How Much Uncompensated Care do Doctors Provide?

The magnitude of provider uncompensated care has become an important public policy issue. Yet existing measures of uncompensated care are flawed because they compare uninsured payments to list prices, not to the prices actually paid by the insured. We address this issue using a novel source of data from a vendor that processes financial data for almost 4000 physicians. We measure uncompensated care as the net amount that physicians lose by lower payments from the uninsured than from the insured. Our best estimate is that physicians provide negative uncompensated care to the uninsured, earning more on uninsured patients than on insured patients with comparable treatments. Even our most conservative estimates suggest that uncompensated care amounts to only 0.8% of revenues, or at most $3.2 billion nationally. These results highlight the important distinction between charges and payments, and point to the need for a re-definition of uncompensated care in the health sector going forward.

A Concurrent IFDS Dataflow Analysis Algorithm Using Actors

There has recently been a resurgence in interest in techniques for effective programming of multi-core computers. Most programmers find general-purpose concurrent programming to be extremely difficult. This difficulty severely limits the number of applications that currently benefit from multi-core computers. There already exist many concurrent solutions for the class of regular applications, which include various algorithms for linear algebra. For the class of irregular applications, which operate on dynamic and pointer- and graph-based structures, efficient concurrent solutions have so far remained elusive. Dataflow analysis applications, which are often found in compilers and program analysis tools, have received particularly little attention with regard to execution on multi-core machines. Operating on the theory that the Actor model, which structures computations as systems of asynchronously-communicating entities, is a more appropriate method for representing irregular algorithms than the shared-memory model, this work presents a concurrent Actor-based formulation of the IFDS, or Interprocedural Finite Distributive Subset, dataflow analysis algorithm. The implementation of this algorithm is done using the Scala language and its Actors library. This algorithm achieves significant speedup on multi-core machines without using any optimistic execution. This work contributes to Actor research by showing how the Actor model can be practically applied to a dataflow analysis problem. This work contributes to static analysis research by showing how a dataflow analysis algorithm can effectively make use of multi-core machines, allowing the possibility of faster and more precise analyses

Time-Series Ensemble Photometry and the Search for Variable Stars in the Open Cluster M11

This work presents the first large-scale photometric variability survey of the intermediate age (~200 Myr) open cluster M11. Thirteen nights of data over two observing seasons were analyzed (using crowded field and ensemble photometry techniques) to obtain high relative precision photometry. In this study we focus on the detection of candidate member variable stars for follow-up studies. A total of 39 variable stars were detected and can be categorized as follows: 1 irregular (probably pulsating) variable, 6 delta Scuti variables, 14 detached eclipsing binary systems, 17 W UMa variables, and 1 unidentified/candidate variable. While previous proper motion studies allow for cluster membership determination for the brightest stars, we find that membership determination is significantly hampered below V=15,R=15.5 by the large population of field stars overlapping the cluster MS. Of the brightest detected variables that have a high likelihood of cluster membership, we find five systems where further work could help constrain theoretical stellar models, including one potential W UMa member of this young cluster.Comment: 38 pages, 13 figures, accepted for December 2005 AJ, high-resolution version available upon reques

Evaluación de la resistencia a la compresión, tracción y flexión del concreto reforzado con sikafiber cho 65/35 nb en elementos horizontales sobre terreno, Trujillo, 2023

El presente trabajo de investigación tiene por objetivo evaluar la resistencia de concretos para estructuras horizontales sobre terreno reforzados con SikaFiber CHO 65/35 NB sometidos a compresión, tracción y flexión, debido a que en los últimos años las fibras han aparecido como una tecnología emergente para el sector construcción, las cuales han aportado soluciones a los diferentes perfiles que se requiere del concreto. Esta investigación pertenece a un estudio de tipo experimental, de corte cuasi experimental y tipo aplicada, se considera una muestra de 72 probetas cilíndricas y 12 probetas tipo viga. Como técnica de recolección de datos se empleará la observación, la técnica de muestreo es de tipo no probabilística por juicio de experto, y tiene como instrumentos a las guías de observación, con lo cual se obtuvo como resultado que las fibras SikaFiber CHO 65/35 NB influyen positivamente en la resistencia a la flexión del concreto, estas aumentan la resistencia a la flexión hasta un 37 % con una dosificación de 7 kg/m3, con respecto a un concreto tradicional. Como conclusión se obtuvo que la influencia de las fibras SikaFiber CHO 65/35 NB en el concreto se da específicamente en la resistencia a la flexión, de acuerdo a una dosificación optima, sin embargo, puede afectar a las propiedades mecánicas de resistencia a la compresión y tracción del concret

Transmission of viruses via our microbiomes.

