Based on the concrete damage data under the interaction of fatigue loads and freeze-thaw cycles, a concrete freeze-thaw cycle deterioration model and a fatigue damage deterioration model are established respectively. Based on the concrete fatigue damage deterioration model, a freeze-thaw influence factor is introduced, and a freeze-thaw The model of concrete degradation under fatigue and fatigue, and the relationship between freeze-thaw damage, fatigue damage and time are discussed separately, so as to study the remaining life of concrete roads.

A new composite counter electrode consisting of Cu2S nanoparticles (NPs) and active carbon/carbon black has been developed for CdS/CdSe co-sensitized solar cells (CdS/CdSe QDSCs). This kind of composite photocathode is suitable for screen printing, and exhibits good catalytic activity toward S22−/S2− redox couple. Based on this Cu2S/carbon composite electrode, sealed CdS/CdSe QDSCs were fabricated, which can present up to 3.87% of light-to-electricity conversion efficiency. Besides, our newly developed Cu2S/carbon composite electrode was primarily stable in 1M polysulfide electrolyte after the QDSCs with this counter electrode were sealed, kept in the dark at room temperature and tested every two or three days for 30 days. On the basis of the above results, CdS/CdSe QDSC modules consisting of four paralleled sub-cells with the aperture area of over 12cm2 have been designed and prepared for the first time. Up to 2.31% of light-to-electricity conversion efficiency of CdS/CdSe QDSC module was achieved. This Cu2S/carbon composite electrode exhibits good potential application for further investigation.

A practical tandem structure with a semitransparent mesh-structured Cu 2S counter electrode sandwiched between two TiO2 photoelectrodes has been designed for quantum dot-sensitized solar cells (QDSCs). The mesh-structured Cu2S counter electrode exhibits high catalytic activity for polysulfide electrolyte. CdS/CdSe quantum dot-sensitized TiO2 films have been applied as both top and bottom photoelectrodes to testify the effectiveness of the tandem structure. The influence of the TiO2 film thickness on the performance of the tandem cell has been systematically studied. The optimized tandem QDSC shows an improved photocurrent and 12-percent increase of efficiency over the top cell with a 4.7 μm thick top cell and an 11.0 μm thick bottom cell, presenting a new effective approach towards highly efficient QDSCs. © 2012 Elsevier Ltd. All rights reserved.

Introduction: We conducted a comprehensive study of the costs associated with amyotrophic lateral sclerosis (ALS), Duchenne muscular dystrophy (DMD). and myotonic dystrophy (DM) in the U.S. Methods: We determined the total impact on the U.S. economy, including direct medical costs, nonmedical costs, and loss of income. Medical costs were calculated using a commercial insurance database and Medicare claims data. Nonmedical and indirect costs were determined through a survey of families registered with the Muscular Dystrophy Association. Results: Medical costs were driven by outpatient care. Nonmedical costs were driven by the necessity to move or adapt housing for the patient and paid caregiving. Loss of income correlated significantly with the amount of care needed by the patient. Conclusions: We calculated the annual per-patient costs to be $63,693 for ALS, $50,952 for DMD, and $32,236 for DM. Population-wide national costs were $1,023 million (ALS), $787 million (DMD), and $448 million (DM). Muscle Nerve49:431-438, 2014

The modules with holes on the counter electrode substrate for photocurrent collection with thin wires were investigated by simulation. This type of module can perform high efficiency for its high open area ratio. An improved model based on our previous work was used to optimize this type of module. By simulation, we found that hexagonal cell is the best choice for this kind of module, and the optimized length of silver finger is related to the assemblage technique. Open area ratio of more than 90% and aperture area efficiency of more than 10% can be easily achieved based on the small area cell with efficiency of 11.1%.

Diabetes, especially type 2 diabetes, is on the rise throughout the United States. Several national health organizations and professional medical societies advocate screening people in high-risk groups for diabetes. However, the US Preventive Services Task Force recommends screening only adults with hypertension. We examined evidence supporting screening high-risk adults, including studies using intermediate outcomes and modeling studies. We found a broad range of evidence of practical relevance to diabetes screening that merits consideration in developing new screening guidelines. This evidence could inform recommendations to expand coverage to screening of other high-risk groups and could facilitate the prevention and early treatment of diabetes. We recommend that the US Preventive Services Task Force consider these expanded sources of evidence and revise its recommendations accordingly.

