Separate Criteria Research Articles

Beyond the Hernia Repair: A Review of the Insurance Coverage of Critical Adjuncts in Abdominal Wall Reconstruction

Insurance companies were selected based on their national and state market share. Preauthorization criteria, preauthorization lists, and medical/clinical policies by each company for component separation, SVRH-P, and SVRH-A were examined. Coverage criteria were abstracted and analyzed. Fifty insurance companies were included in the study. Only 1 company had clear approval criteria for component separation, while 38 cover it on a case-by-case basis. Four companies had clear approval policies for SVHR-P, 4 cover them on an individual case basis, and 28 flatly do not cover SVHR-P. Similarly, 3 companies had clear approval policies for SVHR-A, 6 cover them case by case, and 33 do not cover SVHR-A. Component separation and soft tissue contouring are important adjunctive AWR procedures with efficacy supported by peer-reviewed literature. The variability in SVHR-P and SVHR-A coverage likely decreases access to these procedures even when there are established medical indications. The authors recommend standardization of coverage criteria for component separation, given that differing interpretations of medical necessity increase the likelihood of insurance denials.

Light Chain Predominant Intact Immunoglobulin Monoclonal Gammopathy Disorders: Shorter Survival in Light Chain Predominant Multiple Myelomas.

A proportion of intact immunoglobulin (Ig)-producing multiple myelomas (MMs) was observed to secrete much higher amounts of free light chains (LCs) than usual. To determine the change point between usual and LC-predominant intact Ig-secreting MMs and other monoclonal gammopathic manifestations and the biological significance of the observation. We conducted retrospective examination of laboratory findings in 386 MM, 27 smoldering MM, and 179 monoclonal gammopathy of undetermined significance (MGUS) cases that secreted intact Igs. We recorded the highest levels of involved serum free LC, highest ratio of involved to uninvolved LC, highest concentration of involved LC per g of monoclonal Ig, and highest value for ratio of involved to uninvolved LCs divided by the monoclonal Ig concentration. Each data set was sorted into kappa- and lambda LC-associated lesions. Length of time, in months, between diagnosis and last contact with the patients having myeloma was recorded. Change point analysis of data revealed a subgroup of cases with distinctly higher levels of free LCs. In myelomas, including plasma cell leukemias, 16.4% of myelomas with kappa LCs and 22.3% of myelomas with lambda LCs, the LC secretion was distinctly higher than in the remaining cases, by a combination of 4 parameters, listed herein. Corresponding figures for smoldering myeloma (SMM) and monoclonal gammopathy of undetermined significance (MGUS) were 12.5, 27.3, 3.8, and 6.8, respectively. Ten of the 13 (77%) cases of plasma cell leukemia) and all cases of IgD myeloma (n = 4) showed excess secretion of serum free LCs. Among IgG and IgA myelomas, including plasma cell leukemias, the LC-predominant lesions had shorter survival, by an average of 22.5 months. In total, 18.4% of MMs, including plasma cell leukemias, secrete distinctly higher amounts of serum free LCs than other intact Ig-secreting myelomas and confer significantly lower survival. Quantification of monoclonal serum free LCs may be useful in this subgroup in monitoring progress and potentially in ascertaining minimal residual disease. The findings also stress the need for separate criteria for kappa and lambda LC associated monoclonal gammopathic manifestations. The significantly shorter survival of patients with LC-predominant myelomas warrants consideration in prospective trials of treatments.

Inertias of entanglement witnesses

Entanglement witnesses (EWs) are a fundamental tool for the detection of entanglement. We study the inertias of EWs, i.e., the triplet of the numbers of negative, zero, and positive eigenvalues respectively. We focus on the EWs constructed by the partial transposition of states with non-positive partial transposes. We provide a method to generate more inertias from a given inertia by the relevance between inertias. Based on that we exhaust all the inertias for EWs in each qubit–qudit system. We apply our results to propose a separability criterion in terms of the rank of the partial transpose of state. We also connect our results to tripartite genuinely entangled states and the classification of states with non-positive partial transposes. Additionally, the inertias of EWs constructed by X-states are clarified.

A Multi-Criteria Band Selection Method of Hyperspectral Images

Hyperspectral remote sensing images are characterized by many bands and large amounts of datum, which require the dimensionality reduction, but band selection is one of the basic methods for dimensionality reduction of hyperspectral datum. For this reason, this paper proposes a multi-criteria band selection method. Firstly, the intrinsic dimensionality of hyperspectral image is calculated by virtual dimension, then the subspace is divided according to the band correlation criterion; and secondly, the information criterion is adopted to select the high-quality exponential bands in each subspace; and finally, the most suitable bands in each subspace are selected by class separability criterion to form the optimal band subset. Various experiments show that, compared with the optimum index factor and adaptive band selection methods, the proposed method has better performance in the measurement of information volume and information redundancy.

