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OSU STREAMWOOD is an individual-based stochastic model that simulates riparian forests and in-channel wood dynamics. Stream systems can be simulated from a single reach to small basin. The model is run under a Monte Carol procedure using an annual time step and the results are reported as average conditions per reach. This document is the OSU STREAMWOOD users manual.
The ROM is not intended to stand alone but rather to serve as the regional supplement to other health insurance manuals; e.g., provider manuals, intermediary manuals. Therefore, substance in other issuances will not generally be repeated. Appropriate cross-references will be used instead.
Unlike the office manual provision in the above cases, ROM Sec. 2572-D is not a field-level instructional guide to the application of the statute with respect to the inquiries and circumstances of particular individuals. It is directed not at office-level agency employees and specific recipients but at states and a major category of recipients under state plans.
Unlike the statutes interpreted by the agency manuals in the cases cited by the Secretary, Section 1903(f) expressly authorized the Secretary to prescribe "standards." Congress must have intended that standards thus prescribed by HHS would have the force and effect of law. In promulgating the ROM provision at issue, the Secretary followed the mandate of Section 1903(f).
is available in expenditures for services provided to medically needy recipients whose annual income ... does not exceed the following amounts ...: (a) For couples and families of two or more, 133- 1/3 percent of the highest money payment that would ordinarily be made under the State's AFDC plan to a family of the same size without income and resources.
In certain limited circumstances section 1396b(f) (1) (B) (ii) allows the Secretary to set the MNIL amount higher than 133- 1/3% of the amount paid to a family of the same size under a state's AFDC plan. But this exception applies only if a state's AFDC plan provides that some large families with different numbers of children get equal amounts. The panel renders this congressionally-approved exception a nullity, since under its holding the Secretary would have authority to reach the same result under (B) (i)
the single standard to be employed in determining income and resource eligibility for all such groups, and the methodology to be employed in determining such eligibility, which shall be the same methodology which would be employed under [e.g. AFDC or SSI].
Whether alimony is considered for the purpose of establishing Medicaid eligibility is a "same methodology" question; whether the income exceeds the maximum a family of two or a family of three could receive under AFDC is not
The National Field Manual for the Collection of Water-Quality Data (National Field Manual) describes protocols and provides guidelines for U.S. Geological Survey (USGS) personnel who collect data used to assess the quality of the Nation's surface-water and ground-water resources. This chapter of the manual addresses the selection of equipment commonly used by USGS personnel to collect and process water-quality samples.
N2 - Purpose:The conventional treatment for non-metastatic Head & Neck squamous cell carcinoma (HNSCC) is radiation therapy. Despite technological advances and improved efficacy radiation therapy still relies on manual delineation of gross tumour volume which is both time consuming and prone to inter- and intra observer variability. Several automatic segmentation methods have been developed using positron emission tomography (PET) and/or computerised tomography (CT). The aim of the present study is to develop a model for 3-dimensional auto-segmentation, the level set method, to contour gross tumour volumes (GTV) in a training set of 20 HNSCC patients and evaluate its performance in an independent test set of 25 patients. Materials and Methods: 100 PET/CT textural features were extracted from manual contours of GTV on a training set. The training set consisted of PET and CT scans from 20 patients randomly selected among 45 cases with hypopharyngeal carcinoma treated with radiotherapy. All contours had been performed by experienced radiologists for treatment planning. The Jeffreys-Matusita (JM) distance, a measure of similarity between distributions, was calculated for combinations of features inside and outside the GTV respectively to choose an appropriate feature combination for segmentation of the GTV. The feature combination with the highest dissimilarity was extracted on PET and CT images from the remaining 25 HNC patients. Using these features as input for a level set segmentation method the tumours were segmented automatically. Segmentation results were evaluated against manual contours of radiologists using the DICE coefficient, and sensitivity. The result of the level set approach method was compared with threshold segmentation of PET standard uptake value (SUV) of 3 or 20% of maximal intensity and tested with a paired t-test.Results:The JM analysis determined a combination of 8 textural features as appropriate for segmentation giving a distance of 1.1 out of 1.4.For the level set segmentation the DICE coefficient and sensitivity were 0.480.18 (mean standard deviation) and 0.570.24 respectively. Mean DICE coefficient for the 3 SUV and 20% intensity threshold segmentation were respectively 0.410.22and 0.400.22, giving p-values of 0.04 and 0.02 for a higher DICE coefficient from the level set segmentation. For sensitivity the threshold segmentation yielded 0.520.24 and 0.510.26 for 3SUV and 20% intensity respectively yielding p-values of 0.01 and 0.03. Conclusion:The level set method provides a more robust and stable method for segmentation of HNSCC at hypopharynx than threshold segmentation. But it should be improved in order to resemble the manual contours of radiologist. The segmentation could serve as an initial GTV estimate for manual corrections reducing both time and variance in the process of GTV contouring.
AB - Purpose:The conventional treatment for non-metastatic Head & Neck squamous cell carcinoma (HNSCC) is radiation therapy. Despite technological advances and improved efficacy radiation therapy still relies on manual delineation of gross tumour volume which is both time consuming and prone to inter- and intra observer variability. Several automatic segmentation methods have been developed using positron emission tomography (PET) and/or computerised tomography (CT). The aim of the present study is to develop a model for 3-dimensional auto-segmentation, the level set method, to contour gross tumour volumes (GTV) in a training set of 20 HNSCC patients and evaluate its performance in an independent test set of 25 patients. Materials and Methods: 100 PET/CT textural features were extracted from manual contours of GTV on a training set. The training set consisted of PET and CT scans from 20 patients randomly selected among 45 cases with hypopharyngeal carcinoma treated with radiotherapy. All contours had been performed by experienced radiologists for treatment planning. The Jeffreys-Matusita (JM) distance, a measure of similarity between distributions, was calculated for combinations of features inside and outside the GTV respectively to choose an appropriate feature combination for segmentation of the GTV. The feature combination with the highest dissimilarity was extracted on PET and CT images from the remaining 25 HNC patients. Using these features as input for a level set segmentation method the tumours were segmented automatically. Segmentation results were evaluated against manual contours of radiologists using the DICE coefficient, and sensitivity. The result of the level set approach method was compared with threshold segmentation of PET standard uptake value (SUV) of 3 or 20% of maximal intensity and tested with a paired t-test.Results:The JM analysis determined a combination of 8 textural features as appropriate for segmentation giving a distance of 1.1 out of 1.4.For the level set segmentation the DICE coefficient and sensitivity were 0.480.18 (mean standard deviation) and 0.570.24 respectively. Mean DICE coefficient for the 3 SUV and 20% intensity threshold segmentation were respectively 0.410.22and 0.400.22, giving p-values of 0.04 and 0.02 for a higher DICE coefficient from the level set segmentation. For sensitivity the threshold segmentation yielded 0.520.24 and 0.510.26 for 3SUV and 20% intensity respectively yielding p-values of 0.01 and 0.03. Conclusion:The level set method provides a more robust and stable method for segmentation of HNSCC at hypopharynx than threshold segmentation. But it should be improved in order to resemble the manual contours of radiologist. The segmentation could serve as an initial GTV estimate for manual corrections reducing both time and variance in the process of GTV contouring.
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