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Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion.
BackgroundTo estimate the proportion of pregnant women in Louisiana who do not obtain abortions because Medicaid does not cover abortion.MethodsTwo hundred sixty nine women presenting at first prenatal visits in Southern Louisiana, 2015-2017, completed self-administered iPad surveys and structured interviews. Women reporting having considered abortion were asked whether Medicaid not paying for abortion was a reason they had not had an abortion. Using study data and published estimates of births, abortions, and Medicaid-covered births in Louisiana, we projected the proportion of Medicaid births that would instead be abortions if Medicaid covered abortion in Louisiana.Results28% considered abortion. Among women with Medicaid, 7.2% [95% CI 4.1-12.3] reported Medicaid not paying as a reason they did not have an abortion. Existing estimates suggest 10% of Louisiana pregnancies end in abortion. If Medicaid covered abortion, this would increase to 14% [95% CI 12, 16]. 29% [95% CI 19, 41] of Medicaid eligible pregnant women who would have an abortion with Medicaid coverage, instead give birth.ConclusionsFor a substantial proportion of pregnant women in Louisiana, the lack of Medicaid funding remains an insurmountable barrier to obtaining an abortion. Forty years after the Hyde Amendment was passed, lack of Medicaid funding for abortion continues to have substantial impacts on women's ability to obtain abortions
International approaches to paediatric podiatry curricula : it's the same, but different
Pre-registration / entry-level programmes of study provide the core knowledge, skills and abilities required for clinical practice. These programmes are where students are introduced to specialist domains of practice and begin to shape their professional interests. The aim of this research was to describe paediatric curricula within pre-registration and entry level podiatry programmes across comparable universities and offer a contemporary synthesis of international practices. An exploratory, cross-sectional, online survey was undertaken across a three-month period. Representatives from podiatry programmes delivering pre-registration or entry level podiatry degrees in which graduates are eligible for Professional and Statutory Body registration within their country (deemed at a Bachelor degree or higher), were invited to participate. The survey was administered online using Online Surveys. Descriptive statistics were used to describe the data due to the exploratory nature of the research question and design. There were responses from seven (54% of 13) universities in the United Kingdom (UK), nine (100% of nine) universities in Australia and four (50% of eight) of the invited universities external to the UK and Australia (New Zealand, Malta, Ireland, South Africa). There was some variation in curriculum content, but all universities reported to cover ontogeny and developmental milestones and general paediatric orthopaedic conditions. There was further discrepancy with the number of hours dedicated to paediatric podiatry within the curricula (ranging from 26 h). The findings from this study highlight some disparity in the delivery of training for students relating to paediatrics. The data suggests that there is a need for international coordination in establishing priorities for the paediatric curricula. This will ensure consistency in baseline knowledge, modes of training, amount and nature of curriculum delivery during undergraduate or entry level podiatry training
CALLISTO-SPK: A Stochastic Point Kinetics Code for Performing Low Source Nuclear Power Plant Start-up and Power Ascension Calculations
This paper presents the theory and application of a code called CALLISTO which is used for performing NPP start-up and power ascension calculations. The CALLISTO code is designed to calculate various values relating to the neutron population of a nuclear system which contains a low number of neutrons. These variables include the moments of the PDF of the neutron population, the maturity time and the source multiplier. The code itself is based upon the mathematics presented in another paper and utilises representations of the neutron population which are independent of both space and angle but allows for the specification of an arbitrary number of energy groups. Five examples of the use of the code are presented. Comparison is performed against results found in the literature and the degree of agreement is discussed. In general the agreement is found to be good and, where it is not, plausible explanations for discrepancies are presented. The final two cases presented examine the effect of the number of neutron groups included and finds that, for the systems simulated, there is no significant difference in the key results of the code
Retinal gene therapy with a large MYO7A cDNA using adeno-associated virus.