On the Stable Resolution Limit of Total Variation Regularization for Spike Deconvolution

The stability of spike deconvolution, which aims at recovering point sources from their convolution with a point spread function (PSF), is known to be related to the separation between those sources. When the observations are noisy, it is critical to ensure support stability, where the deconvolution does not lead to spurious, or oppositely, missing estimates of the point sources. In this paper, we study the resolution limit of stably recovering the support of two closely located point sources using the Beurling-LASSO estimator, which is a convex optimization approach based on total variation regularization. We establish a sufficient separation criterion between the sources, depending only on the PSF, above which the Beurling-LASSO estimator is guaranteed to return a stable estimate of the point sources, with the same number of estimated elements as that of the ground truth. Our result highlights the impact of PSF on the resolution limit in the noisy setting, which was not evident in previous studies of the noiseless setting. Towards the end, we show that the same resolution limit applies to resolving two close-located sources in conjunction of other well-separated sources.

Twist drilling SPH simulation for thrust force and torque prediction

Drilling is one of the most common processes in metalworking. The cutting forces that occur during the drilling process have a significant impact on the accuracy and quality of the holes. Uncompensated radial cutting forces lead to an increase in the diameter of the hole being machined, which reduces its accuracy. And when machining laminated materials, excessive axial cutting force leads to a stratification of the composite and reduces the quality of the hole. In this regard, the task of determining or predicting cutting forces is currently quite relevant. This article proposes a method for calculating cutting forces when drilling aluminum homogeneous and isotropic alloy 6061-T6 using smoothed particle hydrodynamics method (SPH). The calculation results are compared with calculations using empirical formulas and the results of experiments of other authors. The influence of the chip separation criterion type and material model on cutting forces during drilling were also investigated.

Three-dimensional elastic-plastic damage constitutive model of wood

Abstract A 3D combined elastic-plastic damage constitutive model for wood is proposed within the theoretical framework of classical plasticity and continuum damage mechanics (CDM). The model is able to describe the various behavior of wood under loading, including the orthotropic elasticity, strengths inequality under tension and compression in each orthotropic direction, ductile softening under longitudinal compression, brittle failure under transverse tension, and parallel shearing, densification hardening under transverse compression. Hoffman criterion and a set of eight separate failure criteria were used to define wood yielding and damage initiation, respectively. Isotropic hardening was assumed after yielding and defined by an exponential type function. The constitutive model was implicitly discretized using backward Euler method, solved through the return mapping algorithm and implemented into ABAQUS through the user-defined material subroutine (UMAT). The proposed model was firstly verified by material property tests considering different stress states: monotonic and repeated tension and compression (in both parallel and perpendicular-to-grain directions), parallel-to-grain shearing, and the interactions between perpendicular-to-grain compression/tension and parallel-to-grain shearing, etc. Mechanical behavior of typical structural elements was further simulated to validate the proposed constitutive model.

Determination of the Fracture Resistance of Ductile Polymers: The ESIS TC4 Recent Experience

Abstract Round-robin (RR) tests carried out under the direction of the Technical Committee 4, “Polymers, Polymer Composites and Adhesives,” of the European Structural Integrity Society (ESIS TC4) showed that the multispecimen methodology employed for the construction of the crack growth resistance curve (J vs crack extension, Δa) of polymers often does not provide reliable data because of the uncertainties associated with the measurement of Δa. With this in mind, the ESIS TC4 attention has been more recently focused on the analysis of a testing scheme based on the load separation criterion, which does not require the measurement of Δa. With the aim to employ this new approach into a standardized procedure, the degree of reproducibility of the results obtainable with the application of this testing scheme to ductile polymers has been assessed by means of multilaboratory RR testing exercises that started in 2011. An ESIS TC4 reference draft protocol was prepared and 10 laboratories participated in the RR activities. The present work describes the load separation criterion-based testing procedure recently examined by ESIS TC4 and gives a summary of the results obtained in the RR activities, which appear encouraging.

