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Svätopluk Štúr is a strong critic of strands of German thought that emphasize the will to power as an organizing principle of human society. Štúr is particularly critical of Nietzsche’s vitalism, which Štúr believes culminated in national socialism and the destruction of the Second World War. This paper describes and examines Štúr’s criticism of a number of German thinkers and focuses especially on Štúr’s criticism of Nietzsche. Štúr criticizes Nietzsche’s emphasis on life over knowledge. Štúr offers a different philosophy of life grounded in the dignity of human beings and the social consequences of ideas and actions. This paper concludes by examining what Štúr means by dignity in terms of a moral agent and as opposed to Nietzsche’s emphasis on vitalism.

OBJECTIVES To determine whether elimination of co-pays for prescription drugs affects medication adherence and total health care spending. STUDY DESIGN Retrospective comparative study. METHODS We conducted a difference-in-differences comparison in the year before and after expansion of a Zero Dollar Co-pay (ZDC) prescription drug benefit in commercially insured Louisiana residents. Blue Cross and Blue Shield of Louisiana members with continuous disease management program enrollment were analyzed, of whom 6463 were enrolled in the ZDC program and 1821 were controls who were ineligible because their employers did not opt in. RESULTS After ZDC expansion, medication adherence fell in the control group and rose in the ZDC group, with a relative increase of 2.1 percentage points (P = .002). Medical spending fell by $71 per member per month (PMPM) (P = .027) in the ZDC group relative to controls. Overall, there was no significant increase in the cost of drugs between treatment and controls. However, when drugs were further categorized, there was a significant increase of $8 PMPM for generic drugs and no significant difference for brand name drugs. Comparisons of medication adherence rates by household income showed the largest relative increase post ZDC expansion among low-income members. CONCLUSIONS Elimination of co-pays for drugs indicated to treat chronic illnesses was associated with increases in medication adherence and reductions in overall spending of $63. Benefit designs that eliminate co-pays for patients with chronic illnesses may improve adherence and reduce the total cost of care.

Objectives To determine whether a program that eliminated pharmacy co-pays, the Blue Cross Blue Shield of Louisiana (BCBSLA) Zero Dollar Co-pay (ZDC) program, decreased health care spending. Previous studies have found that value-based insurance designs like the ZDC program have little or no impact on total health care spending. ZDC included an expansive set of medications related to 4 chronic diseases rather than a limited set of medications for 1 or 2 chronic diseases. Additionally, ZDC focused on the most at-risk patients. Study design ZDC began in 2014 and enrolled patients over time based on (1) when a patient answered a call from a nurse care manager and (2) when a patient or their employer changed the benefit structure to meet the program criteria. During 2015 and 2016, 265 patients with at least 1 chronic condition (asthma, diabetes, hypertension, mental illness) enrolled in ZDC. Methods Observational study using within-patient variation and variation in patient enrollment month to identify the impact of the ZDC program on health spending measures. We used 100% BCBSLA claims data from January 2015 to June 2018. Monthly level event studies were used to test for differential spending patterns prior to ZDC enrollment. Results We found that total spending decreased by $205.9 (P = .049) per member per month, or approximately 18%. We saw a decrease in medical spending ($195.0; P = .023) but did not detect a change in pharmacy spending ($7.59; P = .752). We found no evidence of changes in spending patterns prior to ZDC enrollment. Conclusions The ZDC program provides evidence that value-based insurance designs that incorporate a comprehensive set of medications and focus on populations with chronic disease can reduce spending.

Aims: Chronic diseases impose a substantial healthcare burden. This study sought to evaluate the clinical and economic impact of new disease management (DM) programs, targeting four major chronic d...

Aims: To evaluate the risk-of-hospitalization (ROH) models developed at Blue Cross Blue Shield of Louisiana (BCBSLA) and compare this approach to the DxCG risk-score algorithms utilized by many health plans. Materials and Methods: Time zero for this study was December 31, 2016. BCBSLA members were eligible for study inclusion if they were fully insured; aged 80 years or younger; and had continuous enrollment starting on or before June 1, 2016, through time zero. Up to 2 years of historical claims data from time zero per patient was included for model development. Members were excluded if they had cancer, renal failure, or were admitted for hospice. The Blue Cross ROH models were developed using (1) regularized logistic regression and (2) random decision forests (a tree ensemble learning classification method). All models were generated using Scikit-learn: Machine Learning in Python. Prognostic capabilities of DxCG risk-score algorithms were compared to those of the Blue Cross models. Results: When stratifying by the top 0.1% of members with the highest ROH, the Blue Cross logistic regression model had the highest area under the receiving operator characteristics curve (0.862) based on the result of 10-fold cross-validation. The Blue Cross random decision forests model had the highest positive predictive value (49.0%) and positive likelihood ratio (61.4), but sensitivity, specificity, negative predictive values, and negative likelihood ratios were similar across all 4 models. Limitations: The Blue Cross ROH models were developed and evaluated using BCBSLA data, and predictive power may fluctuate if applied to other databases. Conclusions: The predictability of the Blue Cross models show how member-specific, regional data can be used to accurately identify patients with a high ROH, which may allow healthcare workers to intervene earlier and subsequently reduce the healthcare burden for patients and providers.

