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PurposeThe objective of this study is to mitigate the risks of a blood shortage. The authors designed two simulation studies to identify the superior methodology that can decrease the impact of a massive national donor shortage.Design/methodology/approachThe simulation designs are triggered by the COVID-19 pandemic. The first simulation examines the company’s choice of strategic partners (regionally and nationally), and the second inspects creating a national coordinated effort to organize a pooled blood inventory that would require blood centers to contribute a small percentage of their monthly donations to become a member.FindingsThe results indicate that both methods can significantly manage the risk of stockouts regardless of the availability of safety inventory in a blood center; however, although more effective in reducing the number of shortages per month, creating a national blood pool causes the shortages to be recognized earlier than desired.Originality/valueThe authors contribute to the literature by focusing on the potential risk of blood shortage because it directly impacts healthcare, hospitals’ costs and their ability to provide care. Though a handful of researchers have targeted the study of the blood supply chain, there is not any article that is similar to this study.

Tiered instructional supports are on a steep growth trajectory in the US and getting underway internationally as a means to providing equitable education to all student groups. In the US, the Department of Education funded the expansion of multi-tiered system of support (MTSS) through school and personnel improvement grants to states. This retrospective article examines the history of MTSS and California’s significant investment to scale up the practice statewide, with an eye to identifying key issues that are likely to surface in other such ambitious state efforts. We examine the infrastructure support methodology to develop local capacity to support school-level implementation with measured fidelity. We present some preliminary results from a small sample comparison study that demonstrate students’ academic achievement increased when the California MTSS efforts resulted in implementation with adequate fidelity. These findings suggest long-term replication of this initiative will mirror other student-level impact studies showing positive gains on measures of academic progress, in this case, English Language Arts and Math.

The pore habits of gas hydrate in natural sediment matrices provide essential clues for understanding physical (mechanical, thermal, hydraulic, and electrical) properties of hydrate-bearing sediments, yet there are no tools that can directly visualize the pore habits of natural gas hydrate other than indirect interpretation based on core-scale or field-scale observations. A significant challenge is to obtain a mini-core from pressure cores retrieved from natural reservoirs for high-resolution micro-CT (computed tomography) scans while maintaining pressure and temperature conditions required for stability of gas hydrate during all operational steps including manipulation, cutting, transferring, sub-coring and CT scanning. We present a new set of tools for pore-scale micro-CT imaging of natural hydrate-bearing sediments while maintaining pressure and temperature control. The tests with laboratory-prepared cores and pressure cores successfully demonstrate the capability of this set of tools to subsample a mini-core from pressure cores, transfer the mini-core to an X-ray transparent core holder, and conduct micro-CT scans. Successfully obtained CT images prove the functionality of this set of tools.

This study provides a better explanation for the continued prevalence of high–low (Hi–Lo) pricing strategy. We investigate the impact of market competition on adopting two different pricing strategies in the retail industry: everyday low price (EDLP) strategy and Hi–Lo strategy. We developed two analytic models using a game‐theoretic modeling approach: the profit maximization model and the sales revenue maximization model. We then conducted an econometric analysis based on retail store‐level dataset. The result shows that an EDLP player's equilibrium price depends highly on the cost level rather than competitor's price whereas the Hi–Lo player's equilibrium price depends mainly on the range of promotional basket as well as the cost level.