O15 Recognition of subclinical macrophage activation syndrome in an adolescent systemic juvenile idiopathic arthritis patient receiving tocilizumab: a case report

O15 Recognition of subclinical macrophage activation syndrome in an adolescent systemic juvenile idiopathic arthritis patient receiving tocilizumab: a case report

Convergences in the Architectonics of Tremadodes Musculature and the Relationship Between the Concepts of Convergence and Parallelism

New examples of convergences in the architectonics of trematode musculature are described. These include the complete reduction of the diagonal muscles in the sedentary areas of the integument, the peculiarities of distribution of the dorsoventral muscles within the ventral deepening of the body, the presence of radial parenchymal muscles in the hollow radially symmetrical areas of the body, the spatial distribution of the pharyngeal protractors, the removal of the peripheral layers of the muscles of the oral sucker, the formation of chordal muscles in the oral sucker, and some others. The validity of separating the concepts of convergence and parallelism is discussed. The disadvantages of separation criteria such as the degree of kinship of phylogenetic groups, the occupation of adaptive zones of different scales, and the formation of analogous or homologous organs on the basis of evolution are named. Raising parallelism to the rank of an independent evolutionary phenomenon is estimated as unreasonable.

Algebraic Criteria of the Integral Separation for Solving Certain Classes of Ordinary Differential Equations Systems

One of the important directions of the qualitative theory of ordinary differential equations is to study the properties of linear systems that satisfy the condition of integral separation. Anyway, integral separation becomes apparent in all studies concerning the asymptotic behavior of the solutions for the linear systems under the action of small perturbations.The papers of V.M. Millionschikov, B.F. Bylov, N.A. Izobov, I.N. Sergeev et al. proved that the available integral separation is the main reason for the rough stability of the characteristic Lyapunov exponents, the rough stability of the highest Lyapunov exponent, and the rough diagonalizability of systems by Lyapunov transformations, and other fundamental properties of linear differential systems.The paper presents the basic properties of the set of linear systems with constant, periodic, reducible coefficients and proves the algebraic criteria for their property of integral separation of solutions to be available.The results can be used in modeling dynamic processes.

Analysis of All-Cause Mortality Population of Insurance Applicants

Background: The risk of all-cause mortality is assessed in the study from factors consisting of BMI, medical history, socioeconomic status etc where factors are available in the life insurance organization data and submitted at the time of registration and subsequently in the death claim papers which gives detail about the state of health and cause of death.
 Methods: A retrograde study has been carried out of 300 deceased life insured (2005-2014) from the data of a life insurance organization in Pakistan about all-cause mortality from the available factors in death claim files. The research instruments were consisting of death claim register, proposal forms, medical reports and death claim papers.
 Results: The results indicate maximum deaths found due to Cardiovascular causes (43.34%) followed by Cancer (9.00%) while minimum found in, Endocrine disorders(0.33%)followed by Respiration(0.67%). However significant causes of death occurred due to Accident, Liver, CNS, Multisystem involvement, Natural disaster and Un- natural. The correlation co-efficient found as ‘0.07’ for all-cause mortality indicating positive relationship between BMI and Life Expectancy.
 Conclusion: Medical history plays an important but not a compulsory role in mortality. Since BMI (WHO) showed higher mortality with normal BMI whereas BMI (Asia) showed it at-risk value therefore WHO should make separate criteria of standard of BMI as being different for different ethnicities. In Insurance organization NT-proBNP and BMI of ethnic area be used to asses life expectancy in applicants. Necessary measures should be opted for implementation of “The Sendai Framework for Disaster Risk Reduction 2015-2030”.

Separation safety analysis using CFD simulation and remeshing

The work is aimed to simulate the separation process of a GBU-31 bomb and empty 370 gal fuel tank from an aircraft, using the 6 – Degree Of Freedom (6-DOF) procedure and Computational Fluid Dynamics (CFD) code for body movement. The procedure has an ability to simulate the sequential release from the joints, which is necessary for the lightweight tank separation, in order to avoid a collision with an aircraft. A set of unsteady CFD simulations were calculated. Both the in-house designed 6-DOF procedure and the CFD simulation settings were validated using the wind tunnel experiment data and a Covert criterion for safety separation. Similar approach could be used to analyze the separation of other kinds of external stores and during design the deployment of anti radar chaff, flares or ejection seats. This kind of research is extremely important in the way to improve safety level of flight operations and avoid hazardous situations in the air. This work presents original results obtained by the authors.

Quantum entanglement criterion based on extended complex plane

The state space of quantum system is a Hilbert space with complex inner product. The two states quantum system is called a qubit. Its quantum state gives different geometric representations. The density matrix of a quantum state can describe all the information of a quantum system. In particular, the representation of quantum pure states by means of extended complex plane is given. On this basis, combined with the matrix representation of the quantum states of the composite system, the criteria for quantum entanglement and separability are studied. Finally, the measurement method of quantum pure state entanglement is given.

