Hospital Mergers with Regulated Prices

We study the effects of a hospital merger in a spatial competition framework where semi-altruistic hospitals choose quality and cost-containment effort. Whereas a merger always leads to higher average cost efficiency, the effect on quality provision depends on the strategic nature of quality competition, which in turn depends on the degree of altruism and the effectiveness of cost-containment effort. If qualities are strategic complements, then a merger leads to lower quality for all hospitals. If qualities are strategic substitutes, then a merger leads to higher quality for at least one hospital, and might also yield higher average quality provision and increased patient utility

Implications of species addition and decline for nutrient dynamics in freshwaters.

In terrestrial and aquatic ecosystems, organisms directly affect nutrient storage and cycling by sequestering nutrients via growth and remineralizing nutrients via excretion and egestion. Therefore, species introductions and extirpations can profoundly affect nutrient storage and remineralization rates, and present a challenge for conserving ecosystem function in fresh waters. The literature of consumer-driven nutrient dynamics is growing rapidly, but studies of consumer effects on nutrient storage and remineralization across species and among ecosystems are limited. We compared the effects of 3 grazing taxa, nonnative armored catfish in Mexican streams, native mussels in Oklahoma streams, and native tadpoles in Panamanian streams, on nutrient storage and remineralization. We examined interactions among organismal stoichiometry and biomass, nutrient storage, remineralization rates, and ecosystem size across these 3 groups following species decline (tadpoles and mussels) or introduction (armored catfish) to gain a better understanding of organism-specific effects on nutrient dynamics among freshwater ecosystems. Collectively, our results suggest that the ecosystem-level effect of consumer-driven nutrient dynamics is strongly influenced by environmental variables and is taxon specific. Major changes in biomass of stoichiometrically distinctive organisms can lead to subsequent changes in the flux and storage of elements in an ecosystem, but the overall effect of aquatic animals on nutrient dynamics also is determined by discharge and nutrient-limitation patterns in streams and rivers

Global bionetworks and challenges in regulating autologous adult stem cells

Autologous adult stem cells (ASCs) are increasingly being administered to patients with limited evidence from clinical trials that they are safe and effective. The marketing of autologous ASCs predominantly over the Internet by companies based in low-to-middle income countries, such as the Bahamas, Mexico, India and China, is well documented.(1, 2) However, even in countries such as the United States, Japan, and Australia, physicians are prescribing autologous ASCs to patients outside the context of clinical trials. These doctors often form part of loose collaborative networks of clinicians, businesses, patients and researchers operating both domestically and across national boundaries. The emergence of these networks not only puts patients who seek out these interventions at risk: it threatens to undermine the very basis of ‘good medical practice’.funded by the Ministry of Education, Singapore, and the Humanities and Social Sciences (HSS) Division of the Office of the Deputy President (Research and Technology) at the National University of Singapore (NU

Oversight for clinical uses of autologous adult stem cells: lessons from international regulations

Autologous adult stem cells (ASCs) are being administered by physicians for indications that have not been demonstrated as safe and effective in formal clinical trials. Examination of regulatory frameworks across five countries suggests that balancing the demands of research with clinical freedom has created structural weaknesses that are being exploited.funded by the Ministry of Education, Singapore, and the Humanities and Social Sciences (HSS) Division of the Office of the Deputy President (Research and Technology) at the National University of Singapore (NUS)

Oversight for clinical uses of autologous adult stem cells: lessons from international regulations

Autologous adult stem cells (ASCs) are being administered by physicians for indications that have not been demonstrated as safe and effective in formal clinical trials. Examination of regulatory frameworks across five countries suggests that balancing the demands of research with clinical freedom has created structural weaknesses that are being exploited.funded by the Ministry of Education, Singapore, and the Humanities and Social Sciences (HSS) Division of the Office of the Deputy President (Research and Technology) at the National University of Singapore (NUS)

