Three-year Forecast of Hospital Admission Costs of AIDS Patients in Oklahoma

The sudden onset of the acquired immunodeficiency syndrome (AIDS) in Oklahoma in January of 1983 has created some very serious problems for health care providers. The high costs related to the medical management of AIDS patients have resulted in significant financial burdens for a number of Oklahoma hospitals. In order to formulate a strategic plan for coping with future hospital admission costs associated with the increasing number of AIDS victims, a forecast relating the extent of the potential problem is necessary. The objective of this study is to provide that forecast by combining historical hospital admission costs for AIDS patients in Oklahoma with a computer forecas t of expected new cases over the next three years. Eight hospitals, which managed 87 percent of the reported AIDS cases, provided admission-cost figures for 71 percent of the cumulative Oklahoma morbidity. The Interactive Financial Planning System (IFPS) was employed to derive anticipated case totals for each of the three calendar years. Although the average Oklahoma AIDS patient survives only four months afte r diagnosis, the hospital admission charges total approximately $25,000 per patient. This is based on observed figures, which indicate an average of 35 hospital days at$708 per patient per day. The predictions for new AIDS diagnoses for 1986, 1987, and 1988 reached 44, 69, a nd 100 respectively. In combining these numbers with average cos t figures, charges f or hospital a dmissi ons are expected to reach $1.1 million in 1986,$1.7 mi ll i on in 1987, and $2.5 million in 1988. Thi s reflects a$5 .3 million total for the next three years, in terms of hospital admis s i ons only, for medically managing AIDS patients.Business Administratio

Regional trace element and sulfate transport

The goal of this paper was to investigate the transport of atmospheric sulfate and trace elements across the northeastern U.S.A. Data from a number of sites--Underhill (VT), Whiteface Mountain (NY), Mayville (NY), Laurel Hill and Allegheny Mountain (PA) and Deep Creek Lake (MD)--in August 1983 were considered. Sulfate was found to be regional in nature, displaying temporal variations which were similar at sites separated by large distances (several hundred kilometers) under certain meteorological conditions. Selenium was the only trace species investigated which displayed a regional character, though it too was influenced by local sources. Other elements, such as As and V displayed a somewhat regional nature but less than that observed for sulfate and selenium.The 5-day period 16-20 August, a period of elevated sulfate at all sites, was investigated as to the generality of regional signatures, utilizing trace element ratios. The inter-site variabilities in elemental ratios among the Allegheny, Laurel, Deep Creek and Mayville sites were generally small (a factor of 2 or less) and well within the variabilities at a given site from one day to another. But there were exceptions, probably reflecting influences of local sources. Comparison with earlier trace-element data from the same region suggests that temporal variations may be less than spatial ones. Together the data indicate that it is important to obtain data from multiple sites and periods within a region in any effort to construct a regional signature.An unusually clean period, 13-15 August, with steady air mass advection from the northeast to all sites, was investigated to evaluate the conservation of regional signatures into downwind regions. The inter-regional differences in trace element ratios proved to be far larger than the intea-regional ones--an order of magnitude in some cases, attributable mostly to addition of trace elements in the downwind region. The ability to identify in one region the signature from another region appears to be problematic. However, aerosol trace element ratios are found to be a powerful tool for investigating regional source influences when used in concert with meteorological information.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31952/1/0000905.pd

Quantitation of Aortic Valvular Insufficiency Using Radioactive Tracers: An Experimental Study In Vitro

A method has been developed in vitro for quantitation of aortic valvular insufficiency (Al) based on the use of ladioactive traceis lo genei-ate graphic recordings of the movement of blood out of the ventricle and back again. The regurgitant fraction of stroke volume (peirent of Al) is read from this recording. The method was evaluated in a mechanical heart model by comparing Al values read from the istope recordings and Al values determined volumetrically. The recordings gave excellent agreement with the volumetric results (Corr. Coeff. .9). These in vitro results are of such quality that clinical trials seem justified

Considerations for design of source apportionment studies

This report recommends procedures for source and ambient sampling and analysis in source apportionment studies. The recommendations are based on the results of receptor model studies of atmospheric particles in urban areas, especially a recent study of Houston, TX, undertaken as part of the Mathematical and Empirical Receptor Models Workshop (Quail Roost II). The recommendations are presented at three levels of increasing cost and detail of information obtained. Existing mass emissions inventories combined with chemically resolved test data from similar sources (not necessarily in the same locale) can be used to initially estimate the sources of elements present on ambient particles. To aid local users in construction of chemically resolved emission estimates, the U.S. Environmental Protection Agency (EPA) is compiling a library of compositions and size distributions of particulate emissions from major source types. More reliable source characterization can be achieved if the actual sources are tested directly. EPA should develop and publish detailed procedures for source sampling that would be more appropriate for receptor model use than are existing standard methods. Source and ambient sampling should be conducted by similar methods. If possible, particles from sources should be collected in a way that simulates changes that would normally occur before they reach distant receptors (e.g. by diluting and cooling the particles from hot sources). It is recommended that particulate samples be routinely collected in two size fractions by use of virtual impactors and that all samples be subjected, at a minimum, to mass and X-ray fluorescence analyses. Additional measurements are suggested for obtaining more detailed information: neutron activation analysis; X-ray diffraction; automated particle classification by electron microscopy; analyses for classes of organic species, ^(14)C and thermally released carbonaceous species; and real-time observation of several gases during sample collection. Methods for collecting meteorological data in parallel with ambient samples are described, as are methods for incorporating such data into the source identification process

