Covering Kids & Families Evaluation Case Study of Michigan: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice

Evaluates the impact in Michigan of the RWJF project to increase enrollment in Medicaid and State Children's Health Insurance Programs. Outlines state policy changes and local- and state-level findings on the links between activities and enrollment trend

Contingency maneuver strategies for the Total Ozone Mapping Spectrometer-Earth Probe (TOMS-EP)

The Total Ozone Mapping Spectrometer-Earth Probe (TOMS-EP) is a polar-orbiting spacecraft designed to measure total ozone levels in the Earth's atmosphere. The nominal mission orbit is a 955-kilometer circular Sun-synchronous orbit with an ascending node mean local crossing time (MLT) between 11:02 a.m. and 11:25 a.m. These two mean local ascending node times constitute the boundaries of the MLT box for this mission. The MLT boundaries were chosen to maintain the Sun-to-Earth-to-vehicle orbit-normal (SVN) angle within a preselected set of seasonally independent boundaries. Because the SVN angle is seasonally dependent, but the MLT is not, contingency options for correcting the MLT of orbital states that fall outside of the required MLT range become time dependent. This paper focuses on contingency orbit adjustment strategies developed at the Goddard Space Flight Center (GSFC) Flight Dynamics Division (FDD) during the mission planning phase of TOMS-EP. Time-dependent delta-V strategies are presented for correcting mission orbit states lying outside of the MLT range. Typically, passive control of the MLT drift rate can be used to restore the orbit state to the required MLT before a seasonal violation of SVN angle constraints can occur. Passive control of the MLT drift rate is obtained through adjustment of the semimajor axis and/or the inclination. The time between initial arrival on orbit at an 'out-of-the box' MLT state and violation of the SVN angle constraints is always less than or equal to 1 year. The choice of which parameter(s) to adjust is dictated by the duration of this time period, the desired mission lifetime, the delta-V cost, and operational constraints

Improvements in the 8-Dimensions of the Parkinson’s Disease Quality of Life Questionnaire after 8-weeks of Resistance Training with Instability and/or Cadence Walking in Persons with Mild to Moderate Parkinson’s Disease