Global bionetworks and challenges in regulating autologous adult stem cells

Autologous adult stem cells (ASCs) are increasingly being administered to patients with limited evidence from clinical trials that they are safe and effective. The marketing of autologous ASCs predominantly over the Internet by companies based in low-to-middle income countries, such as the Bahamas, Mexico, India and China, is well documented.(1, 2) However, even in countries such as the United States, Japan, and Australia, physicians are prescribing autologous ASCs to patients outside the context of clinical trials. These doctors often form part of loose collaborative networks of clinicians, businesses, patients and researchers operating both domestically and across national boundaries. The emergence of these networks not only puts patients who seek out these interventions at risk: it threatens to undermine the very basis of ‘good medical practice’.funded by the Ministry of Education, Singapore, and the Humanities and Social Sciences (HSS) Division of the Office of the Deputy President (Research and Technology) at the National University of Singapore (NU

An Optoelectronic Adaptive Resonance Unit

The authors demonstrate a hardware implementation of the adaptive resonance theory ART 1 neural network architecture. The optoelectronic ART1 unit, is a novel application of an old device. This device-the 4-f or Van der Lugt correlator-has historically been used as a fast pattern classifier. Usually the correlation operation is employed as a matched filter, so that a maximum correlation peak corresponds to a well-matched pattern. The device described also uses the large peaks, but takes specific advantage of the fact that a zero-shift correlation is mathematically equivalent to a two-dimensional inner product. The authors describe a promising method for emulating an ART1 unit in optics. They review ART1 from an algorithmic point of view, which shows that inner products are a critical part of ART1. They then discuss its implementation, and show some experimental results. The device works by performing the most computationally intensive parts of the algorithm in optical hardware, and thus offers a suitable marriage of the strengths of electronics and optics

The response of Black Rapids Glacier, Alaska, to the Denali earthquake rock avalanches

We describe the impact of three simultaneous earthquake-triggered rock avalanches on the dynamics of Black Rapids Glacier, Alaska, by using spaceborne radar imagery and numerical modeling. We determined the velocities of the glacier before and after landslide deposition in 2002 by using a combination of ERS-1/ERS-2 tandem, RADARSAT-1, and ALOS PALSAR synthetic aperture radar data. Ice velocity above the debris-covered area of the glacier increased up to 14% after the earthquake but then decreased 20% by 2005. Within the area of the debris sheets, mean glacier surface velocity increased 44% within 2 years of the landslides. At the downglacier end of the lowest landslide, where strong differential ablation produced a steep ice cliff, velocities increased by 109% over the same period. By 2007, ice velocity throughout the debris area had become more uniform, consistent with a constant ice flux resulting from drastically reduced ablation at the base of the debris. Without further analysis, we cannot prove that these changes resulted from the landslides, because Black Rapids Glacier displays large seasonal and interannual variations in velocity. However, a full Stokes numerical ice flow model of a simplified glacier geometry produced a reversal of the velocity gradient from compressional to extensional flow after 5 years, which supports our interpretation that the recent changes in the velocity field of the glacier are related to landslide-induced mass balance changes

Stabilization Environment for Swing Stabilization and MEDEVAC Hoists

This paper presents data related to helicopter sling load stabilization and MEDEVAC (Medical Evacuation) rescues collected by cadets performing research in the field at the United States Military Academy (West Point, NY) and Sapienza University of Rome (Rome, Italy) since 2018. The aim of this paper is to identify engineering constraints in MEDEVAC rescues. Constraints in two typical scenarios are presented. This information can then be included in simulations and models of swing stabilization and hoist control methods. Information is obtained through a literature review and interviews with U.S. Army helicopter pilots and crew chiefs who perform MEDEVAC rescues

Essential Elements for New Student Orientation

New student orientation programs typically have been developed from the perspective of what new students need upon their arrival on a 4-year college campus. There is little consideration given to the environment from which students come, namely, the secondary and high schools from which students graduate. The current study study explores what secondary school administrators perceive to be the most important elements that should be included in an orientation program. This perspective, which largely supports the inclusion of all the Council for the Advancement of Standards' Standards for New Student Orientation, particularly noted the need for orientation programs to help the student identify the personal and financial costs (and benefits) of attending college