Aim To investigate clinical characteristics of asymptomatic Terson syndrome and its clinical impact in patients with aneurysmal subarachnoid hemorrhage (SAH). Methods This retrospective, interventional study included 31 patients with aneurysmal SAH, and the medical records were reviewed. In addition to baseline characteristics of the study population such as age, sex, and underlying medical history, multi-modal imaging analysis, including fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), were also reviewed. Glasgow Coma Scale (GCS), Hunt-Hess (HH) grade, and Fisher scale at the time of admission, and functional outcome by using modified Rankin Scale (mRS) at 6mo were compared. Results Of the 31 patients, 10 patients (32.3%) were diagnosed with Terson syndrome. All the patients with Terson syndrome did not report visual symptoms at the time of ophthalmologic screening. FA showed microvascular changes of retinal capillaries and varying degrees of disc leakage. SD-OCT allowed intuitive anatomical localization of multi-layered retinal hemorrhages and assessment of ellipsoid zone integrity. The patients with Terson syndrome showed significantly worse GCS (P=0.047) and HH grade (P=0.025) than those without, except Ficher scale (P=0.385). There was no significant difference in the mRS (P=0.250) at 6mo. Among baseline factors, the HH grade was the only significant factor associated with Terson syndrome (B=1.079, P=0.016). Conclusion In our study, 32.3% of the patients have Terson syndrome without visual symptoms. The baseline HH grade is significantly correlated with Terson syndrome, and there is no significant difference in the functional outcome between the patients with and without Terson syndrome. Terson syndrome may develop without any visual symptoms as shown in our study, and ophthalmologic screening may be recommended to prevent further visual deterioration especially in the patients with poor HH grade at the time of aneurysmal SAH.

The present study investigated the effectiveness of an equity-based inclusive school reform model nested within a multitiered system of support (MTSS) framework on the improvement of math and reading performance of students with Individualized Education Programs (IEPs). Descriptive statistics revealed that math state assessment scores of students with IEPs increased over the implementation period. Results of multilevel modeling demonstrated that the model’s fidelity of implementation scores positively and significantly predicted state assessment math scores. A further analysis examining the effectiveness of the model in three schools that implemented with adequate fidelity compared with nonimplementing schools indicated students with IEPs in implementing schools increased their math scores at a greater rate than their peers in comparison schools; however, effects on reading scores were equivocal. Findings are discussed in the context of inclusion and efforts to support high fidelity implementation of MTSS.

A 73-year-old woman underwent deformity correction surgery (anterior lumbar interbody fusion of L2-L3-L4-L5-S1, pedicle subtraction osteotomy at L4, and posterior screw fixation from T10 to the pelvis) due to lumbar degenerative flat-back. Following the operation, the patient experienced pain in her back and buttocks, for which she regularly took medications. She reported frequently feeling a heavy and stretched sensation of pain after the operation in those areas, which made her regret undergoing the operation. However, at 33 months postoperatively, she reported that one day, while getting up from a chair, she felt a crack in her back, which was followed by an improvement in her back and buttock pain; thereafter, she stopped taking pain medications. Follow-up radiography revealed a bilateral rod fracture at the L4–5 level on the right side and at the L3–4 level on the left side. The overall pelvic parameters, except pelvic incidence, slightly changed after the rod fracture. Therefore, the broken rod was replaced and another rod was added to the broken rod area; however, the changed pelvic parameters were not corrected further during the reoperation. Following the reoperation, the patient showed improvements and she no longer required pain medication.

Both intra-pore hydrate morphology and inter-pore hydrate distribution influence the physical properties of hydrate-bearing sediments, yet there has been no pore-scale observations of hydrate habit under pressure in preserved pressure core samples so far. We present for the first time a pore-scale micro-CT study of natural hydrate-bearing cores that were acquired from Green Canyon Block 955 in UT-GOM2-1 Expedition and preserved within hydrate pressure–temperature stability conditions throughout sub-sampling and imaging processes. Measured hydrate saturation in the sub-samples, taken from units expected to have in-situ saturation of 80% or more, ranges from 3 ± 1% to 56 ± 11% as interpreted from micro-CT images. Pore-scale observations of gas hydrate in the sub-samples suggest that hydrate in silty sediments at the Gulf of Mexico is pore-invasive rather than particle displacive, and hydrate particles in these natural water-saturated samples are pore-filling with no evidence of grain-coating. Hydrate can form a connected 3D network and provide mechanical support for the sediments even without cementation. The technical breakthrough to directly visualize particle-level hydrate pore habits in natural sediments reported here sheds light on future investigations of pressure- and temperature-sensitive processes including hydrate-bearing sediments, dissolved gases, and other biochemical processes in the deep-sea environment.