Evaluation of Cultivar Identification Performance Using Feature Expressions and Classification Algorithms on Optical Images of Sweet Corn Seeds

Cultivar identification of seeds is important for crop yield and quality. To study the impact of different features expressions and classification methods on cultivar identification, the performance of the feature expressions and classification algorithms affecting the accuracy of cultivar identification was evaluated by image processing techniques. A total of 448 samples of seeds from seven cultivars of sweet corn, namely, Orlando, Beiyasi, Jingketian 183, Jingtian 218, Suitian 1, CT76 and Lilixiangtian, were evaluated. The color, shape and texture features of the seeds were extracted from the images, and the class separability criterion was adopted to evaluate the separability of the features of the embryo side, nonembryo side and both of them combined. The results indicate that the class separability based on the features of the embryo side was higher than that based on the nonembryo side and both of them combined. Based on the embryo-side optical feature data, dimensionality reduction was conducted by two feature selection methods (stepwise discriminant analysis (SDA) and genetic algorithm (GA)) and two feature extraction methods (principal component analysis (PCA) and kernel principal component analysis (KPCA)). Performance evaluation of the feature reductions was conducted by constructing k-nearest neighbor (K-NN), naïve Bayes (NB), linear discriminant analysis (LDA) and support vector machine (SVM) classifiers. Compared to the PCA and KPCA algorithms, the SDA and GA algorithms were more conducive to the cultivar classification of sweet corn seeds; the critical features selected specifically by the SDA, K-NN, NB, LDA and SVM classifiers achieved the best classification accuracies (81.43%, 82.86%, 90%, and 87.14%, respectively). Analysis of variance (ANOVA) revealed that the approach for optical feature selection had a more significant effect on the identification of sweet corn seed cultivars than did the classifiers. Therefore, based on the optical images of the embryo side and the key features obtained by the feature selection method, a classification model was constructed for the accurate and nondestructive classification of different sweet corn seed cultivars.

Searching for distinct classes of atomic and molecular states using convergence and separability criteria

We demonstrated that the solution ψ to the Schrodinger equation (SE) Ĥψ = eψ converges logarithmically in the classically forbidden region, i.e., as e′ approaches to the correct eigenvalue e, the approximate solution ψ′ logarithmically converges to ψ. Knowing that this approximate eigenvalue procedure generates a straightforward but inefficient method to solve a general problem of n-bodies, we thereby discuss the main characteristic of the usual methods to obtain a better convergence for atoms and molecules. Such usual methods consider that the solution of SE can be approached through a linear combination of solutions of systems with analytical solutions. Hydrogen-like atom solutions are used to describe atoms and molecules. This solution avoids the convergence problem of ψ′ even for approximate eigenvalues e′ since all the terms of the linear combination decay asymptotically to zero. We argue that this type of solution works very well for a large class of almost separable atomic and molecular states in which the separation of electronic (and nucleus) movements occurs. We also establish a comparison of this separability and other systems, like gravitational, in which separability is only possible in particular classes of restricted systems. Finally, we consider the existence of distinct atomic and molecular states that may not be described using usual methods that apply this type of solution, which implies the separability of restricted problems. Therefore, usual methods to describe atoms and molecules may be insufficient to reach solutions with different or more general electronic correlations, as discussed in the text. Strategies to achieve general or distinctive solutions, although approximated, should be further studied and developed.

The Distribution Process of the Housing Stimulant Grants Program (BSPS) during COVID-19 Pandemic Situation in Muncan Village, Karangasem Regency

Purpose: The purpose of this study is to know the existence of BSPS as a government program through PUPR and the review focuses on Muncan Village, Karangasem Regency, as one of the beneficiary areas. The program follows the decisions, directions, rules, and procedures established by the provincial government of Bali.
 Research methods: The data are analyzed to separate criteria related to problems and solutions, and also solutions based on procedures and purposely determine informants based on specific criteria and considerations.
 Findings: Constraints were complicated by the emergence of the Covid-19 pandemic, which has an impact on various lines globally. Particular action needs to be taken primarily by TFL with the community. In addition to having to carry out procedures and rules in the distribution of aid, preventive measures addressing various field conditions also need to be considered. The analysis is divided into two categories: conditional on BSPS verification activities to keep going and initiatives to address the Covid-19 pandemic crisis in the field.
 Implications: The various obstacles faced are expected to become a consideration or study for the next period, especially with things that are unpredictable and are force majeure along with the team that is tasked directly in the field.