Physical activity helps slow the progression of Parkinson’s disease (PD). Resistance training with iPhysical activity helps slow the progression of Parkinson’s disease (PD). Resistance training with instability (RTI) and cadence walking (CW) add an additional skill (compared to resistance training and walking alone) to improve neuromuscular connections and blood flow to the brain during exercise. A cross-training exercise regimen, combining both resistance training and walking (RTI+CW), has not been studied to determine its effect on the progression of Parkinson’s disease. PURPOSE: to examine the changes in the 8-dimensions of the Parkinson’s Disease Questionnaire (PDQ39) (mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort) after 8-weeks of RTI, CW and RTI+CW in individuals with mild to moderate PD. METHODS: individuals diagnosed with mild to moderate PD (N=18 ( 6 female, 12 males); MHY stage=1.53 + 0.50; age = 63.67 + 7.23 y; BMI = 27.38 + 3.88 kg/m2) were randomized into RTI, CW or RTI+CW exercise groups for 8-weeks. RTI and CW were performed 3 days/week and RTI+CW was performed 4 days/week (2 days RTI and 2 days CW). RTI included full-body machine and free-weight exercises with volume (reps and sets) and instability progressions. CW included volume (time) and intensity (speed) progressions for 8-weeks. The PDQ39 questionnaire was given at pre- and post-assessments. RESULTS: improvements in the PDQ39 questionnaire were seen across all groups in all 8 dimensions of mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication and bodily discomfort. A significant time effect was observed for dimensions of mobility (17.33 + 7.30 and 15.94 + 7.6, p=0.043), stigma (7.12 + 3.50 and 6.12 + 2.75, p=0.02) and bodily discomfort (7.34 + 1.97 and 6.05 + 2.46, p=0.005). A significant group x time effect was observed for mobility and bodily discomfort. A Tukey’s post hoc analysis revealed significant differences between RTI+CW and CW for mobility (RTI+CW 16.00 + 6.54 and 13.83 + 5.42 and CW 18.00 + 6.48 and 17.33 + 10.39, p=0.04) and RTI and CW for bodily Physical activity helps slow the progression of Parkinson’s disease (PD). Resistance training with instability (RTI) and cadence walking (CW) add an additional skill (compared to resistance training and walking alone) to improve neuromuscular connections and blood flow to the brain during exercise. A cross-training exercise regimen, combining both resistance training and walking (RTI+CW), has not been studied to determine its effect on the progression of Parkinson’s disease. PURPOSE: to examine the changes in the 8-dimensions of the Parkinson’s Disease Questionnaire (PDQ39) (mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort) after 8-weeks of RTI, CW and RTI+CW in individuals with mild to moderate PD. METHODS: individuals diagnosed with mild to moderate PD (N=18 ( 6 female, 12 males); MHY stage=1.53 + 0.50; age = 63.67 + 7.23 y; BMI = 27.38 + 3.88 kg/m2) were randomized into RTI, CW or RTI+CW exercise groups for 8-weeks. RTI and CW were performed 3 days/week and RTI+CW was performed 4 days/week (2 days RTI and 2 days CW). RTI included full-body machine and free-weight exercises with volume (reps and sets) and instability progressions. CW included volume (time) and intensity (speed) progressions for 8-weeks. The PDQ39 questionnaire was given at pre- and post-assessments. RESULTS: improvements in the PDQ39 questionnaire were seen across all groups in all 8 dimensions of mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication and bodily discomfort. A significant time effect was observed for dimensions of mobility (17.33 + 7.30 and 15.94 + 7.6, p=0.043), stigma (7.12 + 3.50 and 6.12 + 2.75, p=0.02) and bodily discomfort (7.34 + 1.97 and 6.05 + 2.46, p=0.005). A significant group x time effect was observed for mobility and bodily discomfort. A Tukey’s post hoc analysis revealed significant differences between RTI+CW and CW for mobility (RTI+CW 16.00 + 6.54 and 13.83 + 5.42 and CW 18.00 + 6.48 and 17.33 + 10.39, p=0.04) and RTI and CW for bodily discomfort (RTI 7.33 + 1.97 and 5.67 + 2.16; CW 7.33 + 1.63 and 6.50 + 1.97). CONCLUSION: All exercise groups improved in scores for all 8-dimensions of the PDQ39 questionnaire. Significant time effects were observed for mobility, stigma and bodily discomfort. RTI+CW improved mobility more than CW alone. RTI improved bodily discomfort more than CW alone. (RTI 7.33 + 1.97 and 5.67 + 2.16; CW 7.33 + 1.63 and 6.50 + 1.97). CONCLUSION: All exercise groups improved in scores for all 8-dimensions of the PDQ39 questionnaire. Significant time effects were observed for mobility, stigma and bodily discomfort. RTI+CW improved mobility more than CW alone. RTI improved bodily discomfort more than CW alone.nstability (RTI) and cadence walking (CW) add an additional skill (compared to resistance training and walking alone) to improve neuromuscular connections and blood flow to the brain during exercise. A cross-training exercise regimen, combining both resistance training and walking (RTI+CW), has not been studied to determine its effect on the progression of Parkinson’s disease. PURPOSE: to examine the changes in the 8-dimensions of the Parkinson’s Disease Questionnaire (PDQ39) (mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort) after 8-weeks of RTI, CW and RTI+CW in individuals with mild to moderate PD. METHODS: individuals diagnosed with mild to moderate PD (N=18 ( 6 female, 12 males); MHY stage=1.53 + 0.50; age = 63.67 + 7.23 y; BMI = 27.38 + 3.88 kg/m2) were randomized into RTI, CW or RTI+CW exercise groups for 8-weeks. RTI and CW were performed 3 days/week and RTI+CW was performed 4 days/week (2 days RTI and 2 days CW). RTI included full-body machine and free-weight exercises with volume (reps and sets) and instability progressions. CW included volume (time) and intensity (speed) progressions for 8-weeks. The PDQ39 questionnaire was given at pre- and post-assessments. RESULTS: improvements in the PDQ39 questionnaire were seen across all groups in all 8 dimensions of mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication and bodily discomfort. A significant time effect was observed for dimensions of mobility (17.33 + 7.30 and 15.94 + 7.6, p=0.043), stigma (7.12 + 3.50 and 6.12 + 2.75, p=0.02) and bodily discomfort (7.34 + 1.97 and 6.05 + 2.46, p=0.005). A significant group x time effect was observed for mobility and bodily discomfort. A Tukey’s post hoc analysis revealed significant differences between RTI+CW and CW for mobility (RTI+CW 16.00 + 6.54 and 13.83 + 5.42 and CW 18.00 + 6.48 and 17.33 + 10.39, p=0.04) and RTI and CW for bodily discomfort (RTI 7.33 + 1.97 and 5.67 + 2.16; CW 7.33 + 1.63 and 6.50 + 1.97). CONCLUSION: All exercise groups improved in scores for all 8-dimensions of the PDQ39 questionnaire. Significant time effects were observed for mobility, stigma and bodily discomfort. RTI+CW improved mobility more than CW alone. RTI improved bodily discomfort more than CW alone