Describing the pore habit of methane hydrate in sediment matrices is essential for understanding natural distribution of methane hydrate, methane trace (transport and solidification) in the hydrate stability zone, physical properties of hydrate-bearing sediments, and the associated influence on potential gas production. Pore habit visualization in natural media at pore scale even with laboratory synthesized cores has been challenging due to the similar densities of methane hydrate from pore liquid. In this work, we used phase-contrast assisted micro-CT with potassium iodine-doped brine to visualize four phases: sand particles, pore fluid, methane hydrate and methane gas. This study visualizes the pore habit of methane hydrate at various stages including during hydrate formation in excess-gas systems, its evolution after brine injection to replace pore fluid, and hydrate formation in excess-water systems. Hydrate tends to adopt round and smooth surfaces when in contact with water while exhibits relatively angular interfaces when in contact with methane gas. Hydrate formation in excess-gas systems results in a partial cementing and partial mineral-coating pore habit, while hydrate in excess-water systems develops mainly as pore-filling, and locally cementing or mineral-coating where big gas pockets exist at the initial state. Pore liquid replacement from methane gas to brine triggers a shift of hydrate pore habit towards pore-filling. Methane hydrate evolution over time produces bigger hydrate particles but with less contact area with sand particles. The effects of hydrate pore habit become less important as hydrate particle size exceeds the pore size. Additionally, hydrate formation could trap residual methane gas and brine as inclusions.

The present study investigated relationships among technical assistance, school leadership quality, and multitiered system of support (MTSS) implementation. The findings indicated technical assistance improved school leadership quality, and improved leadership significantly mediated the relationship between technical assistance and MTSS implementation for both behavior and academic systems. These results provide support for the foundational role of school leadership in MTSS implementation. Implications for providers of technical assistance are discussed.

This study identifies firms’ green purchasing capabilities, classified into operational capabilities and dynamic capabilities, and measures their effects on the environmental and economic performance of a firm. We developed instruments to measure operational green purchasing capabilities and dynamic green purchasing capabilities. This study also investigates the moderating effect of firm size on the relationship between green purchasing capabilities and firm performance. The structural equation model (SEM) is used to analyse 239 responses from Japanese manufacturing companies. The results indicate that their green purchasing capabilities positively affect environmental and economic performance. Operational capabilities and dynamic capabilities have different levels of effects on green purchasing performance. A further analysis of the moderating effect of firm size shows that the high economic performance of green purchasing relies on the level of dynamic capabilities rather than firm size.

Purpose We sought to evaluate changes of mean peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) over 12 months in patients with unilateral central retinal vein occlusion (CRVO). Methods Our retrospective, observational study included 19 patients with treatment-naïve, unilateral CRVO who completed at least 12 months of follow-up period. Mean PCT and mean SFCT in CRVO-affected eyes and unaffected contralateral eyes were measured at each follow-up visit, and then compared. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline×100%) were determined. We also investigated the predictive factors for visual outcome in the CRVO-affected eyes. Results In the CRVO-affected eyes, mean PCT was 146.7±41.9 μm at baseline, and 106.5±24.2 μm at 12 months (P < 0.001). Mean PCT of the contralateral eyes was 129.8±42.6 μm at baseline and 124.6±39.7 μm at 12 months (P = 0.089). Mean SFCT of CRVO-affected eyes was 225.8±77.9 μm at baseline, and 199.4±66.6 μm at 12 months (P = 0.009). Mean SFCT of the contralateral eyes was 218.4±83.0 μm at baseline, and 208.4±78.1 μm at 12 months (P = 0.089). Δ PCT was -41.6±25.3 μm in the CRVO-affected eyes, and -5.2±5.8 μm in the contralateral eyes (P Conclusion Both peripapillary and subfoveal choroidal thickness reduced significantly over 12 months in the CRVO-affected eyes, but not in the contralateral eyes. In addition, the absolute reduction amount and reduction ratio of PCT and SFCT were significantly greater in the CRVO-affected eyes than the contralateral eyes.