Usher 1 patients are born profoundly deaf and then develop retinal degeneration. Thus they are readily identified before the onset of retinal degeneration, making gene therapy a viable strategy to prevent their blindness. Here, we have investigated the use of adeno-associated viruses (AAVs) for the delivery of the Usher 1B gene, MYO7A, to retinal cells in cell culture and in Myo7a-null mice. MYO7A cDNA, under control of a smCBA promoter, was packaged in single AAV2 and AAV5 vectors and as two overlapping halves in dual AAV2 vectors. The 7.9-kb smCBA-MYO7A exceeds the capacity of an AAV vector; packaging of such oversized constructs into single AAV vectors may involve fragmentation of the gene. Nevertheless, the AAV2 and AAV5 single vector preparations successfully transduced photoreceptor and retinal pigment epithelium cells, resulting in functional, full-length MYO7A protein and correction of mutant phenotypes, suggesting successful homologous recombination of gene fragments. With discrete, conventional-sized dual AAV2 vectors, full-length MYO7A was detected, but the level of protein expression was variable, and only a minority of cells showed phenotype correction. Our results show that MYO7A therapy with AAV2 or AAV5 single vectors is efficacious; however, the dual AAV2 approach proved to be less effective
Nomadic ecology shaped the highland geography of Asia's Silk Roads
There are many unanswered questions about the evolution of the ancient 'Silk Roads' across Asia. This is especially the case in their mountainous stretches, where harsh terrain is seen as an impediment to travel. Considering the ecology and mobility of inner Asian mountain pastoralists, we use ‘flow accumulation’ modelling to calculate the annual routes of nomadic societies (from 750 m to 4,000 m elevation). Aggregating 500 iterations of the model reveals a high-resolution flow network that simulates how centuries of seasonal nomadic herding could shape discrete routes of connectivity across the mountains of Asia. We then compare the locations of known high-elevation Silk Road sites with the geography of these optimized herding flows, and find a significant correspondence in mountainous regions. Thus, we argue that highland Silk Road networks (from 750 m to 4,000 m) emerged slowly in relation to long-established mobility patterns of nomadic herders in the mountains of inner Asia
Wetting-induced volumetric collapse of UO2 powder beds and the consequence on transient nuclear criticality excursions
Mathematical and computational models are proposed to simulate wetting-induced volumetric collapse of fissile powder beds. Slumping, nuclear thermal hydraulics, radiolytic gas, and steam production models are coupled with point neutron kinetics to investigate transient nuclear criticality excursions in two 5-wt% enriched UO2 fissile powder beds with varying levels of wetting-induced volumetric collapse. The two beds are distinguished by their mean powder particle size of 30 μm and 100 μm. For the UO2 powder beds modelled, the re-distribution of UO2 powder and moderator due to slumping introduced a negative reactivity into the system. This increased the amount of time taken for a delayed critical state to be reached once infiltration began, and also reduced the total fission energy generated over the course of the simulated transient. The total fission energy generated ranged from 42 MJ to 48 MJ 100 seconds after the initial nuclear criticality excursion was observed for the 30 μm sized UO2 powder bed. The fission energy of the larger sized powder bed (100 μm), varied from 42 MJ to 57 MJ. Larger discrepancies between the slumped and un-slumped initial peak power are predicted. Peak powers varied from 29.2 MW to 106 MW for the smaller-sized powder particles, whereas for larger particles, the peak powers varied from 255 MW to 501 MW
Transient nuclear criticality excursion analysis of highly dispersed particulate three-phase fluidised systems
The aim of this study was to perform sensitivity analysis, investigating how different fluidisation and sedimentation characteristics of three-phase wetted UO2 powder beds, may affect a transient nuclear criticality excursion initiated through the addition of water into a fissile powder bed. This type of postulated nuclear criticality accident scenario may occur in nuclear fuel fabrication facilities when a fire is fought through the use of water, supplied via an automatic or manual fire-suppression system. A similar scenario may also develop as a result of water leaks or flooding of the process area housing UO2 powder. The article introduces a model for gas-bubble induced fluidisation of a UO2 powder bed and examines how this phenomenon may affect the neutron kinetic response of a three-phase fluidised fissile powder system. Empirical analysis has shown that fissile suspensions form agglomerated structures when suspended in water, at agglomerate sizes that range from 18 to 40 . Simulation results indicate that both