Improvements in Bilateral Differences in Lean Mass and Strength in Persons with Parkinson’s Disease Presenting Unilateral Motor Symptoms

In persons with Parkinson’s disease (PD), individuals present altered motor symptoms such as rigidity, tremors and bradykinesia. These motor symptoms typically present in the early stages of PD unilaterally. Resistance training with instability (RTI) and cadence walking (CW) are effective in improving markers of fragility and motor function. The benefit of combining RTI and CW and its effects on lean mass and strength hav not been studied. PURPOSE: to examine the effects of RTI, CW and RTI+CW on lean mass in affected and unaffected sides and strength in persons with PD. METHODS: individuals diagnosed with mild to moderate PD (N=18 ( 6 female, 12 males); MHY stage=1.53 + 0.50; age = 63.67 + 7.23 y; BMI = 27.38 + 3.88 kg/m2) were randomized into RTI, CW or RTI+CW exercise groups for 8-weeks. RTI and CW were performed 3 days/week and RTI+CW was performed 4 days/week (2 days RTI and 2 days CW). RTI included full-body machine and free-weight exercises with volume (reps and sets) and instability progressions. CW included volume (time) and intensity (speed) progressions for 8-weeks. DXA scans and strength assessments were performed at pre- and post-assessments. RESULTS: A significant difference was present between affected and unaffected sides of lean mass in the upper and lower body of PD participants, with the unaffected side averaging more lean mass for all groups. The average lean mass at pre-assessments in the unaffected arm was 2.92 + 1.05 kg versus the affected arm at 2.80 + 0.99 kg, p=0.043. The difference in the unaffected and affected arms’ lean mass decreased and was no longer significant at post-assessments (unaffected 2.9 + 1.01 kg and affected 2.88 + 1.00 kg, p=0.165), indicating a significant time effect. There was not a significant difference in lean mass for the affected and unaffected legs. A significant group x time effect was observed for RTI and RTI+CW in comparison to CW alone for lean mass differences in affected and unaffected arms at post-assessments (p=0.048 and p=0.44). A significant difference was noted between RTI and RTI+CW in comparison to CW alone in chest press improvements at post-assessments (RTI 30.00 + 16.43 lbs, CW 7.50 + 11.29 lbs, p=0.033 and RTI+CW 18.33 + 7.53 lbs, p=0.47). Interestingly, no group differences in leg press were noted. CONCLUSION: Bilateral differences exist in lean mass DXA results in the affected and unaffected arms of persons with PD who present motor symptoms unilaterally. The bilateral differences in lean mass are improved in RTI and RTI+CW but not in CW alone

Improvements in Markers of Fragility after 8-weeks of Resistance Training with Instability and/or Cadence Walking in Persons with Mild to Moderate Parkinson’s Disease

In persons with Parkinson’s disease (PD), resistance training with instability (RTI) and cadence walking (CW) are effective in improving markers of fragility and motor function. The benefit of combining RTI and CW to markers of fragility and motor function in individuals with PD has not been studied. PURPOSE: to examine the effects of RTI, CW and RTI+CW on markers of fragility (6-minute walk (6MW), timed-up-and-go (TUG), walking speed, stride-to-stride variability and handgrip strength) in individuals with PD. METHODS: individuals diagnosed with mild to moderate PD (N=18 ( 6 female, 12 males); MHY stage=1.53 + 0.50; age = 63.67 + 7.23 y; BMI = 27.38 + 3.88 kg/m2) were randomized into RTI, CW or RTI+CW exercise groups for 8-weeks. RTI and CW were performed 3 days/week and RTI+CW was performed 4 days/week (2 days RTI and 2 days CW). RTI included full-body machine and free-weight exercises with volume (reps and sets) and instability progressions. CW included volume (time) and intensity (speed) progressions for 8-weeks. RESULTS: stride to stride variability improved significantly more in RTI+CW versus CW and RTI alone (2.54 + 1.18 inches, 0.19 + 0.28 inches, p=0.006 and -1.38 + 0.98 inches, p=0.008, respectively). Arm swing in the affected versus the unaffected arm significantly improved in the RTI+CW and RTI groups compared to the CW group (3.198 + 1.29 inches, 5.20 + 2.16, p=0.043 and 0.46 + 0.22 inches, p=0.003, respectively). There were significant pre- and post-improvements in distance of the 6-minute walk (1642 + 370 feet, 1801 + 350 feet, p=0.002), stride velocity (1.04 + 0.14 m/s, 0.99 + 0.15 m/s, p=0.002), steps per minute (116.91 + 15.12 spm, 125.38 + 15.73 spm, p=0.011), stride-to-stride variability (2.16 + 1.68 inches, 1.48 + 1.33 inches, p=0.003), arm swing difference between affected and unaffected sides (9.97 + 6.65 inches, 5.70 + 4.24 inches, P=0.005), Berg Balance scale (51.00 + 3.58, 53.39 + 3.18, PCONCLUSION: all exercise groups significantly improved markers of fragility including endurance, stride velocity and variability, hand grip, arm swing difference and balance after 8-weeks of RTI, CW or RTI+CW. Additionally, RTI+CW may be more effective than CW alone in preventing falls in persons with PD due to the significant improvements in stride-to-stride variability. RTI group’s stride-to-stride-variability worsened over the course of 8-weeks. RTI+CW and RTI may be more effective than CW alone in improving arm swing of the PD affected side during walking in individuals with PD