Complications after laser spine surgery are very rare, but in some cases, they can become more serious. The success of laser spine surgery depends on keeping the basic surgical principle, appropriate patient selection, attention to preoperative radiology, careful surgical approach, and careful use of laser.

Conventional open surgical procedures for the treatment of thoracic spine deformity can be associated with significant approach-related morbidity. Recent advances in minimal access technologies have led to the development of posterior minimally invasive approaches for thoracic deformity correction. Minimally invasive surgery (MIS) for thoracic spine deformity is very challenging area and MIS use is very limited in the thoracic spine deformity.

Inclusive educational practices are rooted in a body of research indicating that when students in need of support through special education are meaningfully included in schools, academic and social outcomes improve for all students. To realize this promise of better outcomes, traditional schools with separate classrooms and even schools designated to exclusively serve various learner subgroups (e.g., students identified for special education) will require reorganized systems, structures, and resources.

Understanding mechanical interactions between hydrate and hosting sediments is critical for evaluating formation stability and associated environmental impacts of hydrate-bearing sediments during gas production. While core-scale studies of hydrate-bearing sediments are readily available and some explanations of observed results rely on pore-scale behavior of hydrate, actual pore-scale observations supporting the larger-scale phenomena are rarely available for hydrate-bearing sediments, especially with methane as guest molecules. The primary reasons for the scarcity include the challenge of developing tools for small-scale testing apparatus and pore-scale visualization capability. We present a testing assembly that combines pore-scale visualization and triaxial test capability of methane hydrate-bearing sediments. This testing assembly allows temperature regulation and independent control of four pressures: influent and effluent pore pressure, confining pressure, and axial pressure. Axial and lateral effective stresses can be applied independently to a 9.5 mm diameter and 19 mm long specimen while the pore pressure and temperature are controlled to maintain the stability of methane hydrate. The testing assembly also includes an X-ray transparent beryllium core holder so that 3D computed tomography scanning can be conducted during the triaxial loading. This testing assembly permits pore-scale exploration of hydrate-sediment interaction in addition to the traditional stress-strain relationship. Exemplary outcomes are presented to demonstrate applications of the testing assembly on geomechanical property estimations of methane-hydrate bearing sediments.

Purpose To investigate the prevalence of focal lamina cribrosa (LC) defects in patients with unilateral branch retinal vein occlusion (BRVO) and to compare ocular characteristics between eyes with and without focal LC defect and those eyes with normal-tension glaucoma (NTG). Methods This retrospective, cross-sectional study included 121 patients. Thirty-nine patients had unilateral BRVO (BRVO group), 36 patients had NTG (NTG group), and 36 patients had vitreous floaters, but no other ocular diseases (control group). In addition to baseline characteristics such as age, sex, refractive errors, the ocular characteristics such as peripapillary choroidal thickness (PCT), retinal nerve fiber layer thickness, and subfoveal choroidal thickness were retrospectively analyzed. Results Focal LC defects were detected in 20 eyes of 14 patients (38.9%) in the BRVO group, 24 eyes of 15 patients (41.7%) in the NTG group, and none in the control group (P

Background. Chronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis. Methods. Fourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled. All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels. All patients underwent ablation of the basivertebral nerve (BVN) using 1414 nm Nd:YAG laser-assisted energy guided in a transforaminal epiduroscopic approach. Macnab’s criteria and visual analog scale (VAS) score were collected retrospectively at each follow-up interval. Results. The mean age was 46 ± 9.95 years. The mean symptoms duration was 21.21 ± 21.87 months. The mean follow-up was 15.3 ± 2.67 months. The preoperative VAS score of 7.79 ± 0.97 changed to 1.92 ± 1.38, postoperatively (P<0.01). As per Macnab’s criteria, seven patients (50%) had excellent, six patients (42.85%) had good, and one patient (7.14%) had fair outcomes. Conclusion. The transforaminal epiduroscopic basivertebral nerve laser ablation (TEBLA) appears to be a promising option in carefully selected patients with CLBP associated with the Modic changes.

