The Relative Financial Cost and Benefit of an Ophthalmology Resident Compared to an Advanced Practice Provider, Optometrist, or Faculty Ophthalmologist

Objective The main objective of the article is to determine the relative direct financial cost and benefit of an advanced practice provider (APP), optometrist, and faculty ophthalmologist compared with an ophthalmology resident. Design Single center cost–benefit financial analysis. Methods The direct total expenses, including mean salary and benefits; the cost/week, based upon calculated hours worked; and net revenue, based upon technical collections subtracted from total expenses were collected for all APPs, optometrists, faculty ophthalmologists, and ophthalmology residents at the University of Kentucky for the 2016 to 2017 academic year. Optometry and ophthalmology faculty collections were adjusted for clinical full-time equivalents. Results Total annual mean salary and benefits for 242 APPs, 4 optometrists, 17 faculty ophthalmologists, and 9 ophthalmology residents were $126,797,$117,021, $338,233, and$71,210, respectively. Assuming a 50-hour-work week, the calculated hourly costs were $48.77,$45.01, $130.09, and$27.39, respectively. Ophthalmology residents do not directly generate work relative value units or collections. On this basis, the net annual revenues were −$62,729,$122,757, $566,119, and −$71,210, respectively. Conclusions Ophthalmology residents are relatively inexpensive compared with potential substitute health care providers, although they are unable to generate direct revenue. Indirect costs and benefits are likely substantial, but currently incalculable. More candid analyses of the role and financial impact of trainees in health care are needed

Scaling relationships and physics for mixed heating convection in planetary interiors: Isoviscous spherical shells

We use a suite of 3-D numerical experiments to test and expand 2-D planar isoviscous scaling relationships of Moore (2008) for mixed heating convection in spherical geometry mantles over a range of Rayleigh numbers (Ra). The internal temperature scaling of Moore (2008), when modified to account for spherical geometry, matches our experimental results to a high degree of fit. The heat flux through the boundary layers scale as a linear combination of internal (Q) and basal heating, and the modified theory predictions match our experimental results. Our results indicate that boundary layer thickness and surface heat flux are not controlled by a local boundary layer stability condition (in agreement with the results of Moore (2008)) and are instead strongly influenced by boundary layer interactions. Subadiabatic mantle temperature gradients, in spherical 3-D, are well described by a vertical velocity scaling based on discrete drips as opposed to a scaling based on coherent sinking sheets, which was found to describe 2-D planar results. Root-mean-square (RMS) velocities are asymptotic for both low Q and high Q, with a region of rapid adjustment between asymptotes for moderate Q. RMS velocities are highest in the low Q asymptote and decrease as internal heating is applied. The scaling laws derived by Moore (2008), and extended here, are robust and highlight the importance of differing boundary layer processes acting over variable Q and moderate Ra

Modeling impacts of farming management alternatives on CO2, CH4, and N2O emissions: A case study for water management of rice agriculture of China

Since the early 1980s, water management of rice paddies in China has changed substantially, with midseason drainage gradually replacing continuous flooding. This has provided an opportunity to estimate how a management alternative impacts greenhouse gas emissions at a large regional scale. We integrated a process-based model, DNDC, with a GIS database of paddy area, soil properties, and management factors. We simulated soil carbon sequestration (or net CO2 emission) and CH4 and N2O emissions from China\u27s rice paddies (30 million ha), based on 1990 climate and management conditions, with two water management scenarios: continuous flooding and midseason drainage. The results indicated that this change in water management has reduced aggregate CH4 emissions about 40%, or 5 Tg CH4 yr−1, roughly 5–10% of total global methane emissions from rice paddies. The mitigating effect of midseason drainage on CH4 flux was highly uneven across the country; the highest flux reductions (\u3e200 kg CH4-C ha−1 yr−1) were in Hainan, Sichuan, Hubei, and Guangdong provinces, with warmer weather and multiple-cropping rice systems. The smallest flux reductions (\u3c25 kg CH4-C ha−1 yr−1) occurred in Tianjin, Hebei, Ningxia, Liaoning, and Gansu Provinces, with relatively cool weather and single cropping systems. Shifting water management from continuous flooding to midseason drainage increased N2O emissions from Chinese rice paddies by 0.15 Tg N yr−1 (∼50% increase). This offset a large fraction of the greenhouse gas radiative forcing benefit gained by the decrease in CH4 emissions. Midseason drainage-induced N2O fluxes were high (\u3e8.0 kg N/ha) in Jilin, Liaoning, Heilongjiang, and Xinjiang provinces, where the paddy soils contained relatively high organic matter. Shifting water management from continuous flooding to midseason drainage reduced total net CO2emissions by 0.65 Tg CO2-C yr−1, which made a relatively small contribution to the net climate impact due to the low radiative potential of CO2. The change in water management had very different effects on net greenhouse gas mitigation when implemented across climatic zones, soil types, or cropping systems. Maximum CH4 reductions and minimum N2O increases were obtained when the mid-season draining was applied to rice paddies with warm weather, high soil clay content, and low soil organic matter content, for example, Sichuan, Hubei, Hunan, Guangdong, Guangxi, Anhui, and Jiangsu provinces, which have 60% of China\u27s rice paddies and produce 65% of China\u27s rice harvest

Chronicles of Oklahoma

Necrology section from Volume 39, Number 4, Winter 1961-62. It includes a document honoring the life of lawyer, judge, and civic leader Frederick Page Branson

Reduced methane emissions from large-scale changes in water management of China’s rice paddies during 1980-2000

Decreased methane emissions from paddy rice may have contributed to the decline in the rate of increase of global atmospheric methane (CH4) concentration over the last 20 years. In China, midseason paddy drainage, which reduces growing season CH4 fluxes, was first implemented in the early 1980s, and has gradually replaced continuous flooding in much of the paddy area. We constructed a regional prediction for China\u27s rice paddy methane emissions using the DNDC biogeochemical model. Results of continuous flooding and midseason drainage simulations for all paddy fields in China were combined with regional scenarios for the timing of the transition from continuous flooding to predominantly mid-season drainage to generate estimates of total methane flux for 1980–2000. CH4 emissions from China\u27s paddy fields were reduced over that period by ∼5 Tg CH4 yr−1