Digital triage is a pre-digital-forensic phase that sometimes takes place as a way of gathering quick intelligence. Although effort has been undertaken to model the digital forensics process, little has been done to date to model digital triage. This work discuses the further development of a model that does attempt to address digital triage the Partially-automated Crime Specific Digital Triage Process model. The model itself will be presented along with a description of how its automated functionality was implemented to facilitate model testing.

Background: Valproate sodium injection (Depacon®) is an intravenous form of valproate for use in absence and complex partial seizures when circumstances preclude oral administration. Certain situations may warrant larger and more rapid infusions than permitted by the original labeling. This study evaluated the safety of more rapid infusions. Methods: Subjects with epilepsy were randomized in a 2:1 ratio to receive up to 15 mg/kg of valproate sodium infused at 3.0 or 1.5 mg/kg/min. Up to four infusions were allowed within 24 h to achieve target plasma valproate concentrations of 50–100 mcg/ml. Primary safety endpoints were the changes in the 5-min and minimum post-first infusion blood pressures (BPs). Results: One hundred twelve subjects were treated, (3.0 mg/kg/min group: n =72, 1.5 mg/kg/min group: n =40). No significant treatment differences were detected for changes in the primary BP endpoints. Two subjects in the 3.0 mg/kg/min group had potentially clinically significant low systolic BP values during the study. Similar proportions of subjects in the two groups reported adverse events during or within 6 h following the first infusion. Conclusions: Valproate sodium injection dosages up to 15 mg/kg and rates of 1.5 and 3.0 mg/kg/min were well tolerated in this population.

In the summer of 1998, the Erik Jonsson School of Engineering and computer Science (the Jonsson School) at The University of Texas at Dallas (UTD) obtained approval from the Texas Higher Education Coordinating Board to offer BS and MS degrees in Telecommunications Engineering (TE). These are the first TE degree programs in the United States and the BS program received ABET accreditation for classes to begin in the fall of 1999. This paper discusses the need for such a program at UTD from the perspective of industry as well as the academic justification for a separate degree. The implementation of the program as a combination of Electrical Engineering and Computer Science is addressed as well as the tradeoffs necessary in combining these curricula. Many of the issues are similar to the ones addressed in a Computer Engineering program. However, the resulting tradeoffs are different in the case of a Telecommunications Engineering program.

The use of the continuous wavelet transform and the discrete wavelet transform in analyzing the propagation of optical pulses in nonlinear dispersive fibers is discussed. The analysis is based on the split-step wavelet algorithm which reaches reasonable accuracy as compared to the well-known split-step Fourier method.

In-situ gas phase poly(propylene) (PP) formation over a high activity TiCl 4 -MgCl 2 -supported Ztegler-Natta catalyst has been studied by video microscopy combined with ex-situ light microscopy, SEM, high-resolution TEM, and STEM/PEELS/EDX for the first time. In-situ observation revealed rapid formation of poly(propylene) beads 9-10 μm in size (< 1/30 s) as well as growth of significant amounts of polymer within local regions, Catalyst parricles containing 2-5 nm-sized MgCl 2 crystalline domains are subjected to transformations during catalysis that form PP/catalyst aggregated structures of 30-50 μm in size.

This study evaluated gabapentin monotherapy in 275 patients with medically refractory complex partial or secondarily generalized seizures who were taking one or two antiepileptic drugs (AEDs). Following an 8-week baseline, patients received randomized dosages of gabapentin (600, 1,200, or 2,400 mg/d) during a 26-week double-blind phase comprising 2 weeks gabapentin add-on therapy, an 8-week AED taper, and a 16-week gabapentin monotherapy period. Patients exited the study if they experienced a protocol-defined exit event. Results of outcome measures, including time to exit, completion rate, and mean time on monotherapy, showed no significant differences among dosage groups. Possible reasons for this lack of a dose-response relationship include withdrawal seizures and the limited range of gabapentin dosages studied. Overall, 20% of patients completed the study. Completion rates were higher among patients who had discontinued one AED (23%) than two AEDs (14%), and higher among patients who were not withdrawn from carbamazepine (27%) than among those who were (16%).

Local hire programs have been written about from either a legal perspective or as a tool of economic development. Previous literature has analyzed the constitutionality of local hire programs as well as the shift from traditional statutes and ordinances to the use of contract-based tools as a means of improving the employment opportunities of local residents. This digest is designed to build on the previous research and serve as a comprehensive and practical guide to legal practitioners, community groups, and individuals interested in utilizing and implementing local hire programs. This digest includes discussions of: 1) the Constitutional issues; 2) case law and other legal authority associated with such programs; 3) representative examples of entities that have implemented such programs and have included information regarding program challenges; 4) steps that would be advisable for an agency to take to ensure that its program will pass judicial scrutiny; 5) issues associated with federal funding; and 6) remedies available to an agency if the contractor fails to comply with the requirements. Given the issues confronting the enforceability of local hire programs, this digest provides considerations that public agencies and community groups ought to take into account when contemplating what may be the best course of action when deciding whether to implement local hire programs. It should be useful to attorneys, administrators, board members, legislatures, planning officials, human resources personnel, and contracting officials.