Study design A retrospective analysis of functional limitations due to stiffness after long-level spinal instrumented fusion surgery to correct lumbar degenerative flat back was performed. Objective To analysis the functional limitations in patients treated surgically for adult lumbar degenerative flat back (ALDFB) with long-level instrumented fusion to the sacrum or pelvis. Summary of background data Long-level instrumented fusion for ALDFB decreases back pain and spinal deformity. On the contrary, this surgery considerably eliminates spinal range of motion. This may have the potential to impair function and ability to perform activities of daily living (ADLs). Methods Consecutive 44 patients who underwent long-level instrumented fusion to the sacrum or pelvis for ALDFB were retrospectively included in this study. All patients were followed up for a minimum of 13 months. The Lumbar Stiffness Disability Index for Korean Lifestyle and Oswestry Disability Index were administered and analyzed to assess the impact of spinal stiffness on daily living. Cohorts were defined based on the upper instrumented vertebrae (above T10 [group 1] or below L1 [group 2]) and lower instrumented vertebrae (S1 pedicle screw [group S] or iliac bolt screw [group I]). Results All patients showed deteriorated postoperative ADLs compared to preoperative values. Group 1 showed deterioration postoperatively compared to group 2. Group 1 showed deteriorated postoperative ADLs compared to preoperative values. In group 2, question 5 and 7 showed deterioration postoperatively compared to preoperative values, and question 2 and 10 showed improvement postoperatively compared to preoperative values. Group I showed deterioration postoperatively compared to group S. Conclusion This study will hopefully allow surgeons to provide patients with ALDFB with a more informed explanation of expected surgery effects on specific ADLs. Level of evidence 3.

Purpose To evaluated the changes in choroidal vasculature in patients with ocular ischemic syndrome (OIS) and in the ipsilateral eyes of patients with symptomatic carotid artery stenosis (CAS) Method A total of 50 patients (15 patients with OIS, 10 patients with symptomatic CAS, 25 patients of age-and sex-matched control group) were included, and the medical records were retrospectively reviewed. The mean subfoveal choroidal thickness (SFCT) of each eye was measured, and binary images of the choroid were evaluated to compare the mean choroidal area and the luminal area. Results The mean SFCT was 170.5±75.3 μm in the eyes with OIS, 154.8±62.9 μm in the ipsilateral eyes with symptomatic CAS, and 277.5±73.2 μm in the right eyes of the control group patients (P

A set of schools located across the United States partnered with a federally funded inclusive schools systems approach to improving outcomes for all students—both general and special education students, including students with extensive support needs stemming from intellectual and developmental disabilities. Two years of data from the schools provided evidence of changes in specific school leadership practices. Schools that received targeted, feature-specific technical assistance in the Administrative Leadership domain improved their administrative leadership performance as measured by the Schoolwide Integrated Framework for Transformation Fidelity of Implementation Tool (SWIFT-FIT). Improvements were noted in the two major aspects of leadership measurement: Strong and Engaged Site Leadership and Strong Educator Support System features. Improvements corresponded with higher achievement scores on English Language Arts and Math as measured by the Partnership for Assessment of Readiness for College and Careers (PARCC) assessment. These results show promise for continued focus on improving school administrator leadership in order to install more inclusive systems of support for learning that are associated with higher levels of student achievement.

This article discusses equity-based inclusive education and federal policy drivers that can be used to make positive sustainable change in state, district, and local practice to improve the academic, social, and behavioral outcomes for all students including students with extensive support needs and those with labels of intellectual and developmental disabilities. Educational policies addressed include the Elementary and Secondary Education Act (ESEA), Individuals with Disability Education Act (IDEA), Every Student Succeeds Act (ESSA), and civil rights legislation such as the Americans with Disabilities Act (ADA). The policy domain feature of the Schoolwide Integrated Framework for Transformation (SWIFT) model is examined regarding how it was implemented in districts and schools, working toward the goal of providing an equity-based inclusive education for all students. Translating federal education policy into state, district, and local practice requires leadership and political courage to align federal, state, and district policy with the vision and values of equity-based, inclusive education.