ScanFish Optical Plankton Counter (OPC) data from R/V Pelican cruises PE03-NGOMEX, PE04-NGOMEX, PE06-NGOMEX, PE07-NGOMEX, PE09-05, and PE11-06 in the Northern Gulf of Mexico between 2003 and 2010

Dataset: ScanFish OPCAn optical plankton counter (OPC) and CTD mounted to a ScanFish platform were towed and undulated behind the R/V Pelican during cruises PE03-NGOMEX, PE04-NGOMEX, PE06-NGOMEX, PE07-NGOMEX, PE09-05, and PE11-06 in the Northern Gulf of Mexico between 2003 and 2010. CTD and MIDAS data were synchronized and merged with simultaneously collected OPC data and aggregated into 1 second time bins. Bottom depth was obtained from the NOAA NCEI coastal relief model. For a complete list of measurements, refer to the supplemental document 'Field_names.pdf', and a full dataset description is included in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: http://www.bco-dmo.org/dataset/746081NSF Division of Ocean Sciences (NSF OCE) OCE-1043261, NSF Division of Ocean Sciences (NSF OCE) OCE-1043248, NSF Division of Ocean Sciences (NSF OCE) OCE-1043249, National Oceanic and Atmospheric Administration (NOAA) NA06NOS4780148, National Oceanic and Atmospheric Administration (NOAA) NA09NOS4780198, Gulf Research Program of the National Academies of Sciences, Engineering, and Medicine (GRP) NAS-GRP-200000641

Effect of ambient humidity on dichotomous sampler coarse/fine ratios

Atmospheric aerosols were measured in August 1983 on Allegheny Mountain and Laurel Hill in southwestern Pennsylvania. Ambient humidity was observed to influence the coarse to fine particle ratios as determined by dichotomous samplers. This influence is evident in the particle mass and in its component chemical species. The sampling run with the most pronounced mass shift resulted in an apparent loss of 50 % of the fine mass and 66 % of the fine particle sulfur to the coarse fraction. The magnitude of the mass shift appears to be related to the length of time that the aerosol was in a saturated environment and also to the original dry particle size. These observations have serious implications for receptor modeling with dichotomous sampler data whenever only the fine particles are considered.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27611/1/0000655.pd

The sources of aerosol elemental carbon at Allegheny Mountain

Aerosol elemental carbon measurements were taken at two rural sites in southwestern Pennsylvania during August 1983. Carbon, though a small part of the aerosol mass at both sites, was a leading constituent of the aerosol on an atom basis. Time-weighted average concentrations at Allegheny Mountain and Laurel Hill were 1.2 and 1.4 [mu]g m-3, respectively. Absolute Principal Component Analysis followed by multiple regression and Chemical Mass Balance techniques were utilized to apportion the measured elemental carbon to its sources. Motor vehicles were estimated to be the largest source of elemental carbon at the two sites, contributing 41-68% and 34-56% at Allegheny Mountain and Laurel Hill, respectively.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28963/1/0000800.pd

Divergent controls of soil organic carbon between observations and process-based models

The storage and cycling of soil organic carbon (SOC) are governed by multiple co-varying factors, including climate, plant productivity, edaphic properties, and disturbance history. Yet, it remains unclear which of these factors are the dominant predictors of observed SOC stocks, globally and within biomes, and how the role of these predictors varies between observations and process-based models. Here we use global observations and an ensemble of soil biogeochemical models to quantify the emergent importance of key state factors – namely, mean annual temperature, net primary productivity, and soil mineralogy – in explaining biome- to global-scale variation in SOC stocks. We use a machine-learning approach to disentangle the role of covariates and elucidate individual relationships with SOC, without imposing expected relationships a priori. While we observe qualitatively similar relationships between SOC and covariates in observations and models, the magnitude and degree of non-linearity vary substantially among the models and observations. Models appear to overemphasize the importance of temperature and primary productivity (especially in forests and herbaceous biomes, respectively), while observations suggest a greater relative importance of soil minerals. This mismatch is also evident globally. However, we observe agreement between observations and model outputs in select individual biomes – namely, temperate deciduous forests and grasslands, which both show stronger relationships of SOC stocks with temperature and productivity, respectively. This approach highlights biomes with the largest uncertainty and mismatch with observations for targeted model improvements. Understanding the role of dominant SOC controls, and the discrepancies between models and observations, globally and across biomes, is essential for improving and validating process representations in soil and ecosystem models for projections under novel future conditions