Despite the documented benefits of quitting smoking, studies have found that smokers who quit may have higher lifetime medical costs, in part because of increased risk for medical conditions, such as type 2 diabetes, brought on by associated weight gain. Using a simulation model and data on 612,332 adult smokers in the US Department of Defense's TRICARE Prime health plan in 2008, we estimated that cessation accompanied by weight gain would increase average life expectancy by 3.7 years, and that the average lifetime reduction in medical expenditures from improved health ($5,600) would be offset by additional expenditures resulting from prolonged life ($7,300). Results varied by age and sex: For females ages 18-44 at time of cessation, there would be net savings of $1,200 despite additional medical expenditures from prolonged life. Avoidance of weight gain after quitting smoking would increase average life expectancy by four additional months and reduce mean extra spending resulting from prolonged life by $700. Overall, the average net lifetime health care cost increase of $1,700 or less per ex-smoker would be modest and, for employed people, more than offset by even one year's worth of productivity gains. These results boost the case for smoking cessation programs in the military in particular, along with not selling cigarettes in commissaries or at reduced prices.

Real-time monitoring of the binary colloidal crystal (bCC) growth via evaporation-induced cooperative self-assembly (EICSA) was studied by an in situ optical microspectroscopy technique. Evolution of the recorded reflectance spectra reveals that the whole growth process of bCCs via EICSA could be separated into three different stages corresponding to that of unary colloidal crystals because of the same evaporation model. We show the detailed cooperative self-assembly information, including the evolution of the number of layers and filling factors of different components of the growing bCCs using the scalar wave approximation method. Furthermore, when the size ratio and number ratio of the two colloids were varied, the real-time optical properties of the bCCs with various stoichiometric configurations were investigated systematically. This study would be valuable in furthering the current understanding of the bCC growth dynamics via EICSA and tailoring optical properties of hierarchical materials for applications in many fields.

A series of ordered photoanodic architectures (including ordered TiO(2) nanotube arrays (TNT), ZnO nanorods, ZnO/TiO(2) core/shell nanostructures) for CdS/CdSe sensitized solar cells (QDSCs), were fabricated directly on transparent conductive oxide glasses by a facile sol-gel assisted template process. The morphologies, optical and electrical properties of TNTs and CdS/CdSe co-sensitized TNTs have been demonstrated. The effect of CdSe deposition time on the cell performance was clarified, and the growth mechanism of the CdSe quantum dots on the surface of the TNTs has been proposed as well. Furthermore, the evolution of open-circuit photovoltage (V(oc)) towards CdSe deposition time has been investigated by electrochemical impedance spectroscopy (EIS). A promising light-to-electricity conversion efficiency of up to 4.61% has been achieved with 3 μm long TNT arrays, which is the best record for sandwich-type ordered TNT-based QDSCs.

Low cost reflectors were applied to dye-sensitized solar cell modules to reduce the energy losses caused by the inactive areas occupied by sealing materials and metal fingers, and significant improvement of overall efficiency was achieved. An improved model was used to simulate the modules, and the optimized geometry parameters of the modules were obtained. After applying the reflectors, wider silver fingers, and smaller cells were recommended for large area modules, and the influence of the width of sealing material was reduced. Simulation results show that the maximum total area efficiency of 11.22% for large area modules could be achieved based on the small cell with efficiency of 11.4% and reflectors with reflectivity of 0.9. The reflectors can be utilized in any kind of solar cell with inactive areas. The model can also be applied to other kinds of solar cell module with any geometry characters, and the optimized parameters can be obtained easily for any design.

Real-time monitoring of the whole growth process of evaporation-induced colloidal self-assembly has been conducted using an optical microspectroscopy setup. Our observations suggest that the assembly process can be divided into three different growth stages as evidenced by the variations detected in the reflectance spectra. The thickness variation of the growing colloidal crystal was monitored by examining the Fabry-Perot fringes in the reflectance spectra. Furthermore, the scalar wave approximation was utilized to analyze the evolution of optical properties with growth. More detailed information, including the time dependence of number of layers and volume fraction of water, has been revealed by comparing the experimental and calculated reflectance spectra. The present work demonstrates that in situ real-time microspectroscopy is a promising technique for monitoring and investigating the dynamic process of colloidal self-assembly.

The study of dye-sensitized solar cells (DSCs) has become an important research field for photovoltaic device development.We present a brief description of their basic structure,principle of operation,and essential component materials,as well as recent research progress.Emphasis is placed upon the design of DSC modules.Recent developments and problems are reviewed.

