. During that process of KF and controller checkout, several interesting observations were noticed and investigated. The SDO fine attitude sensors consist of one Adcole Digital Sun Sensor (DSS), two Galileo Avionica (GA) quaternion-output Star Trackers (STs), and three Kearfott Two-Axis Rate Assemblies (hereafter called inertial reference units, or IRUs). Initial checkout of the fine attitude sensors indicated that all sensors appeared to be functioning properly. Initial calibration maneuvers were planned and executed to update scale factors, drift rate biases, and alignments of the IRUs. After updating the IRU parameters, the KF was initialized and quickly reached convergence. Over the next few hours, it became apparent that there was an oscillation in the sensor residuals and the KF estimation of the IRU bias. A concentrated investigation ensued to determine the cause of the oscillations, their effect on mission requirements, and how to mitigate them. The ensuing analysis determined that the oscillations seen were, in fact, due to an oscillation in the IRU biases. The low frequencies of the oscillations passed through the KF, were well within the controller bandwidth, and therefore the spacecraft was actually following the oscillating biases, resulting in movement of the spacecraft on the order of plus or minus 20 arcsec. Though this level of error met the ACS attitude knowledge requirement of [35, 70, 70] arcsec, 3 sigma, the desire of the ACS and instrument teams was to remove as much of the oscillation as possible. The Kearfott IRUs have an internal temperature controller, designed to maintain the IRU temperature at a constant temperature of approximately 70 C, thus minimizing the change in the bias drift and scale factors of the mechanical gyros. During ground testing of the observatory, it was discovered that the 83-Hz control cycle of the IRU heaters put a tremendous amount of stress on the spacecraft battery. Analysis by the power systems team indicated that the constant charge/discharge on the battery due to the IRU thermal control cycle could potentially limit the life of the battery. After much analysis, the decision was made not to run the internal IRU heaters. Analysis of on orbit data revealed that the oscillations in the IRU bias had a connection to the temperature of the IRU; changes in IRU temperature resulted in changes in the amplitude and period of the IRU biases. Several mitigating solutions were investigated, the result of which was to tune the KF with larger IRU noise assumptions which allows the KF to follow and correct for the time-varying IRU biases

Using residential segregation to predict colorectal cancer stage at diagnosis: two different approaches

Studies have found a variety of evidence regarding the association between residential segregation measures and health outcomes in the US. Some have focused on any individuals living in residentially segregated places, while others have examined whether persons of specific races or ethnicities living in places with high segregation of their own race or ethnicity have differential outcomes. This paper compares and contrasts these two approaches in the study of predictors of late-stage CRC diagnoses in a cross-national study. We argue that it is very important when interpreting results from studies like this to carefully consider the geographic scope of the analysis, which can significantly change the context and meaning of the results

On the origin of non-monotonic doping dependence of the in-plane resistivity anisotropy in Ba(Fe1−xTx_{1-x}T_x)2_2As2_2, TT = Co, Ni and Cu

The in-plane resistivity anisotropy has been measured for detwinned single crystals of Ba(Fe$_{1-x}$Ni$_x$)$_2$As$_2$ and Ba(Fe$_{1-x}$Cu$_x$)$_2$As$_2$. The data reveal a non-monotonic doping dependence, similar to previous observations for Ba(Fe$_{1-x}$Co$_x$)$_2$As$_2$. Magnetotransport measurements of the parent compound reveal a non-linear Hall coefficient and a strong linear term in the transverse magnetoresistance. Both effects are rapidly suppressed with chemical substitution over a similar compositional range as the onset of the large in-plane resistivity anisotropy. It is suggested that the relatively small in-plane anisotropy of the parent compound in the spin density wave state is due to the presence of an isotropic, high mobility pocket of reconstructed Fermi surface. Progressive suppression of the contribution to the conductivity arising from this isotropic pocket with chemical substitution eventually reveals the underlying in-plane anisotropy associated with the remaining FS pockets.Comment: 12 pages, 9 figure

Modeling Geospatial Patterns of Late-Stage Diagnosis of Breast Cancer in the US

In the US, about one-third of new breast cancers (BCs) are diagnosed at a late stage, where morbidity and mortality burdens are higher. Health outcomes research has focused on the contribution of measures of social support, particularly the residential isolation or segregation index, on propensity to utilize mammography and rates of late-stage diagnoses. Although inconsistent, studies have used various approaches and shown that residential segregation may play an important role in cancer morbidities and mortality. Some have focused on any individuals living in residentially segregated places (place-centered), while others have focused on persons of specific races or ethnicities living in places with high segregation of their own race or ethnicity (person-centered). This paper compares and contrasts these two approaches in the study of predictors of late-stage BC diagnoses in a cross-national study. We use 100% of U.S. Cancer Statistics (USCS) Registry data pooled together from 40 states to identify late-stage diagnoses among ~1 million new BC cases diagnosed during 2004–2009. We estimate a multilevel model with person-, county-, and state-level predictors and a random intercept specification to help ensure robust effect estimates. Person-level variables in both models suggest that non-White races or ethnicities have higher odds of late-stage diagnosis, and the odds of late-stage diagnosis decline with age, being highest among the <age 50 group. After controlling statistically for all other factors, we examine place-centered isolation and find for anyone living in an isolated Asian community there is a large beneficial association (suggesting lower odds of late-stage diagnosis) while for anyone living in an isolated White community there is a large detrimental association (suggesting greater odds of late-stage diagnosis). By contrast, living in neighborhoods among others of one’s own race or ethnicity (person-centered isolation) is associated with greater odds of late-stage diagnosis, as this measure is dominated by Whites (the majority). At the state level, living in a state that allows unfettered access to a specialist is associated with a somewhat lower likelihood of being diagnosed at a late stage of BC. Geographic factors help explain the likelihood of late-stage BC diagnosis, which varies considerably across the U.S. as heterogeneous compositional and contextual factors portray very different places and potential for improving information and outcomes. The USCS database is expanding to cover more states and is expected to be a valuable resource for ongoing and future place-based cancer outcomes research