BackgroundBacteria inhabiting the human body have important roles in a number of physiological processes and are known to be shared amongst genetically-related individuals. Far less is known about viruses inhabiting the human body, but their ecology suggests they may be shared between close contacts.ResultsHere, we report the ecology of viruses in the guts and mouths of a cohort and demonstrate that substantial numbers of gut and oral viruses were shared amongst genetically unrelated, cohabitating individuals. Most of these viruses were bacteriophages, and each individual had distinct oral and gut viral ecology from their housemates despite the fact that some of their bacteriophages were shared. The distribution of bacteriophages over time within households indicated that they were frequently transmitted between the microbiomes of household contacts.ConclusionsBecause bacteriophages may shape human oral and gut bacterial ecology, their transmission to household contacts suggests they could have substantial roles in shaping the microbiota within a household

Current Advancements in Pancreatic Islet Cryopreservation Techniques

There have been significant advancements in the research of pancreatic islet transplantations over the past 50 years as a treatment for Type 1 Diabetes Mellitus (T1DM). This work has resulted in hundreds of clinical islet transplantation procedures internationally. One limitation of the procedure includes effective storage techniques during donor-recipient cross-matching following islet isolation from deceased donor. Cryopreservation, which is heavily used in embryology research, has been proposed as a prospective method for pancreatic islet banking to bridge the temporal intervals between donor-recipient matching. The cryopreservation methods currently involve the freezing of islets to subzero (−80/−196°C) temperatures for storage followed by a thawing and warming period, which can be increasingly harmful to islet viability and insulin secretion capabilities. Recent advances in islet cryopreservation technologies have improved outcomes for islet health and survivability during this process. The aim of this chapter is to characterize aspects of the islet cryopreservation method while reviewing current procedural improvements that have led to better outcomes to islet health

Precise Measures of Orbital Period, Before and After Nova Eruption for QZ Aurigae

For the ordinary classical nova QZ Aurigae (which erupted in 1964), we report 1317 magnitudes from 1912--2016, including four eclipses detected on archival photographic plates from long before the eruption. We have accurate and robust measures of the orbital period both pre-eruption and post-eruption, and we find that the orbital period decreased, with a fractional change of -290.71+-0.28 parts-per-million across the eruption, with the orbit necessarily getting smaller. Further, we find that the light curve outside of eclipses and eruption is flat at near B=17.14 from 1912--1981, whereupon the average light curve starts fading down to B=17.49 with large variability. QZ Aur is a robust counter-example against the Hibernation model for the evolution of cataclysmic variables, where the model requires that all novae have their period increase across eruptions. Large period decreases across eruptions can easily arise from mass imbalances in the ejecta, as are commonly seen in asymmetric nova shells.Comment: MNRAS in press, 24 pages, 5 tables, 6 figure

The ALMA Early Science View of FUor/EXor objects. IV. Misaligned Outflows in the Complex Star-forming Environment of V1647 Ori and McNeil's Nebula