A new kind of quasi-solid state electrolytes for dye-sensitized solar cells (DSCs) has been prepared by in situ photopolymerization from the precursor 1,6-hexanediol diacrylate (HDDA) in 1-hexyl-3-methyl imidazolium iodide (HMII). The optimal ratio of polymer/ionic liquid is determined by the conductivities of the electrolytes. In order to further increase the miscibility between ionic liquid and the polymer, oligomer polyethylene glycol dimethyl ether (PEGDME) is introduced. By optimization of the amount of PEGDME in the electrolyte, the DSCs using this kind of solid-state electrolytes can present 6.5% of light-to-electricity conversion efficiency under 41mWcm−2. In the meantime, the influence of PEGDME additive is detailedly investigated by electrochemical impedance spectrum (EIS) and intensity modulated photovoltage spectroscopy (IMVS) techniques. Preliminary long-term stability test revealed that this in situ photopolymerized electrolyte exhibits good stability after 1000h thermal test.

A precise numerical model based on Kirchhoff's laws is used in investigating dye-sensitized solar cell (DSC) modules. As the I–V curve of a small DSC is obtained, the performances of DSC modules with any geometrical character can be exactly simulated by this model. By simulation, we find that the poor synchronization of work status in each cell is the main cause of low efficiency of large area module besides the Joule losses in the resistances. The optimized geometry parameters of the DSC module are mainly influenced by the manufacturing technique rather than the performance of the small cell. Simulation shows that the large area DSC module with aperture area efficiency of 10.57% can be produced based on the small cell with efficiency of 11.1%.

Introduction The Disease Management Association of America identifies diabetes as one of the chronic conditions with the greatest potential for management. TRICARE Management Activity, which administers health care benefits for US military service personnel, retirees, and their dependents, created a disease management program for beneficiaries with diabetes. The objective of this study was to determine whether participation intensity and prior indication of uncontrolled diabetes were associated with health care use and costs for participants enrolled in TRICARE's diabetes management program. Methods This ongoing, opt-out study used a quasi-experimental approach to assess program impact for beneficiaries (n = 37,370) aged 18 to 64 living in the United States. Inclusion criteria were any diabetes-related emergency department visits or hospitalizations, more than 10 diabetes-related ambulatory visits, or more than twenty 30-day prescriptions for diabetes drugs in the previous year. Beginning in June 2007, all participants received educational mailings. Participants who agreed to receive a baseline telephone assessment and telephone counseling once per month in addition to educational mailings were considered active, and those who did not complete at least the baseline telephone assessment were considered passive. We categorized the diabetes status of each participant as "uncontrolled" or "controlled" on the basis of medical claims containing diagnosis codes for uncontrolled diabetes in the year preceding program eligibility. We compared observed outcomes to outcomes predicted in the absence of diabetes management. Prediction equations were based on regression analysis of medical claims for a historical control group (n = 23,818) that in October 2004 met the eligibility criteria for TRICARE's program implemented June 2007. We conducted regression analysis comparing historical control group patient outcomes after October 2004 with these baseline characteristics. Results Per-person total annual medical savings for program participants, calculated as the difference between observed and predicted outcomes, averaged $783. Active participants had larger reductions in inpatient days and emergency department visits, larger increases in ambulatory visits, and larger increases in receiving retinal examinations, hemoglobin A1c tests, and urine microalbumin tests compared with passive participants. Participants with prior indication of uncontrolled diabetes had higher per-person total annual medical savings, larger reduction in inpatient days, and larger increases in ambulatory visits than did participants with controlled diabetes. Conclusion Greater intensity of participation in TRICARE's diabetes management program was associated with lower medical costs and improved receipt of recommended testing. That patients who were categorized as having uncontrolled diabetes realized greater program benefits suggests diabetes management programs should consider indication of uncontrolled diabetes in their program candidate identification criteria.

A novel freestanding poly (beta-hydroxyethyl methacrylate), PHEMA-based organogel electrolyte is developed simply by optimization of the solution polymerization in the same solvent as the organic electrolyte for dye-sensitized solar cells (DSCs). The room temperature ionic conductivity of the gel electrolyte is 4.54 x 10(-3) S cm(-1), and the conduction behavior can be well described by the free volume model. The quasi-solid-state dye-sensitized solar cell fabricated with this PHEMA-based polymer gel electrolyte can present high energy conversion efficiency up to 7.5%. Preliminary long-term stability test further reveals that this quasi-solid-state electrolyte exhibits good stability after 1000 h thermal test in comparison with the DSCs based on corresponding liquid electrolyte.