Recent research and federal legislation highlight the importance of family engagement and support. However, meaningful and effective family engagement does not always come to fruition in public schools. Developing and maintaining relationships with families can be especially challenging in an inclusive school setting, given the difficulty of blending general and special education requirements, policies, and practices. The purpose of this research was to investigate (a) the relationship between families' perceived support in 32 schools implementing the Schoolwide Integrated Framework for Transformation (SWIFT) framework, a product of a federally funded technical assistance center; and (b) the degree to which the SWIFT framework was implemented with fidelity in these schools. Results of multilevel modeling indicated that, with the exception of the Inclusive Policy Structure and Practice domain, SWIFT implementation significantly and positively predicted families' perceptions of parent support. This finding suggests that effective implementation of the SWIFT framework can predict parents' participation in and shared information about child progress or school activities.

Inclusive education, defined as “full inclusion,” has generated controversy for nearly three decades with special education placement at the heart of the debate. Whole-school application of Multi-Tiered System of Support (MTSS) offers a reframing of the problem with potential for social and academic gains for all students, including those with extensive needs for extraordinary supports and services. In this paper, we review history and contemporary definitions of MTSS; the emerging evidence base in support of its efficacy for improved student level outcomes; and a comprehensive, sustainability and scale-up system of MTSS called SWIFT (Schoolwide Integrated Framework for Transformation). Some preliminary impact results from a four-year project to provide technical assistance to five states, 17 school districts, and 64 schools installing the SWIFT system are presented.

PURPOSE To evaluate changes in peripapillary choroidal thickness in patients with branch retinal vein occlusion (BRVO) over 12 months, using spectral-domain optical coherence tomography with enhanced depth imaging. METHODS This retrospective, interventional case series included 20 treatment-naive patients with unilateral BRVO with at least 12 months follow-up. The peripapillary choroidal thickness was measured over 12 months. RESULTS In BRVO-affected eyes, the mean peripapillary choroidal thickness was 213.5 ± 51.7 μm (126.1[FIGURE DASH]326.9 μm) at baseline and 129.6 ± 39.3 μm (65.9[FIGURE DASH]197.1 μm) at 12 months. In nonaffected contralateral eyes, the mean peripapillary choroidal thickness was 194.1 ± 39.8 μm (158.5[FIGURE DASH]238.3 μm) at baseline and 156.6 ± 56.2 μm (125.9[FIGURE DASH]213.9 μm) at 12 months. The mean peripapillary choroidal thickness decreased significantly over 12 months in both BRVO-affected and nonaffected eyes (P < 0.001, both eyes). Although the mean peripapillary choroidal thickness was not significantly different between groups at baseline (P = 0.472), it was significantly lower in BRVO-affected eyes than in nonaffected eyes at 12 months (P = 0.036). CONCLUSION Peripapillary choroidal thickness decreased significantly over 12 months in BRVO-affected eyes and nonaffected eyes in patients with unilateral BRVO.

Relative permeability of supercritical CO2 (scCO2) and brine was determined in reactive and non-reactive rock cores using a combination of unsteady-state methodology and computed tomography. Experiments were conducted using a medical grade CT scanner to determine saturation using a custom Python script. The saturation and differential pressure across the core were then used to derive four empirical constants to calculate relative permeability. This methodology increases temporal efficiency while reducing experimental complexity. Additionally, we show that the method can be used to determine scCO2 relative permeability in a wide range of lithologies and flow rates, and with the ability to account for matrix dissolution during scCO2 flooding. Plain Language Summary : The ability to capture and store carbon dioxide (CO2) is an important component of efforts to slow climate change. Long-term geologic storage of CO2 requires accurate descriptions of injected CO2 in subsurface rock formations to account for stored volumes and develop adequate risk monitoring. Effectively describing the migration of CO2 injected in underground reservoirs requires an accurate description of how CO2 moves and interacts with the rock. Relative permeability, or the description of how efficiently a fluid moves in a porous media while in the presence of other fluids, is the most utilized tool for describing the competitive flow of fluids. In this study, we detail a modified unsteady-state methodology using computed tomography that provides relative permeability quickly and can be used to analyze heterogenous media. The methodology can be used to describe the impacts of dissolution on CO2 transport through reactive cores, which to the authors knowledge, has not been described in the literature previously.

