The analysis of TRICARE Navy obstetric delivery costs within continental United States military treatment facilities

MBA Professional ReportNavy medicine spends approximately $75 million on purchased obstetric (OB) care for Navy personnel and their dependents, a sum that continues to increase each year. The purpose of this research is to compare the cost of Navy OB medical care under TRICARE Prime (civilian sector) with similar care provided in four representative Navy Medical Treatment Facilities (MTF). Specifically, the study will examine (1) the quantity of selected deliveries in TRICARE and four specific MTF catchment areas; (2) the average delivery cost for the different types of Purchased Care (PC) deliveries, and (3) best practice techniques to increase the amount of Direct Care (DC) deliveries care in Navy Medicine. The goal of this study is to compare the benefits and drawbacks of each system to gain insights for providing better and more cost-effective OB care in the Navy.http://archive.org/details/thenalysisoftric1094510397Approved for public release; distribution is unlimited

Isolation of a Collagenase cDNA Clone and Measurement of Changing Collagenase mRNA Levels during Induction in Rabbit Synovial Fibroblasts.

To facilitate our studies on the mechanisms controlling collagenase production at a molecular level in rabbit synovial fibroblasts, we have constructed a cDNA library using mRNAs isolated from cells induced with crystals of monosodium urate monohydrate. We have screened this library with cDNA probes made from induced and control mRNA populations. From among 30 clones that hybridized preferentially to the induced-cell probe, 4 contained collagenase sequences. The largest, a clone of 650 base pairs, was identified by its ability to hybrid select a mRNA that could be translated in a cell-free system into a product that was precipitable with monospecific antibody to collagenase. Using this clone to probe blots of RNA from induced cells, we detected the appearance of a collagenase mRNA of 2.7 kilobases within 5 hr of addition of urate. The level of collagenase mRNA continued to increase for 35-40 hr, when it was 60 to 90 times more abundant in induced cells than in control cells. The increase in mRNA levels correlated with an increase in immunoreactive collagenase protein that was detectable in culture medium by 10 hr

Wherever I may roam: social viscosity and kin affiliation in a wild population despite natal dispersal

Dispersal affects the social contexts individuals experience by redistributing individuals in space, and the nature of social interactions can have important fitness consequences. During the vagrancy stage of natal dispersal, after an individual has left its natal site and before it has settled to breed, social affiliations might be predicted by opportunities to associate (e.g., distance in space and time between natal points of origin) or kin preferences. We investigated the social structure of a population of juvenile great tits (Parus major) and asked whether social affiliations during vagrancy were predicted by 1) the distance between natal nest-boxes, 2) synchrony in fledge dates, and 3) accounting for spatial and temporal predictors, whether siblings tended to stay together. We show that association strength was affected predominantly by spatial proximity at fledging and, to a lesser extent, temporal proximity in birth dates. Independently of spatial and temporal effects, sibling pairs associated more often than expected by chance. Our results suggest that the structure of the winter population is shaped primarily by limits to dispersal through incomplete population mixing. In addition, our results reveal kin structure, and hence the scope for fitness-related interactions between particular classes of kin. Both spatial-mediated and socially mediated population structuring can have implications for our understanding of the evolution of sociality

Toxic effects of Pb2+ on growth of cowpea (Vigna unguiculata)

A concentration as low as 1 mu M lead (Pb) is highly toxic to plants, but previous studies have typically related plant growth to the total amount of Pb added to a solution. In the present experiment, the relative fresh mass of cowpea (Vigna unguiculata) was reduced by 10% at a Pb2+ activity of 0.2 mu M for the shoots and at a Pb2+ activity of 0.06 mu M for the roots. The primary site of Pb2+ toxicity was the root, causing severe reductions in root growth, loss of apical dominance (shown by an increase in branching per unit root length), the formation of localized swellings behind the root tips (due to the initiation of lateral roots), and the bending of some root tips. In the root, Pb was found to accumulate primarily within the cell walls and intercellular spaces. (C) 2007 Elsevier Ltd. All rights reserved

Collective decision making and social interaction rules in mixed-species flocks of songbirds

Associations in mixed-species foraging groups are common in animals, yet have rarely been explored in the context of collective behaviour. Despite many investigations into the social and ecological conditions under which individuals should form groups, we still know little about the specific behavioural rules that individuals adopt in these contexts, or whether these can be generalized to heterospecifics. Here, we studied collective behaviour in flocks in a community of five species of woodland passerine birds. We adopted an automated data collection protocol, involving visits by RFID-tagged birds to feeding stations equipped with antennae, over two winters, recording 91 576 feeding events by 1904 individuals. We demonstrated highly synchronized feeding behaviour within patches, with birds moving towards areas of the patch with the largest proportion of the flock. Using a model of collective decision making, we then explored the underlying decision rule birds may be using when foraging in mixed-species flocks. The model tested whether birds used a different decision rule for conspecifics and heterospecifics, and whether the rules used by individuals of different species varied. We found that species differed in their response to the distribution of conspecifics and heterospecifics across foraging patches. However, simulating decisions using the different rules, which reproduced our data well, suggested that the outcome of using different decision rules by each species resulted in qualitatively similar overall patterns of movement. It is possible that the decision rules each species uses may be adjusted to variation in mean species abundance in order for individuals to maintain the same overall flock-level response. This is likely to be important for maintaining coordinated behaviour across species, and to result in quick and adaptive flock responses to food resources that are patchily distributed in space and time

Status, Vision, and Challenges of an Intelligent Distributed Engine Control Architecture

A Distributed Engine Control Working Group (DECWG) consisting of the Department of Defense (DoD), the National Aeronautics and Space Administration (NASA) Glenn Research Center (GRC) and industry has been formed to examine the current and future requirements of propulsion engine systems. The scope of this study will include an assessment of the paradigm shift from centralized engine control architecture to an architecture based on distributed control utilizing open system standards. Included will be a description of the work begun in the 1990's, which continues today, followed by the identification of the remaining technical challenges which present barriers to on-engine distributed control

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

<p>Abstract</p> <p>Background</p> <p>The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management.</p> <p>Methods and design</p> <p>The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed.</p> <p>Discussion</p> <p>The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management.</p> <p>Trial Registration</p> <p>Protocol NCT00325624</p

Scalable continuous solvothermal synthesis of metal organic framework (MOF-5) crystals

Metal–organic frameworks (MOFs) are well suited as nanoporous materials for applications such as gas storage, catalysis and in medical devices. Literature predominantly covers information on the batch synthesis of MOF-5, however, for an industrially viable product to be formed, bridging the gap to scalable continuous processing is essential. Here, we show that crystals of MOF-5 can be formed in a scalable solvothermal continuous process with a maximum space time yield of nearly 1000 kg m3 day1 . Analysis of the solid output as a function of time, in conjunction with variation of concentration of the feed supply, shows high purity MOF-5 is produced using a continuous system, with potentially high throughput on scale up. We also show that the output can be increased by increasing the concentration of reactants in the system, albeit resulting in a reduced surface area. The two most common solvents currently used for MOF-5 production are also compared to identify a more economically viable process