40. AN UPDATE ON THE DEVELOPMENT OF A NEW TOOL TO ASSESS RESPONSE IN LEPTOMENINGEAL METASTASIS

In 2016, a standardized scorecard to aid in the evaluation of MRI findings during the course of disease was proposed by the RANO leptomeningeal metastasis (LM) subcommittee. In this scorecard, LM main features and the different CNS metastases types were to be reported as present or absent, dimensions of measurable nodules were to be noted, and changes from the previous MRI were to be scored from -3 to +3. A feasibility and validation study of this scorecard was performed by asking 19 experts to evaluate response in 22 patients diagnosed with and treated for LM. The outcome was disappointing in that the scorecard appeared to be too complicated (Le Rhun et al. Neuro-Oncology 2019;21:648–658). Specific challenges were (i) to understand that the form should be used to rate the current MRI and to compare it with the previous one, (ii) to use the proposed rating with “minus” or “plus” options to assess the change and (iii) to derive a sum score that does not take into consideration (per instruction) changes for the items “hydrocephalus”, “brain metastases” and “parenchymal medullary metastases”. In addition to the apparent challenges for experienced raters to use the LANO scorecard instructions without further instructions, we identified additional weaknesses. These include to eliminate epidural metastases from response assessment, to include the definition of a nodule, the distinction of leptomeningeal versus parenchymal brain disease, and to include parallel, but clearly separate criteria to document brain parenchymal disease. The revised, published proposal for a new scorecard has been used to rate another series of LM cases by experienced neuro-oncologists from March to May 2020. First analyses of this novel feasibility and validation study will be available in August.

The association between lower Hounsfield units on computed tomography and cage subsidence after lateral lumbar interbody fusion

One vexing problem after lateral lumbar interbody fusion (LLIF) surgery is cage subsidence. Low bone mineral density (BMD) may contribute to subsidence, and BMD is correlated with Hounsfield units (HUs) on CT. The authors investigated if lower HU values correlated with subsidence after LLIF. A retrospective study of patients undergoing single-level LLIF with pedicle screw fixation for degenerative conditions at the University of California, San Francisco, by 6 spine surgeons was performed. Data on demographics, cage parameters, preoperative HUs on CT, and postoperative subsidence were collected. Thirty-six-inch standing radiographs were used to measure segmental lordosis, disc space height, and subsidence; data were collected immediately postoperatively and at 1 year. Subsidence was graded using a published grade of disc height loss: grade 0, 0%-24%; grade I, 25%-49%; grade II, 50%-74%; and grade III, 75%-100%. HU values were measured on preoperative CT from L1 to L5, and each lumbar vertebral body HU was measured 4 separate times. After identifying 138 patients who underwent LLIF, 68 met the study inclusion criteria. All patients had single-level LLIF with pedicle screw fixation. The mean follow-up duration was 25.3 ± 10.4 months. There were 40 patients who had grade 0 subsidence, 15 grade I, 9 grade II, and 4 grade III. There were no significant differences in age, sex, BMI, or smoking. There were no significant differences in cage sizes, cage lordosis, and preoperative disc height. The mean segmental HU (the average HU value of the two vertebrae above and below the LLIF) was 169.5 ± 45 for grade 0, 130.3 ± 56.2 for grade I, 100.7 ± 30.2 for grade II, and 119.9 ± 52.9 for grade III (p < 0.001). After using a receiver operating characteristic curve to establish separation criteria between mild and severe subsidence, the most appropriate threshold of HU value was 135.02 between mild and severe subsidence (sensitivity 60%, specificity 92.3%). After univariate and multivariate analysis, preoperative segmental HU value was an independent risk factor for severe cage subsidence (p = 0.017, OR 15.694, 95% CI 1.621-151.961). Lower HU values on preoperative CT are associated with cage subsidence after LLIF. Measurement of preoperative HU values on CT may be useful when planning LLIF surgery.

PENGARUH ROA, NPM dan DER TERHADAP CORPORATE SOCIAL RESPONSIBILITY (CSR)

The problem in this research is the low level of CSR disclosure or social responsibility in mining companies, even though in reality it is stated in the law that every company is required to disclose social responsibility. This research is an empirical study on mining companies listed on the Indonesia Stock Exchange in the 2014-2018 period. The purpose of this study was to determine the effect of ROA, NPM and DER on CSR. This research is quantitative descriptive. The data used are secondary data with direct collection through the company's annual report. This sampling technique uses a separate sample criteria taken from mining companies that disclose CSR using the GRI index. Data analysis in this study used multiple linear regression analysis with SPSS 24 software. The results of this study indicate that partially the ROA variable has no significant positive effect on CSR, while the NPM and DER variables have a significant positive effect on CSR. However, all variables simultaneously influence CSR.