We present Atacama Large Millimeter/sub-millimeter Array (ALMA) observations of the star-forming environment surrounding V1647 Ori, an outbursting FUor/EXor pre-MS star. Dust continuum and the (J = 2 - 1) $^{12}$CO, $^{13}$CO, C$^{18}$O molecular emission lines were observed to characterize the V1647 Ori circumstellar disc and any large scale molecular features present. We detect continuum emission from the circumstellar disc and determine a radius r = 40 au, inclination i = 17$^{\circ}$$^{+6}_{-9}$ and total disc mass of M$_{\mathrm{disk}}$ of ~0.1 M$_{\odot}$. We do not identify any disc structures associated with nearby companions, massive planets or fragmentation. The molecular cloud environment surrounding V1647 Ori is both structured and complex. We confirm the presence of an excavated cavity north of V1647 Ori and have identified dense material at the base of the optical reflection nebula (McNeil's Nebula) that is actively shaping its surrounding environment. Two distinct outflows have been detected with dynamical ages of ~11,700 and 17,200 years. These outflows are misaligned suggesting disc precession over ~5500 years as a result of anisotropic accretion events is responsible. The collimated outflows exhibit velocities of ~2 km s$^{-1}$, similar in velocity to that of other FUor objects presented in this series but significantly slower than previous observations and model predictions. The V1647 Ori system is seemingly connected by an "arm" of material to a large unresolved structure located ~20$"$ to the west. The complex environment surrounding V1647 Ori suggests it is in the early stages of star formation which may relate to its classification as both an FUor and EXor type object.Comment: 18 pages, 14 figures, 4 tables; accepted for publication in MNRA

The ALMA Early Science View of FUor/EXor Objects - V. Continuum Disc Masses and Sizes

Low-mass stars build a significant fraction of their total mass during short outbursts of enhanced accretion known as FUor and EXor outbursts. FUor objects are characterized by a sudden brightening of ∼5 mag at visible wavelengths within 1 yr and remain bright for decades. EXor objects have lower amplitude outbursts on shorter time-scales. Here we discuss a 1.3 mm Atacama Large Millimeter/submillimeter Array (ALMA) mini-survey of eight outbursting sources (three FUors, four EXors, and the borderline object V1647 Ori) in the Orion Molecular Cloud. While previous papers in this series discuss the remarkable molecular outflows observed in the three FUor objects and V1647 Ori, here we focus on the continuum data and the differences and similarities between the FUor and EXor populations. We find that FUor discs are significantly more massive (∼80–600 MJup) than the EXor objects (∼0.5–40 MJup). We also report that the EXor sources lack the prominent outflows seen in the FUor population. Even though our sample is small, the large differences in disc masses and outflow activity suggest that the two types of objects represent different evolutionary stages. The FUor sources seem to be rather compact (Rc \u3c 20–40 au) and to have a smaller characteristic radius for a given disc mass when compared to T Tauri stars. V1118 Ori, the only known close binary system in our sample, is shown to host a disc around each one of the stellar components. The disc around HBC 494 is asymmetric, hinting at a structure in the outer disc or the presence of a second disc

Diseño e implementación de una red Wireless LAN para mejorar la gestión de incidencias en una empresa privada, Lima – 2022

El objetivo de este desarrollo de tesis será Diseñar e implementar una red Wireless LAN para mejorar la gestión de incidencias en una empresa privada, Lima – 2022. Teniendo un modelamiento de confiabilidad, disponibilidad y mantenibilidad de la plataforma de telecomunicaciones y transmisión de datos, que permita el cálculo de la disponibilidad y la estimación de la confiabilidad de los conmutadores, enrutadores, puntos de accesos y equipos de radio enlace. El tipo de investigación será aplicado, de nivel descriptivo – explicativo, con enfoque cuantitativo y diseño experimental puro. La muestra estará conformada por una encuesta y una ficha de registro considerando una población de 100 trabajadores de las instalaciones de la empresa privada, es decir abril (Pretest) y junio (Post test) del 2022. Para la recopilación de datos se artículos y bibliografías. Finalmente, se estimó un presupuesto de S/. 31,390.54 para la ejecución del trabajo y durara aproximadamente un mes, está propuesta estaría incluyendo 2 Switch Acceso PoE, 12 Access Point Antenas bidireccional y 8 Access Point omnidireccional. Se realizará la configuración en un controlador Cisco 7500Wiriless Controller y se generará los registros de manera automática en el Cisco Prime Infraestructure. Esta investigación puede ser tomado como ejemplo para las implementaciones de Access Point con el fin de reducir las incidencias de WIFI dentro de las empresas a nivel internacional que opten por la tecnología Cisco como una de sus altas capacidades de solución ante problemas de interferencia de canales, interferencia de radiación de SSID propagados y entre otros problemas específicos, las licencias para los Access Point serán adquiridas por el cliente y nosotros nos encargaremos de subirlas al controlador