Implementation of a Hybrid Method to Estimate Real-Time Unsteady Flow Discharge

Knowing discharge in real-time is important for the operation of features like locks and dams, or for river forecasting. However, only river stage can be measured regularly, with a high enough frequency to effectively monitor conditions in real-time, so methods are needed to compute discharge based on observed stage. There are two common approaches for calculating real-time discharge: the rating curve and slope-area methods. A modified hybrid approach, developed by Hunt et al., combined with the Jones formula for calculating unsteady flow discharge, was tested to estimate discharges on the Lower Mississippi River, USA, at Hickman, KY; Memphis, TN; and Helena, AR. The mean percent difference between predicted and measured discharges for a single verification period among all three locations was as low +/- 0.5% and as high as +/- 8%. The model’s performance is decreased at gages with complex stage-roughness-slope behavior or at gages with irregularities in the cross-section

Reducing Hospital Readmissions in New York State: A Simulation Analysis of Alternative Payment Incentives

Examines strategies to reduce hospital readmissions, including improving discharge processes, post-discharge support, and payment incentives. Estimates payers' and hospitals' cost savings from pay-for-performance and episode-based payments

Improving Holographic Search Algorithms using Sorted Pixel Selection

Traditional search algorithms for computer hologram generation such as Direct Search and Simulated Annealing offer some of the best hologram qualities at convergence when compared to rival approaches. Their slow generation times and high processing power requirements mean, however, that they see little use in performance critical applications. This paper presents the novel Sorted Pixel Selection (SPS) modification for Holographic Search Algorithms (HSAs) that offers Mean Square Error (MSE) reductions in the range of 14:7 19:2% for the test images used. SPS operates by substituting a weighted search selection procedure for traditional random pixel selection processes. While small, the improvements seen are observed consistently across a wide range of test cases and require limited overhead for implementatio

Do the peak and mean force methods of assessing vertical jump force asymmetry agree?

The aim of this study was to assess agreement between peak and mean force methods of quantifying force asymmetry during the countermovement jump (CMJ). Forty-five men performed four CMJ with each foot on one of two force plates recording at 1000 Hz. Peak and mean were obtained from both sides during the braking and propulsion phases. The dominant side was obtained for the braking and propulsion phase as the side with the largest peak or mean force and agreement was assessed using percentage agreement and the kappa coefficient. Braking phase peak and mean force methods demonstrated a percentage agreement of 84% and a kappa value of 0.67 (95% confidence limits: 0.45 to 0.90), indicating substantial agreement. Propulsion phase peak and mean force methods demonstrated a percentage agreement of 87% and a kappa value of 0.72 (95% confidence limits: 0.51 to 0.93), indicating substantial agreement. While agreement was substantial, side-to-side differences were not reflected equally when peak and mean force methods of assessing CMJ asymmetry were used. These methods should not be used interchangeably, but rather a combined approach should be used where practitioners consider both peak and mean force to obtain the fullest picture of athlete asymmetry

A National Survey of the arrangements managed-care plans make with physicians

Abstract Background. Despite the growth of managed care in the United States, there is little information about the arrangements managed-care plans make with physicians. Methods. In 1994 we surveyed by telephone 138 managed-care plans that were selected from 20 metropolitan areas nationwide. Of the 108 plans that responded, 29 were group-model or staff-model health maintenance organizations (HMOs), 50 were network or independentpractice–association (IPA) HMOs, and 29 were preferred-provider organizations (PPOs). Results. Respondents from all three types of plan said they emphasized careful selection of physicians, although the group or staff HMOs tended to have more demanding requirements, such as board certification or eligibility. Sixty-one percent of the plans responded that physicians’ previous patterns of costs or utilization of resources had little influence on their selection; 26 percent said these factors had a moderate influence; and 13 percent said they had a large influence. Some risk sharing with physicians was typical in the HMOs but rare in the PPOs. Fiftysix percent of the network or IPA HMOs used capitation as the predominant method of paying primary care physicians, as compared with 34 percent of the group or staff HMOs and 7 percent of the PPOs. More than half the HMOs reported adjusting payments according to utilization or cost patterns, patient complaints, and measures of the quality of care. Ninety-two percent of the network or IPA HMOs and 61 percent of the group or staff HMOs required their patients to select a primary care physician, who was responsible for most referrals to specialists. About three quarters of the HMOs and 31 percent of the PPOs reported using studies of the outcomes of medical care as part of their quality-improvement programs. Conclusions. Managed-care plans, particularly HMOs, have complex systems for selecting, paying, and monitoring their physicians. Hybrid forms are common, and the differences between group or staff HMOs and network or IPA HMOs are less extensive than is commonly assumed. (N Engl J Med 1995;333:1678-83.

Relationship between reactive strength index variants in rugby league players

Two reactive strength index (RSI) variants exist, the RSI and RSI modified (RSImod) which are typically calculated during the drop jump (DJ) and countermovement jump (CMJ), respectively. Both RSI variants have been used to monitor athletes' ability to complete stretch-shortening cycle actions quickly, but they have never been compared. The purpose of this study was to determine if they yield relatable information about reactive strength characteristics. Male professional rugby league players (n = 21, age = 20.8±2.3 years, height = 1.82±0.06 m and body mass = 94.3±8.4 kg) performed three DJs (30 cm) and CMJs on a force plate. RSI and RSImod were subsequently calculated by dividing jump height by ground contact time (GCT) and time to take-off (TTT), respectively. All variables were highly reliable (intraclass correlation coefficient ≥0.78) with acceptable levels of variability (coefficient of variation ≤8.2%), albeit larger variability was noted for DJ variables. Moreover, there was a large relationship between RSI and RSImod (r=0.524, P=0.007), whereas very large relationships were noted between jump heights (r=0.762, P<0.001) and between GCT and TTT (ρ=0.705, P<0.001). Additionally, RSI (0.90±0.22) was largely and significantly (d=2.57, P<0.001) greater than RSImod (0.47±0.08). The DJ-derived RSI yields much larger values than the CMJ-derived RSImod and although a large relationship was noted between them, it equated to just 22% shared variance. These results suggest that the two RSI variants do not explain each other well, indicating that they do not assess entirely the same reactive strength qualities and should not be used interchangeably