Background: TRICARE's Prime (managed care) plan spends more than $1 billion annually in medical expenditures attributed to overweight and obesity.Purpose: This study estimates change in lifetime disease prevalence and medical expenditures associated with weight loss for beneficiaries in TRICARE's Prime plan.Methods: This 2010 analysis uses Markov Chain Monte Carlo simulation with demographics, biometrics, health behavior, and disease presence for 857,200 overweight and 521,800 obese beneficiaries aged 18-64 years in 2008 to model future onset of diseases linked to excess weight. Prediction equations in the simulation come from multiple sources: (1) regression analysis with longitudinal (2007-2008) TRICARE medical claims and electronic health records for 2.1 million beneficiaries; (2) regression analysis with Medical Expenditure Panel Survey (2002-2007) and National Health and Nutrition Examination Survey (1999-2008) data; (3) cancer and mortality risk from Surveillance, Epidemiology, and End Results data; and (4) published findings from clinical trials.Results: Among overweight and obese beneficiaries, lifetime medical expenditures declined $440 (3% discount rate) for each permanent 1% reduction in body weight. This includes $590 in savings from improved health, offset by $150 in additional expenditures from prolonged life. Estimates range from $660 reduction for grossly obese adults aged <45 years to $40 gain from grossly obese adults aged 55-64 years (where expenditures from increased longevity exceed savings from improved health). If weight loss is temporary and regained after 24 months, lifetime expenditures decline by $40 per 1% reduction in body weight.Conclusions: Long-term benefits from weight loss are substantially greater than short-term benefits, underscoring the need for a societal perspective to combat obesity. (Am J Prev Med 2011;40(3):338-344) (C) 2011 American Journal of Preventive Medicine

New research provides revised comprehensive estimates that suggest that the U. S. national economic burden of pre-diabetes and diabetes reached $218 billion in 2007. This estimate includes $153 billion in higher medical costs and $65 billion in reduced productivity. The average annual cost per case is $2,864 for undiagnosed diabetes, $9,975 for diagnosed diabetes ($9,677 for type 2 and $14,856 for type 1), and $443 for pre-diabetes ( medical costs only). For each American, regardless of diabetes status, this burden represents a cost of approximately $700 annually. These results underscore the urgency of better understanding how prevention and treatment strategies may or may not help reduce costs.

OBJECTIVE:To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients.STUDY DESIGN:Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters. The study sample consisted of 23,793 asthma, 4092 CHF, and 29,604 diabetes patients with at least 6 months' tenure in the program.METHODS:Medical claims were analyzed to quantify program effect on healthcare utilization, medical costs, and clinical outcomes. Multivariate regression analysis with an historical control group was used to predict patient outcomes in the absence of DM. The difference between actual and predicted DM patient outcomes was attributed to the program. A patient survey collected data on program satisfaction and perceived usefulness of program information and services.RESULTS:Modest improvements in patient outcomes included reduced inpatient days and medical costs, and (with few exceptions) increased percentages of patients receiving appropriate medications and tests. Annual per patient reductions in medical costs were $453, $371, and $783 for asthma, CHF, and diabetes program participants, respectively. The estimated return on investment was $1.26 per $1.00 spent on DM services.CONCLUSION:Findings suggest that the DM programs more than pay for themselves, in addition to improving patient health and quality of life. Lessons learned in program design, implementation, effectiveness, and evaluation may benefit employers contemplating DM, DM providers, and evaluators of DM programs.

An experimental setup is built for the measurement of monochromatic incident photon-to-electron conversion efficiency (IPCE) of solar cells. With this setup, three kinds of IPCE measuring methods as well as the convenient switching between them are achieved. The setup can also measure the response time and waveform of the short-circuit current of solar cell. Using this setup, IPCE results of dye-sensitized solar cells (DSCs) are determined and compared under different illumination conditions with each method. It is found that the IPCE values measured by AC method involving the lock-in technique are sincerely influenced by modulation frequency and bias illumination. Measurements of the response time and waveform of short-circuit current have revealed that this effect can be explained by the slow response of DSCs. To get accurate IPCE values by this method, the measurement should be carried out with a low modulation frequency and under bias illumination. The IPCE values measured by DC method under the bias light illumination will be disturbed since the short-circuit current increased with time continuously due to the temperature rise of DSC. Therefore, temperature control of DSC is considered necessary for IPCE measurement especially in DC method with bias light illumination. Additionally, high bias light intensity (>2 sun) is found to decrease the IPCE values due to the ion transport limitation of the electrolyte.