To begin statistical analysis, Bayesians quantify their confidence in modeling hypotheses with priors. A prior describes the probability of a certain modeling hypothesis apart from the data. Bayesians should be able to defend their choice of prior to a skeptical audience. Collaboration between evaluators and stakeholders could make their choices more defensible. This article describes how evaluators and stakeholders could combine their expertise to select rigorous priors for analysis. The article first introduces Bayesian testing, then situates it within a collaborative framework, and finally illustrates the method with a real example.

Summary Methane hydrate-bearing sediments exist throughout the world in continental margins and in Arctic permafrost. Hydrates are ice-like compounds when dissociate due to temperature rise or reduction in fluid pressure, release gas. Because of the mechanical property changes caused by dissociation in which the loads supported by the hydrates are transferred to soil grains, these sediments may become unstable. To quantify the risk of ground instability triggered by dissociation, which may happen during operation to extract methane gas or from climate changes, a reliable predictive model is indispensable. Even though many models have been proposed, a detailed validation of the ability to model dissociation impact is still needed. This study investigated the adequacy of an spatially mobilized plane constitutive model and a modeling framework using laboratory-induced dissociation tests under shear from literature. Using laboratory-imposed temperature and pressure changes and the resulting hydrate saturation changes as input, this study was able to capture the geomechanical responses and determine the stability state of methane hydrate-bearing sediments as observed. Copyright © 2017 John Wiley & Sons, Ltd.

This study focuses on finding the trend of efficiency in the healthcare industry in recent years. We applied stochastic frontier analysis and data envelopment analysis methods to capture the efficiency of 1,471 hospitals and found a sign of the Baumol effect, which is detected by the decreasing trend of hospital efficiency with increasing trend of labor costs. Furthermore, we compared the results of both approaches (stochastic frontier and data envelope analyses) in capturing efficiency scores and suggest the U-shaped curve of the size effect may indicate the practice of “cream skimming” by some small hospitals.

Reliable estimations of the relative permeability of gas and water in hydrate-bearing sediments (HBS) and the dependency of the relative permeability on hydrate saturation are critical to predict the productivity of a hydrate reservoir. Yet, this remains poorly estimated owing to lack of experimental data associated with difficulties in conducting multiphase flow experiments in HBS. Recognizing the experimental challenges, this study intends to develop and validate a new experimental system and procedure of unsteady-state relative permeability test that can generate reliable and reproducible flow measurements in HBS. Gas hydrate is considered as a part of solid matrix in the sediment, so one of the challenges is to maintain a constant hydrate saturation, which is achieved in this experimental study using tight pressure-temperature (P-T) control near the hydrate stability boundary. The measured differential pressure across the specimen, methane injection flow rate, and volume of displaced brine are used to calculate the relative permeability by adopting a conventional Buckley-Leverett theory-based interpretation method. Residual brine saturation calculated for the hydrate-bearing specimen is higher than that of hydrate-free specimen, presumably due to decrease in pore size, increase in heterogeneity of solid matrix, and increase in size distribution of solid matrix and pore in the presence of hydrates. Further studies are necessary to represent the results of the unsteady-state flow experiment in HBS with a gas hydrate-dependent relative permeability model.

The present investigation examines the schoolwide applications model (SAM) as a potentially effective school reform model for increasing equity-based inclusive education practices while enhancing student reading and math achievement for all students. A 3-year quasi-experimental comparison group analysis using latent growth modeling (LGM) was used with seven urban elementary or elementary/middle schools and seven matched comparison schools in the same district. Results suggest significantly larger growth for experimental school students in math and no statistically significant difference in reading score growth between experimental and comparison schools. However, reading score growth for experimental schools was statistically significant in a post hoc analysis of selected schools. Additional descriptive analysis is presented for three schools that implemented the model with the highest measured fidelity; these schools made improvements on both reading and math scores while those of matching comparison schools decreased.