Lysosomal enzyme cathepsin D protects against alpha-synuclein aggregation and toxicity

α-synuclein (α-syn) is a main component of Lewy bodies (LB) that occur in many neurodegenerative diseases, including Parkinson's disease (PD), dementia with LB (DLB) and multi-system atrophy. α-syn mutations or amplifications are responsible for a subset of autosomal dominant familial PD cases, and overexpression causes neurodegeneration and motor disturbances in animals. To investigate mechanisms for α-syn accumulation and toxicity, we studied a mouse model of lysosomal enzyme cathepsin D (CD) deficiency, and found extensive accumulation of endogenous α-syn in neurons without overabundance of α-syn mRNA. In addition to impaired macroautophagy, CD deficiency reduced proteasome activity, suggesting an essential role for lysosomal CD function in regulating multiple proteolytic pathways that are important for α-syn metabolism. Conversely, CD overexpression reduces α-syn aggregation and is neuroprotective against α-syn overexpression-induced cell death in vitro. In a C. elegans model, CD deficiency exacerbates α-syn accumulation while its overexpression is protective against α-syn-induced dopaminergic neurodegeneration. Mutated CD with diminished enzymatic activity or overexpression of cathepsins B (CB) or L (CL) is not protective in the worm model, indicating a unique requirement for enzymatically active CD. Our data identify a conserved CD function in α-syn degradation and identify CD as a novel target for LB disease therapeutics

Lactate Produced by Glycogenolysis in Astrocytes Regulates Memory Processing

When administered either systemically or centrally, glucose is a potent enhancer of memory processes. Measures of glucose levels in extracellular fluid in the rat hippocampus during memory tests reveal that these levels are dynamic, decreasing in response to memory tasks and loads; exogenous glucose blocks these decreases and enhances memory. The present experiments test the hypothesis that glucose enhancement of memory is mediated by glycogen storage and then metabolism to lactate in astrocytes, which provide lactate to neurons as an energy substrate. Sensitive bioprobes were used to measure brain glucose and lactate levels in 1-sec samples. Extracellular glucose decreased and lactate increased while rats performed a spatial working memory task. Intrahippocampal infusions of lactate enhanced memory in this task. In addition, pharmacological inhibition of astrocytic glycogenolysis impaired memory and this impairment was reversed by administration of lactate or glucose, both of which can provide lactate to neurons in the absence of glycogenolysis. Pharmacological block of the monocarboxylate transporter responsible for lactate uptake into neurons also impaired memory and this impairment was not reversed by either glucose or lactate. These findings support the view that astrocytes regulate memory formation by controlling the provision of lactate to support neuronal functions

Effect of Materials on the Autoignition of Cyclopentane

Cyclopentane, a flammable hydrocarbon, is being considered as a working fluid for waste heat recovery applications. Experiments were conducted to determine the ignition delay time (IDT) of cyclopentane using an Ignition Quality Test (IQT) device. Two sets of experiments were conducted per ASTM D6890 (with exception to charge pressure and temperature) to determine ignition delay of the fuel at atmospheric pressure for normal air ({approx}21% oxygen) and vitiated air (13.3% oxygen) at a temperature of 530 C. Operation of the IQT device at a much lower pressure (1 bar) than normal operation (21.1 bar) led to very rich conditions and wetting of the stainless steel chamber walls. Catalytic effects produced small IDTs. Experiments were repeated with a modified injector to prevent wall wetting, resulting in average IDTs that are substantially longer