A two-photon detection scheme is used to measure three- and four-photon correlations in a light beam and study their time dependence.

The digital forensic process as traditionally laid out is very time intensive – it begins with the collection, duplication and authentication of every piece of digital media prior to examination. Digital triage, a process that takes place prior to this standard methodology, can be used to speed up the process and provide valuable intelligence without subjecting digital evidence to a full examination. This quick intelligence can be used in the field for search and seizure guidance, in the office to determine if media is worth sending out for an examination, or in the laboratory to prioritize cases for analysis. For digital triage to become accepted by the forensic community, it must be modeled, tested and peer reviewed, but there have been very few attempts to model digital triage. This work describes the evaluation of the Semi-Automated Crime-Specific Digital Triage Process Model, and presents the results of five experimental trials.

The digital forensic process as traditionally laid out begins with the collection, duplication, and authentication of every piece of digital media prior to examination. These first three phases of the digital forensic process are by far the most costly. However, complete forensic duplication is standard practice among digital forensic laboratories. The time it takes to complete these stages is quickly becoming a serious problem. Digital forensic laboratories do not have the resources and time to keep up with the growing demand for digital forensic examinations with the current methodologies. One solution to this problem is the use of pre-examination techniques commonly referred to as digital triage. Pre-examination techniques can assist the examiner with intelligence that can be used to prioritize and lead the examination process. This work discusses a proposed model for digital triage that is currently under development at Mississippi State University.

The radius-of-curvature (ROC) defines the degree of curvature along the centerline of a roadway whereby a travelling vehicle must follow. Roadway designs must encompass ROC in mitigating the cost of earthwork associated with construction while also allowing vehicles to travel at maximum allowable design speeds. Thus, a road will tend to follow natural topography where possible, but curvature must also be optimized to permit fast, but safe vehicle speeds. The more severe the curvature of the road, the slower the permissible vehicle speed. For route planning, whether for urban settings, emergency operations, or even parcel delivery, ROC is a necessary attribute of road arcs for computing travel time. It is extremely rare for a geo-spatial database to contain ROC. This paper will present a procedure and mathematical algorithm to calculate and assign ROC to a segment pair and/or polyline., {"references":["C. H. Oglesby, and G. R. Hicks, Highway Design, 4th ed., New York,\nNY: Wiley, 1982.","Environmental Systems Research Institute, \"ESRI Shapefile Technical\nDescription: An ESRI White PaperÔÇöJuly 1998,\" ESRI Online Library,\nRedlands, CA, 1998.","Transportation Research Board, \"Geometric Design Standards for Low-\nVolume Roads,\" Compendium 1, Transportation Technology Support\nfor Developing Countries, Washington, DC, 1978.","United Nations, Transport Division, Asian Highway - The Road\nNetworks Connecting China, Kazakhstan, Mongolia, the Russian\nFederation, and the Korean Peninsula, UNESCAP Ref No. ST/SCAP/\n173, Blue Ridge Summit, PA: United Nations Publications, 2001.","International Standards Organization, \"Methodology for Feature\nCataloguing,\" Standard 19110:2005, Geneva, Switzerland, 2005.","B.R. Sarker, and E. A. Baylot, \"Estimation of Throughput Capacity for\nConvoy Movement,\" in Proceedings of the 13th International\nConference of Hong Kong Society for Transportation Studies, Hong\nKong, China, 2008."]}

One problem frequently encountered in high-power laser systems is thermal extrinsic damage to the laser materials, which arises from absorbing inclusions. In this paper the maximum tensile stresses as a function of inclusion size, laser pulse width, and laser power are estimated for the common precipitates in CdTe.

For almost sixty years, systematic political opinion surveys have been conducted by formal polling companies. Polls are an integral part of American political structure because of their longevity, their relative suc? cess, and their entrenchment in political campaigning. They have been in? stitutionalized in American politics. The four sections of this paper include discussions of varieties of polling, of how it is used in political campaigns, of its impact on representation, and of current issues in political com? munication.

An intense laser pulse that is nearly resonant with an atomic transition and that can initially be described as smooth and nearly adiabatic can acquire significant temporal and spatial modulation as the result of propagation through an atomic vapor. Computer calculations demonstrate that the temporal modulation is a result of enhancement, under propagation, of the initially small nonadiabatic portion of the transient nonlinear atomic response. The transient nonlinear atomic response varies with the field strength so that the transverse variation in field strength results in a spatial modulation, known as conical emission.