the critical gas velocity and rate of fluidisation may significantly affect transient nuclear criticality excursion dynamics. The re-distribution of fissile mass into a highly dispersed suspension generally reduces the reactivity of the system, however, depending on the H/U ratio, a positive reactivity may be added to the system. Low Péclet numbers in the suspension suggest that gas-bubble induced motion of the suspension causes a highly dispersive flow field. An oscillatory power response is predicted for low critical gas velocities where the reactivity of the system is predominantly governed by the re-distribution of fissile mass within the system. The frequency of these oscillations is greater for a higher hindered settling rate of powder particles. At a higher critical gas velocity, the transient nuclear criticality excursion is governed by the voidage reactivity feedback, making the response quite independent of fluidisation. In all cases, large volumes of UO2 powder may leave the domain due to overflowing of the suspension. Transient nuclear criticality excursions in UO2 powder beds with a low critical gas velocity are terminated once the bed becomes fully saturated
Numerical comparison of mathematical and computational models for the simulation of stochastic neutron kinetics problems
This paper concerns numerical comparisons between five mathematical models capable of modelling the stochastic behaviour of neutrons in low extraneous (extrinsic or fixed) neutron source applications. These models include analog Monte-Carlo (AMC), forward probability balance equations (FPB), generating function form of the forward probability balance equations (FGF), generating function form of the backward probability balance equations (P´al-Bell), and an Itˆo calculus model using both an explicit and implicit Euler-Maruyama discretization scheme. Results such as the survival probability, extinction probability, neutron population mean and standard deviation, and neutron population cumulative distribution function have all been compared. The least computationally demanding mathematical model has been found to be the use of the P´al-Bell equations which on average take four orders of magnitude less time to compute than the other methods in this study. The accuracy of the AMC and FPB models have been found to be strongly linked to the computational e ciency of the models. The computational e ciency of the models decrease significantly as the maximum allowable neutron population is approached. The Itˆo calculus methods, utilising explicit and implicit Euler-Maruyama discretization schemes, have been found to be unsuitable for modelling very low neutron populations. However, improved results, using the Itˆo calculus methods, have been achieved for systems containing a greater number of neutrons
Minimally Invasive Transverse Aortic Constriction in Mice
Minimally invasive transverse aortic constriction (MTAC) is a more desirable method for the constriction of the transverse aorta in mice than standard open-chest transverse aortic constriction (TAC). Although transverse aortic constriction is a highly functional method for the induction of high pressure in the left ventricle, it is a more difficult and lengthy procedure due to its use of artificial ventilation with tracheal intubation. TAC is oftentimes also less survivable, as the newer method, MTAC, neither requires the cutting of the ribs and intercostal muscles nor tracheal intubation with a ventilation setup. In MTAC, as opposed to a thoracotomy to access to the chest cavity, the aortic arch is reached through a midline incision in the anterior neck. The thyroid is pulled back to reveal the sternal notch. The sternum is subsequently cut down to the second rib level, and the aortic arch is reached simply by separating the connective tissues and thymus. From there, a suture can be wrapped around the arch and tied with a spacer, and then the sternal cut and skin can be closed. MTAC is a much faster and less invasive way to induce left ventricular hypertension and enables the possibility for high-throughput studies. The success of the constriction can be verified using highfrequency trans-thoracic echocardiography, particularly color Doppler and pulsed-wave Doppler, to determine the flow velocities of the aortic arch and left and right carotid arteries, the dimension of the blood vessels, and the left ventricular function and morphology. A successful constriction will also trigger significant histopathological changes, such as cardiac muscle cell hypertrophy with interstitial and perivascular fibrosis. Here, the procedure of MTAC is described, demonstrating how the resulting flow changes in the carotid arteries can be examined with echocardiography, gross morphology, and histopathological changes in the heart.Department of Health Technology and Informatics2016-2017 > Academic research: refereed > Publication in refereed journalbcr
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